Clipped, but published.

The reason I am blogging this is not for the same reason as the BMJ letter entry. This time, my letter has been published in the Lancet, albeit abridged. That is why I wanted to put up the complete text that I sent. The shorter, published, version can be found here.

I should say that the editing was not done without my input and they were very patient and helpful.

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What a peculiar situation I find myself in. At the end of 2012, not long after starting vaping after 23yrs of smoking, I realised that things were being grossly misunderstood about what ecigs could offer to smokers. Very naively I, and others, thought we could explain to politicians & Public Health where they were going wrong with what the TPD was trying to achieve. Within months, we learnt what 'AstroTurf' meant, as an Irish MEP informed the press that this is what we were. Why? Because we knew too much.

I was shocked! It seemed so obvious that we were normal people trying to dispel fears & misconceptions with experience & knowledge. Things have gotten significantly worse since then. We have struggled to get the ear of the very people who are advising Government, WHO & the public. We have been insulted or ignored, often both, and in a shockingly aggressive way. And why? I genuinely could not say. We are not an organised group, we are not funded, we act as individuals but have the same cause. The sense of frustration is palpable among us & I for one am horrified by the accusations of being shills & stooges. We are told our accounts are not real, our stories are fake. No matter how polite or constructive we are, some of the most influential & media savvy in PH will instantly bemoan the 'trolling' they are having to endure, which closes doors to people we have never even spoken to. 

When finally we had enough of the bullying & untruths from articles written behind paywalls, public comments about us & at us on social media, we complain to an authority about the extreme behaviour we experienced on Twitter. We are informed of the complaints procedure & told to wait 30 days for a resolution. Then we watch while elements of Public Health stepped up what feels like a campaign to humiliate us further in blaming us for the behaviour of their peers. More articles, more opinion pieces appear. Somehow, we deserved the insults, we bought it upon ourselves. We are unreasonable & silly for expecting to have a say in what's happening with our lives. Decisions are being made about us, but definitely without us.

To finally see the Faculty of Public Health support their president John Ashton, before conclusion of the investigation, without even being asked to further explain our experience is disgusting. It would appear most of you are not even aware of what happened. I ask you all to reflect deeply on who it is you represent, who you are charged with protecting.  Well it's me, and millions of others like me, yet you insulted & ignored me, then when I complained you blamed me.

UPDATE - Thanks to four particularly vocal Anti E-cig Activists responding to my letter, I have written a second letter, here. 

The Right To Reply: or not, as it happens.

Below are responses written to the tenacious, indefatigable even, Martin McKee who has penned yet another scathing, sneering and downright offensive attack on those that have the bare faced cheek to disagree with him. How irritating it must be to know that there are folk that keep pointing out that what you spout to the media is complete and utter nonsense. Seemingly he has nothing better to d....what was that? Ebola you say?

I fail to understand why journals like the BMJ are giving space to unsubstantiated accusations on members of the public. It is also infuriating beyond WORDS to see the sycophants on Twitter, blindly retweeting McKee's article without question of its validity.  

Anyway, these have been submitted to the BMJ in the correct manner, and only appear here as the journal in question has seen fit to disallow these comments about not being allowed to.. Uh.. Comment...so.. yeah.. 

Submitted by me on 9/10/14

Almost a year to the day[1], here I am writing to defend myself and other honest vapers from the same inflammatory outpourings from the same people. What has been learned in that time by those in the very elite of Public Health? Sadly, it appears to be nothing. For the second day in a row, we are subjected to yet another unsubstantiated and unwarranted attack. These continuous and relentless accusations emanating from the upper echelons of those charged with the protection of our health, ceased to be a curiosity a long time ago. We have tried, relentlessly yes, to talk to and deal with the very people who proclaim to all that will listen that we are either Trolls (the definition[2] of which does not actually apply here) or paid industry stooges (be that Tobacco or E-cig). Now we have the added definitions of ‘extreme libertarians’ or ‘deeply troubled individuals’.

Let me be clear. I am not a paid stooge for ANY industry nor am I a Troll. I say this also for the people that I speak to on a daily basis. I would not even call myself a libertarian let alone an extreme one, though I fail to see why that would be an issue; indeed Mckee rather eloquently made the case for them himself.  Am I a troubled individual? Well, yes actually, but certainly not in the ‘unhinged’ manner which Martin implies. I am troubled by the fact that no matter what we do, what we say, we are totally unable to defend against these accusations and still they persist. In fact, given how often we have tried to refute them, I consider them now to be nothing more than lies, constructed in order to make e-cig advocates so very toxic that we are as likely to be spoken to as a tobacco industry member. I am troubled because far from this idea that the use of the ‘block’ button being as a RESULT of contact we have made, it has often been used BEFORE we have been able to say a word. In fact, the author of this smear piece has been un-contactable for more than a year.  As have some of the people I expect to see respond to this article. Yet somehow we are deemed to still be attacking them (challenging their opinion or asking questions), to such a degree that it warrants repeated opinion pieces being published, often behind paywalls so that we are unable to see.

I am troubled as this feels like we are being bullied by people who are untouchable and unreachable yet have absolute authority and the assumed respect of their peers, the media and the public. What are we, unpaid volunteer advocates or lay vapers, supposed to do in the face of this adversity[3]? If there is indeed proof of astroturfing, then I strongly and passionately request that this be made public immediately as we would be as concerned and upset (if not more) as Martin McKee and his ilk are. As yet, despite repeated requests for this evidence, we have seen nothing.

This debacle is serving only to muddy the waters, delay sensible regulation and, worse, create fear and uncertainty in smokers who would otherwise have chosen harm reduction as their route out of tobacco. In truth, the last of these things is the one that should cause the most consternation in anyone who is genuinely interested in the health and wellbeing of smokers. The greatest irony being that the entire movement is in danger of being handed to the tobacco industry through the fear of their involvement in, what appears to be, the least effective part of the market. In the long run, the attention being paid to unjustified scrutiny of us e-cig users, unsupported theories of gateways and gross lack of understanding of the role of flavours, will make cannon fodder of smokers in your war against the tobacco industry. A war we want no part of. Whilst you gaze at your navels contemplating hypothetical fears, millions of smokers have made the decision themselves to choose harm reduction. 

The big question is; how many didn’t as a result of this relentless scaremongering?

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[1] Full response to the first McKee BMJ article 27.9.13 http://oxle.com/topic.asp?tid=6459

[2] http://en.wikipedia.org/wiki/Troll_(Internet)

[3] Further reading on why Vapers are angry http://www.theindefatigablefrog.blogspot.co.uk/2014/09/the-indefatigable-frog-or-why-this-wont.html

Submitted by Sarah Jakes on the 8/10/14

This is the second article [1] I have read today in which McKee attempts to conflate the e-cigarette industry, libertarian bloggers and angry e-cigarette consumers (vapers) in an attempt to paint the latter group as an astroturf organisation in the pay of either big tobacco or big vapour, which of course to his mind are one and the same thing. Is it any wonder that people who do not have the luxury of being published in prestigious journals such as this get even more angry when being maligned in one?

Either McKee does not understand the public he purports to protect or his comments are disingenuous in the extreme. I know that McKee has read Clive Bates' blog article entitled 'Memo to public health grandees: vaping, vapers and you' [2] which attracted 111 positive comments from consumers and is the most read and shared article on the Counterfactual site. I personally asked McKee to read that article because Bates has absolutely nailed the thoughts and feelings of vapers on the head, as is evident from the comments. My request to McKee to read it was a genuine attempt to create some understanding between our two sides. He confirmed that he'd read it, but the message appears to have fallen on deaf ears. 

McKee is completely entrenched and out of touch. He is of course free to disagree with Bates' article, but cannot deny the fact that it has the widespread support of the very people who are its subject. McKee has himself researched a member of the public and indeed uncovered the shocking fact that one Twitter user (who uses his own name and very colourful language) is a freelance writer who sometimes gets paid to write positive articles about e-cigarettes. If he'd researched further he may also have found that this is common knowledge, as is the fact that the person is a British ex soldier with several tours of duty under his belt, which probably explains the liberal use of creative profanities. One, sometimes foul mouthed, squaddie with a genuinely held belief that public health will kill people doth not an astroturf lobby make.

There appears to be a concerted effort by some in public health to deliberately make false associations between a genuine grass roots consumer campaign and organisations with commercial interests, the more malign the better. This of course serves two purposes, firstly, it undermines the voice and views of the public by instilling  the false belief that their views are paid for rather than their own. Secondly, it allows those in public health who are apparently unable to control their own behaviour to keep their jobs due to "mitigating circumstances" - those circumstances presumably being that they were baited into calling members of the public "c**ts" and "onanists" by industry shills with agendas [3]. 

One thing is for sure - if McKee and others continue to provoke vapers with false accusations whilst failing to engage with them on the issues which are important to them, the relationship between the two sides is only going to get worse, and PH will only have themselves to blame. If your job is public health and you find that the public are angry with you then you really should be asking yourself a question - and here's a clue - it's not "who is paying them".

[1] Martin McKee - Peering through the Smokescreen http://pmj.bmj.com/content/early/2014/10/07/postgradmedj-2014-133029.extract

[2] Clive Bates - The Counterfactual - 'Memo to public health grandees: vaping, vapers and you' http://www.clivebates.com/?p=2391

[3] The Times - E-Cigarette debate Heats up in online War of Words http://www.thetimes.co.uk/tto/science/article4200758.ece

Statement from the Faculty of Public Health (now removed from the site):  "The Board has registered its strong disapproval of Professor Ashton’s comments, whilst noting the mitigating circumstances. The Board also agreed that Professor Ashton should continue in his role as President and has given clear direction on the necessary steps to support his return"

Just for fun

I happened to notice that it is World Poetry Day today, so thought I would join in & penned this little ditty.

Dear Public Health, I know you are listening
We are trying to help but your attitude's blistering.
There are good ones among you,
Not even that scarce,
It's time you embraced us,
Not feed us to bears.

The bears are Big T and Big Pharma too,
Your own ideology aligns with the WHO.
But we are your charges,
For us you must care,
Our health should come first,
It's one thing we share.

We are not addicts nor are we trolls,
But this story rolls on oh it rolls & it rolls.
We promise to be reasonable,
Do you promise too?
There's a lot to be gained here,
And too much to lose.

So smoker or vaper we are using our voice,
What we ask for is simple, what we ask for is choice.
Harm reduction is obvious,
When you open your eyes.
Take a breath & dive in,
And stop with the lies.