Tobacco Harm Reduction Advocates and CASAA confront FDA and its TPSAC about risks of different tobacco/nicotine products

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Vocalek

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There's no safe form of driving, either. (Every time you are driving or in a moving car there are risks.) Therefore, by the ACS's standards of safety, driving sober is not a safe alternative to driving drunk.

Can you just imagine if someone tried sending THAT message to the public??

I love that analogy. I really love it. :laugh:

Maybe I will make a badge out of that slogan and wear it at the SRNT conference. :D
 

DC2

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Bill Godshall

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rothenbj inquired:

Where do these figures come from? Many experienced snus and nasal snuff users have diverted their purchases overseas, due to the lack of quality product in the US. Even with the deterrent posed by PACT forcing all shipping costs to rise tremendously and the need for adult signature, the dedicated user has worked around these issues. Are these offshore purchases accounted for or lost in the process of determining usage?

Most of the data I provided about consumption changes in various tobacco products is official US government tobacco consumption data for taxed tobacco products (except for the snus data that was from RJ Reynolds, and the e-cigarette data).

The consumption data I provided in my testimony doesn't include contraband tobacco products.
 

ByStander1

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There's no safe form of driving, either. (Every time you are driving or in a moving car there are risks.) Therefore, by the ACS's standards of safety, driving sober is not a safe alternative to driving drunk.

Can you just imagine if someone tried sending THAT message to the public??

Fabulous!!!

yep, that's going in my lit!
 

LeAnn

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My question is simple, if they want to outlaw e-cigs, why aren't they outlawing analog cigarettes? I know there are some complicated issues but shouldn't we be putting that out ther for the public to chew on. Yes I know what happpened to liquor with proabition but to outlaw a product to help smokers and let the smokers keep killing themselves is an issue in itself, and liquor should have stayed ban also, it would have save many a lives too! That's just my 60 year old opinion:closedeyes:
 

TennDave

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My question is simple, if they want to outlaw e-cigs, why aren't they outlawing analog cigarettes?
Very simple- smoking cigarettes already has a long history and is confirmed to kill the user. They are not quite sure about e-cigs yet (so they say)- if they will do the same. Certainly, they are apt to approve a product that will help Big Pharma- however, one or two exploding PV's occasionally doesn't help Big Pharma at all.
 

kristin

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My question is simple, if they want to outlaw e-cigs, why aren't they outlawing analog cigarettes? I know there are some complicated issues but shouldn't we be putting that out ther for the public to chew on. Yes I know what happpened to liquor with proabition but to outlaw a product to help smokers and let the smokers keep killing themselves is an issue in itself, and liquor should have stayed ban also, it would have save many a lives too! That's just my 60 year old opinion:closedeyes:

Because it's a money train - or more accurately, a money merry-go-round. Big Tobacco, Big Pharma, Big Health and Big Government all make too much money off of smokers. They tried to ban cigarette sales in North Dakota in 2003 and the ANTZ actually opposed the bill. They came right out and said that it would affect their finances:

There's no evidence banning tobacco would prevent and reduce tobacco use because no such approach has been implemented, the groups argued. The ban also could take away certain funding for these groups for tobacco control programs.

You might find this article interesting, too: The sweet deal between Big Pharma and Big Tobacco
 

Hummingbird

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I just want to say THANK YOU to Bill, Elaine, Kristin and any/everyone else evolved in these efforts. I admire your persistence and your superhuman ability to tolerate zealots, bureaucrats and regulators. My hat is off to all of you.

Now I need to get out my wallet and send some funds to CASAA.



Oban, I could not agree more! Nicely stated! I too would like to thank you all!
 

Bill Godshall

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The archived webcast of the March 1, 2012 FDA TPSAC meeting can be seen/heard at:
https://collaboration.fda.gov/p30903822/

If you cannot access that site directly, go to
March 1-2, 2012 - Tobacco Products Scientific Advisory Committee Meeting Announcement
and click on the webcast of the meeting.

The public comment period begins at 14 minutes into the recording.
The four public speakers were CASAA's Elaine Keller, Smokefree Pennsylvania's Bill Godshall, RJ Reynolds' Mike Ogden, and Altria's James Dillard.

TPSAC's report on dissolvable tobacco products must (by law) be published by March 23, which is next week.
 

EJH

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http://www.fda.gov/downloads/Adviso...uctsScientificAdvisoryCommittee/UCM295842.pdf

"Following this [March 1] meeting a summary was prepared and reviewed by the TPSAC on March 1 and revised based on these discussions before approval on March 1, 2012."

After a first read, it seems to me that TPSAC is kicking the can down the road, with a lot of 'we don't know at this time' and 'we can't say with the current evidence.'

But a couple of definitive statements stood out to me:

From the section Key Findings from the Evidence Review:
- "Available data for some products show delivery to users of lower amounts of nicotine and TSNAs than are delivered by cigarettes."

- "Cessation: Evidence considered by the TPSAC suggests that use of DTPs may reduce cigarette consumption, but does not completely substitute for smoking in most regular cigarette smokers."

- "Health risk: Based on understanding of the delivery of toxins to cigarette smokers, exclusive use of DTPs should be less hazardous than regular smoking of cigarettes now marketed in the United States."

- "Childhood poisoning: Studies in the literature indicate that to date there have been few accidental ingestions with serious consequences."

For myself, the quote below was particularly interesting: (my emphasis added in bold)

With regard to benefit, the TPSAC concludes that exclusive use of DTPs by an individual would greatly reduce risk for smoking caused disease compared with regular use of cigarettes. The TPSAC framework indicates several ways that DTPs could reduce the population disease burden caused by tobacco use: 1) decreasing the number of smokers, if availability of DTPs increases successful cessation or decreases the likelihood of initiation and use of smoked products, and 2) decreasing the risk of tobacco caused disease, if availability of DTPs sufficiently reduces cigarette smoking.
 

kristin

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"Cessation: Evidence considered by the TPSAC suggests that use of DTPs may reduce cigarette consumption, but does not completely substitute for smoking in most regular cigarette smokers."

I heard them working this one. The irony is that they took the fact that some research showed most smokers weren't switching as evidence that most smokers wouldn't switch, but didn't take into account that most smokers are still under the mistaken belief that smoke-free is just as dangerous as smoking (so why switch when you enjoy smoking?)

With regard to benefit, the TPSAC concludes that exclusive use of DTPs by an individual would greatly reduce risk for smoking caused disease compared with regular use of cigarettes. The TPSAC framework indicates several ways that DTPs could reduce the population disease burden caused by tobacco use: 1) decreasing the number of smokers, if availability of DTPs increases successful cessation or decreases the likelihood of initiation and use of smoked products, and 2) decreasing the risk of tobacco caused disease, if availability of DTPs sufficiently reduces cigarette smoking.

This is the one I thought could be huge for CASAA Call to Actions - especially in blocking excessive taxation that has been popping up. This supports the argument that smoke-free reduces risks associated with smoking and therefore counters the argument that smoke-free tobacco products should be taxed at the same punitive rate as cigarettes. If something is reducing "the population disease burden" then it should not be treated the same as cigarettes. Additionally, this statement suggests that, in order to be successful in reducing diseases, smoke-free needs to be available and smokers need to be encouraged to switch. This would aid in blocking all-out sales bans on smoke-free tobacco products and also argues for ending the deceptive practice of denying the public information about the reduced risks (ie. requiring manufacturers to tell smokers that smoke-free is not a safe alternative to smoking without admitting the significantly reduced risks.)
 
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NorthOfAtlanta

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This is the one I thought could be huge for CASAA Call to Actions - especially in blocking excessive taxation that has been popping up. This supports the argument that smoke-free reduces risks associated with smoking and therefore counters the argument that smoke-free tobacco products should be taxed at the same punitive rate as cigarettes. If something is reducing "the population disease burden" then it should not be treated the same as cigarettes. Additionally, this statement suggests that, in order to be successful in reducing diseases, smoke-free needs to be available and smokers need to be encouraged to switch. This would aid in blocking all-out sales bans on smoke-free tobacco products and also argues for ending the deceptive practice of denying the public information about the reduced risks (ie. requiring manufacturers to tell smokers that smoke-free is not a safe alternative to smoking without admitting the significantly reduced risks.)

That was my quick thought on this, it's almost a 180 deg turn around from the propaganda that the FDA and the ANTZ have been feeding the public for a long time. Going to be nice to have this to show people when they throw up the 2009 FDA BS.
 

sailorman

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First they put in this statement: (my bold)

With regard to benefit, the TPSAC concludes that exclusive use of DTPs by an individual would greatly reduce risk for smoking caused disease compared with regular use of cigarettes. The TPSAC framework indicates several ways that DTPs could reduce the population disease burden caused by tobacco use: 1) decreasing the number of smokers, if availability of DTPs increases successful cessation or decreases the likelihood of initiation and use of smoked products, and 2) decreasing the risk of tobacco caused disease, if availability of DTPs sufficiently reduces cigarette smoking.

Then, at the demand of a member who insisted on a symmetry that doesn't exist, they write (again, my bold)

The TPSAC framework indicatesseveral ways that DTPs could increase the population disease burden caused by tobacco use: 1) increase the number of smokers, if availability of DTPs decreases successful cessation or increases the likelihood of initiation and use of smoked products.

As hard as that member tried, he couldn't quite persuade the chairman to agree that the use of DTPs could actually cause smokers to smoke more cigarettes, so they had to scrap #2 in this version. In the interests of creating the appearance of symmetry, where symmetry doesn't exist, the report is left in the position of defining one way as "several" ways.

Throughout their report, they continued to used the term "tobacco related" or "tobacco cause" disease despite Lautenbuach's reminder that this was inaccurate. Only when Lautenbach(sp?) insisted that they change a phrase from " tobacco related" to "smoking related" did they relent. Nonetheless, he couldn't, or chose not to, continue to correct them and the final report ended up perpetuating the propaganda meme that all tobacco products caused disease and preserved the myth of "tobacco related disease".

The chair seemed the most reasonable voting member and I shudder to think what the report would have contained if he had not reined in the guy to his right.

The discussion about Snus was particularly telling in demonstrating the extreme bias of the member to the right of the chair who kept insisting, despite all logic, that no health benefit could be realized without completely substituting snus for smoking. When they tried to write that total substitution was necessary to realize maximum benefits, he objected, insisting that a doctor who testified said otherwise. He was forced to concede that smoking is the most harmful form of tobacco consumption yet. Despite that, he chose to make the case that someone who used 50 snus and smoked one cigarette a day experienced no health benefits over someone who smoked 50 cigs and used one snus. How did he rationalize that? Because a doctor had said that the health benefits observed in the Swedish experience were based on full smoking cessation and substitution with snus.

That was the most egregious case of someone allowing his bias to overrule simple third grade logic that I've ever seen.

This report is garbage. Every shred of evidence that DTPs were less harmful than smoking was couched in warnings and declarations that not enough is known. Every time they were forced to concede that DTPs were less harmful than cigarettes, they insisted on hypothesizing about DTPs discouraging total nicotine cessation. Harm reduction wasn't good enough, no matter how much reduction was at stake. 99% harm reduction doesn't justify the off-chance that someone might be dissuaded from quitting nicotine altogether.

Their final recommendations sounded like a laundry list of requirements to approve a new pharmaceutical. No food company would be subject to those kind of requirements. No food additives have been so scrutinized. No genetically modified foods would have to be so throughly analyzed. If the FDA accepts these recommendations, and imposes similar requirements on e-cigs and juices, you can kiss vaping goodbye.
 
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rothenbj

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I wonder how he'd view someone who smoked 50 cigarettes a day before and now 4-5 snus portions and a ml of nicquid every couple days with no cigarettes for over 2 years? Probably one moment from picking up my next cigarette (if he can just figure a way to discourage use of those other products.
 
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