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E-Cigarette Terminology - 3


A list of terms and acronyms encountered in the community, political and medical areas related to e-cigarettes and similar topics - part 3. In some cases these are colourless definitions, in others there is some opinionated interpretation of the meaning.

...continued from Part 2 - see menu at right >>


S to Z, 1 to 9

 


safe : modern, ultra-low-risk THR products are safe.
   The word has a precise measurement of deaths per unit usage, which is given at the end of this entry. The word 'safe' is never used to indicate absolute, perfect safety with zero risk: it always means controlled and acceptable risk. It has a legal definition, which can be found in statutes that specifically measure and quantify risk. For example COSHH (UK), which is just one of the many laws that legally defines acceptable risks as being safe, using terms such as "safe environment" and "above the recognised safe levels" where it is absolutely clear that 'safe' involves a measure of risk.
   Safety is thus legally defined as an acceptable level of risk, and not absolute safety. It never means 'absolutely safe and with zero risk', and therefore using it to mean this is a distortion employed by the disingenuous.
   We can certainly describe Swedish Snus as safe, since any health impact is not reliably measurable. A product with no definable health cost is safe. For a more complete examination of this issue see: https://brainyfurball.wordpress.com/2014/05/02/is-it-safe-to-say-safe/ -- which points out that lollipops are considered safe or they would not be sold to children, but nevertheless they kill around 100 kids a year just in one country. So we can measure the precise value implicit in the term 'safe' here: if 50 million units are sold and 100 children die as a result, the product is safe. From this it is very clear that if few can be reliably identified as having died or suffered serious harm as a result of consuming a product that is sold in the millions (and especially if no casualties at all can be identified with certainty), then a product is undeniably safe, even if unquantifiable risk may exist.

safe and effective : a commonly-used term in the medical world, to mean a therapy that works and is acceptably safe. To be realistic, no therapy will work for everyone, and nothing is absolutely safe - but the meaning is clear enough. However in the tobacco control industry, the term has a different meaning; like 'evidence-based' (qv), there is something of a change in English interpretation. The term 'safe and effective' is often applied to pharmaceutical interventions for smoking cessation, when they are nothing of the sort; they are neither safe nor effective.
   Effectiveness: To be effective, a reasonable person would assume that something needs to work; something that has a failure rate of 9 out of 10 does not fall into this category. There is plenty of evidence from independent researchers that pharmacotherapies for smoking cessation on average do not exceed a 1 in 10 success rate; there is certainly no real-world evidence that they have any better result. There is substantial evidence that these therapies cannot be shown to have any more than a marginal effect on real-world cessation results: every single survey of successful ex-smokers reports that by far the most successful method for quitting was the self-motivated method (aka unassisted or 'cold turkey'), which is always about 70% of those surveyed. There is no survey of ex-smokers that we are aware of that reports differently. Numerous other methods were responsible for the remaining percentage, such as support groups, mentored programmes, hypnotherapy, acupuncture, and pharmacotherapies. No successful quitters in significant number who used pharmaceutical interventions can be found.
   In the real world (not in the laboratory), unassisted quitting is many times more effective than pharmaceutical assistance. That no real-world evidence can be found for claims that these therapies are effective reveals a disconnect between what the manufacturers' research is reporting and what the facts show. In any case, there is a clear disconnect between what the manufacturers report and what independent researchers results show. If the success of quitters is measured at 4 weeks, or 6 months, then there is a reasonable success rate: commonly 34% at 4 weeks for example. But this has no relation to real-world value: only the 12-month success rate has any real relevance, and the gold standard is 20 months (this is the date mark used as the final and best measure of smoking status and cessation success). Most pharmaceutical interventions average out at a 7% success rate or lower, at 20 months: the failure rate is about 93%, although it should probably be adjusted to compensate for the numbers using each different type of pharmaceutical intervention:
a. The psychoactive drugs have a slightly better performance but far fewer use them (as prescribing them is limited due to the risks).
b. The skin patch NRTs have the worst performance of all, scoring a 2% success rate or lower in some trials.
c. Because more people use the NRT types, which have very low success rates, the success rate averaged across all licensed interventions is lower than 1 in 10.
   If a quitter has relapsed by 20 months later, and has returned to smoking, there is no possible way to describe the therapy as successful - the time, money and effort was wasted. For this reason, the 20-month success rate is rarely published.
   Pharmaceutical interventions for smoking cessation are not effective, and describing them as effective is a lie. Anyone describing them as 'effective' is a liar.
   Safety: Regarding the claims they are safe: if the intrinsic safety of nicotine-based therapies is being referred to (NRTs), these therapies are indeed extremely safe - in fact they probably have among the best safety record of any pharmacotherapies, as these have an exemplary safety record (since they are, after all, essentially harmless, and simply a megadose nutritional supplement). The psychoactive drugs, though, are a very different matter: they have significant risks and have hundreds of deaths and tens of thousands of ruined lives to account for.
   As regards the safety profile as a whole, in contrast - if we include the end results of the prescription and use of these therapies - then 'safe' is not a correct word to use; dangerous would be more accurate. They have a risk for death of about 45% under some circumstances.
   To explain: if 50% of continuing smokers are killed by smoking (as we are told by the medical profession, although this may be an over-estimate), and if 9 out of 10 patients fail to quit smoking when prescribed these medications (which we know is the true result), then 45% of patients prescribed pharmaceutical interventions for smoking cessation will die, if they continue to smoke. Of course, this is not the whole story - but there is enough reason to absolutely avoid (if not prohibit) the use of the term 'safe' in connection with these therapies: a very large number of patients will become seriously ill and a significant percentage will die. Anyone describing these therapies as safe is a liar.
   These therapies are very far indeed from being safe and effective; the average, reasonable person might conclude that professional negligence is being risked by qualified persons using such grossly inaccurate terms. To put it simply: describing pharmaceutical interventions for smoking cessation as safe and effective, when stated by a medically qualified person who knows the issues, is a blatant and egregious lie. It is open to question whether such clear iatrogenesis is medical negligence: a doctor who prescribes pharmacotherapies for smoking cessation when it is obvious how ineffective they are, and who also knows that THR is highly effective and has no significant health implications, must be responsible if that patient subsequently dies.
   To be perfectly fair, though, we must include the possibility that the person is badly misinformed. This is quite possible, as a recent survey showed that 44% of UK doctors are completely ignorant of some of these issues and even hold an opinion that is directly opposite to the facts [they thought nicotine is associated with cancer]. Doctors are just as vulnerable to propaganda as the rest of the population.

saving of life; ecigs save lives : it is common to describe a population-level uptake of a THR product as resulting in a substantial saving of life, as this can be clearly seen, for example, in the national health statistics of Sweden. A significant proportion of the Swedish population didn't die, because they switched to Snus, or never smoked (instead, they started with Snus and did not transfer to cigarettes). Snus consumption is invisible in population-level health statistics - the health impact is not measurable since the health outcomes for smokers who totally quit and smokers who switch to Snus are virtually the same; there is no statistically-identifiable difference. This is why Sweden is the world leader in reducing smoking-related mortality, and why the smoking-related death rate is lower than that of other developed countries by a wide margin.
   So, it is commonly stated that if 1,000 smokers switch to [Snus / ecigs / NRTs] either wholly or in part, then X number of lives would be saved. This rather graphic description of the effect may not be entirely accurate since the actual result of changing from a frequently-lethal product to one with no measurable health impact is a prolonging of life, as we all die in the end. Perhaps it might be better to say, "Many lives will be prolonged if smokers switch to a THR product"; or, "Many preventable deaths will not occur"; or, "Many early deaths will be prevented". It is more about semantics than anything else, and unfortunately the more accurate versions lack a certain zing.

scientists : professionally-qualified persons who provide research or commentary on technical, medical or economic subjects, especially those working in hard science and analytical specialities as against social topic areas. They are normally paid to provide materials useful to a commercial funder, or an institution, or, less commonly, work to their own agenda or that of a community group. A scientist sees all problems as science problems requiring the collection of evidence and construction of a solution.
   Consumers on the other hand see everyone working against them when all they want is unrestricted, cheap product availability. Solutions for consumer problems are always money-based not science-based, because consumers' main problems are caused by costs and restrictions imposed by government and rival industries, not the free market. In addition, some forms of science-based evidence may not be applicable to consumer products: RCTs for example are notoriously unreliable when used outside their design area for investigating medical interventions. As a result, even when working with consumers, scientists fail to appreciate that they may be seen as part of the problem, not part of the solution.
   When the problem is in reality fixing corrupt legislators, diverting all efforts into emphasising health gains is not the best use of resources - more science is not the solution when the problem is weak and corrupt government.

serious adverse event reports : the FDA process for reporting problems with products within their remit. As an example, by early 2014 the FDA had received over 10,000 serious incident reports regarding the smoking cessation drug Chantix (varenicline), and admitted to 272 deaths directly attributable to Chantix (suicides and murders), though independent commentators say the total was likely to be very much larger, probably in the thousands; plus many thousands of violent psychotic epidodes, attempted suicides, and heart attacks. Despite this level of serious incidents and the significant number of deaths, Chantix is still on the market, which is said to illustrate the issue of regulatory capture. Two clinical studies report there is a 1 in 30 risk of a cardiac incident for patients on Chantix; this, if reliable, means that there were over 60,000 'cardiac incidents' in the USA attributable to Chantix in 2010.
   Note that France withdrew Chantix from the state-authorised list due to the level of mortality and serious incidents.
   In contrast, e-cigarettes, introduced to the US market at the same time as Chantix, and with a massively larger userbase, do not have a single directly attributable incident of mortality or serious morbidity (currently about 15 million US ecig users reported by surveys at Q2 2015). The FDA had received 47 incident reports regarding e-cigarettes at early 2014; these were examined by Prof. Rodu and in essence dismissed as inconsequential considering the scale of the userbase. One might therefore expect that the FDA would remove Chantix from the market rather than e-cigarettes, since PVs (ecigs) are clearly demonstrated to be many thousands of times safer than Chantix; not so. They attempted to ban the electronic cigarette instead. These kinds of issues tend to reinforce the accusations of regulatory capture, since the only alternative is gross incompetence on an unbelievable scale and/or a willingness to significantly harm public health for no observable reason.
   Note that the FDA have never asked for serious adverse event reports on tobacco cigarettes, presumably because they would not be able to cope with the millions of reports this would generate (or be able to act on them in any case, admittedly, since cigarettes are ring-fenced by law).

social engineering : the public health industry contains many who believe it justifiable to control people, their lives, their purchasing decisions and their lifestyles down to the tiniest detail, so that their lives can be prolonged to the furthest possible extent (and conveniently, so that their expenditure during that extended life can be diverted through approved channels, usually those of their funders).
   This modern form of megalomania is closely aligned with the trend toward zealotry; it ties in well with the odd mix of free market economics / neo-Stalinist control of the population that Western governments embrace: commercial reward mixed with control of the population such that spending is funnelled through preferred channels; and some of the tax revenue is redirected back to the public health industry because they enable the controls. The social engineers, government agencies and their commercial beneficiaries have a symbiotic relationship: each has a substantive need for the other's assistance in ensuring that life provides as many benefits for them as possible.
   A typical example of the social engineer's club is Richard Horton, Lancet Editor. Read his barking mad ramblings here:
http://www.bishop-hill.net/blog/2013/3/10/review-of-what-counts-as-good-evidence-for-policy.html -- find and read the two paragraphs starting with: "So the reason that I believe in judicious intervention, based upon sound evidence is because it delivers freedom."
   The average person would, in contrast, not believe that removing liberty results in freedom; it is the hallmark of communist totalitarian states and also far too close to "Arbeit Makt Frei". Crucially, these modern totalitarians tend toward the far left, not the right: their stronghold is within the hardline socialist wing.
   For those not zealots or afflicted by funding-induced megalomania, it looks more likely that freedom could be achieved by first removing all the toxic parasites in the Public Health industry. Easy enough to do, simply by turning off the supply of their drug of choice: $$.

smoke : the killer component in cigarette smoking. It is the smoke that causes serious disease. Removing the smoke will remove 95% - 99.9% of the risk (opinions vary on the precise figure): any other way of consuming tobacco and especially nicotine has far less risk, and QED cannot have more than a fraction of the risk of smoking. Because it is obvious that the problem is smoke and not tobacco, this abbreviation / hashtag is appropriate:
#ITSS - It's The Smoke, Stupid.

smokeless tobacco : (ST) tobacco that is not smoked: whole-tobacco products such as oral tobacco and dissolvables.
   Note carefully: we are only discussing modern, Western products here - historic products were very different, and Asian products are entirely different products in every respect. Absolutely no aspect is comparable.
   Oral tobaccos include chewing tobacco and Snus (which is a moist snuff used orally, typically in a pouch, and is not chewed). Dissolvable products include orbs, strips, lozenges and sticks. The advantage of ST is that there is no smoke, so the health risk is less than 5% of that for cigarettes. An example of this is that an oral tobacco product with the worst possible safety profile cannot have more than 10% of the risk for oral cancer that smoking has (such products are in any case not widely available in the West, where modern oral tobacco products are of higher quality). Swedish Snus has an oral cancer risk so low that it cannot be reliably identified [-Prof Rodu, the authority on the oral pathology of tobacco consumption, private communication]. The main risk factors for oral cancer are smoking, drinking and HPV (a virus transmitted during oral sex). Products such as Snus do not even register on this scale.
   This product class does not include alkaloid-only products such as e-cigarettes or NRTs.

smoking cessation : the medical description for stopping smoking. As smoking is officially regarded as a disease, it is therefore the legal property of the medical profession and the pharmaceutical industry, who protect its ownership since it is a huge income generator. Thus, 'smoking cessation' is legally a medical process (regardless of the incongruity) and can only be legally addressed by licensed medical products and processes. This has the effect of prohibiting any product that works for smoking cessation being advertised as such unless it has a pharmaceutical license (an MA). The result is that all the best methods for smoking cessation cannot be described as such, as it would be illegal to do so.
   E-Cigarettes are a consumer product and have a worst-case effectiveness for smoking cessation of 31% at 12 months for subjects who wished to transition, when all factors are strongly suboptimal, and which is even so at least three times more effective than pharmaceutical interventions for smoking cessation at 12 months. The first 1-year clinical trial of e-cigarettes has just completed (at late 2014) for subjects who did not want to quit: over 10% quit smoking even when they had no intention of doing so. By Q1 2015 we knew that CT results for consumer products such as ecigs must be multiplied by a factor of 3 in order to derive the real-world result for such an 'intervention' as measured by a CT or RCT - because consumer products are not an intervention and cannot be measured with methods used to measure interventions. In the real world, it is clear that such consumer products will achieve a result around 10 times better than can be expected from any pharmacotherapy, and therefore the results of inappropriate tests and trials (such as RCTs) have to be multiplied up to get the result seen in reality (the opposite of RCT results achieved with pharmaceutical interventions for smoking cessation, which never achieve anything like the success rates seen in RCTs).
   Experts also tell us that the elevation of risk for any disease implicit in e-cigarette use is probably minimal or non-existent on average as harm is not expected to be caused except to those who have known vulnerability to injury due to genetic predisposition or existing disease, and who should avoid the use of such products. However, because the law is in effect owned by the pharmaceutical industry, e-cigarettes cannot be advertised for the purpose of smoking cessation. Only pharmaceutical products, which have a well-demonstrated 9 out of 10 failure rate, can be marketed for this purpose.
   In this particular case we can clearly see that the law works against the public good; the law is harmful, and clearly corrupt.

Smoking Harm Reduction, SHR : (see THR)

Snus : Swedish oral tobacco. A member of the ST class of products: smokeless tobacco. Snus is not a chewing tobacco, it is a moist snuff product most often supplied in a pouched format: a tiny, flat pouch (resembling a small, flat teabag) is placed behind the upper lip, between the upper lip and upper gum at the front; there is no chewing or spitting and the product is invisible in use.
   Snus is specially processed to remove most of the carcinogens, and numerous professors of epidemiology and public health have variously stated that it has no demonstrable elevation of risk for any disease, or that it has health risks so low they cannot be reliably determined, and so on. For example Prof Rodu, the world authority on the oral pathology of tobacco consumption, says that any risk for oral cancer is too low to be reliably identified.
   Snus is the best example of a THR product, as the results are proven: Sweden is the world leader in reducing smoking prevalence, the world leader in reducing smoking-related mortality, and the world leader in reducing smoking-related morbidity. As a result, Sweden's national health statistics are unique.
   The EU banned Snus and continues to support the ban, which is designed to protect the cigarette trade and the pharmaceutical industry's various closely-related income channels, such as the drug market for the treatment of sick smokers (a market at least 10 times the size of the smoking cessation market and probably much larger). This drug market is reducing in Sweden at a rate parallel to the rate smokers switch from cigarettes to Snus and will reach and then pass a 50% reduction (as Snus consumers are well-demonstrated to equal non-smokers in terms of risk for disease). This is a disastrous prospect for pharma, and they are desperate to stop it happening elsewhere, as the sick smoker drug treatment market is one of their most important discrete revenue channels.

solanaceae : the plant family (nightshade) that includes tobacco, most of which contain nicotine. Examples are the tomato, potato, aubergine (eggplant), and the Australian plant Duboisia Hopwoodii (qv).

spongers : financial parasites (British term). Those who take money without any value return. Taking money without work or any useful contribution.
   Commonly applied to the tobacco control industry, since they have no function after the 20% prevalence point if the 20% Prevalence Rule operates (smoking prevalence has remained at 20% for many years in the UK despite huge sums demanded by and funneled through the TCI).
   qv troughers, rent-seekers

Stelda NL : Holland's community ecig usergroup, Europe's first e-cigarette consumer association, followed a month later by ECCA UK.

switch : 'switching' is the THR route whereby a smoker switches to a low-risk alternative consumer product that supplies either tobacco or alkaloid/s without smoke. A safer product is substituted for cigarettes, by the consumer. Switching is the mechanism that most effectively reduces smoking prevalence and thereafter smoking-related morbidity and mortality, once smoking prevalence reduction has stalled when traditional methods are no longer effective (see the 20% Prevalence Rule). By 'traditional' is meant the popular and effective methods of reducing smoking such as public education campaigns.
   Switching / THR probably saves more lives than any other methods once smoking prevalence sinks below 30%, and is the only method shown to work at all when prevalence reaches around 20% in a country where it was originally far higher.
   Substitution is a consumer process and is intrinsically far more effective than any medical process.

TC, TCI : (see tobacco control industry)

tobacco control industry, the : (TC: tobacco control; TCI: the tobacco control industry) originally a random grouping of public health advocates who wanted to reduce the harm from smoking; the injection of large amounts of funding changed it into an organised industry. The original aim was to work toward a smoke-free world; somewhere along the way the agenda changed to incorporate protecting the pharmaceutical industry. This is asumed to be due to the injection of funds from pharma, who demand a quid pro quo, while other funding sources may come with no strings attached. The general aim is to protect the pharmaceutical industry's vast income from smoking (principally the drug market for the treatment of sick smokers, which is far larger than the smoking cessation drug market); but this can only be done by protecting cigarette sales. Specific areas include resisting THR incursions that might cut cigarette sales by 60% and therefore pharma's huge income from the treatment of sick smokers by 59.5% - 60%. This agenda has to be concealed, even from the rank and file members of TC, and a substantial propaganda campaign takes care of that. This is very competently managed and funded by pharma, who are the acknowledged masters of commercial black propaganda (a 'false flag' operation where genuine information appears to be coming from one source but is in fact propaganda paid for by another).
   Thus, the TCI is run by people who profit from the funding but who must conceal the ultimate goal: perpetuation of their employment when smoking could easily be virtually removed by other far more efficient methods. It has therefore been expedient to change the goal from a smoke-free society, to a tobacco-free society, to a nicotine-free society. The millions spent on propaganda achieve this aim.

THR : (see Tobacco Harm Reduction)

Tobacco Harm Reduction : (THR) when capitalised is used as a proper term, referring to a specific process; Harm Reduction refers to consumer substitution of a less harmful consumer product than the original and more harmful product, and specifically excludes any form of cessation as by definition it refers to ongoing consumption. Thus 'THR' and 'Tobacco Harm Reduction' specifically mean substitution of safer consumer tobacco or nicotine products for cigarettes, for ongoing use, and without cessation.
   The best example of THR is Sweden's position as the world leader in reducing the burden of disease and death resulting from smoking; free access to the local oral tobacco product called Snus has resulted in around a 50% reduction in smoking prevalence when compared to similar countries such as the UK. Sweden now has the lowest smoking mortality of any developed country by a wide margin; a smoking death rate about half the EU average; and the lowest male lung cancer and oral cancer rate in the EU. In practice, Sweden is the only developed country in the world with any realistic chance of reducing smoking-related (or 'tobacco-related') death and disease to insignificant proportions.
   The dramatic success of Tobacco Harm Reduction policies in Sweden has caused utter dismay to the cigarette and pharmaceutical industries due to the impact on their sales; these industries have acted aggressively to stop the spread of THR. Tobacco companies have mostly given up fighting, and are moving into THR products themselves; but the pharmaceutical industry has nowhere to go except fight, since there is a realistic prospect of a 60% reduction in their huge incomes from smoking-related channels. Pharma's income from smoking is at least $100bn annually; thus THR will hit pharma's bottom line by several tens of billions of dollars a year. This explains the aggressive fight against THR that they fund.
   Note: a better term, which would be more accurate, is Smoking Harm Reduction or SHR. Tobacco is not the problem: smoking it is the problem (consumption of specially-processed smoke-free tobacco by over 20% of the adult population in Sweden has no reliably identifiable health impact).

TPD : EU Tobacco Products Directive. It defines the regulatory framework for the sale of tobacco products in the EU: in other words, it is the tobacco sales law in the 28 EU countries. The TPD is authored by the Health Directorate but the ENVI committee (environment and health) has the resposibility for its adoption by the EU. The IMCO committee (trade issues) and the JURI committee (legal issues) also have input.
   A rewrite went through the committees, at Q1 2013, and caused an uproar due to the disastrous effect it will have on public health if implemented. The new TPD was originated by the disgraced Health Commissioner, John Dalli, the Maltese appointee sacked for corruption. (And who was subsequently revealed to have solicited bribes of €10m for favourable legislation, and who was reportedly discovered moving a personal fortune of $100m between offshore banks.)
   The new TPD attempts to preserve the status quo, and protect cigarette sales and pharmaceutical industry income from any threat from THR products such as e-cigarettes (by a de facto ban on e-cigarettes, by virtue of a ban on any usable refill liquid) and Snus (by continuation of the 23-year ban on Snus). As a result, the TPD is considered a protectionist vehicle for the pharmaceutical and cigarette industries and massively detrimental to public health, as its direct result will be to prevent the saving of millions of lives - or to cause millions of unnecessary deaths, depending on the point of view.
   As an example of the scale of the issue: Prof Britton of the RCP states that if all smokers in the UK switched to an e-cigarette, the lives of five million UK citizens alive today would be saved. Divide that by half for a more realistic result (as we can predict that around 50% or so of smokers will switch in the foreseeable future, but a greater switch is not a certainty); then multiply that by 28 for the number of EU countries, and adjust for relative differences in population, and you have the number of people that the EU Health Directorate are actively attempting to prevent the survival of (or kill, if you prefer) with their TPD: it comes to tens of millions of people. The Health Directorate's statutes are carefully masked as pro-health by massive propaganda campaigns, but are clearly a public health disaster on an unprecedented scale, designed to protect the status quo.
   The previous Health Commissioner was dismissed for corruption by the EU President immediately the report was made available by the EU fraud investigators, OLAF (it has also been reported that it may have been within 30 minutes of the report's availability); this appears to indicate that President Barroso was well aware of the problem and also felt no need to worry about the outcome of any subsequent hearing or appeal. This decision has been confirmed by continual revelations of Dalli's involvement in dubious financial transactions.
   The TPD is considered to be the most egregiously corrupt statute in history, since it will directly lead to tens of millions of deaths and rather obviously only benefits the pharmaceutical and cigarette industries along with government revenue departments. It is also thought to be one of the most efficient public policy measures to combat population growth ever seen; it is not known if this is a desired or unintended consequence.

Trading Standards : in the UK, the common term for the inspectors of the Trading Standards Institute who in concert with the BIS ('Dept. of Business') control the regulation and enforcement of product sales to the public. TS is one of the two limbs of protection required to ensure consumer safety: regulation (statutes) and enforcement. Inspectors exist at local level in every area of the UK, and visit vendors both physical and online to inspect products (and certain areas of marketing) and to take away products for inspection, testing, and analysis. Infringements of the law result in enforcement procedures of varying severity up to and including seizing of stock and prosecution. As a result, it may be the case that the UK is the only country in the world where e-cigarettes are comprehensively and effectively regulated - because e-cigarettes sales must comply with 17 separate statutes, and because vendors are universally inspected at local level. There is also a valid argument that, due to the 'noise' surrounding the products currently, e-cigarettes are actually regulated more stringently than some other products. Trading Standards inspectors have, for example, enforced a recall on an e-cigarette product where the only infringement was a CE Mark certificate that could not be promply located and the result of faulty manufacture would have been, at worst, an 'electric shock' of 5 volts at 500 milliamps (impossible to feel, except for a goldfish). This is probably a situation infrequent with other products.
   We welcome the BIS and Trading Standards Institutes' strict enforcement of the UK's very comprehensive consumer protection laws, which prevent any contaminants being present or toxic materials being sold, or products with any possibility of danger to consumers.
   A statement that "e-cigarettes are unregulated" in the UK is an outright lie, made by a liar who should be prosecuted for such a statement. Propagandists funded by rival industries need to be constrained.

troughers : pig-like parasites who force their snouts into the trough of public money and have no useful contribution to make. The only product is pig excrement at the other end.
  Troughers is a term commonly applied to the tobacco control industry, who have no further use after the 20% Prevalence Point is reached and are an expensive, useless obstruction to further reduction of smoking prevalence (since only substitution works after that point; because the TCI is part-funded by the pharmaceutical industry, pharma profits must be protected in order to maintain funding - but protecting pharma profits is impossible to reconcile with reducing smoking, especially after the 20% point).
   qv spongers, rent-seekers (US equivalent)

TVECA : Tobacco Vapor Electronic Cigarette Association. A US association of e-cigarette vendors who mostly sell mini ecigs with prefilled cartos, and specialise in the newcomer market. In contrast to the wider e-cigarette and refill market, a larger proportion of this market is shop-based: physical retail sales are much more prevalent in this market sector. TVECA members are unusual in that they can probably survive under the toughest regulatory climate whereas all their competitors (the upgrade and aftermarket vendors, if you like) would likely disappear. If prohibitions on web sales, refill liquids, flavours etc. are introduced, TVECA members might survive, but other vendors would probably not.
   TVECA have unwisely advocated for the classification of the e-cigarette as a tobacco product in the EU, clearly underestimating the ability of EU committee members to remove the e-cigarette from the market due to their pro-pharma and pro-cigarette agenda, and their rigid control of legislation to effect that agenda.

ULR products : 'ultra low risk' - an informal description of modern THR products that have no apparent disease factors (such as e-cigarettes, which have no apparent causative agents for disease) or have a reliable history of minimal impact on health (such as Swedish manufactured Snus).
   Snus is a specially-processed mini-pouched oral tobacco product that has had most of the carcinogens removed; 30 years of data on consumption in Sweden cannot reliably indicate any elevation of risk associated with its use. It must be admitted that, to a certain extent, this is due to a weakness of statistics: since most Snusers are ex-smokers it is hard to remove confounders from the data; and identifying small statistical effects below about 1% or so in a population is difficult. So we must allow that small risk elevations are present but not confirmable; though compared to smoking, the risk must be something like two orders of magnitude lower. This explains Sweden's unique national health statistics: the lowest 'tobacco-related' mortality in the developed world by a wide margin, and still falling (note that 'tobacco-related mortality' is a misnomer since deaths from tobacco consumed without smoke cannot be reliably identified at population level in Sweden; the issue is smoking and therefore smoking-related mortality is far more accurate). As an example: when Sweden's male smoking falls to 5% (around a quarter of the same figure for the UK), which it will do around 2016, then at a later date the smoking-related mortality will fall to a quarter of the UK figure, allowing for the disease timelag and all other factors remaining the same. The timelag for disease to result in reliably-identifiable death is about 20 years (between 15 and 25 years), but all other factors will of course change: by that time Sweden will probably have close to zero male smoking prevalence as most smokers will have switched to Snus and ecigs.

upgrade market : the upgrade / aftermarket in e-cigarette sales can be described as that portion of the market that does not include mini ecigs or pre-filled cartos. In the USA this is termed the 'vapor products' or 'e-vapor' market, as against 'e-cigarettes' which applies to the cigalikes.
   It is based around e-cigarette users upgrading to higher-performance models and bottled refill liquid, from the usual newcomer's choice of a model that looks like a cigarette and comes with pre-filled cartridges. It infers a move up, from 1st-generation equpment (a mini ecig), to 2nd-gen and 3rd-gen ecigs (always larger, as battery physical size is critical in a small electronic device that has to deliver pulses of several amps of DC current).
   Loose calculation showed in 2012 that the mini ecig & prefilled carto market was about 75 -80% of the total US market, and the upgrade market is around 20 - 25%. These percentages have changed dramatically, with 2nd gen preoducts now far stronger.
   Depending on the userbase polled, most owners show a strong upgrade preference and will either eventually upgrade or revert to smoking: 92% of users polled at one public event had upgraded (these were well-informed owners); 31% of users of one brand of mini surveyed online were still using it after one year (these were owners who were probably unaware of the existence of an upgrade path), and 69% had therefore either reverted to smoking or upgraded. The 2nd-generation and up equipment performs far better, the bottled refills and the extensive range of heads allow a much wider range of choice, and refills allow for good cost savings compared to smoking.
   It is very difficult indeed to show any cost savings compared to smoking when minis with pre-filled cartos are examined in a strictly-applied cost analysis; indeed, vaping can be more expensive than smoking under this regime. Savings come only when bottled refills are used.

useful idiots : the rank and file members of the tobacco control industry are sometimes referred to as 'pharma's useful idiots'. (The term is often credited to Lenin but apparently does not appear in his work; it seems more likely to originate from Yugoslav communists' usage first reported in 1946, for duped associates, in the Serbo-Croat language, commonly translated as 'useful innocents' but equally correctly as 'useful fools'.)
The reason for its application to TCI members is because they are told they are working for public health, but cannot possibly be doing so any longer as smoking prevalence cannot be reduced further by the methods they employ; in practice they work for pharma by blocking THR, which is the only solution that can reduce smoking once the one-fifth population barrier is reached when prevalence was originally much higher (as is the case for most/all western developed countries). They work against public health instead of for it, since blocking THR is, QED, massively detrimental to public health.
   The management grade are fully aware of the issue, and reap the rewards: fabulous salaries backed by pharma, paid as long as they toe the line. The rank and file members are persuaded by propaganda and indoctrination that tobacco control is still a useful approach, when the facts directly contradict this.
   Tobacco control - in the modern era - is a wholly corrupt enterprise. It was a valuable contributor to public health until about 2008 (when the barrier was widely reached, for example in the UK); subsequently, it has consisted mostly of job creation schemes that maintain employment but are detrimental to public health and the public purse. In the US this phenomenon is well-recognised, and called rent-seeking.
   Lately there has been a serious breaking of ranks by senior figures in TC such as Britton, West, Hajek, Siegel and others that threatens to rock the boat badly, as they have backed THR. It is becoming clear how the people running the pharma front groups intend to counter this threat, which they need to do in order to continue drawing their huge salaries (over $1m in some cases) and keep their troops in line: it looks as if a redoubling of the propaganda drive against THR is the preferred reaction, coupled with a massive increase in funding to achieve favourable legislation that removes THR as a threat. Some groups (such as ASH UK) have cleverly responded with weasel-worded support for THR, accompanied by support for legislation that removes it as any kind of threat to smoking.
   Their useful idiots are vital to pharma in order to protect smoking and maintain disease levels. Salaries reflect that importance: 'public health' pays very well as a result. The irony is that the tobacco control industry now works assiduously against public health; an irony lost on the useful idiots.

vapemeet : a vapers' get-together, generally small in scale as vapefests provide the large-scale meeting opportunities. Local vapemeets might only consist of five people in a pub, but can run to thirty or forty on occasion.

vapefest : a large-scale vape meet, a vapers' convention. A typical vapefest lasts two or three days; although popular in cities, a vapefest (especially in the US) might be located in a resort location such as Vegas or a Florida beach resort. These large-scale vapemeets are important get-togethers for the community, since most activity takes place online and there need to be conventions where vapers can meet those from afar face-to-face, to network, discuss issues, and hold organised meetings. Local vapemeets perform some but not all of these functions.
   Interesting vapefest factoid: Bill Godshall, the world's most active anti-smoking harm campaigner, attended a vapefest in the US where 300 people vaped constantly in a room, mostly using high-power devices. He reported that the atmospheric effects were so negligible that it was virtually unnoticeable, and caused him no problem whatsoever. (This is the person who has has been the most active anti tobacco corporation campaigner in the world for decades, and who has helped frame many of today's smoking control laws; there is an argument that he has had more influence on smoking regulatory issues than any other single person.)

vaping : use of an e-cigarette, and thus inhalation of vapour; contrast with smoking, the inhalation of smoke. Vapers are persons who engage in vaping.

the war against e-cigarettes : the reason that opposition to e-cigarettes exists is to protect the smoking economy. This benefits governments and multiple large industries; it is both an establishment property and a source of funding for those who protect it. The smoking economy is immense, has tremendous power within government, and is well able to protect itself. The main factors are:
1. The pharmaceutical industy's need to protect its huge income from smoking (certainly at least 10% and perhaps as much as 20% of its total income);
2. The state's need to protect its tobacco tax revenues;
3. The cigarette trade's need to protect sales;
4. The willingness of idealists (aka the 'useful idiots') to work on behalf of the 'nicotine-free world' concept and accept funding in order to provide the public face of the main actors' agenda promotion.
   Depending on time and place, the significance of these reasons varies: in 2013, in Europe and North America, the order as above is correct; previously, or in other places currently, the order changes (the cigarette trade was previously the biggest opponent of ecigs in the West, but have now changed tack and bought in; State incomes appear to be the major reason for ecig bans in some other parts of the world).
   The footsoldiers in this battle, as alluded to above, are usually pseudo-health front organisations owned by pharma, along with medics, politicians, and regulatory-captured government agency staff. These are all paid by pharma to exert pressure, usually with a constant stream of propaganda; this is known as 'black propaganda' as it appears to come from one source but is organised and funded by another.
   The pharmaceutical industry puts tens of millions of dollars into the fight against ecigs every year. This is because smoking earns them tens of billions of dollars per year; in order to protect an income of billions, it is well worth expending significant sums. There are multiple income channels from smoking, the largest of which is the drug market for the treatment of sick smokers, including chemotherapy drugs, COPD drugs, vascular drugs, cardiac drugs and all the other treatments; next comes the massive boost to other drug sales due to smokers' general illness: a 1PAD smoker has a 60% greater chance of being diabetic, for example.
   It is even possible that pharma earns more than tobacco from smoking (they almost certainly do in the UK, for example).
   Pharma's problem is that (a) e-cigarettes will cut this income by about 60% eventually, and (b) they need legislation to remove the threat. The black propaganda war is a highly successful tool to assist in resolution of this problem; in fact it is crucial. It hinges on the use of astroturfing, front organisations (the pseudo-health pressure groups), and corrupt medics, politicians, and government agency staff. The pharmaceutical industry of course are the world's largest criminal corruptors and can legally be referred to as such, since they have paid the world's largest fines for criminal corruption.
   Due to the immense power of the funds pharma controls, even organisations with a global influence such as the WHO can be bought and perverted. Their biggest problem is independent minds and what to do about them: how to handle organisations such as the Royal College of Physicians, who genuinely work for public health and apparently cannot be bought. The answer seems to be to obtain legislation that outmanoeuvres the honest by suborning the corrupt, and the propaganda war is the #1 tool to achieve this - a torrent of disinformation that camouflages the actions of the bought politicians who push through the legislation that removes dangerous competitors who will significantly reduce disease. The ultimate disaster for pharma would be the removal of smoking, since it generates a significant proportion of their income (for example a 1PAD smoker is over 60% more likely to be a diabetic than a non-smoker).

WHO : (World Health Organisation) an NGO that advises governments on health issues. Due to its takeover by the pharmaceutical industry it is now referred to in some quarters as the World pHarmaceutical Organisation or the World Harm Organisation. It is now a centre for the junk science and propaganda industry protecting the pharmaceutical industry's drug treatment market for sick smokers, and utterly discredited as a source of useful advice in the topic area of smoking.
   A clear example is their spokesperson Bertollini's presentation at the EU ENVI committee's TPD hearing on May 7th 2013, which consisted of one of the world's most risible presentations of junk science to date, described by Prof Etter of Geneva, who was present, as "not even worth an F grade if submitted by a student". Simply a collection of lies by omission, misrepresentation and selective presentation (and thus, in total, a lie), it was designed to assist the pharmaceutical industry in its goal of removing a threat to its vast income for treating sick smokers.
   It is reported that four-fifths of WHO funding is commercial, and the quid pro quo is obvious. All State support should be removed, and the WHO should be correctly described as what it is: a commercial pressure group.

WTA : 'whole tobacco alkaloids' - see Vaping Terminology, menu link at right.

zero nicotine cigarettes : tobacco cigarettes can contain any amount of nicotine down to about 0.04%, which could be termed 'zero' as it is so low. Over recent years, the nicotine content of cigarettes has reduced in the West, for obvious commercial reasons: people smoke more in order to get sufficient nicotine but the products can be marketed as 'low tar' or similar.
   Safety: since it is the smoke that kills, and therefore the less smoke the better, the 'safest' cigarette is a high-nicotine one: people will smoke less, either by smoking less of any single cigarette or by generally smoking less, or both. The 'least safe' cigarette is a low-nicotine cigarette, since people will need to smoke more. Safety is used as a relative term here.
   This rather obvious principle is alluded to in the phrase and hashtag: It's The Smoke, Stupid - #ITSS.
   Zero-nicotine cigarettes have been seen before with herbal mixes in the 1960s. They were not successful. Recent modern developments might work if they enable smokers to quit by nicotine reduction; this remains to be seen. The danger is that people smoke more, and since smoking is the harmful activity (#ITSS - nicotine itself is all but harmless and has multiple medical benefits) then this will not be progress.



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Numbers
 

0-nic : zero-nicotine refill liquid (e-liquid). Polls show on average that 7% of vapers use 0-nic. Zero nicotine may not be an absolutely accurate description if organic tobacco flavours are used to flavour the base with, since a very small amount of nicotine may accompany the flavourings.
[see also: zero nicotine cigarettes]

20% Prevalence Rule, The : there is a 20% barrier effect that appears to show that one-fifth of the adult population cannot easily quit smoking (or do not want to), once prevalence is reduced by education and other methods to about 20% in countries where smoking rates were originally much higher (above 40%). This applies to most Western countries.
   Note that:
a. There are various methods of measuring 'prevalence' and all are disputed; the method most commonly used by organisations or governments is the 'past month' adult figure, which counts any person who is an adult and who smoked a cigarette within the past 30 days as a smoker. However this figure varies according to the source, even for countries such as the UK where such information should be easily obtainable. Therefore, all such statistics are best described as an educated guess.
b. At 'the 20% point', only THR solutions are demonstrated to be effective in further significant reduction, where smoking was orginally far more prevalent.
Because the 20% point itself is somewhat vague, due to its composition and its measurement, we placed it in (b) above in quotes; it will be at a different point according to how its composition is defined (whether of the gen. pop., or of adults, or of adults plus older children), and how it is measured (by the 'past month' or the 'daily' or the 'half-pack-plus' methods, for example), and how accurately it was generated from the small population sample used to create the initial data point (a small number of people are surveyed and the numbers are multiplied up).
It is described as a rule here since it appears widely prevalent and indeed there appear to be no exceptions in the Western world. The only 'exceptions' are countries where smoking prevalence was originally far lower than in other developed countries, and these are excluded by the terms of the rule. Nevertheless this may not be a rule, simply an empirical fact: an effect that seems universally applicable. We don't know of any country that the rule applies to which is an exception.
   There may well be different (and better) ways of defining this effect, whether it be a rule, law, or principle; or at what exact percentage (as it seems that in the UK a figure of 22% is closer); though it is too widely observed to be a coincidence.
   Separately, only THR solutions are proven to work for significant smoking prevalence reduction after the 20% point is reached (e.g. Sweden's experience). We are not aware of any country the rule applies to that achieved significant prevalence reduction thereafter without THR.

230 volt standard : a typical story of EU regulation. In Europe, different countries have differing voltage standards, which vary between 220 and 240 volts. This causes problems for machinery manufacturers and can affect machinery performance and safety, because the voltage should not vary; it creates significant and unnecessary costs for electrical product manufacturers. Therefore all the power companies and government bodies responsible for electrical safety met to decide what to do about it. There appeared to be only one option: change power station outputs to a new, agreed, European standard voltage.
   The cost of this would be astronomical and no one could agree. In addition, it suited very few countries because most operated on 220 volts (with poor regulation of even that figure, in some countries), one ran at 240 volts, and a couple ran 230 volts, so that a 'half-way' figure in reality suited very few. One or two countries probably had varying voltage according to the phase of the moon and couldn't afford to fix their problems never mind change to a standard voltage.
   Negotiation went on for months and completely stalled. No one could agree. Then someone had a brilliant idea: agree on a new standard: 230 volts plus or minus 5%. This was agreed on immediately as it meant nobody had to do anything: the cost to the power industries was zero instead of a vast fortune, and the cost to governments was zero instead of massive subsidies to the power station operators for expensive changes.
   The only people to suffer were the consumers, strangely enough. Consumers had to pay more for products that had a risk of being more dangerous than they should have been. The manufacturers of things like washing machines still had the elevated costs, but many of them were in China anyway; and the cost of products rose with production volume and distribution variety because manufacturers had to build multiple different models for the different markets in order to comply with each different set of voltages and regulations, each changing over time. There was a risk that some products would not be specifically built for the voltage in the country of sale, so that performance, reliability or even user safety were compromised. However, the consumers always suffer in EU agreements so nothing changed there.
   The huge EU propaganda machine went into action with its usual whitewash, claiming that new and important benefits to citizens had been agreed. Everyone (who counts) was happy.

 

 


created 2013-07-30
continually updated