Thursday, April 29, 2010

Anti-smoker propaganda from Harvard professor?

To help compensate for declining cigarette sales, RJ Reynolds Tobacco introduced several new smokeless tobacco products. They include Camel Orbs, which come in the form of a pellet designed to “melt in the mouth", Camel Sticks, a twisted stick the size of a toothpick and Camel Strips, a dissolvable film strip which is placed on the tongue. All include various concentrations of nicotine. And, sales are restricted to adults.

Advertised as a cigarette substitute which can be enjoyed “anywhere, anytime and anyplace”, these new nicotine delivery products have raised the ire of hypocritical anti-smoker bigots who claim the new products are being marketed to children. Dr. Jonathan Winickoff contends: “the tobacco industry was creating novel products partly to entice and addict a new generation of smokers to replace those who die”. Dr. Winickoff had his first fifteen minutes of fame as the inventor of third hand smoke.

The anti-smoker brigade also claims that Orbs pose special risks to young children who may be poisoned by ingesting the pellets and the nicotine which they contain. And, of course, they have a scientific study to prove it.

The study was conducted by Gregory N. Connolly, a professor with the Harvard School of Public Health and was published on-line by
Pediatrics (The official journal of the American Association of Pediatrics).

But, Connelly's peer reviewed and published study is a masterpiece of misdirection and propaganda.

From the study abstract: “This study examines child poisonings resulting from ingestion of tobacco products throughout the nation and assesses the potential toxicity of novel smokeless tobacco products, which are of concern with their discreet form, candy-like appearance, and added flavorings that may be attractive to young children.”

From the beginning, there is an attempt to link Orbs with accidental child poisonings from the ingestion of “tobacco products”. The inference is that a substantial number of these child poisonings resulted from ingestion of Orbs or similar “novel” products because of their “candy-like” appearance. But, the study itself shows nothing of the kind.

The study continues its effort to link child poisonings with Orbs, with the “results” of the study: “Smokeless tobacco products were the second most common tobacco products ingested by children, after cigarettes, and represented an increasing proportion of tobacco ingestions with each year of age from 0 to 5 years (odds ratio: 1.94 [95% confidence interval: 1.86 –2.03]). A novel, dissolvable, smokeless tobacco product with discreet form, candy-like appearance, and added flavorings was found to contain an average of 0.83 mg of nicotine per pellet, with an average pH of 7.9, which resulted in an average of 42% of the nicotine in the un-ionized form”. Huh?

First, they cite statistics on child poisoning due to smokeless tobacco products, then follow immediately with a scientific analysis of the nicotine content of Orbs. A deliberate attempt to link the two?

But, the study data could not possibly include Orbs or any of the other recent smokeless products. The study was based on data retrieved from 2006 to 2008, before RJ Reynolds began to test market their new product line in 2009. Linking the study data on child poisoning with the nicotine content of Orbs is deceptive and misleading. It deliberately infers that one is the cause of the other. And that is simply not true.

Child poisoning from the ingestion of tobacco products broke down like this: cigarettes – 77% (10,573); smokeless tobacco products – 13% (1,768); cigars -1% (167); other/unknown – 9% (1,197). No deaths were reported. Just to put those numbers into context, in 2006,
poison control centers in the US reported about two million unintentional poisoning or poison exposure cases with 703,702 emergency department (ED) visits. And, In 2005, there were 23,618 unintentional deaths from poisoning.

And, smokeless tobacco products are not defined in the study? Are they talking about chewing tobacco? Snuff? Snus? Why is the reader misled to believe that it includes Camel Orbs and other “novel” products? And, what in hell is the other/unknown category? If it's unknown, how do they know the poisoning was caused by a tobacco product?

The study concludes: “In light of the novelty and potential harm of dissolvable nicotine products, public health authorities are advised to study these products to determine the appropriate regulatory approach.” Uh-huh.

But, the only evidence that “dissolvable nicotine products” like Camel Orbs represent a hazard is this: “At least 1 case of ingestion of Orbs by a 3-year-old child (Oregon Poison Control Center, personal written and oral communication, July 27, 2009) and 2 cases of mild poisonings in children 2 and 3 years of age resulting from ingestion of snus . . .”

That's right folks. Only one reported case of child poisoning from Orbs since it's release a year ago. (And, since they singled out two cases of child poisoning from snus, should we assume snus was not included under smokeless tobacco products in the study data?)

The study notes that Orbs come in “child-proof” containers, but dismisses the fact as irrelevant ” . . . adults might take multiple pellets out of the container for convenience and unknowingly leave them where infants or children might find and ingest them.” Uh-huh.

But, they ignore similar pharmaceutical products like the Commit lozenge and the new Nicorette Mini Lozenge which also come in flavoured, candy-like form and contain similar amounts of nicotine. Are these somehow less hazardous because they're sold by the drug companies?

Why blame the tobacco companies for the empty-headed behaviour of a few parents? Like leaving cigarettes or ashtrays full of butts around where inquisitive toddlers and young children can get at them. Are they equally nonchalant about common household cleaning agents and prescription (or over-the-counter) medications?

Connelly is quoted in the New York Times as saying:
“Nicotine is a highly addictive drug, and to make it look like a piece of candy is recklessly playing with the health of children.”

He may be right. But . . . disguising bullshit and bafflegab as legitimate science is no less disingenuous or dangerous.

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