“Mommy, why does the state bear smell of burning fur?”
“That’s because his pants are on fire, son.”
The recent formaldehyde fiasco reminded us, if anyone needed it, that we can’t expect a lot in the way of integrity from the weird coalition of temperance zealots, tobacco companies, pharma manufacturers and crackpots who’re opposed to electronic cigarettes. The California Department of Public Health have just upped the ante spectacularly, though. Their latest “State health officer’s report”, released yesterday, is a breathtakingly dishonest document that manages to cram just about every myth, distortion, misrepresentation and outright lie about vaping into its 32 pages. I know a little about propaganda and this is one of the most egregious examples I’ve seen that wasn’t actually printed in Pyongyang – a place Sacramento increasingly acts like a suburb of.
This document, available as a PDF here, has an impressive title and uses serious-sounding terms like “Executive summary” to create an air of scientific rigour. The text itself, however, is far from scientific despite the references that pepper it. It’s heavily slanted and inflammatory, stuffed with loaded terms like “aggressive marketing” and “toxic vapor.” It presents facts out of context and misrepresents statistics – for example it employs the now-common trick of relabeling “calls to poison control centres” as “poisonings”. Worst of all, it lies. I don’t mean it makes errors; I mean it lies. The authors deliberately make claims that they know to be false.
You’d have to be suffering from truly Glantzian levels of insanity to mistake this for an objective, unbiased publication. Its full title is “State Health Officer’s Report on E-Cigarettes – A Community Health Threat.” The first chapter is headed “The Problem: E-Cigarettes“. And that sets the tone. There’s no attempt to balance risks and opportunities, no attempt to weigh up differing views on the potential for health gains or harms; just relentless, almost hysterical negativity from the first page to the last. However I’m not going to deconstruct the entire document right now. I have work to do and bills to pay, and as much as I’d love to I can’t spend all day blogging. I will go through some of the most blatant points, though, and perhaps go into more detail at the weekend. So, here are some of the “facts” California is offering you:
- “E-cigarettes do not emit water vapor, but a concoction of chemicals toxic to human cells in the form of an aerosol.” (p. 9) – Note the loaded language: “A concoction of chemicals”. They might as well have said “witches’ brew”. Is this accurate, though? Technically yes, it is; the chemicals in e-cig vapour are toxic to human cells at a sufficiently high dose. Guess what else is toxic to human cells at a sufficiently high dose?Fucking everything! As I’m sick of explaining, the dose makes the poison. Yes, the stuff in the vapour will damage cells if there’s enough of it. No, there’s not enough of it.
- “Mainstream and secondhand e-cigarette aerosol has been found to contain at least ten chemicals that are on California’s Proposition 65 list of chemicals known to cause cancer, birth defects, or other reproductive harm.” (p.9) – They’re talking about the likes of nickel and cadmium here. Guess what else contains them? You got it; everything. They’re naturally occurring substances. You have trace amounts of them in your body. Some of them are essential to life. So again technically true, but deliberately misleading; none of these substances are present at toxic levels.
- “There is no scientific evidence that e-cigarettes help smokers successfully quit traditional cigarettes.” (p.10)- This is simply a lie.
- “The aerosol also contains high concentrations of ultrafine particles that are inhaled and become trapped in the lungs.” (p.11) – This stinks of Glantz, a suspicion reinforced by the fact that it’s utter rubbish. It’s not technically inaccurate to refer to liquid droplets as particles – although it is a bit odd – but the reason it’s being done is obvious; it’s to confuse them with the solid particles found in cigarette smoke and exhaust fumes, which is what Glantz’s sources about the harms of ultrafine particles were actually talking about. Needless to say liquid droplets don’t get trapped in your lungs; they get absorbed.
- “There has been a significant rise in the number of calls to poison control centers”(p.11) – Yes, we know. Calls. Not poisonings; calls. Now shut up about this; you’re getting boring.
- “Many are concerned that e-cigarettes are a gateway to using traditional cigarettes.” (p.12) – Well so what? Many are concerned that gays are trying to steal your wedding. That’s not true either. There is conclusive evidence from both the UK and USA that vaping is not a gateway to smoking, and in any case we’re still waiting for the ANTZ to explain why it even might be.
- “Younger adults and youth who are experimenting with these products may not realize that e-juice contains the highly addictive chemical nicotine” (p.16) – Only if they can’t read. It’s on the label.
There’s pages of this stuff, some of it backed up by references (Glantz features prominently, as do Tobacco Free Kids, so you can guess at the level of science we’re talking about) but much more is simply asserted. Even if you’re familiar with some of the previous horrors Glantz and others have come out with, this is bad. What’s worst is that it’s not a dry paper in some obscure academic journal that only doctors and the likes of us will ever read; this is being pushed on the public by the state of California. It’s presented as essential advice they need to protect their families from a menace that all the evidence says doesn’t actually exist.
What the hell is going on here? Why on earth would a publicly funded health body in one of America’s most advanced states produce such a deliberately misleading piece of propaganda? The potential consequences are horrific. The percentage of Americans who know that vaping is safer than smoking has already fallen from 85% to 65% in just three years (a similar trend is going on in the UK) because of misleading claims by “health” advocates. The result of that is obvious. Smokers who were tempted to switch to vaping, but now believe that the risk is the same or higher, will stick with tobacco instead. Some of them will try to quit using approved methods, like patches and gum. That’s unfortunate, because of course the success rate of approved nicotine replacement therapies is dismal and while Varenicline (Champix or Chantix) is somewhat more effective it also has a few known side effects. Like, you know, inducing a suicidal psychosis or possibly (evidence on this is mixed) giving you a heart attack.
Keep that in mind next time someone advises you to use a “safe and effective” approved medication. Varenicline might be safer than smoking, but it’s been linked with a lot of deaths – while “unapproved” e-cigs haven’t. The fact that the FDA have approved something doesn’t mean it’s safe; it just means the FDA have hard numbers on how dangerous it is. Next time someone bleats “They’re not approved by the FDA” you can point out to them that actual tobacco cigarettes are. Does that mean cigarettes are safe? I think the FDA might not be too happy if you made that claim.
Still, this isn’t about how happy the FDA are. It’s about trying to work out why the state of California is so hell-bent on restricting e-cigarettes as severely as they can. I could go into the amount of pharmaceutical industry funding Senator Mark Leno receives but I suspect, this time round, it’s more to do with state funds than Leno’s own personal bank balance. My feeling is that we need to look at the 1998 Tobacco Master Settlement Agreement.
Most non-Americans probably aren’t familiar with the MSA, so here’s a quick summary. In November 1998, to end a string of court cases against them by people who apparently couldn’t read the health warning on a cigarette pack, the major US tobacco companies signed a deal with 46 of the 50 states. In exchange for a guarantee of not being sued again they agreed to pay huge sums of money to the states in perpetuity – the agreement was for at least $246 billion dollars over the first 25 years, but the amount each company actually pays is based on its market share and the number of cigarettes it sold compared to the year before. The money is shared between states based on their population, and because California is the most populous US state its share isn’t exactly small – $745 million in 2007. The state keeps about $400 million of this and distributes the rest among the county and city governments.
Now, $745 million a year is rather a lot of money, but it wasn’t enough for California or many of its local authorities. More precisely, it wasn’t coming in fast enough. They didn’t want rather a lot of money every year for the foreseeable future; they wanted shitloads of money now. So what the state, and many counties and cities did, was come up with a clever plan. They decided to sell investment bonds, then use the annual payments to pay out the bonds as they mature. That looked like a good deal to investors and the bonds sold like very popular things that people want to buy.
The annual MSA payments started on 15 April 2000. By 2007 the state of California had received close to $3 billion in payments, but it had sold $13.16 billion in bonds. That put the state $10 billion in the hole, but it didn’t matter; after all the tobacco money would keep coming in forever, and as nobody seriously believed those last stubborn 20% would ever stop smoking the revenue stream was safe. Sure, there was a clause in the agreement that said the tobacco companies could reduce their payments if their sales dropped, but how likely was that?
Then e-cigarettes came along.
Already cigarette sales are down, and MSA payments are down with them. Until a couple of months ago many market analysts, including Bonnie Herzog at Wells Fargo, were predicting that vaping products would outsell real cigarettes within a decade. Right now they’re not so sure; the growth of vaping has slowed, and most people agree the reason for that is the recent flood of alarmist reporting. But if it picks up again, and the number of smokers falls to 10% or less over the next dozen years, then there won’t be enough money to pay bonds as they mature. Some other states that issued bonds could default on them, which is tough luck for the investors, but California guaranteed its bonds with the full backing of the state government.
Unless tobacco sales recover the state of California – as well as all but one of its cities and counties – is in trouble. The state’s already pretty much bankrupt, and if they have to dig into their existing budget to pay for maturing bonds some very tough decisions are going to be made. When the 38 million people of California find that their schools, public transport and emergency services are being stripped bare to pay for a government scheme that turned out not to be all that clever after all there’s going to be hell to pay.
How bad could it be? In 2013 Ohio allocated $31.5 million from reserve funds to make up for the shortfall in MSA payments needed to pay its bonds. But Ohio has less than a third of California’s population, so less than a third of its MSA revenue. California’s shortfall last year was probably in the region of $100 million, and that’s only going to get worse. The more cautious states assumed cigarette sales would fall slightly, but they decided that allowing for a 2% drop per year was all the safety they needed. In 2013, as vaping really started to take off, cigarette sales fell by 4.9%. Investment expert Alan Schankel says that if the fall reaches 6 or 7% per year it will trigger a rapid collapse of the whole tobacco bond racket. In June 2014 Herzog was predicting an average fall of 6.8% per year for the next ten years. That would almost completely destroy the tobacco bond market by the end of the decade.
A complete failure of tobacco bonds would cripple California’s economy, but it’s worth considering what the state’s population would want to cut first. Would it be their kids’ teacher? Or would it be the California Department of Public Health, which isn’t very popular right now anyway after covering up abuse in state nursing homes for more than a decade?
I think we can all guess who the people of California would rather see the back of, and what’s more I think the California Department of Public Health can, too. So what’s the solution? In fact there are two. One is to scare vapers back to smoking, so cigarette sales get back up into a nice safe zone where MSA payments will keep up with maturing bonds. The other is to bring e-cigs into the MSA – even though it’s an Agreement, and none of the independent e-cig manufacturers have agreed to that – or at least slap a tax on them that can then be ring-fenced to pay for the state’s bloated tobacco control industry. And, for anyone who believes in coincidence, guess what the odious Glantz hinted at yesterday?
UPDATE: 29 Jan 2015, 11:40am
Ron Chapman, the outgoing head of the California Department of Public Health, has just spoken to Fox News. He said, “I’m advising Californians, including those who currently use tobacco, to avoid using e-cigarettes“. In other words: “If you smoke, keep right on smoking. Please. We need you to, so we can keep on getting paid to tell you to stop.”
This post was originally published on 29 January 2015