Is Tobacco Control Running Out of Ideas?

I’m getting a bit sick of TC. You would think that they would be happy to have used scare tactics to to frighten smokers and non-smokers to get their smoking bans, and that they would no longer need to use the same tactics when their objectives have moved on to the next ‘logical step’. They may get a ‘smoking ban in cars with children present’, and they may get PP, but it is hard to see how regurgitating the same propaganda can move them on. For example, as LI pointed out, the stuff in this article in the Mail on Line is very old hat:

http://www.dailymail.co.uk/health/article-2617833/Fancy-cigarette-From-rat-poison-nail-polish-remover-list-ingredients-make-think-twice-lighting-up.html

The Headline:

Fancy a cigarette? From rat poison to nail polish remover, this list of ingredients might make you think twice about lighting up.
Cigarettes contain household cleaners, arsenic, lead and lighter fuel.
They also contain cyanide and a banned insecticide as well as rocket fuel.

LI neatly rips these pseudo-scientific claims to bits, but the comments on the article show that people are still lapping the nonsense up. Or are they? It is not unlikely that many of the comments are deliberate plants to give an impression of grass-root support. I mean, surely even the most dense of drones would raise his eyebrows at the mention of rocket fuel.

Having said that, there could be a logical explanation. It is remotely possible that the Mail is throwing its weight in favour of the ASH position on e-cigs. I know that the idea is a remote one, but by regurgitating the cigarette ‘ingredients’ list, the Mail is, indirectly, giving support to e-cigs, which contain little or none of those ‘ingredients’. I suppose that it depends upon whose camp the Mail is in. Other than that, it is hard to see what the reason for the regurgitation is.

Or one could suppose that the tame TC MPs are about to start shouting about Government delay in introducing the car smoking ban. No doubt they will quote the Mail about the substances that fags emit, and how devastating these substances are to little infants, trapped in cars, subjected to vast amounts of diesel fumes ….. Oopst! Wrong story.

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What is odder is the ‘story’ (‘story’ used advisedly since Glantz is involved) in the Lancet this week. I would like to leave just a link, but you need to ‘sign up’ to get access, so I’ll copy the lot:

Smoke-free policies: cleaning the air with money to spare

a) ra Kalkhoran b) Stanton A Glantz.

One reason that politicians are reluctant to invest in aggressive tobacco control policies and programmes is the perception that the costs (money and the risk of irritating tobacco companies) come now, whereas the benefits (reduced disease and medical costs) are years away. In The Lancet, Jasper Been and colleagues’ meta-analysis1 adds another dimension to the already strong case2 that this perception is wrong.
Drawing on 11 studies done in North America and Europe, including more than 2·5 million births and nearly 250 000 asthma exacerbations, Been and colleagues show that smoke-free workplace and public place laws were followed by immediate drops in preterm births (10·4%, 95% CI 2·0—18·8%) and childhood emergency department visits and hospital attendances (10·1%, 5·0—15·2). Although there was no significant change in low birthweight (—1·7%, −5·1 to 1·6%), there was a decline in children being very small for gestational age (5·3%, 5·2—5·4). In addition to clearing the air, smoke-free laws bring rapid health benefits and improved lives, whilst, at the same time, reducing medical costs by avoiding emergency department visits and admissions to hospitals.1
Smoke-free laws are also followed by benefits for adults, including drops in hospital admissions for cardiac disease, cerebrovascular accidents, and respiratory disease, and reduced ambulance calls.2 This fall in adverse events shows up in hospital costs: after German states enacted weak smoking restrictions in restaurants (policies that generally allowed smoking in small bars and parts of large restaurants), hospital costs for angina pectoris and acute myocardial infarction dropped by 9·6% and 20·1%, respectively, totalling €7·7 million in the first year.3 Because stronger laws are followed by bigger declines in admissions to hospital,2 political compromises like those made by German politicians to exempt some venues come with substantial health and economic costs.
Smoke-free workplace and public place laws stimulate people to make their homes smoke free voluntarily,45 which reduces second-hand smoke exposure and supports quitting. This effect is particularly crucial for infants and children who have no control over their environment. Furthermore, living in a smoke-free home and the perception of being covered by a public smoke-free law are associated with smoking a decreased number of cigarettes, increased attempts to quit,6 increased use of pharmaceutical cessation aids, and increased cessation success.7
Children exposed to second-hand smoke have a 1·4 times increased odds of emergency department visits and, in children with asthma, 2·2 times greater odds of admission to hospital compared with unexposed children.8 Furthermore, children admitted to hospital for asthma with detectable cotinine (a biomarker of second-hand smoke exposure) had a 1·5 times greater odds of readmission within 1 year.9 Achievement of such substantial reductions in medical costs through smoke-free policies is a less expensive and faster solution than other present options, including individualised home-based environmental interventions that, although beneficial, can cost more than US$10 000 per patient.10 Medical expenses for asthma exceeded US$50 billion in the USA in 2007,11 and US$20 billion in Europe in 2006.12 If asthma emergency department visits and admissions to hospital decreased by even 10%, the savings in the USA and Europe together would be US$7 billion annually.
The speed of such health improvements and medical cost reductions helps to explain the rapid and huge returns on investment in aggressive tobacco control programmes. For example, between 1989 and 2008, implementation of California’s tobacco control programme cost US$2·4 billion and resulted in US$243 billion in medical cost savings, a 100 to one return on investment.13
The cigarette companies, their allies, and the groups they sponsor have long used claims of economic harm, particularly to restaurants, bars, and casinos, to oppose smoke-free laws despite consistent evidence to the contrary.2 By contrast, the rapid economic benefits that smoke-free laws and other tobacco control policies bring in terms of reduced medical costs are real. Rarely can such a simple intervention improve health and reduce medical costs so swiftly and substantially.
Indeed, the largest cost is paid by politicians who have to stand up to the tobacco companies and their lobbyists. Been and colleagues1 add to the case that it is a cost well worth paying.
We declare that we have no competing interests.
I was intending to bold the offending statements, but there are far too many to bother. I’ll just quote this one sentence:
Achievement of such substantial reductions in medical costs through smoke-free policies is a less expensive and faster solution than other present options, including individualised home-based environmental interventions that, although beneficial, can cost more than US$10 000 per patient.”
What on earth is he talking about? It is that sort of gobbledegook that has brought science into such disrepute. He is, in effect, saying that all you have to do is force/nudge/compel people to stop smoking or, just as much, stop SHS, and the Medical Establishment could be abolished. There would be no more sickness or, indeed, death. The end of smoking would mean the end of death. That must be so since Glantz’s reasoning requires that there be no adverse consequences of stopping smoking and therefore, according to his theory, living longer and longer, with the added incidents of cancers, altzeimers, heart problems, incontinence, pneumonia, cripples, pensions, etc, is no problem financially. Also, Glantz makes a classic mistake as a non-economist. He assumes that his ‘financial savings’ will mean ‘more money in the bank’, as we individuals would expect if we were to stop engaging in some costly activity. But, in macro-economic terms, it does not work that way. For example, it is true that each GP in the UK will come across only one (or less) lung cancer case per year. If all those cases disappeared, would that mean that X number of GPs would no longer be required? In theory, “Yes”, but in practice, “No”. That is because the cost of the LC cases is spread so thinly that it would not make any difference to GP practice costs. Even the cost of oncology in hospitals would hardly be affect, for much the same reasons. It is a major error to believe that a reduction of incidents of a particular cause of hospital visits results in an immediate reduction in hospital costs. Further, in the USA, people pay their own health insurance or their employer pays for them. It the costs which Glantz claims were real, what would happen is that insurance costs would fall. But that would be no saving to the taxpayer. It would reflect in the cost of health insurance. In the UK, because of our NHS system, the savings would be marginal because the costs are so widely spread. Every individual employee of the NHS would have a tiny bit less to do. That does not mean that their services could be dispensed with. Hospitals would still need to be cleaned and porters would still have almost as much work to do. But if NHS hospitals forbid smoking on their grounds, then they need to employ enforcers. These enforcers cost REAL money, here and now.
The opening sentence to the Glantz sermon:
One reason that politicians are reluctant to invest in aggressive tobacco control policies and programmes is the perception that the costs (money and the risk of irritating tobacco companies) come now, whereas the benefits (reduced disease and medical costs) are years away. In The Lancet, Jasper Been and colleagues’ meta-analysis1 adds another dimension to the already strong case2 that this perception is wrong.
Erm…. Did Glantz allow for the REAL cost of enforcement, and the REAL costs to businesses? It costs a lot of money to hire an enforcer when the fruits of that enforcer’s labour have no value, and indeed are almost certain to have negative value.
The reason is that ‘regulatory jobs’ have no productive value.

 

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11 Responses to “Is Tobacco Control Running Out of Ideas?”

  1. The Blocked Dwarf Says:

    OT but might be of interest to you :http://tvbythenumbers.zap2it.com/2014/04/14/tobacco-wars-to-premiere-saturday-april-19-on-cmt/253762/ which is available no doubt from netflops-iPixies or your piratical supplier of choice.
    Something to watch when Mrs Junican needs an early night perhaps.

    • Junican Says:

      Sounds interesting! I have a book (or rather, a tome) about tobacco growing in the late 19th/early 20th century in the USA. It is very,very detailed about agricultural practices.
      The trouble is that the Zealots have changed the emphasis by their lies. The lies involve totalitarian ‘one size fits all’ calculations, which come from epidemiological, population-wide ‘studies’.
      It seems to be taking a long time for real scientists to get together and blast these ‘studies’ to pieces.

      • The Blocked Dwarf Says:

        I watched the first episode tonight . It was somewhat disappointing having very little to do with the actual tobacco farming process and more to do with the dysfunctional kids. The families have a certain bare foot charm …in a Deliverance County kinda way and there were some little nuggets of interest for the home tobacco growers/curers- the sight of of near toothless ‘Pa’ running bare foot along the rows of ‘baccy’ plants in his dungarees and grimy cap heading each plant in turn and ‘stompin’ on Tobacco Weevils was a classic image as were the daisy dukesque daughters wielding tobacco axes to harvest the plants.

        The sight inside the curing barns with their simple, crude, fire pits in the dirt was fascinating and had the former insurance salesman in me itching to look up Fire Insurance policy rates. Seems burning down your curing barn is an occupational hazard in Hazard County y’all!

        Perhaps the most interesting thing for you as a grower was the fact that after removing the flower (and about a foot of the plant/top leaves) they then spray each tobacco plant with ‘sucker oil’ which is a growth retardant so the plant puts all its energies into growing big leaves.

      • Junican Says:

        The practice of cutting off the flowering heads is called ‘topping’, and, as you say, is intended to make the plant put its energy into expanding the leaves. They would not do it if it did not work. I haven’t read about ‘sucker oil’, but I doubt that it would make much difference to my small plots. I suppose that it would make a difference if you were growing tens of thousands of plants.
        I think that, generally, the practice of using open fires to ‘smoke’/’cure’ the leaves is comparatively rare these days, although something might be lost in the ‘taste’. Who knows? The Zealots have killed all these nuances off.

  2. beobrigitte Says:

    “Fancy a cigarette? From rat poison to nail polish remover, this list of ingredients might make you think twice about lighting up.
    Cigarettes contain household cleaners, arsenic, lead and lighter fuel.
    They also contain cyanide and a banned insecticide as well as rocket fuel.

    Typical anti-smoker Daily Fail.

    When taking a little old lady to her hospital clinic appointment, an ASH banner with a list of this was by the entrancen to make people laugh. I guess, you have no problem waiting for a long time to be seen when you are in a good mood….

  3. Rose Says:

    I mean, surely even the most dense of drones would raise his eyebrows at the mention of rocket fuel

    From them Mail illustration

    Methanol – Rocket Fuel

    From the text

    “and hydrazine – a rocket fuel – as well as an acid found in candle wax.”

    Well it all depends if you are up on your WW2 German rocket fuels

    “In 1923, the German chemists Alwin Mittasch and Mathias Pier, working for BASF, developed a means to convert synthesis gas (a mixture of carbon monoxide, carbon dioxide, and hydrogen) into methanol.”

    “During World War II, methanol was used as a fuel in several German military rocket designs, under the name M-Stoff, and in a roughly 50/50 mixture with hydrazine, known as C-Stoff”
    http://en.wikipedia.org/wiki/Methanol

    • Junican Says:

      Rose. I hope that you know what all that means!

      • Rose Says:

        Yes indeed, but there is a American – German connection that could account for this blast from the past getting into anti-tobacco rhetoric.

        I explored rocket fuel on Dr Siegel’s blog in 2007, serves him right for using scary names without explanation of what they mean.

        Wernher von Braun and his rocket team were “scooped up” and taken to America under Operation Paperclip and the ground water at White Sands Test Facility is still contaminated with rocket fuel from those early attempts.

        http://underdogsbiteupwards.wordpress.com/2014/05/02/what-are-little-ciggies-made-of/#comment-25346

      • Rose Says:

        They also mentioned Arsenic in the article.

        That was certainly true in 1923

        U.S. Department of Agriculture
        Farmer’s Bulletin No.1356
        Issued June, 1923
        “Describes methods for the use of arsenate of lead to control the tobacco hornworm and prevent damage to crops.”
        http://digital.library.unt.edu/permalink/meta-dc-3467:1

        At the time arsenate of lead was used widely in apple orchards too.
        Can you imagine? It’s a wonder that anyone survived!

      • Junican Says:

        In all probability, the quantities were far too low to affect humans even though they were enough to kill pests. The fact that arsenic can accumulate in the body is often shown by the fact that it appears in people’s hair. Erm ….. Is not the fact that it is in the hair also an indication that the body is ‘excreting it’? What happens to arsenic in the human body when the amounts involved are minute?

      • beobrigitte Says:

        Arsenic. Indeed, it is eliminated from our system and only accumulates when given in greater quantities than our system can eliminate in a given period of time.

        I have been a smoker for nearly 45 years. Arsenic in cigarettes? How come I am still alive?

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