Dear Public Health: This is why we’re angry

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Dear Public Health: This is why we’re angry

A few days ago I was talking to someone who works in public health. This person is genuinely well-meaning, and seemed upset at the amount of hostility they’re seeing from vapers. Why, they wondered, are we all so angry at them? Don’t we realise that public health activists are trying to help us?

Their hurt and disappointment were so obvious and real that I’d have needed a heart of stone not to laugh. Almost since the first electronic cigarettes appeared on the market, vaping has been under sustained assault from the public health sector. So far their efforts have resulted in a swathe of sin taxes and vaping bans across the USA; the FDA and European Union have imposed draconian regulations that threaten to wipe out the majority of products, choke innovation and make what survives far more expensive; the media is filled with scaremongering stories based on the flimsiest of science; and vapers themselves have been belittled, slandered and insulted. How did they expect us to feel?

Unfortunately, this person seemed to be completely blind to how their own behaviour looks from a vaper’s point of view – and going by the aggrieved complaints from many of their colleagues, they’re far from alone. Just to set the record straight I thought I’d set out why the public health profession is so unpopular with vapers. Settle down in your comfiest chair; this could take a while.

Vapers think public health are paternalistic

It would not be exaggerating to say that a paternalistic attitude dominates the public health sector. The focus is on making people behave the way public health think we should behave, often through coercive means such as legislation or punitive taxes – “supporting people to make healthier choices,” in the doublespeak of the profession.

This attitude suggests that many in public health don’t really understand what makes people tick. Most of us enjoy the feeling of achievement when we do something for ourselves, whether it’s as trivial as baking a loaf or as life-changing as giving up smoking. We like to feel capable and in control; outside the narrow field of identity politics, thinking of yourself as a helpless victim has little appeal.

Vaping gives smokers control. Most smokers know that they should quit, even if they don’t particularly want to, and e-cigarettes give them a way to do so without having to struggle through it or go to a stop smoking service as a supplicant, begging for help to do something they can’t do on their own.

Talk to a vaper who has fully switched, and listen to what they say. More importantly, listen to how they say it. They’ll be positive and upbeat. They will tell you that switching wasn’t difficult; often they’ll say that they suddenly realised it had been days since they smoked a cigarette. What shines through is that they’re rightfully proud of their achievement. They decided to do something, and they went ahead and did it. On their own. Without help.

And now public health want to take that away. Tobacco controllers are elbowing their way into the vaping scene, issuing proclamations on how e-cigarettes should be used and how people should be using them. Britain’s Royal Society for Public Health issued a press release showcasing this last Friday when they complained that, by not screening their customers and refusing to sell to non-smokers, vape shops were ignoring a code of conduct that 95% of them haven’t even signed up to. Of course this causes resentment.

Vapers think public health are dishonest

Vapers perceive public health as either careless with the truth or actively dishonest. A common complaint is that the vapour products industry is deliberately conflated with the tobacco industry as a scaremongering tactic. The reality is that the vast majority of products on the market are made by small and medium independent businesses. Nevertheless, vapers are subjected to campaigns like this:

The likes and retweets this tweet gained can be disregarded; they came almost exclusively from public health, politicians and assorted activists. It’s more illuminating to look at the replies. There were 34 of these, and only one was positive. The other 33 ranged from constructive criticism to open hostility.

It’s easy – and lazy – to lump vaping in with the tobacco industry, and the FDA’s decree that vapour products are tobacco products gives doing so a veneer of legitimacy. It’s also intellectually dishonest, though, because the products don’t contain any tobacco – and vapers know this. Among vapers, attitudes to the tobacco industry vary immensely; some share public health’s antipathy to it, while others do not. What all vapers have in common is that they resent being labelled as industry shills.

Unfortunately, this has become something of a default argument for many in public health. If you advocate for vaping online – even if you’re purely a consumer – it won’t be long before someone rudely accuses you of taking tobacco industry money:

These insults draw an overwhelmingly negative, and often angry, response from vapers.

I know almost all the prominent UK-based vaping advocates. I’ve met them, drunk beer with them, stumbled around Warsaw at three in the morning looking for a kebab with them. We are just ordinary people who advocate for vaping because we believe in its potential as a harm reduction method. We are definitely not industry shills or paid Astroturf, and it’s infuriating to be smeared with that accusation simply because someone would rather discredit us than listen to what we have to say.

Many vapers also suspect that public health researchers are carrying out fraudulent research. In many cases simple incompetence is a more likely explanation, but some experiments do seem to be set up to obtain the “right” answer. James Pankow of Portland State University first infuriated vapers when his research on formaldehyde, published in the NEJM and described by one vaper as “ass hattery”, turned out to have been fatally flawed. In a subsequent study he went on to “find” benzene in e-cigarette vapour, which may not be surprising as he had added huge amounts of benzoic acid to the liquid he used. This attracted critical blog posts and more hostile comments.

Vapers think public health are arrogant and pushy

Public health didn’t invent e-cigarettes. They didn’t persuade millions of smokers all over the world to cut down or quit by switching to a much less harmful alternative. But now they’re trying to crash the party and take over. They want to tell us where we can vape and what flavours we should be allowed. They’re demanding that electronic cigarettes are turned into a medicalised quit aid, and complaining that people actually enjoy using them. To a vaper this looks an awful lot like sour grapes.

A common complaint is that public health refuse to listen. Many activists insist on telling vapers how they think e-cigarettes work and how they should be used, instead of asking how they really work and how they’re actually used. Australian sociologist Simon Chapman is frequently guilty of this, and his articles and blogs tend to attract large amounts of adverse comments from vapers. A regular gripe – one that’s also frequently directed against Glantz – is that Chapman is prone to deleting comments he can’t answer.

In fact, a refusal to engage with vapers is characteristic of public health – and it’s making people angry. Public health’s interest in vaping is almost exclusively focused on imposing new restrictions and taxes, or on co-opting electronic cigarettes to suit their own goals. The people most affected by this are vapers themselves – but we almost never appear on public health’s list of “stakeholders”. Any vaper who doesn’t show them the deference they feel entitled to is generally ignored or, on social media, blocked. It is incredibly annoying when someone starts trying to rearrange your life, but doesn’t even have the courtesy to talk to you about it.

Vapers think public health are self-serving

Many vapers believe that public health are more concerned with their own prestige and careers than with actually helping smokers. A 2014 report from UCSF, partly authored by Stanton Glantz, began its executive summary as follows:

“California’s position as a leader in tobacco control is under threat”

Vapers don’t care about California’s position as a leader in tobacco control. They just want to be able to buy the products that have replaced cigarettes in their lives, and they get annoyed when their well-being is given a lower priority than the ego of Californian anti-tobacco activists. The UCSF report was strongly attacked by Not Blowing Smoke, a consumer advocacy group based in the East Bay, which – like many vapers – links California’s extreme hostility to e-cigarettes with the state’s vulnerability to falling Master Settlement Agreement funding. Not Blowing Smoke has been referred to as astroturf. It is no such thing; it’s run by Stefan Didak, a former smoker and current vaper, who established it with his own money and runs it in his spare time.

E-cigarette advocates are not being paid for what they do. People who work in public health are being paid, and many vapers think that they’re more concerned about preserving their jobs and funding than about actually eliminating smoking. This may be unfair, but it isn’t an unreasonable conclusion given the ferocious hostility to vaping shown by many in the sector. Fair or not, many people believe it.

Vapers think public health despise us

Some prominent figures in public health seem to revel in being loathed by the public. For example, at the recent World Congress on Public Health, Professor Martin McKee – an outspoken anti-vaper – apparently said “Enemy of the people is a label we should aspire to as heroes of public health”.

Predictably, the reaction to this – largely from vapers – was furious; comments ranged from “petulant tyranny” through “useless, greedy sociopaths” to an image of a firing squad.

It’s easy to write McKee off as an ignorant loudmouth, but where was the condemnation from his professional colleagues? Simple: There wasn’t any. This gives vapers the impression that McKee’s opinion is acceptable or even mainstream in public health – and if public health activists aspire to be our enemies, why shouldn’t we hate them? The failure of the majority in public health to condemn the behaviour of the extremists is tarring the whole profession with the same brush.

In one notorious incident in September 2014 the president of the UK’s Faculty of Public Health, John Ashton, launched a drunken rant on Twitter in which he hurled obscenities at vapers. Although Ashton later claimed he had been provoked, his timeline appeared to show that he had been seeking out vapers to abuse. This caused a huge amount of anger, expressed on social media, in forums, through blogs and in numerous complaints to FPH. However, FPH took no action for almost two weeks; then, after a perfunctory “inquiry”, Ashton was allowed to continue as president.

Throughout Ashton’s brief and voluntary leave of absence – he wasn’t even suspended – and the inquiry, numerous public health activists rallied round him. Media coverage was shaped by comments from his colleagues and put the blame on vapers despite the timestamp of tweets clearly showing that Ashton had initiated the incident. His deliberate abuse of members of the public was brushed aside or openly defended.  Ashton’s erratic and obnoxious behaviour – in one bizarre interview he was told he sounded like a bloke in a bar – and the staunch support he received from across the public health sector, generated enormous hostility from vapers.

On another occasion Lorien Jollye, who at the time was a waitress in a Cornish café, submitted a letter to The Lancet calling for a more inclusive debate on vaping. Instead she got an arrogant and dismissive reply from Stanton Glantz, Martin McKee, Simon Chapman and Mike Daube. This was seen as a crude attempt to shout down an unpaid consumer advocate, and provoked more blogs.

Vapers have, increasingly, had enough

Some figures in public health have been detested by vapers for years. Stanton Glantz is particularly unpopular; most vapers see him as an unqualified zealot with a poor grasp of science, and any research he does is usually dismissed (generally with good reason) as junk.

Glantz is so unpopular among vapers that a parody Twitter account has been created to mock him.

Martin McKee and Simon Chapman are almost as unpopular as Glantz, with Matthew Myers of the Campaign for Tobacco Free Kids, Tom Frieden at the CDC and Mitch Zeller of the FDA not far behind. There are many more in the vapers’ pantheon of hate figures, all of whom have richly earned their places.

However, the animosity held by vapers towards public health is becoming less tightly focused and is spreading to take in the whole field of public health activism. Even organisations that were previously seen as somewhat supportive of vaping are now attracting more hostility. Where vapers used to discuss in the hope of reaching a compromise, they increasingly feel that public health works on a ratchet principle – they will push for restrictions, then when these are achieved the goalposts are shifted and a new set of demands is issued. Vapers are coming to believe that any accommodation they reach with public health will simply be a step on the road to full prohibition.

The anger caused by public health’s approach to e-cigarettes is spilling over. Many vapers are now openly hostile to any public health campaign aimed at regulating people’s lifestyles – the global push for sugar taxes, for example. With millions of vapers around the world, and their numbers growing daily, further embedding the “them and us” attitude that’s emerging will reduce public health’s legitimacy in the eyes of the public – and they will only have themselves to blame.


  • Martin Sowle

    Spot on Fergus. More and more we are being stamped upon as evidenced by arnotts recent activity.its about time they learned: nothing about us without us.

  • ScottEwing

    Us traditional smokers tried to warn you. The ANTZ don’t care if you vape or smoke. You are in their cross hairs because you don’t conform to the party line. By uniting we could restore free choice, but no, you try to stand apart from traditional smokers, and the ANTZ exploit that.

    • Fergus Mason

      Yes, this is something I’ve been saying for a while: ANTZ are only interested in vaping as something else to attack smokers with. I’ve never supported the persecution of smokers and I still don’t.

  • Doug Neaves

    Part of the public health problem is they are, to use an analogy, like a driving instructor that has never sat in a car. In the real world, they would never be able to start the car, let alone drive it. Unfortunately, it makes them seem inept when they proclaim that driving is dangerous. Then boldly state that when it is raining the driver must stick their head out the side window to see where they are going, due to the windscreen being obscured by rain. After countless press releases, and TV appearances, they finally, after much cajoling, are made to realise that there are windscreen wipers. The poor darlings cannot back down, as they would appear to be incompetent.

    • ” The poor darlings cannot back down, as they would appear to be incompetent.” Exactly. So, what do they do? They commission a study proving that “No windshield wiper can be 100% efficient. There is simply No Safe Level Of Blindness acceptable while driving!”

  • John Summers

    I said it at GFN last year, it’s about time some of these idiots were brought to book..

    They’re wilfully or recklessly misleading the public and misrepresenting studies in a way that could cause harm, whilst putting themselves forward as being experts and/or receiving money from the public purse.

    That’s called misconduct in public office, and the maximum sentence? Life…. http://www.cps.gov.uk/legal/l_to_o/misconduct_in_public_office/

    • Dick_Puddlecote

      Agree entirely! I’ve often written that some belong in prison, and when I do it’s not rhetoric or a joke. Many in ‘public health’ have done real, tangible, serious damage to people’s lives, and in the case of snus being banned in the EU, have dramatically harmed the public’s health. There needs to be a prosecution before the rest will wake up, stop lying, and stop playing selfish ideological, and policy-driven games.

      • Lollylulubes

        I remember reading a piece about Snus on the Tobacco Control website. The author said it had remain banned throughout the EU because it was made by the tobacco companies. She referred to smokers who wouldn’t be allowed it as “collateral damage”. I’m sick and tired of excuses for their actions riding on the back of what tobacco companies did 50 years ago. It’s not acceptable, it’s downright harmful and yes, it deserves prosecution and a long prison term. How many premature deaths are they responsible for, I wonder? It’s murder but, hey, it’s only smokers! Keep smoking, we need the money!!

        • “collateral damage” — I think that’s also how they refer to smokers who die in balcony collapses and students at banned colleges who fall off roofs and windowsills while sneaking a smoke on exam nights.

      • For crimes against humanity!

  • Jake6731

    Want to know what really burns my ass? I could say a flame about 4 feet high and that would be true. But the thing that’s burned my ass recently is how a public health organization treated concerned, polite and knowledgeable vaping supporters.

    A month or so ago, a so called ‘health’ organization, named NashvilleHealth, decided to host a Twitter chat about Smoking cessation and about a dozen vapers from around the world, decided to participate. (The only other participants were 2 or 3 local American Cancer Society twitter accounts) Questions in the chat included things like “ Do you consider vaping a safe smoking replacement?” The vapers that participated provided thoughtful and factually accurate responses to all the questions posed.

    So, how did the organization that promotes itself as ‘a convener of open dialog’ react?

    The sons of bitches blocked every single vaper who had the audacity to participate in their little echo chamber party. Every single one!

    Now, stuff like that, that’s what really burns my ass!

    • Jake, I’ve been banned and shadow-banned from more venues than I can count on my fingers and toes and even my nose over the years. Antismokers (which as I just noted above are just the superset from which Antivapers derive) can’t win in rational discussion with us. Their only recourse is to limit any back and forth interaction to media that they can control either through biased moderation or by pitching trained and usually very well paid professionals against ordinary folks simply fighting for their rights.

      The Internet allows a passer by to read the back and forth arguments carefully and check the data and sites offered in support of the arguments. It sabotages the Gish Gallup debate tactic where an Anti simply pours forth a waterfall of pseudo-facts and outright lies that only take about five seconds apiece to string together and spew while the Smoker or Vaper only has enough time (either moderated or in audience attention) to clearly refute a small number of those pseudo-facts and lies… leaving the impression that all the rest are probably true. That doesn’t work so well on the net where the tactic can be called out for what it is and Smoker/Vaper can challenge the Gish Galluper to pick their three strongest points from their pile of junk for refutation.

      Heh, the Antis at that point usually display a behavior pattern that I like to describe as “Running Away Faster Than A Little Girl From A Pack Of Tarantulas.”

      – MJM

  • CyZane

    If you think you’re having a déjà vu, you are. Smokers have been there and done that. All public health decisions were taken for them without them in contempt of them and with their taxes! Vapers might have learned something from smokers’ experience but they naïvely or opportunistically believed most of PH’s rhetoric and threw their old selves (the smokers) under the bus going along with the Second Hand Smoke and the over the top ”no safe level of smoking” rhetoric. I don’t want to generalize, because not all vapers went along with it, but far too many vocal ones did and helped drive in the lies even further. You know what they say about sleeping with dogs… There is only one thing that has any chance of redressing the situation: Instead of regarding these professional anti-smokers feeding on our taxes as legitimate and going along with their over the top and bullying anti-tobacco campaigns, exercise political pressure to defund every last one of them. Only then can an ethical, moral and real science based educational lobby can be rebuilt from scratch. If these leeches still want to demonize their fellow citizens for a living, let them do it with their own money.

    • Fergus Mason

      Sleeping with dogs sounds like something you’d see in a Dutch magazine from the 1970s, but I do know a saying about using a long spoon when you sup with the devil. It’s certainly true that some vapers have been taking far too short a spoon to their dinner dates with public health.

      • Fergus, would “feeding the sleeping wolves with long spoons” sound fitting? :>

    • 100% with Iro, although the number of vapers who’ve realized the mistake of feeding the wolf has grown a lot in the last few years after debacles such as we’ve seen in New Orleans (where some of our smoker-supporting vaping activists like https://www.facebook.com/julietteredheadgirl were royally disgusted by the vapers who foolishly applauded the smoking ban when they thought vaping would be exempted) and in the EU where many vapers were totally blindsided when the EU Antismoking organizations blew them out of the water.

      – MJM

    • #Enslaved2TaxationSmokrsVapers #RigamortisGripLying4Dollars You are absolutely correct. If it is 1/5th of all adults that smoke that segment is too lucrative to let alone!

  • Dick_Puddlecote

    I’d also add that the ones in public health who do support common sense in areas such as vaping seem to be doing so without much conviction. In the UK we have heard a lot of weasel words about how e-cigarettes are great and that organisations like ASH & CRUK etc are fully onside with harm reduction. Yet every day we hear of yet another vaping ban while those same people – who have far more power than any of us – sit back and say absolutely nothing. In fact, in some cases they support or welcome the ban while still saying they are supportive of THR. It is no use getting e-cigs more widely recognised as an alternative if there is nowhere anyone can vape. Every ban convinces a few more people that if its banned, it must be dangerous, and ‘public health’ know this very well since they used smoking bans as a way of signalling to the public that passive smoke was dangerous.

    I know that if I started vaping now rather than when I did, I probably wouldn’t have persevered; if I had to go outside to use one, I’d have just smoked instead. I sometimes wonder if that’s the plan anyway, to pretend to back vaping and THR while quietly strangling its prospects so it dies off. If that sounds tin foil hattery, well so be it, we have seen far worse lying, treachery and chicanery from the PH industry in the past 10 or 15 years, and it is getting increasingly blatant the more the spotlight is placed on them by the internet and social media. They don’t care a hoot about the public – who pay their wages and who they are supposed to be serving – and quite simply cannot be trusted.

  • David Abbot

    I think the problem with other public health issues can be summed up pretty simply, to be honest: we’ve caught them lying to us about something we understand, so why should we take their word as valid on any other subject?

    As the saying goes, “I’m not sorry you lied to me, I’m sorry that I can’t believe you any more.”

    • Melody Chard

      I agree wholeheartedly! I find myself looking at everything Public Health has to say with scepticism & mistrust….not just for vaping but Everything! Wonder if they thought the public would never find out the truth? What did they think would happen to their credibility for all things “Public Health” if they were caught in the lies they have been telling? I think the can of worms they have cooked up is very dangerous indeed for the public. Unintended consequence….or….Who Cares?

  • Tony

    Another problem is that there are far too many “public health” groups all vying to justify their existence by seeing who can outdo the other with crazy batshit ideas.

    It’s only going to get worse too, something has got to give.

  • Klaus K

    Single minded doctors and public health fanatics don’t understand that they are totally manipulated by Big Pharma. Brainwashed …

    • A lot of ordinary doctors are probably well-meaning. They DO see a lot of elderly smoking patients with lung cancer and heart problems and will always automatically assume that their smoking MUST have at least had SOMEthing to do with causing it, and they make the same mistake but multiplied a thousand times over, with secondary tobacco smoke.

      The family doctors are usually GPs: “General Practitioners.” Outside of whatever their background specialty might have been in med school, they can barely keep up with half of what they skim rapidly through in a few medical journals and from “cognizant authorities” speaking through the media. They certainly don’t have the time, attention, or motivation to critically examine the science around smoking claims because they figure that any “slight inaccuracies” that might be there are simply “for a good cause.”

      And now the same attitude is carried over to vaping and reinforced by doctors’ fears about malpractice. Imagine being a doctor who told a smoking patient “Switch over to vaping, it’s better for you!” only to have that patient die a month later. The relatives, spurred on by the organized Antis would have the poor doc strung up by his supposedly malpracticing thumbs and get his licence yanked faster than an Antismoker will grab at grant money — and that’s purty damn fast!

      – MJM

  • Klaus K

    From Wikipedia:

    “In Tolkien’s works, orcs are a brutish, aggressive, repulsive and
    generally malevolent species, existing in stark contrast with the
    benevolent Elvish race and generally pressed into the service of an evil power.”

    Doesn’t that ring a bell with public health? The evil power of course being Big Pharma … 🙂

    • Fergus Mason

      I always felt sort of sorry for orcs. They grew up in pretty dreadful circumstances, didn’t have a lot of opportunities and mainly joined the Horde of Darkness to learn a trade and see Middle Earth. Kind of like the Parachute Regiment, really, except orcs have better table manners.

  • Vinny Gracchus

    All of the public health lies, manipulation of data, suppression of dissent, and denial of choice were seen first with smoking and the persecution of smokers. (These tactics of imposing prohibition are also seen in the attacks on chewing tobacco and snus.) The classic case is the fabrication of risk surrounding second hand smoke and the promulgation of false studies to impose smoking bans (at first indoors and now outdoors). These tactics have been represented as a ‘confidence game’ by the tobacco controllers themselves and are mow being used to restrict vaping, move toward prohibition of alcohol, and restrict sugar and soft drinks all in the pursuit of profit and power. Public health needs to be salvaged from lifestyle controllers if it is to survive.

    • Exactly Vinnie. Think how much GOOD public health advice is being ignored by people because they’ve simply come to believe it must ALL be garbage!

  • Very thoughtfully done and beautifully written Fergus!

    The only thing I’d add is that no one should really be surprised at all this. Antivapers are simply Antismokers dressed up in new costumes either to go after new money or to satisfy their old motivating drives. Remember the nine categories of Antismokers:

    https://www.sott.net/article/128768-Recognising+Anti-Smoking+Types

    Of those categories, five of them have simply jumped onto the Antivaping wagon train as it rumbled along beside them (i.e. the Controllers, the Neurotics, the Moralists, the Idealists, and, in particular, the Greedy) while three don’t apply at all (the Bereaved, the Victims, and the Ex-smokers/vapers) {I don’t think I’ve seen a single Exvaper out there raining hell down on vaping though there probably are a few isolated ones.}, one applies extraordinarily rarely if at all (The Truly Affected), and the last (the Innocents) has been drummed up by the antivaping media efforts but with far less success than has been achieved with 40-50 years of antismoking media.

    Aside from the Greedy who want to keep the $500,000,000/year money train for “Tobacco Control” rolling along and filling their pockets, most of the rest of the groups are actually victims of a psychological illness ( Anti Smokers’ Dysfunction Syndrome: ASDS ) as described so well in words by Stephanie Stahl ( https://www.facebook.com/stephanie.stahl.315 ) at

    http://wispofsmoke.net/recovery.html

    and depicted so well in art by Zayats Liontamer of Smokers Against Discrimination (https://www.facebook.com/pg/choose4freedom.sad) at

    https://pbs.twimg.com/media/Cdq8ALoW8AA2x0R.jpg

    Antismokers lie. They always have (particularly since the shift to terrorizing nonsmokers in 1975) and they always will: They operate out of an “End Justifies The Means” mentality and they don’t care who gets hurt in the process. Their goal is The Endgame: the elimination of smokers from the face of the Earth. And the great bulk of them, led by some of their craziest elements, identify vaping with smoking.

    Smokers and Vapers need to work together or they’ll be wiped out separately.

    – MJM

  • Rain Man

    Absolutely, Positively SPOT ON article. I’ve started to speak to a few “Public Health” people here in the U.S. and everything in this article is true, and simply mind-boggling. I have an acquaintance who’s a “new” psychologist specializing in “Public Health” and he’s beginning to see the same closed-mindedness, “misrepresentations”, and puffery in the likes of Glantz & his followers, among others.

    Me? I just keep “taking the tablets” in an effort to keep my blood pressure down where e-cigs have helped put it and avoid where the ANTZ want to raise it.

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