e cigs, advocacy, and prevention

While I appreciate the serious discussion of e-cigarettes, on a global scale it is probably fairly academic. Those most likely to become addicted to nicotine, the poor and undereducated, are unlikely to find nicotine vapor or low emission devices a real option. (if you don't like butts imagine the environmental impact of these latest delivery devices!) Individuals should decide whether they are public health advocates or tobacco prevention advocates working in the realm of public health. The relative harm from spit, low emission, or e-cigarette effluent is rather immaterial if either is not proven to reduce the prevalence of nicotine addiction.

Tobacco free spaces are not ends in themselves but tools for challenging those culpable and profiting from the leading cause of death and disease on the planet.

Recall that harm reduction involving tobacco companies originated with the mirage of the filter tip and the low tar cigarette. Arbitrarily deciding that a certain level of risk is acceptable only serves to collaborate with an industry that could care less.

Spit and other tobacco products

Any doubt that the future of the tobacco cartel as a dealer in the drug nicotine took a hit when Phillip Morris purchased the South African operations of Swedish Match.  Swedish Match is the maker of the Swedish snus, the oral tobacco that is being held up as an alternative to smoking.  This follows in recent years Altria’s  acquisition of  U S Smokeless Tobacco, the maker of Skoal and Copenhagen, and RJ Reynolds purchase of Conwood, the second largest spit tobacco producer.  Worse yet, these tobacco products are ingested into the body without expelling the detritus.

These multi national corporate shifts are the result of growing clean air legislation around the world and an alarming trend in both the public health and the tobacco industry to pursue a harm reduction motif.  This is in addition to claiming spit tobacco as an aid to smoking cessation despite SAMSHA research showing that 88% of smokers who tried smokeless tobacco were still smoking 6 months later.

Renowned advocate Dr. Heinz Ginzel has equated the harm reduction movement as akin to negotiating with Hitler on the beaches of Normandy to see how the tobacco companies can stay in business.  Given the recent successes of the tobacco cartel in the U.S. Congress it's perhaps more like negotiating with the industry while paddling away from Dunkirk.

Heres a nice little interview  with Dr. Joel Nitzkin, chair of the Tobacco Control Task Force of the American Association of Public Health Physicians at Democracy Now.