00:00:06 --> 00:04:28

Martin Cullip: Okay, hello everyone and welcome to this session on the Tobacco Control Playbook. My name is Martin Cullip. I'm a harm reduction advocate and I'm a fellow at the Taxpayers Protection Alliance Consumer Center in Washington, D.C. I've got a great panel lined up for you. I just want to mention that there is translations of this panel into Russian and Spanish, if you want to take advantage of that. I'd also mention that you're being given feedback forms on the way in. Could you make sure you fill those out, if you intend to fill one out, before you leave? No point just taking it home with you and not giving your thoughts on how the whole conference went. So I'll introduce the guests I have with me today. Firstly, in no particular order, we have Gerry Stimson, should need no introduction really, public health social scientist with over 50 years experience in research and advocacy. He's one of the founders of Drugs Harm Reduction in the 1990s and he's Director of Research and Policy at Knowledge Action Change and a co-founder of the Global Forum on Nicotine. which we're all at. To my right, we have Asa Saligupta, a former smoker, he smoked for over 37 years, and he tried almost all methods, and he found vaping about 10 years ago, and he founded ENDS, Cigarette Smoke Thailand, ECST, seven years ago, and is the current director. And we have Nancy. Nancy is the founder and executive coordinator for CAFRA, the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates. CAFRA supports consumer THR advocacy organizations and activities throughout the Asia-Pacific region and beyond. And lastly, we have Konstantinos Vassilinos, physician and senior researcher at the University of Patras and the School of Public Health, University of West Attica in Greece. He's been conducting laboratory, clinical, and epidemiological research on smoking, tobacco harm reduction, and e-cigarettes as principal investigator since 2011, and has published more than 90 studies and articles in international peer-reviewed scientific journals. So, what are we going to talk about today? Well, there was a perfect example last week in the UK. The Guardian newspaper ran an article on Mark Hopes of this parish who was on panels yesterday and the day before. basically accused him of being part of industry plot to spread messages around social media about vaping. The accusation went, if I understand it correctly, that Mark was running WeVape, a consumer association. He later joined the Adam Smith Institute in London as an unpaid fellow. And the Adam Smith Institute about 10 years ago got some funding from JTI, which represented about 3% of their turnover. So therefore, apparently Mark was spreading these messages and it was all funded by tobacco. I spoke to him and asked him what were these messages and he said he bought some adverts on Twitter and the sum total of the adverts was £79. So this is the kind of thing we're talking about. At the same time, on the other side we have Bath University was found out last year to be an intermediary between Bloomberg Philanthropies and the Investigative Desk, which is a Dutch-based organisation which writes articles which are very anti-vaping. And they had a contract with them where they weren't allowed to say that they were getting funding from Bloomberg. And one of the projects that the investigators did was they got an article written in BMJ about hidden sources of funding. Yeah, so there you go. We'll start, I think Gerry, if anyone hasn't seen it, I really advise going onto the website, GFM website, and see if Gerry did a pre-record 13 minutes long where he went through some of the examples of this sort of behaviour that he's seen. And I really recommend you go and watch that if you haven't already. But do you want to start us off, Gerry, with your experiences and get us into the... Yes, I will.

00:04:28 --> 00:12:05

Gerry Stimson: I'll give you a little bit of a flavour of this and I'll be very careful because I realise I'm surrounded by vapours and I'm not. But I've been kind of caught up in a whole lot of weird things over the last ten years since I got involved in tobacco harm reduction. 2014 was the first year of GFN, but in the UK, it was also the year when public health experts were rattled by the rise of vaping. And I couldn't really understand what was going on. It was kind of they couldn't cope with their expertise being challenged. Towards the end of 2014, John Ashton, who's president of the Faculty of Public Health, he let rip on vapers on Twitter. describing them as trolls, as onanists, and hinting that they had, quote, shadowy sponsors. He tweeted a female vapor, have you always been an anonymous C asterisk asterisk T? Have you always been an anonymous C asterisk asterisk T? So I thought, what on earth is going on? He was, as a result of that, suspended from his presidency of the Faculty of Public Health temporarily. This was bizarre because John Ashton was a leading figure in participatory public health in the time of AIDS and HIV, instituting needle exchange outreach to sex workers and so on. But this kind of hadn't come carried across to safer nicotine products. The attacks ramped up later in 2014. A prominent UK vaper, I was going to say a waitress, but I have to, a restaurant server, with no experience of academic publishing, got a comment published in The Lancet. And this was fantastic. Really, to get a comment in The Lancet, what an achievement. And she asked in that article, in that comment, that experts listen to the views of vapors and asked for a more inclusive debate. Her comment was met by a miserable sneering put down by Martin McKee, public health professor, Simon Chapman, a sociologist, and Mike Dorb, a tobacco control activist. And coinciding with that, Chapman tweeted to quote, anxious plea, tweeted this person, anxious plea from a vaping activist who's cozy with trolls who post this stuff. She was up for it. She tweeted wonderfully. I can't actually repeat all of what she said here. But part of it was to quote, murderous, dickless, evidence denying, public health bastards. The whole tweet is more colorful. So Vapors saw through this pretentious, pompous public health posturing. I come from a social science background and a kind of a public health social science background where engagement is crucial. Engagement in patients and populations are crucial and a founding principle of much of public health. So I couldn't really figure, you know, here what was going on. And in part, you know, can you imagine public health leaders criticizing, you know, saying cancer trolls or, you know, any other? You know, it just wouldn't happen. So there's something really peculiar and we need kind of unpick that. But in part, it's a struggle for ownership. And when these public health leaders, these public health activists and tobacco control activists were challenged, they were discombobulated. It's a word I've been wanting to use for a long time. And they didn't understand nicotine consumers as potential allies, and that's been the big sad thing about this. It's the exclusion of people who could really be allies in the move away from smoking. Same year it happened to me at a smoking cessation conference. We put on a panel of vapors, wonderful session. Right at the beginning of it, a friend of mine was excluded from the session. The person was allowed to attend the conference, but our badges were color-coded. He was from a tobacco company, so he was excluded from the session. It was a segregated conference, and I thought, what on earth is going on that you'd ban certain people from sessions? And right at the end of the session, I was approached by Dr. Anna Gilmour from the University of Bath, and it wasn't an interesting session, Jerry, blah, blah, blah. you didn't declare a conflict of interest. Now, in, by then, 40, 45 years of research and going to conferences, nobody had ever said that to me, and it seemed a rather odd entree. So, I'll expand on, I've probably gone over time already, have I? So, we can expand a little bit on that, but there are people who want to police the Framework Convention on Tobacco Control want to police Article 5.3, which is meant to protect policy from the tobacco industry. But it's really become kind of a petty, paranoid, persecutory policing by tobacco control activists, and it's a process of delegitimizing, excluding, and so on. I'll just try to hurry this up a little bit, because I'm pretty thick-skinned, and this kind of, you know, doesn't matter too much to me. But what's really nasty is, as part of this, is the academic onslaught on vapors. And there are two articles in particular won by Pertanavanich and Glantz, which tried to suggest that ECST, vaping is not a crime, was in league with PMI. And so what they do is they look at what ECST is saying, and in fact I think they thought you were an organization rather than a very active individual at that time, and they looked at what PMI was saying, and it's kind of a, a pseudo-causal synchronism. It's kind of more astrology than science. ECST is saying this, PMI is saying this, hence they are in bed together. And there's another similar article by Lindsay Robertson at the time of the FCTC when Vapors were tweeting about the FCTC and others were, including from PMI, and they did a Twitter analysis and the Bath University press release announced vaping advocates critical of global health treaty linked to tobacco giant. But again, it's this kind of magical, there's some magical fluid dynamic going on here that because one bunch of people are saying things and another bunch of people are saying things, they're somehow linked. I'll try and draw it to a close, but somehow along the way tobacco control needs enemies, and it continues because many of you in the audience will have your own personal experience of this. But we can talk about how to address this and how to respond to this, but as I said a little bit earlier, the big sad thing is that it cuts off dialogue and it cuts off engagement with people who should all be working together to bring about an end to smoking.

00:12:05 --> 00:13:00

Martin Cullip: Yeah, thanks Joey. I find it interesting that what you touched on there that that consumers can be excluded from the debate simply because they are speaking in favour of products which would be beneficial to the tobacco industry. So, you know, we say we like vaping products and therefore we're bad because the tobacco industry are making them. Well, that doesn't give us much of a chance, does it really? I'd just like to say, by the way, I forgot to say at the start, if you're watching online, you can put your questions in. I've got a screen here. I can see your questions. And I'd also like to point out that I noticed on social media that this panel attracted a bit of attention from some of our opposition. So welcome to them if you're watching. And you're quite welcome to put your questions in as well, should you choose. Do you want to go on to you next, Konstantinos? Because you've had a quite, well, as I mentioned, the Bloomberg piece on you and the BMJ.

00:13:00 --> 00:19:19

Konstantinos Farsalinos: Yeah, after an article written by Blumberg for me at the time of Evali, which is a misnomer, as we know, saying that I'm basically a soldier of the tobacco industry. Why? Because I replicated studies, and I rejected findings published from American universities that reported some outrageous results in terms of e-cigarette emissions that were completely out of their fantasy and I knew that and that's why I wanted to replicate the studies. And we in fact had hurdles replicating the studies because the scientists who published the studies were not willing to share with us the kind of products that they used in order to get the same products and replicate the studies. So imagine that you're a scientist and you ask a colleague that, please tell me what kind of products did you use because I want to replicate your study. and not receiving any response, you know, and accusing you for wanting to do what? Replication, which is the definition of science is replication. There is no science without being able to replicate the findings. Anyway, the article that you mentioned in BFJ is very interesting because It was not done by scientists, but by journalists who had contacted me a few months before the article, and I explained to them that I have no conflict that I need to mention in any of my studies. Because, first of all, they were talking about studies about nicotine smoking and COVID, so we never mentioned the word harm reduction, we never mentioned vaping, we never mentioned heated tobacco products, snus or anything else. We only discussed about nicotine replacement therapies in all our papers. And of course, there was no conflict because when one academic gets personally, for himself, funding from the foundation, you can't expect someone who just knows him or has been working with him in irrelevant, non-funded projects to declare conflict just because he's working with him in other areas. Anyway, the interesting thing was not only that these people were funded by Bloomberg and they failed to disclose their conflict of interest in the article. It's even more interesting that BMJ did not allow me to respond in their website. So whenever I submit the response, including documents that I received from a Freedom of Information Act request from the University of Bath, that those journalists were funded by Bloomberg through the University of Bath, and that there was a document mentioning that the journalists should not disclose to anyone that they received funding from Bloomberg, I was always getting a response from the BMJ lawyer who changed my text to a way that it was not my response, but it was the lawyer's response. So, after three failed attempts to respond on the website of the BMJ, I had to go somewhere else to a preprint server, to Chaos, and write a 12-page response, which was not only a personal response about an unprecedented ad hominem attack, but also presenting the fact that this is discouraging research. We were not talking about harm reduction, we're not talking about smoking, we're talking about finding what is in smoking that protects from COVID, and whether there are any therapeutic, pharmacological implications in that. And by having such a fearful attack, the industry never discussed about COVID and smoking. Attacking in that way towards scientists, they basically discouraged research on the subject. But they don't care. BMJ doesn't care. The journalists don't care. When I told BMJ that they have not disclosed their funding and they are supposed to play the ethical role of discussing about conflicts, They never changed anything. Anyway, you need to be brave and you need to have the courage to withstand that, because tobacco harm reduction is mostly a political issue, unfortunately, and a very small part is science. And what has been unprecedented is what Jerry mentioned, that the users are excluded, not only excluded, but they treat them in a totally disrespectful way, with irony, with saying that they have conflicts or they've been paid by someone to say that. And unfortunately, I think, Jay, that it's the same story that happened initially with HIV and AIDS. And the same story that happened initially 30, 40 years ago with intravenous drug users. You know, people involved in this research knew better than the people who were suffering from the effects of such dependence. And yeah, people who have probably never seen any cigarette in their life knew better than those who were using their cigarettes every day. And they've been smoke-free. You know, when I started doing the research in 2011, I admitted my total ignorance concerning what an e-cigarette is. And in order to understand what an e-cigarette is, I just knew that they existed, but I knew nothing about them, I went online, I found an online forum of Greek vapors, and I brought them to the hospital. with their devices to explain to me, what's the e-cigarette? Why are you using this device instead of something else? What's happening to you? How did you manage to quit smoking? And that's how I learned. I mean, for something that is new to us, we can't pretend that we were born knowledgeable. We have to ask people who know and who use this before we ever knew their existence. And that's the vapors.

00:19:20 --> 00:19:47

Martin Cullip: Yeah, that was my introduction to vaping as well. I went on to forums and I remember saying, look, I don't know anything about these things, someone educate me. And a kind lady in Leeds sent me a big jiffy bag full of things with post-it notes on it saying, this goes here, this goes there, yeah. So that was my first introduction. You mentioned there, consumers are not allowed to be involved. So we'll get on to some consumers here. Asa, do you want to tell us your experience?

00:19:50 --> 00:23:50

Asa Saligupta: Actually, it could be long, it could be short, but first of all, you know, like Gerry had stated, that they tried to tie us, especially to PMI and because, you know, our organisation, our group, we started by calling ourselves N-Cigarettes Smoke Thailand ECST. Actually, that's not the first name we came up with. The first name was Smoke Harm Intervention Thailand, Once you put it into it, you get that one. It's going to be difficult to put SSH IT on my shirt. So anyway, the opposition, the so-called doctors, they said like, see, this guy is receiving $80 million per year from PMI. and look at their names, E-C-S-T, and cigarettes, Smoked Thailand, when translated into Thai, it's exactly the same as I quit ordinary smoking, which I just found out that was like, that was not even, a longer term for ICOS, ICOS is something else, but they tried to pull in, so they said ECST is equal to ICOS. We're going like, we never even thought of that, or I would have gone back to SHIT, just to avoid all the confusion. So anyway, I have to go back, for some of you who were The last session that, you know, Dr. Farsa and Bernard, they were talking about the mentality, the effect of nicotine. I would like to just take a moment to refer back on that. I have my seizure as my, you know, like happen once in a while, you know, And I talked to a neurosurgeon and the doctor, a specialist in the brain and everything. So I asked him what I can and cannot do. And he said, like, first of all, from that moment that I went back last year, say, like, avoid driving, riding motorcycle. I already sold my bike. Alcohol and smoking. So I pull out my electronic cigarette and say, what about vaping? She said, as a doctor, she wouldn't recommend inhaling anything except pure air, but that is going to be impossible to do. Vaping, she said this, she said like, well at least vaping is much better than going out on the street and inhaling all the smoke and the smoke and the carbon monoxide and everything. She said vaping, there's no combustion in vaping. So go ahead and vape. It might also help you with your nervous symptom and it could relieve and just make you relax more. Maybe you could go to sleep and have a deeper sleep and things like that. So just confirm to the session before this one. This is me. I'm a consumer and I'm also a victim of somebody said I have What was it, Alzheimer's disease and Parkinson's? I don't, but I have seizures. It happened like five times already in my lifetime. And the last one was in Munich right after last year's GFN. I was too tired, dehydrated, and no medication. And I passed out at the airport before going back to Bangkok. I woke up at hospital and then went back, got a treatment at hospital in Bangkok, and a specialist said, like, go on vaping. It's not going to do you harm. Maybe it may even help. So, you know, that's from a consumer point of view and from a patient who suffered the brain thingy also. Yeah.

00:23:51 --> 00:24:21

Martin Cullip: It's interesting the lack of knowledge of medical professionals in some cases. There was a Twitter thread I saw yesterday where someone, an American, was saying they'd spoken to a pulmonologist and she mentioned that she vapes and he said, no, you'd be better off smoking. You know where you are with that. And if anything, that perception seems to be getting worse, doesn't it? Nancy, you've been around a long time, like me. What are your thoughts on this?

00:24:22 --> 00:26:07

Nancy Loucas: What I've seen is that the negativity and the attacks have ramped up as the consumers have actually become more vocal. So I see it as action-reaction. But the other thing I see, and I've said this before, is the more scared and the more threatened your tobacco control people get, the nastier the attacks become. and as you have thick skin like you were saying. But what that tells me, and this is something I tell advocates who get downtrodden or they get burnt out, the fact that they're attacking you means A, they're paying attention to you, and B, they have nothing better to attack on because they can't argue with the science. Hennage uses that argument all the time as well, okay? If they're paying attention to you, that means you're doing the right thing. Okay? And you have to keep doing it. And you have to understand that people who do that, humans, you know, for the various reasons, especially in academia, that people find us a threat. If they lose their cool and they lose their professionalism, you've already won. Okay? Not only have you won because you're healthier, because you've made the switch and you feel better and the clear x-rays like at ECST and all of that, but you've won because they have nothing to counter you with. And that's kind of where I come from nowadays because of what I'm seeing. So the more angry they get and the more effluent that gets published and accusations and everything else, it's like, yeah, okay. It's almost like watching the end of the dinosaurs, that they have nothing better to come at me with. Yeah, we're winning.

00:26:07 --> 00:26:34

Martin Cullip: Yeah, I've often said the same. It's funny how they skip the debate and just go straight for the smear. So it tends to suggest they really haven't got anything else, and they don't want the debate, which was going to be my next comment. What do they hope to achieve with this? Jerry, is it just to silence the debate? Do they not want to have the debate? What do you think they're hoping to achieve with all this sort of puerile? Yes, puerile.

00:26:35 --> 00:28:35

Gerry Stimson: Well, I think it started with a matter of ownership because public health, tobacco control, like to kind of invent things and invent policies and so on and so forth. This came from left field. So right at the beginning, there's kind of a question of ownership. It wasn't something they'd invented. It was coming from somewhere else. that leaves you with nothing much else to do except to express fear, uncertainty and doubt and so suspicions. So I think that's kind of the initial thing but then it gets kind of embedded in the psyche of tobacco control activists and their institutions because it's not just John Ashton throwing something else one Saturday night after, it was described as the Saturday evening Merlot meltdown, to quote, it's not me. It's not just throwing slang and things like that, but then it becomes institutionally embedded, because University Bath, for example, has 20 million plus from Bloomberg to fund the Tobacco Topactics website, which in fact was also, and they are also funded by Cancer Research UK, which is bizarre, but there's huge funding coming from from Bloomberg into the University of Bath. There's funding that goes into the quote stop expose tobacco program, which is also linked between Bath and other institutions. So there is a an institutional framework and psyche for this, which means it's kind of not easily going to go away, and it sort of has its own roller coaster and its own echo chamber. So why it happens, well, I think why it happened initially was fear and uncertainty about what was going on, but then it becomes institutionalized and into kind of a mentality of a, I call it like a psychopathology of tobacco control, but it's there in the psyche of many tobacco control activists, and it doesn't seem to be diluting.

00:28:36 --> 00:28:52

Nancy Loucas: Do you feel that there's a little bit of projection happening as well? You know, because they're accepting these funds from, like, say, Bloomberg or from a pharmaceutical company, and they turn around and automatically accuse us of doing the same thing, except it's a tobacco company.

00:28:52 --> 00:29:01

Gerry Stimson: I don't think they see their receipt of funding as in any way a conflict of interest. You know, they see it as legitimate funding for what they are doing.

00:29:01 --> 00:29:07

Nancy Loucas: But we're getting money. If we're getting money, if we're getting money, they would rather have the money for themselves. That's what I'm saying.

00:29:07 --> 00:29:51

Gerry Stimson: Is it? No, I don't think so. I think it's, you know, I don't think it's projection, but I think there is, you know, it's, you know, Pasolino's talking about declarations of conflicts and so on and so forth. You know, if you're getting money from Bloomberg, you never say that there's a conflict of interest. It's just legitimate thunder. I don't think it's competition so much as just kind of embedded in the, it's what they do. You know, there's an industry with, you know, the team at Bath with Andy Rowell, who was actually one time quite a good investigative journalist, but they have nothing else now to do except to sort of try to name and shame. You know, whole websites which are just dedicated to naming and shaming.

00:29:52 --> 00:32:44

Konstantinos Farsalinos: Well, I think that what they feel does not necessarily represent reality. It is definitely a conflict of interest when you're being paid to have a specific view by people who already have a specific view, and they ask you to move and support that view. And that's exactly what Bloomberg and several other sources, even the FDA and the NIH, if you look at When they release a statement asking for proposals for research and they are providing funding, they're always looking for the bad things. They basically, I wouldn't say not even indirectly, they directly guide you into looking for bad things in order to receive the funding. These people are people who are paid to solve a problem. You cannot be paid to solve the problem unless you create the problem. And in most cases concerning harm reduction, it's more a problem creation by them rather than a problem that really exists. And the more you exaggerate presenting the problem as something which is totally catastrophic, the more money you're going to get. But this is definitely a conflict, because you're being paid for that. And you're being paid by people who have a specific predisposition and prejudice against this strategy. Of course, at the same time, yes, funding by the interest is also a conflict. But you know, conflicts of interest are there to be declared, not to become the criterion for exclusion. What is happening now is that, and it's not only among activists, but it's also among scientists, is that the conflict of interest is being used for exclusion. And there are scientists working in the tobacco industry who are performing excellent research, and they are unable to publish the research. Because the journals refuse to review such papers. They refuse to even accept them to be peer-reviewed. And I've seen... papers that I have reviewed, I've seen comments by other reviewers who are mainly focusing on the source of funding and not on the content of the scientific paper. And that makes no sense. Yes, conflicts of interest need to be declared. Yes, you need to be cautious, but you need to judge the content. You need to judge the data, not simply the funding source and that's going to be the beginning and the end of the review.

00:32:44 --> 00:32:57

Martin Cullip: That's not science. I was going to say on this, because you touch on this, do you think they believe that their actions are promoting public health?

00:32:57 --> 00:34:41

Konstantinos Farsalinos: They definitely believe that, yes, because in my opinion they are so obsessed with being right. I mentioned last year in the Michael Russell Oration, they behave as if they are the only owners of the truth and owners of knowledge. That's how they behave. This is an egoism at a completely different level. They know better than the users, they know better than anyone, and that's why they are not willing to accept any criticism, they are not willing to accept and tolerate any different opinion, and that's why they do not engage into the debate. And Jerry knows very well, I was also in the scientific committee of this conference in the first few years, we tried desperately to bring people to discuss openly here, to present their views in the way they wanted, with as much time as they wanted. They didn't even respond to our attempts to invite them. And I think this also is showing that their arguments are pretty weak. Because if your argument is strong, you would be glad to come to a hostile, let's call it, environment and present your views. I would be glad to go to an environment where everyone else is an anti-THR activist, and I know that they're going to attack me. I would love that. That would be fascinating. But they don't think of the same way, and that's why they don't want to come here. And I'm sure they won't be attacked. But they will be asked questions that they don't want to answer, or they cannot answer.

00:34:42 --> 00:35:05

Martin Cullip: And especially with consumers. I think there was a study done last year that said that the total amount of funding for consumers in the whole world was about $130,000. And a lot of that was probably their own money. And yet consumers aren't allowed to go to these events and ask questions. So why do they fear debate? I'll ask you two. Why do you think they fear the debate?

00:35:05 --> 00:38:47

Asa Saligupta: Let me first go back to about the conflict of interest and plus what Jerry had said at beginning, you know, that we got like Pattana, I can't remember her last name, it's too long, but Rangruti is her first name. Anyway, and all this, everything combined. Let me say, let me ask all of you, you know, especially those watching at home and the doctors and the tobacco control people say like, If you want to discuss conflict of interest, let's take a look, for example, I'm not going to look at the United States or Canada or South Africa in America or in Europe, but in Asia and Asia-Pacific. Think about this, the delegates that will be going to COP10 or the delegates that had gone to COP123456789 or whatever, not nine. What about their conflicts of interest? Take Thailand, for example. The fundings are from Simtex. Isn't that almost directly from tobacco sales? Think about it for a minute. Shouldn't representative of each country be someone in the health department, ministry of health, ministry of public health, or at least be known to the people whom they represent in Thailand, even until now, every year, except one year in India? We don't even know who represent us. And it's those tobacco control people who got 100% of their incomes from the syntax, meaning from tobacco and alcohol. One year in India, many of you would remember that, delegates from Thailand went in and submitted like a plea saying like, Every country in the world should ban vaping like Thailand just did. And the delegates from the United Kingdom said like, where's your proof? Well, we don't really have any proof, but since we are banning cigarettes, this is electronic cigarettes, so it should also be banned. So that's the only answer that they could come up with. And then they came back, and they came back to Thailand. and said, like, hey, listen, you know, we pronounce, we had announced that we are the one of the first country who ever banned vaping and, you know, we will be success. And I was sitting at home and heard their statement. I was like, that's not what I heard. Because, you know, we know where we are within this. And then we heard like, no, I heard something else. But, you know, their voices are strong. They have, they control the medias and whatnot. So it was like, We're going like, is this who we're fighting with? Is this a battle, like a never-ending battle, like there's no chance of winning? We started off with like just me and then a few people, and right now we have like 100,000 members for ECST, members and followers. So I just like to just kind of like shout out, say like, don't think that your voice alone wouldn't make a difference. It would, it would, we have done it. But to talk about the conflict of interest, why don't they declare that kind of conflict of interest?

00:38:47 --> 00:39:41

Konstantinos Farsalinos: Another issue is that you're talking about COP meetings, and COP meetings have one major characteristic, complete lack of transparency. And, of course, exclusion. For example, consumers cannot go to any COP meetings. Journalists have been thrown out of the meetings. They're doing meetings behind closed doors. They are supposed to work for public health, so for the people, but they don't accept the people. They only accept selected people. scientists and people and activists who support their views. And one of the criteria of going there is, what have you expressed as your opinion on the subject? And that's basically the way that they accept people going there. So, what we should be discussing is the complete lack of transparency of the WHO.

00:39:44 --> 00:40:39

Nancy Loucas: Yeah, and I mean, in a lot of governments, I mean, we've seen it in New Zealand and in a couple of other countries. You know, Article 5.3, it was put in place to protect government officials from being corrupted by money from big tobacco companies. They are now using that in some places to refuse to engage with consumers. a complete, you know, hijack of that concept. But yet, as Asa said, they're more than willing to accept the tobacco excise that they collect from the people who pay it for the people who smoke. So they are too accepting, you know, tobacco money. But that's okay because that's the money that they need because, you know, the syntax, okay, they need that for their research, they need that for this, they need that for that. It's so far removed. But that's what I meant by projection. They're accusing us of doing something that they're already doing.

00:40:39 --> 00:40:48

Martin Cullip: Let me ask all of the panel just a sort of mischievous question. I'll start with you, Jerry. Is the tobacco control community a Wild West?

00:40:56 --> 00:45:03

Gerry Stimson: Does it need regulation? It does need regulation, but I can't see where that would come from. It amazes me that there are journals that publish rubbish. I was a journal editor for 20 years, and the stuff I see, particularly in BMJ, tobacco control, is just awful. The paper in which ECST was criticised, I did a long critique of that and sent it to the BMJ. In fact, the critique was probably longer than the paper, because as well as the unfounded accusation that you were working hand in glove with PMI, methodologically pathetic, and a lot of it is. So there's not, as we've discussed this before, there's not a regulatory system within publishing which will stop this. There's also not a peer regulatory aspect. There could be peer regulation, but it surprised me that in the UK, for example, many of the good people in tobacco control, the people doing good work on e-cigarettes and other things and making sensible statements, they're actually all linked in with the University of Bath. They have these shared consortia for research and for public health intervention, None of them, none of them has ever spoken up about the antics at the University of Bath. I mean, they would be shamed into saying something and not participating. But, you know, it doesn't happen. People don't want to rock the boat. You know, you can complain. We complained to the BMJ about that article, and eventually it went, oh, so they're illegal, blah, blah, blah. And they actually altered the article. They didn't publish a correction. they pulled the original article and printed a slightly different new article, which again, not what you do in publishing, you actually say what's wrong. So there's a small triumph there. There was another one with the Lindsay Robertson one and the nasty thing about the analysing the tweets around COP8 from consumer organisations is that they actually named organisations in their presentations and in the paper. Now, many of these organisations are just one or two people, so if you name an organisation, you're naming someone who might be harmed by that publication. So that was taken up with the University of Bath Ethics Committee. and I got a lot of the ethical, the submission about the study and all the rest of it, and all the submissions were about protecting the staff from vapors and from attacks, and no consideration at all that by publishing, you've got deductive disclosure. If you mention a particular small vaping organization, which we know might be just one or two people in a particular country, you've got deductive disclosure. So there's a real risk to people. There's no risk to me because I'm at the end of my career, but there's risk to people's careers and their livelihoods, and real physical risk in some countries by being named in such a way. And the University of Bath Ethics Committee just didn't get that. So there is a failure of self-regulation and regulation. I don't know, just come back to the UK academics. Is it that they don't want to rock the boat, or are they afraid of guilt by association? And you'll notice a lot of them don't come to GFN anymore. There's a lot going on behind the scenes. There are people who are banned from coming to GFN. There's somebody who's got a contract down the line from what was Public Health England, who was told that if they wanted to continue their contract, they would have to cease any conversation with me. and not come to GFN. So there's a whole lot of thing that goes on behind the scenes here, which is very hard to expose. A lot of the world depends on people being nice to each other and not doing all that.

00:45:03 --> 00:45:12

Martin Cullip: It's not just GFN. I've heard of people who've been told they're not even allowed to go to Warsaw in June. Yes.

00:45:12 --> 00:46:59

Gerry Stimson: Just to give a plug for GFN, I mean, you all love GFN, but we welcome everybody. But this banning, this exclusion, there are conferences which are organized around smoking, and the conferences that Bath University, events Bath University is involved in, which ban you from participation if you have any link to the tobacco industry, to the fourth degree of consanguinity. Now, look that up. That's great-great-great-grandparents. Or going forward, it'd be my great-great-great-grandchildren, who'd be forever barred from going to anything like this. It's bonkers. It's a stricter definition than the Nazi definition of being a Jew. It's just a bloodline or by marriage for several generations bans you. And I must give you a little aside. I'm going on a little bit. They even do this with online events. You have to declare that you're not whatever. And so I filled in one of these things. And I said, well, I'm not sure. I didn't use my name. I used somebody else's. I made up a name to sign on to this event. I'm not sure, but I think that going back, the family history is that my great-great-great-grandfather was a plantation manager, a tobacco plantation manager during the time of slavery. But they let that pass. Part of it, you have to be humorous about this, and you have to use ridicule, and most harm reductionists are fun people. And a lot of people we're talking about I don't think are fun people.

00:46:59 --> 00:48:43

Konstantinos Farsalinos: In fact, I would disagree with the statement that the tobacco control is a sort of a wild west kind of situation. In my opinion, it's the exact opposite. They are extremely well organized, very homogenous in the way they behave, in the type of opinions they express and where they express them, and they are excellent in creating consensus, in quotes, by exclusion. So, everyone agrees with our views because we know who we are inviting and we know what these people are thinking and are saying, so we create a consensus among ourselves by excluding everyone else. The big problem is that, unfortunately for them, We are not simply outliers. There are a lot of people who support harm reduction because it makes sense, because harm reduction in tobacco is not very different from harm reduction even in our daily lives and in other issues of public health, and it has been accepted even by those people who behave in a pretty fanatical way against tobacco harm reduction. And just because harm reduction is not only about smoking and it's nothing new, it's something that we have applied in our daily lives for years, that's why it's very hard for them to achieve their goals. They're not Wild West, they are very well organized, they have a consistent kind of behavior, consistent ad hominem attacks against scientists, against consumers, against anyone with a different view, and that's the big problem we are facing. They are well organized and they are well funded too.

00:48:44 --> 00:48:57

Martin Cullip: Can I ask you a question, Konstantin? You're a scientist. What's the effect on science and public health of excluding research, excluding researchers, not listening to the other side? It must surely be harmful.

00:48:57 --> 00:49:50

Konstantinos Farsalinos: You know, science is the art of disagreement. That's how science progresses. And you can't have science without a debate. And debate is not about agreeing, of course. It's always about disagreeing. And that has been... a sort of a failure of GFN, which is not because of GFN and the way it's organized, but because of their denial to engage into a debate. This is something that we tried to implement since the first year, 2014. We failed, but it was not our failure. It was their denial to come and engage in the debate. So that's a big hurdle for science. And this is confusing for regulators. It is very confusing for consumers. And that's why we end up having still 1.1 billion smokers globally.

00:49:50 --> 00:49:55

Martin Cullip: Nancy, I want to ask you, what should advocates do? How should we respond to all this? How should we behave?

00:50:02 --> 00:51:31

Nancy Loucas: One of the things that I do say to advocates who ask me, you know, what do I do? If somebody is attacking you, for example, you know, I've gotten attacked by our friend Tahir. And, if you're out there, hello. And, you know, I refuse to engage with him. Just, in my mind, when somebody's attacking me, that's a toddler having a tantrum. And what do you do when a toddler has a tantrum? You don't engage. Let them flip out and then get back to it. You have to take the high road, because when I go out there and people are coming at me, I'm like, it's not just about me. I represent everyone, not just in Asia Pacific, not just in New Zealand, but I'm a consumer advocate, and as a consumer advocate, if I do something stupid, it's going to make all of us look bad, and I don't want to do that. Staying focused, not allowing yourself to be distracted by the diversionary tactics, because that's a big thing. Divide and conquer is a very, very big thing. They want to get you riled up. They want you to go off message. They want to say, aha, see? It's taken me years not to freak out publicly. I mean, when I'm not online, there's things that are said in my house in multiple languages that wouldn't be fit for anybody. But I realize that what I'm doing, I'm representing not just me, but I'm representing you, and you, and you. And you have to stay focused, and you have to stay on message. And it can be very hard, but with practice, you can do that.

00:51:33 --> 00:52:39

Martin Cullip: We've got about 20 minutes, so we can go for some questions. I've got a question here that we can start with. Can I just say, although I know many of you in the audience have probably got tales of your own examples of exclusions, although your anecdotes might be very interesting, can we have actual questions rather than, we don't want to have just a long, impotent whinge about this subject. come up with ideas of what we can do, how we can move forward and make things better, perhaps. I don't know. It's up to you. But we'll come to them soon. I've got a question here online from Fig. Fig Ramsey, in a recent interview, Clive Bates expressed the view that tobacco control often sees the vapor industry as a predator and its customers as gullible victims who have been trapped by the industry. How do you believe this perception influences tobacco control strategies and initiatives, particularly in relation to harm reduction alternatives like vaping, and what steps can be taken to foster a more empathetic and nuanced approach that considers the potential benefits and risks associated with these alternative products? Who wants to take that one?

00:52:45 --> 00:53:52

Nancy Loucas: Hi, Fig. You know, one of the things that... You and I have actually had this discussion. Fig and I have had this discussion, and one of the things that I find extremely frustrating is the complicity of the media in taking things and twisting them to the point that people go from using something safer and then going back to the thing that will probably hurt them, okay? And it seems like people accept that. And a lot of the independent vape shop owners have been put through so much and being attacked. I mean, as consumers, we get attacked, but they get attacked as well, okay? And the people that get harmed are the people that don't have those choices and don't have those options. And to me, it's not just tobacco control, it's the media. And the way to deal with that, again, remember, The people that are in tobacco control, the people in the government, they work for you. You're the voter, okay? They work for you. Richard wants to ask something. So keep that in mind.

00:53:52 --> 00:53:57

Martin Cullip: Yeah, there's some microphones around you. Richard's got his hand up, and then Norbert.

00:53:58 --> 00:54:24

Richard Prune: Thank you. Richard Prune from Safer Nicotine Wiki. How should we actually approach trying to reach the people that we're actually trying to save, which is the smoker? Is there a way we can bypass the anti-crowd? Can we actually work around them? Is that a possibility? Thank you.

00:54:25 --> 00:54:52

Nancy Loucas: In New Zealand, what we did is we had, there was a group of three of us or four of us. Matua was involved in this before we actually organized, but we would have meetups and people would come up to us and ask us, what are you guys doing? And we kind of mentor them and help them to switch. Okay, we can't do that anymore in New Zealand. But grassroots, if you see somebody who's smoking, walk up to them with your vape, start vaping next to them, start the conversation. That's how we did it.

00:54:52 --> 00:55:02

Richard Prune: Yeah, there was lots of that in the early days in the UK, but that seems to have kind of faded out. Is there anything new that we should perhaps think about?

00:55:02 --> 00:55:04

Nancy Loucas: I think we go back to basics.

00:55:05 --> 00:55:47

Konstantinos Farsalinos: Yeah, I agree also because initially it was something new. There was more motivation by the consumers. Now motivation has weaned off and that's a problem. So I fully agree that we need to go back to basics. The consumer organizations have a huge role to play. Unfortunately, they are seriously underfunded and it's very hard for them to fund themselves and do it because they don't have any financial interest or they don't have any profits that they can invest into such an advocacy. But vape shops and consumers did that initially, and I think that they should take this role seriously again and go back to basics.

00:55:47 --> 00:55:54

Martin Cullip: Okay, and Norbert had his hand up, and then Alex after that. And then Roberto, yeah.

00:55:54 --> 00:57:13

Norbert Schmidt: Norbert Zillatron-Schmidt, German Consumers Organization. I have one tidbit from the tobacco controls that they really like to brag about, and that's the scream test. So every time they get opposition, they feel confirmed that they are doing the right thing. But then they take it a step further and they claim that every opposition they get is a sign that the source of the opposition is totally invalid. and part of the conspiracy against them. And funny thing is how they scream when we hit them, where they don't want to apologize us. When we show them data and science, And they scream, big tobacco, big tobacco, big tobacco.

00:57:13 --> 00:57:27

Nancy Loucas: Choose your battles and choose who you're going to fight with. If you can't talk to someone about that and they don't want to accept it, what you do is you circumvent and you go around. So you go and talk to an MP or someone like that. You don't have to argue with them. Go around it.

00:57:31 --> 00:57:42

Martin Cullip: Yeah, I'll ask you this, as Norbert was saying, the scream test. Should we be happy that they're screaming? Are we hitting them where it hurts? What do you think?

00:57:42 --> 00:59:37

Asa Saligupta: Well, you know, like Norbert has said, one of the things that we've always faced with is if a neutral ground or neutral zone wants to hold a debate or a seminar or things like this, One of the excuses that the tobacco control people will come out and say that, first of all, they don't want to attend with any affiliation with big tobacco, and second, the second one was that they don't want to meet with the violent people. We are violent. They were saying, oh, we don't want to go and fight with all those violent people, meaning us. When did we ever become, you know, we are so peaceful. I mean, you guys are like, hmm. But that's how they look at us, and that's the reason they care for not showing up. Plus, about six years ago, there was going to be a big conference similar to GFN in Bangkok. And there had been responses from a few doctors, specialists in the fields, especially those who are really doctors. And they got scolded from the mafia, the tobacco control people. Even up to the point that these few doctors who already said, like, okay, we'll go, we'll join you, they have been called from this doctor, the boss of Paternopadins, and he said, like, Well, if you want to go, you better be really careful because your career might go haywire and it could end up in HEWL and things like that. So they have been like it's even more than mafia and things like that.

00:59:38 --> 00:59:40

Martin Cullip: Alex.

00:59:40 --> 01:01:22

Alex Wodak: Thank you. Alex Wodak, Australia. My question is to anyone on the panel who wishes to respond. And I want to take up the point that Konstantinos made, which I thoroughly agree with, that the biggest cost we're facing with the behaviour of our opponents is the lack of debate. And really what this means is that we've now got On one side, we've got a closed system, and the feedback loop of correction has been permanently removed. And that's very, very unhealthy. Their response to this is to say that this issue is settled and closed and finished, and any discussion on it is frivolous and a waste of time. Now, we do say in science, as Roberto said the other day, There are no settled scientific questions in science. That's sort of true, but it's not really true in a practical sense. We've stopped debating whether the earth rotates around the sun or the sun rotates around the earth, and none of us would want to engage in a debate on that in 2023. So the question is, how do we decide which questions are indeed frivolous and a waste of time debating, and how do we decide which questions are legitimate and should be open for debate? And if we could, I appreciate this is a difficult question to throw at you now, but if we could come up with some criteria now or in the future, I think it would help us maybe to move forward. Thank you.

01:01:22 --> 01:01:24

Martin Cullip: Do you want to start on that one, Gerry?

01:01:25 --> 01:05:24

Konstantinos Farsalinos: Well, I think the whole subject of harm reduction is a question that we need to address. Of course, I fully agree with you. They think that the debate has been settled, that we know everything that there is to know and that there is only one conclusion, that's undisputable. But it's not like that. Harm reduction has worked, it has been accepted after long battles, and you know that yourself also, in other fields, it has been universally accepted everywhere. What's the difference with tobacco harm reduction? They're going to say it's the big tobacco industry involvement, they're going to say a lot of things. Then you should bring us examples of success stories of countries where harm reduction was endorsed and examples of success stories where harm reduction was banned for tobacco. Sweden is the biggest success story in the world, basically the only smoke-free country, and it was a country which adopted, I mean, not in reality advertised by the authorities, but it was a country that achieved the smoke-free status by using harm reduction for decades, not recently. So, where is another country so successful? where harm reduction was excluded. You can't find examples. Anyway, I think that the whole issue of harm reduction is debatable. You can't have, you know, specific points that should not be debated or are already resolved and there is nothing we can say, because it's a public health issue where you should balance potential benefits with potential risks. And everything is in creating a balanced regulation. Regulation is, of course, definitely needed. There is no doubt. I don't think anyone disagrees with that. But we are missing the balance because the tobacco control movement, the vast majority of them are playing in their own field. They have the holy money from Bloomberg and from government organizations, and they influence regulators and politicians and big organizations like the WHO, which, let's be honest, for some, for many countries, WHO is like a religion. they will accept, with no questions asked, anything they say. And the WHO is also an organization who should be held accountable for excluding people from the debate and for not engaging in any type of a debate. You know, I was once in the Philippine Senate, and the representative of WHO who was invited to speak didn't know that I would be there. And she was terrified because I was there. She was terrified. She wanted to be alone, with no position, with no different opinion, and just present their own views. And they created so much confusion among the senators. It was unbelievable. She was asked by a senator, what's happening with nicotine and whether it's toxic or not. The W.H. representative responded with a ten-minute debate about nothing. And when she finished, I asked the senator, so tell me what was your conclusion from what you heard? And the senator said, I realized that nicotine is a carcinogen. And she never even mentioned the word carcinogen. But they were so confusing in their responses. They didn't want to present facts. They wanted to create confusion. And when you create confusion, you create fear. And the response to fear is restrictions and bans. And that's what they're doing. But that's not scientific. That's not ethical.

01:05:26 --> 01:05:35

Martin Cullip: There was an industry in the past that used to sow a lot of confusion and doubt. I can't remember what industry that was. So they're acting the same way.

01:05:35 --> 01:06:32

Gerry Stimson: Jerry, you were going to say something. I'll try to be brief because there's still a lot of questions. We can learn a lot about the structure of scientific revolutions, the shift from one paradigm to another paradigm, but we also got to remember that it's not just about the questions and the facts and the science, but how those paradigms are so tied up with worldviews, belief in God, belief in certain values, and all the rest of it. And I think that's the big struggle here. It's not just agreeing questions and what the evidence might be to look at those questions, but you're dealing with something that's really passionate and deeply held within people. And I've been thinking through this. I mean, can we look at South Africa and Northern Ireland? Is there a reconciliation process? Can people agree on trying to? But I don't think there's anywhere near that. yet, because, as it were, the other side don't want peace and reconciliation. So how you get to that starting point is a big issue.

01:06:32 --> 01:06:39

Martin Cullip: Roberto, you had a question. Wait for the microphone.

01:06:39 --> 01:07:21

Roberto Sussman: Very simple question. How can we react to moral panics? This is important because we are sort of stable and disagreements and exclusion, all these things, but suddenly, bang! a moral panic and moral panics are like fire. They start and it is difficult to reply. Shall you follow the moral panic or shall you simply say no and confront people? It's important. We are in this type of fires. What would you say about that?

01:07:22 --> 01:09:48

Asa Saligupta: Yeah, I'll answer that. First of all, let me go back to the question before this one, plus all the science there, because I was fortunate enough to watch your session, and science is always changing with challenges. Back to the question about before moral panic, when you go out, like the plan for the future, what I would like to say is that you've got to know your audience, right, and this will also include the moral panic. You have to know your audience. You already know your topic, your session yesterday, your workshop, like we had come up with vaping safe life example, and then you know your audience, who you're going to talk, and mainly you have to know that what kind of topic or what, at that moment, at that moment in time, what are they interested in? And then you push harm reduction into whatever is their interest. So you're gonna pull their interest in the first, like, for example, you know, like, this is June, so it's Pride Month, so we might do something with that. How can we play along with that? And that will also go with, like, the moral panic. It's the same answer to that question, is that, know your audience, know how to talk with them, know their minds, you know, like that, when someone's going to throw in, it's like an easel of fables, you know, the coconut fell down and the dead rabbit just ran all over the forest, saying the world is coming to an end. So you have to calm people down for the moral panic and then just hit them with the truth. But don't just go, wham, this is the truth. No, no, no, no, but don't be so persistent. Just go calmly, slowly, and just try to educate them, make them understand. For myself, what I would do is I would use myself for an example. How I've been smoking and what happened to my health before and after I quit and how I could quit. You know, when you speak from your own personal view, you get more attention, like, hey, this guy is talking because he's been through it. You know, I have climbed that Everest mountain. What was it like? How's the weather up there? Instead of saying, like, oh, I know a guy who knows a guy who had climbed the mountain, which is going to be different.

01:09:50 --> 01:10:26

Nancy Loucas: Yeah, they use the children. But you know what? The thing is, as advocates, one of our big jobs is to humanize this and do what Asa is saying about our stories. When they talk about the children, I mean, it's up, I think, if the scientists give us the information, we can present that information to people like, you know, you've done it too, like Pete. We say, hey, we agree. Yeah, we agree, but we don't want kids vaping. However, let's look at this realistically. We have to humanize it. On the consumer side, that's on us.

01:10:27 --> 01:11:14

Konstantinos Farsalinos: Well, the big problem, Roberto, is that it's the scientists of the tobacco control movement who are pretty emotional and use emotion and panic attacks in a moralistic way and try to present it as unethical, it's the kids, it's a disaster. What's the ideal situation that no one uses anything, no one gets any harm from anything? And I agree that consumers are the only ones who can respond in an emotional way, as Nancy both said, basically. In our case, in terms of science, we can only respond with data. And we will try to bring the discussion back to a discussion about evidence and data rather than a discussion about emotions and fear.

01:11:16 --> 01:11:33

Martin Cullip: I'm afraid we're out of time. I'm sorry, Bengt and Helen. If you want to come up and ask your questions afterwards, we have to wrap up. We're out of time. But thanks everyone for listening. And if you'd just put your hands together for the panel, Asa, Nancy, Jerry, and Konstantina.