Doctor and activist


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Category: Tobacco/Vaping

Please Write Submission re Vaping by 16 January

28 December 2022

Vaping is now own by tobacco companies who are following exactly the same path as they did with tobacco. They managed to get out of having to prove it was safe because a few naive doctors, still fight the tobacco wars said it was ‘better than tobacco’, an incredibly low bar to clear- not really a bar at all.

Then they said it could be used to quit, and a handful of doctors who made a living from Quit clinics when 99% of people quitting just do so, supported this. Now it is being marketed in new ways to that the adds are not visible to those who are likely to oppose vaping and the habit is growing hugely, with the Industry also using peer-to-peer marketing to evade and futures regulations or prohibitions.

Vaping is now more of a gateway to smoking than a path from it, and that suits the Industry just fine.

It is likely that the solvents will be harmful in the long term, so the precauti0onaly principle would mean that it should be banned until it is proven safe, which is frankly unlikely.

In London there is now a coffee shop that advertises Vaping and Coffee’ which assumes that indoor vaping is not smoking and will be tolerated by non-vapers. Presumably they will resists vaping controls indoors until passive vaping is shown to be harmful and tat might take 30 or 40 years- a total tobacco epidemic re-run. So please write a submission to the inquiry.

 

smh.com.au

Now here’s a deadline: We have until January 16 to help stop toxic vaping

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British American Tobacco launches new Campaign to legitimise Vaping.

23 November 2022

Almost all the vaping products are owned by tobacco companies, and the marketing is almost a re-run of their tobacco campaigns. i.e:

1. Assume that it is here to stay, and hence legitimate and unstoppable.
2. Suggest that ‘courtesy and consideration’ is all that is needed.
3. Fight regulation as much as possible.

Naturally they are keen to say that any attempt to restrict nicotine is doomed to failure as it is already totally available on the Black Market.

It might be noted that when there were different regulations in Canada from the US for tobacco labelling, cigarettes were smuggled through the Indian reservations, and all labelling that used to allow the source of the cigarettes to be identified was removed from the packaging, which showed what contempt the tobacco industry had for regulations that lessened their sales.

We might expect that similar things are happening in sales of vaping products and liquids. Naturally as they talk about how hopeless it is to regulate vaping products they want to hark back to the failure of alcohol prohibition in the 1930s, which led to Al Capone and his gangsters.

Older folk will remember that as the tobacco control movement grew stronger in the late 1970s we were attacked as ‘wowsers’ and ‘killjoys’, with the implication that we were stopping people having a good time, which was what smoking was all about. It is the same tactic again. We want to stop all the happy vapers.

The tobacco industry used the fact that some doctors think that vaping can help people QUIT to allow them to sell their product without having to prove it was safe. They only had to prove it was less dangerous than tobacco- a very very low bar.

Now vaping is used more as a gateway to smoking than a path from it, and often if there is nicotine in the vape it can be used alternately as a substitute. So presumably will be a move to push vaping in smoke-free areas. Then vaping will be the ideal product for the tobacco industry, being used everywhere, helping consumption, and keeping some people smoking at other times. Just like the good old days.

Health interests have to keep the government onside, but also demand some serious anti-vaping campaigns.

Vaping uses solvents, which dissolve fats. If this is the case, it is like upmarket petrol sniffing, as it will dissolves cell membranes, especially in the brain, which has the highest blood supply of any fatty tissue in the body. This is likely to lead to gradually progressive dementia. Naturally this may take years to manifest, and even longer to be identified and scientifically proven, given that a highly sceptical Industry that will criticise the research; in short a re-run of the tobacco wars.

If we look at the history of tobacco, it was used in relatively small quantities until the invention of the cigarette rolling machine by Duke in 1898. It was massively marketed during and after WW1 from 1914. It was shown to cause lung cancer in 1950. Advertising bans started in the mid 1970s, but full sponsorship bans and smoke-free indoor air did not come until 2000. The tobacco epidemic lasted a full century; so watch out for a vaping re-run with a dementia epidemic in older folk. Unlikely? No;. quite possible. So will the tobacco industry prove it is is safe. They can’t, don’t want to; now don’t have to, and have put out this BS new organisation.

www.theaustralian.com.au/the-oz/news/big-tobacco-company-behind-vaping-overhaul/news-story/1078baf2358e5ba3d96c6235aac49610

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BUGA UP Nostalgia

16 November 2022

BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) was most active fro m 1979-1985, and had a big effect on tobacco and smoking. It was also a high point in the demand for advertising to be responsible for the consequences of its use of its products.

In the end, the advertisers accepted a ban on tobacco to keep the threat of stronger regulation at bay. They cut back on sexism a bit and the movement to regulate them died down. So alcohol, gambling annd junk food ads have survived.

Here is a link to some of the TV programs from that time and a little after.

www.youtube.com/user/BUGAUPTube

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Submission to Inquiry into Online Gambling

11 November 2022

Dr Arthur Chesterfield-Evans

The Internet Problem

The issue of online Gambling is similar to many problems in that online gambling involves an area of activity that is largely beyond the direct control of the Australian Parliaments, or indeed any single Parliament.  The internet was designed to be anarchic, and so it is.

Programs to deal with gambling regulation are thus ineffective, but the limited terms of reference of this inquiry suggests that governments are not thinking in terms of what they can do at a systemic and global level and are turning instead to a focus on the individual.

Need for an Industry focus rather than an Individual Focus

It must be noted that where creating public health problems benefits an Industry, the response must be against that Industry.  Concentrating on individuals while the Industry markets to the world is a very inefficient strategy.  To use a historical example, the Tobacco Industry marketed with ubiquitous ads, sponsorships, product placements and many other techniques, yet wanted medical professionals and school education to be the only techniques used against them, framing the issue as personal choice (and responsibility) and ‘smokers v. non-smokers’ requiring courtesy (and no criticism and restrictions).

This is the situation that the Gambling Industry is in now. They demand to be able to market to the world, but want all harm minimisation programs directed at individuals.  They know that this is a winning strategy for them.

What the Federal Government Can Do

While it is true that the Australian Federal government has no effective jurisdiction over the internet, and does not licence or control the Hotels, Clubs and Casinos with their poker machines, it has control over Australian media advertising laws and also allocates grants to States.  The Federal government could ban all Gambling advertising on electronic media in Australia, and lessen grants to States in proportion to their revenue from Gambling. This would stop the States getting any benefit from gambling revenue, which they rely on quite highly.  Western Australia, which is missing out on Gambling revenue would certainly support this.

The ban on tobacco advertising and sponsorship has set a precedent for action on public health issues, and there was censorship of certain opinions that were antithetical to a national COVID strategy, so the idea of a ban on Gambling advertising is not new or radical.  VicHealth also replaced tobacco advertising with ads for healthy lifestyles and anti-Gambling advertising could replace ads for Gambling. The protest group, BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) in the 1980s used satire of tobacco advertising to sharpen the focus on the Tobacco Industry’s absurd imagery and callous disregard for the lives of their customers.  They won hearts for their Robin Hood approach to the entrenched power of the Tobacco Industry and set the world standard for action against tobacco, because compared to their actions, everything else became ‘moderate’.  But less recognised than their billboard campaign  was the re-framing of the debate from ‘smokers v non-smokers’ and ‘personal choice’, to a ‘Tobacco Industry campaign to make a profit even though it kills people’.  This reframing in the public mind allowed governments to stand up to the Tobacco Industry and forced political parties to eschew their donations (at least publicly).. 

Gambling Industry Strategy

The Gambling Industry’s ads are very clever, appearing to take the loser’s side to identify with (usually) him and dangle the prospect of a win, though of course this is statistically impossible in the medium term. They are perverting the idea of ‘mateship’ to a group Gambling session with a cheery comparison of who they are backing as they watch sport.  This would be very vulnerable to a satiric response, based on a commiseration as to which mug lost the most and a final comment that ‘gamblers are losers’.

Laissez-faire v. Health

The Federal government is responsible for the health of Australians and with an increasing percentage of health problems being related to lifestyle choices, the government cannot simply ‘leave health to the market’.  ‘The market’ will sell anything that makes money irrespective of whether it has good health outcomes or not, so leaving the national wellbeing to ‘the market’ is a highly flawed strategy as the government in the end picks up the tab for all problems. The Federal government should unashamedly promote sales and practices that are good for health and discourage things that are not.

Encouraging good personal decisions

Any reasonable management textbook will say that the best way to manage things is to have good decisions made at the lowest possible level within the organisation. Yet gambling advertising uses distractions and dreams of riches that are statistically extremely unlikely to encourage people to gamble, and thus not use their money wisely. If the ads said ‘Do not contribute to superannuation’, ‘Do not save’, Do not worry if you do not have enough money to feed your kids’, there would be a huge outcry.  Yet this is the outcome with a large percentage of gambling money received being from people who cannot really afford it.  The social problems created take an immense amount of effort from government and NGO charitable organisations to try to rectify them. Often they cannot.  This problem is entirely created because of bad decisions on gambling made by people who the Gambling Industry has conned.  It is exactly like people taking up smoking. It was portrayed as a bit of harmless pleasure, but when people were hooked, it did them immense harm.  Gambling is the same.

Need for Gambling Research

One the other problems of Gambling is that the research is funded by the industry, so its scope and nature are controlled.  The amount of harm that it does is poorly quantified, so that there is little evidence for those opposing Gambling to use in political debate. The lack of evidence and the lack of debate suits the Gambling Industry fine- they are more than happy to continue and extend the status quo.  Given that the Federal government is a major player in cleaning up the social problems created by the Gambling, it should insist that there be well funded research on the social consequences of Gambling, and the nature of this research should not be determined by the Gambling Industry.  The Gambling Industry in Australia is extremely large by world standards, perhaps the largest in the world apart from little enclaves like Monaco or Macau where the money is retained by the State and the social problems are either ignored or assumed to be manifest elsewhere.  The social indices of distress are very high in Las Vegas.  It might be said that the Gambling Industry in Australia is like the gun lobby in the US; it is almost unchallengeable.  This must change, and the Federal government must initiate the change.

Off-line Gambling

It is interesting that the Clubs lobby is under challenge at a state level.  The origin of this is uncertain.  There has always been a lobby against Gambling, and this may have been helped by the rapid rise in the inflation rate which is straining the family budget, particularly of disadvantaged people, who are the ones most affected by Gambling losses.  It is also no doubt helped by the revelations that the Casinos have happily laundered money for organised crime, by-passing their regulatory systems, and being perceived by organised crime as an easier target than foreign jurisdictions.  The public also notice that the Casino boards were well stacked with ex-politicians, who were presumed to be there to smooth the political pathway of the Casinos in their dealing with regulation or (even) enforcement. It might be noted that despite the huge amounts of money being laundered and the findings that the Casinos were not fit to have licences, their share prices have only suffered modestly, showing that everyone knows that eventually their licence will be restored and it will be ‘business as usual’. The public is also well aware that the charade, ‘’I had no idea what was happening’ from the politically connected people at the top, merely leads to a resignation or two, but there is no penalty on the individuals.  An aboriginal youth can go to gaol for petty theft, but laundering billions for organised crime merely leads a Casino director to a sojourn in the yacht club.  While the major political parties have been very reluctant to upset the Hotel and Club industry, as evidenced by the 20 year delay in introducing smoke-free indoor air legislation, the rise of the Teal candidates threatening once safe seats, has pressured the major political parties to take a more ethical stance, and also  blunted the financial advantage that support  from the pubs and clubs lobby gives to their campaigns. 

Online v. Off-line Gambling

But the final possibility for the pressure on the Clubs and Hotels may have come from the Online Gambling lobby. If it is assumed that people who want to gamble will use what is available, there is a real possibility that the lack of poker machines availability in pubs and clubs may lead to an increase in online Gambling.  Supporters of the pubs and clubs are quick to point out that the clubs are non-profit and spend their monies enlarging their premises and providing facilities in Australia, as well as paying at least some tax to State governments. If there were a change towards online Gambling this money would go overseas.  This overlooks the social context of gambling. Playing a poker machine is quite different  from going online, so there is unlikely to be a direct transfer, even if the online experience is made more similar.

Need for Federal Government Action on all Gambling

The lesson for the Federal government, however, is that Gambling must be discouraged at both the pub and club level, and online at the same time. Both have similarly detrimental financial consequences for the players and punters, though the industries are distinct. From the public’s point of view, it is worrying that the terms of reference of this inquiry neglect that issue of Gambling in pubs, clubs and the TAB, as it suggests that these influences have restricted the terms of reference.  The regulation of the internet is also a wider problem, which usually comes into focus with the issues of inflammatory hate speech, medical disinformation, defamation or an aspect of pornography.  Gambling for money should be in a similar category to these and discussed in a similar context.

Recommendations:

  1. The Federal Government should recognise that the Gambling Industry and its power is the reason that Australia has a worse Gambling problem than almost any other developed country and the the Gambling Industry has a hold on Australian politics as strong as the Gun lobby in the USA, and with a detrimental effect that could be of similar magnitude.
  2. The Federal government should take an unequivocal stand that Gambling is harmful in that it encourages poor financial decision-making which puts a strain on the whole welfare system, Federal, State and NGO.
  3. The Federal government should recognise that all forms of Gambling need to be discouraged, pubs, clubs, TAB, on-course and online and this needs to be an unequivocal campaign, similar to Quit or for the necessity for vaccination.
  4. The campaign against Gambling needs to be in schools and have both a mathematical component as part of statistics, and a more practical part looking at online Gambling, and the social institutions which encourage Gambling.
  5. The campaign against Gambling must involve electronic media advertising bans on TV and all advertising and sponsorship.  It must involve active ads against Gambling as well as merely bans on pro-Gambling ads.  It should use satire and be prolonged.
  6. The control of online Gambling should be seen in the context of minimising the harm of the ubiquitous internet, and research on how to lessen Gambling should be pursued with endeavours to lessen other social harms such as child sexual exploitation, bullying, vaccine disinformation, tobacco and vaping advertising and disinformation, hate speech, video games that promote violence and defamation.
  7. The Federal government should fund Gambling research so that the social consequences can be quantified and rational decisions made about the cost-benefit to society.  Gambling research should not be neglected, limited, financed and controlled by the Gambling Industry as is currently the case.
  8. There must be support for people who have a gambling problem. Such services need to be publicised, and destigmatised, as happened for those with mental illness.  However, individual services must not be a substitute for a more systemic industry-focussed approach.
  9. There needs to be  a national register of addicted gamblers to allow better exclusion from gambling facilities. If this were comprehensive, it could be used to prevent addicts losing money online with a caveat emptor for those who took the bets from registered addicts.  The credit card companies could be recruited not to allow Gambling to such addicts and not to honour Gambling debts incurred by registered addicts.
  10. The Federal government should consider family support for addicted gamblers in the same way that child support is available for at risk families.

About the Author

Dr Arthur Chesterfield-Evans is medical doctor, who trained in surgery and became a tobacco-control advocate, then an Australian Democrat MLC in the NSW Upper House. He is currently working as a GP.

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Vaping- A WHO Guide

10 November 2022
The World Health Organisation is trying to lessen vaping, which is now reaching epidemic proportions in young people. The attached article clarifies the tobacco Industry’s gobbledygook, though it is fairly soft on their rapacious marketing.

Social media has allowed the tobacco industry to target children and young people without adults noticing, which is different from the tobacco marketing days, when everyone saw the same ads.

The Industry claims that since vaping is less harmful than smoking, it should be legal, and most importantly that they should not have to prove it is safe. They have achieved this latter, and now because this has allowed them to achieve high sales they have made it hard to ban. They also use a lot of kids marketing to kids, as happens with illicit drugs, to make it harder again.
Of course not very many people use vaping to quit, and it now seems that vaping is a gateway to smoking, and a way of not quitting. But do not expect the Industry to do anything except maximise their profits.
The health interests are ponderously getting their resources together, for a battle that will take a generation or two, if tobacco, asbestos, lead etc are any guide.
www.facebook.com/groups/GlobalTobacco/?multi_permalinks=5906974112658360&notif_id=1668001224984823&notif_t=group_activity&ref

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Belated Federal Govt. Action on Vaping

13 April 2022
The Federal government has made statements to try to lessen vaping especially in children. Health Minister, Greg Hunt has made statements and asked for State help on the issue. This is only days before the Federal government goes into ‘Caretaker’ mode before the election, so can have no real effect. Hunt himself is retiring at the election. Perhaps he is doing his best, but he has been undermined by a determined ‘pro-vaping’ group within the Liberal government, which includes Trent Zimmerman, MP for North Sydney. (One might wonder whether the vaping groups are funding the major parties, as they have significant tobacco company ownership. Presumably this will come out eventually- too late to be relevant)
Vaping has been increasing due to the same sort of marketing that launched tobacco, making it exciting, sexy and rebellious. With the internet, social marketing and ‘social influencers able to be paid and target certain groups, this can happen much more under the radar than in former times. As my son commented recently, ‘People believe what their algorithm feeds them’. Older folk who are not fed the ads do not notice what is happening. But now even student correspondents are complaining that there is so much vaping that the school toilets are polluted.
As one Professor of Medicine commented on Radio National Life matters today, ‘We should not be comparing vaping to smoking, we should be comparing it to breathing fresh air’. Exactly.
There were two articles in the SMH this week, ‘Federal bid to stop children vaping’ by Dana Daniel on 7/4/22 and on 9/4/22 (below).
We can only hope that the vaping members lose their seats and that the new Labor government takes a much more active stance. It is late to act on this, but better late than never.

Greg Hunt urges state governments to stop vapes being sold to children

By Dana Daniel April 9 2022

Health Minister Greg Hunt has written to his state counterparts urging them to halt the illicit sale of e-cigarettes to children, but state health ministers want the federal government to stop them at the border.
Community concern is growing about e-cigarettes in schools as increasing numbers of teenagers take up vaping – despite state laws making it illegal to sell the devices to under-18s, regardless of whether they contain nicotine.
“I ask that you take active steps to enforce these laws by taking action against retailers contravening your laws, for example by selling NVPs to school children,” Mr Hunt wrote in the letter, seen by The Sydney Morning Herald and The Age.
Under Commonwealth law, it has been illegal to import liquid nicotine, unless prescribed by a GP as a smoking cessation aid, for the past six months.
But e-cigarettes and vape juices containing nicotine remain widely available through a black market both online and in retail stores and schools are grappling with an escalating problem.
Mr Hunt’s letter dated March 18 linked to a report in The Age about a five-year-old boy who was hospitalised with breathing difficulties after vaping with his brother and a seven-year-old classmate at school.
In that case, the vape was not alleged to have been sold to a child by a retailer, with the child’s father telling the ABC it belonged to another student’s mother.
Victorian Health Minister Martin Foley hit back on Friday, telling the Age and Herald: “We need more action from the Commonwealth to strengthen e-cigarette regulation at a national level – and we encourage the Morrison Government to get on with it.”
A spokeswoman for NSW Health Minister Brad Hazzard, who is recovering from COVID-19, said a national approach was needed to tackle vaping, which the state had formally requested “on multiple occasions, including during feedback on the new National Tobacco Strategy”.
“The federal government previously tried to get a uniform approach on e-cigarettes, but was met with opposition from supporters of vaping,” the spokeswoman said.
Mr Hazzard had already asked NSW Health to “step up its compliance action” before receiving Mr Hunt’s letter.
“Hopefully, it will be possible for federal compliance to be stepped up to minimise the importation of illegal vaping products.”
The federal health department is finalising the National Tobacco Strategy, a draft of which recommends new restrictions on “the marketing, availability and use of all e-cigarette components in Australia, regardless of their nicotine content”.
Australian Border Force Commissioner Michael Outram told a Senate estimates hearing in February that the ABF had not committed any additional resourcing to the detection and seizure of nicotine vaping products since the ban on importation without a prescription began last October.

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Vaping- the beginnings of a disease description

25/3/22

It seems that the tobacco industry has won the first major vaping battle.  They have succeeded in getting their new product legal, and now they do not have to prove it is safe, the medical world has to prove it unsafe. Progressive elements of the medical profession are describing the diseases caused by vaping.  Its progressive practitioners are also aware of the political aspects of vaping’s progress, though their power in this area is not great.

After my last article on vaping Anne Jones, who used to run ASH (Action on Smoking and Health,) sent me a significant lecture by Prof Andy Bush, from the Brompton Hospital.  (Brompton is probably the most prestigious hospital for respiratory diseases in Britain). 

The 45 minute lecture is quite medical/technical and as such quite hard going, but it is interesting in that it combines very detailed medical aspects with an astute analysis of the political and economic significance of vaping.  As a student I was subjected to endless lectures on the harm of tobacco without any consideration of the political aspects of its political cause or prevention.  As Prof Bush himself says, ‘Fool me once, shame on you.  Fool me twice, shame on me’.

He points out the similarities between smoking and vaping, but also the differences.  There is something of a nightmare of acronyms, so I will help where I can.

Currently vaping is being marketed using the same symbols of success as was used before tobacco had any restrictions  on it, freedom, rebellion and glamour.  The difference is that it now uses social media to market to CYPs (Children and Young People). BAT has spent a Billion pounds on social influencers.  Although vaping is supposedly allowed to help people get off tobacco, the marketing to kids is to those who do not smoke anyway, so clearly it either a gateway drug to smoking or an entirely separate habit to be fostered and developed. 

He points out that the tobacco industry has taken over the major vaping brands.  VUSE is owned by RJR, who were R.J.Reynolds Tobacco.  VYPE is owned by BAT, British-American Tobacco.  BLU is now owned by Imperial Tobacco, and JUUL is now significantly owned by Altria, the new name for Philip Morris.

If that were not enough, one brand Puffit2 is owned by a company called Discreet Vape Company and the vaping device looks like a Ventolin inhaler!  Philip Morris purchased Vectura, a British pharmaceutical company that manufactures respiratory drug delivery devices, in September 2021. 

ENDS (Electronic Nicotine Delivery Systems) (= vaping devices) deliver chemicals.  Prof Bush points out these chemicals have no information publicly available about their nature and properties. 18 flavours have carcinogenic, tobacco-specific components and there are bacterial and fungal contaminants in a high percentage of vaping products.  These contaminants may have their own ability to generate allergic lung diseases, which are similar to emphysema.   In one case the nicotine was at 120% of the level stated on the pack.

Passive vaping is similar to passive smoking in that the non-vapers get similar levels of nicotine in their urine to passive smokers. 

Vaping is not a gateway to smoking cessation and may even be a gateway to smoking. A study which compared nicotine replacement therapy to vaping showed that while 9% of nicotine replacement patients were off cigarettes after 6 months as opposed to 18% of people using vaping, 80% of the people who had used vaping were still vaping a year later (Hajek et al, NEJM 2019).  If Buprion was used with nicotine replacement the quit rate was 25% at 6 months and 20% in a year.  Varenicycline achieved 27% (Borelli and O’Connor NEJM 2019).  Interestingly, if you pay people to quit, it is a better investment than the drugs!

Vaping has risen rapidly amongst American teens and is currently at 28% and the prevalence of smoking has stopped declining since the vaping rise started. 

Prof Bush’s lecture states that the acute toxicity of vaping is actually worse than cigarettes. Researchers always do an immense amount of work, and doctors struggle to keep abreast of it.  The effect has been measured on foetal lungs, levels of all kinds of proteins, cytokines, chemokines, enzymes, Cell functions, lung pathology, oxygenation levels and from many areas including broncho-alveolar lavage (BAL), (i.e. washing from lungs).  Rat models have also been used to look at emphysema (poor little guys).  It increases their alveolar (lung air sac) size and causes a fall in transcutaneous oxygen levels. This may be due to a lipoid pneumonia due to lipid (fats) being leached out of the lungs.  The negative effects of e-cigarette vapour condensate on macrophages (the cells that fight infection) were similar with or without nicotine in the condensate. The condensate was also more toxic than the e-Cigarette liquid!   (Scott, Thorax 2018).

Vaping has been shown to increase bacterial adherence to epithelial cells which increases susceptibility to infection.  It also considerably worsens the effect of COVID infection.

There are case histories of a 16 year old previously healthy boy who was admitted urgently to an Emergency Dept with a lung disease so serious that he ended up on ECMO (Extra-Corporeal Membrane Oxygen- the artificial lung).  He had only used OTC (Over the Counter) vaping products.

Prof Bush describes a new disease that has been called EVADI (E-cigarette Vaping Acute Lung Injury), though it would not be medicine if they were not arguing over the new name which some want to call EVALD (E-cigarette Vaping Acute Lung Disease).

Bush finally asks that the recommendations of FIRS, (Forum of International Respiratory Societies) be implemented:

  1. ENDS (Electronic Nicotine Delivery Systems) should be considered as tobacco products and taxed and regulated as such.
  2. Sales to CYPs (Children and Young People = minors) must be prohibited and this must be enforced.
  3. All advertising and promotion should be regulated and made inaccessible to CYPs.
  4. Flavourings increase rates of youth initiation, so should be banned in ENDS
  5. Vaping should be prohibited in indoor locations, public parks, and places where children and youths are present.
  6. While their health risks are increasingly recognised, more research is needed
  7. Routine surveillance and surveys concerning combustible and electronic cigarette use should be carried out.

Prof Bush makes the point that they also need plain packaging and health warnings like tobacco products and says, ‘There is no chemical model that shows inhaling hot chemicals is a good idea.  You show me the proof that it is harmless.’

We all need to lobby on this.  Here is the video of the lecture: https://www.youtube.com/watch?app=desktop&v=yhdiIuz0ec4&fbclid=IwAR2ETBxTR8LD87Nmng54uo_w2xZ6vI7kRmYBqITPOv36R0

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The Smoke Screen Recurs.

20 March 2022

An article in the Good Weekend 19 March notes that screening services such as Netflix have a lot of smoking in their movies.

There was a lot of placement of smoking in movies for many years and in the 1920s and 30s there was more smoking in movies than in real life, which was probably not a coincidence.

Steve McQueen smoked in ‘Wanted: Dead or Alive’ and like Yul Brunner, Humphrey Bogart, Betty Grable, Paul Newman, and John Wayne was in the many Hollywood stars to die of lung cancer. 

In the 1950s and 60s tobacco companies sponsored many TV programs, such as the ‘Jack Benny Show’ (comedy) and ‘Gunsmoke’. Walt Disney, Larry King, Moe Howard (3 Stooges), Larry Hagman (Dallas), Chuck Connors (The Rifleman) and Ed Sullivan were some of the TV stars to die of smoking-caused cancers.  Some musicians to die were Nat King Cole, Dean Martin, Duke Ellington, George Harrison and Sammy Davis Jr.

The heath activists managed to get rid of tobacco advertising in Australia in 1976, but sponsorship, which was cheaper than actual advertising and got much more coverage lasted until after 2000. In the US activists drew attention to product placement in movies where brands were displayed or whole characters written to publicise smoking and fund movies.  Product placement by tobacco was banned in Australia in 1992 and in the US in 1998, unless historical figures were known to smoke.  

But now smoking in movies is rising again, and it seems to be worse in streaming services like Netflix.  Smoking does not seem to be increasing yet, but with vaping acting as a new gateway to smoking, the battle ain’t over yet.

From the ashes: Smoking’s curious comeback on the silver screen

Once the epitome of Hollywood glamour, cigarettes were all but snuffed out in films and TV shows by the turn of the millennium. Now they’re making a comeback. Plot-driven or something more sinister?

By Tim Elliott  Good Weekend   March 18, 2022

Smoking has made a furtive, and somewhat puzzling, comeback in recent years, something one US veteran anti-tobacco activist says is not random: “Nothing in Hollywood happens by chance.” 

When news broke, in mid-2021, that the cult turn of the millennium TV series Sex and the City was to return, the world’s entertainment media suffered a brief bout of tachycardia, the kind of hand-flapping hysteria that could reasonably be expected to herald the return of another well-known cult figure. The excitement was understandable. The new series, called And Just Like That, promised contemporary viewers everything that had made the original show so effortlessly watchable; cheeky humour, exceptional shoes and a non-threatening dose of prime-time friendly transgressiveness.

Yet there was one facet of And Just Like That which got special attention: one of the lead characters, Carrie Bradshaw (played by Sarah Jessica Parker), was smoking again. “Why, decades after she quit the habit, would Carrie return to it?” asked W magazine. A headline in New York magazine read: “And Just Like That … Carrie Is Smoking Again.” “Carrie’s smoking again!” the Daily Mail yelped.

Such head-shaking suggested not just disapproval but bewilderment. The common consensus was that, thanks to decades of pressure from anti-tobacco groups, smoking in TV and films had all but disappeared. In fact, smoking has made a furtive, and somewhat puzzling, comeback in recent years. Agent Smith lights up in The Matrix Resurrections; Kate Winslet vapes in Mare of Easttown; and Christina Applegate’s character Jen sparks up in the woman buddy show, Dead to Me. There’s plenty of smoking in the Netflix series The Umbrella Academy and in Orange is the New Black, and also in Modern Family and Law & Order: SVU.

Sarah Jessica Parker’s character Carrie Bradshaw resumed her smoking habit in the latest Sex and the City series, And Just Like That.

The fug that all but envelops The Queen’s Gambit, which is set in the mid-1950s and ’60s in the US, could plausibly be excused: after all, in 1954 a full 45 per cent of Americans smoked, that country’s highest level. (Australia reached its peak – also 45 per cent – in 1960). But smoking is also popping up in contemporary films, and especially those aimed at kids: a 2019 report from the US Centres for Disease Control and Prevention (CDC) found that the number of times tobacco use appeared on-screen in PG-13 films jumped 120 per cent between 2010 and 2018.

So what’s going on? “It’s not totally clear, but we’ve got a few ideas,” says Professor Stanton Glantz, a veteran anti-tobacco activist and founder of Smoke Free Media at the University of California, San Francisco, which tracks the incidences of smoking in movies and video. “One thing for sure is, these are not random creative decisions. Nothing in Hollywood happens by chance.”

Cigarettes and movies have been inextricably linked for generations. Ever since the advent of the talkies, tobacco companies have understood the power of film to shape cultural norms. In the 1930s and ’40s, tobacco companies paid Hollywood stars to appear in cigarette ads and smoke on screen. In return, the studios received funding for film advertising. Some actors, including Joan Crawford and Carole Lombard, appeared smoking in posters that promoted both the film and the brand of cigarette.

In the 1950s and ’60s, tobacco companies shifted their focus to television, spending hundreds of millions of dollars sponsoring popular programs such as The Jack Benny Program and Gunsmoke. Steve McQueen smoked in Wanted: Dead or Alive. Peter Gunn smoked. Even the Flintstones smoked. In 1962, the American television network CBS assured tobacco companies that the TV set “is the greatest cigarette vending machine ever devised”.

In the early 1970s, however, regulators in the US and Australia began banning cigarette advertising on TV and radio, prompting the tobacco companies to turn their attention once more to the movies. Product placement became rife, with Big Tobacco paying millions to have its brands on screen.

In 1982, Superman II featured a classic fight scene in which Superman is thrown into a Marlboro truck by General Zod. In 1989, Philip Morris paid $US350,000 ($472,000) to have its Lark brand featured in the James Bond film Licence to Kill.

Some companies were literally throwing cigarettes at actors: in 1984, American Tobacco supplied more than $US5000 worth of cigarettes to the set of Beverly Hills Cop. “I do feel heartened at the increasing number of occasions when I go to a movie and see a pack of cigarettes in the hands of the leading lady,” Hamish Maxwell, then president of Philip Morris, told a marketing meeting in 1983, adding, “We must continue to exploit new opportunities to get cigarettes on screen and into the hands of smokers.”

Such marketing has been phenomenally powerful, not only at creating new smokers but at manipulating reality. “You often hear these days that, ‘Oh everyone smoked in the 1920s and 1930s,’ ” says Glantz. “But it turns out that people back then smoked less than they did 10 years ago. The reason people now think people smoked so much then is that the movies back then had so many people smoking.”

Paying for on-screen product placement was banned in Australia in 1992, and in 1998 in the US. By 2007, according to the CDC, smoking on screen was at an all-time low: virtually the only people you saw puffing away were historical figures whose persona was inseparable from their habit: Winston Churchill, Fidel Castro or King George VI in the 2010 film The King’s Speech, in which he’s frequently depicted lighting up as he struggles with his speech impediment.

But smoking soon rose from the ashes. According to the CDC, tobacco use in top-grossing movies jumped 57 per cent from 2010 to 2018. Meanwhile, in the real world, smoking rates in the US were going in the opposite direction, from 19.3 per cent in 2010 to 13.7 per cent in 2018. The CDC didn’t attempt to explain why there was more smoking in films, but it would be naive to think that Big Tobacco had simply walked away from the movies.

“If you see a pack of Marlboros on screen, someone would have had to approve that,” says Glantz. “It doesn’t get in there by accident. How exactly it gets there, we don’t really know at this stage. There are still product placement companies, but they all deny they work with Big Tobacco. But if you see smoke, there is a fire.” (A spokesman for Philip Morris in Australia said the company does not engage in product placement in movies or on television.)

Streaming services aren’t bound by regulatory agreements, which is how shows like The Umbrella Academy managed to include cigarettes in every scene of its latest season.

Streaming is a big part of the problem, according to Glantz. Every year the tobacco companies must certify to the US Federal Trade Commission that they haven’t paid for their product to be placed in movies, TV shows or video games. But the agreement doesn’t cover streaming content, the enormous quantity of which makes it all but impossible for anti-tobacco groups and regulators to monitor.

“The cynic in me says that tobacco ads have been so curtailed globally that the tobacco industry must have a role in it,” says Becky Freeman, associate professor of public health at the University of Sydney.

“But then, given how many productions are involved and the sheer number of people, it seems unlikely there would be big money changing hands without someone leaking about it.” Freeman believes it’s more likely that streaming services are using smoking “to stand out from the big budget movies, and to appear more ‘indie’.”

Some streaming services are more “indie” than others. Despite a pledge to limit smoking on screen, Netflix remains the worst offender. (According to the Truth Initiative, an American anti-smoking group, scenes involving smoking tripled in the latest season of its superhero series The Umbrella Academy, which managed to include tobacco in every scene.)

The major studios also have policies that aim to restrict the amount of on-screen smoking. The strictest is Disney, which banned it in 2007. Thus its 2021 film, Cruella, which features the ghoulish De Vil without her signature cigarette. But all of the studios – even Disney – make allowances for creative licence and historical accuracy.

Kate Winslet as Detective Sergeant Mare Sheehan vapes in the crime drama, Mare of Easttown.

“Smoking was so widespread in the 20th century that it would be inauthentic not to show it in a drama set in that period,” says novelist and screenwriter John Collee. Collee, whose credits include Master and Commander, Happy Feet and Hotel Mumbai, is writing an adaptation of Trent Dalton’s bestselling book, Boy Swallows Universe, which is set in Brisbane in the early 1980s among working-class criminals and journalists. As it happens, the movie will include a historical figure called Slim Halliday, who was a member of the Brisbane underworld and an enthusiastic smoker. (Spoiler alert: in the film, Halliday dies of lung cancer.)

The problem for groups like the Truth Initiative and Smoke Free Media is that smoking in movies often signifies recklessness, and being reckless is cool.

History aside, smoking holds a strong stylistic appeal in cinema, which, says Collee, uses a “Freudian kind of dream language, where some things signify other things”. In Mad Men, the popular series about hard-living advertising executives in 1960s New York, smoking stands in as moral commentary, a metaphor for lead character Don Draper’s shadowy past and heedless chauvinism.

In the 1999 movie, Fight Club, Brad Pitt’s character, a poisonously disillusioned soap salesman named Tyler Durden, smokes so greedily it’s as if he’s eating the cigarette. “His smoking is like saying, ‘Here is a guy who doesn’t much care for his own survival,’ ” Collee says.

In Mad Men, smoking stands in as moral commentary, a metaphor for lead character Don Draper’s shadowy past and heedless chauvinism.

The problem for groups like the Truth Initiative and Smoke Free Media is that smoking in movies often signifies recklessness, and being reckless is cool. The bottom line, says Collee, who worked as a doctor before becoming a writer, “is that, unlike a public health announcement, a drama is essentially non-didactic. To a certain extent, you have to trust your audience to discriminate between a good thing and a bad thing.”


In the 2012 Judd Apatow film, This is 40, the lead female character, Debbie (played by Leslie Mann), has a sneaky smoking habit, puffing away near the bins out the back of her house. When her teenage daughter Sadie discovers her, Debbie is aghast and promises to give up. Like Debbie, today’s filmmakers have been busted smoking. Like Debbie, they have promised to give up. Like Debbie, their heart’s not in it.

Everyone has different ideas about how to fix the problem. India tried to ban all smoking scenes in Bollywood movies in 2005, but failed thanks in part to opposition from the creative community, which argued that it would curb artistic freedom. Instead, all scenes involving smoking are now accompanied by a caption at the bottom of the screen warning viewers that “Smoking is injurious to health”. In Thailand, meanwhile, the act of smoking and cigarette packs are pixelated.

Stan Glantz has long advocated, unsuccessfully, to have all movies with smoking scenes rated R. But prominent Australian anti-tobacco campaigner Simon Chapman believes this would be a mistake, not only because it’s unfeasible (would a minor character smoking one cigarette trigger an R-rating? What about scenes that depict smoking negatively? And what 15-year-old kid takes notice of movie ratings anyway?), but also because having health advocates dictate the content of movies is a really bad idea. “This kind of approach just seems a bit North Korea to me,” he says.

Some of the most memorable anti-smoking messages have come from within the film industry itself. In 1985, the actor Yul Brynner, who had been a smoker since the age of 12 and was then dying of lung cancer, appeared on Good Morning America, imploring the viewers: “Whatever you, just don’t smoke.”

Some of the smoking scenes in The Queen’s Gambit may not have had quite the effect Big Tobacco was hoping for.

 Then there is the hit series The Queen’s Gambit, in which sassy chess prodigy Beth Harmon (Anya Taylor-Joy) rises up the chess world while battling booze and drugs. In one scene, Harmon, hitting rock bottom, stumbles around her house, hopelessly hungover, a cigarette dangling from her lips. She heads to the fridge and grabs a beer, then dances around the kitchen to Shocking Blue’s Venus.

As the song hits full stride – “A goddess on a mountain top, was burning like a silver flame” – Harmon twirls, cigarette in hand, smoke in her hair, and promptly pukes in the sink. Not quite the product placement Big Tobacco might have hoped for.

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Vaping is Now Endemic

18 March 2022

It gives me no pleasure to say that vaping is endemic, or that I told you so.

I spent 20 years more or less full time trying to get smoke-free air, which equated to fighting the tobacco industry, who were dedicated to selling as much tobacco as was possible with no regards for its health effects.

As I attended endless conferences at my own expense, there were parallel better funded conferences on the Quit issue, where a second tier of anti-smoking professionals went to conferences on nicotine replacement strategies. 

Some of them ran Quit clinics on the model that people would come to them saying “I have a tobacco addiction problem, please help me wean off nicotine”.  The Health Dept. set up and funded quite a number of these clinics. The tobacco industry did not object as they made little difference to the number of people who smoked or the ubiquitousness of the habit, and allowed the government to say that it was doing something, avoid doing something more useful and continue to get the tobacco industry’s political donations.  As an enthusiastic smoking activist, I visited these clinics.  I was always warmly welcomed by the health promotion staff running them who were always up to date on the latest tobacco control literature and happy to talk.  It took me a while and some direct questioning to realise that the model was flawed; very few people came to the clinics and the staff were well read because they did not have much else to do.  Eventually the government stopped funding them.

When the activists had reduced the credibility of the tobacco industry to laughing stock, and the deliberately long contracts of the sponsored sports and other apologists had run out, we managed to get rid of the advertising sponsorships and get smoke free air (with a generous definition of ‘outdoors’ to allow smoking in poker machine areas in pubs to keep the money engine ticking over). This was in 2000.

The vaping technology was being improved as part of this parallel Quit universe, and its medical protagonists were grateful that there was less tobacco use and hoped that the world would perceive their Quit efforts as the last stage in mopping up the smokers remaining, and they could take more of the limelight.  Seeing the whole world from a Quit smoking perspective and possibly having attended a few well-funded conferences, they concluded that vaping would be good for quitting, and because it was much less harmful than burning leaves, it was a step in the right direction.  The assumption that the only use of vaping was to get smokers to quit was naïve in the extreme.  Some of the vape makers are the same companies that were happy to sell cigarettes, and now there are as many people starting smoking from vaping as leaving smoking for vaping.

But the key to vaping is that it is a new consumer product, with the potential to do immense public heath harm and to make massive profits.  The economic engine is in place, the government apathy continues helped by the naïve abovementioned Quit doctors.

In the fight against tobacco, the fact that the ubiquitous ads affected children was self-evident, but like everything in the tobacco wars had to be proved, so a study was done which showed that the brand preference of kids was not the same as adults, but the brands chosen by kids were the ones most advertised.

But now marketing is much more sophisticated. Social media allows targeting by age, gender, location and even personal opinions and preferences.  So kids can be reached without adults even being aware, and this is what has happened.  Vaping has become ubiquitous, just as we were achieving a smoke-free generation.  Now vaping will have to be shown to be harmful, rather than have to be shown to be safe.  So the research will take years, be denied by its industry protagonists, and be subject to the venal indolence of the political process. Inhaling solvents with random additives is likely to be harmful, but this of course is not ‘proof’.  The industry should have had to prove it was safe before it being released, but because the Quit people allowed tobacco to be the bar that it had to beat, it became legal without scrutiny, and now has become ubiquitous without being noticed.

I was therefore not happy but not surprised to read a schoolkid talking about vaping, and sadly he was also realistic enough to assume that the government was not likely to be of much help. Here is his article.

Vaping, a constant craving for too many of my school friends

Ari Katz, High school student

March 15, 2022, Sydney Morning Herald p19

It started as a novelty, a bit of harmless fun. The snap, crackle and pop of each nicotine-fuelled hit was exciting, enticing. The headspin was a new experience. We felt rebellious, revolutionary, cool. Vapes then started appearing at parties, the beach, the cinema.

But when friends started vaping regularly in the bathrooms at school, it became clear this device – resembling a coloured pen, bright and slim (concealing the fusion of wires, batteries and chemical compounds) – was here to stay.

During assessment-intensive periods at school, vapes act as a coping mechanism, a seemingly indispensable form of stress relief. Is this really the way we want our youth to be dealing with the challenges life throws at them?

The highly addictive, flavour-filled substances in vapes are engineered by profit-hungry foreign manufacturers who, I fear, pay little attention to the long-term health implications of their product.

What began as youthful self-discovery and experimentation has descended into a state of unfettered addiction among the adolescents – boys and girls – I know, some as young as 12. This is because vapes are too accessible, too easy. For me, having seen this obsessive relationship with vaping in all types of peers, including those who excel in sport or academic work, the extent of the issue becomes overwhelmingly clear. Vape addiction does not discriminate – everyone is susceptible.

So why should you care?

A Victorian father is warning parents about the dangers of having vapes near children after his son was hospitalised with what are believed to be the effects of smoking one.

The full negative health implications of vaping are as yet unknown. But the concern is that the recurrent inhalation of chemicals will do significant damage to the underdeveloped lungs and brains of teen vapers. However, from my perspective, far worse is the impact that this dependency and incessant craving has on the mental and social wellbeing of my peers. Teen brains aren’t prepared for the burden of addiction.

We know adults are largely oblivious to the scale of the problem, so how can we ask for help when we know the first reaction of the unprepared parent is likely to be a reprimand rather than a helping hand?

The cognitive dissonance of knowing vaping is harmful, while not being able to stop, is taxing on the mental wellbeing of adolescents. We have little experience of addiction and are not taught to deal with it. We know it’s harmful, we know it’s toxic, but we can’t stop.

Vaping is no longer a fad; the fun has been over for months now. From what I can see in my circle, few people who vape actually want to vape.

Government education campaigns will be largely impotent against the vape culture because addiction, by nature, does not just end by the push of a button. It takes personalised support, resources and encouragement to curb the dependency. Where is all this when we need it?

Vulnerable, developing brains are suffering at the hands of an insidious device, yet this challenge is only now starting to receive attention.

Seeing friends and peers suffer is shattering. This is Australia’s future we are talking about.

Ari Katz is a high school student in Sydney’s Eastern Suburbs

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