A list of terms and acronyms encountered in the community, political and medical areas related to e-cigarettes and similar topics. In some cases, an opinionated interpretation of the meaning follows the definition.
For the terminology of vaping: ecig hardware and refill-related topics - see: Vaping Terminology
A to I
ad lib : ad libitum (Latin), freely and as desired.
addiction : (see dependence)
aftermarket : (see: upgrade market)
AG, Attorney General : (see: Master Settlement Agreement)
aka, a.k.a. : also known as. Example: the smoking-related death rate, aka 'tobacco-related mortality'.
alkaloids : biologically active compounds that we primarily associate with plants, but are in fact produced by almost all classes of organisms (life). Although we take the word to mean 'human-active non-acid plant compound', this is not really the case - only the 'active in humans' part is correct, though most are indeed found in plants.
The name alkaloid ('alkali-like') was originally used because they were thought to be exclusively alkalis ('opposite' to acids), though it is now known that some are neutral or acids. The common names of alkaloids generally end in the suffix -ine, either a reference to their chemical classification as amines or a simple addition of the suffix to the name of the plant they are derived from. About 20% of plants are believed to contain alkaloids. About 12,000 alkaloids have been isolated.
The majority of useful alkaloids are produced by plants; the notable exceptions to plant manufacture include the various poison arrow frog alkaloids such as epibatidine. Interestingly, this is a painkiller more than 200 times as effective as morphine in humans - but the fatal dose is so close to the useful dose that it cannot be used.
Alkaloids often have pharmacological effects on the human organism, sometimes powerful, and many are used pharmaceutically (i.e. in medicines) and in consumer products such as toothpaste (example: sanguinine), consumer inhalants (example: berberine), consumer therapies (example: quinine), and consumer drinks (example: trimethylxanthine, aka caffeine, as in coffee).
Beneficial alkaloids include the anti-bacterials sanguinine and berberine, the anti-cancer compounds vincristine and vinblastine, the anti-hypertension agent reserpine, the cholinomimetic galantamine, the anti-inflammatories anatabine and colchicine, the CNS stimulant and painkiller synergen caffeine, the anti-cholinergic atropine, the vasodilator vincamine, the anti-arrhythmic quinidine, the arrythymia diagnostic ajmaline, the analgesic morphine, the anti-asthmatic ephedrine, the anti-malarial quinine, and the cognitive function enhancer nicotine.
Alkaloids of use are frequently used in consumer products; they are of equal use in consumer products and medicines; defining them as exclusively for medicinal use or even legally as medicines indicates either ignorance or more likely some form of commercial agenda.
anecdote, anecdotal : any effect not observed in a clinical trial for specific examination of that effect, even where the effect is powerful enough to affect national health statistics. In other words, (a) if a number of clinical trials report an effect that was not the specific target process examined in the trial; or (b) if millions of people report an effect but it has not yet been confirmed by clinical trials, then it is regarded as anecdotal (not well-demonstrated). However, if it is the established, and especially establishment, view - even when unsupported by any evidence - then it is not regarded as anecdotal.
cf clinical evidence, qv
anti smoking harm campaigners : a group of advocates, both professional and unpaid, who are loosely associated with tobacco control but who have significantly different aims. They are primarily interested in abating harm caused by smoking, rather than removing all access to tobacco or nicotine in any form and eliminating the tobacco industry, which tend to be the main objectives of the core within the tobacco control industry. As such they promote public health by methods that are not in themselves harmful: they principally support measures such as education, smokefree public buildings, and assisting smokers to switch to low-risk smoke-free products. This pro-health rather than anti-everything stance means that they are supporters of THR; which in turn means they are not popular with the tobacco control industry, which has no room for compromise and does not respect personal freedom, even where harm to others is not possible (such as with e-cigarettes or Snus) and who are too closely associated with the pharmaceutical industry to deviate far from an agenda that is rigidly anti-THR for commercial reasons.
Anti smoking harm advocates tend to be pragmatists interested in policies that work to improve public health, as against idealists who believe that ideals are more important than lives in their battle against the tobacco industry. A feature of ideology is that it leads to zealotry; and zealots tend to be blind to the facts, which may be inconvenient, and willing to sacrifice others for the sake of ideology as it is more important than people's lives. Ideology is a mistake when connected in any way with public health; in this particular case, it can lead to millions of preventable deaths due to opposition to THR: the reverse of the professed aim of saving life.
A critical difference between the anti smoking harm group and the core tobacco control believers is that smokers are expendable in the eyes of tobacco control - it is not important if they die, or if millions (or all of them) die in the course of achieving the ultimate goal: the destruction of the tobacco industry. This is opposite to the view of the anti smoking harm group, for whom preventable deaths are not acceptable and are unnecessary. Thus, for the tobacco control industry, the end justifies the means: any/all methods are acceptable and extensive loss of life is justifiable; but for anti-smoking harm advocates, the means are as important as the goal, and all loss of life is seen as preventable.
Anti smoking harm campaigners are supporters of e-cigarettes and other THR solutions, for multiple reasons. Opponents of THR solutions cannot be classified as either campaigners against the harm from smoking or public health advocates, since they pursue an ideological goal in which the prevention of unnecessary deaths and people's basic rights are not important, and in which widescale death is acceptable; they have a core tobacco control ideology which is more important than any other issue. In the real world, funding is a crucially important factor as the funder's aims eventually control the agenda; as the tobacco control industry's main commercial funder (and in some cases principal funder) is the pharmaceutical industry, they are fatally conflicted since smoking provides at least 10% of pharma's total revenues. By definition pharma cannot afford to cut smoking by 50% or more, which is what THR is proven to do; thus the TCI block THR on behalf of pharma.
In many people's minds, Bill Godshall is the person most closely associated with the campaign against harm caused by smoking, as against tobacco control.
ANTZ : anti-nicotine and tobacco zealots. Generally, persons employed within the tobacco control industry, and typically funded by the pharmaceutical industry (either directly or indirectly). Zealots are blind to the facts, and these particular ones hate the tobacco industry so much that many have lost sight of the original aim of tobacco control, which was probably to reduce the burden of disease and death caused by smoking. They have changed into a movement that seeks to ban any form of consumer nicotine product and are the public voice of opposition to THR; which, perversely, means that in practice they work to protect the status quo and therefore to protect cigarette sales. None appear able to see the obvious, which is that they are now working for big tobacco and big pharma to maintain death and disease at its current levels. Pharma (principally) recognises its debt to their dumb proponents by funding them directly if they will accept the money, or indirectly if they won't (via the universities and organisations they work for).
Origin: ANTZ was derived by Kristin @CASAA from the common usage within the e-cigarette community of the slang term 'the antis'.
ASH, ASH UK : Action on Smoking and Health, the US and UK pseudo-health pressure groups. The two groups appear unrelated except by dogma.
ASH (USA) is well-known for its alleged operation as a pharma front group. It is one of the most vociferous opponents of THR including e-cigarettes.
ASH UK is different in that it is slightly more pro-health as against anti-everything that might threaten pharmaceutical industry income; they have expressed support for e-cigarettes (as a theoretical concept). In practice they are against e-cigarettes because they support medicalisation of ecigs, which is equivalent to a de facto ban. In the EU, a framework of medicalisation would leave almost all effective products unlicensed and therefore prohibited; in the UK, all current products of any/all type would be banned, and a new type of ecig with metered dosage would have to be invented before any product could be licensed, according to the MHRA themselves (2014). Thus, medicalisation equals a 100% ban in the UK. Since this situation must be obvious to ASH UK, their professed support of ecigs is described as weasel-words or lying.
Both groups publish disinformation and misrepresentation; considering the position they hold, and the scale of harm to public health that such falsification involves, it cannot be considering anything other than lying (in the case of ASH UK this refers, at 2016, to their position on unhindered access to consumer vaping products). It is easy to dismiss such positions as that of crackpot ideologists, except that they would not exist but for funding, and a proportion of it is likely to be commercial and come with a quid pro quo. In practice the effect of their work is to protect cigarette sales, as they are against unrestricted access to e-cigarettes or other consumer THR products, which are the only real challenge to smoking in most of the developed Western countries due to the one-fifth population barrier seen in western developed countries, below which smoking prevalence cannot be significantly reduced by conventional means (which may be referred to as the 20% barrier or the 20% Prevalence Rule, qv).
ASH UK produce accurate surveys and statistics on smoking and THR-related issues such as vaping, the lack of ecig use by non-smokers, and the lack of ecig use by children. These materials cannot in general be faulted. Their pronouncements on ecigs and their intense and concerted political lobbying to have vaping restricted or in some circumstances banned, on the other hand, are widely seen as disinformation or corrupt and may simply reflect the commercial pressures they face.
Their intense and focused political lobbying is against the rules of their public funding, but of course there is one law for the government and another for everyone else.
astroturfing : a fake citizen's campaign that is in fact commercially funded propaganda. It gets its name from being a synthetic and false version of what looks like a 'grassroots' movement but is in reality synthetic, since it is paid for.
The pharmaceutical industry specialise in this form of propaganda/lobbying and have the world's largest astroturfing programme, run by front groups set up to look like pro-health or citizen's lobbying organisations, but which in reality exist to exert pressure on behalf of the industry purely for commercial gain. Many of these front groups also engage in tobacco control activities, so there is a close link between pharma front groups and the tobacco control industry (as in some cases they are the same thing).
The principle mechanisms used are the publishing of propaganda, obtaining agenda-based slanted research, buying medics to publish pro-industry statements, lobbying policy makers, and obtaining legislation to remove or restrict commercial rivals and/or protect pharma income. It is all carefully managed to look like academia-based or citizen-based health campaigning, when instead it is commercially funded and carefully stage-managed. The two centres of this effort are Washington, USA and Brussels, Belgium, where the two largest markets for pharma products are controlled from (Brussels is the centre of EU policymaking). The pharmaceutical industry's astroturfing and black propaganda campaigns are inextricably linked (qv propaganda).
Staff working for the pharma front groups in the USA earn fantastic salaries, and a CEO normally earns at least half a million dollars annually. The boards commonly have more than a hundred paid non-exec directors, a method used to pay fees to those who assist the propaganda and lobbying effort.#
Virtually every US 'health' org with a name like American [insert organ name here] Association has been taken over and operates as a pharma front group; there are equivalents in Europe. They cost millions to run, but make the industry billions in return; it is a phenomenally effective tool for managing public opinion, obtaining legislation, and protecting the industry.
As an example of their effectiveness: if you think nicotine is dangerous; if you think nicotine is associated with cancer; if you can't buy natural health products locally or cheaply; if you can't buy e-cigarettes locally or they are highly restricted; then pharma's astroturfing programme worked on you or against you. It is extremely effective and well worth the millions they pay to run it; it earns billions in return.
See also: useful idiots.
In contrast, the large and vociferous e-cigarette community is bitterly resented by pharma's front groups. The community had giant online forums with millions of posts before pharma or tobacco realised the threat from ecigs. Pharma's puppets have been desperate to deny the fact that the public have a voice at all, never mind the growing citizen power that protests pharma's iron grip on any health-related issues.
aubergine : (eggplant), the vegetable (food plant) containing the highest quantity of nicotine. Depending on the sources used as a reference for the amount of nicotine in aubergines, and the amount of nicotine in the atmosphere in a smoky room, and the amount absorbed by a non-smoker in such a room, then it is possible to state (for one combination of those figures, at any rate) that one portion of aubergine contains the same amount of nicotine as would be absorbed by inhabiting a room with several smokers for 30 hours.
benchmark : the most common instance, usually of good quality but not the best; the item that others must be judged against; the item with the best combination of availability / quality / economy.
For example, the benchmark e-cigarette at Q1 2014 is a mid-size (= an eGo type) with a clearomiser head and a 650mAh battery - this is the best combination of reasonable performance, average price, minimum size (the things that consumers measure by) and thus average popularity, and is the standard against which all other ecigs are judged for performance, cost, and any other metric deemed of interest.
The benchmark UK cheap car was the Ford Cortina or VW Beetle. The benchmark UK small diesel car was the Peugeot 305 and is now the VW Golf. The benchmark UK sailboat was the Westerly Centaur. A 'benchmark' item needs to work well and be popular - it is a good, average product against which others can be easily judged. There is a tendency for benchmarks to be medium size, however that might be measured.
The benchmark smoking cessation status timepoint is 12 months, because it is a combination of the longest period that is economic to measure in studies and the shortest period that demonstrates a result that has any meaning.
cf Gold standard : the benchmark in high quality or top performance. It is not the best, but the best comparative example at the top end of the scale.
The gold standard for smoking cessation status is 20 months, because it is measurable if the funding is adequate for a high-quality study, and it can demonstrate precise values, and effects not visible by extrapolation from earlier results such as confirmation of a 12-month value that may otherwise not appear reliable. It can also show any variation from typical extrapolations (graphical projections) used in lower-quality studies.
big tobacco : (or, BT): a term used to encapsulate the whole of the tobacco industry and perhaps especially the largest cigarette corporations. They have a poor reputation for truth and accountability. The problem is that the products they sell may kill half of continuing users when used as directed, which is unusual for consumer products since only the purveyors of products used in cave diving and base jumping have achieved a similar level of success, and who in contrast have never tried to obscure the dangers involved. The industry is seen as responsible for institutionalised lying on an unequalled scale, which has some degree of accuracy. Although they have had to pay extremely large sums in civil damages, fines paid for criminal activities are minimal in comparison with those paid by the pharmaceutical industry. Thus, in legal terms, the pharmaceutical industry are by a huge measure the greater criminals. However it is alleged that the cigarette firms are party to criminal activity by organising or allowing the smuggling or redirecting of cigarettes to avoid duty in what is called the transit trade. Convictions for such activities seem minimal.
As regards culpability: everyone everywhere has known for decades that cigarettes are strongly dependence-creating, will probably harm you, and are quite likely to kill you (and therefore justify the use of the term 'addictive'). Because of this universal knowledge, the most severe criticism that can perhaps be levelled at BT is that of grossly incompetent management. An example of this is that while denying that smoking is addictive and causes death, in government hearings, court cases, and in the media, they left a convenient paper trail that revealed that they knew they were lying.
Incompetence is perhaps not a strong enough word. In this context, for the sake of completeness, it is necessary to make the point that the cigarette trade is a business; and if the end result of (a) lying about the products then having to pay damages together with the cost of a negative public image is more profitable than (b) being honest in the first place and accepting the lower sales resulting, then (a) is a good business decision (disregarding any human cost). However, it is attractive to wonder what the outcome would have been if they had simply been honest and taken the hit on sales.
It appears that lying is a culture within the cigarette industry, and the resulting public image is rather problematic when they wish to be seen as becoming a more responsible industry by supporting harm reduction. Of course, we should also note that some of the most accomplished liars on the face of the planet work in the tobacco control industry; so perhaps it is a marriage made in heaven.
Apparently smoking is all about lies - whichever side you are on.
big pharma : (or, BP): a term used to encapsulate the whole of the pharmaceutical industry and perhaps especially the largest corporations. They have a poor reputation for honesty, since taken as a whole, due to the unprecedented level of fines paid for criminal fraud and criminal corruption, which total in the billions and are a record (e.g. google 'bbc pfizer fraud') - see References page - they can accurately (and legally) be described as the world's largest-scale criminals. No other industry has paid such massive fines for criminal activities on such a wide scale. The most impressive thing about the pharmaceutical industry is how the world's largest-scale criminals are regarded by the public as respectable; surely, the acme of achievement for such a group. They have unequalled power within government for an industry with such a significant criminal record. Their propaganda and lobbying machine is without peer, and certainly worth the millions it costs in funding the organisations, universities and medics who do the dirty work.
The arms industry has probably killed more people; the oil industry appear able to start wars for profit without any problem; the energy industry seem able to pollute on an impressive scale without hindrance; but although the pharmaceutical industry uses fraud and corruption as its basic operational methods, governments love the world's biggest criminals so much they make sure every policy decision suits pharma perfectly - even when it will clearly result in millions of unnecessary deaths.
BMA : British Medical Association, the UK doctor's trade union. Absolutely discredited as a source of information due to their employment of blatant liars, crackpot ideologists and pharma pimps as spokespersons and authors. Their spokesperson was revealed on radio as an outright liar. They appear to operate as a pharma front group; their published information in the smoking / nicotine / THR topic area consists largely of disinformation, and is obviously based on a pro-pharma agenda. It is not clear who they are funded by.
They act severely against anyone in their ranks who complains about their lies, and are famous for their hypocrisy: promoting the denormalisation and prohibition by taxation of alcohol while consuming as much of it as they can themselves.
The least-respected of all the medical associations, and in most ways the opposite of the Royal College of Physicians: the BMA employs liars, publishes lies, and attempts to silence any of its members who comment on it.
The theory is that doctors put up with the unavoidable discrediting of their reputation associated with representation by proven liars because of the BMA's well-recognised strength in salary negotiations: they have made it possible for every doctor to become wealthy.
CASAA : the US consumer group: Consumer Advocates for Smoke-free Alternatives Association. CASAA was the first THR consumer group and is the most strongly supported, with the best resources. It benefits strongly from having members of the professions on its board - lawyers, scientists and so on. CASAA supports all forms of THR product including e-cigarettes, Snus and other new alternatives to smoking (such as dissolvables). Its finest achievement is the ongoing success in stopping city and State bans on e-cigarette sales and use, with special reference to unjust and illegal inclusion in indoor smoking bans. It also stopped the ban on ecig use on US airlines.
Note that CASAA is a consumer group and not a trade association, a significantly painful situation for anti-THR propagandists due to CASAA's continuing successes, and who often deliberately lie about this. There is no clearer sign of industry's hate and fear of consumer groups than their continual need to deny or denigrate such groups.
clinical evidence : an anecdote observed by someone with letters after their name.
clinical researcher : in the areas of research related to tobacco control, it appears that the term may not have a meaning based on standard English (much like 'evidence-based policy'). Instead, it may mean something like, 'a person X, funded by Y, to produce result Z; paid by results on a scale related to how favourable the results are and how well presented, and the value to the funder, and the stature of the researcher in the field, and the ability of the funder to pay'.
Of course, there may be clinical researchers in this field with an ethical agenda but they are probably poor; the nicotine and tobacco areas are the spiritual home of junk science, created to order.
clinical trial : commonly, a research study that tests the effects of a drug or treatment regime.
In the smoking-related area, the term 'clinical trial' tends to have a different meaning: a research study paid for by a funder who requires a specific result and who locates researchers willing to produce the specified result for a fee. Typical examples are the research trials of smoking cessation pharmacotherapies carried out for the manufacturers, the results of which are often impossible to replicate by independent researchers and have no possible relation to real world results.
If such results are designed to cause the state to approve and/or purchase such drugs, or to influence doctors to prescribe such drugs, or to appear to show efficacy for treatment of dependence, or to prevent harm to health or prevent death, then such trials are fraudulent because no such equivalent results can be expected in reality. Since harm and death is the inevitable result (on average 9 out of 10 patients return to smoking and for some treatments it may be as high as 98 out of 100, and since smoking is reported to kill 50% of ongoing smokers) then clinical trials for smoking cessation therapies can accurately be described as criminally fraudulent, as they induce the purchase of almost useless products that are dangerous as a result of use (unless they correctly report that on average 9 out of 10 patients will fail and return to smoking).
clinical trials of NRTs : clinical trials of all smoking cessation pharmacotherapies have an interesting phenomenon attached: if the RCT result (the success rate for smoking cessation as reported in the randomised clinical trial) is divided by 3, the real-world result can be found with remarkable accuracy. So, in the case of a pharmaceutical intervention that is reported as having a 9% success rate for smoking cessation at 12 months in a clinical trial, we find that in the real world this intervention will have a reliably-measured success rate of 3%.
Interestingly, this can be compared with clinical trials of consumer products (an impossible concept of course) such as 'a clinical trial of e-cigarettes for smoking cessation' - in quotation marks as such a measurement is not possible in an RCT - where the 'success rate' can be multiplied by 3 to get the real-world effect.
clinical trials, rigging of : in the smoking-related area, clinical trials are generally carried out for pharmaceutical product manufacturers. These trials need to report a successful result, but such a result cannot normally be expected as these therapies don't work (in the average person's interpretation of the meaning of the term). Therefore, clinical trials need to be rigged in order to falsify the results. In fact, there are so many ways to rig a clinical trial that several books have been written on it (e.g. Ben Goldacre).
As an example, here are five ways to pre-load the results that will not appear in the final write-up and will ensure the 'right' results are obtained: 1. Use young not old subjects; 2. Group De-selections; 3. Individual De-selections; 4. Drug Washouts; 5. Placebo Washouts. In other words, the subjects are first pre-selected for favourable outcomes, by running two or more trials. The first trial identifies successful or unsuccessful subjects in terms of the drug or placebo effects, and only the successful subjects go forward to the second trial. This may be repeated. The final trial is the one fully documented, and it gets the desired result since all failures were eliminated first. Since the documentation for the final trial is specific to that trial, it does not need to reveal the fact that there were one or more pre-trials; it appears to be genuine. Negative outcomes are thus efficiently suppressed by such methods: there are none to begin with.
Criminally fraudulent clinical trials appear the norm in manufacturer's trials of smoking cessation pharmacotherapies, as the results cannot be replicated by independent researchers, the results have no relevance to real-world observation, they cause drugs that don't work to be purchased and used, and the patients are at significant risk of harm and death since 9 out of 10 fail and return to smoking with its reported 50% chance of death.
A substantial body of smokers who have quit successfully by the use of pharmaceutical interventions has never been located by any of the many surveys of ex-smokers; unassisted quitting (aka self-motivated or 'cold turkey') is always reported as by far the most successful method in the real world; about 70% of successful quitters are consistently reported as unassisted, and the remaining 30% is split between multiple categories. The most effective method of smoking cessation is proven to be self-motivation by the unassisted method, as the group of successful quitters who used this method is by far the largest, and is consistent across all surveys. One of the least effective methods is proven to be pharmaceutical intervention, as the group who used this method is always a fraction of the size of the unassisted group. Any statement that differs from this is a lie; and if it is designed to promote pharmaceutical interventions for smoking cessation in some way, then it is fraud.
A statement by a medical professional who may gain in some way by promoting pharmacotherapies for smoking cessation, describing them as effective, is probably best classed as criminal fraud.
cohort : (1) a group of subjects (or a sub-group) in a clinical study who are the same age, or (2) a group of subjects in a large-scale longitudinal study who were qualified specifically in a certain year of the study (a more common but less correct usage). For example a group who were smokers in 1995 among a larger group in the same year. A 'large cohort' study is one with a large number of subjects in the same group. Therefore there is an 'age cohort' use and a 'year cohort' use, the latter being perhaps more common but not strictly correct usage.
the community : the e-cigarette user community ('vapers') are an unprecedented force in the public health debate. A consumer group so large, so engaged, and so well-organised has never been seen before in this arena; it is bitterly resented by the rent-seekers who normally have absolute control of health policy, and equally by the pharmaceutical industry who stand to lose tens of billions if THR products reduce smoking elsewhere as they have done in Sweden. Pharma in particular cannot afford to recognise the existence of a large group of organised consumers who campaign against the pharmaceutical industry's toxic grip on health.
For these reasons and others, a torrent of lies has been published about the community, typically that it is controlled by the e-cigarette trade (or even by the tobacco industry). Because such a community has never been seen before, the media have frequently believed the propaganda (also because no one is more skilled in the use of black propaganda than the pharmaceutical industry).
The unpalatable truth is that the ecig community was large and organised well before pharma had ever heard of them; in fact even before the first tobacco firm bought into ecigs, vapers had giant online forums with 5 million posts already archived. Vapers will be a powerful voting faction before long, and pharma's paid-for politicians and all the rent-seekers in 'public health' must be terrified of that day. They have never seen anything like it: it marks the end of their exclusive hold on health policy: the ownership of 'health', held in a vice-like grip by commercial interests working for their own benefit not that of the public, may be coming to an end. The toxic parasites of the 'public health' industry are enraged and dismayed by this consumer-led revolt, and lie prodigously about it as a result.
conflict of interest, COI : an expectation of future benefit that may affect the accuracy of a person's work. A situation where someone's present or future funding or employment, or their expectations, or their history (e.g. prior positions) may have a material effect on the independence of their work.
Research, and science in general, is supposed to be factual. In theory it is supposed to benefit the general public, and if the work is the health sphere, and the person concerned is employed within that sphere, there is a general expectation of a duty of care in terms of the accuracy of the work and lack of harm to the general public that may result from the work. Such an expectation may simply be a moral imperative, although it may be enforceable depending on the position of the person creating the work. Therefore producing inaccurate (or harmful) work is opposite to the general duty of the author of the work.
When it is new and untested, and the work illuminates areas that are not matters of fact, or it brings a new interpretation to an area that is well understood but has potential for reevaluation, then such work ought to be accurate and unaffected by any external pressures. Having a COI in some form could affect the accuracy and independence of the work; so any COI should be declared. In point of fact, everyone has some form of COI, so the full methodology of the work and the data produced needs to be given in order that observers can come to their own conclusions. The peer review process is supposed to prevent inaccurate work being published, but it appears to have no effect in the public health area, which is the spiritual home of junk science. A better system by far is pre-publication of the work in draft with a request for comments, along with full details of the methods and data.
Although we usually define a substantive COI as an expectation of future benefit, it is not the exclusive driver for inaccurate work: defence of prior positions, for example, is a powerful factor that can warp results. As an example: if a doctor has built a career and reputation on the concept that disease is caused by a foul miasma, and then new work suggests that disease may be caused by bacteria, then further work by the doctor to attempt to show that disease is caused by miasma not bacteria demonstrates a conflicted viewpoint. There is no expectation of future gain - but if a party who benefits from miasma-causated disease has funded or assisted the doctor in some way, then there are two separate COIs preventing the public from receiving the best information: protecting a prior position, and assistance from a beneficiary of the prior position.
When what someone does, writes or says, instead of it being an independent and honest action or opinion, is materially affected by their funding or other pressures, they have a COI. Everyone in the world is subject to COI, therefore some sort of filtering needs to be employed if avoiding a COI is to make any sense. The devil is in the detail. In medical journals, for example, virtually all COIs are simply ignored - since otherwise there would be little or nothing to publish. The best policy is to publish everything reasonable along with a list of possible conflicts; and to provide the full methodology and data to anyone who wants it. Any other approach is censorship.
consumer product safety : the statutes and enforcement mechanism that protect consumers. In order that consumer products are safe to buy and use, the two separate limbs of statute and enforcement are required; without efficient implementation of either, consumer safety does not exist. It also needs to be appreciated that the enforcement mechanism must work right down to micro-local level, or in practice consumer safety does not exist. This means that there need to be statutes (laws, regulations) that define safety standards, and the universal existence of local inspectors to enforce the law. There is no such thing as consumer safety without both. The UK is an example of a country where, as a result, e-cigarettes are comprehensively and effectively regulated: (a) consumer products must comply with 17 separate statutes that define everything from packaging to toxicity; (b) there are local inspectors in every area who enforce the statutes; (c) there is an additional safety layer in the form of the EU consumer protection apparatus, which includes the RAPEX system; (d) and in addition, the community alert system ensures that no e-cigarette product with elevated risk can remain on the market.
We know that, as a result, e-cigarettes are many times safer than pharmaceutical products in the UK (simply due to the relative mortality/morbidity rates, and the speed and ease with which questionable e-cigarette products are removed from the market compared to the impossibility of removing certain lethal or significantly harmful pharmaceutical products from the market).
See also: Trading Standards.
continuum of risk : a scale of risk elevation representing the relative risk of certain activities where all have risk and where the relative risks can be compared. Activity such as a particular way of consuming a particular product could be placed on a graph to represent the comparative risk of such activities; for example, tobacco or nicotine consumption by different methods.
CV Phillips states that there is no continuum of risk in consumption of tobacco products because smoking is at one end, and everything else is at the other - there is either significant risk or insignificant risk, with nothing in the middle. This is a fair statement of the situation in the West - virtually all activity, in terms of high volumes of consumption, in the Western world, can be placed at either end of the scale. If cigarette smoking has a risk of 100 then the highest risk for any other (high-volume Western) product is at most around 1 or 2. Swedish Snus consumption will be found at somewhere around 1; current estimates are that e-cigarettes will be considerably lower than this since there are no apparent disease vectors.
Phillips' statement may not be correct if low-volume products or non-Western products are considered: for example cigar, pipe, hookah / shisha use or especially South Asian 'chewing tobacco' (oral products that normally contain tobacco though often with other ingredients that may be more important in disease initiation), which might perhaps be found at some point on the scale not at the top or bottom ends. Some are very low volume compared to cigarette smoking, others are not relevant to Western life, and therefore the Phillips' position that there is no continuum of risk appears correct if these exemptions are made. The statement should be taken as it was probably intended: a general statement of tobacco / nicotine risks from a Western viewpoint. It is an important point to make, in order to counter the propaganda generated by the pseudo-health groups, who speak of 'tobacco' when they mean 'smoking', who massively overstate the risks of modern Western oral tobacco products, and who are desperate to prevent access to THR products since a population-level move to THR would equal game over for them.
As an example, 'tobacco-related mortality' in the USA is reported as around 440,000 per year by the CDC. Virtually all these deaths can be attributed to cigarette smoking since the number attributable to other products is so small the CDC cannot identify the figure and is almost certainly below 1% of the total. Thus, the term used should be smoking-related mortality instead, since any figure for non-smoked products is too small to be reliably identified.
cravings : the strong need to consume a substance, caused by its cessation, resulting from dependence. Smoking is a typical example although no one has ever definitively stated which compounds cause the cravings - this may be impossible since we know that the dependence-creating materials vary between individuals. In addition, there are other factors involved with smoking dependence that are not related to chemical dependency.
Insofar as the chemical dependency issue alone is concerned, some smokers attempting to quit are entirely satisfied when supplied with nicotine, but others still experience strong cravings even when inhaled nicotine is more than sufficient and physical routine factors are well-replicated. This leads to the conclusion that other tobacco alkaloids may be required for some individuals; or that nicotine synergens or additives in cigarettes are responsible; or that the products of combustion play a part (or a combination thereof); or that MAOIs plus nicotine are responsible.
WTA refill liquids (qv) or Snus (qv) do resolve the issue for some individuals, leading to the supposition that, for those people, the other tobacco alkaloids play a part. More research is needed.
'deeming regulation' : an FDA notice to regulate certain products as tobacco products. For historical reasons (related to the Sottera vs FDA court case), reinforced by federal statute (the FSPTCA), the FDA has the right to classify e-cigarettes as a tobacco product and regulate them as such. In order to do so, they must issue a notice of regulation 'deeming' e-cigarettes (or constituents such as the refills) to be a tobacco product. Depending on its content, this regulation may create a de facto ban of e-cigarettes, since if the FDA wish to enforce the full provisions of tobacco law on e-cigarettes then numerous provisions of that law would mean 99.99% of e-cigarette products would have to be removed from the market (as they were not sold prior to early 2007; flavours would be prohibited; bottled refills might be prohibited; and several more issues). Another issue following on from this (but not specifically covered by a 'deeming regulation') is that internet sales may eventually be stopped (as web sales of tobacco products may be prohibited).
Here is a statement by the FDA on this issue: "The FDA currently regulates cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. The Family Smoking Prevention and Tobacco Control Act (TCA) permits the FDA to deem other 'tobacco products' to be subject to the Federal Food, Drug and Cosmetic Act by regulation. The agency has announced its intent to issue a proposed rule deeming products meeting the definition of a 'tobacco product' to be subject to FDA regulation."
At Q4 2013 the deeming proposal has been lodged with the White House by the FDA. Legally, it must be released for action by mid-January 2014, although the White House has previously held back similar regulatory proposals beyond the legal limit for such delay, without penalty.
Update 2014-04-24: On Thursday April 24th the FDA published their proposals for a deeming regulation (see References page).
de facto : (Latin - say: "day faktoh") - in reality, in practice, for all practical purposes. It is used when something exists that for all practical purposes is different from the defined situation. Example: banning all useful or usable e-liquids amounts to a de facto ban on e-cigarettes (an outright ban, in reality) - since an ecig is useless without a working refill.
dependence : Dependence and addiction are complex issues and notably hard to define. This is because definitions for such things are only current within an era and a community, and because the meaning of language itself changes over time. This discussion is one of philosophy, not science.
The topic is constantly debated by everyone interested, and by the three arms of the medical profession concerned: the physicians, psychologists and psychiatrists. It is unlikely that all within any single one of the three branches agree on issues such as treatment, never mind whether the chemical or psychological compulsion is more important when substance abuse is involved; agreement between professions is not likely, and overall agreement by the medical profession is even less likely. Indeed, all aspects of these issues are endlessly debated, none more so than a way to fix it.
A current version of the difference between addiction and dependence is that one may cause significant harm and the other doesn't; thus:
- Dependence is a compulsion to consume or act, the need or consumption or cessation of which, on average, causes no apparent harm either physical or social (example: coffee, tea, bird-watching). There may be real or perceived benefits although this is not relevant to the compulsion. The condition is, essentially, harmless. It may result from the modern urban lifestyle and not exist otherwise. Dependence implies lack of harm although in some cases harm may result: on average there is no risk of harm visible above the background noise from modern urban lifestyles. It is likely that some forms of dependence do indeed have a risk of harm - such as substantial coffee consumption - but such risk is considered a normal urban lifestyle choice and any harm resulting is considered acceptable. Because it is considered normal, therefore culturally acceptable, dependence on coffee carries no stigma. This illustrates how such issues involve a cultural metric in addition to any medical one.
- Addiction is a compulsion to consume or act, either the need or consumption or cessation of which, on average, involves a significant risk of harm of either a physical or social nature, or both (ex: some illicit drugs, gambling). Addiction implies a risk of harm although in some cases no harm will result: on average there is a risk of harm. A shortform definition is that addiction is a morbid compulsion; but this leaves no room for any cultural marker, and terms such as dependence and addiction are definitions of a combined medical and cultural nature. This might be clearer if we look at the simplest definition of 'abuse':
- Abuse is consuming more of something than I do.
Neither addiction nor dependence are affected by individual status of any type: a heroin addict may be a wealthy and relatively healthy; because this individual appears unaffected in any way physically or socially by the addiction does not mean the addiction does not exist; just that others are unlikely to be so fortunate. Similarly, because a million people drink a lot of coffee without visible effect, but it kills one person, does not mean that person had anything other than a dependence: they were not average.
Much of the population is probably affected by a harmless, mild dependence on common products such as coffee. It has life-enhancing effects, causes no apparent harm (although cannot be harmless), and is not impossibly difficult or harmful to cease. Essentially, it is a feature of modern urban life - a ploughman had little need of such things and his bread, cheese and cider sufficed; the modern commuter is under far more pressure. Dependence on prescription drugs for insomnia, anxiety, stress or pain relief is a less-visible issue that is probably more serious and straddles the line between dependence and addiction.
Nicotine dependence can be created by smoking. If the subject exchanges the toxic delivery system for a relatively harmless one, but continues to consume nicotine, then this is a dependence not an addiction. Smoking is an addiction because there is a greater than equal chance of harm being caused. Describing nicotine as 'fiercely addictive', as has been seen, is simply wrong; smoking may be - and may well cause subsequent dependence - but that is a different matter. Dependence on nicotine is extremely unlikely to destroy anyone's life, provided they make the right choices. Exactly the same applies to tea: it's better to drink it than smoke it.
In addition, nicotine does not create tolerance: the need for larger quantities to achieve the same effect. E-cigarette users routinely reduce the strength of the refill liquid they consume, using less and less for the same effect. Whether or not this applies to smoking is irrelevant in several ways - smoking is not nicotine.
And once again, a reminder: this is about philosophy, not science. Science cannot define social norms.
Duboisia Hopwoodii : common name: the pituri plant. An Australian plant, long used by Aborigines as a source of nicotine and other active alkaloids (such as scopolamine). Some strains of the pituri plant are thought to contain as much nicotine as the tobacco plant, on average, so the pituri (also because it survives in difficult hot, arid conditions) is thought to be the best alternative nicotine-producing crop if tobacco is to be avoided. Care in selection of a cultivar would be needed as some variants contain significant quantities of many other active alkaloids including scopolamine and hyoscyamine.
ECCA UK : the Electronic Cigarette Consumer Association of the UK. The second consumer group to be established in Europe.
ECITA : Electronic Cigarette Industry Trade Association. The first e-cigarette trade association in the world. Originally a UK-only group, they now have trade members in other countries. Best known for its well-organised code of quality standards, which is unofficially used as the framework for regulatory enforcement at local level in the UK. This is also the procedure used in some other UK industries, so is not an anomalous situation.
economics : the science and practice of the use of limited resources.
It is impossible to understand THR issues without considering the financial and other pressures on government, industry, organisations, populations, sub-groups and the individual, and a basic appreciation of economics is useful. Regulatory policy, especially in the health field, needs to be developed by persons qualified in economics.
economic timebomb : it is probable that e-cigarettes will have an economic timebomb effect. This is because, in a comparatively short time, a significant economic force (the 'smoking economy', that proportion of global financial activity that results from smoking) and population size control (smoking-related mortality) will be drastically reduced or even mostly removed. The smoking economy is worth at least $1 trillion per year and perhaps as much as $2 trillion - (at least double the ~$650bn value of annual tobacco sales including tax @Q1 2013 and perhaps triple); it will eventually be reduced at least 50% by the encroachment of THR products.
The period involved will certainly be decades, but could be as little as two decades for much of the effect to operate. If e-cigarette sales prove impossible to ban or severely restrict in order to limit the damage, it may even be possible that the economic changes will start to take effect in as little as a single decade, by 2023; however, numerous actors who will be severely hurt by ecigs replacing smoking are working diligently to redress the issue.
The reasons for this effect are multiple and complex, because that is the nature of the smoking money machine, but are expressed simply by two factors:
1. The turning-off of multiple income channels without provision of a suitable replacement.
2. A population effect caused by the prevention of millions of deaths.
Just because disease will be reduced in proportion to the switch to electronic cigarettes does not mean that everyone will be happy; quite the contrary, as we can clearly see already: multiple industries and organisations profit from it.
The idea that a drastic reduction in morbidity and mortality will be universally welcomed is already shown as fallacious; it has too many serious financial consequences to be widely accepted as beneficial.
electronic cigarette : or e-cigarette, ecig - these are all marketing terms for the smoke-free, tobacco-free, battery-powered electronic nebuliser to replicate cigarette smoking invented by Chinese pharmacist Han Li in the late 1990s. A more accurate term for such a device is EV, electronic/electric vapouriser (or PV, personal vapouriser) since there is no physical, functional or material connection with a tobacco cigarette.
It is a clean nicotine delivery system (although it can be used without nicotine). As it is an alkaloid-only delivery system, it is not in the ST smokeless tobacco class of products, although both are smoke-free products. An EV can be made to resemble a tobacco cigarette, but such models are dramatically inferior functionally due to the restrictions of the small battery size.
By delivering nicotine in a water-based mist, it removes the smoke (the principal killer in smoking), and it removes almost all other tobacco impurities, leaving a product that faithfully replicates smoking but without any observable disease vectors. This leads to the conclusion that it may have somewhere between 100 to 10,000 times less risk than smoking. The UK NHS recognises e-cigarettes as around 1,000 times less toxic than cigarettes (see References page, Public Health, 2.)
Nicotine is recognised as relatively harmless by official medical bodies such as NICE, the UK clinical guidance organisation; authorities in the field describe it as having about the same risk as coffee (nicotine is not associated with cancer or heart disease, in humans). The refill liquid used has been tested by the FDA as having the same microscopic level of carcinogens as pharmaceutical NRTs such as skin patches (c. 8ng/g). Prof Rodu describes this as, "A level about a million times lower than conceivably harmful to health".
The modern ecig was invented by Han Li (the Latin script version he uses himself: see the board of directors of Dragonite; alt. spelling: Hon Lik) in the late 90s, and patented by him in 2003. There had been previous versions such as the Herbert Gilbert version, but these had not been commercially successful. A Chinese pharmacist who was a smoker, and whose father had been a smoker and who had died from cancer, Han Li wanted to continue to smoke but without the harm; a desire shared by millions of other people.
The e-cigarette will produce a public health revolution similar to (or greater) than that from the discovery of antibiotics, because it will save tens of millions of lives; probably hundreds of millions eventually. Whether this is a good thing for the planet is another question, although it seems a fairly important issue to the individual.
EVs represent an economic timebomb, because of the resulting loss of the vast tobacco revenues for governments and the removal of numerous other significant income channels (principally for the pharmaceutical industry), as well as the removal of an important population control now that disease and wars are less effective in that regard. Currently, no-one is talking about these issues.
ENVI : EU Committee on the Environment and Health Issues. One of the EU committees that decides on the content of the TPD.
epidemiology : the study of disease versus health in populations; a mix of medicine, statistics and public health. The branch of medicine that deals with the incidence, distribution, and control of diseases; the science of the study of the patterns, causes, and effects of disease in defined populations.
Theoretically, an important tool in public health policy-making; but because public health policy is so thoroughly corrupt, and often has no place for science-based decisions, policy can be be decided in exact opposition to the evidence from the epidemiology. For example, replacement of smoking with Snus in Sweden has reduced tobacco-related mortality and morbidity to uniquely low levels; but Snus is banned elsewhere in the EU for financial reasons, and the epidemiologic evidence is ignored.
EU : the European Union, a federation of 28 countries in Europe. Described as a vast, stinking cesspit of corruption.
The EU was formed as a trading group (the 'Common Market') but eventually developed into a federated state. EU law is superior to national law in all member countries. It is thought that the member countries prefer the huge costs and problems that the EU creates to the traditional state of affairs in Europe, which has been continual war for the last 2,000 years. Some European wars have lasted 100 years, so the arguments for a federated state are fairly compelling, and of course there are major benefits to having a centralised European management system, from trade standardisation through to air traffic control.
Nevertheless, the EU mechanisms are far from perfect; the major problems are huge costs, inefficiencies, and corruption within the committees that leads to appallingly bad decisions that benefit industries and governments at high cost to the public interest.
From the perspective of EU citizens, then: the EU prevents wars but is murderously corrupt and incompetent. EU policies that benefit industry and governments kill at least 70,000 citizens year in the tobacco policy area; and the EU accounts have never been signed off by an auditor, ever, since the accounts are fraudulent.
At 2013, notable countries that are not members include Norway and Switzerland. However, these countries have trade agreements within the EU and are therefore trade members but not political members; a situation that many people are increasingly envious of.
EU committees, EU directorates : the chief mechanism by which legislation is created and adopted. Trade agreements are the principle benefit, but some committees have allegations of corruption against them which are difficult to dismiss when looking at their highly anomalous decisions. Established industries are always protected in any decision that requires a choice between the interests of the public and industry. This even applies in the health area, where pro-industry decisions have a high cost to public health. The clearest example of this is the EU Health Directorate's ongoing ban on Swedish Snus (qv) in the TPD (qv) that costs tens of thousands of EU smokers' lives every year; and their current attempts to stop Sweden's world-beating success in the reduction of smoking prevalence and mortality and even try to increase smoking and its related morbidity there by means of new restrictions on Snus within Sweden.
EU consumers : the people that time forgot. EU business is mainly enacted to protect industries and governments, the idea being that industries are economically important and provide stability, and governments need stability in order to function correctly. The citizens' wishes do not really matter in this situation, because their requirements might conflict with those of major industries and governments.
This is problematic in terms of public image, so the EU has a massive propaganda machine working full-time to redress this issue and make it appear that the EU is run on behalf of its citizens - a wonderful irony when some policies kill tens of thousands of citizens by preventing public health advances that would seriously hurt major industries.
A case in point is the EU ban on Snus, which either prevents the saving of tens of thousands of lives each year or kills them, depending on your point of view (the dead smokers who would have switched to Snus given the opportunity, and survived as a result). The ban is directly responsible for over 70,000 deaths a year in the EU, whichever way you prefer to describe the effect.
One might think that an organisation that trumpets the importance of the 'stakeholders' (and the citizens are the major stakeholders) and 'citizen's rights' (this is an amusing concept in the EU) would welcome the input of citizens in the decision-making process; in fact, the EU does anything and everything possible to exclude citizens from any decisions. Consultations on a decision that receive nearly 100,000 replies from citizens asking for a policy will end with a decision favouring half a dozen industry/government opinions instead (e.g. the TPD consultation); and consumer groups have no chance of representation (the EU does everything possible to exclude them from any important process). Instead, there is a propaganda industry within the EU that presents it as a 'citizen's federation', when the reality is exactly the opposite: it is an organisation for the protection of large, established industries.
The EU has been described as, "The world's most sophisticated and successful corruptocracy". There are multiple ways of interpreting this insightful description: for example, (1) the way in which policy favours industry even where this is harmful to citizens (who in theory are supposed to be the beneficiaries of EU policy); therefore the process is corrupt; and (2) the way that EU committees are clearly influenced, presumably at a personal level, by large industries, and are therefore corrupt at an individual level (health policy is a good example: 70,000 EU citizens or more are killed annually by the TPD (qv), a directive that is supposed to protect health but kills on an industrial scale for profit; and which is being re-written to increase the death rate exponentially).
EV, EVs : electronic / electric vapouriser or vapourisers. The most accurate term to describe an electronic cigarette or ecig. The terms 'electronic cigarette' and 'e-cigarette' are marketing terms that are inaccurate in most respects.
evidence-based : a term generally used in the medical world to describe a treatment regime that has a weight of evidence to demonstrate its effectiveness. In short: it works. In the world of tobacco control, though, it has a completely different meaning, since treatments described as 'evidence-based' do not work, in the average person's interpretation of the meaning of English. Something that has a failure rate of around 98% (such as nicotine skin patch NRTs) does not work.
Carl Phillips suggests that within the tobacco control industry, the term has a completely different meaning: instead, it means something like 'a therapy or policy that is approved by senior industry figures'. Perhaps CVP was being a little charitable here; we might refine it further, with: "a therapy or policy that is approved by senior industry figures, despite its known ineffectiveness, perhaps in some cases for reasons associated with funding sources".
Another widely-used term with an equally anomalous meaning within tobacco control is 'safe and effective' (qv).
FDA : Food and Drug Administration of the USA. The pharmaceutical licensing authority for America.
The FDA is in practice the legal arm of the pharmaceutical industry and will act to protect it whenever possible. It is regarded as one of the best examples of a regulatory-captured government agency.
There is too much evidence for this to dismiss it, such as joint signed letters to the media by scientists and technicians working for the FDA who protested about science-based decisions being overturned in favour of decisions that were much more financially-rewarding for the pharmaceutical industry though detrimental to public health. A good example of the way in which the FDA is regarded in the political world is this: a vaper was having a private discussion with his Congressman about the way the FDA might regulate e-cigarettes and the reasons they appear unfavourable. The Congressman looked him straight in the eye and said, "You know they're not interested in your health, right?".
The MHRA is the UK equivalent.
forums : online message boards. These are the heart of the vaping community. The first was established in 2007 and since then hundreds have been set up. The community is almost entirely online-based because the vapefests and vapemeets are organised online. The level of engagement among ecig users is extraordinary and unique among leisure product usergroups of this type. For example there is no equivalent-size community of smokers, NRT users, vitamin users, health food supplement users, or smokeless tobacco users. The community can be considered as an ex-smokers support group combined with a technology-based interest group together with a campaigning function. It grows at a minimum of 40% per year currently (Q1 2014).
The ecig community is hated, feared, and denied by the special interest groups who depend on smoking for their funding, and most especially those funded by the pharmaceutical industry. This is because the word from the top in these orgs is that ecigs are evil and must be destroyed. This isn't surprising when the only threat to smoking now is THR, and the incomes of giant industries that depend on smoking (the tobacco and pharmaceutical industries) are under threat of at least a 50% cut in their smoking-related income channels. Denial of the ecig community's existence is a little difficult when these forums had millions of posts archived before the tobacco control industry had properly organised against ecigs and before the first ecig firm was bought up by a cigarette firm (the first forum now has about 12 million pages on its sitemap).
Forums - etymology : there are two plurals of the noun forum - fora and forums. The strict Latin plural is fora, and this means 'locations in which something is debated'; it could be the letters page of a newspaper, or a town council meeting. The anglicised plural is forums, and this refers specifically to online bulletin boards. The two plurals therefore replicate the situation with a word of similar origin, datum. This again has two plurals, data and datums, both being equally correct and with specific meanings (data = a collection of or multiple items of information; datums = reference points such as chart datums, the reference levels used in marine charts relating to minimum water depth over the seabed under theoretical conditions). It is perfectly correct to have a Latin and an anglicised plural for a noun of Latin origin, where each has a specific meaning.
To be clear: it is absolutely correct grammatically to refer to forums, specifically as the plural for online discussion boards; just as it is perfectly correct to refer to chart datums. The Admiralty has been doing so for at least a hundred years, and complaints should be addressed in the first instance to them. Tip: take several battleships with you.
gateway : the gateway effect is a standard theory in pschopharmacology that posits there are beginner or 'soft' drugs that lead to hard drug use. Leaving aside any discussion of the validity of this theory, the gateway theory as applied to ecigs suggests that vaping leads to smoking, among youth, and therefore vaping causes cigarette smoking. In other words people (usually referred to as youth) start smoking when they would never have done so without the availability of ecigs. (Here, we will avoid the proper science: how this might be measured, and without the significant confounders that probably make this impossible; and what degree of positive result would qualify as demonstrated, or as well-demonstrated and considered to be a serious issue.)
In the UK it is obvious that there is no such thing, since (1) we have accurate, honest and rapidly-available statistics; (2) no gateway effect can be seen; (3) the data has been obtained in a neutral manner, with reasonable efficiency, and is owned by the public and available to them; (4) data is gathered using the most honest procedures possible - in other words survey questions are not in general ambiguous, loaded, deliberately obfuscatory in any way, or managed in a way that prpoduces a desired result; and (5) the raw data is available in a timely manner.
It is not clear if a gateway effect may prevail in other countries, since they do not have statistics and data that can be described in the terms used above. Indeed, where accusations of a gateway effect are levelled at vaping, the stats and data appear to be of a quality, ownership and general management directly opposite to the UK situation, and it is tempting to suggest that the two issues are linked.
gold standard : (see benchmark)
greenwashing : a money-laundering process whereby dirty funds are routed through an apparently respectable institution (or chain) and used by a third party for purposes dictated by the original funder. The classic example in the THR area is the method a pharmaceutical firm uses in funding a university, which then employs a researcher ('professional liar' is a more accurate term) to produce junk science that benefits the pharmaceutical firm.
Sometimes a longer route is used in order to try to obfuscate the purpose of the funding: the pharmaceutical company gives the funds to a charitable foundation >> the foundation gives the funds to a university >> the university employs the researcher, who is directed by the original donor.
Greenwashing is an important method by which tobacco control industry spokespersons and authors are funded, since they can then claim independence while promulgating junk science and the inevitable accompanying press release, while attacking others for being funded by other industries. They are of course liars - but since 2008 (some would say much earlier), tobacco control has been founded substantially on lies in any case. Greenwashing is just part of their strategy of lies.
Greenwashing is also an important method of publishing research in medical journals, since the author/s can claim no relevant COI: they are (apparently) funded by a university. The fact that pharma in effect owns the universities involved does not seem to be of any interest.
GSP : General Sales Product, in the UK the Customs & Excise classification for standard consumer products, determining their import, classification, taxation and regulatory status. Electronic cigarettes and ancillaries are GSP.
Harm Management : the proper term for medical harm reduction. When a medical process or products, or a combination, are used for harm reduction purposes, this is Harm Management. In all forms of harm reduction, some element of the original remains but risk is reduced.
Examples of Harm Management: needle exchange for IV drug users, NRTs for smoking cessation.
Harm Reduction : when capitalised and used as a proper term, it defines the consumer substitution of a product that may be intrinsically harmful by a safer one, or mitigation of an activity that may have risk by use of a consumer-driven safety mechanism. It specifically excludes any medical intervention as it is exclusively a consumer process.
Examples of Harm Reduction: low-alcohol beer (for safer driving), low-fat foods, decaff coffee, smokeless tobacco, consumer nicotine vapourisers ('ecigs'), seat belts, condoms.
harm reduction : when used in a generic sense as harm reduction without capitalisation, it refers to any continuation of an activity but in a less harmful form, and may employ consumer or medically-managed approaches. For example, smoking harm reduction includes use of consumer nicotine vaporisers ('ecigs') or medical NRTs. qv Harm Management
IMCO : EU committee in inter-state trade affairs. One of the EU committees that has input to the TPD.
continued in Part 2 - see menu at right >>