Video on the Bad Science That Keeps Smokers Smoking, and Dying

 

I recently participated in a panel discussion about tobacco harm reduction (THR) at the Tobacco Merchants Association meeting.  While assembling my powerpoint presentation, I recalled that I presented to this group 18 years ago, in 2006, what was likely their first introduction to THR. 

To view my 10-minute primer on bad science – then and now – watch this video, starting at the 26-minute mark.  I discuss the genesis of the myth that smokeless dip and chew products present a high risk for mouth cancer (discussed extensively in this blog by searching for “Winn”), and my THR team’s attempts to correct fatally flawed vaping research articles.    

I’m happy to provide the slides upon request.    

What Medscape Subscribers Really Thought About Its Tobacco Harm Reduction Programs

 

Earlier this year, Medscape, which describes itself as “the leading online global destination for physicians and healthcare professionals worldwide,” invited me to participate in a series of short continuing medical education (CME) programs on tobacco harm reduction (THR).  Medscape clearly disclosed that the series was sponsored by Philip Morris International, but the programs were firewalled; faculty were not in contact with or influenced by the sponsor.

Topics included, among others, an examination of nicotine, and the differential risks of combusted versus smoke-free tobacco/nicotine products.

I recorded two programs.  The first, “Nicotine Misperceptions: What Does the Evidence Say,” was published online by Medscape around March 1.  The second, in collaboration with Dr. Sally Satel, “Harm Reduction From Tobacco: An Evidence-Based Discussion,” was published April 1.  Dr. Satel also recorded a third program.

Following publication, a few anti-tobacco crusaders objected, threatening “a rapid global boycott by healthcare professionals disgusted by [Medscape’s] behaviour” in two British Medical Journal articles and one in The Examination.  I will not provide links to these, as they include ad hominem attacks on me.  Dr. Satel recounts the sorry tale in this article (here).    

As Dr. Satel notes, Medscape buckled, whining that “use of this funder was a misjudgment that was out of character for Medscape Education and that doing so may have disappointed our members.”

But were Medscape members truly offended by the PM sponsorship?  Evidence from an email I received from a Medscape manager says “NO.”  Shortly after my nicotine program aired, I received an unsolicited email from the manager titled, “One of the best CME programs I have seen in a long time…” Following is the text of that email, with some passages highlighted by me.

“We have the preliminary results from your program that was posted less than a month ago, and I am personally flabbergasted by the participation - over 6000 learners and over 2200 test takers!

“The comments from participants have been incredible as well:

• I can better educate and motivate pts on how to cut down their use of nicotine products. I am also more cognizant now that those who use cigarettes may have a more difficult time quitting. Will refer these pts to our clinical pharmacist who can also help advise and prescribe the appropriate tobacco cessation products.
  

• This was fantastic! This down to earth harm reduction approach is absolutely key to help meet people where they are, as nicotine addiction is so strong! Much better outcomes can be achieved as these presenters described, using less harmful forms of nicotine. As the doctors stated, there is a great need to educate providers, and clarify misconceptions about nicotine vs various methods of ingesting nicotine. I hope this presentation reaches a wide audience! One of the best continuing eds I have done in a while.
  

• Dispelled many myths I previously held about nicotine that I will no longer propagate.

• Thank you for bringing up such an important topic that can bring down the costs of healthcare and truly improve the public health. I am a psychiatric provider and have had a large number of patients successfully quit smoking with harm reduction measures!”

It is tragic that Medscape capitulated to rabid tobacco prohibitionists and stopped providing vital, life-saving information to health professionals.

 

Call It Whatever You Want -- Tobacco Harm Reduction Saves Smokers’ Lives

 

The U.S. desperately needs tobacco harm reduction, starting with reducing the harm from the pronouncements of federal officials.  Case in point: FDA Commissioner Robert Califf’s April 11 tobacco testimony before the House Oversight Committee.

Dr. Califf made so many false statements that I penned a response for Real Clear Health. Following are some additional observations related to his testimony.

Readers know that I don’t tolerate doctors who claim they saw many people die from the ravages of tobacco, when those patients actually died from the smoke!  Similarly, I can’t let the federal official in charge of regulating tobacco get away with mislabeling it in the same fashion as the World Health Organization and the National Cancer Institute.

Dr. Califf wrongly claimed that harm reduction is an industry term.  My late colleague Dr. Philip Cole and I used that term in an article published by the American Council on Science and Health in 1995.  The Institute of Medicine, hardly a tobacco industry tool, titled a 2001 report, “Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction (here).”

For 30 years, I’ve been saying, without challenge, “Nicotine, when consumed without the harmful constituents of cigarette smoke, is no more harmful than caffeine.”

Fifteen years ago Britain’s Royal College of Physicians, one of the world’s oldest and most prestigious medical societies, agreed with me, finding, “…that smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

Dr. Califf should stop supporting the cigarette industry by trashing vastly safer cigarette substitutes.  That's called tobacco harm escalation.