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This Charming Man

Doctor and ex-BMJ editor speaks out on the topic of public health and ecigs

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Richard Smith should command the respect of his peers. He has been a successful medical practitioner and stands tall in his opposition to corrupt practices of the pharmaceutical industry. As the ex-editor of the British Medical Journal (BMJ) he continues to act as a voice for common sense and strives to promote open access publishing.

His latest contribution to the BMJ is one that balances insight and coherence as he addresses: “How public health moralists are promoting harm from tobacco and helping the tobacco industry”.

Stop me if you think you’ve heard this one before

Smith quotes Canadian anti-tobacco lawyer saying: “almost every schizophrenic smokes and smokes heavily.” He reels of the stat that serious mental health problems accounts for 10% of American cigarette consumption. “These people are self-medicating,” he writes. “Nicotine helps with information overload and improves attention.” Addressing the conflation of nicotine use with tobacco, he touches on a subject many vaping advocates hit their head against time after time.

That joke isn’t funny anymore

It is amazing that anybody would have to state: “the harm comes from sucking smoke into the lungs not from the nicotine; the problem is the dangerous delivery system.” Incredible, but arguments against vaping so often return the evil posed by a substance with a health threat similar to caffeine.

But Smith doesn’t rest there: “It thus makes huge sense to encourage a safer way for some people to access nicotine. It may even make sense to offer ways of accessing nicotine, perhaps through e-cigarettes, to some of these people who might not smoke.” It is rare that a medical practitioner will advocate such an approach to a drug that is regularly demonised in medical journals and the media.

But these are not his words; it’s a continuance of the anti-tobacco lawyer’s tale. It’s a journey in logic that likens the use of ecigs with quitting to that of seat belts in cars. It is a story so rooted in logic that the good doctor accords it the value it deserves and one in which public health and medical science ought to be conjoined.

There is a light that never goes out

Vaping advocates hold that eventually reason has to win out, that there will come a point in time when everyone can accept that although vaping is not safe it is safer than smoking by orders of magnitude – and that in itself justifies ecigs being included in a harm reduction mind-set. When Smith writes: “Fast thinking moralisers may be preventing other benefits for those who cannot stop smoking,” vapers will picture McKee and Glantz in their mind’s eye. Ecig users, almost all ex-smokers, will raise their atomisers in tribute and think of Mark Drakeford when they read: “The moralisers who react instinctively against e-cigarettes may not only be harming those who find it impossible to stop smoking but also helping tobacco companies.”

Bigmouth strikes again

But this does not matter to Doctor Frank Ashall who descries the article: “I think that your statements are as much "moralistic" as the ones you criticize as being moralistic.” Ashall says that he: “is a strong advocate for a tobacco disease-free world.” But his response, calling for evidence while supplying none, conflates the vaping industry with Big Tobacco and clings forlornly to things like “8,000 flavours” as if mentioning a big number adds more weight to the nonsensical statement.

In respect to anti-tobacco crusaders and public health moralists, it’s as if the world won’t listen.

Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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