Bloomberg Tobacco Article Misleads on Nicotine Effects

In an article published on March 4, Bloomberg reporter Tiffany Kary quotes from a February 25 letter sent to the FDA from Paige Magness, tobacco manufacturer Altria’s senior vice president for regulatory affairs. 

Per the article, “Altria asked the FDA to tackle misperceptions about nicotine as part of a proposed $100 million advertising campaign to reduce the harm caused by tobacco…three-fourths of U.S. adults incorrectly believe[e] nicotine causes cancer, Altria said in the communication, citing government research.”

While National Cancer Institute survey data show that only 25% of Americans correctly believe that nicotine does not cause cancer, Bloomberg erroneously asserts “it’s been known for years that nicotine isn’t the direct cause of many of smoking’s ills.”

The article continues, “The drug has even been touted as a way to ease tension and sharpen the mind,” before noting that it is “the ingredient that addicts people to tobacco products, and it has risks, including possibly making people more susceptible to abusing opioids.”

“Tout” is a derogatory term meaning to describe or advertise boastfully.  Given that nicotine conveys many proven benefits (here, here), touting is not required.  Still, Bloomberg irresponsibly and inaccurately paints it as a gateway to hard drugs.

Altria is not wrong to ask the FDA to combat misinformation about nicotine and tobacco, but the agency is unlikely to act on their request.  FDA officials have made their position clear, saying, in essence, “We will continue to tell Americans that all nicotine/tobacco products are dangerous.  Any manufacturers’ claims to the contrary about their products must be approved by us first.”

Bloomberg says the agency “does have the budget and marketing chops to reach the masses through its public education campaigns. But the agency uses much of those resources on targeting the health risks of products made by the likes of Altria. Its recent ‘Real Cost’ ads say oral tobacco can cause mouth cancer [which is not true, according to government research here], tooth loss [totally bogus, here], brown teeth and jaw pain [also caused by coffee and chewing gum], while ‘most vapes contain seriously addictive levels of nicotine.’” 

In addition to filling smokers’ brains with misinformation, the FDA’s “Real Cost” campaign costs taxpayers real money.  In a commentary published last year in the American Journal of Public Health, I commented that “The [second] largest FDA Center for Tobacco Products budget item ($159.5 million, or 22%) supports public education campaigns and communications to ‘reduce tobacco use’ and tell ‘target audiences’ about the ‘harms of tobacco product use.’ (Original Reference 6)  In this category, ‘The Real Cost’ Youth E-Cigarette Prevention Campaign (http://bit.ly/2IWTSWj ) shows e-cigarettes invading adolescent bodies as worms and a magician converting e-cigarettes into combustible cigarettes. The FDA has acknowledged, apparently without concern, that the campaign convinces adult smokers that e-cigarettes are equally or more harmful than cigarettes, thus suppressing quitting. (Reference 7).”

Attempting to lend credence to the story, Bloomberg quotes Eric Lindblom, a lawyer who has worked for the FDA and for the prohibitionist Campaign for Tobacco-Free Kids.  Offering the pseudo-revelation that “Nicotine isn’t benign,” Lindblom opines that nicotine “can interfere with brain development [a documented fallacy] and birth outcomes” and closes with a non sequitur: “It’s an agricultural poison in large doses.”

What is the relevance of large-dose agricultural applications to smokers, dippers and vapers?  Absolutely zero, as with the value of the cited Bloomberg hit piece.

 

 

 

New York City: Prohibition Prison

New York Mayor Michael Bloomberg’s 2003 prison smoking ban produced a pervasive black market, where single cigarettes cost inmates $30, and a pack runs as high as $200, according to the New York Daily News (here).

That might sound shocking, but I predicted those unintended consequences nine years ago in a column for the Las Vegas Review-Journal, after the California State Assembly imposed a state-wide prison tobacco ban.

February 5, 2004

California, Cigarettes and Prisons: Ban Smoking, Not Tobacco

Brad Rodu

Special to the Las Vegas Review Journal

On January 26 the California Assembly passed a bill that would ban all tobacco products in state prisons (Assembly Bill No. 384).  According to sponsor Tim Leslie (R-Tahoe City), the bill “is a win, win, win for California.”  But the ban may be a loser for everyone else concerned, including prisoners, staff and the prison system. 

According to Leslie, about 80,000 California prisoners smoke.  At 1½ packs per day and $3 a pack, prison sales of cigarettes in California is worth $131 million.

  

One hundred million dollar markets just don’t disappear with the stroke of a legislative pen.  They transform, and often in ways that don’t please prison officials.

First, the California prison system will lose the revenue generated by sales of legal tobacco products.  But over-the-counter revenue lost is under-the-table revenue gained, as smuggling takes over and entrepreneurs compete for the lucrative tobacco market.  In Colorado prisons, where tobacco prohibition was instituted four years ago, an $11 can of Bugler loose tobacco generates $5,000 in hand-rolled cigarettes—a 45,000% markup.  In other words, the Colorado ban spawned an instant black market serviced by prisoners and their families, guards, teachers and supervisors.  Officials have conducted 154 investigations – at considerable additional cost -- and made dozens of arrests.  All because Colorado officials chose in effect to ban nicotine, the consumption of which is absolutely legal everywhere in the US except behind bars.

 

Absolutely legal.  And almost absolutely safe.  Nicotine is among the most powerful of addictive substances, but it is not the reason that smokers die.  In fact, nicotine itself is about as safe as caffeine, another widely consumed addictive drug.  It is the other 3,000 agents in tobacco smoke that are responsible for the diseases that kill smokers.  Smokers who switch permanently to other, safer forms of nicotine, including smokeless tobacco products, live longer and healthier lives and don’t pollute the air around them.

           

There is a very simple alternative to a complete ban on tobacco and nicotine: corrections officials should offer smokers alternatives in the form of smokeless tobacco.  Smokeless tobacco satisfies smokers and serves as an effective permanent substitute, because it rapidly delivers a dose of nicotine comparable to that from smoking.  For comparison, nicotine medications provide only about one-third to one-half the peak nicotine levels of tobacco products, which is unsatisfying for many smokers.  In addition, medicinal nicotine is expensive and designed to be used only temporarily.  All of these reasons are why nicotine replacement has a paltry 7% success rate among American smokers.

Smokeless tobacco use is vastly safer than smoking, which is entirely consistent with the stated health goal of Leslie’s bill.  Our research documents that smokeless use imposes only about 2% of the risk of smoking.  The only consequential adverse health effect from long-term smokeless tobacco use is oral cancer, but even this risk is much lower than that associated with smoking.  In fact, the average reduction in life expectancy from life-long smokeless tobacco use is only 15 days, while the average smoker loses almost 8 years.  For further context, the risk of death from long-term use of smokeless tobacco (12 deaths in every 100,000 users per year) is about the same as that from automobile use (15 deaths in every 100,000 users per year).

Newer smokeless tobacco products deliver the nicotine kick smokers crave and they can be used almost invisibly.  Spitting, once the stigma of smokeless tobacco use, is nonexistent with these products.  New products are neatly packaged as wafers or small pellets of tobacco.  Some modern products are the size of breath mints and completely dissolve during use, leaving no tobacco residue.

    

Data from Sweden show that smokeless tobacco can easily substitute for smoking.  For 50 years men in Sweden consistently have had the lowest smoking rate and the highest smokeless tobacco rate in Europe.  The result:  Rates of lung cancer – the sentinel disease of smoking – among Swedish men have been the lowest in Europe for 50 years.  World Health organization statistics reveal that Swedish men have the lowest rates of lung cancer among 20 European countries.  In the US smokeless tobacco is already working for many Americans. Statistics from the Centers for Disease Control and Prevention (CDC) show that 1.5 to 2 million former smokers have chosen this option on their own.

In summary, when prison systems provide smokeless tobacco as a substitute to inmates who smoke, they accomplish several goals.  First, they promote the health of smokers by offering a cigarette substitute that is 98% safer for users (because smokers who switch to smokeless tobacco reduce their risk for all smoking-related illnesses, including mouth cancer).  Second they ensure the health of nonsmoking inmates and staff (because passive smoke is eliminated).  Third, they restore the prison tobacco market to its rightful balance, in which revenue from tobacco sales is removed from the black market and returned to the correctional facility.  In other words, corrections officials can meet both health and fiscal goals by providing an environment that is smoke-free, not necessarily nicotine and tobacco-free.

Unfortunately local, state and federal officials have blindly embraced tobacco prohibition.  Mayor Bloomberg’s policies have made New York City a tobacco prison, with cigarette prices, at $12-15 a pack, the highest in the nation.  Now he wants to prohibit cigarette sales to anyone under 21 years of age (here), which will force more of today’s legal consumers to the black market.

Half of the cigarettes sold in New York State are illegal, shifting a quarter billion dollars of government revenue to criminals  (updated link here). 

Prohibitionists love to claim the moral high ground, but they are bootleggers’ best friends.