twitter: @rolygate


A central page for references, papers cited and resources linked on this website.

Categories - listed in alphabetical order
Lists - online lists of references
Caution - a note on COIs


Cigarettes - technical

1. 9,600 different identified compounds in cigarette tobacco and smoke:
Rodgman, Perfetti 2013
The Chemical Components of Tobacco and Tobacco Smoke, 2nd Edition.

2. 5,300 tobacco compounds identified (the earlier edition):
The  Chemical  Components  of Tobacco and Tobacco Smoke.
Rodgman, A. and Perfetti, T.A.
Boca Raton, FL: CRC Press, 2009

3. Explanation for the chemical dependency action of tobacco smoke:

4. MAOIs: norharman (beta-carboline) and harman (1-methyl-beta-carboline) are beta-carboline alkaloids and MAOIs:

5. A list of MAOIs:


Cigarettes - sales

1. Danish cigarette sales down 11% partly due to ecigs:


Clinical research

1. Demonstration that nothing exists unless it has a published clinical study supporting it (parachutes cannot work since there has never been a therapy vs placebo clinical trial):

2. Concealment of clinical trial results:

3. Clinical trial results routinely withheld:

4. Half of all press releases about medical research contain spin:



[caveat: see Caution at foot]


E-Cigarettes - commentary

1. Molimard - ecigs (FR):

2. Restaurateur talks about ecigs at local uni:

3. How children know that ecigs = not smoking:

4. Huge increase in UK vapers forecast by SaveEcigs:

5. Public health leadership and electronic cigarette users
G Stimson 2014
Points out that public health orgs need to support ecigs.

6. Remarkable rise in e-cigarette use in Britain
G Krol 2014

7. Farsalinos and colleagues refute any potential for ecigs to elevate risk for CVD:


E-Cigarettes - regulation

1. Prof P Hajek:

2. Cabinet Office business regs blocking:

3. ASH UK:

4. MHRA ecig licensing:

5. ARI regulator guidance:

6. Viscount Ridley argues very cogently for less ecig regulation:

7. Achieving appropriate regulations for electronic cigarettes
Polosa et al 2014
The penultimate paragraph contains the most honest (and only correct) interpretation of the ecigarette regulation issue ever written by any medical professional - the incredible naivety of the medical profession is, unusually, not seen here.

8. POSTnote ecigs PDF:

9. Lords Q on ecigs:

1. Analysis of the FDA deeming regulation possibilities:

2. FDA nicotine licenses:

3. Bill Godshall pre-release presentation, before publication of the FDA deeming proposals:

4. FDA proposals for a deeming regulation:

5. ECF forum on FDA regs:


E-Cigarettes - research

1. Electronic cigarettes pose no health concern for users or bystanders:
Prof I. Burstyn, Drexel USPH

2. List of ecig studies:

3. ASH UK ecig survey:
Use of e-cigarettes in Great Britain among adults and young people (2013)

4. Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes?
Cahn Z, Siegel M. - 2010
notable points:
- ecigs are ~1,000 times less toxic than cigs
- 8.2ng/g carcinogens detected, same level as NRTs

5. Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette Use.....
Farsalinos et al 2013
65% of ecig users in this study reduced their nicotine level over the time period of the study.

6. 1 in 3,000 vapers is a never-smoker:
Etter, Bullen 2011
3,307 ever-users of e-cigarettes responded; 187 used the devices without nicotine (5.6%); of 2,850 who used an e-cigarette that does contain nicotine, one (1) was a never-smoker (0.03%); indications are therefore that about 1 in 3,000 ecig users were not previously smokers.

7. Survey of enthusiasts at a vaping event in Philadelphia:
Foulds, Veldheer, Berg 2011
54% of experienced ecig owners use an APV model, 38% of experienced ecig owners use a mid-size model, 8% of experienced ecig owners use a mini (92% of enthusiasts have upgraded from a mini).

8. A longitudinal study of electronic cigarette users.
Etter, Bullen 2014
Ecigs are effective for maintenance of non-smoking status.

9. Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey
Siegel, Tanwar, Wood - 2011
31% quit smoking with Blucigs @6months.

10.a. Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers
Farsalinos et al 2014
Large survey of enthusiasts. Median use 10 months; 81% had quit smoking; ecigs work for highly-dependent smokers; 21% use >20mg strength refills; 3.5% use 0-nic (note variance with all other surveys, which generally report ~7% 0-nic).

10.b. ACSH commentary:

11. What you need to know about electronic cigarettes
Britton, Bauld, Bogdanovica
Royal College of Physicians, 20 March 2014
"Switching completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely."
"...any gateway risk should be assessed in the context that nearly one in five 16-19 year olds in Britain has already become a regular tobacco smoker."
"...first generation cigalike products ..... are about as effective - but no more effective - as cessation therapy as are transdermal nicotine patches."
"E-cigarettes will save lives, and we should support their use."
The comment about ecig effectiveness for smoking cessation is correct in terms of some clinical trials but a wildly inaccurate underestimate of real-world success, because ecigs are unlike medicines in that they work better outside the lab. A success rate as poor as that referenced here would be impossible to find in any real-world scenario, for multiple reasons. People just buy a better model or a stronger refill or a nicer flavour, when using consumer products with free choice - they don't give up on the attempt abruptly as in trial situations. There are many ways that ecigs are something entirely new in smoking cessation/substitution, for example there is no other product that gradually causes a smoker to use it more frequently, to the exclusion of smoking; or that causes a smoker to quit when they have absolutely no intention of doing so. This indicates that academics are completely out of their depth when trying to compare the consumer effects to that of other products - clinical trials have never been so irrelevant. In effect, researchers are unable to evaluate their own lack of competence in this area.

12. Current US ecig clinical trials:

13. 31% success in smoking cessation at 6 months using Blucig
Siegel et al 2011
Of the respondents, 31% had successfully ceased smoking; however few responded from the overall number polled.


E-Cigarettes - research - junk science

1. E-Cigarettes: A Scientific Review
AHA / Grana, Benowitz, Glantz 2014
An attempt by the tobacco control industry to produce a document similar to the Burstyn/Drexel review, but instead of being neutral it is funded by and written to the WHO/pharma agenda, ignoring any positive or neutral data, and cherrypicking only negative data from studies funded by the pharmaceutical industry, and featuring only the CDC's corrupted statistics. Glantz specifically denies any COI while his university is for all practical purposes owned by pharma and enforces its agenda, and his salary is in effect paid by pharma. Agenda-based junk science in its purest form.

There is a ton of this kind of junk to choose from: search 'prue talbot' or 'glantz' for multiple examples. This example is included as it is typical, by one of the most consistent offenders, and outrageously protective of cigarette sales for a purely commercial purpose and to ensure continued employment of the authors by pharma.


E-Cigarettes - statistics

2012 US ecig users:
total US pop @Mar1 2012 = 313.1m
1.4% in survey at Mar 2012 were ecig users.
Assuming the survey was of adults only, then adults are 77% of the population,40,41/416,417
77% of 313.1m = 241m
1.4% of 241m = 3.3m
So, at Mar 2012 this survey appears to demonstrate that there were 3.3m ecig users in the USA.


E-Cigarettes - technical

1. It has been known since late 2009 that only around 50% on average of the nicotine in e-liquid is transferred into the vapour, due to the work of the professional chemists on ECF:

2. The first published study to address ecig nicotine transfer efficiency. The study found that on average, approximately 55% of nicotine in e-cigarette refill liquid ('e-liquid') is transferred to the vapour. We refer to this study as 'Goniewicz 1'.
Nicotine Levels in Electronic Cigarettes
Goniewicz et al 2012

3. This study examines the topic again, in more detail and with more measurements; it shows that, on average, 50% of the nicotine in e-liquid transfers to vapour (though there is an extreme range of efficiency from around 10% - 80%). We refer to this study as 'Goniewicz 2'.
Nicotine content of electronic cigarettes, its release in vapour, and its consistency across batches: Regulatory implications
Goniewicz, Hajek, McRobbie 2013

4. Dawkins, Corcoran 2014
E-Cigarette use raises nicotine plasma measurement to 7ng after 10 minutes, 14ng/ml average at 60 minutes, with a small sample of experienced users with 1st-generation hardware (minis) and average/low strength refills (18mg):

5. Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices
Faralinos et al 2014
Demonstrates that 2nd-gen hardware (mid-size models) with average/low nicotine strength refills (18mg) raises plasma nic level to 6ng in 5 minutes and 23ng in 65 minutes; nic delivery from 1st-gen hardware (minis) is lower. A refill strength of about 50mg would be needed to replicate the faster and greater nic delivery from cigarettes. (The current max retail strength is 45mg and would probably suffice.)



1. A well-researched article:

2. Nicotine, the Wonder Drug?
Discussion of nicotine's clinical use; no citations given, so searches are required to find the source material. Interesting article, but this sort of approach requires references otherwise it might be regarded as hearsay.


1. J Britton - 5 million preventable deaths at stake just in the UK:

2. A high-quality video on ecigs from France:

3. US doctor explains the advantages of ecigs:
(S Satel, Yale USM lecturer)

4. ASH Scotland's CEO gets hot under the collar:


Morbidity, assorted

1. Popcorn lung:
Bronchiolitis obliterans, or 'popcorn lung', is of interest as it is one of the extremely rare disease factors possible for ecigs, if the butter-popcorn flavouring diacetyl (or possibly one of its analogues) is used in refills - although we don't know if disease can be caused by inhalation of the tiny quantities likely to be present in vapour.



1. MHRA / pharma COIs:
Pointing out that essentially the MHRA and the pharmaceutical industry are one and the same; not the ideal arrangement for a regulator.

2. Paul Flynn MP (Lab) claims that the MHRA lied to him:



1. MSA payments start to slide, earlier than expected; ecigs will destroy the MSA payments, which is why US States and state Attorneys General need to ban ecigs (the States depend on MSA funds to prop up their economies and the AGs benefit personally from the MSA funds):



1. Prof Mayer:
Archives of Toxicology 10.1007/s00204-013-1127-0, 4th Oct 2013.

2. The nicotine addiction myth - multiple clinical trials of nicotine administered to never-smokers report zero withdrawal effect or dependence potential. No trial has ever shown any potential for dependence:
a. Clinical trial examining the effect of nicotine on cognitive impairment (that utilised never-smokers given high doses of daily nicotine for 6 months):
b. [as above]
No withdrawal symptoms or dependence potential were noted (as for all clinical trials of nicotine with never-smokers including the following examples).
Prof Etter states that these nicotine trials with never-smokers showed zero dependence effect for nicotine:
c. Davila et al, 1994 - Nicotine treatment for sleep-disordered breathing
d. Sandborn et al, 1997a - Nicotine enema treatment for ulcerative colitis
e. Sandborn et al, 1997a - Nicotine transdermal treatment for ulcerative colitis
f. Bittoun, 1991 - Nicotine treatment for apthous ulcers
Etter 2007: "Furthermore, there was no report of subsequent nicotine dependence in never-smokers who were treated with nicotine for ulcerative colitis, apthous ulcers and sleep-disordered breathing."
g. Kumari et al, 2003 - Cognitive effects of nicotine in humans: an fMRI study

3. Assorted nicotine-related resources:

4. Nicotine in diet:

5. Survey of doctors revealing widespread ignorance about nicotine; 44% of UK doctors thought nicotine was associated with cancer, directly opposite to the facts (see NICE guidance - no association with cancer):

6. Nicotine in medicine:

7. Long-term effects of nicotine inhalation:

8. 2 year rat trial inhaled nicotine:

9. Nicotine inhaler trial:

10. Anti-inflammatory effects of nicotine in obesity and ulcerative colitis
[data collation and discussion - not a trial]

11. DFG nicotine research library:

12. FDA Consumer Updates: the FDA no longer considers nicotine either dependence-forming or dangerous with overdose:

13. MCDA briefing:

14. Prof P Killeen of ASU:

15. Prof P Hajek, UKNSCC, 2013

16. Molimard - the myth of nicotine addiction:
An explanation of the reasons why nicotine dependence is not an issue, and how in his opinion Fagerstrom is partly responsible for reinforcing the myth for commercial reasons.

17. Nicotine and Health
Laugesen / ACSH 2013
An interesting document as it reveals a historical, establishment view of nicotine as inseparable from smoking and almost always conflated with it in all respects; and riddled with errors as a result. It is unfortunate that people with practical experience of daily working with nicotine are never consulted for these papers, such as ecig refill chemists and lab staff; they are written by people with no experience of the materials they describe. Some of the material appears ridiculous to those who work with nicotine.
There are far too many errors due to a rigid historical view of nicotine, such as the farcically low LD50 quoted for nicotine, and the description of nicotine as 'highly addictive' when there is zero evidence for even marginal dependence potential for nicotine without exposure to tobacco.
This statement is wrong on multiple counts: "Nicotine is the drug in tobacco that causes addiction." It certainly is not worthy of a scientist, since the basic premise has no independent evidence for it; and since it is obvious that there are multiple (and variable per individual) factors in the chemical dependency profile for smoking.
"Nicotine is highly and rapidly addictive..." Another statement with zero evidence for it. After reading one-quarter of the document there is no room to list further mistakes.
In general this is a paper about smoking; and there is altogether too much conflation of nicotine with smoking in an era when we know the two must be considered as and researched as completely different entities. There are so many errors in this paper that realistically it would be better if it had not been written.

18. A good article on cognitive enhancement research:

19. Nicotine is useless for suicide:

20. 2-year trial of huge doses of inhaled nicotine with rats (no effects):

21. Prof Molimard's overview of nicotine, its potential for dependence, and the gradual pharmaceuticalisation of smoking cessation treatment with little success.
Good list of citations.

22. The infamous CDC nicotine trial that they tried so hard to conceal - but as it had already been extensively cited, that proved impossible. They also conveniently named it to try and create the impression that dietary nicotine is instead absorbed from ETS.

Preliminary data: Exposure of persons aged = / >4 years to tobacco smoke - United States.
Centers for Disease Control and Prevention, 1993
Journal of the American Medical Association. 1993;269:852

All 800 subjects in this clinical trial to determine the presence of nicotine in the population tested positive for nicotine metabolyte (cotinine), despite the majority being non-smokers and many having zero contact with smokers. The result so surprised the scientific community that another large-scale test was carried out, with 136 subjects, with the same result (everyone tests positive for nicotine).
Later, better knowledge of nutrition provided the explanation: nicotine is a normal ingredient in the diet, being present in many vegetables and contributing to a measurable plasma nicotine level in anyone with a good diet, although this was not widely known at the time (nutrition has always struggled for recognition as an important life science).
The CDC subsequently tried to hide this trial because it became clear to everyone that nicotine was a normal dietary ingredient, and this didn't agree with their agenda.
Many thanks to Dr Farsalinos for unearthing it.


Nicotine - business

AmeriNic, Inc. "expects to begin production of liquid nicotine before the end of the calendar year" (2013):
[This is of interest because all liquid nicotine originates in Asia (there are no western sources despite what may be read on this topic). AmeriNic will, if it gets off the ground, and if it survives more than a few months, be the first US source. This is not by any means a certainty since its product will be many times the price of Asian pharmaceutical grade nicotine and will have to be marketed on some kind of 'luxury' basis since the quality will not be an improvement (you can't improve on 99.9% purity) - but B2B buyers don't care about that.]


Nicotine - positive

1. Positive effects of nicotine:

2. Nicotine treatment for UC:


Nicotine - online resources

1. Germany-based online nicotine resource:

2. Stimson, Bates, Farsalinos:

3. IHRA:

4. Bates:
(comments from Sweanor, Hajek, etc.)



1. NRT success rate 0.8% at 12 months:


Pharmaceuticals - business
World pharma gross value ex-factory 2012: $858bn
41% in N America, 27% EU. UK market c. €14bn.
In the EU, manufacturers on average receive about 65% of the retail price, and government 10%. UK tax = 0% presc., 20% OTC.


Pharmaceutical industry - criminal activity

1. Pharma & crime:

2. Pharma crime analysis:

3. Pharmacia & Upjohn criminal fraud:
(FBI: largest criminal fine ever paid, to date)

4. Pharmacia criminal fraud:

5. Pfizer criminal fraud:

6. Merck criminal fraud:

7. Abbott criminal fraud:

8. GSK criminal fraud, criminal corruption:

9. a. GSK corruption in China:
b. GSK bribery affair timeline:

10. Supreme Court rules that all generic drugs are exempt from civil actions (80% of US drug sales):

11. Is big pharma addicted to fraud? (article)

12. Wikipedia list of 20 largest US fines for criminal fraud and criminal corruption by pharmaceutical companies:

13. list of notable fraud cases:

14. Johnson & Johnson criminal fraud:

15. Janssen criminal fraud:

16. Pfizer: Chantix - evidence for >500 suicides; good list of links to sources:

17. Takeda / Lilly fined $9bn for hiding cancer risks:
(The fines are likely to be reduced on appeal.)

18. Nicotine patches were invented by a fraudster (and are still promoted by fraudsters):


Pharmaceutical industry - funding

1. GSK funding:

2. RWJF grants to UCal / Glantz:

3. Glantz funding:;jsessionid=91D75662601DFC29C610F2305F59F817?root=5253


Pharmaceutical industry - influence

1. Experts Say Medical Practice Corrupted by Pharmaceutical Industry:

2. A document addressing the problem of medical professionals' COIs:

3. Dr P Rost: how pharma buys the medical establishment:

4. Medical malpractice:

5. Half of drugs prescribed in France "useless or dangerous", "causing 20,000 deaths a year":

6. Unhealthy Pharmaceutical Regulation: Innovation, Politics and Promissory Science
Courtney Davis, John Abraham
Palgrave Macmillan 2013

Corruption issues attributed to pharma
1. EU - more on Dalli:

2. Jeremy 'pharma' Hunt:

3. Pharmaceutical industry helps determine NHS policy:

4. Dr Peter Rost, former vice president of Pfizer describes how pharma buys universities:
"And that's how you influence the medical establishment - simply with money."


Pharmaceutically-caused mortality

1. Pfizer settles 2,700 cases out of court for >$273m, in US Chantix class action:

2. Zyban associated with multiple mortalities in UK:

3. The murder drug:


Pharmaceutical industry - propaganda

1. Pharma foundations and front groups:


Pharma-tobacco commercial links

1. Atria-Fertin


Public Health

1. NICE public health guidance 45
Tobacco: harm reduction approaches to smoking
[see commentary on this site]

2. Hansard: NHS asserts that ecigs are 1,000 times less toxic than cigarettes, and reasserts it in Parliament
[search: Smoking]
[the NHS citation is Cahn, Siegel 2010]

3. Prof R Polosa: Health policy is made for financial not health reasons:

4. Government-funded charities "subvert the democratic process and squander taxpayers' money":
[join this link to repair it]

5. The Sock Doctrine: state-funded political activism:

6. Zealots:

1. How ideological beliefs make it impossible for people to recognise facts and evidence:
Motivated Numeracy and Enlightened Self-Government
Kahan, Peters, Dawson, Cantrell, Slovic
September 3, 2013. Available at SSRN:

National health services
1. NHS SSS (stop smoking services)

2. a. NHS SSS begins switchover to ecigs, following the 20% drop in demand for their services.
Leicester SSS:

2.b. VTTV show featuring Leicester SSS:

3. UK prescription costs 2012:
This is not a complete list of NHS drug costs or smoking cessation drug costs.

4. NHS SSS 2013 results:
394,354 attempted to quit during 2013.
144,757 had been validated as successfully quitting at the 4-week point.
This is 36% of those attempting to quit, and tallies well with the normal ~34% successful quit rate @4 weeks.
This normally falls to 12 - 15% by 12 months and 6 - 7% by 20 months.
63 per cent received NRT only; 26 per cent received Champix only; 1 per cent received Zyban only; 5 per cent did not receive any pharmacotherapy. This indicates 3% received multiple therapies.


Research and Publishing Bias

1. PN Lee 2013
Re: Journal policy on research funded by the tobacco industry
(Letter to BMJ from tobacco funded researcher pointing out that his research often has conclusions that are highly damaging to the cigarette industry)

2. Low quality research - para 1 page 2 appears to decribe pharma-funded e-cigarette research perfectly:

3. Should pharma-funded research be rejected for publication:

4. Identifying bad science:
'Research' that is critical of ecigs always contains at least one of these factors, and in some cases, most of them.


Smoking cessation

1. Dr Ablow - 70% smoking cessation success at 3 months:

2. US ex-smokers survey:
July 2013
~68% quit using cold turkey
8% quit using pharmacotherapy
3% quit using ecigs
The survey closely replicates all other surveys of ex-smokers (except for the now-visible effect of ecigs): all surveys show about 70% quit unassisted, and the pharmaceutically-assisted group is always a fraction of the size; thus self-motivation is by far the most successful method. This is the first survey to show a clinically-significant effect (3% or greater) for ecigs. It will probably grow by 1%+ per year.

3. S Chapman on how unassisted quitting is best (and he is both correct and impossible to contradict):
Chapman is something of a rarity in the TCI as he is not a pharma pimp, and should be commended for it.

4. John Polito resources:

Smoking - statistics

1. Assorted resources:

2. India:
"Going by the Global Adult Tobacco Survey, India has an estimated 27.49 crore tobacco users including 16.37 crore users of smokeless tobacco and 7 crore smokers. The remaining 4 crore use both."
[1 crore, cr = 10 million, a South Asia numbering system]
Thus, India has:
7 + 4 cr smokers (110m)
16.34 + 4 cr ST users (203m)
4 cr dual users of cigs and ST (40m)
total 27.49 cr tobacco users (275m)

3. ONS smoking stats 2012 (UK):
"One in five adults (aged 16+) in Great Britain were cigarette smokers in 2012. The rate of smoking in Great Britain has remained largely unchanged over the last five years."
"It is likely that the survey underestimates cigarette consumption and, perhaps to a lesser extent, prevalence..."

4. R West et al
Smoking prevalence in England was 19.3% in 2013.
"Smoking prevalence in England is below 20% for the first time in 80 years."
West's Smoking Toolkit data is regarded as the most accurate of smoking stats for the UK.

5. Global smoking trends:

6. ISS -  International smoking statistics from PN Lee:

7. Youth smoking in Scotland at record low level:

8. Useful figures from CVP on relative risks of the amount of smoking:

9. R West's UK longitudinal / ongoing smoking research studies, reputed to be the most accurate current smoking stats in the world.
The 2014 update reveals:
- 16% of current and recent UK smokers now use ecigs
- Ecig use by never-smokers is extremely rare
- The increase in use of ecigs has been accompanied by a decline in use of NRTs
- There has been a small increase in motivation to quit [i.e. no reduction] and attempts to quit [again, no reduction]
- There has been an increase in the rate of quitting smoking
- Smoking prevalence is declining faster than any year since 2008
- Cigarette and overall nicotine use has decreased
- The cigarette and nicotine markets are both declining
- The evidence does not support any view that ecigs are undermining tobacco control, motivation to quit, or reduction in smoking prevalence - the opposite is the case since they appear to be contributing to a reduction in smoking prevalence by improving the quit rate

NB: (separately) NHS SSS managers report a 20% decline in demand for stop smoking services (@Q1 2014), probably due to smokers turning to ecigs as a perceived better option. The best NHS SSS managers are now using ecigs, since that is where the growing demand is.

10. ASH UK, April 2014
Use of electronic cigarettes in Great Britain
2.1 million UK vapers
33% have quit smoking
693,000 UK citizens have quit smoking by use of an ecig @April 2014

11. Recent UK smoking and ecig surveys, April 2014:

Both the ASH UK and R West Smoking Toolkit ongoing surveys agree:
There are more than 2 million ecig users in the UK.
The number of ecig users has trebled in 2 years.
More than half of smokers have tried (or use) an ecig.
About 33% of ecig users have quit smoking (~700,000)
Half of all quit attempts are now made with an ecig.
Quitting using an ecig is far more successful than any other assisted method, and vastly more successful than demonstrated in clinical trials (rough calc is x3).
41% of vapers use a refillable device.
About 0.1% of previously non-smokers use an ecig.
Only 1% of non-smoking minors have ever tried an ecig, and the number who are ecig users is not measurable.

This destroys the 'gateway' argument, the 'threat to children' argument, the 'flavours will hook children' argument, the 'ecigs don't work for smoking cessation' argument, and the 'ecigs will prevent smokers from quitting' argument (i.e. all the pseudo-arguments against ecigs enabling protectionist policy decisions). The only valid argument left is: "We don't know what the long-term health impact is", an argument that does not have sufficient merit to support bans or severe restrictions since we know what the short-term effects are and there are no visible disease paths.


Snus & ST

1. Lee, Hamling 2009
Systematic review of the relation between smokeless tobacco and cancer in Europe and North America.
(Large-scale meta analysis of 89 ST studies; Snus has no demonstrated elevation of risk for oral cancer, but obsolete US products were implicated)
Short form:
Full study:

2. B Rodu
2009 article - an analysis of Lee, Hamling's work

3. Lee 2011
Summary of the epidemiological evidence relating Snus to health.
(No association with cancer, heart disease),f1000m,isrctn

4. Lee & Hamling 2010
Powerpoint slides from a presentation on Snus

5. Ingeborg, Scheffels 2012
The Relative Risk to Health From Snus and Cigarettes
(Good explanation of ST vs smoking risks; useful list of refs)

6. Timberlake, Zell 2009
...smokeless tobacco's role in harm reduction
(A commentary from CDC personnel; some obfuscation of the facts discussed, e.g. an incorrect report of Lee, Hamling's conclusions)

7. Phillips, Rodu
Health Effects of ST
(Good Q&A on ST & health, esp. myths)

8.a. Foulds, Ramstrom, Burke, Fagerström 2003
Effect of Snus on smoking and public health in Sweden.

8.b. Full text:
An exhaustive dissertative analysis of multiple Snus studies - the effects on health and the difference in findings between studies and how unadjusted confounders might affect results.
Above all this study shows that by 2003 it was widely known that Snus consumption was not just safer than smoking but that it had barely-measurable risks; and that smoking, drinking (and likely diet) were substantially more important risk factors.
Studies examined included sample sizes of up to 98,000 subjects, which allowed for cohorts of significant size and statistical power, along with longitudinal capability. These were not just small-scale cross-sectional studies, but about as powerful as you can get. The results are fascinating if an evidence source is required as a means to understanding the facts (Sweden's unique national health statistics).
About 30% of ex-smokers in the studies they examined used Snus to quit, which is by far the largest successful ex-smoker group behind the unassisted group.

9. Environ 2010
Review of the Scientific Literature on Snus.
(An evidence review for Swedish Match, the Snus manufacturers)
[join up this link to repair it]

10. Snus consumption not associated with heart disease:
This study reports that long-term nicotine consumption has no association with CVD.
Commentary by Rodu:

11. Snus consumption dies not increase risk for stroke:
This study reports that long-term Snus consumption does not elevate risk for stroke; but there is a small increase in worse outcomes for stroke victims.
Commentary by Rodu:

12. Snus consumption and risk of stroke:
Hansson et al 2014 (16 co-authors)
Zero risk for stroke is demonstrated by this meta study of 8 Snus studies of never-smokers: "Use of snus was not associated with the risk of stroke. Hence, nicotine is unlikely to contribute importantly to the pathophysiology of stroke."

13. Snus - lifespan reduction about 10 weeks:
[NB: numerous citations exist for lifespan reductions attributable to Snus consumption of between 6 and 10 weeks]

14. TSNA content of ST:


EU and Snus
1. Bates, Ramstrom 2013
Proposed revision to the Tobacco Products Directive.

2. Rodu 2013
What the EU Snus Ban Means: 290,865 Casualties Per Year
(Brad Rodu kindly updated his estimates for EU mortality due to regulatory policy; a useful guide to the cost in human life)
We now know that the EU Snus ban costs between 70,000 lives (current absolute minimum [i]) and 291,000 lives (probable maximum) per year

[i] The EU Snus ban is 21 years old @2013. To suggest that less than 10% (70,000) of the reported annual 700,000 smoking deaths in the EU could not have been prevented by allowing free access to Snus would be a fantasy (Sweden is the world leader in reducing smoking mortality, due to free access to Snus, and has the lowest smoking-related mortality by a wide margin).

UK and Snus
1. Snus letter to Jeremy Hunt from public health experts:



1. A fresh look at tobacco harm reduction: the case for the electronic cigarette
R Polosa, B Rodu, P Caponnetto, M Maglia, C Raciti 2013

2. Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach
Nutt et al, 2014
Eur Addict Res 2014;20:218-225 (DOI:10.1159/000360220)
A report that attempts to estimate values for harm caused by a range of nicotine-containing products, using the full spectrum of possible harms including financial and social harm.
The main criticism is that a scale of 100 is insufficient to measure these factors: there is no possible way the NRT patch can be placed at a 1% harm mark compared to smoking since it is at least 10,000 times less harmful than smoking by any conceivable measurement. Other products are poorly represented according to experts. The report is probably an attempt to show that THR is a good idea, but looks more like an attack on it as the science is so poor; risk-reduction is massively underestimated and harm is hugely over-represented. Any scale that places nicotine patches, one of the world's safest medicines, at a position representing greater than than 1000th of the harm from cigarette smoking is clearly ludicrous and it is of no consequence what measure is used.


THR blogs & resources

Carl Phillips
Ex-Prof of Public Health at Alberta. Authority on the science base for THR and principal scientist curating the evidence.
- A blog that mainly examines anti-THR junk science and propaganda, and the liars (often named) who protect smoking to benefit pharma.

CV Phillips (see above)
- A blog on the 'ep-' sciences, especially as related to THR and associated public health issues.

Brad Rodu
Prof of Medicine at Louisville, KY. Specialist in oral pathology, leading authority on the oral pathology of tobacco consumption. Authority on the science base for THR.
- Blog that examines public health and THR issues, with a speciality in smokeless tobacco (e.g. Snus).

Michael Siegel
Prof of Public Health at Boston Uni. Tobacco control practitioner though supportive of e-cigarettes.
- 'The Rest of the Story...' blog - looks at the full story behind news items in the public health / tobacco area. Although a tobacco control industry member, Siegel struggles with the evidence of fraud within his own profession, frequently commenting on the poor standard of published research, or the obvious misuse of parts of it by anti-THR propagandists.

Phillips, Rodu, plus other contributors.
- A site featuring various resources related to the THR area. Now essentially an archive, since the authors have moved to other sites for their main work in this area.

Paul Bergen
Tobacco Harm Reduction: News & Opinions
- A blog on public health / THR issues by a well-known Canadian researcher. Originally an Alberta product and including posts by others such as CV Phillips, the authors have moved on, and PB now concentrates on the CAN vapers / ECTA blog below. Essentially an archive now, like THR org.

Rodu, Cole
- A blog for smokers, examining THR alternatives and similar issues.

Murray Laugesen
- A resource site run by the veteran NZ researcher who has the honour of having carried out the first research on ecigs, many years ago.

- Paul Bergen's new home.

10. THR blog list:

THR RSS feeds

The first consumer association in the world for ecigs, also covers all THR substitution products such as Snus and dissolvables (less thoroughly).


Tobacco Control Industry

1. A wiki on the industry:

2. Not all in tobacco control are inveterate liars - other TCI members criticise the latest bogus science by Glantz:

3. ALA/ACS lies collection:

4. Nathanson (BMA) and Arnott (ASH UK) caught out in lies:

5. Nathanson lies: the infamous 23 times claim:

6. Pharma owns tobacco control:


Tobacco Control Industry - fraud

The black lung lie
Tobacco control is based on propaganda and disinformation to the extent that much of it can be referred to as lies. One example of this is the fraudulent portrayal of smokers' lungs in images as black, when this is impossible. The lungs pictured as black have been specially stained black, or are coal-miner's lungs, or are even pig's lungs specially prepared and dyed.

"Smoking does not discolor the lung."
- Dr. Duane Carr
Professor of Surgery, University of Tennessee College of Medicine

"I have examined thousands of lungs both grossly and microscopically. I cannot tell you from examining a lung whether or not its former host had smoked."
- Dr. Victor Buhler
Pathologist, St. Joseph Hospital, Kansas City

"It is not possible grossly or microscopically, or in any other way known to me, to distinguish between the lung of a smoker or a nonsmoker. Blackening of lungs is from carbon particles, and smoking tobacco does not introduce carbon particles into the lung."
- Dr. Sheldon Sommers
Pathologist and Director of Laboratories, Lenox Hill Hospital, New York

"I could never see on a pair of lungs if they belonged to a smoker or non-smoker. I can see clearly the difference between sick and healthy lungs. The only black lungs I’ve seen are from peat-workers and coal miners, never from smokers."
Dr. Jan Zeldenrust
Pathologist for the Government of Holland from 1951 - 1984
TV interview

"In the UK, donors with a positive smoking history provide nearly 40% of the lungs available for transplantation."
Prof Robert Bonser
Queen Elizabeth Hospital, Birmingham; University of Birmingham


Totalitarian Government

1. EU outlaws criticism:
"The European Court of Justice ruled yesterday that the European Union can lawfully suppress political criticism of its institutions and of leading figures, sweeping aside English Common Law and 50 years of European precedents on civil liberties."

This will certainly help to suppress criticism of its officials, who in the health-related area are considered among the most murderously corrupt in the world and who have become fabulously wealthy as a result. Dalli, for example (ex-Health Commissioner), is thought to control a personal fortune of approaching $100m, a sum impossible to accrue from any legitimate employment on his record - alleged to have resulted from his successful maintenance of the ban on Snus, the blocking of THR in all forms including ecigs, and similar highly-profitable legislation to benefit large indistries, believed to mostly comprise elements of the pharmaceutical industry.




Lists of THR-Related References

1. THR org list

2. Ecig research list:

3. CASAA lists:

4. List of ecig studies (FR):

5. Ecig studies:

6. Ecig studies:
[join ip this link to repair it]

7. 295 ecig-related documents in this search of PubMed @Q1 2014:
"e cigarette"[Title/Abstract] OR "electronic cigarette"[Title/Abstract] OR "electronic cigarettes"[Title/Abstract] OR "e cigarettes"[Title/Abstract] OR "electronic nicotine delivery systems"[Title/Abstract] OR "e cig"[Title/Abstract]OR "e cigs"[Title/Abstract]


9. List of ecig-related studies:






This list of references does not imply support or approval, simply that some aspect of the citation or material listed is of interest. Some studies are materially influenced by an agenda and such studies may or may not be present here.

It is also important to take into account that the system of research publication in medical journals is itself incorrigibly corrupt: clear conflicts of interest, funders' influence, blatant agendas and obvious errors are all routinely ignored and pass editor and peer review. The problem is that if research were to be honestly judged on its own merits, and poor quality or clear bias were to result in refusal, then the publications would in most cases go bankrupt. This fact alone should make it obvious that published research can in many cases be regarded as of interest value only, possibly revealing more about the researcher and funder than the subject discussed.

Please see the article at: About Clinical Studies And Evidence



created on 2013-10-29
last update 2014-07-14