Christopher Snowdon's Blog, page 271

The magic 25%

A handful of anti-smoking extremists have long hoped that smoking is linked to breast cancer. The pink ribbon breast cancer campaign is arguably the best-publicised and best-funded initiative in pubic health. Because breast cancer is the most common form of cancer amongst women, even a small association with smoking would allow tobacco control advocates to claim that millions of cases could be prevented by stamping out tobacco.

The problem is that there really isn't any reason to think the two are related. Sixty years of epidemiological research has failed to find a link and, unlike with diseases of the lung and airways, there is no obvious causal mechanism. As recounted in Velvet Glove, Iron Fist (pp. 236-38), neither the International Agency for Research on Cancer (IARC) nor the American Cancer Society believe there is a link and even the otherwise outré Surgeon General's report of 2006 didn't claim smoking to be a cause of breast cancer.

Outside of California, it is generally accepted that breast cancer is not a smoking-related disease. Inside California, things are always a little different. From his pulpit at UCSF, Stanton Glantz has been insisting on a connection for years, and the California Environmental Protection Agency (Cal-EPA) conducted a meta-analysis in 2004 which found an association between breast cancer and passive smoking. When the American Cancer Society expressed reservations about this meta-analysis (amongst other flaws, it excluded a notable cohort study which would have wiped out the association), Glantz went berserk and referred to doubters as "religious fanatics", thus displaying an extraordinary lack of self-awareness.

Glantz has been at it again this month following a review of breast cancer risks conducted by the Institute of Medicine. Getting rather excited at the prospect at linking arms with the pink-ribbon campaign, he overstated the conclusions of the IOM report and announced:

It's time for the large breast cancer advocacy groups to join the tobacco control community.

Glantz seems to think that the IoM report implicated smoking (and passive smoking) as a cause of breast cancer. That is not how I read it, nor is it how the New York Times read it. What the IoM actually found was this:

The evidence also indicates a possible, though currently less clear, link to increased risk for breast cancer from exposure to benzene, 1,3-butadiene, and ethylene oxide, which are chemicals found in some workplace settings and in gasoline fumes, vehicle exhaust, and tobacco smoke.

This was the only reference to tobacco in a 700 word press release. In the report itself, the IoM say that they cannot rule out a link, but that the evidence is equivocal. Tobacco remains a "possible" cause in the same way that mobile phones were found to be a possible cause of brain cancer in a recent IARC report. In other words, the collated evidence does not suggest a causal link, but some studies have found an association.

There are two interesting aspects of the breast cancer/smoking hypothesis. The first is that there was barely a hint of a link for the first 40 years of epidemiological research, as the IoM acknowledge:

Before 1993, more than 50 epidemiologic studies examined the relationship between breast cancer and exposure to tobacco smoke. Although the quality of studies was highly variable, the better conducted studies did not suggest a causal relationship (Palmer and Rosenberg, 1993). An IARC review published in 2004 included studies conducted before 2002, and it relied heavily on a pooled analysis of 53 case–control and cohort studies by the Collaborative Group on Hormonal Factors in Breast Cancer Study (2002) that contended that apparent associations with smoking were confounded by alcohol consumption. The IARC (2004) conclusions were that neither active nor passive smoking was associated with increased risk of breast cancer.

In any other field of research this would be enough to put the matter to bed, but tobacco control was flooded with money in the 1990s and so it continued. This coincided with the rise of ultra-low risk epidemiology and cherry-picked meta-analyses which, in turn, was accompanied by the burden of proof being relaxed in the science to the point where statistically insignificant findings were taken seriously.

Breast cancer is a very common disease and smoking is a very common behaviour. Given these facts, any association between the two should have been evident very early on (by the 1950s, if not even earlier). That no one found an association despite smoking being the most studied risk factor of the twentieth century strongly suggests that none exists. "If smoking was a major cause of breast cancer, we would have found it by now," says Dale Sandler, chief of the NIEHS Epidemiology Branch.

Those who say that smoking (active or passive) causes breast cancer are making an extraordinary claim and, despite efforts being redoubled in the last fifteen years, there is no extraordinary evidence and very little ordinary evidence.

From the IoM report:

Active smoking 

The summary risk ratio was 1.10 (95% CI, 1.07–1.14), indicating a weak association with increased risk for early initiation of smoking. For women who smoked only after a first pregnancy, the summary risk ratio was 1.07, but it was not a statistically significant increase in risk (95% CI, 0.99–1.15). A subsequent report from the NHS found a statistically significant increase in risk associated with greater smoking intensity (i.e., pack-years of smoking) from menarche to a first birth (p for trend <0.001) (Xue et al., 2011). At 1–5 pack-years of smoking before a first birth the hazard ratio (HR) is 1.11 (95% CI, 1.04–1.20); for 16 or more pack-years, the HR is 1.25 (95% CI, 1.11–1.40).

No increase in risk was evident for pack-years smoked from after a first pregnancy to menopause. For 31 or more pack-years, the HR was 1.05 (95% CI, 0.92–1.19). However, pack-years of smoking after menopause may be associated with a slight reduction in risk (p for trend = .02) (Xue et al., 2011). For 16 or more pack-years of postmenopausal smoking, the HR was 0.88 (95% CI, 0.79–0.99).

... For women who started smoking between ages 15 and 19, the HR was 1.21 (95% CI, 1.01–1.44); whereas those who initiated smoking after age 30, the HR was 1.00 (95% CI, 0.76–1.32).

Brown et al. (2010) concluded that their data did not show a consistent association between smoking and significant increases in breast cancer risk among U.S.- or foreign-born Asian women. For example, the results for current smokers showed an OR of 0.9 (95% CI, 0.6–1.3) while ex-smokers had an OR of 1.6 (95% CI, 1.1–2.2).

A study that examined risk for triple-negative breast cancer found no statistically significant increase in risk over nonsmokers based on smoking status, age at initiation, or duration of smoking (Kabat et al., 2011). By comparison, women with estrogen-receptor- positive cancers (ER+) were at significantly increased risk with earlier initiation (< age 20: HR = 1.16, 95% CI, 1.05–1.28) and longer duration of smoking (≥30 years: HR = 1.14, 95% CI, 1.01–1.28).

These relative risks are low or non-existent and even the positive findings are often not statistically significant. The most interesting thing about these associations is that they are actually lower than the associations claimed for passive smoking.

Passive Smoking

A 2005 review by the California Environmental Protection Agency of various health hazards associated with exposure to secondhand smoke included a meta-analysis of 19 epidemiologic studies of breast cancer ... The meta-analysis produced an overall estimate for exposed women of RR = 1.25 (95% CI, 1.08–1.44) (CalEPA, 2005; also reported in Miller et al., 2007). When the analysis was restricted to five studies with more comprehensive exposure assessment, the overall estimate was RR = 1.91 (95% CI, 1.53–2.39).

In 2006, the U.S. Surgeon General's report The Health Consequences of Involuntary Exposure to Tobacco Smoke, which included consideration of many of the same studies as the California review, concluded, "The evidence is suggestive but not sufficient to infer a causal relationship between secondhand smoke and breast cancer" (HHS, 2006, p. 13). The conclusion was based on a review of the findings from seven prospective cohort studies, 14 case–control studies, and a meta-analysis of all of these studies. The meta-analysis found that women who had ever been exposed to secondhand smoke (10 studies) were at increased risk of breast cancer (RR = 1.40, 95% CI, 1.12–1.76).

The idea that passive smoking is more dangerous than active smoking is patently absurd, but that didn't stop ASH (USA) hyping Cal-EPA's meta-analysis with this headline in 2005:

Secondhand Tobacco Smoke More Dangerous Than Smoking Itself

It is fitting that an organisation that endorses so much flim-flam should wind up embracing the principles of homeopathy, but any reasonable person understands that the dose makes the poison. In its understated way, the IoM acknowledges that it is a tad unlikely that people who inhale less than 1% of the dose inhaled by smokers would be at greater risk.

For most other smoking-related diseases, the relative risks are much stronger for active smoking than passive smoking. Thus findings of equivalent or stronger relative risks for breast cancer with passive smoking than with active smoking are difficult to explain mechanistically.

And yet these perverse findings exist and they require explanation. At first glance, it seems that the epidemiological research into breast cancer and tobacco don't tell us very much at all. Certainly, they don't tell us very much about the environmental causes of breast cancer, but I think they tell us quite a bit about the state of epidemiology. They show how easy it is to find a relative risk of around 1.25 (ie. a 25% increase) in an observational study. It takes only moderate recall bias or deficiencies in a study's design to come up with such associations. In the case of secondhand smoke and breast cancer we can surmise that the associations are false because there is no link with active smoking, but it is curious that the claimed associations with other diseases also fall in the same ultra-low bracket, regardless of the magnitude of the risk from active smoking.

Smokers are around 1,000 to 2,000% more likely to develop lung cancer. The passive smoker's excess risk is said to be around 25%.

Smokers are around 70% to 100% more likely to develop coronary heart disease. The passive smoker's excess risk is, again, around 25%.

Smokers are not any more likely to develop breast cancer, but the passive smoker's excess risk is said to be—you guessed it—25%.

Despite huge variations in the effects of smoking, the effects of secondhand smoke—if we are to take the epidemiological studies at face value—are remarkably consistent. Consistent with each other, that is. Not consistent with the rest of science.

Reason reviews The Art of Suppression

I'm delighted to see that Reason magazine has reviewed The Art of Suppression and compares it favourably with the recent PBS documentary about Prohibition...

The new Ken Burns and Lynn Novick documentary Prohibition is a five-and-a-half-hour missed opportunity to demonstrate why bans on substances are doomed from the start. Fortunately, for those who want to understand the irresistible lure of all types of prohibitions, there is Christopher Snowdon's The Art of Suppression: Pleasure, Panic and Prohibition Since 1800. Although Snowdon's comprehensive history will never reach as many people as the PBS series, The Art of Suppression makes the case that Burns seems to go out of his way to avoid: that prohibition of products that people desire, whether alcohol a century ago or Ecstasy today, is bound to fail miserably.

Deploying a colorful cast of characters, Snowdon, a British journalist whose first book, Velvet Glove, Iron Fist (2009), documented the history of anti-tobacco campaigns, tells the story of prohibition's broader context. He brings to the task the stinging humor reminiscent of H.L. Mencken, whom he quotes in describing one of the book's central villains, the Anti-Saloon League lawyer Wayne Bidwell Wheeler: "He was born with a roaring voice, and it had the trick of inflaming half-wits."

Please go read the whole thing.

You can buy the book here (UK) and here (rest of the world).

The limits of cigarette taxation

Today's blog post is at the Adam Smith Institute. While ASH deny that higher prices cause smuggling, the Irish have realised that further cigarette taxes will make them less money.

Laffer curve spotted in Ireland

Strange unintended consequences

Some saucy news from Manitoba, Canada...

After smoking in public places was banned in 2004, happy hour crowds dwindled in bars across the province.

Lies, all lies! Stanton "black is white" Glantz has conducted studies into this and has proved that smoking bans are good for business. Why do bar-owners around the world continue to deny this? The fools!

In a bid to woo customers back to his lounge, Ron Petryna, the owner of the Headingley Hotel, began running conventional Friday night bingo games.

And why not?

"We started off giving away pretty tame stuff -- cases of pop or boxes of candy," Petryna says. Then he recalled a Ladies' Night promotion he`d witnessed south of the border -- one that climaxed with a few rounds of "naughty bingo" where female participants went home with vibrators and such.

"So we began to introduce adult toys into our own bingo games," says Petryna. "Next we added special martinis and cocktails named after the games. This all evolved from there."

Oh, I say.

"This all" refers to the fact that Manitoba has quietly become the undisputed erotic bingo capital of the world. Sure, you can find comparable goings-on in places like Toronto, Ont., Portland, Ore. and Orlando, Fla. But "dirty bingo" or "X-rated bingo" or however it's billed in those burgs isn't a standard occurrence. Not like it is at Dick's Dylan's, the Stock Exchange Hotel and the Riverside Inn, to name a few local nightspots that now host erotic bingo on a weekly basis.

Tis a frenzy of x-rated bingo in Manitoba.

"Last weekend was the busiest it's ever been, in fact; we had a 28-girl bachelorette party and a soccer team from the U of M. We ended up having to seat people at the pool tables so that everybody could play."

A full house, if you will.

"My first reaction was that it sounded kind of skanky," says Kaisaris. "We don't do strippers here -- we're not that kind of place -- but I quickly discovered that erotic bingo isn't like that at all. It's good clean fun." (Good, clean and free: none of the bars we visited charges people to take part.)

Nowadays, erotic bingo at "The Nob" is definitely a family affair...

Steady on. You're just being silly now.

You can read more of this smut here.

A true sports personality

I'm not usually very interested in BBC Sports Personality of the Year, but I notice that Darren Clarke has been nominated this year. Clarke has been described as a "walking, smoking, Guinness-drinking counterblast to the notion that the modern professional golfer has to be a finely-tuned athlete with a six-pack." He smoked his way to victory at this year's British Open and then stayed up all night on a nineteen hour bender. His manager, Chubby Chandler, says he plays better when he's fat. Clarke does not disagree.

"I'm not going to change anything that I do. I think it would be very poor of me if I was to change the way I am because of a few people's opinions. That's not going to happen.

"I drink a little too much, smoke a little bit too much and enjoy myself a little bit too much at times. But when it comes down to it, I'll put my head down and work whenever I really have to."

I can think of no better way of driving the Righteous to distraction this Christmas than by having this fine athlete win Sports Personality of the Year. Please vote and vote often. You know it makes sense.

The Hitch on snitches

Christopher Hitchens (1949-2011)The death of Christopher Hitchens earlier today robbed the world of one of journalism's most eloquent and articulate voices. Here he is speaking about the nanny state in 2004...

When the complete ban on smoking in all public places was enacted in California, I called up the assemblyman who wrote the legislation and I said: "I've just discovered that bars are not going to be able to turn themselves into a club for the evening and charge a buck for admission for people who want to have a cigarette. You won't be able to have a private club. You won't even be able to have a smoke-easy, if you will, in California."

And he said, "That's right."

I said, "Well, how can you possibly justify that?"

And he said, "Well, it's to protect the staff. It's labor protection legislation. We don't want someone who doesn't want to smoke, who doesn't like it, having to work in a smoky bar."

And I said, "You don't think that if there were bars that allowed it and bars that forbade it, that, sooner or later people would apply for the jobs they preferred, and it would sort of shake out?"

He replied, "No. We could not make that assumption."

So we have to postulate the existence, if you will, of a nonexistent person in a nonexistent dilemma: the person who can find only one job, and that job is as barkeep in a smoking bar. This person must be held to exist, though he or she is notional. But everyone who actually does exist must act as if this person is real.

...The worst part is that the staff has to become the enforcers. The waitresses have to become the enforcers. The maitre d' has to become the enforcer. He has to act as the mayor's representative. Because it's he who is going to be fined, not you. If you break the law in his bar, he is going to have to pay.

So everyone is made into a snitch. Everyone is made into an enforcer. And everyone is working for the government. And all of this in the name of our health.

Now, I was very depressed by the way that this argument was conducted. There were people who stuck up for the idea that maybe there should be a bit of smoking allowed here and there. But they all said it was a matter of the revenue of the bars and the restaurants. That was the way the New York Times phrased it.

In no forum did I read: "Well, is there a question of liberty involved here at all? Is there a matter of freedom? Is there a matter of taste? Is there a matter of the relationship of citizens to one another?"

And something about it made me worry and makes me worry still. The old slogan of the anarchist left used to be that the problem is not those who have the will to command. They will always be there, and we feel we understand where the authoritarians come from. The problem is the will to obey. The problem is the people who want to be pushed around, the people who want to be taken care of, the people who want to be a part of it all, the people who want to be working for a big protective brother.

Read the full article here.

Anna Gilmore returns

Anna Gilmore's new study doesn't seemed to have generated much media attention, perhaps because any editor looking at the headline of the press release is likely to think "well, duh":

Smoke free legislation linked to drop in second-hand smoke exposure among adults

Levels of second-hand smoke exposure among non-smoking adults fell by almost 30 per cent after smoke free legislation was introduced in England in 2007, researchers in the Department for Health have found.

...Professor Anna Gilmore, who directed the study, said: "The importance of this study is that it examines the impacts of smoke free policies on adults' exposure using a specific biological-marker of smoke exposure (rather than self-reported exposure) while simultaneously controlling for underlying declines in exposure.

"To our knowledge it is the first study to do this. The fact it shows marked declines in adult exposure provides further evidence of the important public health benefits of smoke-free policies."

What, if any, are these "public health benefits"? The study looked at cotinine readings in nonsmokers before and after the English smoking ban and found that they fell by 27%. Cotinine itself is perfectly harmless, but it is a bio-marker for nicotine which is, in turn, is a proxy for "secondhand smoke exposure". Nothing wrong with that, nor is there anything surprising about cotinine readings falling as a result of a total smoking ban in 'public' places.*

The graph below (which comes from the study) shows saliva cotinine levels in nonsmokers before and after the ban (click, as ever, to enlarge).


'SFL' indicates the start of the 'SmokeFree Legislation'. What is most striking about this graph is how much cotinine and, it must be assumed, secondhand smoke exposure declined before the smoking ban. After the ban, cotinine levels did not change for people living in smoking households and Gilmore found that people in social classes IV and V experienced no reduction in secondhand smoke exposure at all (inevitably, this leads to her calling for "further efforts to reduce SHS exposure to benefit those who remain most exposed.")

Only nonsmokers from social classes I to III who live in nonsmoking households saw a decline in their saliva cotinine levels. Gilmore claims that this decline was greater than would be expected from the long-term trend, although none of her graphs appear to support this.

Gilmore's track record gives us no particular reason to trust her assertion that the smoking ban accelerated the existing trend towards less secondhand smoke exposure. However, it is obviously very plausible that a smoking ban would have this effect so, for the sake of argument, let us agree that there was a 27% drop in saliva cotinine readings as a result of the ban.

Her data show that before the ban (1998 to 2007), average cotinine levels in nonsmokers' saliva fell from 0.36 ng/ml to 0.14 ng/ml. After the ban, this declined continued and, by the end of 2008, cotinine levels were at 0.071 ng/ml.

The question is: so what? Is this decline—which sounds impressive when described as a 30% fall in secondhand smoke exposure—of any practical significance? How do these levels compare with actually smoking?

A systematic review of cotinine readings found that the average smoker has a saliva cotinine reading of 318 ng/ml. This is more than 2,250 times greater than levels found in nonsmokers before the ban.

This difference is so vast that it is difficult to show it visually. The graph below shows cotinine levels of nonsmokers in 1998, 2007 (pre-ban) and 2008 (post-ban) compared with a typical cotinine reading from a smoker. If you click to enlarge, you may just be able to see the nonsmokers' data.



While smokers have average cotinine readings of 318 ng/ml, the smoking ban reduced the average nonsmokers' levels by 0.0019 ng/ml. This is beyond negligible. Whether before or after the ban, we are talking about truly homeopathic levels of exposure. It takes a leap of faith to believe that reducing 'exposure' levels from 0.03% of a smoker's level to 0.02% of a smoker's level really constitutes "the most significant and beneficial public health intervention for a generation". Far from showing us how effective the smokefree legislation has been in tackling the passive smoking peril, this study reminds us how overhyped the peril was in the first place.



* However, it is wrong of the press release to describe a 27% fall in nonsmokers' cotinine levels as meaning that "second-hand smoke exposure among non-smoking adults fell by almost 30 per cent". This suggests that if all secondhand smoke was eliminated, cotinine levels would fall to zero. This would never happen because nicotine, and therefore cotinine, exists at low levels in various nightshade vegetables.

Yes, it's all about prohibition

An anti-smoking group calling themselves Tobacco-Free Washington have taken their crusade to its logical conclusion by demanding the prohibition of tobacco. Under their proposed law, possession would be a class C felony. Sale would be a class B felony.

Yes, I am serious and so are they. Initiative 512 reads...

(1) It is unlawful to sell, manufacture, or possess any tobacco products including, but not limited to, cigarettes, cigars, and smokeless tobacco.

(2) A person who:

(a) Sells or manufactures any tobacco product is guilty of a class B felony punishable according to chapter 9A.20 RCW; or

(b) Possesses any tobacco product is guilty of a class C felony punishable according to chapter 9A.20 RCW.

(3) For the purposes of this section, "tobacco product" includes any product containing tobacco or nicotine that is expected or intended for human consumption.

The prohibitionists are now looking for 300,00 signatures to move Initiative 512 forward. The good news is that they have used a clumsy definition of tobacco products which includes pharmaceutical nicotine 'therapies', so the bill will meet strong opposition from Big Pharma and the various anti-smoking groups they fund.

You have to laugh at the guy who is behind this law. Dr Ed Dolan is a dentist who doesn't sound too bright (you can listen to the half-wit here). Whenever prohibitionists are looking for a handy precedent to seem less nuts, it's only a matter of time before they point to seat-belts laws. They are, after all, one of the few laws which are imposed on people for their own good.

Such a law, if it came in to existence, would likely illicit a lot of resistance from those who believe taking away their right to smoke is a violation of their civil liberties. So Dolan compares it to the seat belt law - a law that yes, infringes on civil liberties, but significantly increases the average life expectancy of someone living in Washington.

One of the main objections to seat-belt laws in the 1980s was that they would be the start of a slippery slope to banning smoking, drinking and Lord knows what else. "Nonsense!", said the campaigners, but here we are 30 years later doing just that.

Dolan does acknowledge that it treads on a slippery slope. 

Dude, you're calling for the possession of tobacco to be a felony. Possession of alcohol wasn't even a felony under Prohibition. You don't need to worry about treading on the slippery slope. You hurtled down that a while ago.

When [it was] suggested that if cigarettes are outlawed, then red meat and alcohol could be next, Dolan said he's not sure about what could happen regarding health concerns and laws.

At least this numpty doesn't try to deny it. It's the next logical step, innit?

Repetition, repetition, repetition

Knock, knock, knock at the door they go—the incessant whining designed to make the government sigh and give in, with the forlorn hope that maybe they'll finally shut up and go away. We saw it with the smoking ban. We saw it with banning below-cost alcohol.

And do they ever shut up and go away?

They do not.

Ban cut-price alcohol to save lives, leading doctors warn
In a letter to The Daily Telegraph, medical experts urge the Government to take "bold action" and follow the lead of Scotland by bringing in minimum prices for drinks.

Firstly, writing a letter to the Telegraph shouldn't be considered front page news, even in the Telegraph.

Secondly, quit it with this "bold action" stuff will you? You tried it last month...

The British Medical Association (BMA) is calling on ministers to bring in the "bold and courageous" ban for reasons of health rather than road safety.

There's nothing bold about putting up tax and banning things. It's cowardly and self-serving. Your attempts at flattery are nauseating and your cynicism is transparent.

Sir Ian [Gilmore—for it is he] is calling for a return to the higher prices of 20 years ago, when alcohol was about 50 per cent more expensive in real terms.

Does anybody understand what 'real terms' means any more? It means 'after adjustment for inflation', not 'compared with average wages'. As I never tire of pointing out, the Office for National Statistics has looked into this and concluded:

Between 1980 and 2008, the price of alcohol increased by 283.3%. After considering inflation (at 21.3%), alcohol prices increased by 19.3% over the period.

Actually, I do tire of pointing this out, so please stop it.

New figures were made public last week showing that twice as many people were being treated in hospital because of alcohol compared with 10 years ago.

New figures?! You must be kidding. The "twice as many people being treated in hospital because of alcohol" story appears more often than the crossword. It's done the rounds three times this year alone (in February, May and December).

In addition to reporting this "news" last week, the Telegraph reported it in May and August—using the same photo to illustrate it on each occasion. It was first reported back in 2008 and has appeared with unfathomable regularity ever since.

The repetition of the 'hospital admissions double' canard (and it is a canard) epitomises the campaign for minimum pricing, which is based on nothing more than a relentless, circling PR exercise by the UK Alcohol Health Alliance modelled on the smoking ban campaign. There is nothing in the article or the accompanying letter of any interest. None of it is new. It is the same hysterical half-truths masquerading as news.

And so, in the absence of anything interesting to write about, I will use the occasion to launch my new leisurewear collection. The Snowdon Winter 2011 collection includes two high quality white t-shirts (other colours are available) featuring simple but lovingly designed motifs which will give the wearer years of satisfaction.





Order now to avoid disappointment.

Nicotine wars: Latest

There can now be little doubt that the EU's ban on snus is being maintained at the behest of the pharmaceutical industry. It is not about health. It is not about science. As the Swedish press recently reported, the battle lines are drawn:

In the battle over snus the world's largest pharmaceutical company is in one corner of the ring and the world's largest tobacco company in the other. The battle is about the hundreds of millions of smokers who are trying to quit. Big time lobbying is clearly visible in the EU snus debate. The tobacco industry was most successful in mobilising support for petitions via YouTube and the Internet, while the pharmaceutical industry has achieved success by more selective actions.
"There is clear competition between us and the pharmaceutical industry," says Swedish Match's Public Affairs Director Patrick Hildingsson. "In the EU there are 107 million smoking consumers both our industries want to reach. The pharmaceutical industry does not want see the success snus has had in helping people stop smoking to spread outside Sweden."
But Pfizer's Medical Director John Brun does not see snus as competition: "Absolutely not. Tobacco is a major health risk regardless of how it is consumed, which is why we have committed ourselves to reaching out from a health perspective in public debate."

Pfizer—maker of Nicorette and Champix—does not see snus as competition?! How strange that they should waste so much their time and money lobbying for it to remain illegal (almost as strange as them funding studies into the economic impact of smoking bans). You'd think they'd have better things to do that worry about a niche smokeless tobacco product, unless of course they're worried that it's a more effective smoking cessation aid than their own products.
Instead, they're keen to rush the European Commission into producing its new Tobacco Product Directive, which will address the question of whether the snus ban is justifiable. The following is a letter Pfizer put its name to (along with Anna Gilmore, Luke Clancy and other useful idiots):

Dear President Barroso,

We are writing to you as a group of NGOs, charities, researchers, industry representatives and MEPs representing a majority of Member States and every major major political group, to urge you to bring forward the proposal for a revision of the Tobacco Products Directive at the beginning of 2012, as promised.

... As a signatory of the Framework Convention on Tobacco Control the European Union has a responsibility to implement measures which reduce tobacco use across Europe, and the revision of the Tobacco Products Directive is central to that. As this report will be so important, and undoubtedly controversial, the Council and Parliament will need time to thoroughly scrutinise and negotiate an effective revision. If we do not begin work at the beginning of 2012 we could be in real danger of having to restart the whole process after the 2014 elections. Given our commitment to the Framework Convention on Tobacco Control this is simply not an option.

We are of the view that further delays are not acceptable, and would appreciate if the Commission could inform us of a definitive timetable for the revision of the Tobacco Directive.

The only problem is that the EU's public consultation didn't exactly go Big Pharma's way...

Of the citizens who submitted their opinions, more than eight out of ten, 84 percent, support lifting the export ban on snus. 86 percent of government representatives and 74 percent of industry representatives wish to lift the ban. Only among lobbyists and NGOs is there a slim majority, 56 percent, who want to keep the ban on snus.

The consultation was a disaster for Pfizer because the anti-tobacco extremists neglected to get their NGOs and fake charities to respond en masse. Worse still, tobacco retailers in two countries organised petitions which generated 82,000 responses.

Mind you, those 82,000 people were probably tobacco users so the EU won't be counting them...

The EU Commission, however, dismisses a significant portion of the responses from the 82,000 citizens on the grounds that two-thirds are from Italy and Poland, where tobacco merchants organised petitions.

Some people say the EU is anti-democratic, y'know.

But even if we exclude these two countries, the majority is still for lifting the export ban on snus, 10-6, when respondents are broken down by country.

Bit of a bugger. What if we exclude the public altogether?

DN's review of the 400 responses in this group shows that even among the responses from parliamentarians, municipalities, government agencies and ministries a large majority, 71 percent, support lifting the export ban. 

Ouch! Surely there must be some way to fiddle the figures?

Even when only EU governments and ministries are included, there is still no majority against snus, but rather 3-3.

Damn it! How is the EU supposed to justify its arbitrary, scientifically indefensible prohibition when even politicians won't lend their support?

Oh well, there's only one thing for it...

The European Commission's health directorate claims to have received responses from governments who in other ways support the ban on snus, but refuses to show them.

Bingo!

"You know that public consultation that went against us? You won't believe this, but I've just found a bunch of responses down the back of the sofa. Thousands of them, and all of them support the ban! 


Sorry, you want to what? Oh, you want to see them? Er, yes...erm...ah... Good Lord is that the time? I really must be going..."

Some people say the EU is corrupt as well, y'know.

However, there may yet be a glimmer of hope...

The European Commission has promised Sweden it will take another look at its ban of the tobacco product snus, which is allowed in Sweden but banned elsewhere in the European Union, the Swedish trade minister said on Wednesday.

Trade minister Ewa Bjorling said she had met EU Health Commissioner John Dalli and discussed the results of a survey of EU states about current tobacco laws.

"What I believe is most important is that you base your reasoning on scientific facts. That is what I try to tell Dalli, and I ask the question: Why do you still want to have a ban on Swedish wet snuff when there are other snuff products on the market in the EU, for example Pakistani snuff?," Bjorling told Reuters.

This was the second time she raised the snus issue with Dalli.

"I think he was listening in a different way this time. The first time he dismissed it simply saying their goal is to get everything away for health reasons," Bjorling said.

I suppose not dismissing the idea out of hand is some sort of step forward. Interesting to note that the real goal is total prohibition of all tobacco products, but I think we'd worked that out already.