I have been banned from attending the Ottawa Model Conference on Smoking Cessation, the same conference where I have been a guest speaker a couple of times in the past, because of my association with the tobacco industry and vaping organizations.

Cynthia Callard from Physicians for a Smoke-Free Canada has made it clear that she does not want to receive emails from me and if I send her something she will not reply.

People I know in traditional tobacco control organizations have “ghosted” me; they will no longer speak to me or answer my emails.

Why? Because I have been paid for work I have done for tobacco companies and vaping organizations.

So what have I done to upset them?

Took part in a study of the long-term health effects of vaping

Everyone keeps on saying that “We don’t know the long-term effects of vaping”. Rather than bemoan this fact, I applied for and got a position supervising the Canadian part of an international study to find out. The study was funded by CoEHAR which in turn is funded with a grant from the Foundation for a Smoke-Free World (FSFW), which in turn is funded by Philip Morris International (PMI), a tobacco company currently diversifying into smokeless tobacco and other revenue streams.

There are a million vapers in Canada, some of whom have been vaping for over a decade. Why has Health Canada not sponsored any research on the health effects of vaping? It seems hypocritical to say that we cannot support vaping because we do not know the long-term health effects, not to do or sponsor that study, and then criticize someone for doing it because you disagree with how the research is funded.⁸

Prepared an affidavit about the importance of flavours in vape for smokers trying to quit

In a free country, people who think that a law is unfair or unjust have the right to challenge it in court. The two sides assemble experts, and a court determines who is correct. It is the same as a criminal case, where even people accused of murder are entitled to have a lawyer represent them, and that lawyer is entitled to get paid. Our legal system depends on both sides being able to make the best case possible for their position. I believe, based on my reading of the research, that a flavour ban will do little to reduce teen vaping, but will create a black market and will discourage adult smokers from switching to vape or quitting smoking. The Canadian Vaping Association hired me to write an affidavit stating my opinion, so I spent many hours preparing a detailed legal document. It is likely that I will end up having to testify in a hearing, so every sentence has to be supported by evidence. It is unrealistic to expect anyone to do that amount of painstaking and detailed work for free.

Reviewed and edited a smoking cessation game aimed at indigenous people

Everyone knows that indigenous people have high smoking rates and that this group seems hard to reach with existing methods. I worked with an indigenous professor to help her improve an innovative game-based smoking cessation program aimed at indigenous groups globally. This important and original work was funded by FSFW. If you do not like me doing this, what better ideas do you have for reducing smoking in indigenous groups? If you think this work should have been funded by a charity, please let me know which charities give grants for research and public education about the benefits of vaping.

“Communicating about Vaping”

Physicians for a Smoke-Free Canada (PSFC), who are funded by grants from Health Canada, wrote a document called “Science has marched on”. This was a ridiculous document with many major errors. PSFC suggested that Health Canada should tell the public that:

Vaping is increasing nicotine use and reversing the decades-long decline in smoking

Smoking kills, and vaping almost certainly kills too.

E-cigarettes are not effective cessation aids

https://smoke-free.ca/science-has-marched-on-its-time-to-update-the-advice-to-canadians/

These statements are all false. Vaping AND smoking are declining in both Canada and the USA, no one has died from vaping-related illness in Canada, and three systematic reviews say that vaping is more effective at helping smokers quit than conventional nicotine replacement therapy.

The Canadian Vaping Association hired me to write a rebuttal and correction. I worked with two other doctors to produce “Communicating about Vaping“, a report that ended up running to 26 pages and over 10,000 words. Careful drafting and editing of this document took weeks, and we charged a fee that reflects our expertise and the time we devoted to the task.

Vaping disinformation in Canada

Official Health Canada surveys show that Canadians think that vaping is more dangerous than smoking, and only 4% of the know that vaping is in fact very much less harmful than smoking. Only 6% of family physicians would recommend vaping as a way to quit smoking, even though it is more effective than traditional approaches. Websites are full of misinformation. The Heart and Stroke Foundation and the Canadian Cancer Society websites say that vaping is leading to an increase in smoking, when in fact the largest decreases in smoking are occurring in the age groups that are most likely to vape. The British Medical Journal article they use as a basis for these statements was corrected two years ago. Even medical journals and Health Canada are exaggerating the risks of vaping. For example, they are saying that vaping can cause “popcorn lung”, even though this has never actually happened.

In June 2022 I will be going to Warsaw to attend the Global Forum on Nicotine and give a presentation on “Disinformation about Vaping in Canada” My flight and my hotel are being paid for by the conference organizers. I do not know, or care, where they get their funding from.

“A Physician’s View of Tobacco Harm Reduction”

As an anesthesiologist, I have seen the damage that tobacco can do to the human body. I have watched as my surgical colleagues sent my patient’s lung to the pathology department or wrapped her leg in a garbage bag for incineration. I have supported many programs aimed at reducing the disease, disability and death from tobacco smoking. It is my sincere personal and professional opinion that vaping is an effective harm reduction tool to reduce tobacco-related disease and deaths, and that it is being deliberately vilified by many people who do not fully understand the issue, or who have a conflict of interest.

I think that most physicians have given up trying to help their patients to quit smoking, and they are unaware of the literature that shows, for example, that smokers with COPD improve their lung function when they switch to vaping. I wrote to 200 family physicians in the Toronto area, offering to give rounds to their group or to consult with their smoking patients about vaping, but not a single one responded.

Philip Morris International invited me to give my talk to about 40 physicians in Vancouver. They covered my expenses and paid me a speaking fee, but had no control over what I said. My talk was well received and led to a 30-minute discussion. None of the physicians had heard about the benefits of vaping for smoking cessation before I gave my talk. Feedback was very positive and 93% of people said that they wanted to learn more.

I know that PMI makes 600 billion cigarettes per year. I wish they did not, but I am pleased to see that 31% of their revenue now comes from smokeless tobacco, and am encouraged to see them diversifying away from tobacco into medicines and vaccines

I wish that Health Canada, Physicians for a Smoke-Free Canada or the Ottawa Model for Smoking Cessation would pay me to tell physicians the truth about tobacco and less-harmful sources of nicotine, but until that time comes I am obliged to take funding from the tobacco industry. PMI has the resources to invite a group of physicians to a dinner meeting, but I do not.

Quit by Vaping

Before Covid and before the “EVALI” scare I was working to establish a physician-led smoking cessation program centred on using vaping as a way to quit smoking, especially for smokers who had failed to quit by other means. I deliberately chose to set this up as a for-profit business, rather than seek government funding or establish a charity, for several reasons:

I felt that if my clients paid for my services directly they would appreciate them more and take them more seriously. As vaping is much cheaper than smoking, in the long run, they would save money by participating.

I wanted to have the freedom and flexibility to do things the way that I wanted and to change rapidly based on feedback or on new data.

If the program was successful it could be quickly and widely replicated as a franchise, allowing for a rapid scaling up and the maximum benefit to as many people as possible.

In conclusion

I am proud of the work that I have done on tobacco and vaping issues. I have done my best to tell the truth. I know that organizations that should know better have lied and misled people about vaping, including the WHO, the CDC and Health Canada. I believe that some groups, such as the Ottawa Model for Smoking Cessation, are biased because they receive funding from “big pharma”. Bloomberg has used his immense wealth to spread his anti-nicotine bias, and in the USA the “Truth Initiative” is using a large grant to spread lies. There are no checks or balances to the way that the Bloomberg Foundation or the Truth Initiative spend their money; they are accountable to no one.

Of course, I am aware of Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) which states that “In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law”. The WHO also praised India for banning e-cigarettes, prohibiting 120 million smokers from having the right to choose less harmful alternatives to the cigarettes and bidis that remain on sale. The governments of many of the member countries that fund the WHO have large stakes in, or own, tobacco companies, so the WHO is not an independent and apolitical organization.

The WHO is now refusing to authorize Canada’s new Covid vaccine, not because it is not safe and effective, but because its development was funded in part by the tobacco industry.

Tobacco companies cannot just disappear. The management has a fiduciary duty to protect shareholder value. They cannot simply close their factories, lay off their staff, and allow their share value to fall to zero. They have to diversify into other areas. By preventing them from making profits in other areas, such as medicines and vaccines, the WHO only prolongs their dependence on cigarette sales.

Without funding, all I can do is write on Twitter, Facebook and this blog, all of which are only read by my friends and family. To get things published and distributed to reach a wider audience, I need funding and support.

It is sad, in fact, it is disgraceful, that I need to have funding from the tobacco industry or from vaping organizations to help me tell the truth to Canadian smokers, the people whose very lives depend on being informed about the availability of much less dangerous sources of the nicotine they are dependant on.

The groups and organizations that should do this work are being derelict in their duty, and 4,000 Canadians are dying un-necessarily every month as a result.