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Moore / E-cigarettes, they’re here to help!

TOBACCO, when used exactly as directed, kills two thirds of its users 10 years earlier than those who do not smoke.

Michael Moore

Australia should remain a world leader in tobacco control; just 12.2 per cent of our population is addicted and recent surveys show only 2 per cent of our 12 to 17-year-olds taking up smoking.

Big Tobacco does not seem worried. It is simply moving to new markets. The developing world is one with electronic cigarettes, of which they are by far the biggest suppliers is another. Tobacco companies love to emphasise that they sell a legal product. Sure, they make money – but how does anyone in this industry selling such a lethal product sleep at night?

Electronic cigarettes have been marketed as a tool to assist quitting. Although true for a tiny minority, the evidence is incredibly thin to support such claims.

The Australian National Health and Medical Research Council explained: “There is currently insufficient evidence to conclude whether e-cigarettes can assist smokers to quit”.

It went further: “There is currently insufficient evidence to support claims that e-cigarettes are safe and further research is needed to enable the long-term safety, quality and efficacy of e-cigarettes to be assessed”.

Remember when the wool was pulled over society’s eyes with “just filter it”! The “filter it” ploy set back tobacco regulation by years as scientists and health experts were put on the back foot to prove filtering did not make cigarettes safe. The new ploy is “but electronic cigarettes are 95 per cent safer than ordinary cigarettes”. Don’t believe it.

Prof Stanton Glantz, from the University of California, traced this claim to a “single consensus meeting of 12 people convened by DJ Nutt in 2014″. The report of the meeting even admitted there was a “lack of hard evidence for the harms of most products on most of the criteria”.

A “Lancet” editorial in 2015 identified a number of the people who were at the meeting had strong connections to tobacco and electronic-cigarette companies.

Evidence of increasing harm of electronic cigarettes has been accumulating since 2014. There are now more than 500 brands and nearly 8000 flavours available.

Knowing what is in e-cigarettes is difficult. However, the inhaled vapour contains lead, cadmium and nickel, and that the electronic cigarettes themselves contain formaldehyde, acetaldehyde, acrolein, propanal, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines and fine and ultrafine particulate matter.

Many advocates choose to ignore this evidence. It is not unlike the “just filter it” ploy where the companies make outrageous claims to delay regulation while the health and scientific communities disprove them. Many advocates argue for little or none of the restrictions applying to conventional smoking. Fortunately, in Australia we have a system that puts the shoe on the other foot when it comes to the safety of such products.

The Therapeutic Goods Administration (TGA) is responsible for ensuring safety and efficacy of such products. We rely on it to protect us from unhealthy products claimed as therapeutic.

After an exhaustive examination of the case presented in application, the TGA determined that there was not enough evidence to make the nicotine available in this form.

The advocates then chose a political path with Liberal Democratic senator David Leyonhjelm as their champion who, like the National Party, is tobacco-company funded. The senator is a libertarian favouring an approach of let everyone do whatever they want, when they want, however they want. There are like-minded colleagues who have established separate inquiries in both houses of the Federal Parliament. The inquiries have been flooded by short, sharp submissions from current or would-be users who want no restrictions.

The big push is that electronic cigarettes are a harm-reduction method. However, for years Australian drug policy has combined harm reduction with demand reduction and supply reduction. To minimise harm requires adequate treatment to reduce demand and enforcement to reduce supply for a system of controlled availability. Members of the Parliamentary Standing Committee on Health, Aged Care and Sport ought to apply this successful approach as the least harmful way to have electronic cigarettes available in Australia.

Michael Moore was an independent member of the ACT Legislative Assembly (1989 to 2001) and was minister for health. He is CEO of the Public Health Association of Australia and president of the World Federation of Public Health Associations.

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Michael Moore

Michael Moore

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10 Responses to Moore / E-cigarettes, they’re here to help!

strayan says: 7 September 2017 at 12:47 pm

Mr Moore’s reputation is on the line. He claims the evidence about e-cigs is incomplete but has already adopted the position that e-cigarettes are not only ineffective but also a big tobacco plot to undermine public health. Only time will tell Michael… but having just finished reading the Royal College of Physicians review on Electronic cigarettes I’d be preparing my letter of resignation.

To all the other readers out there I suggest you go visit the submissions to these inquiries that Mr Moore claims to have been “flooded by short, sharp submissions from current or would-be users who want no restrictions”. What you actually find is completely different – submissions in support of electronic cigarette from many of the most senior and respected figures in the addictions and medical establishment in Australia. Here are just a couple – excluding the overseas experts:

Ian Webster, AO MBBS MD (Melb) FRACP FAFPHM FAFRM FAChAM FRACGP Physician and Emeritus Professor of Public Health and Community Medicine, UNSW

Prof Richard Osborne Day – Professor of Clinical Pharmacology, St Vincent’s Clinical School and School of Medical Sciences, UNSW Medicine, The University of New South Wales. Senior Academic, Masters in Medical Science in Drug Development, School of Medical Sciences, UNSW Medicine, The University of New South Wales

Dr Alex Wodak AO MBBS, FRACP, FAFPHM, FACHAM. Emeritus Consultant, Alcohol and Drug Service, St Vincent’s Hospital

Prof Paul Haber MBBS, MD, RACP, FAChAM, Head of Addiction Medicine a the University of Sydney, Senior Staff Specialist and Professor and Medical Director, Royal Prince Alfred Hospital Drug Health Services, Sydney, New South Wales

Dr Benny Monheit – Adjunct Senior Lecturer (Department of General Practice at Monash University), Drug & Alcohol Specialist Physician (Alfred Hospital, Melbourne)?

Dr Catherine Silsbury. MBBS, M. Health Sciences, FAChAM. Staff Specialist, Addiction Medicine. Drug Health. Centre for Addiction Medicine

Dr Richard Hallinan, FAChAM (RACP) Staff Specialist at South Western Sydney Drug Health/Byrne Surgery

Dr Michael Atherton FAChAM, MBChB, MRCPsych (UK), FRANZCP cert Addiction Psych. Psychiatrist, Addiction Medicine Specialist The Sydney Clinic

Dr David Outridge Conjoint Lecturer School of Medicine and Public Health – University of Newcastle

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Simon Chapman says: 8 September 2017 at 9:13 pm

Interesting that none of the above signatories have any experience in tobacco control policy or research. I don’t believe an of them have ever sat on any state, national or international advisory committee on tobacco control. Wodak has a small number of publications about prison smoking but I don’t believe has ever done work on any other area of tobacco control. Please correct me if I am wrong in this. I would not make recommendations about their areas of expertise. I wonder why they feel their views count for much?

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Mike says: 12 September 2017 at 5:33 pm

“I would not make recommendations about their areas of expertise”

Simon, you have a documented history of:
– attacking the person when you can’t fault their arguments
– making recommendations on matters you are not an expert in

An example that comes to mind:

“Public health professor and wind farm advocate Simon Chapman has published a long apology to ­industrial noise campaigner Sarah Laurie for falsely claiming she had been deregistered as a doctor.”

http://www.theaustralian.com.au/national-affairs/climate/wind-farm-advocate-simon-chapman-sorry-for-false-allegations/news-story/08bd8cc2324d8f98a72226851ee88094

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Simon Chapman says: 13 September 2017 at 10:09 pm

Mike, I suggest you get busy and get onto the editors of seven specialised international research journals (Noise and Health, the International Journal of Acoustics and Vibration, Journal of Low Frequency Noise, Vibration and Active Control, Environmental Research, Environmental Pollution, the Journal of Psychosomatic Research and Energy Policy) who asked me to review research submissions about wind farms and health for them in recent years; the National Health and Medical Research Council, which appointed me as an expert reviewer of their 2010 rapid review of the evidence on wind farms; and the dazed incompetents running the Australian Acoustical Society, the Australasian College of Toxicology and Risk Assessment and the Clean Air Society of Australia and New Zealand, all of whom asked me to give plenary session talks on wind farms and heath to their scientific meetings of acousticians and environmental health specialists in recent years. Explain to them the views of your authorities on my expertise : the Australian newspaper and ex-Senator Madigan, a blacksmith.

On Dec 1 you can read 115,000 words of my attack on their arguments in my new book

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Natalie Vassallo says: 11 September 2017 at 12:09 pm

The TGA are for abstaining from smoking! Yes, abstaining from tnings has been proven to work in so many instances! NOT……….Ask any person that has been a victim of the Catholic Church. You make me feel sick. The TGA also has the most ridiculous regulations for Cannabis as well. I am a terminally ill patient, that should legally be allowed to use cannabis. Not so, Cannabis is the ONLY MEDICINE IN THE WORLD THAT I AM NOT LEGALLY ALLOWED TO HAVE!!

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M. R. Coleman-Dion says: 12 September 2017 at 11:03 am

Australia is NOT a world leader in much of anything unless you count covering up their eyes and ears to anything they don’t agree with! Vaping was not created nor has it ever been run by “Big Tobacco”. The fact that this is the sole issue that aussie TC extremists focus on simply shows they have zero evidence or reason to keep life saving alternatives away from adults who’d choose to use them if available. They honestly feel that adults everywhere in AU. aren’t smart enough to decide for themselves!

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Simon Chapman says: 12 September 2017 at 11:59 am

M.R.Coleman-Dion, not a world leader? Please tell me which countries have lower smoking prevalance than Australia? This might help https://www.doctorportal.com.au/mjainsight/2017/33/fake-news-is-smoking-really-increasing-in-australia/ And the “sole issue” Really? Perhaps you forgot about plain packs, the highest tax rates in the world, graphic health warnings, duty-free limits, total advertsing bans, total sport sponsorship bans, retail display bans, bans on misleading descriptors (lights & milds), tobacco companies all stopped manufacturing here and record low smokinf rates in kids? Easy to forget when if your only tool is a hammer, all your problems look like nails?

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Brad says: 12 September 2017 at 5:14 pm

Barbados, Colombia, Ecuador, Ethiopia, Ghana & Uganda to name a few… Not to mention Sweden who have hit the magic 5% mark, all thanks to Snus – Another harm reduction product that Australian Tobacco control have refused to acknowledge.
Australia sits around 20 on the list.

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Simon Chapman says: 14 September 2017 at 6:03 am

Brad there are nations where smoking prevalence is low because of cultural prescriptions on female smoking whereby their ultra-low rates drag down the total smoking prevalence. Australia is on the lowest rung of nations who have successfully reduced smoking. You give no sources but the Swedish figure you cite almost certainly would only be daily smokers, not total smokers See table 2..1.1 http://www.who.int/fctc/reporting/party_reports/sweden_2012_report_final_rev.pdf I do not believe Sweden would have fallen from 21% to 5% since 2012.

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