I posted a link to the meeting documents that took place on March 1st 2012. I have given a cursory glance over the document titled
March 1-2, 2012: TPSAC Meeting Transcript (PDF - 480KB). On page 24 of that document, starting on line 12 you will see the following excerpt that is the beginning of the presentation presented by Elaine Keller, president, the Consumer Advocates for Smokefree Alternatives Association (CASAA). Again, look at the FDA's slant on the e-cig and what it publicizes and compare it to MS. KELLER's presentation:
Begin excerpt:
So we have four public commenters today. You've each been allocated 10 minutes for your presentation, and you will receive a warning when you have two minutes left in your presentation. I think the lights are up on the podium for you to see. And at the end of 10 minutes, please end your presentation.
Our first presenter is Elaine Keller, president, the Consumer Advocates for Smokefree Alternatives Association. Please.
MS. KELLER: Good afternoon. My name is Elaine Keller, president of CASAA, The Consumer Advocates for Smokefree Alternatives Association. I have no conflicts of interest.
Before I address TPSAC's draft report on dissolvables, I have a true story to share with you. During the last several years that I smoked, I was being kept awake by my own loud nighttime wheezing, I had a productive morning cough, and laughing would trigger an embarrassing coughing jag.
On March 27, 2009, I finally smoked my last cigarette. Within a month, the wheezing and the morning phlegm were gone. Best of all, I was able to enjoy a good belly laugh for the first time in years.
Now, how many of you believe that these health improvements would have happened if I had continued smoking for the last three years? Anyone? Me, neither.
Why didn't I stop smoking earlier? It wasn't for lack of trying. The problem is that every medically approved smoking cessation method requires complete abstinence from nicotine. When my inability to concentrate, pay attention, and remember became unbearable, I would relapse. I'd try it again, only to experience defeat time after time.
Don't think for a moment that I'm the only victim on this wheel of misfortune. The vast majority of today's smokers will never be able to quit if nicotine abstinence is a requirement.
How did I finally manage to stop inhaling smoke? I switched to what was then a brand-new product called an electronic cigarette. The device vaporizes a liquid solution that contains a small amount of nicotine. Imagine my dismay when I learned the FDA wanted to ban these products.
I used to believe in science and in the honesty and goodwill of scientists, researchers, and doctors. In July 2009, I lost my credulity and my innocence. The FDA's Center for Drug Evaluation and Research issued a news release headlined, "FDA and Public Health Experts Warn about Electronic Cigarettes."
The press statements cleverly employed classic propaganda techniques with the goal of making the public believe that these products are much more dangerous than smoking. "They contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze," announced the lead paragraph.
The words "carcinogens" and "antifreeze" were carefully selected, aimed at creating feelings of fear and loathing on the part of the public. CDER failed to mention that conventional tobacco cigarettes contain nearly 16,000 times higher levels of the so-called carcinogens. The FDA found 1 percent DEG in a cartridge that holds half a milliliter of liquid. CDER failed to mention that even a small adult, weighing in at 50 kilos, would need to drink the contents of a thousands cartridges in a single day to reach a lethal dose.
Unsupported conjecture was expressed with all the conviction of proven fact by a host of experts who had no firsthand knowledge whatsoever. The goal of the campaign was to make the public believe that these products are much more dangerous than conventional combusted cigarettes. To a large extent, the campaign was effective. Smokers who had been considering trying e-cigarettes announced, "Man, those things will give you cancer or poison you. I'm sticking with my smokes."
Numerous foreign countries banned sales of e-cigarettes based on the press coverage of the FDA's testing. Millions of smokers across the world were denied the opportunity to switch to an alternative that might have saved their bodies from further smoke damage.
I have seen some of the same hidden persuader techniques applied in the testimony and reports presented to this committee regarding dissolvable tobacco products. I commend the committee for looking past the hype and recognizing that dissolvable tobacco products reduce exposure to TSNAs and do not increase nicotine intake.
The important issue is not that some potentially harmful substances have been detected in the products. We have these in our drinking water. The issue is whether these substances are present in large enough quantities to endanger health. Are they? The peer-reviewed literature failed to reveal this important information.
It isn't enough to say that TSNA yields of dissolvables are lower than those of cigarettes. The public should be informed that levels are more than 100 times lower. If switching to snus results in the same life expectancy as becoming completely abstinent, it stands to reason that switching to a dissolvable form of tobacco could provide similar lifesaving benefits.
TPSAC's draft report states the 50 percent of snus users in Sweden are new tobacco users. The report needs to acknowledge that increased use of snus has lowered both the smoking rates and the total use of tobacco. In 1981, 47 percent of males used tobacco and 34 percent were smokers; 27 percent of women used tobacco, and nearly all of them smoked. The percent who were snus users grew modestly, but total tobacco use among men dropped to 31 percent and among women to 20 percent.
It isn't enough to state that labeling in Sweden differs from the U.S. It's important to point out that labeling in Sweden doesn't mislead tobacco users into believing that switching to smoking won't increase their health risks.
Why is the FDA concerned that availability of products with much lower health risks than cigarettes might lead to increased used? Even if every single adult in the U.S. took up use of a tobacco product that was 90 percent less hazardous than smoking, there would be 171,000 fewer deaths from tobacco each year. But it is probably more likely that snus, e-cigarettes, and dissolvables are 99 percent less hazardous than smoking, which would save over 400,000 lives every year.
The Institute of Medicine's 2001 report, "Clearing the Smoke," mentioned something that really should be obvious to everyone in this room. The faster you can help smokers to stop inhaling smoke, the less irreversible damage will be done to their bodies. Conventional smoking cessation methods and products are not working fast enough.
One tool to help smokers halt the damages is to encourage them to switch to non-smoked sources of nicotine such as snus, e-cigarettes, and dissolvable tobacco products, even long-term use of NRTs. It boggles my mind that some people in tobacco control believe that if only they can discourage smokers from switching to something safer, those smokers will suddenly quit altogether.
This type of magical thinking is dangerous. Even if someday they do quit altogether, someday will be too late for many smokers. Let's stop insisting on the perfection of complete nicotine abstinence. It isn't working. Let's strive for the good of harm reduction. Thank you.
DR. SAMET: Thank you. And are there questions or comments from committee members?
[No response.]
MS. KELLER: I left them speechless.
DR. SAMET: Thank you.
END EXCERPT.
I encourage all to read the whole document. It is quite interesting.
