Inside the Philip Morris campaign to 'normalize' a tobacco device | Hacker News Reader

Inside the Philip Morris campaign to 'normalize' a tobacco device

reuters.com

109 pointshhs125 comments

It seems very hard to have clear policy discussions about "less harmful" products.

Opiates > Marijuana > No Drugs

Cigarettes > Juul > No Tobacco

Bottled Soda > Bottled Water > Tap Water

They all seem to devolve into a group that only looks at the first two arguing with a group that only looks at the second two. Are there any good policy frameworks for how to evaluate something that reduces very harmful behavior while increasing less harmful behavior?

Are there any harm reduction frameworks?

wikipedia.org/wiki/Harm_reduction

> Are there any good policy frameworks for how to evaluate something that reduces very harmful behavior while increasing less harmful behavior?

Yes, you can do a multi-decade-long study of health outcomes of long-term self-reported users, and compute how many quality-of-life-adjusted-years of life each vice costs them and their families.

For illegal substances, you'd also probably want to take into account a mountain of other externalities, such as the impact of prison, black markets, drunk driving, etc.

Or you can just skip doing all that work, and loudly legislate from an ideological position, because doing the work is a waste of time, as people tend to cherrypick facts that suit their worldview.

I'm also under the impression that the evidence for Juul being meaningfully safer than cigarettes doesn't really exist. It's more a lack of evidence in either direction (whether Juul and similar vape products are more or less harmful than cigarettes) because research is still ongoing.

Lacking soot and tar, I find it hard to believe vape products are as harmful as smoking in principle. Of course there may be other factors in play; for instance it seems plausible that some vaporizers might out-gas other harmful chemicals when they get up to temperature. The use of plastic parts in such devices seems pretty sketchy.

That's my strong intuition anyway. I don't have any skin in this game; I don't consume tobacco products in any form.

There's plenty of research about what harm tobacco/smoking does that isn't going to be present in vaping* [1]. There is also intrinsically less evidence on the parts of vaping that are unique to it such as the solvents, the device materials, etc.

It's been a few years since I've really looked at the research in depth but as I recall (smoking) tobacco was just a crazy outlier on the scale of what causes cancer. Part of the issue was the amount people smoked what seems absurd now where even someone who seems like they smoke a lot really only smokes a few a day. And compare that to cannabis consumption and the amount of organic material burned/inhaled per day is just astounding when you look at heavy tobacco smokers.

Also, as far as I've heard, the US's campaign against and problem with teenage vaping is unique and its treated completely differently in Europe/UK.

[1]. http://ecigarette-research.org/research/index.php

The null hypothesis for the harm caused by vaping should have no reference to the harm caused by smoking. They're different activities.

Our baseline should be the harm caused by nicotine by itself, propylene glycol, and food-safe flavors: nicotine causes addiction, which can definitely be considered a harm, but isn't itself associated with other negative health outcomes. Propylene glycol and flavors are generally regarded as safe.

Then, of course, we should extensively study the subject, since the lungs are a new route of administration† and vaping has become popular.

But it's important to correctly set the baseline. Associating vaping and smoking because they're behaviorally similar is superstitious behavior.

† Not new for proylene glycol, which is used in fog machines.

>> They're different activities

It's the overlap in user groups that connects them, especially considering they are more frequently (though not always) mutually exclusive and one is positioned, in the market and as lobbying of public policy, as a safer alternative than the other.

So, yes, scientifically it's important to understand the baseline risks of vaping independently of traditional smoking. But the outcome of that scientific research has to be used to inform policy decisions, and so from that perspective you have to compare those two baselines to each other.

Think of it like research on new medications: Showing the efficacy of your new medication over placebo is necessary but not sufficient. Part of the process entails a discussion on how your new medication compares to existing medications targeted at the same/similar health issues.

Yes, this is an important comparison when there is adequate data.

Which, we're not really starting from the null hypothesis at this point, but let's pretend that we are.

Starting from no data, saying that there's no evidence that vaping is less harmful than cigarettes is no different from saying there's no evidence that vaping is less harmful than guavas.

There's no evidence. That's where the sentence needs to stop. Then you get evidence, and we can have an informed conversation.

I think where we disagree is on "no evidence". There is not definitive, comprehensive evidence, but there is some evidence. Nicotine, for example, is fairly well understood and so the knowledge base for that is shared between traditional cigarettes and vaping. We also know from chemical analysis that something like Juul has fewer & lower levels of known carcinogens. We don't know long term effects of inhaling novel chemicals found in vaping but not cigarettes, and that is a major gap.

However, in the face of having to form public health policy decisions in the time between right now and a decade+ down the road where real, long-term studies can be completed, we can only use and compare that available data. Though we should hew very close to specific facts and avoid words open to very wide interpretation like "safer". (it may be safer along a single vector, carcinogens, but much worse in others, so it's a misleading term) We would be more wise to stick to specific known evidence like:

--Nicotine levels are similar, so there is little or no difference in health issues related to nicotine ingestion, except in so far as evidence shows nicotine salts used in vaping may hit your system faster.

--There are fewer known carcinogens or lower levels of them in vaping, but the effects of novel chemicals are not known. Short term health benefits in switching to vaping have been observed but longer terms outcomes are completely unknown, and could be worse.

--Use Risk, as apposed to a more ambiguous "safety", and say that vaping is not a risk-free activity from a health perspective.

The above could probably still be better stated, but I think the point is clear enough. This is no different than any other scientific issue or area of research. You use available data to convey the current state of knowledge, possible implications, further areas of study, etc. And as more data arrives, you expand and revise. But we're not starting from zero data.

A primary issue in this topic is that it is front & center in the media. Media in general is not good at conveying technical nuances, and the well-funded marketing arms of tobacco (and now vaping) companies have every reason to help the media make incorrect leaps of logic and over generalizations, e.g, fewer carcinogens == safer.

Another consideration is individual context: I'm trying to get my 67 year old father to switch from smoking to vaping because available evidence shows he will very likely be able to breath more easily, reduce his risk for heart disease, and so on. But he's 67: Long term risk from unknown vaping effects are probably a non issue for him, while he's about 4 years away from COPD. And there's zero chance of getting him to quit while I'd peg my chances around 1 in 10 of getting him to vape instead. If it were a friend my own age, I would have a different message, such as "You may very well be trading some short-term health for long-term issues that are as bad, or worse. Or maybe not, but we don't know, so quitting is the proper response, not switching to vaping"

> I think where we disagree is on "no evidence". There is not definitive, comprehensive evidence, but there is some evidence.

We don't disagree on this, as I indicated, we're not starting from a null hypothesis here. It's a useful abstraction for the sake of argument.

All available evidence suggests that vaping is dramatically less harmful than cigarettes. There is a large enough population, who have been vaping long enough, that we should have some evidence to the contrary by now, if any was to be forthcoming.

Cigarette smoke, in addition to dozens of known carcinogens, contains small particle and carbon monoxide. Both of which are known to be terrible for your health, both of which are completely absent in vaping.

If I were trying to convince a young person not to vape, I'd stress that nicotine addition is a pointless and expensive mental slavery that is best avoided. Unless I knew they had ADHD or schizophrenia, in which case I'd leave them alone, since other people's medication is none of my business.

Stressing unknown harms that haven't been observed and probably won't be is a bad argument. They would be right to ignore it.

>>Stressing unknown harms

We have to measure and make decisions about unknown harms every day. We're not always good at it, but it's unavoidable. With respect to vaping, we know of very little in the way of foreign chemicals that can be safely inhaled. I think it's fair to say that available medical knowledge about inhaling chemicals points to a non-negligible chance that it might be bad for you. You seem to be saying we should mostly avoid reasoning about such uncertain risks. I'm saying it's not unreasonable to tell people, "we know inhaling many type of chemicals is harmful to your health, so there is potential for harm here as well. We'll know more in about a decade, and be fairly certain in 30 or 40 years."

Scientific rigor does not preclude reasoning about these risks before those 10 to 40 years are up.

If we don't inhale chemicals we die in a matter of minutes.

Certainly. But smoke a pack a day for 6 months, then vape incessantly for 6 months. Tell me how you feel after each. The unscientific observation is extremely clear.

Anecdata storytime:

I used to smoke a pack a day, and when I switched to vaping I personally felt much better. I was able to do things a bit better than when I was smoking cancer sticks.

Looking back I was lying to myself thinking it was just as good as quitting. I didn't feel the heavy tar on my lungs like cigarettes. I still noticed when pushing myself on work outs or hiking or biking or anything requiring aerobic activity that I would get sick to my stomach and almost puke like when you run long distance and are not used to it. I could go further than when I smoked but I would always hit this "wall" where I would get sick.

Quit 100% 3 months ago and took up XC Skiing. I could only do 2 miles when I first started. Just last week I did 10 miles and I have been going once on the weekend every week so in 12 sessions I was able to 5x my aerobic ability.

Starting at 0%, switching to vaping I would say made me feel/perform overall 15-20% better compared to cigarettes.

Quitting vaping filled in that other 80% and the difference is like night and day and so obvious I was lying to myself to keep the habit alive longer than I needed to.

Smoking timeline:

Smoked 18-30, transitioned to vaping.

30-31 vaped 12mg juice.

31-32 vaped 6mg juice.

32-33 vaped 3mg juice.

33-34 vaped 0 mg juice.

Quit Vaping 100% last Thanksgiving cold turkey (really was just mental habit at this point smoking 0 mg juice) 3 months vape free!

congrats it sounds like vaping really helped you

Never only just 1 cigaret again! I quit similar circumstances 4 years ago.

Congratulations on breaking free. Enjoy!

If you quit vaping and started skiing at the exact same time that makes it pretty hard to know how much of the improvement came from each.

This was posted on HN recently.... Tobacco smoke contains Polonium-210, the same stuff used to murder the Russian spy Litvinenko. A pack and half a day exposes the smoker to the same amount of radiation as 300 chest xrays a year. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2509609/

So someone just needs to blow some vape on a Geiger counter to test its radiation levels. I suspect the vape will be radiation free, as it doesn't need to contain the extra chemicals that lend tobacco its flavour.

Wtf, radionuclides aren't flavorings they're concentrated from soil by plants!

> Are there any good policy frameworks for how to evaluate something that reduces very harmful behavior while increasing less harmful behavior?

Ideally freedom reductions are evaluated alongside harm reductions in said framework.

"Cigarettes > Juul > No Tobacco"

IQOS is neither of these, it's another new category of electronically heated tobacco, though to be less harmful than smoking but really rather untested.

So they're marketing tobacco vaporizers and trying to push it as an upscale luxury good. Most people here know how hard it is to watch someone die of tobacco related illness, just a terrible way out. How is this company that has profited off of so much death and misery still thriving while our jails are full of addicts?

I was at a tobacco company hq once. It surprised me to learn that almost everyone there smoked. A lot.

how is that any different than alcohol? sugar? gambling? standing in the sun? how is that different from work? are you profiting off of the people that put together the building you are sitting in?

watching anyone die is hard. no matter what we do, it will probably have a factor in our death.

Or crack, heroin, meth?

The argument that anything can be bad so therefore nothing is bad is a meaningless slippery slope. Clearly there are differences and you have to draw the line somewhere.

The prevailing sentiment in my circle of friends is that substance addiction should be treated as a health, not a moral, issue. That lets us neatly draw the line at 'the user sought it out'. Health outcomes tend to improve under that kind of paradigm as well, so it's not just libertarian ideology either.

What's the rationale for drawing the line at a particular substance?

Do we also allow people to seek rotten meat, ineffective medications, or not wearing seatbelts?

There are known things we can do to substantially reduce harm to the public. It’s always a balancing act between a “parental gov” and individual liberty: there is no universal answer. But over time we learn as humans what we think those trade offs should be.

Note I’m not necessarily for making sins illegal personally, but I am for finding ways to regulate the hell out of them.

This. Not to mention the public costs of dealing with the ill.

IMO the middle ground is to restrict the marketing, not the sale.

> "Do we also allow people to seek [...] ineffective medications,"

Not that I think we should, but we do. Grocery stores like Whole Foods have entire aisles dedicated to snake-oil.

FWIW those aren’t “medications,” they’re “supplements.” Regardless of the lack of regulating supplements being good or bad, it wasn’t what I meant in this case.

It seems to me that's just wordplay used to avoid regulation. These products are marketed in a way that suggests they might be used in lieu of regulated medicines.

> Do we also allow people to seek rotten meat, ineffective medications, or not wearing seatbelts?

For the first two, we definitely do. No one says you can't let your meat rot before you eat it, and certain forms of rotten food are cultural delicacies. Most groceries have aisles full of ineffective junk medicine. Not wearing seatbelts I will grant you, although enforcement of those laws is generally very lax in my experience.

I strongly disagree with regulating them. Consumers should be given information to make a well informed decision, and then we should butt out. You don't want to wear a seat belt? It increases your risk of dying as a result of a crash by XX%. Go for it if you are willing to take that risk.

I don't feel right imposing my own personal values on someone else when their actions aren't harming others (which I know is somewhat debatable with seatbelts). Nothing makes me feel that my own values and morals are superior enough to force them on someone else.

This is an incorrect way of understanding phenomena. You're essentially claiming that things are the same so long as certain elements of them intersect, regardless of the magnitude. Therefore we cannot distinguish between them.

I disagree they are claiming they are the same. They are instead claiming that these personal vices are not different enough to treat so different. It becomes difficult to discuss general vice freedoms when comparisons always devolve to complaints about the comparison meaning exact equality. This is especially true when it is in response to emotionally charged comments that are used to buttress the original argument.

I purpose the argument that our similarity function is ill equipped to differentiate those intersections in a meaningful way. I think this matters because it calls into question if our differential treatment is really, or is solely, based off of the results of the similarity function.

For example, while we can attempt to justify our reaction to weed by the harms it does, in light of the harms alcohol does and the treatment it gets, one wouldn't be wrong to wonder if our treatment of weed was tied to some other factor that we aren't willing to admit.

It's different because tobacco products were engineered for maximal chemical addiction.

So is fast food. So is Junk food. Casino's were designed with no windows or clocks so patrons would lose track of time while giving out free alcohol.

Casinos are regulated where permitted, and often flat out banned. "Sin taxes" for junk food (particularly soda pop) are becoming increasingly common.

Vice industries often point to each other when trying to justify themselves, which I suppose demonstrates that there is safety in numbers. The strategy of tackling one problem at a time is countered by demands for all-or-nothing tactics, with "all" being obviously and conveniently impractical.

Funny aside, you know what else is considered a "Sin Industry" by the US tax code? Golf Courses.

In some climates, environmentally, that might be a reasonable classification.

you mean like candy?

They profit because some people like to relax and have a smoke. With everyone knowing the health trade off now is there anything wrong with that?

The health impact of smoking overwhelmingly comes from inhaling smoldering organic compounds.[1] There's no evidence that the psychoactive compounds in tobacco, including nicotine, has any impact on mortality[2].

At worst (smokeless) nicotine is no more harmful than caffeine. In fact nicotine appears to be neuroprotective against Alzheimers, Parkinsons, and general age-related cognitive decline[3].

[1]https://www.ncbi.nlm.nih.gov/books/NBK53014/ [2]https://www.gwern.net/Nicotine [3]https://www.tampabay.com/news/health/study-finds-nicotine-sa...

How does that line up with the fact that chewing tobacco is still associated with oral cancer?

Unless nicotine gum has a similar association, it's probably the same generic cause.

That may be carcinogenic in another way. It's my impression that nasally ingested dry snuff tobacco is not as strongly associated with cancer as smoked or chewed tobacco. That said, it's hard for me to trust anything I read suggesting that, since I can't rule out the possibility that the tobacco industry has corrupted anything I might read suggesting it.

https://en.wikipedia.org/wiki/Snuff_(tobacco)#Health

Most preparations of chewing tobacco are smoke or fire cured. The process still introduces many of the byproducts that are created during the combustion of dried organic material.

The most prominent example of chewing tobacco that isn't smoke cured would be Scandinavian-style snus. There's pretty compelling evidence that snus is not associated with oral cancer[1], or at the very least the risk is substantially lower than traditional chewing tobacco.

[1] https://onlinelibrary.wiley.com/doi/full/10.1046/j.1360-0443...

There are a few meta-analysis about snus cancer risk. I think generally the opinion [1] is that while lower than other smoke-cured tobaccos, there still exists a non-zero risk for oropharyngeal cancer risk and statistically-valid increase in pancreatic and esophageal cancer risk compared to non-tobacco users. [1](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...)

I agree with your second point, however, respectfully, your first point is incorrect (I was going to call it absolute bloody bullshit, but that would be the amphetamines talking).

Here's a better breakdown of carcinogens in cigarette smoke (same book, same author)[0]. The most lethal way tobacco smoking impacts health is through carcinogenic by-products created from metabolizing said tobacco.

"PAH, N-nitrosamines, aromatic amines, 1,3-butadiene, benzene, aldehydes, and ethylene oxide are probably the most important carcinogens because of their carcinogenic potency and levels in cigarette smoke."[0]

To elucidate on one of your points: nicotine isn't on any of the "carcinogens in tobacco" lists, because it, nor any of its metabolites, aren't carcinogens at any dosage that is practically applicable to humans.[1]

[0] https://www.ncbi.nlm.nih.gov/books/NBK53010/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/

> The most lethal way tobacco smoking impacts health is through carcinogenic by-products created from metabolizing said tobacco.

Maybe, we're misunderstanding each other. But all those compounds you listed are directly present in smoke itself. I.e. they're not metabolic byproducts.

In fact they're not even related to tobacco specifically. (With the major exception of N-nitrosamine). Cannabis smoke (gram for gram) contains equivalent of higher levels of PAH, benzene, 1,3-butadiene, aldehyde, and aromatic amines.[1] These are all pretty much universal byproducts of burning any type of dried plant material, and the same reason that exposures are similar for wood-burning fireplaces.[2]

[1] https://pubs.acs.org/doi/full/10.1021/tx700275p [2] https://www.epa.gov/burnwise/wood-smoke-and-your-health

You do not actually disagree with dcolkitt.

Right, but there are going to be other compounds released from this heatedtobacco product, most likely. Maybe not combustion products, but more than in (say) vaping.

What's unclear to me is if you are advocating for releasing addicts from jail (ideally compensating them for the misery caused by their incarceration), or throwing more people in jail?

If it's the former, I'm with you.

These companies are selling an addictive poison and continuing to get away with it -- never forget that.

Also alcohol companies as well.

I’m under the impression that alcohol is substantially less chemically addictive than Nicotine. Is that correct?

Substantially less chemically addictive, but causes a much higher degree of social harm for those who do get addicted.

Much more harmful even if you are not addicted. Take road accidents and fights for example.

This is actually a surprisingly difficult question to answer. If you had asked specifically about tobacco, you'd be correct. But, nicotine itself may not be as addictive as tobacco products are.

Remember that tobacco contains many other compounds that influence how the body metabolizes things (MAOI's and such). Here's a link with some citations: http://www.healthnz.co.nz/Addiction_TobNic.htm

EDIT: My personal anecdote is that I tried vaping when the first 901 ecigs started to hit the US market: the idea was twofold. I wanted to assess whether there was any cognitive benefit in using nicotine through a cleaner delivery system and I also wanted to get my dad to quit smoking cigarettes. Both goals were failures, I found it too difficult to dose reliably using this method and the side effects weren't worth it to me. I did not find myself addicted after around a month of use.

I’m under the impression that alcohol is substantially less chemically addictive than Nicotine. Is that correct?

Doesn't addictiveness vary from person to person?

You can die from quitting alcohol cold-turkey, which is not true for nicotine.

Was about to post this. They're really very different addictions. Nicotine withdrawal is mostly medically harmless.

This is a good point, and I either didn’t know or forgot that

Most alcohol users (in many countries, the majority of the adult population) are not addicts. As far as I know, most cigarette and e-cigarette users are addicted.

Also: there are some computer games, which have the potential for addiction. Some others (especially "free to play") shamelessly monetarize on addiction.

Similar things goes from other businesses: e.g. loans, dating websites, social media, etc.

Yes, but I think that the majority of alcohol is consumed by addicts. I have a few 750mL bottles of liquor that I use to make a drink for myself once or twice a week. My alcoholic childhood friend has drunk an entire handle of liquor (1.75L) in a day and then walked to the liquor store in the snow to get more. I’m counted as an alcohol user, but my usage is a rounding error of his.

Yes, in the past I knew a couple people that were addicted - as in, they got the shakes if they didn't drink. They would drink several 750ml bottles of vodka per day.

I'm struggling to find a source, but I was taught in school that some large majority of the total beer consumption is by a core group of beer drinkers that average > 3/4 gallon (around eight cans of beer) per day

I was staggered, at my last health physical, to learn that --light to light/moderate-- alcohol consumption for someone my size is 14 beers a week.

I have 14 beers (or its equivalent hard alcohol) over the course of a month or two, and that still seemed like a lot.

2 beers a day to be specific. 4+ beers in a single day for a male is in the heavy alcohol use classification

The normal recommendation is 2 "servings (beer, shot, glass of wine) per day, without any roll over. That's the important part. You can't really measure it on a weekly basis as you can't have all of those beers in just a few days.

90% of the booze is consumed by 10% of the population. They're all alcoholics. These are the people who prop up the industry.

> Also alcohol companies as well.

Indeed, death in the US due to alcoholism is about 88,000 a year it is the #3 leading preventable cause of death. [1] Tobacco related deaths is #1 (preventable) by 480,000. [2] Obesity is #2 for completeness. I have loved ones that have died or are dying from one or a combination of these vices.

[1] https://www.niaaa.nih.gov/publications/brochures-and-fact-sh... [2] https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal...

Their whole strategy is dumb. They could be winning the legal cannabis game but rather they fight against it.

Phillip Morris has a pretty diverse portfolio; they just play every side.

Phillip Morris invested over $2b in Cronos Group. They are playing in the cannabis game.

I feel blessed to live in a world where companies can "get away with" selling products to people who are informed of the risks and choose to buy them. The urge to remove the option for others to behave irrationally runs strong in some, but we mustn't be carried away by ego.

“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience. They may be more likely to go to Heaven yet at the same time likelier to make a Hell of earth. This very kindness stings with intolerable insult. To be "cured" against one's will and cured of states which we may not regard as disease is to be put on a level of those who have not yet reached the age of reason or those who never will; to be classed with infants, imbeciles, and domestic animals.” --C.S. Lewis

"Omnipotent", there, is palming a card.

I think he’s referring to something like a surveillance state - folks in charge who know everything about you and wish to police all your behavior.

It’s a great quote from 70 years ago that speaks well to modern politics, but its application to Phillip Morris here seems to be a bit of a stretch to me.

You may be right, but he still dodges the comparison. His moral busybodies are "omnipotent", while his robber barons are not. I understand why this should be the case - were it otherwise, the thought of living under robber barons would not come off nearly so well - but I see no reason why it should pass without comment.

How does this apply to second-hand smoke? I did not consent to have poisonous fumes near me. Second-hand smoke should be considered a form of battery, of which tobacco companies are accomplices and enablers.

How does this apply to the misinformation campaign waged by tobacco companies? Their customers were deceived, and therefore could not give informed consent.

It also raises questions on the nature of consent, agency, and responsibility in the case of an addicted person who continues their addictive behaviour (with interesting answers depending on whether the person is willingly or unwillingly addicted). It is not a settled question in philosophy to answer that an addict has all the agency (especially to be "informed as to the risks") as others[0].

[0] "There is certainly widespread agreement about the paradigm threats to personal autonomy: brainwashing and addiction are the favorite examples in the philosophical literature. But philosophers seem unable to reach a consensus about the precise nature of these threats. They cannot agree about how it is that certain influences on our behavior prevent us from governing ourselves." From: https://plato.stanford.edu/entries/personal-autonomy/

Cause and effect rule all things. We are formed by genetics, experiences in childhood, all of our trauma, and whether we were born rich or poor. It’s not obvious to me that addiction or brainwashing are different in kind from all of the other influences we are exposed to.

Traditionally, following Harry Frankfurt, volitions can be separated into two camps: first-order and second-order. First order volitions are things you just want (such as food). Second order volitions are things you want to want. Someone who only has first-order desires can be said to have no free will. Addiction (and especially brainwashing) are a detriment to second-order desires in that they limit your self-control and take over the second-order desires.

Not all addictions are the same, and the fact that some people are able to stop their addictions attests to that. But they are definitely in a "meta" category of desire which childhood experiences and genetics are not.

>Consider first the unwilling addict, who is someone that has both a first-order desire to take the drug, and a first-order desire not to take the drug. Crucially, however, the unwilling addict also has a second-order volition that her first-order desire to take the drug not be her will. This is the basis for her unwillingness. Regrettably, her irresistible addictive desire to take the drug constitutes her will. Next, consider the case of the willing addict. The willing addict, like the unwilling addict, has conflicting first-order desires as regards taking the drug to which she is addicted. But the willing addict, by way of a second-order volition, embraces her addictive first-order desire to take the drug. She wants to be as she is and act as she does.

>It is now easy to illustrate Frankfurt’s hierarchical theory of free will. The unwilling addict does not take the drug of her own free will since her will conflicts at a higher level with what she wishes it to be. The willing addict, however, takes the drug of her own free will since her will meshes with what she wishes it to be.

>> Second-hand smoke should be considered a form of battery, of which tobacco companies are accomplices and enablers.

That's hyperbolic to the point of seeming like farce.

I used to think that being smart was inherently virtuous, but I've noticed that some people use it to infinitely rationalize their demands of others. It is utopian thinking, colored by some flavor of personal bias, which inevitably falls short of the real world in its attempts to optimize other people's lives.

The traditionally spiritual mindsets are necessary to be a positive fit. Wisdom, mindfulness, humility, acceptance etc. I think they are correlated to intelligence but they are not as immediately accessible as cleverness, they must be intentionally cultivated.

Everybody has to seek these for themselves and try to be a good model for those they interact with. Nobody is good enough to be good for everybody else, plan the whole system, and cure everybody by rule of force. The inability to tolerate some amount of imperfection and dirtiness is the root of a greater evil. Don't invite dragons to take care of your wolf problem.

> I did not consent to have poisonous fumes near me.

Me neither. However, the construction trucks driving around in front of my apartment with exhaust so thick it covered my patio with a thin layer of soot don't give a fuck about my consent.

Second-hand tobacco smoke is a non-issue, as smoking is already banned in places where people don't have a choice to be in (bus stations, building entrances, etc..).

But if we go with the 'battery' hyperbole, I would 'batter' back people who sneeze/cough and don't cover their mouths. I don't consent to have poisonous bodily fluids near me.

There are any number of things that give off poisonous fumes, from home heating to driving your kids to the park[1], at higher volumes and lower distances than cigarettes.

I abhor secondhand smoke too, and applaud legal constraints on where you can emit poisonous fumes, like smoking bans in enclosed spaces. But cigarette smoking is easily separable from the worst of its local air pollution effects, and unless you're willing to condemn even more harshly people who choose to live in the suburbs, this is a dishonest argument.

> How does this apply to the misinformation campaign waged by tobacco companies?

No argument here; this is the reason I'm no fan of tobacco companies. Though this is again a theoretically-separable evil from selling cigarettes per se.

Lol. The tailpipe exhausts, agriculture emissions and smokestack releases are genocide by that rational.

Seeing how battery is kind of a stretch, do you see obese people as homeless (because of ruining their bodies/sanctuary)?

I still laugh when I think of how much nicotine and coffee were consumed by NASA to get the space program going back in the day. I'm pretty sure intelligent people are/were aware of the dangers of their indulgences.

Smoking in confined spaces may not be recommended, but smelling smoke (from tobacco) in an outside setting should not warrant such an irrational response.

How would a very smart rocket scientist go about evaluating tobacco risk back in the 60's, presumably when the disinformation campaign by the tobacco industry was well underway?

Using the scientific method? Its use does date back to the times of the pharaohs.

I guess unless you've never smoked before, you may not be aware of the pleasures of a good cup of coffee and nicotine session.

https://m.youtube.com/watch/llOvhzKr0_A

I was in a good mood this morning and thought battery was an over-reaction. Karma says otherwise, if thats to be taken into account.

I'm also an avid golfer and cigarette use among some of the greats is/was no secret, so depending on your role models, smoking is just another vice adults can enjoy (in moderation, of course).

Are alcohol companies responsible when a person drinks and drives?

> I feel blessed to live in a world where companies can "get away with" selling products to people who are informed of the risks and choose to buy them.

Except people aren't informed until laws force companies to tell the truth. Until then the advertising swindle will continue to kill millions. I wish you didn't feel blessed about any of this and rather felt sympathy towards countries that don't enforce the same laws as yours.

Thank you. I nodded along with the others, semi-consciously weary, but then saw your quote, and reading it felt alleviated.

It's funny how sometimes following the downvotes takes you better places than following the upvotes.

The things that most need to be said are always unpopular.

Of course, things are also often unpopular for being stupid and wrong. But if you always err on the side of leaving people alone, saying something stupid doesn't hurt anybody. So I don't worry about it too much, and I just say what I think.

Sugar is addictive.

"Using brain-scanning technology, scientists at the U.S. National Institute on Drug Abuse were among the first to show that sugar causes changes in peoples' brains similar to those in people addicted to drugs such as cocaine and alcohol.6,7 These changes are linked to a heightened craving for more sugar.8 This important evidence has set off a flood of research on the potentially addictive properties of sugar.9" https://sugarscience.ucsf.edu/the-growing-concern-of-overcon...

Obesity, metabolic syndrome, diabetes, etc. all cause society a massive loss in lost length and quality of life, lost productivity and increased health costs.

https://truthinitiative.org/research-resources/emerging-toba...

For those who also had no idea what an "IQOS" was. Looks like it's an e-cig you shove a cigarette into. Seems dumb. If I was a kid, I wouldn't think it seemed preferential over regular e-cigs.

If you think of it as an e-cigarette, it’s dumb. If you think of it as a fancy filter for regular cigarettes, it’s potentially clever. Especially if, for some reason, you already have the cigarettes, or can acquire them for cheaper than you can acquire e-cig liquid (because e.g. you work at a convenience store.)

It's a vaporizer for leaf material. People have been using this tech for weed for 20+ years.

Oof. I don't know who would really trust research about it being "less harmful" coming from that company after their history. It may very well be, but I wouldn't trust them on the matter.

Saw extensive use of these type of devices across Tokyo a few months back. Hadn't yet seen them in the market at our local QT/Circle Ks.

> If I was a kid, I wouldn't think it seemed preferential over regular e-cigs.

If I was a kid none of these options would be preferential over just not smoking.

I've never smoked, but to my knowledge it doesn't carry any positive effects. That means utility doesn't really make any difference. The tobacco game is a pure marketing play.

Maybe you could even sell a JUUL and an IQOS device to the same people (JUUL for everyday use and the IQOS for trips where you can get new capsules)

Nicotine is a nootropic with a number of documented cognitive benefits. E-cigs appear to be largely harmless so far, excepting black market pods, so I've been happy to see that we've potentially turned a very harmful vice into one that is as dangerous or less than alcohol.

We don't have much research on the subject yet so we really don't know harmful they are. I'd say it's pretty fair to say they are better than cigarettes but a big step to call them largely harmless. Your still running molecules over a red hot coil and inhaling it. At the very least we know that that creates large concentrations of free radicals that can damage cells. I do agree it's probably a lesser evil but we shouldn't forget that it is still harmful.

I think it's notable that the most damning thing anti-tobacco advocates can say about it is that it's addictive, and I think it's notable that the English Public Health agency was confident enough to declare it to be at least 95% less harmful than cigarettes https://www.bmj.com/content/363/bmj.k5429/rapid-responses I don't believe alcohol is 95% less harmful than cigs.

This claim appears so frequently but without links to data to back the assertion, so unless you have something to back that all up, people would be better served educating themselves on the lung damage and deaths caused by vaping - https://www.cdc.gov/tobacco/basic_information/e-cigarettes/s...

The CDC has reported that the problem was black market juice. They call it "products from informal sources"

https://www.cdc.gov/mmwr/volumes/69/wr/mm6902e2.htm?s_cid=mm...

Anecdote: my high school buddy, who was always looking into supplements and health boosters, said this exact thing and started taking pure nicotine. We all had a good laugh when it made him vomit repeatedly while we were all playing video games over skype - seemed like poetic justice for ignoring everyone's parents' advice to avoid nicotine. He eventually just started smoking cigarettes and is still addicted to them today.

And for those who have no idea what it smells like, it’s a mix of fart and wet dog. I don't understand how they can market it.

I'm not entirely sure that tobacco is the worst product involved with this article. At this point Instagram seems to be doing more social harm than any form of smoking could.

I'm half joking, but to me this is all a freedom thing. If a person is capable of making their own decisions in this already pretty complicated world, the option to use (or to not use) tobacco seems like one they can handle.

Mental health is so much harder to measure. I have a feeling that social media is boiling the frog already. Like health crises of the past, we won't realize what we've done until it's too late. Except with mental health it'll be much easier to blame the victims instead of the institutions that caused the problem.

I think this is also a very individually subjective thing.

I typically don't engage in social media, but sometimes I post pictures of food I've made to Instagram and about once a week I take a quick scroll through Facebook to keep in touch with relatives.

And it's never seemingly done me any harm. I've had weeks when I've forgotten to do the above, and aside from a family member mentioning it, would have never noticed.

But for some people, it certainly seems like Facebook causes them a whole bunch of harm. I don't think that's per se intrinsic to Facebook specifically (I have plenty of other things to blame them for, they're not off the hook). I think there are people who maybe due to anxiety or something else going on really struggle with social media and it causes them great panic.

But if the issue is with the individual and it is highly subjective, then that suggests the solution isn't to change social media but to change the individual having troubles.

Blaming social media for mental health issues sounds deeply questionable no matter how many correlative studies. I doubt it is generally healthy but making it out to be the next tobbaco is absurd. There are far too many overlapping changes with potential negative effects, let alone the role of diagnosis and awareness affecting apparent numbers - a town without any access to diagnosis will look mentally healthy even if literally everyone has severe PTSD.

Even if a correlation is taken as granted it is logically flawed as concluding kids eating their lunch alone are at an increased suicide risk - never mind shunning or bullying that is the shared cause of both!

I'm not blaming social media for the problem, per se. Ultimately, it is the way people use the tool that will determine whether it is a pro or a con. The issue is that the general public (or, most anyone) does not fully grasp how their use of the tool will affect themselves and those they interact with.

Story time. These folks funded a restaurant industry magazine "startup". I got hired to build their online version.

The people I was dealing with were severely out of their depth and all over the place frankly. I was very confused as to who was giving these people money.

They had me meet them at their "office", which was actually the lunch area in the back if an IQOS-branded office. Eventually I put it together, and confirmed that it was in fact funded by a tobacco company.

The magazine flopped shortly thereafter. I imagine the intent was to become popular amongst restaurant staff, then push this IQOS device.

I put "startup" in quotes, because they never had a viable business plan or the ability to follow anything through. The while thing made a lot more sense when I realized it was a tobacco shill project.

This happened in Vancouver.

Edit: typo

As a Romanian I can testify that Iqos is quite prevalent. While smoking is normally prohibited inside, there are places where Iqos devices are allowed.

They also have a fancy building to showcase their products in the Bucharest city center, under the guise of some sort of art/media center: https://qreator.ro/

As cited in the piece, this is the 313-page white paper: http://tobacco.stanford.edu/tobacco_main/publications/IQOS_P...

Apparently there are also privacy concerns for this device. Great.

https://www.reuters.com/investigates/special-report/tobacco-...

In the first picture, what is the white cylinder next to the sign that says "no smoking, IQOS only"?

IQOS “ashtray”:

https://uk.iqos.com/shop/iqos-3/iqos-3-accessories/trays-and...

The fact is that adults don't take up a new nicotine habit, so it's no surprise that PM must market IQOS as a sexy, exciting "lifestyle" for young people. This is part and parcel of the industry they're in. They'd be doing it in the US, too, but for the strict regulations here which disallow it.

>> The fact is that adults don't take up a new nicotine habit

That's not a fact. There are plenty of smokers who acquire the habit as adults.

According to the CDC[0], 9 out of 10 new smokers are under 18.

[0]https://www.cdc.gov/tobacco/data_statistics/fact_sheets/yout...

What you're presenting is not factual evidence that adults don't take up new nicotine habits, it's evidence to the contrary.

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