A list of terms and acronyms encountered in the community, political and medical areas related to e-cigarettes and similar topics - part 2. In some cases these are colourless definitions, in others there is some opinionated interpretation of the meaning.
...continued from Part 1 - see menu at right >>
J to R
junk science : a term used to describe inaccurate research, varying from poorly-managed studies through to criminally fraudulent studies intended to promote drugs that either cannot perform remotely as well as reported or that have information regarding unwanted side effects suppressed.
There is a scale of low quality that runs from junk science, to bogus science, to fraudulent science.
The spiritual home of junk science is tobacco control and related pharmaceutical interventions, where the highest proportion of junk to honest work can be found. The liars and fraudsters who produce junk research can be found exposed on Carl Phillips' Anti THR Lies blog, where he names the fraudsters (and has never been subject to civil suit, since even a judge without the slightest knowledge of the topic would likely dismiss any suit rapidly with costs against the plaintiff). Virtually all junk science in this area is funded by the pharmaceutical industry, who depend on illness caused by smoking for a significant percentage of their gross income, and therefore work to protect it. As a result, almost all researchers producing junk in this area can be seen to be directly or indirectly funded by pharma: they either receive direct funding, or the universities they are employed by are funded by pharma and route the funds through to the researcher. (See: greenwashing)
More scientists are now exposing the junk science emanating from the tobacco control industry, who attempt to please their commercial funders by trying to block consumer access to THR; Polosa, Siegel, Farsalinos and others now speak out. Consumer advocates such as Bates and Godshall also refute the junk science attack on THR. Legal experts and ethicists also point out the fundamental error of denying people safer products (Sweanor etc.), especially when prohibition is based on fabrications.
JURI : EU committee on legal affairs. One of the EU committees that has input to the TPD.
legislators : the people at national, regional or city level who make laws. In the area of smoking, the law (and this especially includes the law pertaining to health) is owned by major industries, frequently to the detriment of the consumer (generally both in health and financial cost). It follows therefore that a proportion of legislators are owned by those industries; and that proportion cannot be insignificant.
the London Corruption Triangle : (and its relation to the Dept of Health) the UK press were occupied for the entire year of 2013 by juicy revelations of a tripartite arrangement between the London media, the Met Police and the Prime Minister's office to each help remove any embarrassments to the other. It had apparently worked well for many years, until the pressure from press whistleblowers made it untenable; a revenge feud then ensued in which each party attempted to hurt the others, in response to the round-robin series of revelations affecting all of them.
1: The press were revealed as routinely hacking phones for a story, including episodes such as hacking a missing, dead child's phone, causing intolerable grief to the parents; paying off police officers; and buying immunity from prosecution.
2: The police played along as they didn't want too much publicity about the Met's shoot-to-kill policy, the resulting collateral damage, and its continual repetition and the resulting riots they caused; their utter incompetetence at dealing with the riots, which largely consisted of ignoring them while parts of cities burnt down and were looted; and their gross perversions of justice in cases like the Hillsborough affair.
3: The PM's office complied because politicians need the media like a piglet needs a teat, and without it they're sunk; and because smooth government needs minimising of all the 'little problems' in daily life.
It explains why the endemic corruption in some government departments is not challenged: it can't be, when it goes right to the top. The PM can't do anything about the Dept of Health (clearly rotten to the core, and about as bad as it can get outside of Brussels) when his own office is fixing little problems all over the shop.
When the agreement broke down, it became a free-fire zone: the press dumped on the Police over Hillsborough, the slight problems with identifying the right person before killing them, the lack of any firearms being present before people were summarily executed, and causing various cities to get partly burnt down and looted then doing nothing whatsoever to stop it; then on the PM's office for conspiring with criminals (those in the media and the police). The Police started arresting journalists by the dozen (they'd had a get-out-of-jail free card for years so there was a slight backlog); then framing government officers and/or subsequently lying blatantly about meetings. Downing Street suddenly conjured up legislation to curb the press (who had acted criminally for years while everyone knew but no one could act, as the fallout would have been too painful come election time, and the Police had as much to lose as Downing Street); and kicking the Police in the nuts whenever the opportunity arose: budgets, staffing, performance, you name it.
A glorious time was had by all. But one thing you can bet your life on: they all need each other too much to allow the sniping to continue. The politicians need the press and they need immunity from the Police, within reason; the press need immunity from the Police as long as they don't go way over the top like before, and they need the crumbs the politicians throw them; the Police need the politicians to pay them and leave off the pressure, and they need the press to overlook the occasional little peccadillo. It will soon be back to business as usual.
lifestyle : a term describing life choices that may affect health and lifespan. See:
Master Settlement Agreement : (MSA) an agreement made in November 1998 between four large tobacco companies and 46 US States, which set out the level of costs and damages payable by those companies currently and in the future, and limited their liability. It therefore defines most tobacco firms' future costs in most of the USA.
The MSA settled all past and future claims for damages against the participating members of the cigarette trade for both State medical costs and private claims, within the 46 participating States. A total of $206bn was envisaged for the first 25 years of the agreement, although the volume of cigarettes sold ('sticks') and the effects of inflation will affect payments. Subsequently, more tobacco firms joined, and the non-participating States also lodged separate claims. At the same time, an agreement was also reached regarding smokeless (oral) tobaccos, known as the STMSA.
Here, we are specifically interested in the effect of growing e-cigarette sales and falling cigarette sales, and how that will affect the MSA. Bill Godshall reported in 2012 that the MSA payments are essentially unaffected by current events, mainly due to the effects of inflation, built-in inflation-proofing clauses, and a protective effect from built-in increases in the payments. Thus, an ~8% switch to ecigs as has occurred in the US appears, at Q2 2013, to have had little effect.
Bill Godshall is also on record as believing that the MSA favours the tobacco industry as it gives carte blanche protection at low cost. And of course the industry does not pay in any case: the cost just goes onto the price of a pack of cigarettes.
However, it is likely that by the time a certain percentage of smokers have switched to e-cigarettes, this situation will have changed; a 'break point' must be reached at some stage, at which the payments will start to slide. At a certain point there will be a drastic effect on the MSA funds; there will also probably be a knock-on effect from the reduction in payments (related to the 'economic timebomb' effect, qv). Added to this is the MSA bond effect: some States took their future expected earnings from MSA funds in advance, by issuing bonds; if MSA payments fall then the bond repayments are threatened, which would result in serious financial issues for the States concerned - if they needed the money up front so badly, then repayments from nonexistent income if the MSA funding falls looks to be an impossibility.
It has been suggested that the obvious threat to MSA earnings is one reason for the strong resistance to e-cigarettes. The critical point at which MSA payments will start to reduce has not been calculated; but in terms of the timescale, it is likely that by 2020 a considerable effect will have been observed. If this is the case, we might expect to see the start of some sort of reduction in MSA payments by 2018. The Attorneys General of several States have urged that e-cigarettes be strictly regulated, and from this it can be seen that they would prefer that ecigs are removed from the market. The AGs, although head of the justice system in each State, are also key policy makers in a State's fiscal affairs. It therefore appears that the AGs are desperate to protect cigarette sales in order to protect the MSA payments on which their States' economies (and their own personal finances) now depend.
Huge cash sums are very much like heroin, as can easily be seen by the same effect on the 'public health' pressure groups: it creates junkies; and sooner or later the junkie will do anything to get their fix. As an example of how corrupt the system is, many Attorneys General now appear prepared to kill tens of thousands of their citizens in order to balance the books and keep their personal benefits.
Update Q1 2014: MSA payments are beginning to look shaky, well ahead of the forecast slide. Several cigarette companies report they have withheld a percentage of the MSA payments due in this quarter. (see References page)
Update Q2 2015: MSA payments have now started to slide, well ahead of the expected point, due to the high penetration of vaping and falling cigarette sales. There are now reported to be 15 million US vapers (one survey says 21m), all of whom will be reducing the amount of cigarettes smoked and a percentage of whom will have quit smoking. This is desperate news for the States, the pharmaceutical industry and the cigarette industry. It can be expected that their fight to remove or restrict ecigs will reach fever pitch.
medical journals : publish papers, studies and trials related to therapies, treatments and related areas, and often with an online version. Some specialise in a particular field. There is a declared emphasis on peer-reviewed material, evidence-based therapy, and lack of COI funding although for practical reasons such issues are not efficiently addressed.
There is no way of ensuring that peer-reviewed materials are any more accurate than non-reviewed research, since the reviewers chosen will have the same agenda as the authors; and thus some of the most egregiously faulty research ever published has been 'peer-reviewed'.
'Evidence-based' may be the most abused term in existence since, in certain areas of medicine, it clearly refers to treatments or policies that are proven not to work (a therapy with a 98% failure rate cannot honestly be described as successful). An illustration is at the BMJ; this points out the hypocrisy enshrined in the term very well:
Since everyone is affected by a COI to a greater or lesser extent, this presents some difficulties. There are obvious anomalies in the policies of some journals, since they block research funded by tobacco companies, who most are aware have a chequered past, but allow research funded by the world's largest-scale criminals (the pharmaceutical industry, who have a record of the most widescale criminal activities of any industry, and who have paid the largest industry-wide fines ever for criminal activities); an industry that successfully camouflages its criminal operations, arguably, most of the time.
MHRA : Medicines and Healthcare Regulatory Agency, the UK's pharmaceutical licensing agency. An agency within the Dept. of Health. Considered as the UK's best example of a 'regulatory-captured' government agency, since if there is a choice between promoting or protecting public health or protecting pharmaceutical industry income, the decision appears to favour the industry. An example of this is their attempt to ban e-cigarettes in 2010, a serious attack on public health as e-cigarettes have the potential to take 50% of the cigarette market and therefore reduce smoking mortality by ~50% - an achievement impossible by any other method due to the 20% Prevalence Rule (see right-hand menu for link). This is a proven solution since in Sweden THR access has resulted in a world-leading position in reducing smoking mortality and morbidity; therefore THR solutions such as e-cigarettes cannot be dismissed as 'unproven'; in fact THR is the only solution that is proven to work.
The MHRA acts to prevent THR as far as is possible. Expert medical opinion is overwhelmingly in support of harm reduction (the Royal College of Physicians for example), making the MHRA's policies impossible to equate with a public health agenda.
They are dedicated to removing e-cigarettes from the market in order to protect the pharmaceutical industry's income for drug sales to treat sick smokers (a channel worth several billion pounds in the UK). Since an outright ban* by virtue of pharmaceutical licensing failed, their next step will be to try to find another way of regulating them out of contention.
*The MHRA have categorically stated that all current e-cigarette products (hardware and refills) must be removed from the market on the date medical licensing begins; that no current ecig product will receive a license; that no current ecig product is licensable; and that they have no idea of what the costs might be (Jeremy Mean of the MHRA, E-Cigarette Summit, November 2013).
**Current estimates are that costs for the average ecig firm will total in the millions, therefore almost all would go out of business.
Since the furthest-advanced ecig firm failed to gain a license after 4 years and £2m investment in R&D in an attempt to comply, and taking into account the MHRA's position as stated above, it is absolutely correct to say that medical licensing equals a total ban on ecigarettes (certainly as we know them today); anyone who says otherwise is either a liar, corrupt, or stupid beyond belief.
morbidity and mortality : medical descriptions for disease and death. Here, we are interested in tobacco-related mortality and similar issues. Note, though, that what is under discussion is deaths from smoking (as tobacco is not the problem, smoking it is). This means a more accurate term would be smoking-related mortality.
naive : in medical usage, it refers to a lack of experience of something - 'not previously exposed to'. For example: a 'nicotine-naive' person means someone who has not previously been exposed to nicotine in supra-dietary amounts; an 'ecigarette-naive' person would be a person who has never used an e-cigarette.
nicotine : a normal and natural component of the diet. To date (Q2 2013), all large-scale surveys (including one of 800 people by the CDC in the USA, which they have tried as hard as possible to bury of late) showed that everyone tests positive for nicotine. No such survey has ever found a single person who did not test positive for nicotine. This is because it is a normal ingredient found in vegetables of the solanaceae family, such as tomatoes and potatoes, and other foods (such as tea). However as the urban diet becomes progressively worse over time, it may even be possible that people will begin to test negative for nicotine, as people eat fewer vegetables. The normal background blood plasma nicotine level was found to be about 2ng/ml in the past, but this will presumably be reducing. Note carefully that a sister compound, nicotinic acid, is a vitamin (vitamin B3, aka niacin). Both these compounds show some similar activity in humans (improvement of cognitive function, improvement of short-term memory, improvement of work capacity, improvement of alertness, reduction of stress, etc.) and those who need a B3 supplement might well be those who need to supplement their dietary nicotine intake.
Smokers consume cigarettes in order to supplement their dietary intake of nicotine, but die from the smoke. qv zero-nicotine cigarettes
nicotine dependence : undemonstrated, as far as nicotine itself is concerned (no one argues against smoking causing dependence, and that ex-smokers may be dependent on nicotine; this is not relevant to nicotine-only issues).
No published study exists of nicotine administration to humans and any resulting potential for dependence (i.e. a study of the effects of pure nicotine on nicotine-naive subjects, that is to say, never-smokers). All citations lead to studies on smoking dependence; but since tobacco / smoke has 9,600 identified compounds (Rodgman, Perfetti 2013), this is irrelevant. Nicotine is not dependence-forming unless/until supplied in tobacco and especially cigarette smoke, which is presumed to cause some sort of brain chemistry change. In any case there are few dietary ingredients (as nicotine is) that are dependence-forming, and the circumstances of dependence creation for these substances seem unusual (e.g. vitamin A). Nicotine would also be unlike other dependence-creating substances because it does not create tolerance (the need for more of the substance, over time, to deliver the same effect): e-cigarette users routinely reduce the amount of nicotine they consume, usually with no problems and with no observable deficit, so that smaller and smaller amounts deliver exactly the same effect. This appears to be the opposite of tolerance, which is noted as a core feature of dependence-creating drugs.
There is now sufficient evidence to state that nicotine itself has no potential for dependence. Academics who state this are subject to condemnation by colleagues; but until some sort of evidence is available to show that nicotine causes dependence in never-smokers - separate from smoking or any other delivery system with 9,600 potential synergens - we might perhaps agree that the issue is not yet determined.
"Studies have shown that none of the nicotine replacement therapies - chewing gum, inhalers, patches - none of those are addictive. Nicotine is not addictive. The cause of addiction is the release of monoamine oxidase inhibitors, or MAOIs, along with nicotine." - Prof Peter Killeen, Emeritus Professor of Psychology, ASU
Some may agree or disagree with Prof Killeen's view of the causative agent (as being the sole agent in all cases); but currently, no one can prove him wrong, as there is no evidence either way.
"The risk of addiction to nicotine alone is virtually nil." - Dr. Paul Newhouse, Director, Vanderbilt University Center for Cognitive Medicine. Dr Newhouse is currently (2015) the world's leading authority on nicotine and unexposed subects, as he has administered more pure nicotine, to more never-smokers, for longer periods, than any other researcher; he investigates nicotine in treatment of neurodegenerative diseases.
[see: Vapoing Quotes]
[see Articles: Missing Nicotine Trials]
[see References page: Nicotine section]
nicotine and cancer : no association is known, in humans. Nicotine does not cause cancer and is not associated with cancer, according to the UK clinical guidance organisation NICE and many other experts in this field (and there is a very large amount of data to support this; it is not opinion, it is fact).
This may not be true in the case of animals; but we know that animal nicotine models do not transfer to humans (in multiple ways).
nicotine, pharmaceutical grade : is extracted from tobacco plant crops. It is thought that most if not all pharma grade nicotine originates in China and India, although it may have certification from India or Switzerland and eventually even be sold as 'US-sourced'. Purity varies, as for most chemical products.
In early August 2013 a US firm announced they will start to produce liquid nicotine of pharma grade, and they will be the first US firm doing so. At Q2 2014 they have yet to go on-line.
nicotine, production : all nicotine used for pharmaceutical or consumer products is extracted from tobacco (the tobacco plant Nicotiana Tabacum), because this is the cheapest crop - it has the highest amount of nicotine. It could be extracted from any other solanaceae plants or the Duboisia Hopwoodii (and there may be others). Costs would increase dramatically, though.
nicotine, synthetic : does exist, but: (a) is extremely expensive, (b) has only 50% of the biological effect of organic (natural) nicotine (as the D-nicotine synthetic form does not have the same bioactivity as the L-nicotine or racemic natural form), and (c) there is no published research on its safety profile in humans.
Since nicotine is optically active (the forms are distinguishable from each other by the use of polarised light, termed levorotatory or dextrorotatory - left or right rotation), it is possible to examine liquid nicotine optically to determine which type it is; this is quicker, simpler and cheaper than other types of analysis.
No e-cigarette refill manufacturer uses synthetic nicotine as it costs far more than pure pharmaceutical grade nicotine extracted from tobacco (from 100 to 1,000 times more), it would require double the quantity for the same effect, and there are questions about the health issues since there is no research on its use. There would be no advantage to using synthetic nicotine and many disadvantages. It would probably be cheaper to produce it from Duboisia (or others) if the perceived advantage was to avoid tobacco use.
It has also been stated in the past that production of L-isomer (active) nicotine synthetically would be easy (and thus cheap). However, it cannot be either easy or cheap or someone would be doing it.
nicotinic acid : vitamin B3. Also known as 'niacin' - a contraction of nicotinic acid; because when researchers discovered the vitamin, due to the taboo surrounding nicotine, they realised that people might not accept that a form of nicotine is a vitamin, and provided a new name so that their research would not be dismissed. B3 deficiency has several physical and psychiatric symptoms, and can have serious implications (such as pellagra, the skin disease). Nicotinic acid is a similar and related compound to nicotine, is generally co-located in the same vegetables, and has some effects in common on the human organism, and in some organisms is a metabolyte of nicotine (but not in humans as far as is known); though because of its well-established nutritional effects it is a recognised nutrient.
nornicotine, anatabine, anabasine, myosmine : some of the other active alkaloids present in tobacco as well as nicotine (there are several more), though nicotine is present in the highest quantity. At least one, anatabine, is shown to have an anti-inflammatory action and is used in pharmaceuticals, for example for the treatment of rheumatism.
NRT : nicotine replacement therapy - a pharmaceutical intervention for smoking cessation that is a core treatment within the Harm Management division of medical treatment for smoking cessation (Harm Management is the exact medical equivalent of Harm Reduction). The two main groupings of pharmacotherapy for smoking cessation are psychoactive drugs and NRT. Typical NRT products include nicotine skin patches, nicotine chewing gum, nicotine inhalers and nicotine lozenges. NRT drugs are among the safest pharmaceuticals, since nicotine is a very safe drug: in fact it is simply an aggressive nutritional supplement therapy. In contrast, the psychoactive / psychotropic drugs have significant risk.
Unfortunately, NRTs have an extremely low success rate, variously reported as anywhere between 0% and 7% at the 20-month mark but generally agreed as around 2% when independently verified. Manufacturer's clinical trials of NRTs tend to show much higher success rates, but are said to be among the most extensively rigged of all clinical studies; their results cannot be replicated by independent researchers, and have no relationship to real-world results. If 100 patients receive NRT as a treatment for smoking dependence in order to achieve smoking cessation, then 95 or more will have relapsed to smoking within two years.
In the UK, NRTs have now been licensed for long-term treatment and multiple concurrent use since they are known to have no implications for health. NICE report they have 5 years' data, although NRTs have been used for much longer than this. (It is not clear why NICE state they only have 5 year's clinical data when NRTs have been used since around 1984.)
The Snus data from Sweden was used in the licensing application hearings to demonstrate there are no health implications for long-term nicotine use (Snus consumption, and thus nicotine consumption, has no clinical significance).
'on average' : normally; when applied to most people. For example, when used as a term used in describing health implications, as in: "On average, the activity has no clinical significance", it means that for any normal person there is very low risk. However, not everyone is normal, and some have a genetic predisposition to certain morbidities; therefore some types of activity may entail far higher risk for them.
parasites : those who take without giving. Becoming more common to describe the public health industry and particularly the especially useless section of it concerned with smoking, known as the tobacco control industry - because smoking prevalence has remained static for many years in countries such as the UK and cannot be reduced significantly once the 20% Prevalence Point is reached, and demanding money for zero result verges on fraud. In fact the number of smokers has actually risen in the UK - therefore the TCI have no apparent use, especially considering (a) the extraordinary cost of employing them and implementing their increasingly useless policies, and (b) their protection of cigarette and pharmaceutical industry profits by blocking the only real threat to smoking, THR.
qv spongers, troughers, rent-seekers
PDF : portable document format, with the file extension of .pdf - a common form of computer document type, used because it is platform-agnostic (can be viewed on any computer of any type running any operating system, with a suitable reader app) and prints correctly, unlike many other page formats, which often do not print well. Adobe's principal achievement (the software house that invented it), and the best example of global 3rd-party software. The main use of a PDF is for onward transfer of a document that needs to be usable by anyone anywhere, that prints nicely, and that works just as well on the web.
Note that PDFs generally appear of better quality when printed than when viewed onscreen.
peer review : the process by which authors wishing to publish in scientific journals have their colleagues anonymously review and pass material for publication. There is no way of ensuring that peer-reviewed materials are any more accurate than non-reviewed research, since the reviewers chosen will have the same agenda/funding as the authors; and thus some of the most egregiously corrupt research ever published has been 'peer-reviewed'. Indeed, the peer-review process is currently seen as the optimal silution for publication of junk science.
A medical journal editor described it as follows: ".....peer review is an utterly corrupt, ignorant, stupid, mad system that we’ve created, it’s just that we haven’t come up with anything better" (Horton, The Lancet). This is not correct since scientists who want their work to be correct before publication will frequently pre-publish in draft form and ask for comment. Genuine work, then, will often be first seen in draft form; junk science is never seen first in draft.
The system of anonymous peer review is fundamentally flawed; thus, the meaning of 'peer-reviewed' is, at best, that the material probably has no spelling mistakes.
pharmacotherapy : a medical intervention using licensed drugs. In our area it refers to the use of pharmaceutical interventions for smoking cessation such as NRTs and psychoactive drugs. These drugs are very profitable but almost useless; they have about a 9 out of 10 failure rate on average; some, such as nicotine skin patch NRTs, generally achieve around a 2% success rate (a 98% failure rate) in independent trials.
pharma pimps : also pharma whores - descriptions used for medical professionals who work to a pharmaceutical industry agenda instead of in the best interests of public health. If the medic promotes the pharma agenda in general (which in the smoking-related arena means to protect the status quo and thus industry income), they are referred to as a 'pharma whore'. If in addition the medic promotes pharmaceutical products (in preference to other products that work better) then they are described as a 'pharma pimp'.
Such persons can be accurately described as corrupt, if they are supported in some way by public funds: to work against the public interest (by acting contrary to the best interests of public health) when paid by the public is an accepted definition of corruption.
Example: describing pharmaceutical interventions for smoking cessation as 'safe and effective' when clearly they are neither (at 20 months they have a failure rate of 9 out of 10, and since almost all patients return to an activity with a 50% risk of death then the interventions cannot be described as safe; and although NRTs are very safe indeed, the psychoactive drugs in contrast have killed hundreds, harmed thousands, and ruined tens of thousands of lives).
Example: promoting a pharmaceutical intervention with a 98% failure rate (such as nicotine skin patches) while obstructing the use of e-cigarettes (which have a minimum success rate of about 30%), when each have about the same risk.
propaganda : the technique of managing public perception by promoting an agenda-based and untruthful version of an issue, in order to achieve a result not otherwise easily obtainable. The core techniques include lying by omission, selective choice of facts, artful representation of a situation in order to emphasise or remove information, and other methods of distorted presentation.
Propaganda may include outright lies, but the most skillful does not directly lie but instead alters the balance of the facts so that a distorted version is presented as the truth, and which can be continually reinforced until, in the minds of the recipients, it becomes the truth; it is harder to refute because it does not contain outright lies. The best propaganda eventually becomes fact in the minds of those targeted.
Good propaganda subtly alters perception of an issue so that even 'experts' believe the altered version; an excellent example is revealed by a recent survey (Q2 2013) that showed 44% of UK and Swedish doctors think nicotine is associated with cancer - the opposite of the truth, and something that has been described as 'medical malpractice' since it should be not be so obviously misunderstood by those tasked with the medical care of patients. It shows that even those considered by the public to be a source of expert knowledge on a subject can be coached to believe the opposite of the truth.
The word comes from the Italian 'to propagate' and was first used by the Catholic Church in 1622 to describe their propagation of the church's message. Later, it became used to describe an agenda-based alteration of the truth in order to promote a particular point of view. All industries use propaganda since in its most benign form it is simply marketing. All governments use propaganda, consciously or unconsciously, since the message they wish to convey may not exactly align with the unpalatable truth.
Propaganda normally consists of a continual dripfeed of slanted material, so that the climate is favourable to the required opinion, and so that when the true facts are reported, they are dismissed as incorrect.
In the 21st century, the masters of benign propaganda, aka marketing, are the consumer industries of the Western world. The masters of political propaganda are states with an agenda to promote, which is frequently to protect their economy by supporting a major industry - example: invading another country for the purposes of gaining cheap oil but promoting it as a blow for democracy. The masters of commercial propaganda are the pharmaceutical industry, who have made it a core business tool and are especially adept with 'black propaganda': a message that appears to come from one source but actually comes from another, and use it to obtain legislation that removes competitors: the material appears to originate from the academic or health communities but is organised and funded by the industry.
public health : "The corruption of medicine by morality." - HL Mencken.
In the modern era, public health has been changed, by a mixture of extremist ideology and commercial exploitation, from a method of preventing and controlling widescale outbreaks of disease into lifestyle regulation (see:
The suborning of organisations such as the WHO (the funding that 'talks' is the commercial funding, especially that of the pharmaceutical industry, who appear to own the WHO), and the changing of its agenda from taking all possible actions to protect public health into a commercially-funded pressure group working for the pharmaceutical industry that protects smoking from threats such as the electronic cigarette; and the EU (the Health Directorate does everything possible within its power to protect smoking from serious threats, presumably to benefit pharma), means that 'public health' is now seen as any agenda that suits the pharmaceutical industry and/or crackpot ideology to extend life at all costs, despite the overwhelming wish of most of the populace to live freely without hindrance and to be able to make their own choices.
In the past, such an agenda would have been seen as completely unrelated to public health in any way whatsoever; now, personal and private lifestyle decisions are viewed as the responsibility of the state. Thus, the new 'public health' is an extension of the neo-Stalinist elements of the hybrid form of governance that many Western governments now subscribe to: a free market economy combined with some elements of communist-like control of the population. See also:
"When I teach public health students, I always point out to them that they are signing up to enter into a corrupt special interest group."
- Prof CV Phillips
CVP is a THR advocate who believes that public health is now an industry with its own agenda, and therefore not always acting in the best interests of the public.
"This is a story that is going to be very difficult and challenging to teach to my public health students this fall."
- Prof M Siegel (referring to the tobacco control industry deliberately blocking laws that would have prevented the sale of e-cigarettes to minors)
MS still believes in public health / tobacco control, but struggles with the evidence that it works for its own interests and those of its commercial funders, not the public.
The public health industry is an industry like any other: it works for profit. Its products are pronouncements and policy, all of which are always profitable for the industry itself, and usually for its funders, often conflicting with the public's health. It has been shown that smoking can be virtually eliminated by THR (Sweden's male smoking prevalence falls at 1% per year and will be 5% in around 2016, due to Snus substitution for smoking); but eliminating smoking and its associated disease and death means the closing down of public health groups in this field (called the tobacco control industry), and they clearly don't want that result as they are the fiercest opponents of THR.
public health - the best and the worst : public health probably came into being when Dr John Snow identified the cause of disease and acted to stop it: in 1854 he removed the pump handle from a public water pump in London that was spreading cholera. He had to face vicious opposition and ridicule from The Lancet and the general medical community, who at the time believed disease was caused by miasma (bad air). The Lancet is apparently still a comic run by morons, today.
Snow's actions typify the best aspects of public health: a fight to protect the health of the public in the face of powerful opposition from the establishment.
Public health eventually became a corrupt enterprise in the West, when communicable and environmental disease was no longer a serious threat. As part of the establishment, Public Health had become too powerful, wealthy and well-funded to shrink - it had become a lobbying tool for commercial funders. The worst aspects became clear in the late 1930s when the first clear and unambiguous use for state control of the population was employed: the Third Reich ordered members of the Hitler Youth movement to follow certain health-related practices as their bodies belonged to the State. Public health has been a statist tool ever since, at least when not working for commercial funders.
It is also of interest that although modern public health was created by the fascists, today it is an important tool used by the spectacularly well-funded neo-communists who govern all aspects of health politics and consumer spending in the West. Totalitarians on both sides all want the same result, after all: your absolute obedience and your money.
PV : personal vapouriser. A term often used instead of electronic cigarette, and more accurate since the device has no physical or functional relationship to a tobacco cigarette. Unfortunately, if the term were to be used exclusively, it is likely that user numbers would only be at 10% of the current figure, because smokers are far less likely to try out a device that has a name sounding like a medical device; because the media prefer vivid descriptive terms and so popularise the 'e-cigarette'; and because the specificity of internet searches means that the product would not be located by normal means. To put it simply, calling it an 'e-cigarette' guarantees much greater popularity, although coupled with much more resistance and negativity.
quitting : (here) the act of stopping smoking; the process of ceasing the consumption of cigarettes. Cigarettes are notably dependence-forming, on average, and quitting is often difficult. Some smokers appear able to quit easily; some cannot quit no matter how often they try and whatever method or assistance they employ (with the exception of THR); the majority appear able to quit but with varying degrees of difficulty. However, it appears that 20% of the adult population either require dietary nicotine supplementation, or some other feature of smoking, since it is extremely difficult to reduce smoking prevalence below one-fifth of the population (see: 20% Prevalence Rule).
q.v. : see elsewhere in this article.
RAPEX : 'rapid exchange' (say "wrap-ex"): the EU product alert system that, "...facilitates the rapid exchange of information between Member States and the Commission on measures taken to prevent or restrict the marketing or use of products posing a serious risk to the health and safety of consumers with the exception of food, pharmaceutical and medical devices, which are covered by other mechanisms." In practice, it provides a mechanism for alerting consumer product legislation enforcement officers in EU countries to products which infringe any aspect of consumer product legislation. Thousands of alerts are created annually in each of the common product categories of electrical goods, cars, children's toys and children's clothing - these are the categories of goods with most RAPEX alerts. E-Cigarettes have had only nine RAPEX alerts @Q1 2013 and these mostly concerned labelling or packaging issues or missing CE mark certificates - one of the clearest indications that ecigs are among the safest of consumer products, since virtually all other categories generated hundreds or even thousands more, and far more serious, alerts (e.g. poisonous children's toys, brake faults in cars, dangerous mains electrical goods).
Ironically, the existence of a few RAPEX reports of minor infringements has been used as propaganda in pharma's war on ecigs, showing how facts can easily be twisted by skilled propagandists.
regulation : the system by which the state controls an industry in order to protect the public interest (theoretical meaning). In practice, any large market is regulated by makers or haters: people who make it or profit by it, or who want to abolish it. The makers generally win out, if the scale is large enough (as funds for greasing the wheel are essentially unlimited).
The process by which regulatory bodies eventually become owned by the industry they were designed to regulate is called regulatory capture - see below.
regulators : the people who make and enforce industry-specific regulations. All regulators are eventually owned by the industry they regulate, unless the business area is very small (and therefore poor) or very new; or perhaps rarely where government has extremely strong anti-corruption measures in place. This principle is called 'regulatory capture'. The best examples in our area are the FDA and MHRA, who protect and promote pharmaceutical industry income even where this is massively detrimental to public health.
In the past, bribes were paid by transfers to offshore bank accounts, but this method is no longer the primary means of corruption because in the computer age it leaves a 'paper trail'. Instead, the consultation fee, revolving door and future employment methods are used:
a. In the 'consultation fee' method, senior regulatory staff are paid fees by industry to consult on issues. This allows the industry to control who gets paid and when.
b. In the 'revolving door' ploy, the industry and regulatory staff are the same: they move between the two. This allows industry to place its staff within the regulator or reward ex-government staff with a secure job.
c. In the 'future employment' ploy, senior regulators are promised a well-paid position with industry (or one of its foundations or cut-outs) at a later date, for services rendered while in government employ. This may even take the form of a non-executive directorship, meaning that the ex-regulator can be paid for zero attendance or work. This is why the boards of pharma front groups often have over a hundred members, all being paid for services rendered.
These are the modern methods of corruption and they work exceptionally well, as can be seen by decisions that always prioritise industry income over public health.
regulatory capture : the process by which a government agency originally established to regulate and control an industry (to protect the public) eventually becomes owned by and operates on behalf of the industry, to the detriment of the public interest. The Wikipedia page on this topic is, in this case, an accurate overview and a good starting point for further research. The best-known example of regulatory capture is said to be the US FDA, which is alleged to work for the pharmaceutical industry rather than public health in instances where there is a conflict. There is sufficient evidence for this to prevent dismissal as rumour: for example, anomalous decisions that are significantly detrimental to public health but protect industry income; and jointly-signed letters to the newspapers by scientists and technicians working for the FDA who state that science-based decisions by the technical staff (and thus beneficial to public health) were overturned by management in favour of decisions that were more profitable for industry but detrimental to the public interest. (qv serious incident reports)
Regulatory capture is virtually guaranteed under weak governments who tolerate corruption as a means of reducing departmental problems. The principal issues are two:
a. The revolving-door staff exchange by which industry staff move to the regulator, and government staff move to the industry, such that the staff are essentially the same people;
b. In particular, the ability of government regulatory staff to retire into the industry with a highly-paid position as a reward for services rendered. This may be with a 'cut-out', a third-party organisation such as a foundation that can be said to have little or no connection with the funding firm, and/or with a position that requires no actual work, such as a non-exec board position.
The revolving-door staff exchange is far more important now that it is much easier to track payments into offshore bank accounts. It is a direct route to corruption, should be prohibited, but rarely is.
Regulatory capture by special interest groups: an aspect of regulatory capture is the way in which some regulatory processes are captured by opponents of the product or activity which is regulated. Thus, e-cigarette regulations become owned by opponents of e-cigarettes. It is not clear if anything anywhere - especially in any health-related area - is regulated by independents as against those who profit from it or are dedicated to removing it.
"Everything is regulated by makers or haters." - CP, July 2013. An over-simplification, but with more than a grain of truth.
rent-seekers : a term in popular economics (esp. US) for seeking to profit through public policy without creating economic value or any measurable benefit; especially with regard to pressure groups that pronounce on health policy and demand public funding in order to do so. Rent-seekers are those who clamour for policy changes that only have any real benefit in providing them with work.
Rent-seeking is a core driver for some sections of the public health industry and especially tobacco control (which ceases to have much of a function after the 20% barrier is reached and is redundant thereafter).
'Rent-seekers' is a polite way of describing the toxic parasites in the tobacco control industry who work to their funder's agenda, not for public health. They campaign to block public health improvements such as unhindered access to THR products because this will significantly harm their funders: government departments that depend on tobacco tax revenues; NGOs that depend on MSA funds to survive (e.g. Legacy); States and cities, who fundamentally depend in some cases on tobacco tax and/or MSA funds for their economic survival; and the pharmaceutical industry; who all rather obviously need to protect smoking at any cost.
qv troughers (Brit. equiv.), spongers
continued in Part 3 - see menu at right >>