More bans, confusing research, incurable drug rage and a deadly message to smokers. Tobaksfakta's first newsletter of the season adds nothing new. But what does it matter? Scary headlines are to be expected.
This is an opinion piece. Do you think differently? Please comment below.
The summer is over.
No, it's not about the weather, or schools starting, or traffic jams and congestion on the way to work.It's all about the news flow. The staff of the lobby organizations have now started their campaigns. A few weeks before the parliament opens, the headlines start to pour in the emails.
The clearest example of this is the first newsletter of the season from think tank Tobaksfakta.
Tax-funded organization
Tobaksfakta is a lobbying organization funded by the Public Health Agency of Sweden. Its mission is to influence legislation and frameworks on nicotine, which in turn governs the activities of the said authority and ultimately determines how much money should go to "tobacco prevention", that is, to Tobaksfakta's activities. Fantastic set-up. Tobacco Facts, together with the team professional and community associations who controls the activity, 6 million each year by the Public Health Agency, directly, without any political intermediaries, to do the job.
Apart from the fact that it involves tax money journalists should prick up their ears; this is close to what many would call propaganda. Nevertheless, it is part of the debate on nicotine and smoking, and the newsworthiness lies in the underlying message rather than the direct content of the articles.
Pregnant mice like vejpar
Tobaksfakta's first newsletter of the season is, not surprisingly, a delight for anyone who genuinely dislikes developments in the nicotine market. The message is that e-cigarettes, snus, nicotine pouches are dangerous and completely unnecessary products that serve no practical purpose whatsoever.
It starts strongly, with an article on aA study suggesting that e-cigarette use during pregnancy negatively affects fetal development.
Is it interesting? Of course it is. This is worrying because most people know that quitting smoking is difficult and that many people actually use nicotine to help them quit. This of course also applies to pregnant women. But is the study worth writing about?
Well, yes.
It turns out that the study is done on mice.
Mouse studies are very unreliable in determining the risks to humans. They can, and at most should, give an indication of what we should research further. The hypothesis is whether e-cigarettes affect the unborn child and whether this poses a risk to the child's health. This information is very important at a time when many people are using e-cigarettes (or snus) to stay smoke-free.
Risks are not even measurable
In this case, the hypothesis has actually been tested more than once. And it has been done via randomized control trials with humans. Two independent studies concluded that when e-cigarettes are used for smoking cessation in pregnancy, fetal development does not differ from that of non-smokers (unlike smoking, where the risk of harm is imminent). However, nicotine replacement therapy is very effective in keeping the pregnant woman smoke-free, far more effective than nicotine replacement therapy.
Smoking is very harmful to the development of the child. Researchers therefore conclude that the combination of effectiveness in smoking cessation and low risk to the child means that the benefits far outweigh any risks. Vejpkollen wrote about one such study just one week ago. Further a study on this was published a few years ago.
The danger lies in the message
The somewhat nasty comment is that the only thing we learn from that study in Tobaksfakta newsletter is that mice should not vejpake when pregnant. And that smokers should consider both nicotine replacement therapy or e-cigarettes if nothing else works to stay smoke-free.
But that journalists will be critical of this kind of research is far from obvious, and the lobbyists at Tobaksfakta know it. I'm guessing that other media outlets will be gobbling up this study like hungry perch. We are unlikely to see any nuances. Why would Tobacco Fact highlight something that goes against their agenda?
The question is, what message does Tobaksfakta really want to send to pregnant smokers? Or to those who barely keep smoke-free with the help of snus, e-cigarettes or nicotine pouches during pregnancy? The risk of them falling back into smoking is indeed imminent. But the user perspective is completely absent from Tobaksfakta's fierce war against non-medicalized nicotine.
'Unnecessary products' and bans
Much of the news flow on nicotine in Sweden has for some time been directly linked to Tobaksfakta. They not only provide "news" but also suitable interviewees for the media. It is very often the same people who make statements in articles on the subject around the country. It is all too often doctors and civil servants, who are close to the organization, act as "experts" when needed. Strikingly, they often say exactly the same things about the 'problems' with nicotine today and the measures that should be taken.
Tobacco Fact's solution to the nicotine issue? Prohibition and tighter regulation. All nicotine should be removed, or at least medicalized (via nicotine medication and treatment). This is also made clear in the newsletter.
With a snazzy PR image on the Public Health Agency Secretary General Karin Tegmark Wisell, Tobaksfakta proposes that all nicotine products (except pharmaceutical parts) should be treated as cigarettes - with taxes, flavor bans and the whole paternity thing. After all, these are "unnecessary products" that are also deadly for babies. For smokers who want to quit smoking, there are already proven medicines available.
Now, this isn't exactly news. Vejpkollen has reported on the Public Health Agency attitude to the nicotine issue on several occasions. But it is striking how stubbornly organizations like Tobaksfakta continue to push the issue - especially as it is no longer about smoking but about all nicotine. It seems even more strange when Swedish politicians have already taken a clear position in the other direction: they want harm reduction instead of more restrictions. A majority in Parliament wants products such as snus and e-cigarettes to reduce the harm from nicotine use - as substitutes for cigarettes and smoking.
Perhaps someone should react to the fact that Tobaksfakta actually spends millions of tax dollars to counteract this development?
Studies dating back 10 years
Tobacco Facts finally lets a chronicling doctor tell the reader that snus does not work for smoking cessation. She bases her analysis on a Norwegian study, where statistical data showed that snus use (mostly among women - who made up over 70% of the test group) was not associated with smoking cessation. Oh shit, says the news nose. Worth an article?
Well, yes.
It turns out that the study is based on statistical data from 2010 - 2012. i.e. information that is over ten years old. Somewhere in there the news value disappears.
The doctor has (consciously or unconsciously) chosen not to note that a lot has actually happened in the nicotine market in Norway (and the rest of the world) since 2010. Such as new raspberry-flavored nicotine pouches becoming established on the market, the popularity of these products, and the fact that smoking in Norway has decreased drastically over the past five years, especially among young women who use snus?
The study is so fundamentally irrelevant that it should be left to any decent thinking doctor to furrow their brow.
It will be interesting to see if any journalist bother, or take the time, to review the actual content of the study, beyond the inflammatory press release?
Snus and lobbying
Speaking of snus in Norway.
Vejpkollen, and indeed several Norwegian media outlets, have reported on several studies in recent years showing that snus is the most successful method to quit smoking in the country. This is in competition with the cold turkey method (which most smokers try at least once in their lives - sometimes several times...). From the Norwegian authorities, there is little doubt that the development of new nicotine products in recent years has an impact on the use of cigarettes. Smoking has declined as snus use has increased, particularly among young people, but also among Norwegian adults.
You can think what you like about this. But it can be reported on without falling into a black and white pattern, where the use of nicotine is only about profit for the tobacco companies and children attracted by sweet tastes. We wish more media would take the time to scratch the surface and look at the reality underneath.
What is the purpose?
Tobaksfakta is an umbrella organization. It brings together doctors, psychologists, nurses, teachers and anti-tobacco santas, as well as other professional associations. They all have a common agenda: to reduce access to nicotine and are working, more or less consciously, to bring this market under the Medicines Act. Banning the products that smokers insist on like more than nicotine gum, sprays, tablets and patches. are means that justify the ends. Is it the case that pharmaceutical companies sponsor Tobacco Facts and their partners? Probably. But it is difficult to track donations or to measure the value of conferences, career opportunities and networking with influential business contacts. What is true is that Tobacco Facts' message is aligned with strong business interests. Perhaps it should be given more attention.
Business as usual
Smoking claims lives every day. If smokers, or would-be smokers, can learn to use less dangerous ways of using nicotine, it can save lives. But the message from Tobacco Facts is clear:
"It doesn't matter how you use nicotine. Nicotine is also dangerous and you are just trading one dangerous addiction for another. You don't want that, do you?" This is a line of reasoning that has trickled down through doctors and health professionals to smokers. It has become a mantra, frequently recurring in Facebook comment sections, both under Vejpkollen's posts and in stop smoking groups. It comes strikingly often from smokers, who for various reasons are unable to quit smoking. Harm reduction (e-cigs, snus, nicotine pouches) is not high on the agenda. Ignorance is rife. I can only conclude that this attitude has not spread by itself. Mn Tobaksfakta's good memory, it is "business as usual" in the death factory.
An autumn full of control
Tobaksfakta's first news roundup is the start of an eventful fall. Not only in Sweden. The WHO is holding a major meeting in November (COP10) to develop the future tobacco convention - a global agreement that affects legislation worldwide. It is the tenth such meeting since 2004. User associations and company representatives are barred from the meeting, but organizations like Tobaksfakta are welcomed with open arms. Who else will be there representing Sweden? Probably people from the same department at the Public Health Agency that happily funds Tobaksfakta. Many fear that the WHO will be tougher on both e-cigs and nicotine pouches than it is on smoking tobacco and medicines in future convention texts.
Furthermore, we plan to EU horizontal regulation of nicotine pouches - something that does not bode well for either prices or flavors. Here too, the influence of Sweden's most governmental lobby organization is strong. But who cares about that?
Vejpkollen will of course keep an eye on COP10, the EU and Tobacco Facts - as usual from a user perspective - and always with a critical eye.
Have a nice fall!
Stefan Mathisson
Editor-in-chief and publisher in charge
Roadkollen.se
