FDA Should I donate to help fund Dr. Michael Siegel's new study?

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bigdancehawk

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I don't think there will ever be a study on vaping and vapers that produces authoritative data (or, more specifically, data that are instructive on a societal level). No matter how good your protocols, or how good your methodology, you can't accurately replicate the world of the vaper in a clinical setting. A clinician doing a study is always seeking to eliminate variables and standardize equipment/behavior as much as possible. But vaping is popular and successful precisely because there are so many variables, and because every detail of the vaping experience is fully customizable to what the user wants.

Dr. Siegel might have perfectly good intentions with this study, and it might even wind up being the best study yet done on this topic. But at the same time, it's very obvious that he has no firsthand experience as a vaper, and (like most people who are lifelong tobacco/smoking researchers) he doesn't realize you can't use the same methods to study vapers that you do to study smokers.

A better study design would involve giving half the subjects nicotine patches, and with the other half, rather than deciding for them what type of vaping device they're going to use, they should be given a budget to buy their own gear. Build a trial-and-error allowance into the budget (which, at $4.5 million, shouldn't be difficult), have everyone save their receipts, and a month or two later, when your subjects have determined what products they like, then start gathering the behavioral data.

Yup, that's very close to what I had in mind. But, as you correctly pointed out, it's not "scientific" because it lacks the rigid controls that clinical researchers typically impose. And, therefore, I wonder if the FDA would simply dismiss it as not conforming to the kinds of protocols they're accustomed to dealing with.

EDIT: I doubt that a clinical study, in the traditional sense, can be devised to show that vaping (a) has no severe long-term ill effects and (b) helps people quit smoking.

We think (a) is probably true, but we can't prove it right now. Common sense tells us it's much less harmful than smoking, and even Zeller seems to agree.

Our own experience proves that (b) is true. A well devised survey should confirm that, and it shouldn't cost $5 million.

Rather, what Zeller and his ilk are fixated on is the "gateway effect," youth initiation with "flavors," and other such nonsense. I don't know how you deal with speculative "concerns" other than to ridicule them. It seems to me that those raising such "concerns' should have the burden of proof. But in the bizarre world of TC--a world which rivals Alice in Wonderland--that seems not to be the case.

I live in a world where those who advance a proposition of fact have the burden to prove it. These people aren't even making factual assertions. Rather, they're advancing "concerns." The media dutifully deems these "concerns" as somehow newsworthy, simply because the "concerned" people have PhDs and such. I've known plenty of stupid PhDs.
 
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Nate760

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"EDIT: I doubt that a clinical study, in the traditional sense, can be devised to show that vaping (a) has no severe long-term ill effects and (b) helps people quit smoking.

We think (a) is probably true, but we can't prove it right now. Common sense tells us it's much less harmful than smoking, and even Zeller seems to agree."

I would submit that clinical evidence for (b) will eventually become a moot point. The sheer number of people who quit smoking, and the sheer drop in the number of cigarettes consumed, will obviate the need for clinicians to tell us anything on that front.
 

bigdancehawk

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I would submit that clinical evidence for (b) will eventually become a moot point. The sheer number of people who quit smoking, and the sheer drop in the number of cigarettes consumed, will obviate the need for clinicians to tell us anything on that front.

Oh, I fully agree. Given half a chance, it will become moot. My point was that the FDA has a certain, rigid way of regulating products which is at odds with the real world of smoking, e-cigs and smoking cessation. I have only a limited understanding of how to conduct clinical studies, but I think I get the general idea. It seems to me that they are fine for certain things, but not for resolving such questions as, "How effective are e-cigarettes for smoking cessation?"
 

roosterado

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Just read CASAA advice on donating to this 4.5 million dollar study. Advocacy Donation by Vapers more effective donated to Vaping Militia-CASSA or other Electronic Cigarette Rights Organizations. Or Wait to Donate to Dr F's upcoming study which will cost 10% of this study.

CASAA.org - The Consumer Advocates for Smoke-free Alternatives Association
8 hours ago
We have received several queries about the current fundraising effort by Dr. Michael Siegel. After assessing the matter and corresponding with him, we have decided against supporting this effort and are recommending at this point that people not donate to this project.

It is with a heavy heart that we make this recommendation, which we realize might be misinterpreted as a negative statement about Dr. Siegel. Like many of you, we consider him an invaluable friend of our cause. But it is our assessment that the research project he is seeking funding for will not be useful, and that the resources it requires would be far better spent elsewhere. Dr. Siegel has provided few details about the specifics of his project (a problem in itself), but he is hoping to conduct a randomized clinical trial that includes smokers switching to e-cigarettes. We consider this to be a particularly bad way to study e-cigarettes. Trials like this do not represent the real role of e-cigarettes in society and are likely to grossly understate their value. He believes that this would influence the FDA, but we disagree. We see no reason to believe that this would affect FDA's major decisions or that they are at all interested in the results of such a study.

Most important, the proposed cost of this project -- $4.5 million -- is staggering. If every penny ever given by the community over the last 5+ years for advocacy and research were devoted to this project, it would only cover 5% of the total cost. The only way a study like this could ever be fully funded is a federal grant, and if such a grant happens, then the small sum given by the community would not matter at all.

By contrast, that sum could be enormously valuable if devoted to other projects. The critically important study by Dr. Burstyn, which the community generously paid for, cost only one half of one percent of that sum. Dr. Farsalinos has conducted several crowd-funded studies for similarly low costs. CASAA acts as your advocate at the state and federal level, provides educational materials and ongoing analysis, and supports various research projects for annual expenditures that are about 2% of the budget for this single study. We fear that community donations to Dr Siegel's project will take away from critical needs elsewhere and will still be insufficient to make the project happen.

We realize that this could be seen as mercenary, and some will think that we are asking people to give money to us and not this study. But this is not about CASAA. It is about the needs of the community as a whole. If you were thinking about donating to the project then, of course, CASAA would appreciate the donation instead. But if that is not your preference, please give the money to, for example, the Vaping Militia, Vape A Vet, your local ecig group, one of the European groups that is trying to form, or hold onto it for Dr. Farsalinos's next project.
 

Jman8

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With any of these studies, I would desire an itemized budget provided upfront which explains/justifies the costs. Being science and all, I would think that ought to be a no-brainer. But given politics, I'm thinking this is one of those things that is deemed my responsibility to investigate that information. And once I do, THEN I'll consider donating to your study that costs more money than everyone I know makes in 1 year.
 

dragonpuff

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Just read CASAA advice on donating to this 4.5 million dollar study. Advocacy Donation by Vapers more effective donated to Vaping Militia-CASSA or other Electronic Cigarette Rights Organizations. Or Wait to Donate to Dr F's upcoming study which will cost 10% of this study.

CASAA.org - The Consumer Advocates for Smoke-free Alternatives Association
8 hours ago
We have received several queries about the current fundraising effort by Dr. Michael Siegel. After assessing the matter and corresponding with him, we have decided against supporting this effort and are recommending at this point that people not donate to this project.

It is with a heavy heart that we make this recommendation, which we realize might be misinterpreted as a negative statement about Dr. Siegel. Like many of you, we consider him an invaluable friend of our cause. But it is our assessment that the research project he is seeking funding for will not be useful, and that the resources it requires would be far better spent elsewhere. Dr. Siegel has provided few details about the specifics of his project (a problem in itself), but he is hoping to conduct a randomized clinical trial that includes smokers switching to e-cigarettes. We consider this to be a particularly bad way to study e-cigarettes. Trials like this do not represent the real role of e-cigarettes in society and are likely to grossly understate their value. He believes that this would influence the FDA, but we disagree. We see no reason to believe that this would affect FDA's major decisions or that they are at all interested in the results of such a study.

Most important, the proposed cost of this project -- $4.5 million -- is staggering. If every penny ever given by the community over the last 5+ years for advocacy and research were devoted to this project, it would only cover 5% of the total cost. The only way a study like this could ever be fully funded is a federal grant, and if such a grant happens, then the small sum given by the community would not matter at all.

By contrast, that sum could be enormously valuable if devoted to other projects. The critically important study by Dr. Burstyn, which the community generously paid for, cost only one half of one percent of that sum. Dr. Farsalinos has conducted several crowd-funded studies for similarly low costs. CASAA acts as your advocate at the state and federal level, provides educational materials and ongoing analysis, and supports various research projects for annual expenditures that are about 2% of the budget for this single study. We fear that community donations to Dr Siegel's project will take away from critical needs elsewhere and will still be insufficient to make the project happen.

We realize that this could be seen as mercenary, and some will think that we are asking people to give money to us and not this study. But this is not about CASAA. It is about the needs of the community as a whole. If you were thinking about donating to the project then, of course, CASAA would appreciate the donation instead. But if that is not your preference, please give the money to, for example, the Vaping Militia, Vape A Vet, your local ecig group, one of the European groups that is trying to form, or hold onto it for Dr. Farsalinos's next project.

I need to respectfully disagree with CASAA's position on this. Granted, I applaud CASAA in all the work they do, and I will continue to support them in any way I can. I simply disagree on this point.

The proposed cost is high indeed, but keep in mind that is just his goal for fundraising, i.e. this is what he hopes to raise so he can conduct the largest study possible. He will make do with less, he has already stated that he will cut down on the sample size and possibly change some of the study parameters to fit his budget. I have a feeling that he is intentionally trying to appeal to some big players to donate larger amounts of funds to supplement the budget - he knows full well he will not raise that kind of money on community donations alone.

I do agree with CASAA that Dr. Siegel is overreaching when he says that the study will help the FDA make decisions about e-cigarettes. It states in the deeming regulations itself that each product would have to be approved individually, and therefore each product would require its own trials. Besides that, I don't think that any scientific studies which show positive aspects of vaping will have any influence on the FDA at this point.

However, that is not to say this study won't have influence. It is common in the United States for lawmakers, public health personnel, and even medical professionals to disregard anything that happens outside of this country (for instance, the fact that smoking rates have dropped noticeably in the UK will have little to no influence on decision making here). For this reason especially, it is critical that we conduct more studies in the US. Any study conducted in this country will have far more influence on our lawmakers, and as it stands we have not conducted any major studies of this nature. Currently studies on vapor products in the US consist primarily of toxicological analyses and at least one meta-analysis on other studies. As far as I am aware, there haven't been any studies conducted in the United States that specifically examine the behavioral effects of vaping and its potential to facilitate smoking reduction in a controlled trial (which, while derided by many, is still the gold standard for behavioral studies). That is where Dr. Siegel's study comes in, and I feel that such a study is absolutely necessary.

I believe it is more useful overall, if you have to choose who to donate to, to put that money toward CASAA or one of the other organizations they mention - the work that they do for our cause is invaluable. But if you plan to donate to multiple organizations, and it wouldn't hurt your budget to do so, I will again urge members of this community to kick a few bucks here and there toward Dr. Siegel's study.
 

SeniorBoy

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TO: CASAA Board of Directors, Officers, and Associates

Some facts on my perspective: I have devoted a significant portion of my life to Vaping Activism. See my signature. I launched a web site out of my own funds in an effort to provide the Vaping Community with resources and views to mitigate the FDA Deeming regulations. I have spent time in the field with local B&Ms evangelizing and educating them. I have always supported CASAA with a prominent spot on my sidebar, my own posts, my own endorsements, engaging in your Call To Actions, and educating anyone who will listen that they should join and support CASAA. I have always admired and respected volunteer activism. I embrace the "Same Page" philosophy even in those cases where I don't agree with some details of a specific effort. "They are engaged" in a positive manner is all that has ever mattered to me. I am also a regular poster on ECF where for the most part I am surrounded by independent thinkers, Smart Vapers, and members who have helped me understand the issues we face today. My activism may be imperfect in the view of some but my efforts are "pure" with total transparency and extensive details on my "About This Site" page. My comments are inserted below your announcement and source document links appear at the bottom of this post.

We have received several queries about the current fundraising effort by Dr. Michael Siegel. After assessing the matter and corresponding with him, we have decided against supporting this effort and are recommending at this point that people not donate to this project.

--> It's one thing not to support an effort but to clearly state not to donate is IMHO, a clear signal that one aspect of your position is about money to your own cause and your "favorites". At the expense and detriment of the entire Vaping Community. Ironically, you actually admit the core of the issue in your final paragraph while attempting to talk out of the other side of your mouth.

It is with a heavy heart that we make this recommendation, which we realize might be misinterpreted as a negative statement about Dr. Siegel. Like many of you, we consider him an invaluable friend of our cause. But it is our assessment that the research project he is seeking funding for will not be useful, and that the resources it requires would be far better spent elsewhere. Dr. Siegel has provided few details about the specifics of his project (a problem in itself), but he is hoping to conduct a randomized clinical trial that includes smokers switching to e-cigarettes. We consider this to be a particularly bad way to study e-cigarettes. Trials like this do not represent the real role of e-cigarettes in society and are likely to grossly understate their value. He believes that this would influence the FDA, but we disagree. We see no reason to believe that this would affect FDA's major decisions or that they are at all interested in the results of such a study.

--> Respectfully, your statement is specious and self serving. In fact Dr. S HAS provided some details which in fact appear to replicate what new Vapers who wish to mitigate their addiction to combustables experience. Does his presentation leave room for improvement. Absolutly yes. NONE of US are perfect. Myself, CASAA, and every member of ECF. Dr. S has made incredible sacrifices to further our casue. Jeopardized his own reputation to fight ANTZ and his ability to not only earn a living but raise additional funds. You even "spin" the specific nature of his study. Your failure to disclose this and "spin" is disappointing.

--> Specifically: "In BSCiTS, we hope to conduct a six-month, randomized study that looks at changes in smoking behavior over time when smokers who wish to quit or cut down are offered a free, ten-week supply of either nicotine patches or electronic cigarettes."

--> I am having a very hard time understanding your statement "We see no reason to believe that this would affect FDA's major decisions or that they are at all interested in the results of such a study." What factual basis can you provide? IF I had a self serving agenda and was primarily interested in my own contributions and favorites, I could make the same statement about your own efforts with the FDA and your choice in sending Dr. Igor Burstyn and Dr. Carl Phillips to the FDA workshop. Respectfully, your statment is unfair and impunes the credibility of Dr. S just as my own "IF" senario does. I'm sorry but your views convey favoritism and politics at the expense of the entire Vaping Community. Granted, the chances of any study influencing the FDA in a significant fashion is slim to none but you fail to mention the positive traction that could be garnered from the mainstream media with even a survey conducted by a Scientist/MD from a prestigious university with an outstanding CV.


Most important, the proposed cost of this project -- $4.5 million -- is staggering. If every penny ever given by the community over the last 5+ years for advocacy and research were devoted to this project, it would only cover 5% of the total cost. The only way a study like this could ever be fully funded is a federal grant, and if such a grant happens, then the small sum given by the community would not matter at all.

--> In an effort to justify your own position on this issue you fail to mention the numerous instances of a disclaimer by Dr. S and his team. Specifically: " Our research team reserves the right to alter the scope of the proposed research project to keep it in line with the funds raised. This might mean reducing how many smokers can be enrolled in the study, or how long we can follow them over time. Alternatively, if the funds we raise are insufficient, we might choose to conduct a survey study to answer these questions. Whatever the case, the purpose of our research will remain the same: to examine changes in smoking behavior associated with the use of electronic cigarettes, in comparison to the nicotine patch."

---> I could easily conclude that in a worst case situation you also see no value in contributions for a survey since you have chosen to condemn all contributions to Dr. S's efforts and not your own. Was the "ask" of 4.5 millon an overreach. I would say so but when you study all his plans and his fallback positions it's certainly not enough justification to warrant a "not donate to this project".


By contrast, that sum could be enormously valuable if devoted to other projects. The critically important study by Dr. Burstyn, which the community generously paid for, cost only one half of one percent of that sum. Dr. Farsalinos has conducted several crowd-funded studies for similarly low costs. CASAA acts as your advocate at the state and federal level, provides educational materials and ongoing analysis, and supports various research projects for annual expenditures that are about 2% of the budget for this single study. We fear that community donations to Dr Siegel's project will take away from critical needs elsewhere and will still be insufficient to make the project happen.

--> It's that last sentence that I take exception to. Your agenda is quite clear. You wish all contributions to go to you and your "chosen" and fail to provide any evidence or even mention that a survey by Dr. S would be significantly less expensive.

We realize that this could be seen as mercenary, and some will think that we are asking people to give money to us and not this study. But this is not about CASAA. It is about the needs of the community as a whole. If you were thinking about donating to the project then, of course, CASAA would appreciate the donation instead. But if that is not your preference, please give the money to, for example, the Vaping Militia, Vape A Vet, your local ecig group, one of the European groups that is trying to form, or hold onto it for Dr. Farsalinos's next project.

--> I've not given up entirely on my devotion and support of CASAA. I'm hopeful and implore you to reconsider your position on Dr. S. Certainly, your current position is in fact "mercenary" and self serving in a short cited effort to convince the Vaping Community to only contribute to you and your chosen few. The net effect is a dilution of our collective efforts, playing into the hands of ANTZ with a lack of unification, and the assurance that we will fail in any effort to mitigate the FDAs efforts to obliterate vaping. To be fair, had you posted all the facts/complete picture with respect to Dr. S's study and that you are unable to endorse the efforts of Dr. S BUT still encourage Vapers to use and or join/contribute to CASAA and as many resources or organizations as they wish or don’t join any and communicate directly, I still might have had "private" objections but would certainly understand and respect your position.

Sources:

https://www.facebook.com/CASAAmedia
http://tobaccoanalysis.blogspot.com/2014/09/rest-of-story-announces-fund-raising.html
http://www.biscuitsstudy.com/
http://www.biscuitsstudy.com/files/94697087.pdf
 
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dragonpuff

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I'm with CASAA on this ... the 4.5 is too much for this kind of study.


Sent via iPhone

Understandable, but as both I and Seniorboy noted in our posts above, it is simply his fundraising goal, i.e. what he hopes to achieve, not the minimum amount required. He wants to raise that much money so that he can have a very large sample of subjects for the study, since each individual subject will require supplies. Studies with large samples are preferred to generate more accurate data for these kinds of studies; current studies of this nature have such small sample sets that they are often not considered representative of the population.

In other words, if a study on 300 people shows that 100 of them quit smoking with e-cigs, could you say that 1/3 of the whole population would likely quit? Probably not, but if the sample size were 3,000 you'd be more likely to consider it - but that multiplies the cost by ten.

(I will reiterate that I understand many people inherently distrust clinical research of this nature, but it is still the gold standard of behavioral studies and it is type of research that is required to prove behavior patterns to the scientific community - so whether you like it or not, we do need these studies.)

Also, Dr. Siegel did say explicitly that he will reduce the sample size and change some parameters of the study if the amount of funding raised does not meet his goal.
 

Stubby

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(I will reiterate that I understand many people inherently distrust clinical research of this nature, but it is still the gold standard of behavioral studies and it is type of research that is required to prove behavior patterns to the scientific community - so whether you like it or not, we do need these studies.)

Also, Dr. Siegel did say explicitly that he will reduce the sample size and change some parameters of the study if the amount of funding raised does not meet his goal.

Clinical studies are certainly not the gold standard for behavior patterns. In fact they should be avoided at all cost when trying to predict behavior in the real world. They are, simply put, to far removed from the real world to have any real use. I would suggest reading this to get a clue.

How the medicalized history of public health damaged its science too, particularly including understanding ecigs (fairly wonkish) | Anti-THR Lies and related topics

Phillips has said there will be more coming on the subject in short order. Phillips is the scientific director of CASAA.

I see no one has challenged my critic of Siegel's standing as an objective scientist. If in doubt look up his studies on second hand smoke to get a clue as to how far over the cliff he is willing to go to push his ideology. You may also want to check out his views on smokeless tobacco, which sound like something coming out of the CDC or ALA then someone with a rational view of tobacco.
 

JustJulie

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TO: CASAA Board of Directors, Officers, and Associates

As we said, this isn’t about CASAA; it is about the community. However one looks at it, $4.5 million is an extraordinary amount to try to raise in a community. In this case, it’s an amount that could potentially cripple the entire advocacy effort if even only a very small fraction of the amount were extracted from the community, all in an effort to support a study that, at the end of the day, we simply do not believe will accomplish what Dr. Siegel is hoping to do.

First, we do not believe that a randomized controlled trial (RCT) is an effective way of accurately quantifying the effects of e-cigarettes on smoking behavior. In fact, we believe that a truly representative survey (which is Dr. Siegel’s fallback position if he can’t meet his fundraising goal) is actually a far better way of quantifying this. We shared this view with Dr. Siegel, namely, that a comprehensive and well thought-out survey would be far more useful for this purpose. We further offered to actively support such a project if he designed and reported a good protocol. Dr. Siegel’s response was that a survey might be what he pursues if he can’t raise the funds to do a RCT, but offered no useful information.

To be clear, while Dr. Siegel feels that a survey is a lesser alternative, one to be pursued only if he can’t raise enough money to do an RCT, we believe that a survey for these purposes is actually a far more valuable tool. Accordingly, at this point, we can’t support the fundraising appeal for an RCT, nor can we recommend that the community support it. And, no, it’s not simply about the money—it is about the project itself and whether it can meet its stated objectives. We believe that the results are more likely to send misleadingly negative messages about e-cigarettes than they are to help.

Second, navigating the FDA labyrinth in terms of new product approvals is not simply a matter of providing any old study. It is a massive undertaking with an almost unending set of hoops to jump through. We specifically asked Dr. Siegel whether he was working with experts who are knowledgeable about the information the FDA would consider acceptable and relevant and whether he had had consulted with CTP scientists to get some assurance that they would pay attention to this. He did not respond to this point, a point which we feel is crucial.

Third, regardless of what one thinks of the project itself, $4.5 million, $2 million, or even $1 million is simply too much to try to crowd source in this particular community without necessarily diverting resources from other worthwhile and often critical efforts. To be clear, CASAA is not looking at its funding in particular. We are but one piece of the advocacy puzzle in the community. We recognize that other efforts are important as well. The efforts we listed aren’t our “favorites”—they were listed by way of example, and the list was not at all intended to be a complete or exhaustive one. Moreover, the costs of these efforts were listed to try to illustrate the sheer enormity of the amount of money being sought for this one project.

We have made our recommendation and explained our basis for it, but obviously that does not prevent people from doing as they wish. And should Dr. Siegel choose to pursue a well-designed survey (which we feel is a superior tool in this particular case) and seek to crowd source within the community a reasonable sum, we will support that effort.
 

NorthOfAtlanta

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Dr. Siegel is trying to drive the changing polygon shape of e-cigarettes into the square hole of clinical testing and it will never fit. Even surveys can't keep up with how fast e-cigarette technology is changing but well written ones could collect the anecdotal evidence into a format that even the FDA would have trouble ignoring.

:2c::vapor:
 

DC2

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I am sitting on both sides of this fence...

The only way this study gets done (even at a fraction of the stated financial goal) is with very large donations from those outside the vaping community.
And in light of that, our money would just be a drop in a very large bucket.

Seriously, if the vaping community could put together this kind of money, it would be better spent on a massive public education campaign.
That is the most important thing we could ever do in terms of reversing the swelling tide that threatens to drown us.

But yes, a study such as this, if done correctly, would not hopefully be a bad thing.
As long as it shows what we all know to be true, which is that vaping is far more successful at eliminating smoking than any other method ever devised.
 

Kent C

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I am sitting on both sides of this fence...

The only way this study gets done (even at a fraction of the stated financial goal) is with very large donations from those outside the vaping community.
And in light of that, our money would just be a drop in a very large bucket.

Seriously, if the vaping community could put together this kind of money, it would be better spent on a massive public education campaign.That is the most important thing we could ever do in terms of reversing the swelling tide that threatens to drown us.

Or used in the lawsuits to come :)

I've been around the Libertarian movement since the early 80's and this isn't to promote that - just to show where I think a lot of 'movement' has taken place. I've contributed to the Cato Institute, Atlas Society - belonged to the Libertarian Party at one point and many other venues.

The Institute for Justice (think: an ACLU with a libertarian viewpoint - ie all rights, instead of just speech and press) has made great strides via lawsuits. They sued Donald Trump who was attempting to grab a neighborhood near his Taj Mahal in Atlantic City for a parking lot, taking, by 'eminent domain', homes that were in some cases 3 generations deep who didn't want to move. And IJ won that case. There are many other similar cases - taxis in Nevada, cornrow stylists, flower arrangers - all who were stopped by guilds, unions and ties to local gov'ts - all lost to IJ on Constitutional grounds. Even the one case they lost - the "Kelo" case in New London Conn. the backlash from that decision got laws passed against gov't trying to use people's property for private companies (not public use as the Fifth Amendment requires) they think will create a bigger tax base.

IMO, while the Cato Institute has done much to 'educate' people, IJ gets the job done. That doesn't mean we should stop education - that's essential as well but winning a case sets a precedent that is hard to overturn. And sometimes even losing creates more education as in Kelo.

As a side note - one big money guy threatened to take by eminent domain, Justice Souter's house and build a casino - using the same reasoning Souter used in his supporting argument for the local gov't to take the old houses for the construction of a new condo unit in New London :)
 
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Nate760

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Seriously, if the vaping community could put together this kind of money, it would be better spent on a massive public education campaign

Billboards. Big, forcefully worded, fact-stating billboards next to major freeways (or highways, or thruways, depending on your regional vernacular).

If we're going to wrest control of the narrative from BG/BP/BT/BPH, it's going to require acts that are big and bold, and maximally cost effective.
 
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