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An interview of David Sweanor, a tobacco control expert, on the hot topic of the public health war helps better understand this hot topic and its context.

What cigarette do you smoke, doctor?

Cigarettes has been largely promoted at the onset of the 20th century, at a time when the medicine had not yet made the link with cancers and other diseases. The modern live saw the invasion of smoking cigarettes in every places, from battle the fronts to the living rooms and even in the offices of physicians.

What e-cigarette would you recommend, doctor?

After more than one century after its introduction, the prevalence of smoking has reached a maximum in the late seventies and is now on a decreasing ramp, thanks to several measures including ban on advertising, on any kind of sponsorships, on smoking in public  spaces and workplaces. New laws are restricting in-store display, increasing taxes and health warnings and reinforce the decrease.

David Sweanor has spent the last 30-years on the front lines in the battle against smoking and he played a key role in Canadian efforts on, among other things, tobacco taxation, advertising restrictions, package warnings, environmental tobacco smoke, smoking cessation, litigation and product regulation as a counsel to the Non-Smoker Rights Association and an independent consultant. He is now a Adjunct Professor at the Faculty of Law of the University of Ottawa.

People smoke for nicotine but die from tar

“E-cigarettes could be one of the biggest breakthroughs ever in public health” -D. Sweanor
D. Sweanor explains why so many of his anti-smoking colleagues seem to disagree with his view of the e-cigarette. Before all, the expert recalls that it is an established fact that people smoke for nicotine but die from tar, but the nicotine is not typically a hazard and compares to caffeine. Some people ingest very large amounts of caffeine without any trouble, but if they get their caffeine by smoking tea leaves instead of brewing tea then it becomes a hazard.

There is not doubt that getting rid of the smoke is getting rid of vast majority of the problems associated with cigarettes. In this case, anybody who is open minded and understands a little bit of science may embrace the benefit of vaping compared to smoking.

The expert thinks that the demonization of the e-cigarette is, for some of his anti-smoking colleagues, a way to fight Evil in the form of cigarette companies. They lost sight of the public health component of the fight and have just in mind to kill this industry.

The big public health issue is cigarette, not nicotine

The modern era gave the monopoly of long-term nicotine use to the cigarette companies so that if one needs nicotine on a daily basis, there is virtually no other option than to turn to this industry, with a huge probability to be killed by it.

D. Sweanor notices that each time a new way of delivering nicotine without the smoke appears on the market, this alternate of the cigarette gets attacked. It is like treating smoking, nicotine and tobacco together like a sin rather than a public health issue.

Vaping is being jammed into the same legislation as tobacco, what is impact of that?

The facts are that in nicotine consumers’ mind, vaping products are not seen as less hazardous but conversely more hazardous than cigarette. And this is because the government’s messages are not clear, they are closing vape shops since e-cigarettes are supposed to be safer, they put bans on vaping and restrict the advertisement on the product.

“The final message is like telling smokers: keep smoking!” -D. Sweanor
The way that scientific findings are presented to the press, showing things out of context, is scaring people. All this affects the perception of the product and calls for more transparency and less skewness in scientific interpretation.

 

The idea of a sort of puritanism around anti-smoking movements was shown as a threat to public health by the British journalist Ian Dunt. He compared the current system to assist smoking withdrawal to “protestant abstinence” during which “smokers must go through some sort of trail-by-punishment before they can emerge as pure, unsmelly, decent members of the society”. And to him, the solution to get people off smoking is to reward them. Vaping can be seen as a reward for quitters, provided that e-cigarette is made more attractive than tobacco. More attractive and more accessible.

In a web extra, D. Sweanor explains the mechanisms underlying the skewed research conclusions. To him, the researcher is in business to get funded for his activity and for the major funding bodies, the goal is a tobacco-free america and not to reduce diseases. It results an absurd drift that consists in matching the conclusion with the objectives and not with the results and to publish a press release that is not reflecting the real content of the study. This is the main reason why vaping research is skewed. And the question is why they don’t stop doing this?