I’m 93,000 words into finishing my next book, Quit Smoking Methods of Mass Distraction, for Sydney University Press Three incomplete chapters to go, with an end-of-year finish line.

So this blog will probably be dormant for a while.

Here’s a link to the archive of all the blogs I’ve written

Keep COVID-19 safe everyone, and love the ones you’re with

Directed by Alan Brain (2021) 94m

Screening at The Sydney Film Festival and on demand. Dates here

Trailer

Facebook and website

Interview with director by Banning Eyer

Anyone with even a passing familiarity with world music knows about the unstoppable global impact of American blues, Jamaican reggae, and Cuban rumba, son and danzon.  Muddy Waters and other Chicago blues legends, Bob Marley and the multiple tentacles that spread from the 1996 Buena Vista Social Club documentary and albums all have found their way into millions of homes.

But far fewer are familiar with African music beyond Paul Simon’s huge global leg-up to South African township jive with the 1986 Graceland album, Senegal’s Youssou Ndour’s world hit 7 Seconds Away with Nenah Cherry (1994) and perhaps Guinea’s Mory Kante 1986 monster dancefloor hit Yé ké yé ké.

Most people I know, including those with  eclectic musical tastes, could not name a single musician or band from the Congo. But across much of African, Congolese rumba and its faster variant soukous are peerless as a kind of pan-African musica franca. No form of African music other than Congolese rumba has permeated the night clubs and bars of francophone west Africa and beyond. I’ve seen Congolese bands in Harare, Kampala and Nairobi. But in the west it remains marginalised in world music festivals and rarely if ever played on mainstream radio.

I’ve been obsessed with west African jazz since seeing Sam Mangwana and the African Allstars in London in 1984. It was simply a life changing experience that over the next four decades saw me seek out and buy many 100s of albums and spend hours in the African quarters of every city I visited in Europe and north America searching for hard to find albums.

Alan Brain’s documentary is a glorious experience, a testimony to his vast access to extraordinary archival photography and footage of Congolese musicians from a four year period living in the Congo. Much of it is told directly by surviving and recently deceased musicians from the golden era of rumba (1950s-1980s) around which the film is concentrated.

Belgium’s King Leopold II achieved recognition for the Congo Free State in 1885, turning it into the Belgian Congo in 1908. Congolese were treated like slaves by the colonialists and the film has wrenching material showing this oppression. Music emerged as a salve for many Congolese. The Belgians broadcast news through loudspeakers in the streets, but also played music. This drew crowds and foreign music infected an appetite for the new sounds in many Congolese. Cuban rumba records were first brought to the country by merchant sailors from the 1930sand became very popular in Kinshasa. Greek and Jewish entrepreneurs tapped the vast interest in the music and film shows several examples of Congolese singers and musicians from the 1940s who developed followings.

Three pioneering giants, singer and bandleader of African Jazz Joseph Kabasele (le Grand Kallé), the guitarists “Dr Nico” Kasanda and the incomparable Franco Makiadi Luambo are profiled, with superb guided explanations of their innovations. Franco led TPOK Jazz from 1956 to his death in 1989 and released 84 original albums and many more compilations, with one estimate being that across his 40 year career he averaged  releasing “two songs a week … which ultimately comprised a catalogue of some 1000 songs”

Western guitar-based music centres around two guitars, lead and rhythm. There’s a spell-blinding scene where three guitarists demonstrate the unique third or mi-solo guitar role in Congolese rumba. There are also several street performances from veteran musicians including a sublime song filmed on a river boat.

Over and again, those interviewed explain the way in which the Congolese infatuation with music lifted spirits and national pride particularly after independence in 1960. My first taste of  Congolese music has never left me. This potent film seems likely to drive a lot of interest in this often mesmerising music.

Recommended reading & my Spotify Best African playlist (573 tracks)

Graeme Ewens. Luambo Franco and 30 years of OK Jazz 1956-1986. A history and discography. (1986) Off the Record Press: London 64pp

Ronnie Graham. Stern’s guide to contemporary African music. (1988) Zwan: London. 315pp

Ronnie Graham. The world of African music. Vol 2 (1992) Pluto Press: London 235pp

Graeme Ewens. Congo colossus. The life and legacy of Franco & OK Jazz. (1994) Buku Press: North Walsham 320pp

Gary Stewart. Rumba on the river. A history of the popular music of the two Congos.(2000) Verso: London 435pp

Irrepressible vaping advocates Colin Mendelsohn and Alex Wodak were at it again in the Sydney Morning Herald yesterday with their usual litany of gloom about the apocalypse that starts from Oct 1 when anyone wanting to legally vape nicotine will need to have a prescription authorising purchase or imports.

Vaping advocates have had 15 months to spruik their message about the scheme to Australia’s 23,000 practising GPs, but have often lamented that only a handful have been willing to issue prescriptions, an option that has been allowed for several years already.

So how has it happened that nearly 100% of Australian GPs have apparently decided that prescribing vaping was not such a good idea? What do they know that our good doctors don’t? Perhaps they’ve read some of the 16 reviews and major cohort studies published since 2017 that say the evidence for vaping being good for quitting smoking is poor? Or one of the many reviews of cardio-respiratory disease markers that point to very worrying developments? (eg here, here, here)

Political support for vaping has always been dominated in Australia by the extreme right of politics. The 28 MPs who signed the Matt Canavan initiated letter included a who’s who of deep political conservatism, climate science denialism, sports rort facilitation and ex-Institute of  Public Affairs staffers.  Here’s the letter the 28 sent to Greg Hunt.

The Nationals received $55,000 from Philip Morris as “gold” level support in 2019-20. Money well spent!

Mendelsohn and Wodak suggest Australian politicians should be quaking about the uprising of angry vapers coming down the tracks, 3500 in every seat, who may tip out sitting members at the next election. That threat has worked so well in the past when at various elections the now fully politically plucked Liberal Democrats told vaping voters they would fix things for them. So who will these angry voters turn to? Not the LNP, who have given them the loathsome prescription scheme. Not Labor or the Greens who support it. Maybe One Nation? That seems like a plan.

Australia might have 600,000 vapers now, they say. Of course no source is given for that nice fat number. It’s 80,000 above the 2019 National Drug Strategy Household Survey figure for the number of Australians who were “currently” vaping then. That “current” number included those who vaped less than monthly, so was about as meaningful as saying that we should count “current” French champagne drinkers as everyone who has as much as one glass in the last year.

There are 2.9 million Australians who smoke at all, with 2.3 million smoking daily. If, switching to vaping is the factor driving down smoking rates faster in the US and UK than in Australia, and our two numbers men say we might have 600,000 who vape today, then that’s a 21% fall in smoking prevalence they might predict when the next national survey is due next year. Nothing remotely like that has ever been recorded.

Of course this utterly fanciful stuff isn’t going to happen and it’s not happening in the UK or the USA where the evidence is that most vapers keep smoking and have higher rates of relapse back to smoking than quitters who don’t vape.

A 2019 US PATH longitudinal paper reported that former smokers who had quit a long time ago but who vaped were far more likely than those who had never vaped to relapse back to smoking and that vapers were far more likely than those who had never vaped to have transitioned from being never smokers to smokers:

“Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up (P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking (P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers (P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates.

A 2020 paper from the ITC four country (Australia, USA, UK, Canada) survey found that after 18 months:

“smokers with established concurrent use [smoking and vaping] were not more likely to discontinue smoking compared to those not vaping … it is clear that the rates of transitioning away from smoking remain unacceptably low, and perhaps current vaping tools at best bring the likelihood of quitting up to comparable levels of less dependent smokers. The findings of our international study are consistent with the findings of the US PATH transition studies, and other observational studies, in that most smokers remain in a persistent state of cigarette use across time, particularly the daily smokers.”

But cigarettes don’t need a prescription!

Mendelsohn and Wodak reel off the argument that cigarettes are sold freely from 20,000 retail outlets while nicotine vapes require a prescription. How wrong is this, they ask. As I argued here, every conceivable error was made in allowing tobacco products to be sold freely from the nineteenth century onward. We’ve been pulling political teeth since the 1970s to win the suite of policy and legislation that today sees tobacco highly taxed, plain packaging, a total advertising and sponsorship ban, graphic health warnings, personal import bans, a duty free limit of one pack, universal smokefree legislation and the lowest adult and youth smoking rates ever recorded.

I do not recall either of them playing any role in the struggles for that. And I must have missed them editorialising for a ban on the sale of cigarettes.

The prescription model will allow adults who want to vape nicotine to do so, but will make it so much harder for kids to buy these products from vape shops and convenience stores where selling will attract huge fines.

The $220,000 fines for possession or importing without a prescription will of course never be applied to an individual vaper but are set as a maximum for industrial level importing and illegal sales, just as they would be for criminals importing commercial quantities of tax- evading tobacco or prescribable opiates. Without such serious deterrents, many would take their chances with getting a wrist-slap level fine.

The Herald’s sub-editor who captioned the photograph below accompanying their article got it very right, writing “Vaping can help accelerate smoking levels”. Every tobacco company in Australia is strongly opposed to the TGA’s prescription approach. That ought to tell us all we need to know.

On September 3, 2021 the very busy vaping advocate Dr Colin Mendelsohn published a blog on his website where he critiqued a large report in the Sydney Morning Herald on the inundation of disposable flavoured nicotine vaping products into Australia.  Early in his blog, Mendelsohn made three statements about the prevalence of vaping in underage, young people.

1.“Official government figures show that underage vaping is rare in Australia, and frequent vaping is very rare. Less than two per cent of Australian teenagers vaped in 2019 and more than 90% had never tried vaping. News reports suggest vaping has increased since then but we have no data to confirm that, just ‘anecdotal’ reports.”

2. “What the article didn’t say is that almost all young people who vape regularly are already smokers before they tried vaping.”

3. “They also forgot to mention that most vaping is infrequent and short-term and one in three young vapers do it only once or twice.”

In his blog, Mendelsohn switches between two data sources, the National Drug Strategy Household Survey (NDSHS), conducted in 2019 and published in July 2020, and the Australian Secondary Students’ Alcohol and Drug (ASSAD) survey, conducted two years earlier in 2017.

Let’s look closely at how his statements align with what the two reports actually say.

Statement 1: Less than 2% of Australian teenagers vaped in 2019

Here, he links to the 2019 NDSHS as his source. There are 17 data tables on vaping in Australia at the NDSHS link. Table 2.19 shows any lifetime vaping (ie even experimental puffs) for 14-17 years olds at 9.6% and Table 2.24 that current use is 1.8%, a doubling since 2016.

Statement 2: That “almost all young people who vape regularly are already smokers before they tried vaping”

Here Mendelsohn linked the 2017 ASSAD schools survey to support his statement. But the ASSAD report states “Of the students who had ever used an e-cigarette (n = 2,403), 48% reported that they had never smoked a tobacco cigarette before their first vape”.

We can also look at the NDSHS data on this issue. Table 2.27 shows that 64.5% of 14-17 year olds who had vaped were never smokers when they initiated use of e-cigarettes.

So Mendelsohn is very wrong here regardless of which data set he might have chosen to support his assertion.

Statement 3: “most vaping is infrequent and short-term and one in three young vapers do it only once or twice.”

Mendelsohn again links to the NDSHS data to support this statement. Here it seems likely that he used Table 2.28 for support here because the “big” numbers in the table for  “I only tried them once or twice” appear consistent with his claims. However it should be noted that Table 2.28 has no data specific to  teenagers; it relates to all users aged “14 and over”. The definition of ‘current smoker’ used in this table includes ‘social smoker’ and ‘occasional smoker’ as well as ‘regular smoker’. This is important because some of the people included in that column may be young people who had only experimented with smoking in a very limited way. Relevant here, the ASSAD report found that “Of the students who had smoked before they tried e-cigarettes, 20% had only smoked a few puffs of a cigarette, 11% had smoked fewer than 10 cigarettes”.

The ASSAD report found:

• that for all 12 to 17 year old students overall in 2017, around 14%  indicated they had ever used an e-cigarette at least once, and 32% of these students had used one in the past month (Tables 3.11 and  3.12)

• Of those who had tried e-cigarettes, younger students were more likely to have used them recently. Around 37% of 12 to 15 year old users and 27% of 16 and 17 year old users reported vaping at least once during the past month. Younger vapers were also more likely to have used e-cigarettes at least three times in the past month (12-15: 16%; 16-17: 10%).”

• “Around 12% of students reported buying an e-cigarette themselves.”

The huge inundation of disposable flavoured vapes into Australia rapidly accelerated from mid-2020 and therefore are not reflected in the 2019 NDSHS data let alone the 2017 ASSAD data. If you Google “vaping in schools”, there are many reports of what Mendelsohn dismisses as anecdotes from school principals, teachers and parent, nearly all expressing alarm at the obvious surge in teenage vaping.

More blogs in this series:

Vaping advocates say the darndest things 1: The Cancer Council Australia takes huge donations from cigarette retailers. WordPress  30 Jul, 2020

Vaping advocates say the darndest things 2: Tobacco control advocates help Big Tobacco. WordPress 12 Aug, 2020

Vaping advocates say the darndest things 3: Australia’s prescribed vaping model “privileges” Big Tobacco Feb 15, 2020

Vaping advocates say the darndest things 4: Many in tobacco control do not support open access to vapes because they are just protecting their jobs. WordPress 27 Feb 2021

Vaping advocates say the darndest things 5: I take money from China and Bloomberg to conduct bogus studies. WordPress 6 Mar, 2021

Vaping advocates say the darndest things 6: There’s nicotine in potatoes and tomatoes so should we restrict or ban them too? WordPress 9 Mar, 2021

Vaping advocates say the darndest things 7: Vaping prohibitionists have been punished, hurt, suffered and damaged by Big Tobacco WordPress 2 Jun, 2021

Vaping advocates say the darndest things 8: I hide behind troll account. WordPress 29 Jun, 2021

Vaping advocates says the darndest things: 11: The sky is about to fall in as nicotine vaping starts to require a prescription in Australia. WordPress 28 Sep, 2021

Last Friday I went to my local supermarket. Behind the checkout and below the closed cabinet where tobacco products have been legislated to be kept out of sight in NSW since 2008 was a clearly visible large stack of disposable flavoured vapes on sale. The sale of vaping products containing nicotine is illegal in NSW. I reported what I had seen to NSW Health’s on-line reporting page and posted on my local Facebook community page about it, providing the link for others.

The next  morning I read two posts saying that the vapes on sale were nicotine free. I then posted a link to this Australian study which showed that 60% of vape products sold as not containing nicotine in fact did contain it. Vaping products on sale in Australia are not subject to any regulatory oversight and could contain any substance or chemical compound other than proscribed illicit substances. Ingredient labelling is scant to non-existent and not legislated.

A self-described “fiercely passionate advocate for vaping” then chimed in, telling me without explaining why in even a single word that I was “wrong”, that I “don’t understand what [I’m] talking about”. He also wrote this: “They sell cigarettes in the shops too!!!!!!!!! Won’t someone please think of the children”. His Facebook photo showed him with three children.

Probably filched from Lovejoy’s Law after Helen Lovejoy in the Simpsons “Won’t someone please think of the children” has long been a meme beloved by vaping advocates. Redolent of  the curmudgeonly misanthrope W.C. Fields who made a virtue out of loathing children (“Children should neither be seen or heard from – ever again”) vapers who think they are on a persuasive winner here seem to be beyond clueless about how hugely self-absorbed this makes them sound.

What we all are supposed to understand by “Won’t someone please think of the children” is of course that no-one should ever think of the children. Moreover, there should be a plague put on the houses of anyone who dares to propose any policy, law or regulation which ever in the slightest way puts the interests of children in the path of adult vapers’ interests.

When it’s pointed out that the sickly sweet flavours that are popular with kids are also popular with some adults, we see a parade of special pleading from kidults explaining that they routinely buy sickly sweet alcopops too, furtively sneak bags of sweeties at 5 year olds birthday parties, and have no objection to cuddly animated cartoon characters promoting vapes because, hey, they think they are cute too.  There’s actually no pitch or appeal that could ever be said to be directed at children, because if even one adult vaper puts their hand up as being excited about (for example) the Tuck Shop range of flavours, that’s all that should matter.

Way back in 1980, Rothmans argued that Paul Hogan who fronted Winfield advertising could not be said to be in breach of the then self-regulatory code of tobacco advertising which did not allow anyone to advertise tobacco who had “major appeal to children”. Hogan appealed to adults too, they argued, so let us keep using him alone. That argument went down like a lead balloon with Sir Richard Kirby, who ruled that Hogan could no longer be used.

Vaping advocates, just like tobacco companies have done for 40 years, have perfected a public discourse routine that runs like this:

1. Vaping is all but totally harmless and fantastically effective at helping smokers quit

Comment: Actually, every review that has ever looked at the evidence about possible harms from vaping  has concluded that we have no evidence about the long term health effects of vaping, just as we had no evidence for the massive harms caused by smoking for several decades after cigarette smoking became hugely widespread. And plenty of evidence on harm is already rolling in (see examples here). There have also been 14 reviews of the evidence for the effectiveness of vaping in smoking cessation published since 2017 which have rated  the evidence as low or poor.

2. The full range of flavours should be available to any vaper as these will help keep people vaping, which is a good thing.

Comment: The US Food and Drug Administration in late August 2021 took a decidedly different view of the risk-benefit balance when it came to flavoured vapes. Announcing that it had issued marketing denial orders over 55,000 flavoured vaping products submitted by three manufacturers it said the applications “lacked sufficient evidence that they have a benefit to adult smokers sufficient to overcome the public health threat posed by the well-documented, alarming levels of youth use of such products.”

3. As highly responsible people and companies, we certainly do not want to see children take up vaping

Comment: Again, this has been a mantra drilled into every tobacco industry employee for 40-50 years, but one that of course is beyond laughable when considered against the weight of a huge number of internal industry documents showing an acute, furiously salivating interest in as many children smoking as possible to replace quitting and dead smokers

4. For those who worry about kids vaping, we can recommend a range of measures that promise to be highly effective in stopping kids from vaping while not in any way inhibiting adults from accessing vapes.

Comment: This is where it all gets very funny, with chirpy, vague and profoundly naïve or disingenuous allusions to advertising that can be somehow only be seen by adults but not children; “crackdowns” on shops which sell to kids which will be as effective as all those crackdowns which stopped cigarettes being sold to kids … oh wait; and placement of those astonishingly effective signs in shops which say that vaping products will only be sold to adults. Such a pity that many shopkeepers cannot read the same signs in their own shops

5. But if some kids very unfortunately do vape, then this is far preferable to them taking up smoking, and seeing that we have already argued that vaping is almost entirely harmless anyway, there’s no big deal if kids do vape.

In the last months the Australian news media has been dominated with massive concern about the vulnerability of COVID-19 unvaccinated children. Predators on children are reviled and parents who neglect or harm  their children can have them removed by the state. Against that background, some in the vaping fraternity think sneering sarcasm about concern for children’s health will win them respect. Google “vaping” + “Won’t someone please think of the children” and be deluged with how widespread this  all-about-me meme has become.

In 45 years in tobacco control I don’t ever recall even the most frothing pro-smoker ever saying that they hoped their children would take up smoking. Ninety percent of smokers regret ever starting and the average smoker at 40 will have made about 40 attempts to quit smoking. 

A very recent paper in Addiction looked at adolescent electronic cigarette use and tobacco smoking in the UK’s huge Millennium Cohort Study. It concluded “Among youth who had not smoked tobacco by age 14 (n = 9046), logistic regressions estimated that teenagers who used e-cigarettes by age 14 compared with non-e-cigarette users, had more than five times higher odds of initiating tobacco smoking by age 17 and nearly triple the odds of being a frequent tobacco smoker at age 17 , net of risk factors and demographics.“ The paper also knocked the stuffing out of the glib “kids who try stuff, will try stuff” “common liability” dismissal of the concern that vaping acts as trainer wheels for smoking take-up in later years in kids.

Vaping advocates  believe they are on a mission from God to save lives. This allows then to argue that, unlike all pharmaceuticals, foods, beverages, and cosmetics which are subject to standards and regulations, vapes are above regulation.  While quacks claiming that some magic potion can prevent cancer, asthma, COVID-19 or AIDS would be quickly prosecuted for making such claims, vaping manufacturers and advocates endlessly make therapeutic claims for the effectiveness and safety of vaping. The prevalent  smarmy indifference to vaping by kids needs to be called out whenever it occurs.

Other blogs in this series:

Vaping advocates say the darndest things 1: The Cancer Council Australia takes huge donations from cigarette retailers. WordPress  30 Jul, 2020

Vaping advocates say the darndest things 2: Tobacco control advocates help Big Tobacco. WordPress 12 Aug, 2020

Vaping advocates say the darndest things 3: Australia’s prescribed vaping model “privileges” Big Tobacco Feb 15, 2020

Vaping advocates say the darndest things 4: Many in tobacco control do not support open access to vapes because they are just protecting their jobs. WordPress 27 Feb 2021

Vaping advocates say the darndest things 5: I take money from China and Bloomberg to conduct bogus studies. WordPress 6 Mar, 2021

Vaping advocates say the darndest things 6: There’s nicotine in potatoes and tomatoes so should we restrict or ban them too? WordPress 9 Mar, 2021

Vaping advocates say the darndest things 7: Vaping prohibitionists have been punished, hurt, suffered and damaged by Big Tobacco WordPress 2 Jun, 2021

Vaping advocates say the darndest things 8: I hide behind troll account. WordPress 29 Jun, 2021

Vaping advocates say the darndest things 10: “Almost all young people who vape regularly are already smokers before they tried vaping” WordPress 10 Sept, 2021

Here are some of the best I’ve seen. If you know more, please send them to me (via contact) & I may add.

This week’s Guardian Essential Poll had some very disturbing news for all of us hoping that Australia will pull itself out of the basement of nations with high COVID-19 full vaccination levels. Just under half of respondents to the poll  (47%) said they would be willing to get the Pfizer jab but not AstraZeneca. Another while 24% are willing to get either, and only 3% are willing to get the AstraZeneca vaccine but not Pfizer. But here’s the clanger: 14% — 1 in 7 of us — remain resolved that they won’t be getting either.

With paediatric vaccinations, today we have national complete immunisation rates at 92.% for 2 year olds and 95.2% for 5 year olds. These are the rates that should be also possible for COVID-19.

These spectacularly good rates rates are a function of blanket vaccine availability and decades of targeted efforts to reduce a multitude of cultural, geographic and educational barriers. But they also reflect decades of efforts by many of the infectious disease epidemiologists, psychologists and educators who have become household names through their daily TV and radio presence since the pandemic broke in March 2020. Many of these people have spent years raising public awareness of the benefits of vaccination, putting the very small risks that exist into perspective and discrediting misinformation spread by dedicated anti-vaccination fruitcakes.

What sort of messaging cuts through most?

Australia has long been a world leader in public awareness campaigning across a wide range of health issues. I worked on Australia’s first major mass reach, well-funded health warning campaign, Quit. For Life (1980-82).  We ran ads like these, the most famous being the Sponge ad made by Sydney advertising director John Bevins, where a hand wrung out a sponge oozing with black tar into a beaker with the explanation that this was this was the amount of tar that the average smoker pulled through the filter into their lungs in a year. The quitline rang off the hook.

These ads worked wonders. In Sydney where the ads were run, 23% of a cohort who were followed up 12 months later had quit compared with just 9% in Melbourne where the campaign was not being run.

The Every Cigarette is Doing You Damage campaign (started in 1997) with its unforgettable ad showing white, gelatinous atheroma (plaque) being squeezed from an aorta turbo-charged the downward fall in smoking.  Research trialing various candidates for graphic health warnings on packs rapidly discovered that cheery positive messages about not smoking being wonderful, sporty and healthy rarely cut it while tough, unforgettable realism did. And remember actor Yul Brynner spoke from his grave after dying from smoking caused lung cancer saying “now that I’m gone, I tell you don’t smoke”?

Professor Melanie Wakefield’s group from the Cancer Council Victoria is a global leader in health campaign evaluation and strategic research for campaign development in health. An evaluation of the impact of different styles of Australian quit smoking advertisements looked at the differential impact of ads predominantly evoking fear, sadness, hope, or evoking multiple negative emotions (i.e., fear, guilt, and/or sadness).

Their 2018 paper concluded “Greater exposure to hope-evoking advertisements enhanced effects of fear-evoking advertisements among those in higher SES, but not lower SES areas. Findings suggest to be maximally effective across the whole population avoid messages evoking sadness and use messages eliciting fear. If the aim is to specifically motivate those living in lower SES areas where smoking rates are higher, multiple negative emotion messages, but not hope-evoking messages, may also be effective.”

The pioneering anti-smoking ads were the vanguard for several decades of gloves-off, see-once-and-never-forget campaigns in Australia. Millions of saw and have never forgotten the HIV/AIDS Grim Reaper ad (1987), hot-wiring demand for condom use in causal encounters ever since.  Road safety campaigns in several states showed the carnage of  drink driver and speed. Examples were vignettes of grieving drivers after realising they’d killed someone and exploding dropped watermelons simulating massive head injury from a head going through a windscreen. Annual NSW road fatalities per 100,000 population fell from 28.9 in 1970 to 4.4 in 2019. Each new policy introduced was accompanied by often hard-hitting warning campaigns.

There have been highly memorable campaigns about melanoma and sun tanning, preventing scalding in kids from boiling pots on stoves, wearing bicycle helmets and fire prevention, to name a few.

Old school experimental psychologists have tut-tutted for years about all of this, clutching onto a faded dogma dating from studies of dental education from the 1950s where showing pictures of decayed teeth to students made no difference to their brushing behaviour. But meanwhile,  ask any ex-smoker why they stopped and there is daylight between their number one reason (worry about health consequences) and whatever else is in second place.

A 2016 meta-analysis of  research on the use of fear and scare concluded “Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors, (b) there are very few circumstances under which they are not effective, and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.”

So what have governments learned from all this in Australia with COVID-19 in 2021? Instead of massive national campaigning, we’ve seen dreary memos-to-the-public style ads advising that COVID is highly infectious and deadly, and that vaccination is very important. These are in scintillating writing, with all the magnetism of wallpaper and bring messages that you would needed to have been asleep in a cave on Mars for 18 months to have never heard.

We also had an actress rigged up on a ventilator gasping for breath in a bed. This drew instant criticism from critical care clinicians who were angry at the implication that patients in hospitals would be lying in terror without being intubated and sedated. The ad seems to have quickly disappeared, thankfully. This was an object lesson in how not to use scare in persuasion.

The recent momentum toward COVID-19 vaccination passports is very welcome. While there are many who never plan to travel overseas and rarely go to the cinema or restaurants, if app-based passports are required to get into shops, bars, football games, the TAB and the rest this will doubtless drag many vaccine refusniks to get jabbed.

Please, let’s get serious and see some significant government investment in developing messaging that will erode vaccination apathy and hestitancy, and bolster public momentum toward zero tolerance for those too self-absorbed to play their part in ending lockdown and reducing death and serious illness from this pandemic   We did it for drink driving. We did it for indoor smoking. We can do it for COVID-19.

See also:

Is it unethical to use fear in public health campaigns? WordPress 11 Aug 2018

Should those avoiding AstraZeneca vaccination because of the clotting risk also avoid having an anaesthetic? WordPress Jun, 2021

Eight common excuses for not being COVID-19 vaccinated and what you can say that might help. WordPress 27 May, 2021

With the risks of AstraZeneca blood clots being tiny, what explains COVID19 vaccine hesitancy? WordPress 23 May, 2021

A reverse white feather? Let all who are COVID19 vaccinated wear a badge proclaiming and normalising it. WordPress 21 May, 2021

The ethics of shaming prominent COVID-19 mask opponents. WordPress 26 Jul 2020.

How can we erode self-exempting beliefs about COVID-19 contagion and isolation that might subvert flattening the curve. WordPress Apr 19, 2020.

Twitter has long been a playground for miscreants, liars, anonymous cowards and trolls which is why so many people find its block and mute functions a godsend. But when you think you’ve seen it all, along comes a pile-on thread of such galactic stupidity that your thesaurus just can’t do it justice.

First, a little background. Last year, I had the interesting experience of being publicly accused on Twitter of lying under oath to a parliamentary committee by this self-described “social commentator and public speaker”. There was not a syllable in what she wrote below which was true.

She avoided legal action by pinning the notice below to the top of her feed for 12 months.

She follows me on Twitter and on 26 June 2021, was at it again, posting that I “had not denied owning or being party to the troll account known as @350zeee”. Senator Joe McCarthy (“Are you or have you ever been a communist?”) would have approved of this form of outing.

Vaping advocate Alex Wodak excitedly grabbed hold of this with both hands, tagging five of his echo chamber, with one, fellow ATHRA director Joe Kosterich, dutifully retweeting (ie republishing) it.

Wodak kept it rolling, addressing @350zeee as Simon and prescribing some corrective reading for “my” simplistic understanding.

As you might expect, I mute Pippa. I’ve found her take on vaping to be often very silly as I wrote in this earlier blog. And strange as it is I know, I prefer to avoid the incontinent deluge of vaping theology that almost invariably gushes into my feed whenever I engage with a vaping missionary.  So I missed any question she may have put to me about whether I owned or was a “party” to the account @350zeee.

On being shown these tweets, I looked through her feed. The tweet below may have been the one that she just knew I had seen.

“Chiming Slapman’, geddit? Here’s someone who finds this grown-up stuff very amusing.

When she defamed me last year, she got everything wrong in her tweet before hitting ”send”.  So let’s see how likely it is that I indeed am @350zeee

First and most obviously, why on earth would I open a fake Twitter account when I already have one and have hardly been inhibited in tweeting material about vaping? Perhaps this thought sprang to Pippa’s and Alex’s minds  because they are probably well aware that this is a tactic with which their pals in vaping are well practised?

All these accounts are run by the same aggressive, often bad spelling person, right Hamish?

And here’s a day’s work from totally different authors at accounts all run from the same shop that runs the Legalise Vaping microphone

Then there’s this. @350zeee opened their Twitter account in December 2008 (see below). I joined Twitter in November 2009. So I guess this now all makes perfect sense: I open my first Twitter account in a fake name and then nearly a year later, opened one in my own name! And 10 years down the track, I write a blog about joining Twitter where I cunningly throw a false trail about being totally disinterested in Twitter before I joined it, needing to be coaxed into it by a journalist friend. I did this of course, because I was prescient or telepathic enough to know that Pippa and Alex were planning to break my cover a full 19 months later, as they’ve just now done. Sadly, there’s no escaping such exquisite detective prowess.

Nicotine only addictive in cigarettes, not in vapes

In the global movement among vapers to rehabilitate nicotine as a quasi-vitamin, I’ve noticed a bizarre meme emerge about nicotine not being addictive when being vaped. You see, it’s only addictive when being smoked in those terrible cigarettes.

This seems to rather fly in the face of what we see in plain sight when watching vapers chugging away all day like old steam engines. A recent study monitoring vaping found  exclusive vapers pulled the vapourised nicotine/flavourings/propylene glycol/metal particle cocktail deep into their lungs on average 173 times a day — a mere 63,188 times a year. Those who were dual users (ie who smoked and vaped) inhaled only 72 lung-basters on their e-cigarettes. The average 12 a day cigarette smoker takes about 96 puffs.

No. Vaped nicotine isn’t addictive. It’s just that exclusive vapers just can’t get enough of the stuff. And not forgetting too that these new hedonists are just very busy pleasuring themselves all day long.

And then there’s all the evidence we have of rodents have been shown to bar press to get pure nicotine. And comparisons of vaping with smoking on standard measures of dependence. The 1988 639 page door-stopper report of the US Surgeon General on nicotine addiction apparently got it all wrong.

Politicians have told me often about the rabid abuse they get often get from vapers and the “your correspondence has been received” replies they send in return. For many years, I posted a stock reply to fruitcakes who sent me unsolicited abusive email. “Dear …. I have just received the email below from some deranged person using your email address. It looks like you may have been hacked. I suggest you contact your IP provider as soon as possible.”  Another failsafe response was “Thank you for your recent email. Please be assured that any future correspondence from you will get all the attention it deserves.”

I’m thinking it’s time to resurrect these.

Other blogs in this series:

Vaping advocates say the darndest things 1: The Cancer Council Australia takes huge donations from cigarette retailers. WordPress  30 Jul, 2020

Vaping advocates say the darndest things 2: Tobacco control advocates help Big Tobacco. WordPress 12 Aug, 2020

Vaping advocates say the darndest things 3: Australia’s prescribed vaping model “privileges” Big Tobacco Feb 15, 2020

Vaping advocates say the darndest things 4: Many in tobacco control do not support open access to vapes because they are just protecting their jobs. WordPress 27 Feb 2021

Vaping advocates say the darndest things 5: I take money from China and Bloomberg to conduct bogus studies. WordPress 6 Mar, 2021

Vaping advocates say the darndest things 6: There’s nicotine in potatoes and tomatoes so should we restrict or ban them too? WordPress 9 Mar, 2021

Vaping advocates say the darndest things 7: Vaping prohibitionists have been punished, hurt, suffered and damaged by Big Tobacco WordPress 2 Jun, 2021

Vaping advocates says the darndest things: 9: “Won’t somebody please think of the children”. WordPress 6 Sep, 2021

Vaping advocates say the darndest things: “Almost all young people who vape regularly are already smokers before they tried vaping” WordPress 10 Sept, 2021

The world’s annual vaping advocacy shindig, the Global Forum on Nicotine, was held for the 8^th time last week, in Liverpool, England. Run over two days on 17 and 18 June. Opening the conference , Harry Shapiro “executive editor” at the conference’s organisers Knowledge Action Change (KAC), lamented that the small live audience who attended in Liverpool was rather thin on the ground with public health experts. But with the  conference being live-screened globally, he excitedly promised that  Netflix and CNN should “eat your hearts out”.

Three days after the conference kick-off, the live stream audience hit all of  778 for day one, falling to 450 on day two. In previous years, those running it have posted all individual presentations and discussions on YouTube. The cumulative 2020 viewing data make interesting reading as a window into the size of the global community of vaping activists keen to watch their dear leaders. The table below shows the total viewing numbers for 36 sessions in the June 2020 fully online GFN meeting during the global COVID-19 pandemic across the next 12 months, and the viewers for the live streaming over the two days of  the 2021 conference (data accessed 20 Jun 2021).

SPEAKERS                                            Youtube hits 1 year on (per day)
Welcome 11 June (day 1)
Stimson	287 (0.77)
Sweanor	159 (0.43)
Perspectives: setting the scene
Bates	454 (1.21)
Glover	191 (0.51)
Godfrey	120 (0.32)
Virginio	131 (0.35)
Tyndell	335(0.89)
Q&A	214 (0.57)
Nicotine science, ethics and human rights
Nadelmann	116 (0.31)
Conley	128 (0.34)
Chowdhury	96   (0.26)
Gilchrist	372 (0.99)
Oysten	132 (0.35)
Patten	129 (0.34)
Nadelmann	116 (0.31)
Michael Russell Oration
Stimson	83   (0.22)
Ross	221 (0.59)
Stimson	53   (0.14)
12 June (day 2)
COVID19 and other epidemics: the challenges for tobacco harm reduction science
Notley	73  (0.19)
Polosa	1117 (2.98)
Farsalinos	601 (1.60)
Matzner	107 (0.29)
Sussman	137 (0.37)
Q&A	104 (0.28)
Tobacco harm reduction: taking stock on regulation
Fottea	90 (0.24)
Philips	147 (0.39)
Kovacevic	135 (0.36)
Fottea	114 (0.30)
Du Plessis	151 (0.40)
MacGuill	141 (0.38)
Tobacco harm reduction: risks and benefits
McGirr	65   (0.17)
Wodak	79   (0.21)
Babaian	105 (0.28)
Sucharitha	124 (0.33)
Ngema	107 (0.28)
Closing remarks
*Stimson	78 (0.21)
Mean (2020)	189 (0.49)
Day 1 live stream (2020)	1704
Day 2 live stream (2020)	1130
Day 1 live stream (2021)	778
Day 2 live stream (2021)	450

With billions around the world in lockdown over weeks and months, many  of us found time to binge on mini-series and movies. But not an awful lot found the time to feast on the offerings from the 2020 GFN conference. Just two speakers’ magnetism and compelling messages managed to attract more than 500 viewers in the whole year following their presentations, with the average across all 36 sessions being 189, or less than one viewer every two days. Australia’s own Alex Wodak pulled 79 views in 373 days.

This desultory attention is in spite of the conference organisers, KAC, having received $US1,051,364 (2017-2018); $US1,378,366 (2019) and $US937,191 (2020), from the fully Philip Morris International funded Foundation for a SmokeFree World. Makes you wonder what their KPI targets were …

A colleague very unkindly pointed out that this amateur video of my old band singing a reworked Leader of the Pack tribute to Australia’s former health minister Nicola Roxon has had 1,628 views, more than double the total live-stream viewing audience for Day 1 of the 2021 conference. And even my crooning an Elvis cover with a Turkish wedding band on a boat on the Bosphorus has had 192 hits, placing it ahead of hits fpr 27 of the 36 2020 GFN videos.

The opening presentation

This year’s opening “keynote” presentation was by Fiona Patten, the sole state politician elected to represent the Reason Party (formerly the Sex Party) in Victoria. Her talk, which you can watch here  traversed several tenets of modern vaping theology with the aplomb we have come to expect from vaping advocates.

In an often rambling talk, Patten made the following points:

• Australian governments are making nicotine vapers into “criminals” (she’s presumably  alluding here to those “criminals” who will, from October, refuse to get the required prescription for legal nicotine vaping of exactly the kind  that somehow millions of Australians who take prescribed drugs every day have managed to live with for decades)
• Political parties refuse to accept donations from Big Tobacco, yet they still “protect” it. (quite clearly, Big Tobacco is so protected in Australia that all companies have long closed their local factories. Go and put the kettle on while you read a long list here of all the ways that Australian governments have “protected” the tobacco industry, for example the highest taxes in the world, banning smoking in all indoor areas, plain packaging, display bans etc).
• Health expertise like that provided to the government by the NHMRC in the early 1960s on the dangers of smoking was laudable, but governments in those days didn’t act. And now with vaping, it’s exactly the same! (“we are seeing this history repeat itself” as “report after report, expert after expert have told the government that that [vaping] can save lives”). What’s rather awkward here though, is that the NHMRC is one of many health and medical expert agencies in Australia which is very much not marching in step with open-slather vaping regulation being advocated by nearly all of vaping’s disciples.
• With COVID-19, the Australian government has emphasised repeatedly that we all must “listen to the evidence and the experts”. But when it comes to vaping, the duffers just won’t listen to the right experts. Strangely, they listen to agencies with expertise and track records in assessing evidence and with decades of successful involvement in tobacco control. Fiona will be “holding [these agencies] to account”.
• “When we see science being questioned like this, it opens the door to vaccine hesitancy, to QANON.” Yes, she actually said this. So please understand that the TGA, the NHMRC, the Royal Colleges of Physicians and GPs, the Thoracic Society, the Heart Foundation, all state and federal health departments, the Lung Foundation, the AMA, VicHealth and many more are abetting vaccine hesitancy and QANON. You know it makes sense.
• If governments acted on vaping in the ways she supports “we would save 20,000 lives, immediately.” Note this: “immediately”. What on earth are we to make of that?

Meanwhile, here’s what tobacco control, so often vilified by vaping messiahs has and will achieve  in Australia.

Without tobacco control, there would have been an estimated 392,116 lung cancer deaths over the period 1956–2015; of these 20% (78,925 deaths; 75,839 males, 3086 females) have been averted due to tobacco control. However, if past and current measures continue to have the expected effect, an estimated 1.9 million deaths (1,579,515 males, 320,856 females; 67% of future lung cancer deaths) will be averted in 2016–2100.

The most interesting part of her presentation was her obvious dis-ease with the company that her embrace of vaping has put her in. She said “politicians who say [about COVID-19] ‘let the virus rip, we can’t cope with anymore lockdowns. We can’t have anymore  mask wearing, quarantine should end, self-isolation should end … some of those are the same people that support vaping in Australia. So that’s fairly uncomfortable bedfellows for me anyway.”

Patten’s boutique Reason Party is presumably designed to appeal to voters who put evidence at the centre of their assessment of government policy and are disillusioned with the major parties. So she’s big on saying she supports “evidence”, provided the evidence is compatible with what she wants to see happen with vaping policy. The ragbag of far right politicians who have been prominent in supporting vaping in Australia clearly make her uneasy. At the end of her presentation she’s asked to elaborate on her comment about the “unholy alliance” with such people to progress things. Here she stammers out a fractured response about having to team with “climate deniers … let-the- virus-rip types of politicians” saying almost apologetically “we take support whenever we can get it”.

Goethe wrote “Tell me with whom you associate and I’ll tell you who you are.” I wonder how many of her current and potential political supporters who (like me) would applaud her policy advocacy on issues like  voluntary assisted dying, pill testing, gambling, climate change, COVID-19, and social housing would recoil at her judgement on vaping?

This week a second Australian death (a 52 year old woman from NSW)  was reported following COVID-19 vaccination with the AstraZeneca vaccine. This follows a 48 year old woman also from NSW who died in April. The probable cause of death was thrombosis with thrombocytopenia syndrome (TTS), likely linked to the AstraZeneca vaccine. There have been 48 confirmed and probable TTS cases in Australia.  

As of June 10, there have been 5,487,670 Australians who have received at least one dose of COVID-19 vaccine, 142,808 in last 24 hours. Some 3.6 million of these have received the AstraZeneca vaccine.

This means that the current incidence rate in Australia of thrombosis with thrombocytopenia syndrome following AstraZeneva vaccination is about 1 in 75,000 and the mortality rate is  a vanishingly low 1 in 1,800,000.

People are choosing to be vaccinated in a risk calculation to help avoid serious illness and possible death from COVID-19. In Australia, the current COVID-19 rate is  1,173 per million population and the death rate is 35 per million, both among the lowest in the world.

An interesting comparison with these mortality rates can be made with deaths in those undergoing anaesthesia for operations in hospital. We consent to undergoing anaesthesia because we have serious medical problems needing surgery or to have investigations like endoscopy  and colonoscopy looking for early signs of serious disease.

Anaesthetic risk is thoroughly monitored and researched. In Australia and New Zealand the Australian and New Zealand College of Anaesthetists (ANZCA) publicly reports on mortality associated with anaesthesia. The most recent Safety of Anaesthesia report was published this year and reports data for the years 2015-2017.

Across the three years, the rate of anaesthesia-related deaths per number of procedures per annum was 1 in every 57,125 anaesthetic events. In 85% of these deaths, chronic health conditions contributed to anaesthesia-related mortality. A total of 2,909 people died while under anaesthesia across the three years, of which 239 were considered by ANZCA to be wholly or in part due to anaesthesia.

So the risk of not surviving anaesthesia in Australia (1 in 57,125) is  31.5 times higher than the risk of dying from thrombosis with thrombocytopenia syndrome after having the AstraZeneca vaccine (1 in 1,800,000).

I know several highly educated people in my age group (I’m 69) who are hesitating about getting the AstraZenica vaccine.  Yet I know some of them have not hesitated to have surgery when they needed it. And I know none of  them would even for a nanosecond contemplate having surgery without anaesthesia to avoid the very, very small risk of being killed by the anaesthetic.

If we are to get COVID-19 vaccination rates up to the 85%+ rates necessary to confer herd immunity, investment in research that helps us better understand the psychodynamics of the varied ways that people navigate risk taking with COVID will be money very well spent.