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Speaker 1: Hi, I'm Ethan Natalman, and this is Psychoactive, a production

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Speaker 1: of I Heart Radio and Protozoa Pictures. Psychoactive is the

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Speaker 1: show where we talk about all things drugs. But any

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Speaker 1: views expressed here do not represent those of iHeart Media,

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Speaker 1: Protozoa Pictures, or their executives and employees. Indeed, heed, as

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Speaker 1: an inveterate contrarian, I can tell you they may not

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Speaker 1: even represent my own. And nothing contained in this show

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Speaker 1: should be used as medical advice or encouragement to use

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Speaker 1: any type of drug. Hello Psychoactive listeners. Today we're gonna

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Speaker 1: get into an issue that's not about illegal drugs, at

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Speaker 1: least not yet. It's an issue that I kept an

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Speaker 1: eye on all those years I was running the Drug

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Speaker 1: Policy Alliance and dealing with the consequences of the war

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Speaker 1: on draws US. But this one has to do with

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Speaker 1: tobacco and nicotine and the question of whether or not

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Speaker 1: the whole idea of harm reduction applies as much to

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Speaker 1: tobacco products and smoking as it does with the illegal drugs. Now,

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Speaker 1: around the time I was stepping down from DP about

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Speaker 1: four years ago, the whole phenomena a jewel came around

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Speaker 1: kids Jeweling and using East cigarettes. I mean, these cigarettes

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Speaker 1: have been around for a while, but there was this

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Speaker 1: explosion of adolescent vaping with Jewel and some of the

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Speaker 1: competing products, and this public hysteria in the United States

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Speaker 1: that resulted in all sorts of localities and even states

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Speaker 1: starting to ban these products, and with people kids and

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Speaker 1: adults being told that these cigarettes were as are more

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Speaker 1: dangerous than cigarettes. And meanwhile, there's all sorts of evidence

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Speaker 1: out there that adults who have had a really hard

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Speaker 1: time quitting smoking could really benefit from making the switch

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Speaker 1: to eat cigarettes. So this issue has been seriously in

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Speaker 1: the news. In fact, but for the COVID pandemic, we'd

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Speaker 1: probably still be talking about the vaping epidemic. Now, it's

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Speaker 1: the f d a's job to regulate this industry, and

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Speaker 1: they delayed doing that for many years. But they're supposed

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Speaker 1: to issue a ruling, uh fairly soon about what this

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Speaker 1: entire e cigarette industry is going to look like. You know,

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Speaker 1: which flavors can be sold, if any of these things

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Speaker 1: can be sold at all, how much nicotine can be

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Speaker 1: put in, whether just to allow tobacco flavors, what restrictions

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Speaker 1: on access to kids, So whenever the FDA rules. This

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Speaker 1: could fundamentally reshape this entire industry. Until then, though, I

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Speaker 1: want to provide some introduction to the issue, and I'll

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Speaker 1: tell you that as I was learning more and more

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Speaker 1: about this issue over the last few years, it was

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Speaker 1: just one name that just kept popping up, left, right

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Speaker 1: and center. And that's my guest today. His name is

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Speaker 1: Clive bates Uh. He was a leading figure in the

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Speaker 1: United Kingdom in late nineties and only two thousand's in

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Speaker 1: the fight against smoking and big tobacco. He ran the

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Speaker 1: leading anti smoking organization, which in the UK is called

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Speaker 1: Action on Smoking and Health or ASH, and he stayed

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Speaker 1: active in this area ever since and really emerged as

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Speaker 1: really perhaps the outstanding expert and in some respects propponent

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Speaker 1: of tobacco harm reduction. His website, Clyde based dot com

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Speaker 1: is probably the best resource in the world on this issue.

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Speaker 1: There's probably nobody I've learned more from on this issue

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Speaker 1: than Clive. So Clive, thank you so much for joining

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Speaker 1: me today. Him it's a real pleasure to be here.

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Speaker 1: I've been a long stunting admira of you into your

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Speaker 1: work on the war on drugs. So I promised our

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Speaker 1: audience that with people whom I agree with a lot,

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Speaker 1: I'm going to avoid this being any kind of love

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Speaker 1: fest or disagreement fest. So what I'd like you to

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Speaker 1: do is start off by just laying out the overall

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Speaker 1: argument for why things like jewel and others were maybe

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Speaker 1: good things, and why maybe people shouldn't be as worried

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Speaker 1: about the whole kids thing or about this as most

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Speaker 1: of my country and many other countries seem to be. Well.

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Speaker 1: First of all, we have to start off with a

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Speaker 1: definition of the public health problem, and that is that smoking,

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Speaker 1: even now is a massive killer worldwide. W h O

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Speaker 1: says eight million deaths per year um. Typically. I think

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Speaker 1: in the United States they would typically say four under

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Speaker 1: an eighty thousand premature deaths per year, and in developed

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Speaker 1: countries tobacco would be killing or smoking would be killing

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Speaker 1: more than obesity, alcohol, road accidents, drug misuse, and HIV combined. Now,

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Speaker 1: the pattern of illness, it's a sort of late onset problem.

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Speaker 1: So the median lifelong smoker would typically be losing around

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Speaker 1: ten years of life in their seventies, so that's the

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Speaker 1: sort of shape of the problem. But really after the

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Speaker 1: sort of mid thirties to forties, people who smoked all

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Speaker 1: their lives are starting to die prematurely from cancer, from

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Speaker 1: heart disease, from serious lung ailments like emphysema, and so on.

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Speaker 1: So that's the basic problem. Now, that problem is caused

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Speaker 1: by smoke, not by the underlying drug using pattern. Okay, Now,

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Speaker 1: just to unpack that slightly, People are smoking and using

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Speaker 1: tobacco for the nicotine that is the recreational drug habit involved.

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Speaker 1: You know, it's a relatively in drug terms, a relatively

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Speaker 1: benign drug. Doesn't cause intoxication, and it doesn't cause people

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Speaker 1: to lose control, it doesn't cause violence, it doesn't call

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Speaker 1: family breakdown typically, and so on. But the harm is

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Speaker 1: done by the mode of delivery, and the mode of

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Speaker 1: delivery is to set fire to tobacco in the tip

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Speaker 1: of a cigarette and inhale the products of combustion in

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Speaker 1: the form of a kind of nicotine bearing aerossault. And

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Speaker 1: those products of combustion, the tar and the hot gases

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Speaker 1: that you inhale, those are the things that cause the disease. Now,

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Speaker 1: what we have now is a range of products that

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Speaker 1: don't involve combustion but allow users to consume nicotine. So

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Speaker 1: these would be vaping products, heated tobacco products, smokeless tobacco

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Speaker 1: products like snooze, and these new oral nicotine products are

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Speaker 1: kind of pouches that don't contain tobacco but do contain nicotine.

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Speaker 1: You're put in your mouth and absorb the nicotine through

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Speaker 1: the mouth, And if you can take nicotine without the smoke,

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Speaker 1: then you are likely to be avoiding all or nearly

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Speaker 1: all of the disease risk that affects smokers. So there

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Speaker 1: is a massive harm reduction potential in these smoke free products,

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Speaker 1: of which the product Jewel that you mentioned, Ethan is

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Speaker 1: you know, one amongst many, but one of those that

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Speaker 1: has had the most spectacular success in terms of switching

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Speaker 1: smokers from a smoked product to a smoke free product.

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Speaker 1: And the more of that we can do, the more

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Speaker 1: that we can convert the world's stock of around one

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Speaker 1: billion smokers to smoke free forms of nicotine, the more

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Speaker 1: that we're in in play to get a massive public

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Speaker 1: health dividend out of migration from combustible to noncombustible forms

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Speaker 1: of nicotine. So that's the basic public health problem and

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Speaker 1: the harm reduction premise explained in overview terms. So now

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Speaker 1: when I look at public opinion polls in the United States,

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Speaker 1: we now see that a majority of Americans think that

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Speaker 1: vaping are using a jewel or e cigarette is as

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Speaker 1: or more dangerous, and cigarettes we see a majority of

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Speaker 1: people believing that nicotine is why cigarettes cause cancer. So basically,

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Speaker 1: what you're saying is that these public perceptions are the

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Speaker 1: opposite of the truth. Those public perceptions are completely wrong,

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Speaker 1: and they are very dangerous because people act on the

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Speaker 1: basis of their perceptions, and if you hold those perceptions,

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Speaker 1: you would be indifferent to whether you're consuming nicotine by

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Speaker 1: smoking or by vaping, or by heated products or by

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Speaker 1: smokeless tobacco, and you should not be indifferent about that.

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Speaker 1: The health risks are radically different. And we know this

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Speaker 1: really beyond any reasonable doubts. So if you measure hazardous

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Speaker 1: agents toxicants that you find in the blood urine saliva

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Speaker 1: of people using these products, you'll find dramatically lower levels

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Speaker 1: amongst people who are using smoke free products. Then you

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Speaker 1: would find among people who are smoking cigarettes almost the

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Speaker 1: same in many cases as non smokers, or down to

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Speaker 1: the levels where people quit smoking. And therefore it's just

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Speaker 1: completely implausible that there would be the same disease risk. Now,

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Speaker 1: some people say, well, you just don't know about the

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Speaker 1: long term future, and of course, you know, we don't

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Speaker 1: have time travel. We can't go forward forty years and

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Speaker 1: find out what happened from prolonged use of products that

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Speaker 1: were only invented, you know, ten, fifteen years ago. But

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Speaker 1: if you have dramatically lower exposures, it's a pretty reasonable

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Speaker 1: assumption that you're going to have significantly lower disease risk.

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Speaker 1: And maybe you're going to be below the thresholds that

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Speaker 1: the body can deal with and have negligible disease risk,

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Speaker 1: you know. And if you're losing from lifelong smoking ten

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Speaker 1: years of life in your seventies, maybe you'd be at

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Speaker 1: worst losing a few months. And then you start to

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Speaker 1: get a risk behavior where the risks are kind of

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Speaker 1: in the noise of other things that you do in life,

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Speaker 1: whereas smoking is not in the noise. It is an

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Speaker 1: outlier in terms of personal risks are assumed through substance

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Speaker 1: use or consumption, or lifestyle or behaviors of any sort.

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Speaker 1: So I don't buy these ideas that anything like equivalent.

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Speaker 1: One final thing to say about this ethan, though, is

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Speaker 1: that this is not accidental. People have those perceptions because

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Speaker 1: those perceptions have been implanted by an expert community of academics,

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Speaker 1: of activists, of public health officials who don't want you

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Speaker 1: to think that these products are lower risk. They don't

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Speaker 1: like the harm reduction concept. They think everybody should cease

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Speaker 1: using nicotine completely, and therefore a much safer way of

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Speaker 1: using nicotine in their world works against their ultimate goal,

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Speaker 1: which is a nicotine or drug free society. And it's

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Speaker 1: no accident this people work tirelessly to confuse the public

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Speaker 1: about the risks of using these products. It's despicable, it's irresponsible,

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Speaker 1: and they're not accountable for it. But that's what's going on. Yeah,

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Speaker 1: I will say. I mean, it's been stunning to me

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Speaker 1: when I look in the political environment and see that

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Speaker 1: some of the most vociferous anti harm reduction folks in

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Speaker 1: the tobacco field are the people who are my allies

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Speaker 1: on drug policy reform. You know, the governors, the senators,

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Speaker 1: the congressman, the local legislators who were my allies on

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Speaker 1: legalizing marijuana for medical purposes and more broadly, on advocating

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Speaker 1: for needle exchange and harm reduction with illicit drugs, are

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Speaker 1: the ones introducing bills and banning these cigarettes. So before

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Speaker 1: we get into why that's happening, let me just ask you,

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Speaker 1: in greater specificity, some of the things that I hear

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Speaker 1: from this other side. Right, one of them says, Okay,

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Speaker 1: maybe east cigarettes are good. If you're smoking and you

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Speaker 1: can't quit entirely, then it's good to switch to an

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Speaker 1: east cigarette or a heated tobacco product. Many of them

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Speaker 1: will admit to that, but they'll say, what about the kids.

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Speaker 1: I mean, first of all, you now have kids vaping

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Speaker 1: who never would have touched a cigarette, but they're getting

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Speaker 1: into vaping, and then they're getting addicted to vaping, and

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Speaker 1: it can't be healthy for you to just be inhaling

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Speaker 1: this stuff through these electronic devices where we don't really

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Speaker 1: have long term studies. I mean, how do you respond

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Speaker 1: to that class? Well, I don't think anybody approves of

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Speaker 1: any kids doing anything risky, you know, drinking, taking drugs,

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Speaker 1: drink driving, having premature sex. There is a whole range

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Speaker 1: of risk behaviors that young people enter into that adult

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Speaker 1: society generally would rather they didn't. But the problem is

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Speaker 1: they do, and they do that partly because adolescens are

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Speaker 1: in a kind of graduation process from being children to

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Speaker 1: being adults. Adults use these substances, so they do. Therefore,

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Speaker 1: I I think you just have to recognize that risk

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Speaker 1: behaviors are part of life. They happen to be concentrated

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Speaker 1: in kids that have usually had a bit of a

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Speaker 1: tougher life. They haven't done well at school, their families

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Speaker 1: are not always as sort of robust as you would like.

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Speaker 1: They may have some mental health issues, they may be

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Speaker 1: in poverty or so on. So you see, the underlying

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Speaker 1: causes of these things are pretty fundamental. And therefore I

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Speaker 1: would start from the position, and this is an unpopular view,

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Speaker 1: I I you know, I don't deny that that some

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Speaker 1: kind of drug use, you know, is a given in

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Speaker 1: all societies everywhere, from ancient history onwards, and will probably

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Speaker 1: continue to be. And therefore the sort of job of

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Speaker 1: adult society is, to the extent it can not just

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Speaker 1: to condemn it with a sort of just say no message,

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Speaker 1: but to ensure that the options available are as safe

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Speaker 1: as possible, are not outrageously dangerous. At least there are

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Speaker 1: good options available if you want them. Now, with vaping,

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Speaker 1: there's a lot of very frivolous behavior going on, it's

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Speaker 1: a new thing. You can do silly things like blowing

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Speaker 1: big clouds with them. They're slightly funky tech gadgets and

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Speaker 1: so on. So what we find with youth vaping is

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Speaker 1: that there is a lot of infrequent use. So this

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Speaker 1: is kids basically being kids, messing around at parties, blowing

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Speaker 1: big clouds and being silly. It's not an unusual thing

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Speaker 1: for kids to do that, and it shouldn't be causing

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Speaker 1: people to go mad with concern about what they're doing.

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Speaker 1: When you look at more frequent users, so people who

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Speaker 1: are using the products you know, most days or every day,

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Speaker 1: what you find is that those are the kids who

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Speaker 1: did or would be using tobacco anyway, and they're they're

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Speaker 1: you know, around a one third of us teenage vapors

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Speaker 1: would otherwise be typically smokers. Now for them, the intriguing

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Speaker 1: thing here is that vaping maybe a diversion from doing

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Speaker 1: something worse i smoking. And there's some evidence in the

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Speaker 1: time series data that suggests the arrival and rise of

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Speaker 1: products like jewel or vaping products more generally has caused

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Speaker 1: a diversion re effect in the trajectory of smoking. In

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Speaker 1: other words, it's accelerated the downward trend in smoking and

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Speaker 1: vaping is effectively displacing smoking in the teenage population, and

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Speaker 1: that's a good thing. So I think when people talk

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Speaker 1: about youth vaping, you have to take a much more

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Speaker 1: nuanced view of it. How much of it is frivolous,

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Speaker 1: how much of it is more you habituated, and of that,

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Speaker 1: how much of that is a diversion from smoking? And

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Speaker 1: for goodness sake, let's take youth risk behaviors in context.

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Speaker 1: Vaping is amongst the most innocuous things that kids do,

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Speaker 1: amongst the whole spectrum of dangerous things that you know

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Speaker 1: kids do, and it's not Honestly, I think government agents

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Speaker 1: or anyone else should really be focused. Look at the

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Speaker 1: opioid epidemical, you know, binge drinking. I mean, I hear

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Speaker 1: you talk about you know who, who's who's smoking, who's vaping?

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Speaker 1: And I think we know from the evidence that smoking

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Speaker 1: at this point, I mean, when I was growing up,

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Speaker 1: I think he was likely to see upper middle class,

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Speaker 1: wealthy lawyers, doctors, teachers, professors smoking as poorer people. But

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Speaker 1: now it really is among people lower income, white and black,

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Speaker 1: right is among people mentally ill, among LGBT community, etcetera, etcetera.

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Speaker 1: But what struck me about the phenomenon and jeweling, and

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Speaker 1: here I should say, you know, like jewel is to

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Speaker 1: eat cigarettes, right more or less, like Kleenex is two tissues,

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Speaker 1: or xerox is to copy machines, or maybe even like

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Speaker 1: produce pharmace. Oxy content was toxy codon right where it's

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Speaker 1: plays a big role in the market, but it seems

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Speaker 1: even more dominant because it's become a generic name. What

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Speaker 1: I was struck, especially in places like San Francisco and

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Speaker 1: other cities, and even where I live in New York,

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Speaker 1: was that what was happening was that middle upper addle

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Speaker 1: class kids, kids go into the private schools that you know,

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Speaker 1: living in the fancy neighborhoods, that they were beginning to

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Speaker 1: vape and getting into jewel and sometimes having a hard

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Speaker 1: time stopping. And their parents, I mean their parents either

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Speaker 1: had never smoked or hadn't done it in decades. They

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Speaker 1: basically don't hang out with people who smoke or vape.

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Speaker 1: They think they don't know anybody who smokes are vape.

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Speaker 1: I mean, the only people they know smokers are vape

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Speaker 1: are probably the people who work for them, and those

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Speaker 1: people don't do it in front of them. So these

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Speaker 1: upper middle class who can call their local legislator are

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Speaker 1: finding their kids vaping and they're totally freaking out that,

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Speaker 1: my god, my kid was not going to smoke at all,

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Speaker 1: so he's doing this stuff. And then they read like,

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Speaker 1: oh my god, the adolysts and brain is vulnerable, and

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Speaker 1: what do you say about that? All right, So there's

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Speaker 1: a couple of things that even I mean, first of all,

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Speaker 1: you're absolutely right. You know, the concerned soccer moms have

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Speaker 1: enormous political cloud and their definition of the problem, which

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Speaker 1: is that their kids doing this is you know, a

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Speaker 1: national crisis of aping epidemic. Is how that has played

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Speaker 1: in the media. I don't think the data is fully

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Speaker 1: in on that yet, but I don't think that will

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Speaker 1: actually play out. When we have all the data. What

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Speaker 1: we'll see is that most of the better off kids

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Speaker 1: will be amongst the more frivolous users. And also they

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Speaker 1: will be the ones who give up, you know, fairly quickly,

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Speaker 1: either after they leave school or after they leave college,

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Speaker 1: that they get serious jobs, they settled down, have families

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Speaker 1: and so on. That's at least what the history of

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Speaker 1: smoking has told us. If you go back to the

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Speaker 1: time when you know, you had twelfth grade, you might

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Speaker 1: have had thirty of young people smoking. What you'd have

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Speaker 1: seen is a fairly even social economic distribution, which then

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Speaker 1: consolidated into a sharp socioeconomic gradient as the better off

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Speaker 1: kids gave up as they entered you know, if you

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Speaker 1: like middle class society, and I suspect that we will

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Speaker 1: see that again as those kids age into their twenties. Again,

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Speaker 1: if we're really concerned about this would be focused on

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Speaker 1: the disadvantage kids, the kids who would be smoking now

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Speaker 1: and are now vaping instead, or at least now have

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Speaker 1: the option to vapor instead of smoking. That's where there's

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Speaker 1: a public health win. And of course the soccer moms

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Speaker 1: who are you know, running points on this campaign, pay

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Speaker 1: no attention to them. They're not really interested in the

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Speaker 1: class basis of youth vaping. They're interested in the middle

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Speaker 1: class basis of youth vaping, and they're missing something really

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Speaker 1: important because of that. You know, I was gonna say,

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Speaker 1: I mean, you know, it's obviously people are worried about

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Speaker 1: their own kids, and obviously when upper middle class people

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Speaker 1: are worried about their own kids, that's a politically great significance.

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Speaker 1: But you know, one thing is Jewel came up with

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Speaker 1: his product right there was particularly innovative, like a little

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Speaker 1: thumb drive a good effect. But what argument could be, Okay,

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Speaker 1: let's ban the products that kids seem they are so

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Speaker 1: attracted to, even if the adults like them as well,

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Speaker 1: but allow the products that don't seem as appealing to kids,

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Speaker 1: like these heated tobacco products, heat that burn, right. Philip

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Speaker 1: Morris just guide its product called icos right, which is

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Speaker 1: a kind of bulkier product and seems to be effective

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Speaker 1: as a harmonduction device. Why not just allow the heated

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Speaker 1: products and say no, you can't do those, these cigarettes

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Speaker 1: or things that where kids are going to be drawn

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Speaker 1: to them. Well, I think the first thing to say

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Speaker 1: about that is that vaping is enormously popular with adults,

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Speaker 1: and the dual product has had amazing success in converting

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Speaker 1: adults smokers to vapors. And the reason is that it

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Speaker 1: the whole package of it works very well for smokers.

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Speaker 1: It's easy to use, delivers it can if you want

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Speaker 1: it to deliver nicotine roughly the same levels that cigarettes can.

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Speaker 1: It's small, it's compact, uh uses low volumes of liquid,

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Speaker 1: and it looks Okay, so that package has been very,

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Speaker 1: very attractive with smokers. It's not obvious that, you know.

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Speaker 1: I think one of the things that smokers are trying

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Speaker 1: to do is they're trying to get away from the

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Speaker 1: experience of smoking. So the heated tobacco products are very

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Speaker 1: good and they work for some people some of the time,

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Speaker 1: and one of the reasons that they work is the

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Speaker 1: experience is closer to smoking. So for people who want

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Speaker 1: something that is a closer substitute, they work very well.

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Speaker 1: But the whole bunch of other people who want to

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Speaker 1: migrate away from smoking and end up using a flavor

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Speaker 1: that is, I don't know, peach Melbourne or something that

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Speaker 1: has no echoes or cues associated with smoking whatsoever. So

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Speaker 1: I think you've got to be really careful before you say, well,

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Speaker 1: on the basis of these kids using these products, we're

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Speaker 1: going to stop the adult smokers who are actually the

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Speaker 1: at risk population from having access to these products that

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Speaker 1: they really like and work for them. And at the

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Speaker 1: same time, you've also got to keep coming back to this,

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Speaker 1: You've got to be mindful that there's a lot of

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Speaker 1: kids who would otherwise be smoking, otherwise doing other risk behaviors.

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Speaker 1: And I think if I was one of these concerned parents,

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Speaker 1: if you were to sit down and rank the list

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Speaker 1: of things that you should be worried about as a parent, Okay,

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Speaker 1: drink driving would be up there at number one. I mean,

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Speaker 1: kids getting smashed up in cars is the number one

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Speaker 1: cause of death in the age range from fifteen to

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Speaker 1: twenty four, and that's driven by reckless driving, often fueled

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Speaker 1: by alcohol, So that I think would be my number one.

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Speaker 1: I would be really concerned about vulnerabilities caused by alcohol,

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Speaker 1: the risk of violence, the risk of sexual assault, and

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Speaker 1: so on. I would be concerned about some of the

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Speaker 1: things that are going on now, like cyber bullying, some

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Speaker 1: of the things that go on in terms of the

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Speaker 1: way social media are used. I would be really concerned

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Speaker 1: about kids mental health status, what's going on with self

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Speaker 1: harm and kids being depressed and suicidal ideation and so on,

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Speaker 1: And be extremely concerned about any uptake of opioids and

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Speaker 1: use of fentanyl. As I say, I think it's important

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Speaker 1: to get these risks, the risk associated with vaping, which

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Speaker 1: are very very low in context with the whole panoply

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Speaker 1: of youth risk behaviors, and behave accordingly and recognize that

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Speaker 1: for a whole section of the population, these vaping products

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Speaker 1: are extremely beneficial and maybe life saving for them. So

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Speaker 1: it's not just that vaping is a lesser public health

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Speaker 1: problem and smoking. It is actually a huge public health

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Speaker 1: benefit for smokers who managed to switch. And that's the

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Speaker 1: kind of grown up discussion we need to have about

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Speaker 1: these products, including with parents and the flavors issue, because

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Speaker 1: sometimes hear people saying, Okay, allow the tobacco flavored eat cigarettes,

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Speaker 1: but band you know all the ones that the kids like,

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Speaker 1: what's your response to that. Well, I mean, there's a

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Speaker 1: lot to say about that. But obviously the purpose of flavors,

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Speaker 1: I mean, it can't be denied, and it's trivially obvious.

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Speaker 1: Flavors are put in the products to make them more attractive.

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Speaker 1: And if you have an unflavored vape doesn't really taste

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Speaker 1: of anything. So what you're trying to do is create

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Speaker 1: a rival proposition to smoking. Now, smoking is full of flavor.

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Speaker 1: It's not added flavors, but it's full of flavor that

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Speaker 1: comes from the smoke, the actual products of combustion. So

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Speaker 1: to satisfy somebody who smokes, you need something in its place.

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Speaker 1: You need the products to actually taste interesting and be good,

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Speaker 1: otherwise no one will use them. It simply won't play

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Speaker 1: a role in displacing smoking and driving down smoking related disease.

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Speaker 1: The interesting thing about the flavors debate in the United

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Speaker 1: States is that the activist community, the anti aping activist community,

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Speaker 1: started off saying, well, we shouldn't have things like gummy

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Speaker 1: bear or cotton candy flavors because these are obviously childish

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Speaker 1: type things. And then they discovered that kids were or

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00:25:15,240 --> 00:25:21,160
Speaker 1: adolescents were taking up duel. But duwel comes in fairly bland, well,

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00:25:21,200 --> 00:25:29,200
Speaker 1: fairly bland sounding flavors, so cucumber, mango, crem so these

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Speaker 1: flavors were not in any way targeted at kids, but

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Speaker 1: because kids were using them, the activist organization said, ha ha,

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Speaker 1: those must be kids appealing flavors too, so we need

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Speaker 1: to ban all of those. So what started off as

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Speaker 1: a niche proposition that you would ban things that were

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Speaker 1: obviously childlike like gummy bear or whatever, suddenly massively expanded

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Speaker 1: in scope to include every flavor that wasn't a tobacco flavor.

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Speaker 1: So the real fanatics in this field now, so you

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Speaker 1: should ban every flavor that isn't a tobacco flavor, And

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Speaker 1: for some reason they think it's a good thing that

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Speaker 1: the only vaping products you should have on the market should,

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Speaker 1: as far as possible, resemble cigarettes. I simply don't understand

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Speaker 1: the logic of that, so I don't agree with flavor

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Speaker 1: bands where I think you could do something. There are

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Speaker 1: basically three ways of controlling flavors. The first is as

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Speaker 1: a chemical So do the chemical agents in this flavor

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Speaker 1: cause cancer? Are the immutagenic? Are they reprotoxic? Are the

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00:26:32,680 --> 00:26:36,879
Speaker 1: respiratory sensitizers? So treat them as toxic agencies? And if

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Speaker 1: they are, then don't allow them or restrict them in

429
00:26:39,280 --> 00:26:44,800
Speaker 1: some way. Secondly, you have a flavor sensation, so you

430
00:26:44,880 --> 00:26:49,040
Speaker 1: subjectively decide that this product taste of apple, or it

431
00:26:49,119 --> 00:26:53,639
Speaker 1: tastes of key lime pie, or it tastes of tequila

432
00:26:53,720 --> 00:26:56,800
Speaker 1: sunrise or something that is a much harder thing to

433
00:26:56,960 --> 00:26:59,679
Speaker 1: interact with that that's a subjective opinion of what the

434
00:26:59,680 --> 00:27:01,960
Speaker 1: flame that is, and I don't think you should be

435
00:27:01,960 --> 00:27:05,400
Speaker 1: trying to ban that. The third area that you can

436
00:27:05,440 --> 00:27:10,200
Speaker 1: regulate in terms of flavors is the flavor descriptor. So

437
00:27:10,600 --> 00:27:13,080
Speaker 1: you know, we call this gummy bear or we call

438
00:27:13,160 --> 00:27:16,639
Speaker 1: it cotton candy, or we call it unicorn vomit, or

439
00:27:16,680 --> 00:27:20,800
Speaker 1: we call it something that is designed to capture the

440
00:27:20,840 --> 00:27:24,639
Speaker 1: imagination of kids. Now, that is an area where I

441
00:27:24,680 --> 00:27:29,440
Speaker 1: think you could justify intervention, not so much the flavor itself,

442
00:27:29,480 --> 00:27:33,280
Speaker 1: but the communication about the flavor and the attempt to

443
00:27:34,240 --> 00:27:36,679
Speaker 1: appeal to kids. Now, I happen to think that a

444
00:27:36,680 --> 00:27:40,239
Speaker 1: lot of adults like childish sounding things, as well as

445
00:27:40,240 --> 00:27:42,760
Speaker 1: a lot of nostalgia and retro in there. But if

446
00:27:42,760 --> 00:27:45,679
Speaker 1: you're going to regulate anywhere, I think it should be

447
00:27:45,720 --> 00:27:52,560
Speaker 1: on the descriptors, not on the flavors themselves. We'll be

448
00:27:52,600 --> 00:28:07,240
Speaker 1: talking more after we hear this add So some people say,

449
00:28:07,280 --> 00:28:10,560
Speaker 1: I mean, the UK seems to be United Kingdom seems

450
00:28:10,560 --> 00:28:13,480
Speaker 1: to be one of the models for embracing to some extent,

451
00:28:13,560 --> 00:28:16,640
Speaker 1: a harm reduction approach. You know, even e cigarettes tapes

452
00:28:16,680 --> 00:28:19,760
Speaker 1: can be sold in hospital shops, and you know, the

453
00:28:19,760 --> 00:28:23,160
Speaker 1: governments started behind getting people to transition, and it appears

454
00:28:23,320 --> 00:28:26,400
Speaker 1: that the uptake among young people is much lower than

455
00:28:26,440 --> 00:28:29,280
Speaker 1: in the US. But some people then say, well, that's

456
00:28:29,320 --> 00:28:33,280
Speaker 1: because the UK limits the nicotine level of these cigarettes.

457
00:28:33,359 --> 00:28:35,320
Speaker 1: You know that jewel or others are what is it

458
00:28:35,400 --> 00:28:37,920
Speaker 1: fifty milligrams or whatever. In the UK, it's got to

459
00:28:37,960 --> 00:28:40,880
Speaker 1: be half or a third of that. So what about

460
00:28:40,960 --> 00:28:45,600
Speaker 1: restricting the nicotine content. Well, again, there's a lot to

461
00:28:45,600 --> 00:28:47,840
Speaker 1: say about that. I mean, people have noted that there's

462
00:28:47,840 --> 00:28:50,640
Speaker 1: a limit of on the strength of nicotine in the

463
00:28:50,760 --> 00:28:54,440
Speaker 1: cigarettes in Europe and still including in the UK. It's

464
00:28:54,560 --> 00:28:56,760
Speaker 1: very difficult to show that that is the reason why

465
00:28:56,800 --> 00:29:00,800
Speaker 1: there is a low level of the cigarett at uptake

466
00:29:01,080 --> 00:29:04,680
Speaker 1: in UK kids. We do have the problem that I

467
00:29:04,720 --> 00:29:07,920
Speaker 1: don't think products like the Jewel product have been anything

468
00:29:07,920 --> 00:29:11,840
Speaker 1: like as effective at converting smokers in the UK as

469
00:29:11,880 --> 00:29:14,520
Speaker 1: we've seen in the United States. It's a bit hard

470
00:29:14,560 --> 00:29:18,080
Speaker 1: to really understand why cigarette smoking or vaping goes up

471
00:29:18,120 --> 00:29:21,160
Speaker 1: and down anywhere, but I suspect it's something to do

472
00:29:21,240 --> 00:29:26,320
Speaker 1: with fashion, with the way group preferences are are formed,

473
00:29:26,920 --> 00:29:30,000
Speaker 1: and I have to say I think it's probably something

474
00:29:30,040 --> 00:29:34,040
Speaker 1: to do with the near hysterical levels of moral panic

475
00:29:34,080 --> 00:29:38,000
Speaker 1: about vaping in the United States. C d C did

476
00:29:38,440 --> 00:29:41,400
Speaker 1: a survey I think it was two thousand and eighteen

477
00:29:41,920 --> 00:29:45,480
Speaker 1: and looked for the reasons kids said that they were

478
00:29:45,520 --> 00:29:50,080
Speaker 1: taking up vaping, and the number one reason was curiosity

479
00:29:50,480 --> 00:29:54,440
Speaker 1: and flavors were number three, and you know, less than

480
00:29:54,520 --> 00:29:58,000
Speaker 1: half of the kids cited that compared to curiosity. Now,

481
00:29:58,080 --> 00:30:02,320
Speaker 1: if you've got every newspaper, every parents, every teacher, every agency,

482
00:30:02,400 --> 00:30:06,320
Speaker 1: every TV station blasting out at you, hey, kids, all

483
00:30:06,360 --> 00:30:09,880
Speaker 1: other kids are doing this. People think it's fashionable. People

484
00:30:09,920 --> 00:30:12,520
Speaker 1: think it's really cool. Look here's how you hide it

485
00:30:12,560 --> 00:30:14,920
Speaker 1: in your rucksack. There's a whole bunch of kids that

486
00:30:14,960 --> 00:30:18,320
Speaker 1: can even do it in class. You've got these sort

487
00:30:18,320 --> 00:30:23,440
Speaker 1: of bizarrely weird anti vaping campaigns that sort of, you know,

488
00:30:23,520 --> 00:30:26,640
Speaker 1: hark back to sort of reefer madness, kind of levels

489
00:30:26,640 --> 00:30:31,560
Speaker 1: of bizarreness. I just suspect that that may actually be

490
00:30:31,640 --> 00:30:36,320
Speaker 1: a contributory driver, because which respectable kids says, well, this

491
00:30:36,400 --> 00:30:39,520
Speaker 1: is something I must now try. If adult society is

492
00:30:39,560 --> 00:30:43,320
Speaker 1: this upset about it. In the UK, the whole thing

493
00:30:43,440 --> 00:30:48,360
Speaker 1: is much more mundane. The government advertises e cigarettes on

494
00:30:48,440 --> 00:30:54,920
Speaker 1: television and pitches it at rather uninspiring kind of forty

495
00:30:55,120 --> 00:30:59,160
Speaker 1: plus year old people. It looks like something that kind

496
00:30:59,200 --> 00:31:03,080
Speaker 1: of more older people do as an alternative to smoking,

497
00:31:03,640 --> 00:31:07,719
Speaker 1: and we don't have everybody losing their minds about it.

498
00:31:07,720 --> 00:31:12,000
Speaker 1: It's seen as something that's good for health, and something

499
00:31:12,000 --> 00:31:14,160
Speaker 1: that you should do if you're a committed smoker. That's

500
00:31:14,160 --> 00:31:17,960
Speaker 1: how the positioning has been. So I think those reasons

501
00:31:17,960 --> 00:31:21,720
Speaker 1: are probably more likely than the nicotine reason. I mean,

502
00:31:21,760 --> 00:31:25,440
Speaker 1: going to why I think the nicotine reason is less likely.

503
00:31:25,520 --> 00:31:28,160
Speaker 1: I mean the nicotine strength thing is a little bit

504
00:31:28,200 --> 00:31:31,640
Speaker 1: of a red herring in understanding this. Just because a

505
00:31:31,760 --> 00:31:35,520
Speaker 1: nicotine liquid is stronger doesn't mean you consume more nicotine.

506
00:31:35,720 --> 00:31:38,080
Speaker 1: It means you consume less liquid. It's a little bit

507
00:31:38,200 --> 00:31:41,680
Speaker 1: like whiskey. You know, you don't consume whiskey by the

508
00:31:41,760 --> 00:31:45,600
Speaker 1: point you consume it by a few millilitres at a time.

509
00:31:45,640 --> 00:31:49,080
Speaker 1: It's not something that you glugged down like you would

510
00:31:49,120 --> 00:31:51,800
Speaker 1: glug down beer. And it's the same kind of thing

511
00:31:51,840 --> 00:31:55,400
Speaker 1: with stronger vaping liquids. So the dual product uses a

512
00:31:55,440 --> 00:31:59,000
Speaker 1: strong liquid, but the user will get about the same

513
00:31:59,080 --> 00:32:01,880
Speaker 1: nicotine that some body using a weak liquid in a

514
00:32:01,960 --> 00:32:04,840
Speaker 1: much larger device would use. Well, some people have come

515
00:32:04,840 --> 00:32:07,080
Speaker 1: back and you say, Okay, I buy your argument about

516
00:32:07,200 --> 00:32:09,560
Speaker 1: the benefits for adults, but why not just make it

517
00:32:09,600 --> 00:32:12,200
Speaker 1: available by prescription. That will help keep it out of

518
00:32:12,240 --> 00:32:14,440
Speaker 1: here as kids and adults can still get it just

519
00:32:14,480 --> 00:32:17,520
Speaker 1: as easily as they get other drugs that doctors prescribed

520
00:32:17,600 --> 00:32:20,880
Speaker 1: very easily. Why not? Why not prescription only? The reason

521
00:32:21,000 --> 00:32:23,520
Speaker 1: is that if you're dealing with a population of smokers,

522
00:32:23,520 --> 00:32:26,600
Speaker 1: you're trying to get them to do something that they

523
00:32:26,720 --> 00:32:30,400
Speaker 1: may be reluctant to try. If you start to put

524
00:32:30,520 --> 00:32:34,320
Speaker 1: barriers in the way of people accessing the alternatives, or

525
00:32:34,360 --> 00:32:40,040
Speaker 1: if you misunderstand their drive to use these products, then

526
00:32:40,080 --> 00:32:43,400
Speaker 1: you will get a much lower rate of switching. So

527
00:32:43,600 --> 00:32:48,200
Speaker 1: there are really two kind of competing models for quitting smoking.

528
00:32:48,240 --> 00:32:51,520
Speaker 1: One is this sort of medical route in which you

529
00:32:52,080 --> 00:32:57,200
Speaker 1: get a nicotine replacement therapy or a pharmaceutical prescription only

530
00:32:57,360 --> 00:33:01,200
Speaker 1: preparation like verenically or be appropriate, and the idea of

531
00:33:01,240 --> 00:33:06,200
Speaker 1: those is to manage withdrawal and craving while you move

532
00:33:06,320 --> 00:33:12,160
Speaker 1: from smoking to abstinence. The e cigarette public health model

533
00:33:12,200 --> 00:33:16,280
Speaker 1: works in a completely different way. It works by replacing

534
00:33:16,360 --> 00:33:21,480
Speaker 1: one pleasure smoking with another pleasure, vaping that has many

535
00:33:21,520 --> 00:33:26,520
Speaker 1: of the same characteristics. So it's branded, It comes in flavors,

536
00:33:27,080 --> 00:33:30,840
Speaker 1: it has a nicotine delivery that you like, It has

537
00:33:31,120 --> 00:33:35,000
Speaker 1: throat sensation, hands and mouth movement, It forms part of

538
00:33:35,080 --> 00:33:38,520
Speaker 1: behavioral rituals, and so on. It replaces many things that

539
00:33:38,560 --> 00:33:42,720
Speaker 1: people get from smoking, but with a lot lower risk.

540
00:33:43,080 --> 00:33:47,560
Speaker 1: So it's an alternative consumer proposition. Now, if you suddenly

541
00:33:47,600 --> 00:33:51,440
Speaker 1: try to take that and cram it into the medical box,

542
00:33:51,960 --> 00:33:55,520
Speaker 1: you're breaking the basic appeal that that proposition has to

543
00:33:56,040 --> 00:33:58,880
Speaker 1: smokers who do not always see themselves as sick and

544
00:33:58,960 --> 00:34:03,040
Speaker 1: in need of treatment the healthcare system. Okay, so Clive,

545
00:34:03,560 --> 00:34:07,880
Speaker 1: the people selling these cigarettes right are ultimately gonna be

546
00:34:08,000 --> 00:34:10,640
Speaker 1: Big Tobacco. They didn't start it right. It got started

547
00:34:10,640 --> 00:34:13,360
Speaker 1: as something that was almost challenging Big tobacco, and the

548
00:34:13,400 --> 00:34:16,239
Speaker 1: whole vaping world was anti big tobacco. But when big

549
00:34:16,239 --> 00:34:19,200
Speaker 1: tobacco saw the opportunities and maybe saw the writing on

550
00:34:19,239 --> 00:34:21,759
Speaker 1: the wall, and what I also hear from people is

551
00:34:22,000 --> 00:34:26,400
Speaker 1: so okay, cigarette markets are declining, Big tobacco is trying

552
00:34:26,440 --> 00:34:29,680
Speaker 1: to save its ask by getting people addicted to something new.

553
00:34:30,239 --> 00:34:33,080
Speaker 1: They are now going to be doing ever more sophisticated

554
00:34:33,160 --> 00:34:35,800
Speaker 1: east cigarette and other types of devices. They're going to

555
00:34:35,880 --> 00:34:38,359
Speaker 1: be hooking a whole new generation to a new set

556
00:34:38,400 --> 00:34:41,600
Speaker 1: of nicotine products that they'll be making money on. And

557
00:34:41,640 --> 00:34:44,719
Speaker 1: in the same way that decades ago Big Tobacco experiment

558
00:34:44,760 --> 00:34:47,319
Speaker 1: it would how to make cigarettes more addictive. Now they're

559
00:34:47,320 --> 00:34:49,080
Speaker 1: gonna be trying to figure out how to make these

560
00:34:49,120 --> 00:34:53,000
Speaker 1: e cigarettes more addictive so that a young generation starts

561
00:34:53,120 --> 00:34:55,959
Speaker 1: like they did with cigarettes, you know, decade and generations ago,

562
00:34:56,400 --> 00:35:01,240
Speaker 1: and they become lifelong consumers with a product debt is

563
00:35:01,520 --> 00:35:05,000
Speaker 1: still of you know, safer than cigarettes, but we don't

564
00:35:05,040 --> 00:35:09,840
Speaker 1: know how much safer. So Big Tobacco is a burden

565
00:35:10,080 --> 00:35:12,080
Speaker 1: that all of us who work on the public health

566
00:35:12,120 --> 00:35:16,960
Speaker 1: side of this have to contend with. They worked tirelessly

567
00:35:17,080 --> 00:35:23,000
Speaker 1: to acquire a truly dreadful reputation over smoking and disease,

568
00:35:23,160 --> 00:35:28,600
Speaker 1: and they deserve their pariah status, and their involvement in

569
00:35:28,680 --> 00:35:32,880
Speaker 1: this makes things much more difficult. Ironically, I think in

570
00:35:32,920 --> 00:35:36,880
Speaker 1: a way that cartel involvement in in the drug trade

571
00:35:37,200 --> 00:35:40,759
Speaker 1: hasn't actually been a barrier to harm reduction, and may

572
00:35:40,760 --> 00:35:43,680
Speaker 1: be wrong about that, but I feel that the salience

573
00:35:43,800 --> 00:35:47,240
Speaker 1: of Big Tobacco in the nicotine and harm reduction debate

574
00:35:47,360 --> 00:35:50,600
Speaker 1: actually has been very negative. But there's not much they

575
00:35:50,640 --> 00:35:55,160
Speaker 1: can do about that. Their incentives are to go where

576
00:35:55,160 --> 00:35:58,440
Speaker 1: the consumer goes, and if the consumer is switching their

577
00:35:58,480 --> 00:36:03,720
Speaker 1: preferences for nicotine, you from smoking to vaping too heated

578
00:36:03,760 --> 00:36:07,520
Speaker 1: tobacco products to other noncombustible products. Then that is where

579
00:36:07,880 --> 00:36:11,560
Speaker 1: the tobacco companies will go. And I think what we're

580
00:36:11,560 --> 00:36:14,239
Speaker 1: seeing is that they will evolve, and they are. This

581
00:36:14,320 --> 00:36:20,040
Speaker 1: is happening already. They are evolving into nicotine companies and

582
00:36:20,640 --> 00:36:23,839
Speaker 1: to varying degrees. And the companies are not monolithic. There

583
00:36:23,880 --> 00:36:26,040
Speaker 1: isn't really a big tobacco They're all different and they

584
00:36:26,040 --> 00:36:29,279
Speaker 1: all compete with each other, but to varying degrees. The

585
00:36:29,360 --> 00:36:35,480
Speaker 1: companies are trying themselves to make a transition from combustible

586
00:36:35,520 --> 00:36:40,840
Speaker 1: to noncombustible products. So Philip Morris International, biggest company in

587
00:36:40,880 --> 00:36:44,600
Speaker 1: the world outside China, I think, now has something like

588
00:36:44,640 --> 00:36:50,160
Speaker 1: twenty three percent of its net revenue from non smoked products,

589
00:36:50,239 --> 00:36:53,080
Speaker 1: up from you know, a tiny fraction in around point

590
00:36:53,080 --> 00:36:56,960
Speaker 1: one percent in two thousand and fifteen. So those companies

591
00:36:56,960 --> 00:37:00,560
Speaker 1: are undergoing a transition, and that is base sickly a

592
00:37:00,640 --> 00:37:05,359
Speaker 1: good thing. It is good that they are trying and

593
00:37:05,440 --> 00:37:10,080
Speaker 1: hopefully increasingly driven out of the merchant of death business.

594
00:37:10,600 --> 00:37:13,480
Speaker 1: The more that we can encourage them to do that,

595
00:37:13,560 --> 00:37:19,040
Speaker 1: the less heavily their footprints will tread on global mortality.

596
00:37:19,080 --> 00:37:22,120
Speaker 1: That would be a good outcome. We get back to

597
00:37:22,760 --> 00:37:26,440
Speaker 1: sort of fundamentals here, What are we actually dealing with.

598
00:37:26,640 --> 00:37:29,040
Speaker 1: Are we dealing with something that would simply go away

599
00:37:29,040 --> 00:37:31,799
Speaker 1: if the tobacco companies went away, Well, I don't think

600
00:37:31,840 --> 00:37:36,800
Speaker 1: we are. I think nicotine is amongst the legal recreational

601
00:37:36,920 --> 00:37:40,840
Speaker 1: drugs that have proved popular in society, had been popular

602
00:37:40,880 --> 00:37:45,120
Speaker 1: for you know, many centuries, and I think in trying

603
00:37:45,160 --> 00:37:48,680
Speaker 1: to sort of wish away nicotine us, we're making some

604
00:37:48,719 --> 00:37:52,480
Speaker 1: of the same mistakes that the sort of abstinence only

605
00:37:52,520 --> 00:37:56,719
Speaker 1: crowd in drug policy have made. It's much better to

606
00:37:56,880 --> 00:37:59,600
Speaker 1: work with the assumption that people will wish to use

607
00:37:59,640 --> 00:38:02,160
Speaker 1: these drugs and in the case of nicotine, is a

608
00:38:02,280 --> 00:38:06,080
Speaker 1: relatively benign drug, and try to make arrangements so that

609
00:38:06,120 --> 00:38:10,400
Speaker 1: they can be used safely with some sort of accountability,

610
00:38:10,600 --> 00:38:17,759
Speaker 1: quality control, redress, taxation, and regulated management of the risks

611
00:38:17,840 --> 00:38:22,040
Speaker 1: and the noncombustible products allow us to do that and

612
00:38:22,320 --> 00:38:25,279
Speaker 1: create a platform I think for people who want to

613
00:38:25,360 --> 00:38:29,480
Speaker 1: use nicotine for the foreseeable future, in which the tobacco

614
00:38:29,560 --> 00:38:32,360
Speaker 1: companies are bound to play some sort of role. But

615
00:38:32,520 --> 00:38:35,680
Speaker 1: that's a good thing. They have an enormous reach, and

616
00:38:35,840 --> 00:38:38,920
Speaker 1: if they manage to convert most of their customers, we'd

617
00:38:38,920 --> 00:38:43,239
Speaker 1: see the smoking disease epidemic fade away pretty quickly, and

618
00:38:43,360 --> 00:38:45,720
Speaker 1: it kindly seems to me there's the dynamic you wide

619
00:38:45,960 --> 00:38:49,600
Speaker 1: is that you wid startup companies, very disruptive companies like

620
00:38:49,719 --> 00:38:52,520
Speaker 1: Jewel wise or if you think about like Tesla wise

621
00:38:52,600 --> 00:38:55,839
Speaker 1: with respect to electric vehicles, right, that you want these

622
00:38:55,880 --> 00:38:58,880
Speaker 1: independent companies who are committed to taking over the world

623
00:38:58,960 --> 00:39:02,840
Speaker 1: selling their base sickly safer product to be challenging the

624
00:39:02,880 --> 00:39:06,120
Speaker 1: traditional companies that are selling their more dangerous product. And

625
00:39:06,160 --> 00:39:09,399
Speaker 1: then you want the big tobacco companies are the same

626
00:39:09,400 --> 00:39:11,600
Speaker 1: thing with the big auto companies. You want them feeling

627
00:39:11,680 --> 00:39:14,080
Speaker 1: so challenged that they see no choice except to move

628
00:39:14,120 --> 00:39:16,800
Speaker 1: in that direction as well. Yet, at the same time,

629
00:39:17,280 --> 00:39:20,080
Speaker 1: if it's left just up to big tobacco, if they're

630
00:39:20,120 --> 00:39:23,560
Speaker 1: taking over the whole East cigarette and harm reduction product market,

631
00:39:23,960 --> 00:39:27,120
Speaker 1: I mean big tobacco, their bottom line is the shareholder

632
00:39:27,280 --> 00:39:30,200
Speaker 1: is profits. Right, So even when they say they're committed

633
00:39:30,600 --> 00:39:33,560
Speaker 1: to moving the harmonduction direction, even when they're doing stuff

634
00:39:33,560 --> 00:39:36,080
Speaker 1: to do that, they still may not wanted to move

635
00:39:36,120 --> 00:39:39,600
Speaker 1: too quickly in that direction because that might undermine their profits.

636
00:39:39,640 --> 00:39:42,560
Speaker 1: They would seem to have an interest in moderating the

637
00:39:42,640 --> 00:39:46,680
Speaker 1: transition because cigarettes are immensely profitable to them, more than

638
00:39:46,719 --> 00:39:49,080
Speaker 1: the East cigarettes are at this point. So I mean

639
00:39:49,120 --> 00:39:52,160
Speaker 1: the question is, how does one incentivize the big tobacco

640
00:39:52,200 --> 00:39:54,680
Speaker 1: companies to move as quickly as possible as are there

641
00:39:54,680 --> 00:39:56,720
Speaker 1: things that government can do or there are other ways

642
00:39:56,760 --> 00:39:59,840
Speaker 1: to do this? Look Ethan, I agree with that not

643
00:40:00,400 --> 00:40:03,560
Speaker 1: very strongly. I think the example of Tesla is a

644
00:40:03,600 --> 00:40:06,520
Speaker 1: really interesting one because what you have there is, you know,

645
00:40:06,680 --> 00:40:12,879
Speaker 1: radical innovator, but the worldwide impact of electric vehicles will

646
00:40:12,920 --> 00:40:17,400
Speaker 1: be felt through whatever Toyota and Volkswagen do, what General

647
00:40:17,440 --> 00:40:21,000
Speaker 1: Motors and Ford do, not what Tesla does. And so

648
00:40:21,280 --> 00:40:24,200
Speaker 1: I think that model is exactly right. And we've had

649
00:40:24,239 --> 00:40:28,880
Speaker 1: that up through the previous decade. The smaller, if you like,

650
00:40:29,080 --> 00:40:34,120
Speaker 1: insurgent e cigarette companies have changed the game and completely

651
00:40:34,200 --> 00:40:38,480
Speaker 1: changed consumer expectations. They've made this a thing, and now

652
00:40:38,520 --> 00:40:41,120
Speaker 1: the tobacco companies have to follow, and they'll follow by

653
00:40:41,160 --> 00:40:45,880
Speaker 1: acquisition or by innovation in their own labs. And that

654
00:40:46,040 --> 00:40:49,239
Speaker 1: is a good dynamic. That is how you get a

655
00:40:49,320 --> 00:40:53,000
Speaker 1: technology change. That is the process of creative destruction working

656
00:40:53,080 --> 00:40:57,839
Speaker 1: as intended as new innovations diffused through the user population

657
00:40:57,920 --> 00:41:01,680
Speaker 1: to obsolete the old technology. The question then is how

658
00:41:01,760 --> 00:41:06,000
Speaker 1: do you incentivize that process so that it works faster,

659
00:41:06,320 --> 00:41:09,799
Speaker 1: better and the change is more rapid and deeper. And

660
00:41:09,880 --> 00:41:13,880
Speaker 1: again here it's about taking the incentives of all the

661
00:41:13,920 --> 00:41:18,680
Speaker 1: companies involved and aligning them with transition from high risk

662
00:41:18,760 --> 00:41:24,239
Speaker 1: to low risk products, both as consumers and producers. And

663
00:41:24,560 --> 00:41:27,719
Speaker 1: this is one of the frustrations I have. My frustration

664
00:41:27,800 --> 00:41:30,239
Speaker 1: is coming over here. It's one of the frustrations I

665
00:41:30,320 --> 00:41:33,000
Speaker 1: have is that so many people in the public health

666
00:41:33,160 --> 00:41:37,839
Speaker 1: world seem to be working against that huge amounts of

667
00:41:37,960 --> 00:41:43,200
Speaker 1: money seemed to be going into slowing this highly desirable

668
00:41:43,280 --> 00:41:47,400
Speaker 1: creative destruction process from high risk to low risk products.

669
00:41:48,160 --> 00:41:51,239
Speaker 1: If you take the situation in the United States, the

670
00:41:51,320 --> 00:41:57,120
Speaker 1: process for licensing and e cigarette product is massively burdensome,

671
00:41:57,640 --> 00:42:03,520
Speaker 1: requiring a huge authorizing shan process running to millions of

672
00:42:03,560 --> 00:42:07,760
Speaker 1: dollars per unit that really only the biggest companies can afford.

673
00:42:08,680 --> 00:42:13,400
Speaker 1: The FDA itself is creating a dynamic that will restore

674
00:42:13,840 --> 00:42:18,759
Speaker 1: the tobacco industry oligopoly in the e cigarette market, replicating

675
00:42:18,760 --> 00:42:21,560
Speaker 1: the oligopoly it has in the cigarette market. We see

676
00:42:21,760 --> 00:42:27,160
Speaker 1: who going around the world applauding every time a developing

677
00:42:27,200 --> 00:42:33,640
Speaker 1: country outright bands e cigarettes, effectively introducing a regulatory protection

678
00:42:34,239 --> 00:42:38,480
Speaker 1: of the incumbent cigarette trade. I mean, nothing could be

679
00:42:38,520 --> 00:42:42,160
Speaker 1: more mad than that. Yet, in theory, the top public

680
00:42:42,160 --> 00:42:46,399
Speaker 1: health body in the world, that's its favored policy prohibit

681
00:42:46,600 --> 00:42:52,439
Speaker 1: e cigarettes outright leave the cigarette trade relatively untouched. Yeah. Well, Clive,

682
00:42:52,480 --> 00:42:54,440
Speaker 1: I think we're getting to the issue of the elephant

683
00:42:54,480 --> 00:42:57,400
Speaker 1: in the room here, which is a fellow named Michael Bloomberg.

684
00:42:57,440 --> 00:42:59,719
Speaker 1: You know, my distinguished mayor for many years in the

685
00:42:59,840 --> 00:43:02,960
Speaker 1: Ark City. But here's a guy who's what maybe the

686
00:43:02,960 --> 00:43:05,840
Speaker 1: tenth wealthiest guy in the world, you know, fifties sixty

687
00:43:05,840 --> 00:43:08,320
Speaker 1: billion dollars a year. He put a lot of money

688
00:43:08,480 --> 00:43:10,719
Speaker 1: into trying to get people to quit smoking, which I

689
00:43:10,800 --> 00:43:13,160
Speaker 1: think we can agree was a very good thing for him.

690
00:43:13,600 --> 00:43:16,760
Speaker 1: But he's now spending, you know, committed hundreds of billions

691
00:43:16,760 --> 00:43:20,000
Speaker 1: of dollars to banning vaping. And then I look deeper

692
00:43:20,120 --> 00:43:22,520
Speaker 1: and you see that he's given a hundred million dollars

693
00:43:22,560 --> 00:43:25,759
Speaker 1: I think, to the w h L World Health Organizations Foundation,

694
00:43:26,000 --> 00:43:28,360
Speaker 1: and he's given a hundred million dollars to the CDC,

695
00:43:28,600 --> 00:43:31,319
Speaker 1: the foundation of the Center for Disease Control, and he's

696
00:43:31,360 --> 00:43:33,920
Speaker 1: funding all these groups that we're talking about, right, So

697
00:43:34,160 --> 00:43:37,560
Speaker 1: it seems to me there's a powerful, corrupting thing going

698
00:43:37,640 --> 00:43:41,080
Speaker 1: on here with somebody who's been very committed in other

699
00:43:41,120 --> 00:43:43,880
Speaker 1: areas to public health and even to harm reduction, but

700
00:43:44,000 --> 00:43:48,919
Speaker 1: who has a kind of ideological prohibitionist abstinence view here.

701
00:43:49,360 --> 00:43:52,160
Speaker 1: And I'm wondering if there's you know, how far does

702
00:43:52,239 --> 00:43:55,920
Speaker 1: this influence go. I mean, you look at the medical societies,

703
00:43:55,920 --> 00:43:59,319
Speaker 1: You're the ones, the cancer societies, the heart associations, I mean,

704
00:43:59,360 --> 00:44:02,880
Speaker 1: even these organizations that should be leading advocates for protecting

705
00:44:02,920 --> 00:44:06,799
Speaker 1: health buying into the anti harmonuction thing. Is all that

706
00:44:07,040 --> 00:44:09,759
Speaker 1: just about this money? Or is it? I mean, what

707
00:44:09,960 --> 00:44:14,759
Speaker 1: is it? M So Look, I mean Mr Bloomberg, I

708
00:44:15,080 --> 00:44:19,160
Speaker 1: don't doubt for one minute his intentions and his motivations

709
00:44:19,239 --> 00:44:21,600
Speaker 1: are good. I think he's trying to do good in

710
00:44:21,640 --> 00:44:24,120
Speaker 1: the world. He's trying to spend his fortune in a

711
00:44:24,160 --> 00:44:27,240
Speaker 1: way that improves things, and I think everyone should acknowledge

712
00:44:27,239 --> 00:44:29,839
Speaker 1: that he's done a lot of really good work. But look,

713
00:44:30,200 --> 00:44:35,200
Speaker 1: he's a financial services billionaire. He is not well connected

714
00:44:35,320 --> 00:44:38,760
Speaker 1: with public health or with the lived experience of people

715
00:44:39,440 --> 00:44:43,600
Speaker 1: who live in poverty and various forms of disadvantage. He

716
00:44:43,680 --> 00:44:46,279
Speaker 1: doesn't know what it's like to be a smoker or

717
00:44:46,320 --> 00:44:50,240
Speaker 1: a vapor and yet he's a kind of instinct player.

718
00:44:50,760 --> 00:44:54,720
Speaker 1: He is putting an immense amount of money into this field,

719
00:44:55,280 --> 00:44:59,120
Speaker 1: but matched by kind of billionaire confidence that what he's

720
00:44:59,160 --> 00:45:02,640
Speaker 1: doing is right and that the problem is that not

721
00:45:02,719 --> 00:45:06,040
Speaker 1: everything Mr Bloomberg does do is right or has the

722
00:45:06,080 --> 00:45:08,640
Speaker 1: effects that he expects it to have. You know, I

723
00:45:08,719 --> 00:45:11,440
Speaker 1: just say one example recently, so he has put a

724
00:45:11,560 --> 00:45:16,759
Speaker 1: hundred and sixty million dollars into campaigning to ban e

725
00:45:16,920 --> 00:45:21,760
Speaker 1: cigarette flavors in the United States. Now, in advocacy terms,

726
00:45:21,920 --> 00:45:25,520
Speaker 1: that is a gigantic sum of money to try and

727
00:45:25,600 --> 00:45:29,920
Speaker 1: secure a policy objective that is sort of relatively obscure

728
00:45:30,160 --> 00:45:33,000
Speaker 1: in kind of most people's thinking. Yet, we have just

729
00:45:33,080 --> 00:45:36,400
Speaker 1: had some early data in from San Francisco where they

730
00:45:36,400 --> 00:45:39,080
Speaker 1: did introduce a ban on e cigarette flavors, and you

731
00:45:39,080 --> 00:45:44,720
Speaker 1: know what happened, Youth smoking when up When surrounding districts

732
00:45:44,719 --> 00:45:48,600
Speaker 1: that are not bandy cigarette flavors, smoking rate continued to

733
00:45:48,640 --> 00:45:52,799
Speaker 1: track downwards. So there we have the example of an

734
00:45:52,920 --> 00:45:57,960
Speaker 1: unintended consequence arising. We can't say for certain about cause

735
00:45:58,000 --> 00:46:01,520
Speaker 1: and effect, but it appears very strong Lee related that

736
00:46:01,760 --> 00:46:05,520
Speaker 1: we had a policy measure favored by Mr Bloomberg, and look,

737
00:46:05,680 --> 00:46:09,680
Speaker 1: it's turned out to have an unintended consequences that causes

738
00:46:10,120 --> 00:46:13,719
Speaker 1: the public health impact be worse, not better as a

739
00:46:13,760 --> 00:46:17,680
Speaker 1: result of his investment. Now, Bloomberg also told The New

740
00:46:17,719 --> 00:46:21,279
Speaker 1: York Times during his run for the presidency that he

741
00:46:21,360 --> 00:46:24,840
Speaker 1: thought that vaping should be outright prohibited and that it

742
00:46:24,880 --> 00:46:27,120
Speaker 1: would be good if the future president of the United

743
00:46:27,160 --> 00:46:31,120
Speaker 1: States did that. Now, prohibition comes with just the worst

744
00:46:31,280 --> 00:46:36,880
Speaker 1: kind of possible unintended consequences. Yet he is promoting these

745
00:46:36,960 --> 00:46:40,640
Speaker 1: kind of policies around the world. He's put in over

746
00:46:40,680 --> 00:46:44,800
Speaker 1: a billion dollars worldwide inter campaigning, including into the World

747
00:46:44,800 --> 00:46:48,600
Speaker 1: Health Organization, including into the World Bank, including into a

748
00:46:48,719 --> 00:46:52,839
Speaker 1: large network of supposedly civil society organizations who really are

749
00:46:52,960 --> 00:46:57,759
Speaker 1: just kind of AstroTurf for him, all pushing these kind

750
00:46:57,800 --> 00:47:01,879
Speaker 1: of ideas, and they create a kind of out call

751
00:47:01,880 --> 00:47:05,920
Speaker 1: it a sort of Bloomberg anti vaping propaganda complex. It's

752
00:47:05,920 --> 00:47:12,480
Speaker 1: a gigantic enterprise funded by enormous quantities of money and

753
00:47:12,640 --> 00:47:18,960
Speaker 1: ideological commitment to actually marginalizing these products and marginalizing the

754
00:47:19,000 --> 00:47:23,520
Speaker 1: harm reduction concept in favor of his own preferred package

755
00:47:23,520 --> 00:47:27,200
Speaker 1: of measures which he thinks will lead to total abstinence.

756
00:47:27,480 --> 00:47:31,319
Speaker 1: So he's an abstinence only campaigner in a world of

757
00:47:31,400 --> 00:47:35,440
Speaker 1: public health that generally favors harm reduction in all other areas,

758
00:47:35,440 --> 00:47:39,880
Speaker 1: whether it's HIV, sexual health, drugs, alcohol, and sort on,

759
00:47:40,160 --> 00:47:43,560
Speaker 1: we tend to favor harm reduction and not him in

760
00:47:43,600 --> 00:47:47,520
Speaker 1: this area. And he is really causing an immense amount

761
00:47:47,520 --> 00:47:50,439
Speaker 1: of trouble, and his legacy, I'm afraid to say, will

762
00:47:50,480 --> 00:47:53,960
Speaker 1: be dominated I think by a reanalysis at some point

763
00:47:53,960 --> 00:47:56,720
Speaker 1: in the future that no one did more to protect

764
00:47:56,800 --> 00:48:00,640
Speaker 1: the incumbent cigarette trade than he did, and he will

765
00:48:00,719 --> 00:48:05,200
Speaker 1: bear responsibility for hundreds of thousands, maybe millions of deaths

766
00:48:05,200 --> 00:48:07,439
Speaker 1: as a result. Yeah, no, I mean claim. I agree.

767
00:48:07,480 --> 00:48:09,719
Speaker 1: It's a tragedy because you know, we look at the

768
00:48:09,760 --> 00:48:12,440
Speaker 1: evil work of big Tobacco over all those years and

769
00:48:12,480 --> 00:48:14,880
Speaker 1: how many people have died, and now to see Bloomberg's

770
00:48:14,880 --> 00:48:18,879
Speaker 1: philanthropic money basically, you know, standing in the way of

771
00:48:18,920 --> 00:48:22,279
Speaker 1: what would be an effective public health campaign, apparently because

772
00:48:22,320 --> 00:48:25,240
Speaker 1: he's just surrounded himself with the wrong people in this area.

773
00:48:26,280 --> 00:48:28,200
Speaker 1: Let's take a break here and go to an ad

774
00:48:38,880 --> 00:48:42,120
Speaker 1: When you look at the Heart Association the longer associated.

775
00:48:42,160 --> 00:48:45,680
Speaker 1: I mean, why are these medical associations, which should be

776
00:48:45,719 --> 00:48:48,319
Speaker 1: focused on the science and the evidence, why aren't they

777
00:48:48,400 --> 00:48:52,400
Speaker 1: getting much more behind tobacco harm reduction. Either. It's a

778
00:48:52,560 --> 00:48:55,440
Speaker 1: great question, and actually it's the question I'm most often

779
00:48:55,520 --> 00:48:57,480
Speaker 1: asked because a lot of people are like, you know,

780
00:48:57,600 --> 00:49:01,520
Speaker 1: can't understand why, why why can't everyone just get behind

781
00:49:01,560 --> 00:49:03,680
Speaker 1: this and will have dealt with smoking in a couple

782
00:49:03,719 --> 00:49:06,240
Speaker 1: of decades, it will be gone completely from the world,

783
00:49:06,560 --> 00:49:09,239
Speaker 1: you know, or it will be highly marginalized. I think

784
00:49:09,239 --> 00:49:12,360
Speaker 1: there's lots of reasons behind it. I think there is

785
00:49:12,800 --> 00:49:18,440
Speaker 1: a strong gut instinct of disgust about smoking that came

786
00:49:18,640 --> 00:49:23,200
Speaker 1: from people who were, you know, perhaps non smokers rights campaigners,

787
00:49:23,280 --> 00:49:25,800
Speaker 1: the fact that people had to grow up in smoky

788
00:49:25,920 --> 00:49:30,200
Speaker 1: environments and so on, and I think those people, their instinct,

789
00:49:30,200 --> 00:49:32,640
Speaker 1: their gut visceral instinct, is that they just want the

790
00:49:32,640 --> 00:49:36,439
Speaker 1: whole thing gone. Then I think there's the medical establishment view,

791
00:49:36,560 --> 00:49:39,279
Speaker 1: which is, look, we know best, you should give up

792
00:49:39,320 --> 00:49:43,239
Speaker 1: this habit using a medicalized approach that we favor. You

793
00:49:43,320 --> 00:49:46,040
Speaker 1: are our patient, you are in treatment, do what we

794
00:49:46,120 --> 00:49:49,480
Speaker 1: tell you, and you will recover and be cured. Unfortunately,

795
00:49:49,520 --> 00:49:53,240
Speaker 1: that model doesn't really work very well for most nicotine uses.

796
00:49:53,320 --> 00:49:55,239
Speaker 1: Most of the time, the success rates of that are

797
00:49:55,280 --> 00:49:58,600
Speaker 1: extremely low. And medically you're talking about things like nicotine

798
00:49:58,640 --> 00:50:01,040
Speaker 1: patches and arms and some of the parmaceutical products to

799
00:50:01,080 --> 00:50:04,440
Speaker 1: help people quit. Yeah, I think there's a medicalized model

800
00:50:04,600 --> 00:50:08,280
Speaker 1: behind this that says, oh, look, this is tobacco use disorder.

801
00:50:08,400 --> 00:50:13,280
Speaker 1: It's a psychiatric ailment. We will cure you using pharmaceuticals

802
00:50:13,320 --> 00:50:16,319
Speaker 1: that will deal with your withdrawal and cravings, and we

803
00:50:16,320 --> 00:50:18,759
Speaker 1: will get you from being a user to being abstinent.

804
00:50:19,000 --> 00:50:23,319
Speaker 1: That's a model. It's not one that says, actually, we're

805
00:50:23,360 --> 00:50:26,839
Speaker 1: cool with nicotine use, just don't smoke because that's what's

806
00:50:26,840 --> 00:50:30,680
Speaker 1: going to give you cancer, heart disease and respiratory ailments.

807
00:50:31,200 --> 00:50:34,319
Speaker 1: That is not the way medical people think about this,

808
00:50:34,400 --> 00:50:37,279
Speaker 1: and they've they've aligned around that. But I think I

809
00:50:37,280 --> 00:50:39,880
Speaker 1: think there's even bigger reasons for this. So and I

810
00:50:39,960 --> 00:50:42,440
Speaker 1: was part of this. I as you said in the introduction,

811
00:50:42,480 --> 00:50:44,279
Speaker 1: I used to run Action on Smoking and Health in

812
00:50:44,320 --> 00:50:47,360
Speaker 1: the UK in the late nineties to early two thousands,

813
00:50:48,040 --> 00:50:52,920
Speaker 1: and basically we built a massive fighting machine for fighting

814
00:50:52,920 --> 00:50:57,239
Speaker 1: big tobacco and fighting the cigarette trade and smoking and

815
00:50:57,280 --> 00:51:01,000
Speaker 1: we were all, you know, basically in the Gray Tobacco Wars,

816
00:51:01,120 --> 00:51:03,560
Speaker 1: and it was, you know, a big conflict with a big,

817
00:51:03,600 --> 00:51:08,480
Speaker 1: bad industry. The trouble is that machine still exists, and

818
00:51:08,520 --> 00:51:11,200
Speaker 1: I think what it's done is, rather than say, look,

819
00:51:11,200 --> 00:51:14,320
Speaker 1: there's no more war to fight, it's sort of swiveled

820
00:51:14,360 --> 00:51:17,399
Speaker 1: its gun turrets towards the new thing and has now

821
00:51:17,480 --> 00:51:20,960
Speaker 1: started blasting away because that's what it does. That's what

822
00:51:21,040 --> 00:51:24,640
Speaker 1: you do in the anti tobacco, anti smoking movement. You

823
00:51:24,760 --> 00:51:29,319
Speaker 1: go into battle against big businesses and behaviors that you

824
00:51:29,640 --> 00:51:32,319
Speaker 1: kind of disapprove with. And so there's a kind of

825
00:51:32,440 --> 00:51:38,080
Speaker 1: institutional inertia that sort of sits behind this in the

826
00:51:38,120 --> 00:51:41,160
Speaker 1: same way that there isn't a kind of caffeine control

827
00:51:41,280 --> 00:51:44,520
Speaker 1: industry or the alcohol control industry is much smaller and

828
00:51:44,560 --> 00:51:47,720
Speaker 1: weaker because it doesn't fight the same kind of battles

829
00:51:47,760 --> 00:51:50,560
Speaker 1: that we used to fight against big tobacco. And then,

830
00:51:50,600 --> 00:51:52,879
Speaker 1: I don't know, money plays a role. I mean, many

831
00:51:52,920 --> 00:51:56,680
Speaker 1: of those organizations that you mentioned, you know, Lung Foundation,

832
00:51:57,160 --> 00:52:01,040
Speaker 1: Heart Foundation, they have taken significant money from Bloomberg for

833
00:52:01,200 --> 00:52:05,040
Speaker 1: joining in this anti vaping effort. So you can't rule

834
00:52:05,080 --> 00:52:08,200
Speaker 1: out the effects of money. You also see that happening

835
00:52:08,280 --> 00:52:12,160
Speaker 1: in academia. Food and Drug administration and National Institutes for

836
00:52:12,200 --> 00:52:15,279
Speaker 1: Health are a huge source of funding for research. But

837
00:52:15,360 --> 00:52:19,640
Speaker 1: the kind of research they want is research that finds problems,

838
00:52:19,680 --> 00:52:24,120
Speaker 1: that finds reasons to regulate, that finds bads. They are

839
00:52:24,239 --> 00:52:29,360
Speaker 1: much better at research that develops a problem than research

840
00:52:29,440 --> 00:52:33,640
Speaker 1: that acknowledges or investigates an opportunity. You just don't see

841
00:52:33,880 --> 00:52:36,680
Speaker 1: research looking to kind of round out and quantify the

842
00:52:36,719 --> 00:52:40,400
Speaker 1: opportunities at anything like the scale or with anything like

843
00:52:40,440 --> 00:52:45,839
Speaker 1: the financial backing that you see form from problem orientated research. Clive,

844
00:52:45,880 --> 00:52:47,920
Speaker 1: I'll tell you when I started getting involved in this

845
00:52:48,000 --> 00:52:51,640
Speaker 1: area a few years ago, what really struck me was

846
00:52:51,719 --> 00:52:56,879
Speaker 1: that I was meeting these wonderful researchers, distinguished academics who

847
00:52:56,880 --> 00:52:59,600
Speaker 1: are pro heart reduction, and they reminded me a lot

848
00:52:59,680 --> 00:53:01,879
Speaker 1: of the people I had met in the academic world

849
00:53:01,920 --> 00:53:03,680
Speaker 1: who were doing the work on harm reduction and needle

850
00:53:03,719 --> 00:53:06,719
Speaker 1: exchange and over those prevention in the eighties, nineties and

851
00:53:06,719 --> 00:53:09,320
Speaker 1: and adds. I mean, basically, when people who were focused

852
00:53:09,320 --> 00:53:13,600
Speaker 1: on how do we most effectively reduce the harms associated

853
00:53:13,600 --> 00:53:16,479
Speaker 1: with the consumption of tobacco in our society, and that

854
00:53:16,760 --> 00:53:20,600
Speaker 1: was the focus balancing these the kids, these the adults,

855
00:53:20,600 --> 00:53:22,640
Speaker 1: you name it. And then what I saw on the

856
00:53:22,719 --> 00:53:26,279
Speaker 1: other side was this kind of massive establishment fronted with

857
00:53:26,320 --> 00:53:29,800
Speaker 1: government money and Bloomberg money, who also wanted to reduce

858
00:53:29,840 --> 00:53:34,799
Speaker 1: the harms of tobacco, but who diverged a because where

859
00:53:34,800 --> 00:53:37,680
Speaker 1: they had started off being just anti smoking, now they

860
00:53:37,719 --> 00:53:41,880
Speaker 1: had adopted a sort of ideological anti all nicotine approach,

861
00:53:41,920 --> 00:53:46,160
Speaker 1: a kind of abstinence only approach. That Secondly, it seemed

862
00:53:46,200 --> 00:53:49,720
Speaker 1: like they were so traumatized by their multi decade battle

863
00:53:49,840 --> 00:53:53,160
Speaker 1: with big tobacco that basically driving a stake through the

864
00:53:53,239 --> 00:53:57,080
Speaker 1: heart of big tobacco seemed to be a greater objective

865
00:53:57,120 --> 00:54:00,319
Speaker 1: for them than was adopting a really comprehend of harm

866
00:54:00,320 --> 00:54:02,520
Speaker 1: reduction approach. And now, as you say, they have the

867
00:54:02,560 --> 00:54:04,400
Speaker 1: money to fight this battle, But I mean, is that

868
00:54:04,480 --> 00:54:07,480
Speaker 1: the way the world looks to you as well? Honest? Yes,

869
00:54:07,960 --> 00:54:10,080
Speaker 1: it does actually, and I think I think it's a

870
00:54:10,160 --> 00:54:14,080
Speaker 1: very good assessment of the current situation. It's harder and

871
00:54:14,239 --> 00:54:19,200
Speaker 1: harder for them to maintain the argument about harm reduction

872
00:54:19,280 --> 00:54:22,759
Speaker 1: in the nicotine and smoking area. Evidence is coming in

873
00:54:22,800 --> 00:54:26,600
Speaker 1: all the time that vaping is displacing smoking with the

874
00:54:26,719 --> 00:54:29,680
Speaker 1: net public health benefit. And you know, I'm sure that

875
00:54:29,800 --> 00:54:32,600
Speaker 1: evidence will get stronger and stronger over time. There's no

876
00:54:32,640 --> 00:54:35,680
Speaker 1: real doubt about it. There's multiple strands of evidence that

877
00:54:35,760 --> 00:54:39,280
Speaker 1: confirm that that is the case. So what we've seen

878
00:54:40,000 --> 00:54:42,879
Speaker 1: is the people who oppose these developments, the anti harm

879
00:54:42,920 --> 00:54:48,440
Speaker 1: reduction abstinence only groups have gravitated to two basic sets

880
00:54:48,480 --> 00:54:53,280
Speaker 1: of arguments. One is kids and the vulnerability of kids

881
00:54:53,280 --> 00:54:55,440
Speaker 1: to nicotine, in which I think we've discussed that quite

882
00:54:55,480 --> 00:54:57,200
Speaker 1: a bit, but I think you have to just take

883
00:54:57,239 --> 00:55:01,040
Speaker 1: a much more nuanced view of youth th behaviors to

884
00:55:01,120 --> 00:55:03,840
Speaker 1: work your way through that. And the second, and you

885
00:55:03,920 --> 00:55:08,520
Speaker 1: hear this getting louder and louder, is the tobacco industry. Essentially,

886
00:55:08,640 --> 00:55:12,840
Speaker 1: tobacco industry comes with such terrible reputational baggage they form

887
00:55:12,960 --> 00:55:16,400
Speaker 1: an almost perfect enemy. And it's almost as if you

888
00:55:16,440 --> 00:55:21,040
Speaker 1: can dismiss an entire public health concept like tobacco harm

889
00:55:21,080 --> 00:55:25,600
Speaker 1: reduction just by mentioning the word tobacco industry or suggesting

890
00:55:25,640 --> 00:55:29,200
Speaker 1: that the tobacco industry may benefit from selling the products

891
00:55:29,239 --> 00:55:33,200
Speaker 1: that are harm reduced, low risk alternatives to smoking. That

892
00:55:33,440 --> 00:55:38,520
Speaker 1: almost for some people ends the argument cligant Before COVID

893
00:55:38,600 --> 00:55:42,600
Speaker 1: came along, right, The sort of epidemic before the pandemic

894
00:55:43,200 --> 00:55:45,200
Speaker 1: was the epidemic of vaping, right. It was on the

895
00:55:45,280 --> 00:55:49,200
Speaker 1: headlines and TV shows and magazine covers in the United States,

896
00:55:49,560 --> 00:55:52,440
Speaker 1: And then towards the end of that in mid we

897
00:55:52,480 --> 00:55:54,560
Speaker 1: saw this whole thing about, Oh my god, people are

898
00:55:54,600 --> 00:55:56,960
Speaker 1: landing up in the hospital, right and their lungs are

899
00:55:57,040 --> 00:56:01,160
Speaker 1: getting destroyed. And the CDC, the usider Disease Control labeled

900
00:56:01,160 --> 00:56:04,759
Speaker 1: the disease and E cigarette and vaping E Valley. I

901
00:56:04,760 --> 00:56:07,160
Speaker 1: can't remember what a L stands for, but they labeled

902
00:56:07,160 --> 00:56:10,439
Speaker 1: it that thing. Now, it turned out, of course, that

903
00:56:10,560 --> 00:56:14,799
Speaker 1: virtually the entire thing was not about nicotine vaping. It

904
00:56:14,880 --> 00:56:19,120
Speaker 1: was about illegally produced th HC vape cartridges, which some

905
00:56:19,200 --> 00:56:22,920
Speaker 1: knuckleheads were producing and mixing with vitamin E oil because

906
00:56:22,960 --> 00:56:25,720
Speaker 1: that way they could, you know, basically cut their costs

907
00:56:25,719 --> 00:56:28,720
Speaker 1: and make more profit. And what struck me about it

908
00:56:28,800 --> 00:56:33,360
Speaker 1: was the evidence that this was about tainted, illegal th

909
00:56:33,600 --> 00:56:38,200
Speaker 1: HC vape cartridges and not about the cigarettes seemed incredibly

910
00:56:38,239 --> 00:56:43,480
Speaker 1: apparent from early on. Yet health authorities and political officials

911
00:56:43,520 --> 00:56:47,560
Speaker 1: and even the Center of Disease Control kept obscuring that fact.

912
00:56:48,000 --> 00:56:51,080
Speaker 1: I mean, what was going on there. I think this

913
00:56:51,440 --> 00:56:55,560
Speaker 1: was an information sort of black operation. Basically, you're quite right.

914
00:56:56,040 --> 00:57:00,920
Speaker 1: There was a cause, you know, maybe around three thousand hospitalizations,

915
00:57:00,920 --> 00:57:05,759
Speaker 1: over sixty deaths, very very severe acute respiratory disorders, and

916
00:57:05,800 --> 00:57:09,560
Speaker 1: therefore there was a massive concern about it. But all

917
00:57:09,640 --> 00:57:12,200
Speaker 1: the evidence, and it's not just even some of all

918
00:57:12,239 --> 00:57:16,200
Speaker 1: the evidence is clear. This arise from the addition of

919
00:57:16,200 --> 00:57:20,880
Speaker 1: a cutting agent to th HC vaping oils. Cutting agent

920
00:57:21,000 --> 00:57:24,600
Speaker 1: was vitamin e acetate. It's used to dilute the oil

921
00:57:24,640 --> 00:57:27,080
Speaker 1: for economic reasons, a normal sort of you know, drug

922
00:57:27,160 --> 00:57:30,920
Speaker 1: production kind of economics. It was done in the illicit

923
00:57:30,960 --> 00:57:33,880
Speaker 1: market by you know, the criminals that produce and market

924
00:57:33,960 --> 00:57:38,160
Speaker 1: these products. Had absolutely nothing whatsoever to do with vaping nicotine.

925
00:57:38,200 --> 00:57:41,240
Speaker 1: There's no link at all. You can't add that additive

926
00:57:41,280 --> 00:57:44,120
Speaker 1: to a nicotine vape. It just it's not soluble in

927
00:57:44,160 --> 00:57:47,160
Speaker 1: the liquid, and there is no economic purpose to doing

928
00:57:47,200 --> 00:57:51,560
Speaker 1: it whatsoever. So, having defined the cause, and I agree

929
00:57:51,640 --> 00:57:53,920
Speaker 1: with you, this outbreak kind of came to light in

930
00:57:54,160 --> 00:57:59,320
Speaker 1: probably around June two thousand and nineteen. By August two

931
00:57:59,360 --> 00:58:01,640
Speaker 1: thousand and nine, ten, it was pretty clear what the

932
00:58:01,680 --> 00:58:05,880
Speaker 1: problem was. But I would say that CDC, in particular,

933
00:58:06,320 --> 00:58:10,080
Speaker 1: were maintaining a kind of ambiguity about the cause which

934
00:58:10,120 --> 00:58:13,120
Speaker 1: persists to today. I mean, they've never said, which they

935
00:58:13,120 --> 00:58:17,200
Speaker 1: should definitively, that nicotine vaping liquids were nothing to do

936
00:58:17,280 --> 00:58:21,439
Speaker 1: with this, And it's just not possible that there would

937
00:58:21,480 --> 00:58:24,840
Speaker 1: have been a separate cause in the nicotine vaping supply

938
00:58:24,960 --> 00:58:27,440
Speaker 1: chain that happened in the same geography in the United

939
00:58:27,480 --> 00:58:30,360
Speaker 1: States and exactly the same time mid two thousand and

940
00:58:30,440 --> 00:58:32,840
Speaker 1: nineteen to early two thousand and twenty, with exactly the

941
00:58:32,880 --> 00:58:36,360
Speaker 1: same symptoms, but was caused by something else. Now, there

942
00:58:36,400 --> 00:58:40,280
Speaker 1: was some confusion because some people denied using THC. What

943
00:58:40,400 --> 00:58:44,480
Speaker 1: a surprise. If you admit to using cannabis, you can

944
00:58:44,480 --> 00:58:47,320
Speaker 1: get in trouble with your employer, with the police, with

945
00:58:47,440 --> 00:58:51,440
Speaker 1: your college, with your school, and with your parents. So unsurprisingly,

946
00:58:51,920 --> 00:58:53,680
Speaker 1: some people said no, no, no, no, I was never

947
00:58:53,760 --> 00:58:58,320
Speaker 1: vaping th HC, and therefore that was used to maintain

948
00:58:58,360 --> 00:59:00,320
Speaker 1: the myth that this may have been something to do

949
00:59:00,440 --> 00:59:03,720
Speaker 1: with nicotine vaping. But the fact that it never occurred

950
00:59:03,720 --> 00:59:07,080
Speaker 1: anywhere else, the fact that the cause in the illicit

951
00:59:07,080 --> 00:59:10,320
Speaker 1: th HC vaping supply chain is clear, tells us what

952
00:59:10,360 --> 00:59:12,920
Speaker 1: we need to know, and that incident is over because

953
00:59:12,920 --> 00:59:16,640
Speaker 1: not even criminals want to actually kill their customers. So

954
00:59:16,680 --> 00:59:18,920
Speaker 1: as soon it was clear what was causing it, they

955
00:59:18,920 --> 00:59:23,240
Speaker 1: stopped doing it, stopped using that thickener, the supply chain emptied,

956
00:59:23,760 --> 00:59:27,960
Speaker 1: and the problem tailed out in early two thousand. Hasn't

957
00:59:27,960 --> 00:59:30,160
Speaker 1: really been seen since except the odd thing that's been

958
00:59:30,240 --> 00:59:33,480
Speaker 1: lingering in somebody's cupboard. It just seemed like an opportunity

959
00:59:33,800 --> 00:59:36,720
Speaker 1: for the anti harm reduction folks, right, and they really

960
00:59:36,760 --> 00:59:38,480
Speaker 1: took it right. I mean, it was a myth. They

961
00:59:38,560 --> 00:59:42,479
Speaker 1: propagated and perpetuated, essentially a lie, even though they knew better.

962
00:59:42,480 --> 00:59:45,760
Speaker 1: They promoted misinformation. They did this from the Center for

963
00:59:45,840 --> 00:59:48,720
Speaker 1: Disease Control, and they said, well, if we're not being

964
00:59:48,720 --> 00:59:51,560
Speaker 1: so successful of discouraging them with whatever truth we have

965
00:59:51,640 --> 00:59:54,040
Speaker 1: on our side, let's take advantage of a myth and

966
00:59:54,080 --> 00:59:56,360
Speaker 1: a popular fear and run with that. And I think,

967
00:59:56,400 --> 00:59:58,880
Speaker 1: you know, I haven't seen the latest surveys, client, but

968
00:59:58,920 --> 01:00:02,160
Speaker 1: I think probably in the jority of Americans still believe

969
01:00:02,400 --> 01:00:06,680
Speaker 1: that that long damage, that long problems resulted from nicotine vaping.

970
01:00:06,840 --> 01:00:09,920
Speaker 1: It just hasn't been corrected. No, I think you're right.

971
01:00:09,960 --> 01:00:13,040
Speaker 1: I mean that that has created the perception that these

972
01:00:13,400 --> 01:00:16,560
Speaker 1: products are highly dangerous, and there's been good measurements on

973
01:00:16,600 --> 01:00:19,520
Speaker 1: how risk perception shifted in the United States, and actually

974
01:00:20,120 --> 01:00:22,480
Speaker 1: it flows across the Atlantic of course, so we get

975
01:00:22,480 --> 01:00:25,280
Speaker 1: this in the UK as well. People think these products

976
01:00:25,320 --> 01:00:27,960
Speaker 1: are much more dangerous than they are and that is

977
01:00:28,040 --> 01:00:31,919
Speaker 1: one reason why. And the fact that CDC has never

978
01:00:32,360 --> 01:00:36,040
Speaker 1: definitively sort of crushed that idea, which they could do

979
01:00:36,120 --> 01:00:38,480
Speaker 1: if they wanted to, the fact that they have let

980
01:00:38,520 --> 01:00:41,200
Speaker 1: it roll and let it run tells you that they

981
01:00:41,200 --> 01:00:44,640
Speaker 1: have found it useful as part of their anti vaping campaign.

982
01:00:44,920 --> 01:00:48,520
Speaker 1: The problem is the unintended consequences of making people fear

983
01:00:48,600 --> 01:00:51,720
Speaker 1: vaping is that you get relapse from vaping to smoking,

984
01:00:51,800 --> 01:00:54,720
Speaker 1: and you get fewer smokers willing to switch from smoking

985
01:00:54,880 --> 01:00:58,000
Speaker 1: into vaping. So you know, the idea that that was

986
01:00:58,040 --> 01:01:00,240
Speaker 1: a good thing to do is actually an incredibly a

987
01:01:00,320 --> 01:01:03,680
Speaker 1: responsible thing to do. And then also for the people

988
01:01:03,720 --> 01:01:08,160
Speaker 1: who are used as an illicit th HC vapes, diffusing

989
01:01:08,280 --> 01:01:12,360
Speaker 1: the problem across nicotine vaping, th HC vaping, any kind

990
01:01:12,400 --> 01:01:16,880
Speaker 1: of vaping has not given the sharp public health message

991
01:01:17,160 --> 01:01:19,840
Speaker 1: which should be watched out when you buy an illicit

992
01:01:20,160 --> 01:01:23,640
Speaker 1: th HC vape you know, that message was lost as well,

993
01:01:23,680 --> 01:01:27,240
Speaker 1: so there was a harm associated with not warning vaping

994
01:01:27,280 --> 01:01:31,640
Speaker 1: cannabis users properly about the danger. So the whole thing

995
01:01:31,920 --> 01:01:35,800
Speaker 1: is grossly irresponsible in my opinion, and it's one of

996
01:01:35,840 --> 01:01:40,040
Speaker 1: the reasons why it's effectively pans out as another form

997
01:01:40,080 --> 01:01:43,000
Speaker 1: of defense of the cigarette trade. It gives people the

998
01:01:43,040 --> 01:01:44,760
Speaker 1: reason to say no, no, no, no, I'm going to

999
01:01:44,840 --> 01:01:46,920
Speaker 1: stick with this. And one final point on this ethan

1000
01:01:46,960 --> 01:01:50,400
Speaker 1: if if you don't mind, it's also been conflated with

1001
01:01:50,520 --> 01:01:55,120
Speaker 1: another lung related thing, which is popcorn lung. So people

1002
01:01:55,160 --> 01:01:57,880
Speaker 1: have this big fuzzy idea. You know, normal people don't

1003
01:01:58,040 --> 01:02:00,880
Speaker 1: get into the detail or read papers on this, quite reasonably,

1004
01:02:01,440 --> 01:02:05,080
Speaker 1: but they've heard about something called popcorn lung being associated

1005
01:02:05,080 --> 01:02:09,160
Speaker 1: with vaping, which it isn't. It's associated with one additive

1006
01:02:09,760 --> 01:02:13,080
Speaker 1: use sometimes in vaping when you're exposed to massive levels

1007
01:02:13,120 --> 01:02:15,760
Speaker 1: of it. But you've heard about popcorn lung, and then

1008
01:02:15,800 --> 01:02:19,800
Speaker 1: you hear that there's people dropping dead from vaping because

1009
01:02:19,840 --> 01:02:22,480
Speaker 1: of this VALI thing. Put two and two together and go,

1010
01:02:23,200 --> 01:02:25,479
Speaker 1: I'm not even going to take that risk. I'll stick

1011
01:02:25,520 --> 01:02:27,439
Speaker 1: with the lung disease that I know and like, which

1012
01:02:27,480 --> 01:02:30,080
Speaker 1: is cigarettes. Yeah, you know, I guess what it comes

1013
01:02:30,120 --> 01:02:32,720
Speaker 1: down to, Clive, is we think about it. There's over

1014
01:02:32,760 --> 01:02:36,720
Speaker 1: a billion people still smoking cigarettes or other combustible tobacco

1015
01:02:36,760 --> 01:02:40,120
Speaker 1: products around the world. There's thirty five to forty million

1016
01:02:40,280 --> 01:02:42,840
Speaker 1: smokers in the US, which is roughly equal to the

1017
01:02:43,080 --> 01:02:46,440
Speaker 1: entire population of California, or almost the same as the

1018
01:02:46,560 --> 01:02:50,560
Speaker 1: entire population of black people in America. And if all

1019
01:02:50,600 --> 01:02:54,479
Speaker 1: of them were to suddenly switch to vaping or using

1020
01:02:54,520 --> 01:02:57,640
Speaker 1: these oral products or heated products, it would probably be

1021
01:02:57,680 --> 01:03:01,120
Speaker 1: one of the greatest public health advances in human history.

1022
01:03:01,320 --> 01:03:04,040
Speaker 1: And it seems that what stands in the way is

1023
01:03:04,120 --> 01:03:08,040
Speaker 1: just the same sorts of ignorance and foolishness and self

1024
01:03:08,080 --> 01:03:10,800
Speaker 1: interest that drove the war on drugs for many years.

1025
01:03:11,040 --> 01:03:13,640
Speaker 1: Would you agree with my formulation that way? I agree

1026
01:03:13,640 --> 01:03:15,600
Speaker 1: with you. I think the more you look at this,

1027
01:03:15,840 --> 01:03:19,720
Speaker 1: the more it has the feeling of war on drugs mentality.

1028
01:03:19,840 --> 01:03:22,960
Speaker 1: We we used to be in a battle against harm.

1029
01:03:23,000 --> 01:03:25,040
Speaker 1: I mean, I got into the business because you know,

1030
01:03:25,320 --> 01:03:29,280
Speaker 1: it was about cancer, about heart disease, about people living

1031
01:03:29,280 --> 01:03:32,880
Speaker 1: in utter misery with emphysema, and so on. My father

1032
01:03:32,960 --> 01:03:37,080
Speaker 1: died smoking related disease associated with heart failure. There were

1033
01:03:37,160 --> 01:03:40,720
Speaker 1: real public health reasons to be involved. Now, as we're

1034
01:03:40,760 --> 01:03:44,120
Speaker 1: beginning to solve that problem with these noncombustible products, we're

1035
01:03:44,160 --> 01:03:47,320
Speaker 1: seeing a big shift to a war on drugs mentality,

1036
01:03:47,360 --> 01:03:49,280
Speaker 1: which is that we don't think people should use the

1037
01:03:49,360 --> 01:03:53,200
Speaker 1: drug nicotine. Now, that's a very different public health proposition,

1038
01:03:53,480 --> 01:03:56,640
Speaker 1: and it's not one that I think we should be pursuing.

1039
01:03:56,680 --> 01:04:00,400
Speaker 1: I think we should be pursuing reduction of harm, aerial

1040
01:04:00,960 --> 01:04:05,720
Speaker 1: disease outcomes, a life expectancy outcomes, and not worrying ourselves

1041
01:04:05,760 --> 01:04:08,960
Speaker 1: about nicotine so much. I mean, I'm not recommending nicotine use,

1042
01:04:09,400 --> 01:04:12,000
Speaker 1: but people are going to use it in the same

1043
01:04:12,000 --> 01:04:15,560
Speaker 1: way that they use alcohol. Not recommending that either, but

1044
01:04:15,720 --> 01:04:18,680
Speaker 1: people do like it. People do use it. Question is

1045
01:04:18,720 --> 01:04:21,320
Speaker 1: can you keep the harm under control? Yeah, claud you know,

1046
01:04:21,560 --> 01:04:24,680
Speaker 1: I think also for me growing up, my basic exposure

1047
01:04:24,720 --> 01:04:28,960
Speaker 1: to addiction was seeing my dad's relationship to cigarettes center food,

1048
01:04:29,560 --> 01:04:31,840
Speaker 1: and he died of a massive heart attack when he

1049
01:04:31,880 --> 01:04:34,479
Speaker 1: was fifty eight as a result. I probably he can't

1050
01:04:34,480 --> 01:04:37,160
Speaker 1: prove it, but probably of his packet day cigarette habit

1051
01:04:37,200 --> 01:04:40,120
Speaker 1: and his obesity. And I oftentimes have thought in recent

1052
01:04:40,200 --> 01:04:42,320
Speaker 1: years that my dad would have been a good candidate

1053
01:04:42,400 --> 01:04:45,160
Speaker 1: to have switched to an east cigarette or a heated device,

1054
01:04:45,200 --> 01:04:47,960
Speaker 1: and it might have made the difference in his living longer.

1055
01:04:48,080 --> 01:04:51,040
Speaker 1: Sounds like your story somewhat similar. I think exactly the

1056
01:04:51,040 --> 01:04:53,600
Speaker 1: same about my father. He would have loved the innovation.

1057
01:04:54,000 --> 01:04:57,640
Speaker 1: He'd have been an earlier adopter, and had he done

1058
01:04:57,680 --> 01:05:01,080
Speaker 1: that early enough in his smoking, rarely have these things

1059
01:05:01,080 --> 01:05:04,040
Speaker 1: been availably still be alive too. Now I'm convinced of it. Yeah,

1060
01:05:04,080 --> 01:05:06,120
Speaker 1: I mean I looked at a very powerful politician like

1061
01:05:06,160 --> 01:05:08,720
Speaker 1: Senator Durbin who said that he hates vaping and the

1062
01:05:08,880 --> 01:05:12,280
Speaker 1: cigarettes because his parents died from smoke gay, and I'm thinking,

1063
01:05:12,360 --> 01:05:15,400
Speaker 1: why didn't he come down where we are? He's missing

1064
01:05:15,400 --> 01:05:19,240
Speaker 1: the point. Yeah, So, Clive, you know I should say

1065
01:05:19,280 --> 01:05:20,640
Speaker 1: at the end, it is that you really are one

1066
01:05:20,640 --> 01:05:23,920
Speaker 1: of my heroes here. I mean, seeing the extraordinary amount

1067
01:05:24,080 --> 01:05:26,080
Speaker 1: of work that you pump out and the ways that

1068
01:05:26,160 --> 01:05:28,880
Speaker 1: you're engaging with the World Health Organization, the f d

1069
01:05:28,880 --> 01:05:31,360
Speaker 1: A and all folks and covering the literature and reading

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01:05:31,360 --> 01:05:34,480
Speaker 1: it is basically a one man operation. So I just

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01:05:34,560 --> 01:05:36,600
Speaker 1: hope you're going to keep doing this and keep doing

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01:05:36,640 --> 01:05:40,360
Speaker 1: it until this battle is one. Um. You know, I

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01:05:40,880 --> 01:05:43,520
Speaker 1: think we both know that sometimes these battles can feel quixotic.

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01:05:43,880 --> 01:05:46,000
Speaker 1: But I'm incredibly grateful for the work you're doing and

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01:05:46,040 --> 01:05:48,320
Speaker 1: also for taking the time to have this conversation with me,

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01:05:48,520 --> 01:05:50,959
Speaker 1: So thank you very much. Thank you, Ethan. I wish

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01:05:50,960 --> 01:05:54,480
Speaker 1: it wasn't necessary, It shouldn't be necessary, but unfortunately is.

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01:05:56,480 --> 01:05:59,760
Speaker 1: Psychoactive is the production of I Heart Radio and Protozoa

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01:05:59,800 --> 01:06:03,440
Speaker 1: pic Shirts. It's hosted by me Ethan Naedelman. It's produced

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01:06:03,480 --> 01:06:07,360
Speaker 1: by Katcha Kumkova and Ben Cabrick. The executive producers are

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01:06:07,480 --> 01:06:11,480
Speaker 1: Dylan Golden, Ari Handel, Elizabeth Geesus and Darren Aronovski for

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01:06:11,520 --> 01:06:15,200
Speaker 1: Protozoa Pictures, Alice Williams and Matt Frederick for I Heart

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01:06:15,320 --> 01:06:18,880
Speaker 1: Radio and me Ethan Nadelman. Our music is by Ari

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01:06:19,000 --> 01:06:22,120
Speaker 1: Belusian and a special thanks to a Vivit Brio, Sef

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01:06:22,440 --> 01:06:26,560
Speaker 1: Bianca Grimshaw and Robert Beatty. If you'd like to share

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01:06:26,560 --> 01:06:29,680
Speaker 1: your own stories, comments, or ideas, please leave us a

1087
01:06:29,720 --> 01:06:35,560
Speaker 1: message at eight three three seven seven nine sixty. That's

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01:06:35,760 --> 01:06:41,320
Speaker 1: one eight three three psycho zero. You can also email

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01:06:41,400 --> 01:06:44,640
Speaker 1: us as Psychoactive at Protozoa dot com or find me

1090
01:06:44,640 --> 01:06:47,600
Speaker 1: on Twitter at Ethan Nadelman. And if you couldn't keep

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01:06:47,600 --> 01:06:50,400
Speaker 1: track of all this, find the information in the show notes.

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01:06:54,640 --> 01:06:58,400
Speaker 1: Next week we'll be talking with Larry Krasner. He's the

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01:06:58,440 --> 01:07:03,320
Speaker 1: District Attorney of philadel Fia and playing a pioneering role

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01:07:03,640 --> 01:07:07,920
Speaker 1: among the progressive prosecutors who are reshaping the face of

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01:07:07,960 --> 01:07:12,040
Speaker 1: criminal justice in American cities. You think most people, I

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01:07:12,040 --> 01:07:14,520
Speaker 1: mean most of the cops and prosecutors and judges in

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01:07:14,560 --> 01:07:17,520
Speaker 1: Philadelphia would now vote for legalizing marijuana. Are we going

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01:07:17,560 --> 01:07:19,840
Speaker 1: to count the retired ones. If you count the retired ones,

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01:07:19,880 --> 01:07:22,160
Speaker 1: I would say no, no, But the current ones probably is.

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01:07:22,520 --> 01:07:26,920
Speaker 1: I think that there are subgroups, maybe younger officers, probably

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01:07:26,920 --> 01:07:29,120
Speaker 1: officers of color, who would vote for it. I think

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01:07:29,520 --> 01:07:31,600
Speaker 1: overall they would vote against it, And to be honest,

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01:07:31,680 --> 01:07:34,680
Speaker 1: they have a specific financial interest in voting against it

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01:07:35,000 --> 01:07:37,600
Speaker 1: because they don't simply get paid to arrest people. They

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01:07:37,600 --> 01:07:40,080
Speaker 1: get overtime, and they get a lot of overtime for

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01:07:40,160 --> 01:07:42,400
Speaker 1: going to court to testify when they're not on shift.

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01:07:42,440 --> 01:07:44,760
Speaker 1: I mean, honestly, I think if they could arrest people

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01:07:44,800 --> 01:07:47,160
Speaker 1: for blue shirts. I'm wearing a blue shirt today, some

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01:07:47,200 --> 01:07:49,000
Speaker 1: of them would be mercenario up to say, hey, it

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01:07:49,040 --> 01:07:51,600
Speaker 1: sounds like a good plan. Let's arrest people for blue shirts.

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01:07:51,600 --> 01:07:53,160
Speaker 1: I want a beach house and they would do it.

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Speaker 1: Subscribe to Cycleactive now see it, don't miss it.