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Mountain Vapor Blog

Welcome to the blog area of our site where we hope to keep you updated on the trends of the e-cigarette industry as well as product reviews.

Vaping Plays a Role in Young Adults’ Low Smoking Rate


The anti-tobacco Truth Initiative tweeted that the smoking rate among young adults (18-24 year old) in the U.S. is “just 10.4%,” based on the 2017 National Health Interview Survey (NHIS) (here).  But the Initiative didn’t tell the whole tobacco “truth.”  Using the same NHIS data, I prepared the chart at left which confirms that smoking is way down among young adults, continuing a decline I reported previously (here).  Nearly 85% of young adults have never smoked, including 2.7% who currently vape, 13% who tried e-cigarettes and 69% who never used either product.  Among the 5% who are former smokers in this age group, over half were current vapers or had tried vaping products.  Even more impressive, 7 out of 10 current smokers were either current vapers or had tried e-cigarettes, meaning they could eventually make the switch to smoke-free. Advocates of greater tobacco control make a specious boast when they celebrate lower smoking rates while ignoring the positive impact of vaping.  Original author: Brad Rodu
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Letter to WHO’s DG against prohibition and for risk-proportionate regulation

Dr Tedros Adhanom GhebreyesusDirector GeneralWorld Health OrganisationAvenue Appia 201202 Geneva

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Innovation for Consumers: E-cigarettes and novel tobacco products – Part of the problem or part of the solution?

September 5th, 2018

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Slight Teen Vaping Increase and A Continued Smoking Decline in 2017


Despite the rhetoric, there is no “Juul epidemic” among high school students.   The purported epidemic has been widely cited in the media.  Just last week, an article in the New England Journal of Medicine (here) asserted that “use of these products is rampant among young people.”  The authors based their claim on “Media stories about Juul … [that] highlight anecdotal reports from students, parents, teachers, and school superintendents.”  This falls far short of normal journal standards.  (The NEJM commentary also included the confounding contentions that “Pod mods are easy to conceal from authority figures” and “Juul vaporizers measure 93.98 cm,” or an astounding 37 inches.) Campaign for Tobacco-Free Kids president Matt Myers has been a cheerleader for the mythical epidemic: “Everyone was asleep at the switch.  And by the time we woke up, we had an epidemic on our hands.  I've never seen a tobacco-related product spread across this country as fast among young people as this product.” (here)     In fact, no one else has seen it.  Claims of a Juul epidemic are baseless.  Government data show that while e-cigarette experimentation increased among American high school students from 2011 to 2015, the year Juul was introduced, vaping stabilized in 2015 and smoking rates continued to drop.  In 2017, 1.15 million (7.7%) American high school students were current (past 30 days) e-cigarette users, 556,000 (3.7%) smoked, and 632,000 (4.2%) used both products, according to the Centers for Disease Control and Prevention’s 2017 National Youth Tobacco Survey (NYTS). Comparing those numbers to 2016 (here), smoking and dual use declined marginally, by about 0.2 percentage point, while vaping increased by 0.5 point.  While Juul sales may have surged, neither they nor any other e-cigarette brand produced a youth vaping epidemic. *The apparent spike in e-cigarette use increased among high school students from 2013 to 2014 was partially due to what researchers term an artifact, related to a change in the survey design.  Questions about e-cigarette use were bundled with those for “other” tobacco products until 2014, when they appeared in a separate section, after cigarettes, cigars and smokeless tobacco. Original author: Brad Rodu
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FDA Tobacco Center Exaggerates Number of Youth Tobacco Users




The FDA Center for Tobacco Products published an inaccurate graphic in June (the “Most Used Tobacco Products in 2017” Venn diagram here) and tweeted it on August 8 (here), asserting that 2.1 million U.S. middle and high school students in 2017 were current (past 30-days) users of e-cigarettes, 1.4 million were current cigarette smokers, and 1.3 million were current cigar smokers. The graphic, which mischaracterized data from the 2017 National Youth Tobacco Survey, would lead most to believe that nearly 5 million youth used the three products. That conclusion would be grossly off the mark. In fact, NYTS data indicate there were only about 3.3 million current users of these three products, with a 40% overlap. (This is not surprising, as research shows that use of one tobacco product is associated with use of others here, hereand here.) The next chart breaks out exclusive and multiple users of e-cigarettes, cigarettes and cigars, based on my analysis of the 2017 NYTS data.  Over 50% (1,125,000) of the 2.1 million e-cigarette users didn’t smoke at all, 22% smoked both cigarettes and cigars (red font), 15% smoked cigarettes, and 12% smoked cigars (yellow font).  These distinctions are important, as they are associated with different levels of e-cigarette use, shown in the following chart.  A large majority (74%) of exclusive vapers used e-cigarettes infrequently (1-5 days in the past month); only 12% reported frequent use (20-30 days).  Vapers who smoked cigarettes or cigars were much more likely to be frequent e-cigarette users (20-21%); frequent use was 38% for users of all three products.   Using a misleading graphic, the FDA exaggerates the number of teens who use tobacco.  Original author: Brad Rodu
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UK Favors E-Cigarettes, Scores Major Smoking Reduction; Anti-Vaping Ireland Sees Smoking Rates Unchanged


There is, as I have noted (here), a stark contrast between British government and medical authorities’ support for e-cigarettes and vaping, and the demonization of same by most of the American public health community.  A similar clash of positions exists between the United Kingdom and Republic of Ireland. The British blogger Dick Puddlecote observes (here) that the UK and Ireland are “nearest cultural neighbours, so closely aligned [that] we that we don't even enforce passport requirements between the two countries.  The British and the Irish are about as good a comparison for ecological purposes as there can possibly be.  And, as [British Member of Parliament Sir Kevin] Barron said, the only difference between UK policy and Irish policy is that over here our government cautiously welcomes new nicotine products whereas in Ireland they don't.” Puddlecote underscores: “In the UK smoking rates have nosedived, while in Ireland they have barely shifted.” I have verified that statement by reviewing government data.  The UK’s Office for National Statistics reported that smoking prevalence was 20% in 2012, after stalling during the six previous years (here).  However, between 2012 and 2017, the rate fell to 15% (here).  Ireland started out in 2012 at nearly the same prevalence, 22% (here).  But five years later it was unchanged (here), according to the Ireland Department of Health. The difference in smoking reduction in these neighboring countries is extraordinary.  As Puddlecote observes, “this deserves more attention…You just have to wonder why the tobacco control industry and other politicians, both sides of the Irish Sea, have been so silent about it.” Indeed.   Original author: Brad Rodu
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South Africa draft tobacco Bill – protects cigarette trade and denies smokers options to quit


August 8th, 2018

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More Vaping Facts, Not All Good, from 2017 CDC Data


CDC and other U.S. government agencies rarely publish straightforward numbers and conclusions about adult e-cigarette use; their focus is usually on underage use.  Last month, by re-analyzing the federal data, I demonstrated that the number of American vapers declined in 2017 (here); following are additional insights. As seen in the table below, the number of every-day e-cigarette users increased between 2014 and 2016.  However, in 2017 the number dropped by almost a quarter-million.  The proportions of current, former and never smokers in 2014 were 50%, 46% and 4%.  By 2016 the proportions were 32%, 58% and 10%, indicating that more every-day e-cigarette users were former smokers.  In 2017, the proportion of former smokers inched up again: 32%, 60% and 8%..nobr br { display: none } td { text-align: center}Number (in millions) and Prevalence (%) of Every-Day and Some-Day E-Cigarette Use in the U.S., 2014 to 2017Every-DaySome-DayAll20142.71 (1.1%)6.20 (2.6%)8.91 (3.7%)20152.94 (1.2%)5.40 (2.2%)8.34 (3.4%)20163.03 (1.2%)4.77 (2.0%)7.80 (3.2%)20172.79 (1.1%)4.09 (1.7%)6.88 (2.8%)  The number of some-day e-cigarette users declined in 2017 for the third consecutive year, to 4.09 million – over 2 million fewer than in 2014.  Most were current smokers in all years, but the proportions shifted:  In 2014, they were 80%, 12% and 8% for current, former and never smokers.  By 2016, the proportions were 68%, 18% and 14%; and in 2017, they were 62%, 15% and 23%. In 2017, there were 1.17 million never smokers who were current vapers, and 80% of this group (933,000) were using e-cigarettes some days.   The vast majority of some-day users were either 18-24 years of age (68%), or 25-34 (23%), suggesting that vaping is displacing smoking in these younger groups. It is unfortunate that the number of daily and some-day U.S. vapers is declining, as the facts demonstrate that tobacco harm reduction can only be successful if smoke-free tobacco consumption increases among inveterate smokers. Note: Thanks to Bill Godshall for requesting these additional insights. Original author: Brad Rodu
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More Proof from FDA Population Data Showing E-Cigarettes As Popular Quit-Smoking Aids


While the number of American vapers declined over the last three years (as I reported here), e-cigarettes were still far more popular quit-smoking aids than medicinal nicotine or other drugs, according to researchers at the University of California San Diego (here). Tarik Benmarhnia and colleagues used information from Waves 1 and 2 of the FDA-funded Population Assessment of Tobacco and Health (PATH) Study to evaluate “the influence of [e-cigarettes] and pharmaceutical cessation aids [varenicline, bupropion and nicotine medicines, NRT] on persistent abstinence (≥30 days) from cigarettes, and reduced cigarette consumption” during the period 2013 to 2015.  They concluded: “Our results indicate that [e-cigarettes] are a more popular choice than approved pharmaceutical products as a smoking cessation aid among US quit attempters, over three quarters of whom were daily smokers.  In the future, as [vapor] products continue to evolve to make nicotine delivery more similar to that obtained from a cigarette, it is possible that they may play a bigger role in assisting smokers to quit combustible tobacco.” This study confirms my research group’s earlier analysis of Wave 1 PATH data: E-cigarettes are among the most commonly used quit aids for American smokers, and they are the only aid more likely to make one a former smoker (i.e., a successful quitter) than trying to quit cold-turkey (here). Original author: Brad Rodu
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CDC Data Shows That E-Cigarette Use Declined Again in 2017


About 6.9 million Americans were current users of e-cigarettes in 2017, according to data in the 2017 National Health Interview Survey, the source for CDC national smoking estimates.  That’s a million fewer vapers than the prior year, and over two million fewer than in 2014, the first year NHIS surveyed for vaping.     The number of current vapers who were former smokers had increased through 2016, but dropped in 2017, from 2.62 to 2.3 million.  This is not good news for tobacco harm reduction. Another fascinating detail from 2017 is that 1.17 million never smokers currently used e-cigs, and over two-thirds of those were 18-24 years old.  This may be an extension of the recent increase in high school vaping (here), but it’s important to note that smoking in this age group is way down (here).  Vaping has been portrayed as a menacing new epidemic by tobacco and nicotine prohibitionists in government and elsewhere.  It now appears that the misinformation in their anti-vaping messages has been effective (here).  The number of vapers has tragically declined.  Original author: Brad Rodu
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FDA: You Can Run Models, But You Can’t Hide Facts About Smokeless Tobacco


In a recent New England Journal of Medicinearticle, FDA researchers went to great lengths to conceal the fact that smokeless tobacco (ST) use has an entirely negligible impact on life expectancy. The article, “Potential Public Health Effects of Reducing Nicotine Levels in Cigarettes in the United States,” (here) by Benjamin Apelberg and colleagues, was the centerpiece of FDA Commissioner Scott Gottlieb’s March 15 announcement of a radical nicotine reduction rule for cigarettes.  Drawing from the research, an FDA press announcement (here) declared that if cigarettes were minimally- or non-addictive by 2020, approximately 5 million additional adult smokers would quit smoking within just one year; only about 1.4 percent of the U.S. adult population would smoke cigarettes by 2100, in part, because more than 33 million people would avoid becoming regular smokers; more than 134 million years of life [would be] gained among the U.S. population. While it is entirely unclear how nicotine reduction would produce the first two results, there is a fundamental flaw in Apelberg’s model that mainly affects the third, years-of-life, claim.  Correcting for that error, the model would likely confirm that ST products are nearly risk-free. Apelberg estimates excess deaths among smokers by linking participants from National Health Interview Surveys (NHIS, 1997-2004) to the National Death Index (NDI) through 2006.  He also estimates deaths among users of ST, but uses an entirely different dataset – smokeless users who were enrolled in 1982 in the American Cancer Society Cancer Prevention Study II. Apelberg’s use of two data sets -- NHIS for smokers and CPS-II for ST users – violates a basic rule of modeling: all inputs should be from the same or similar sources.  NHIS should have been used for analysis of both groups.  That was the procedure, for example, when Michael Fisher and colleagues used NHIS and NDI to produce a stable estimate for all-cause mortality among smokers and ST users (here).  Apelberg may have used CPS-II because it shows that ST users’ mortality rate was 18% higher than that of never tobacco users.  Had he used NHIS, he would have had to acknowledge that smokeless users had no significant risks, as Fisher documented only a 5% excess that was not significant (HR= 1.05, CI = 0.90 – 1.23) (here). The FDA analysis was biased through the use of exaggerated risks from an American Cancer Society study that has never been evaluated by independent researchers (here, hereand here).  In this way, the FDA hid the negligible health impact of ST use. A letter I submitted to the New England Journal of Medicine describing the flaw was not accepted. Original author: Brad Rodu
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Weight Wisdom: Avoid Extremes, But Being “Over” May Have Benefits


A new CDC-released study by National Center for Health Statistics’ Dr. Katherine Flegal and colleagues (here) confirms results from her groundbreaking 2005 report (here): compared with people of normal weight (BMI = 18.5 to less than 25), those who are overweight (BMI greater than 25 but less than 30) have a lower mortality rate.  Higher mortality rates are seen with obesity (BMI greater than 30) and underweight (BMI under 18.5).     Applying weight-based mortality rates to the U.S. population, Flegal estimated in 2005 that overweight resulted in 82,094 fewer deaths, and a significant number of excess deaths were associated with obesity, a (n = 111,909) and underweight, (n = 33,746).  As I noted in this blog five years ago (here), Flegal’s conclusions are consistent with those of many other scientific studies.  I have long had a professional interest in population research on weight and health. In 2004, I published the first study to show that Swedish men who quit smoking by switching to snus avoided the weight gain usually seen with smoking cessation (abstract here).  In 2015, my research group analyzed data from the National Health and Nutrition Examination Surveys to demonstrate that changes in population smoking do not contribute significantly to changes in population overweight and obesity.  (BMC Obesity article available here). The impact of weight on life expectancy is clear: Those who are underweight or severely obese are at risk of dying prematurely, while mere overweight is associated with a lower mortality rate.Original author: Brad Rodu
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Vapers: Tell the FDA You’re Not Merely An Anecdote!


A year and a half ago, I blogged about government agencies ignoring federal survey data showing that 2.5 million former smokers were current vapers (here).  When FDA tobacco center director Mitch Zeller dismissed this evidence as mere “anecdotal reports,”  I argued that such data constitutes legitimate population-level evidence. Aiming to build a fresh dataset on smokers’ success in using vapor as a quitting aid, the Vapor Technology Association (VTA) and Consumer Advocates for Smoke-Free Alternatives (CASAA) just launched a national campaign called “I Am Not An Anecdote” (here). The groups are asking vapers to submit to the FDA detailed, sworn statements to “encourage Congress and federal regulators to reject any proposal that would ban OR limit flavored e-liquid products.” The groups note that “FDA Commissioner Scott Gottlieb has said that your ‘personal stories are important to me.’  But, he also refers to your stories of quitting cigarettes with vapor products as ‘anecdotes.’” While individual cases are, in scientific terminology, anecdotal, their cumulative value is considerable.  Vapor is replacing combustion at dramatic rates worldwide.  My research team used 2013 FDA-funded survey data to produce a peer-reviewed report on U.S. e-cigarette use (hereand here).  Our analysis showed that e-cigarettes are the most popular quit-smoking aid among American smokers and that they are the only aid more likely to make them former smokers (i.e., successful quitters) than are cold-turkey attempts (here). FDA should give weight to published studies, even when they do not conform to visions of a tobacco-free society.  The agency should also recognize the scientific value of mass declarations of smoking cessation accomplished through vaping substitution. Original author: Brad Rodu
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American Cancer Society’s Combustible Tobacco Statement Contains Falsehood


The American Cancer Society’s new position statement offering a “bold new framework” for eliminating combustible tobacco use in the U.S. (here) contains a demonstrably invalid statement: “Cigarette smoking is the leading cause of cancer mortality in the United States (1), accounting for as much as 98% of all tobacco-related deaths (2) [emphasis added]. The problem with the highlighted phrase is that no estimate of “all tobacco-related deaths” in the U.S. has ever been produced by the government, academia or health organizations.  The percentage of deaths attributable to smoking, while undoubtedly large, is simply not known. In reference 2 above, ACS attributes the false assertion to a New England Journal of Medicine article by tobacco researchers Michael Fiore, Steven Schroeder and Timothy Baker (here).  That article made virtually the same statement and cited a citizen petition submitted to the FDA in 2010 by Dr. Joel Nitzkin on behalf of the Tobacco Control Task Force of the American Association of Public Health Physicians (here).  Careful review of the Nitzkin filing reveals nothing to support the ACS or NEJM claim. This falsehood can be corrected.  With some effort, the very small number of deaths from smokeless use and cigar/pipe smoking can be estimated from large federal datasets.  Government researchers and the ACS have the resources and should make this a priority, in order to provide a scientific foundation for FDA tobacco regulation. Fabrication, or repetition of false statements, particularly by trusted authorities, organizations, and public figures, can result in widespread acceptance of myth as truth. Such cavalier inattention to fact is not acceptable in scientific discourse or public health policymaking, where actual lives are at stake (here). Original author: Brad Rodu
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American Cancer Society Sees Zero Cancer Risk for Smokeless Tobacco


A June 11th American Cancer Society policy paper (here) states that the Society will “focus on the primary goal of ending deadly combustible tobacco use… Given this imperative, ACS will provide smokers and the public with clear and accurate information available on the absolute and relative health impact of combustible tobacco products, nicotine-based medications, [electronic nicotine delivery systems] and other novel tobacco products…ACS will increase its efforts to guide smokers toward evidence-based cessation options that enable them to quit as quickly as possible and eliminate their exposure to combustible tobacco smoke.” ACS researchers have estimated the number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States (available here).  They identified 17 risk factors causing 660,000 cases of cancer.  Cigarette smoking was the primary cause (responsible for nearly 300,000 cases), while herpes virus type 8 produced the fewest cases (1,040).  Smokeless tobacco was not among the 17 risk factors – a tacit acknowledgment that the risk of cancer from smokeless tobacco is de minimis.  Taking this position, ACS seems to be abandoning its 30-year crusade against tobacco harm reduction. Over the years, I have noted in this blog how ACS failed to provide smokers and the public with clear and accurate information about smokeless tobacco.  Rather, it exaggerated risks (here, hereand here); withheld risk information (here, here, hereand here); and criticized the British Royal College of Physicians’ harm reduction report (here).  ACS describes its new stance on eliminating combustible tobacco use as a “bold new framework for action.”  The policy paper indicates a shift to cautious support of e-cigarettes, conceding that “although the long-term effects of [e-cigarettes] are not known, current-generation [e-cigarettes] are markedly less harmful than combustible tobacco products.” In fact, the long-term effects of smokeless tobacco use are known to be next to nil.  I hope ACS follows with bold new action explicitly acknowledging that dip and chew products are vastly safer than cigarettes.  Original author: Brad Rodu
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FDA Aims at Wrong Target in Effort to Protect Teens


FDA Commissioner Scott Gottlieb has again mistakenly blamed e-cigarette companies for teen vaping.  Addressing the American Society of Clinical Oncology, Dr. Gottlieb issued a direct threat: “They better step up and step up soon – to address these trends along with us.  So far, I must say, I’ve mostly been disappointed by the tepid response from companies that know that a meaningful portion of their sales are being derived from kids.  The e-cig companies have a chance to do something about it.  The window is open. But it won’t be open for very long.” (here)  The commissioner also tweeted about “additional regulatory policy measures and new enforcement actions as part of our ongoing campaign.” (here)  FDA survey data show that Dr. Gottlieb’s concern is misplaced.  The charge that “a meaningful portion” of e-cigarette sales are made to children is undermined by a 2014 FDA survey: of 12.9 million adult (here) and 770,000 teen current e-cig users (here), only 9.9% of teens had bought their own e-cigs.  The 76,000 teens who purchased products from retailers accounted for only 0.5% of all users and an even smaller fraction of all sales.  The fact that over 90% of teens obtained e-cigarettes from social sources, such as friends or family, makes “policy measures and new enforcement actions” against retailers entirely misguided.  It is illogical for the FDA to hold retailers responsible for teen e-cigarette use.  The federal government has pursued the elimination of tobacco sales to children for decades.  Beginning in 1997, Washington required states to report underage sales via the Synar Program (here).  The latest Synar data shows that 9.6% of retailers were noncompliant in 2013.  The FDA also conducts compliance checks of tobacco retailers.  In 2016, the FDA reported a noncompliance rate of 11% (here).  The FDA should focus on this far more dangerous illegal cigarette sales issue, rather than obsessing over e-cigarettes.  Bad actors – that small percentage of retailers who sell e-cigarettes to children – should be punished, but their infractions should not cause the entire vaping industry to suffer undue, overly broad sanctions. Were government officials to truly prioritize teen safety issues, alcohol would be their number one target.  One-third of high school seniors drank in the past 30 days last year, and nearly 1 out of 5 were drunk (here), even though the legal age for alcohol purchase is 21.   Demonizing e-cigarettes and their marketers and retailers may generate easy headlines, but real public health gains require data-based prioritization of threats, and for teens, those are alcohol and cigarettes. Original author: Brad Rodu
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Smoking Cessation Clinical Trials…and Tribulations


The medical establishment has transformed a behavior, cigarette smoking, into a disease, and now defines how smoking should be “treated” and “cured”. The ramifications of this scheme were laid bare last week in a New England Journal of Medicine report on a smoking cessation clinical trial (here).  The article, “A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation,” demonstrated one important fact:Clinical trials are awful for assessing human behaviors and preferences like smoking.The authors, mostly from the University of Pennsylvania, enrolled 6,006 smokers employed at 54 companies and gave them “usual care”, consisting of wellness website links and information about the National Cancer Institute’s free text-messaging program, plus one of four “treatments”:1.     Free medicines, including nicotine, bupropion and varenicline, plus free e-cigarettes “if standard therapies failed;”2.     Free NJOY e-cigarettes;3.     A reward of up to $600 if smokers stayed abstinent, plus number 2 above; or,4.     A deposit account up to $600, plus number 2 above.Here are the results:.nobr br { display: none } td { text-align: center} “Treatment” Groups and Successful Quitting at 6 MonthsTreatment (number)Number (%) of Successful QuittersUsual Care (813)1 (0.1%)Free Medicines (1,588)8 (0.5%)Free E-cigarettes (1,199)12 (1.0%)$600 Reward (1,198)24 (2.0%)$600 Deposit (1,208)35 (2.9%)All (6,006)80 (1.3%)In all, only 1.3% of smokers quit, ranging from 0.1% with usual care, to 2-3% for those given financial incentives.  In the study, which lasted only six months, the best “treatment” had a 97% failure rate.  After a full year, the standard period for such trials, one could expect percentages to be even lower.  While the futility of using clinical trials to gauge smoking cessation has been demonstrated repeatedly, medical research and regulatory authorities still demand clinical trial proof – the medical treatment standard – for the benefits of switching from combustible cigarettes to smoke-free products.  Just as common sense tells us that a hammer can’t be used to fasten a screw, the medical community should acknowledge that clinical trials can’t be used to assess smoking cessation. The reason is simple: smoking is not a disease.  Most smokers don’t want treatment, cure, nagging or ostracism. They want information about the full suite of their options, including abstinence and all forms of tobacco harm reduction.  In publishing this uninformed study, The New England Journal of Medicine’s authors and editors demonstrate that the illness-treatment-cure model of smoking is erroneous and completely uninformative.  The medical/public health community needs to embrace population evidence from the FDA survey proving that smokers are quitting with e-cigarettes (here). Original author: Brad Rodu
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Kentucky Adopts a Rational Tobacco Tax Plan


Last month, the Kentucky legislature overrode Governor Matt Bevin’s veto and passed HB366 (here), a tax reform bill that increased cigarette excise taxes from $0.60 to $1.10, while leaving taxes on smokeless products unchanged and leaving e-cigarettes with no excise tax. This policy mirrors the tax plan that my research group designed (here) – one endorsed by 16 tobacco research and economic policy experts from across the nation, and by the Pegasus Institute (here).  Watch my interview with Nick Storm of Spectrum News here to learn more. Enacting this plan, legislators rejected demands from anti-tobacco crusaders to double the cigarette tax increase and make vastly safer smokeless and e-cigarettes equally expensive.  One of their spokesmen, Foundation for a Healthy Kentucky president Ben Chandler, had argued, “you’ve got to have the sticker shock…” (here) That reasoning is both insensitive and nonsensical.  Many Kentucky smokers are unable or unwilling to quit tobacco and nicotine entirely.  For them, traditional quit-smoking methods, which strive for nicotine and tobacco abstinence, don’t work.  Our tax plan encourages and incentivizes smokers to quit or switch to less expensive and vastly safer smoke-free tobacco products, including smokeless tobacco and e-cigarettes.  Decades of epidemiologic studies document that the health risks of dipping and chewing tobacco are, at most, a mere two percent of those associated with smoking.  Unlike cigarettes, smokeless tobacco does not cause lung cancer, heart and circulatory diseases or emphysema.  A recent study conducted by federal researchers and experienced epidemiologists found that men who dip or chew tobacco have no excess risk for mouth cancer (here).     Our plan also encourages smokers to switch to e-cigarettes, which already are among the most common – and most successful – quit aids in the U.S. (here).  HB366 contains another provision favoring reduced risk products.  Kentucky excise taxes will be reduced by half for products that are permitted by the FDA to be marketed as “lower risk.”  Reduced risk applications have already been filed with the FDA for three products: IQOS heat sticks, Camel Snus and Copenhagen moist snuff.  Science tells us that all of these are vastly safer than cigarettes.  The question is: When will the FDA acknowledge this indisputable fact? Original author: Brad Rodu
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Tobacco Research Is Not Immune to Scientific Scrutiny


Recently, the authors of a research article on e-cigarettes groundlessly attacked my credentials and academic independence after I noted, in a letter to journal editors, a lack of scientific rigor in their reporting. The article falsely claimed that e-cigarette use caused experimental smokers to become regular smokers.  In response to my critical remarks, the authors made these charges in their own letter to the editors: “This recent comment is another in a long series of letters or comments from Dr. Rodu…in which he has criticized research that is inconsistent with the tobacco industry’s interests in promoting e-cigarettes and smokeless tobacco.” As an academician, I have both authored articles and scrutinized tobacco research for many years, advising journal editors on those occasions when I found factual deficiencies in published articles.  This effort has served the interests of science and the pursuit of truth. Professional medical journals position themselves as platforms for the publication of honest, transparent, reproducible research.  In an effort to identify inaccuracies and other defects, submissions are subjected to review by editors and multiple external authorities who are experts in relevant fields. Over the last 24 years, in addition to my authorship of 54 peer-reviewed articles for medical and scientific journals (here), I have had 11 letters of scientific criticism published in leading journals, linked below.                1.  Rodu B, Cole P.  Excess Mortality in Smokeless Tobacco Users Not Meaningful.  American Journal of Public Health85:118, 1995. 2. Rodu B, Cole P. Smokeless Tobacco and Periodontal Disease. Letters to the Editor. Journal of Dental Research84:1086-1088, 2005. 3. Rodu B, Cole P. A deficient study of smokeless tobacco use and cancer (letter).  International Journal of Cancer 118: 1585, 2005. 4. Rodu B. Snus and the risk of cancer of the mouth, lung, and pancreas.  Lancet 370: 1207, 2007. 5. Rodu B.  Smokeless tobacco: Society response debatable (electronic letter).  CA: A Cancer Journal for Clinicians 2008; 58.  6. Rodu B, Heavner KK.  Errors and omissions in the study of snuff use and hypertension (letter).  Journal of Internal Medicine 265: 507-8, 2009. 7. Rodu B, Heavner KK, Phillips CV.  Snuff use and stroke (letter).  Epidemiology 20: 468-9, 2009. 8. Rodu B.  Dual use (letter).  Nicotine & Tobacco Research 13: 221, 2011. 9. Rodu B, Plurphanswat N, Phillips CV.  Discrepant results for smoking and cessation among electronic cigarette users (letter).  Cancer 2015 Mar 4. doi: 10.1002/cncr.29307. [Epub ahead of print] 10. Rodu B, Phillips CV.  Regarding “Discontinuation of Smokeless Tobacco and Mortality Risk after Myocardial Infarction” (letter).  Circulation 2015 Apr 28;131(17):e422. doi: 10.1161/CIRCULATIONAHA.114.012038. 11. Rodu B.  Re: Smokeless tobacco use and the risk of head and neck cancer: pooled analysis of US studies in the INHANCE consortium.  American Journal of Epidemiology2017  DOI: 10.1093/aje/kwx211 All scientific research should be subjected to rigorous objective review. On those occasions when pre-publication editorial and peer review fail to identify deficiencies, honest criticism should be encouraged and acknowledged by offending publications. Original author: Brad Rodu
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Pediatrics Editors Claim Compliance with – But Instead Violate Publication Ethics Guidelines


In previous blog posts I described how Pediatrics editors refused to retract a fatally flawed study by University of California San Francisco authors (hereand here).  I also described how they allowed publication of unsubstantiated ad hominem attacks, then tried to cover them up by scrubbing the journal website (here).  Carl Phillips afforded the editors a chance to account for their unprofessional actions in an article at The Daily Vaper (here).  They responded by saying that their actions were consistent with the Committee on Publication Ethics (COPE) guidelines for journals.  This is demonstrably false.  The editors violated three of the guidelines (available here). The COPE guidelines say that “Editors are accountable and should take responsibility for everything they publish.”  However, instead of taking responsibility for publishing an ad hominem attack, they simply erased the attack from the Pediatrics website with no retraction or apology (here).  To make matters worse, they also deleted another comment by Bates and colleagues (here), which violated another COPE principle: “Editors should adopt editorial policies that encourage maximum transparency and complete, honest reporting.” Carl Phillips described another instance of zero transparency: “During the dispute over the comments, the editors informed Rodu that they were commissioning an independent ‘expert’ review of the dispute. Clearly there was no genuinely expert review, because that would have concluded that Rodu was right and Chaffee’s comment was nonsense. The editors did not post the review to the comments thread, as they should have, and refused a request by The Daily Vaperto see a copy of it.” Finally, as Phillips and I have documented in detail, the Pediatrics editors violated a third principle: “Editors should guard the integrity of the published record by issuing corrections and retractions when needed and pursuing suspected or alleged research and publication misconduct.” The original manuscript from Benjamin W. Chaffee, Shannon Lea Watkins, and Stanton A. Glantz was never retracted after it was clearly demonstrated to be deficient, and the Pediatricseditors – Drs. Lewis First (University of Vermont), Alex Kemper (Nationwide Children’s Hospital, Columbus Ohio) and Mark Neuman (Harvard) – are guilty of publication misconduct. Original author: Brad Rodu
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