GFN 2025 Keynote #3 - delivered by Maria Papaioannoy-Duic, hosted by Jagannath Sarangapani, response from Konstantinos Farsalinos.
A consumer advocates’ approach, cutting through the noise to deliver factually accurate information about safer nicotine products is a constant struggle. Maria will present a ‘real-world how-to guide’, drawn from the lived experience of consumer advocates, identifying some useful tools to counter vaping and THR misinformation.
Transcription:
00:11 - 05:09
[Jagannath Sarangapani]
All of us here have experienced a barrage of misinformation, or as my good friend Nancy so perfectly mentioned in one of our earlier sessions, misinformation, disinformation, and malinformation. One short 10-second reel, a random doctor's comment is all it takes, and we spend days battling over it. And it happens again and again and again. In a world flooded with information, How do we separate fact and fear? Media headlines paint nicotine as a villain, while safer alternatives like vaping and nicotine pouches are framed as dangerous or just as bad as smoking, if not worse. What's the truth? Science and real-world stories from all of us prove that tobacco harm reduction actually works. And through real-life stories and fact-based approach, we challenge myths repeatedly. bake through the noise, drive honest conversations about safer nicotine product and their roles in saving lives. We come here year after year to this amazing GFN conference in many ways to get in touch with our roots, listen to experts, share and exchange ideas, and update ourselves. I'm Jagannath, a consumer advocate from the city of Hyderabad in India, and I'm privileged to be hosting this keynote tree, which is what I hear versus what I know, battling misinformation from the newsroom to Facebook comment sections. To help us get a proper grasp of this and navigate the space, we have our speaker, Maria Papayone. I hope I got that right, thank you. Close, okay. She's known in this vaping community as someone who just doesn't give up. She embarked a journey towards a smoke-free life in September 2010 when she embraced vaping as an alternative to smoking. I believe it was a device given to you by your mother-in-law, right? Yeah. Recognizing this transformative potential of vaping, Maria soon became a vocal advocate for the industry and its enthusiasts. In 2013, Maria took a bold step in establishing one of Canada's first vape shops, positioning herself at the forefront of a rapidly evolving market. Simultaneously, she dedicated her efforts to championing better regulations within the vaping sector. Her commitment to advocacy was evident as she organized and led protests, both federal and provincial government, ensuring that the voices of vapers were heard on policy matters. Maria has played a pivotal role in founding Vapers Advocates in Ontario and spearheading the Rights for Vapers movement in 2019. For over a decade, she has leveraged her expertise to address legislative bodies, passionately advocating against flavor bans and contributing to the broader discourse on vaping. In 2021, Maria went a step further, and she registered as a third party during the federal elections, further amplifying her commitment to shaping policies that align with the interests of vaping community. In 2024, through Right for Vape, she encouraged the Canadians to communicate with the government in Canada, and collectively, Canadians who support vaping have sent over 100,000 letters to the government opposing restrictive and oppressive regulations against access to these products. She is a tireless champion for personal liberty, public health, and safer nicotine alternatives. Dr. Constantinos Fatsilonas, The respondent is no stranger. While appearing larger than life, he is someone who puts you at ease with his infectious laugh and wit. He's a physician, a cardiologist by training, a serious researcher who has since 2011 published over 110 studies and presenting in an equally number of staggering conferences worldwide. And besides being an author and the handling editor on the first scientific book on electronic cigarettes, In 2019, he was declared as one of the most cited researchers by the Web of Science from a list of over 6,200 scientists. His work has influenced and helped shape the EU regulatory framework on vaping. Maria will lead this, followed by Farsalonos, who will share his initial responses, after which we will open up for a Q&A. for everyone here, including those who are watching us online. Please welcome Maria with a nice round of applause, everyone.
05:15 - 06:35
[Maria Papaioannoy-Duic]
Thank you. Hello, everybody. I am so glad you're here, and I want to say thank you for showing up to my very first GFN keynote, what I hear versus what I know, battling misinformation from the newsroom. Sorry, I don't know how to use this clicker very well. Battling misinformation from the newsroom to the Facebook comment section. So quick confession, I think I missed a keyword in that title. It should have included government because misinformation does not just sit in our aunt's Facebook comment section. Sometimes it sits in government, and in my case, the House of Commons. Last year, we collectively had a jaw-drop moment when our then Minister of Health, Mark Holland, a man who, if you didn't know, lobbied for tobacco control, specifically with heart and stroke, he stood up and made a dramatic and knowingly false claim about vaping. I could read it to you, but honestly, he delivered it with much more flair than I could ever replicate. So let's play the video. If I can figure it out. Okay.
06:37 - 07:30
[Mark Holland]
Let me say in the first order that when it comes to cessation, we want to see innovation. We want to see products that are going to get people off of nicotine and off of tobacco. I was with Heart and Stroke when we dealt with the issue of vaping. And there were many voices at that time when information was uncertain who said, let this exist as a cessation tool. Don't take action. The result of that, unfortunately, was that the tobacco industry was able to addict a whole new cohort of young people who had no exposure to nicotine to something that's absolutely deadly for their health. We cannot allow that to happen again. So my intention, I don't ever want to go through this again. What we saw happening in vaping, all the illness, the death, the sickness, we cannot allow that to happen in nicotine pouches. We cannot allow this to happen again. in an abuse of a channel, a legitimate channel in cessation.
07:32 - 29:23
[Maria Papaioannoy-Duic]
Okay, guys, he lied. He lied. I cannot even say that. I need to repeat it again. He lied. Not one child in Canada has died from vaping. In fact, no Canadian has died from vaping or using any safer nicotine product. Just last year, 48,000 Canadians died from tobacco-related illness. You see, The fact that he didn't tell the truth didn't stop him or others from pushing a narrative that isn't just wrong, it's dangerous. What I've learned is when science doesn't back tobacco control story, they don't revise the policy, they rewrite the story, not with facts, but with fear, drama, and deliberate misinformation. The fight for access to safer nicotine products, while the truth isn't just ignored, it's attacked, silenced, and mocked. Many of you in this room know exactly what that feels like. A health official makes a statement, a journalist runs with it, a politician amplifies it, and suddenly it's viral. Meanwhile, we consumers, advocates, we're in our chat groups. We are sharing sources, correcting headlines, and trying to hold the line with science, evidence, and facts. Sadly, the damage is most likely already done. It's exhausting, it's infuriating, and sometimes it feels like we don't matter. But we do. So let's get to the heart of it. Let's change this guy's face too. Let's get to the heart of it. Here's what I hear almost daily, and I'm sure all of you do as well. Vaping isn't just as bad as smoking. Nicotine causes cancer. You're just shilling for big tobacco. These aren't just lies. They're loud, repeated consistently, and often by people in power. And when something's loud enough, often enough, it starts to feel true, even when it's not. But here's what I know. Here we go. Smoking kills. Smoking kills. Nicotine by itself doesn't. The real villain is combustion. Burning tobacco. Remove the smoke and you remove most of the harm. Safer nicotine products, vapes, nicotine pouches, heated tobacco aren't a big tobacco trap. They're a public health opportunity, and they're working. Millions upon millions of us have already used them to quit smoking for good. So why is the public still so misinformed? Because misinformation has had a head start and a megaphone. During National Non-Smoking Week, a major Ontario health unit tweeted this. Let's get that up there. They tweeted, vaping harms your lungs. Short-term effects of vaping include coughing and shortness of breath. Long-term effects include lung damage and lung disease. It's never too late to quit. Learn more. We know that's misleading. But the headline stuck. It wasn't the fact that there was nothing to support this statement. They didn't look at the 50 plus comments calling them out. In fact, they muted those comments and removed them. And they also didn't care about the community note that was put on this. So I decided, what can I do? Why don't I use their system? So I followed their process and I decided to do a delegation and tell the health unit what they said was incorrect. I got my five minutes. And when I was done, the chair of that committee asked me one question. Did you try to contact the health unit? I responded with, I wouldn't be here if they answered or returned my call. The misinformation is institutional not only in Canada but around the world. Health agencies, regulators, even doctors often repeat outdated or debunked info, sometimes out of fear, sometimes out of habit, and most times because they just don't have the time to learn. And the thing is, tobacco control knows this, and they capitalize it because no one wants to really defend nicotine because it's not sexy. But this isn't about being liked, it's about eradicating smoking. And that means telling the truth, even when it's uncomfortable. The public is misinformed, and that's not a reason to quit. It's the reason to keep going because when people know better, they choose better. That's where change starts. As consumers, we do have a voice, but fear and stigma are powerful weapons and the consequences, they're very real. This isn't an abstract debate. It's real people making real decisions based on bad information and they're suffering from it. We need to speak up, because right now, misinformation is winning. In Canada, public health authorities are virtually the only ones allowed to speak openly about the relative risks of vaping to smoking, and they're funded to do so. Meanwhile, vape shops, where most people who smoke show up, are risk fines or jail time for telling the truth about relative risks. God forbid a vape shop employee sells a vape to someone based on telling them it's 95% safer than smoking. They could go to prison for 18 months. And nicotine pouches? Zonic, an approved Health Canada product, was sidelined by that dramatic health minister and an overreaching ministerial order. Now that product is only available behind a pharmacist counter in mint or menthol. It is easier to buy a pack of cigarettes in Canada than a product designed and approved to help you quit smoking. It is absolutely absurd. And what about awareness campaigns for safer nicotine products? The media will not allow us to run factual ads. Social media, Instagram, Facebook, forget about it, they will ban you. The public space on the truth is silent. And what fills that silence? Misinformation. So here's what that looks like. So in 2022, the Canadian tobacco and nicotine survey broke down the numbers on relative risk and beliefs among Canadians. Among the general population, 49% believe vaping is as harmful or more harmful than smoking. Okay. 32% say they don't know. That totals to 81% of Canadians either misunderstand or have no idea that vaping is safer than smoking. And when we zoom in to people who smoke, 79% don't know that vaping is safer. And among those who smoke but have never tried a vaping product, okay, there we go. A staggering 90% believe vaping is as bad or worse. These are the very people who stand to benefit the most from switching to safer alternatives, yet misinformation has left them stuck, misled, confused, and still smoking. They truly believe, because of where they go to get their information, that smoking that cigarette will keep them alive longer and healthier than switching to a vape. Being an advocate in this space isn't easy. On paper, it sounds simple. You're standing up for science, for public health, for people too often ignored. You're trying to bridge a gap between policymakers, the public, and people who use nicotine but don't want to die from it. I mean, heck, people are quitting smoking. Isn't that the goal? My first real leap into advocacy came in 2014 shortly after opening a vape shop. I learned that the city of Toronto was planning to ban vaping on city property while still allowing smoking in those same spaces. So I went to the hearing. I naively believed that if I just stand up and say, hey, this helped me quit smoking, and so many others, they'll get it. But instead, I was met with questions from uninformed politicians about profit margins. Not a single question about the people who use these products. No one asked how many people quit smoking. And that was the moment I realized the stories, the people, all of us who quit, need to fight for that space. You speak to policy makers, you're called naive, a lobbyist. You speak to the public and you're drowned out by panic and misinformation. And when you speak to the people who smoke or vape, they get it, but quietly because they're too afraid to speak up because of stigma. And when you are effective, when you make that choice, that's when the fight gets real and the backlash gets personal. I've been called a liar, a danger to children, an industry puppet. I've been censored, deplatformed, and disinvited. Not because I said anything false, but because I challenged their script. Advocacy is personal for consumers, shop owners, scientists. There's a deep connection to safer nicotine products. I was someone who smoked. I loved smoking. And I never thought I would quit until in 2009, my mother-in-law bought us all our first electronic cigarette. And for the first time, quitting was easy. And maybe that's what people don't like, that we found an easy way to quit smoking because we all know how hard it is with patches and gums. And also, taking those hot baths and long walks to forget about that cigarette you want didn't really work either. Globally, my 2009 self would never believe in 2025 and what is happening. Millions of us who quit smoking with safer alternatives are now being told we're wrong. Instead of tobacco companies being the villains, it's us. People who use safer nicotine products and speak up and out about it. We are cast as the threats. Globally, governments are pushing their citizens to break the laws just to access a vape or pouch because the alternative to them is going back to smoking. When it comes to policy, science is to take the lead. But in this space, emotion seems to win. Panic spreads faster than peer review studies. Tobacco control is a well-oiled and frankly spoiled machine. It has no hesitation to reframe the narrative to make anyone that goes against them the enemy, including folks who speak up for safer nicotine products. To them, we're the enemy because we're telling the world nicotine isn't the problem, combustion is. Today, safer nicotine products, they were created and sold by the very people who tobacco control once claimed to fight for, people like me who simply wanted to find the best way to quit. Michael Russell, the father of tobacco harm reduction, said it best. People smoke for nicotine, but they die from the tar. Millions of us understand that. The only ones who don't seem to be the Puritans of TC. We say vaping is 95% less harmful than smoking. They say there's no proof. What about the kids? We say it helped us quit. They say there's no proof. What about the kids? We point to evidence. They point to distractions. A perfect example is with Cochran. When Cochrane reaffirmed vaping's effectiveness in November of 2022, the old guard tobacco control didn't respond with data. They blogged with manipulation. What followed was brilliant. So here's some of the statements that was made in that. Cochrane has confirmed that the clinical trials, other stop smoking medications available in Canada do better than e-cigarettes. This Cochrane review is out of step with other scientific assessments of the usefulness of e-cigarettes as quitting aids. There is no evidence that encouraging smokers to use e-cigarettes has benefited health in Canada. What followed was brilliant. Jamie Hartman Boyce and Nicola Lindzen responded calmly, firmly to criticisms from Physicians for a Smoke-Free Canada they clarified they're not pro-vaping advocates, they're researchers doing their job. Yes, their communications are funded because sharing science isn't a side hustle, it's essential. They push back on the claim that e-cigarettes don't work, pointing out that quitting smoking is hard, and even modest success saves lives. Comparing raw data across studies, apples to oranges, that's why they're working on proper meta-analysis. They defended clinical trials because science matters, addressed long-term use and youth concerns, and reminded critics that Cochrane reviews follow strict protocols, even when authors are also trial investigators. Then came the mic drop moment. Vaping debates are fracturing the tobacco control movement. Maybe, they suggest, we should stop fighting each other and focus on the real enemy, cigarettes. What I know is that response from academics empowered consumers around the globe. Because when we see academics and people who are putting out science, defending it to the misinformation, it gives us the opportunity and the motivation to go out there and amplify that. And I know that the policy makers who regulate these products, they have the access to the same intranet where accusations and rebuttals play out and are all well trained to see past the smoke and mirrors of misinformation. We have to fight back. I'm not a scientist, but when I see researchers standing up to misinformation, it gives me fuel. It pushes me to speak louder, to find spaces where people and their stories can be heard. I have never been more certain that this work matters, because in Canada, we've kept a flavor ban at bay for over four years, even though many people wanted it to happen. Why? Because we found our way to keep the science and the lived experience louder than the fear So what do we do? We continue to push back with facts, with strategy, and with heart, and most importantly, with action. From rallies to letters, from bus tours to social media, from simple pop-ups to emails, we find a way to tell our story. We find ways to make sure that our voice is heard. It means engaging respectfully when it's hard. Even when someone misquotes data, spreads fear, or calls you names, because yelling at them is not gonna change their mind, but if we listen, maybe we can. When you show up calmly with credible information and lived experience, that's when cracks start to form. In 2018, flavors became a political issue in Canada. My dear friend and mentor, David Sweenor, and I were discussing it when he suggested, why don't you launch a postcard campaign and explain why flavors matter and mail them to the Minister of Health? Just so you know, it's free to mail our government in Canada, so we take advantage of that. So that's exactly what we did. We sent over 30,000 postcards from Canadians across the country. Unfortunately, Health Canada treated those 30,000 postcards as if they came from one person. a single voice, counting them as one submission. As you can imagine, that distorted the results. Instead of recognizing that 97% of respondents opposed a flavor ban, the report suggested that over 80% supported it. But we didn't give up. We learned from the experience, and instead of complaining and fighting, We played by their rules. In 2021, when the flavor ban once again returned to the table, we knew we had to do things differently. We needed individual, unique responses, and we understood that many consumers didn't have the time or confidence to submit formal responses on their own. So we built a more advanced website that made it easy for people to send personalized emails directly to the government. We did that with no money. and we did that with passion. This time, we generated over 20,000 unique submissions opposing the ban, and each one was counted individually. The facts are there, and we all have the information available. You see, when voices come together, when harm reduction meets medicine meets policy meets lived experience, that's when we get traction. But truth-telling in this space isn't just about tactics, it's about resilience. You have to know when to push forward. You have to know when to pause and really listen. And sometimes when the conversation is going nowhere, you have to know when to walk away and save your energy for the next fight because there will be a next fight. We just need to keep the truth in circulation, to keep that door open for the next person who's ready to walk through it. So whether you're an advocate, a policymaker, a health professional, or someone trying to make a difference in your own circle, facts matter, continue to share them because lives depend on them. And the louder the noise gets, the more committed we must be to the truth. Changing the narrative doesn't start with regulations or headlines, it starts with us. calling out misinformation, sharing what we know, and standing firm even when it's uncomfortable because it works. In 2024, after that minister, I like to call him that guy, made that outrageous claim about vaping killing kids, we responded even stronger. Across Canada, we mailed, again, free, over 100,000 personal unique letters to the Minister of Health, the Minister of Mental Health and Addictions, and members of Parliament, sharing why flavours matter. We ended the year with no flavor ban. Vaping flavors remained protected. Sadly, we couldn't say the same for nicotine pouches, but it's 2025 and that brought us a fresh start and a new goal to protect all safer nicotine products. That's the power of truth when we refuse to give up on it. The noise can be loud, it can be cruel, it can be exhausting, but what we know, what we stand on is science, evidence, and the lived experience of real people. It's rooted in truth and it's driven by hope. Over the past decade, I have met academics who were never too busy to answer my questions, edit an op-ed, join a Zoom workshop, speak on a panel, or even show up at one of our many protests. Their knowledge gave me the strength and courage to engage, to speak up, and to keep going. I hope in return I offered something back, maybe a perspective they hadn't considered or a voice they hadn't heard. These people are not just friends, they're my teachers. So today in this room, this is a little bit of a challenge, everybody. We have both consumers and academics, and I urge you to find each other. Academics, find a consumer buddy. Consumers, find a science buddy. Because when we work together, our voices are amplified and heard even further. Thank you.
29:41 - 35:32
[Konstantinos Farsalinos]
So, Maria, thank you very much for the amazing presentation and for all the work that you're doing in Canada, a very difficult country for tobacco harm reduction, I must admit, with really stubborn politicians and legislators, as well as scientists. In 2016, We published a study, my research team published a study, examining perceptions of healthcare professionals in Greece about nicotine, smoking, and e-cigarettes at that time as a harm reduction product. More than 80% of physicians reported that the contribution of nicotine to smoking-related lung cancer was important, very important, or extremely important. Nicotine is not even classified as a carcinogen. The same proportion reported that the contribution is equally important of nicotine to smoking-related cardiovascular disease. In 2021, a study of more than a thousand US physicians said that 83% strongly agreed with the statement, nicotine causes cardiovascular disease, and 80.5% strongly agreed with the statement that nicotine causes cancer. You understand that this level of misinformation, misperceptions, is not only widely present in society and among non-experts, but among experts. And experts have been the source of information for consumers, and in that case of misinformation. So over the last several months in Greece, I have received almost on a weekly basis consistently messages and emails from vapers with links to videos on social media of physicians. All of them were physicians or psychologists. I mean, similar specializations. discussing about harm reduction products, mainly e-cigarettes and heated tobacco products, reporting whatever you can imagine. The level of misinformation, the level of confusion is tremendous, but these were presenting themselves as experts because they were physicians, psychologists, psychiatrists. And as you understand, that created an environment of credibility from their side towards the consumers. And now, thinking of what Maria said, that academics and the consumers need to meet each other, it's definitely true, but there are ways to make this meeting happen that are impractical or impossible to do. For example, it wouldn't make sense for me to visit, to go to every video post and write down a response, a comment or whatever, because there were videos with 50,000 views, 100,000 views, and my comment would be one out of 50 comments, and probably five or ten people would be able to read it. So what I did four weeks ago is launch my own social platform. A social network on Facebook, Instagram, TikTok, and YouTube named THR Talks and Stories by Dr. Farsalinos. And coincidentally, I mean, I didn't do it just because of me participating in this keynote. It just happened out of coincidence. But I have prepared a short clip, a two-minute clip. It's parts of two of my social media videos. The videos are in Greek, but I added English subtitles. And I will ask dear Camille to show the video. It's a two-minute video to give you an idea of the strategy that I thought would be useful in promoting the right message to the consumers. And then we're going to comment on that. Do you use e-cigarettes? Yes, but it contains all the chemicals. E-cigarettes contain oils, oils, and can cause pneumonia. By using them, the e-cigarette will be filled with spirit water. These are just a few of the many things that e-cigarettes users hear, and mainly those who have stopped smoking. What are electronic cigarettes after all? In 2017, the world's largest scientific publishing house, ICOS Elsevier, asked me to be a scientific correspondent and writer in the first book on electronic cigarettes. The book was published by me, three Americans and one Italian scientist and was published in English and Chinese. So I read and translate from English. Four are the basic components of electronic cigarettes. Propylene glycol, glycerin, nicotine and aromas. Propylene glycol is a synthetic substance that does not exist in nature. It was first manufactured in 1859 and was approved as safe for use in food and drugs in 1982 by the Organism of Food and Drug Administration of the United States. As we know from gymnasium chemistry, every substance that ends in "-oli", propylene glycol, glycerin or glycerol, is alcohol. So, The myth that electronic cigarettes contain oils and cause pneumonia, a myth that has been published in a scientific journal, is false. Many scientists, as well as electronic cigarette users, worry about what happens to the temperature of the liquids and what they eventually inject into their minds. Let's go and see the concerns of a colleague and, in fact, the same specialist cardiologist about electronic cigarettes.
35:32 - 35:41
[Video]
I notice two substances that trouble me, aldehydes, acetaldehyde and formaldehyde, also known as formol. Formol is used for preservatives.
35:41 - 41:39
[Konstantinos Farsalinos]
So, acetaldehyde and formol are injected into preservatives with electronic cigarettes. So, what I thought would be important is check all the supposedly evidence that all the other physicians who have no relevance to THR or even to tobacco control science and research, and start addressing all these myths. And the way of doing that is sell my expertise and my relevance to the field, Present studies. I'm always, in all my videos, I present screenshots of the study title and the authors. I also mention what the study, when the study was published and what university usually published the study. But do it in very simple and easy to understand terms and words because, you know, non-experts are unable to understand scientific terminology. The thing is that, and the problem is that we have been doing things like that, but we lacked consistency, we lacked repeatability, and frequency. We were doing it sporadically. So I think that, first, we have underused social media. I mean, when I say we, I mean the supporters of THR and those who have been involved in research even more. We have underused social media, and we haven't done any consistent effort to educate consumers and, on a second note, also physicians. I mean, I'm sure that lady who saw the video tried to comment on my video because I exposed her. I think she will think about it very carefully before releasing another video on e-cigarettes. And I plan on exposing even more physicians, and all of them are physicians. I have a collection of videos of nonsense, literally. There is a cardiologist in Greece who said, with e-cigarettes you're going to get a valley, a clinical manifestation of which is popcorn lung. Completely relevant issues. The same lady who is a cardiologist said, that diacetyl causes popcorn lung and the disease is called popcorn lung because on the x-ray, the lung defects look like popcorn. They don't even go on Google to search simple things like what's an aerosol. Another colleague of mine was saying that we shouldn't call vapors as vapors. We should call them dusters from dust because they inhale an aerosol and the aerosol is a collection of dust dispersed in air. And you can just go on Google and write the term aerosol definition, and you're going to find the definition on Google. So this is extreme. And the problem is that because this subject is quite popular, these people had 100,000 views, 150,000 views in Greek only. So I'm talking about the Greek population here, which is 10 million in total. And that triggered them to create a second video post about e-cigarettes and other harm reduction products, a third one. One of them has a collection of eight video posts simply because he saw that they were the most popular videos in his social media platform. Now, we need to fight that on a consistent basis. My first video about the contents of e-cigarettes in a social media platform that was one week old, had 840,000 views in Greek. So only addressing the Greek audience. The second one about formalin had 305,000 views. So I think that We need to expand this effort. Of course, Greek is not enough in any case, but we need, and what we have been, we have not been doing till now is do it in an organized, consistent way. For example, my goal is to release consistently one video a week, so not overload of information, but not really sporadic once a month or whatever. Every Tuesday I'm releasing a video. I'm doing my best. It's very time consuming. It's much more difficult than it looks. All videos should be short. My goal is to be two, three, maximum five minutes. Because the consumer and the audience is not going to pay any attention if it's longer than that. But we have to do it consistently. So I fully agree with Maria. We need to have academics meet with consumers. We need to be informed because I wouldn't have been informed about this content had Vapers not sent me videos all the time. So that's how I was aware of all this campaign in social media. But we need to do it in a practical way, in a way that will work and will have an effect. It won't have an effect if we go in every video post and we write a comment. What has an effect is to do ourselves, organize, selling our expertise and our involvement in the field, which creates, of course, reputation, credibility on what you say, and do it organized. And I think we should do that globally.
41:40 - 42:20
[Jagannath Sarangapani]
I agree with you, and thank you for that, because I guess that's what is needed. We need the academics and the scientific community to back us up. And the one problem that we all face is these 10-second shots that kind of flood our social media, and that seems to be the attention span that everyone has. And so if we kind of get long and complicated, we are probably just going to be swiped away, you know? So thank you for that. We will open up now for questions from the audience. I see one, two hands already. Can we have the mic over?
42:24 - 42:47
[Roberto Sussman]
Very simple question. Impressive. Congratulations. I wish I had your energy. But what would have happened if instead of Dr. Constantinos Farsalinos, it would have been, well, in Greece, it could have been Joe the Vapor.
42:48 - 43:33
[Maria Papaioannoy-Duic]
You know, what would have been the... I have considered responding to these videos in Canada, and I don't have... I mean, I have a lot of letters after my first name, but none of them follow an MD. So... I don't have the credibility. So we would call him Yanni the Vapor in Greece. So that is why that though, Yanni the Vapor can share Dr. F's post. And that's where we start getting fueled. And that's why the sharing is also important because it falls into other people's places. I mean, feeds.
43:33 - 44:58
[Konstantinos Farsalinos]
Roberto, I'll tell you what the problem is. The competition. would be relentless. So, someone presenting himself as a vapor. But forget the vapor. A physician, without being involved actively in this field. A simple physician. I mean, I would be a physician who have never done any research on THR. The response would immediately be that, yeah, you're a doctor who is saying this. There are 10 doctors out there, just in Greece, I'm not even talking globally, who are saying the exact opposite things. Why should we believe you and not the 10 other physicians? Imagine now having a consumer. they would simply think that the consumer has been influenced by the industry or whatever, that he's stupid, they could say whatever they want. Because these physicians are also selling their expertise, being physicians, of course, no expertise in THR, in order to present their views as having some credibility and reputation. So you can't compete that because there are many, many more like them who are saying the same things, mostly nonsense. So in order to compete, you have to show somehow that you are different and that your view matters more. Because in democracy, as you know, everyone can have a view, but not all views are the same. And that's what we need to use.
44:59 - 45:35
[Jagannath Sarangapani]
One of the things that also does happen is when you have, say, for example, a cardiologist who comes on social media ever so now and then talking about various aspects of lifestyle changes, and then he slips one in about... vaping and about nicotine pouches and how bad they are, that seems to gain credibility compared to a doctor who only talks about harm reduction all the time. Maybe that's something that we need to also consider because then they seem to get a widespread acceptability about knowledge about a wide-ranging set of topics. Maybe that's something we could think about. So you, yeah.
45:40 - 46:57
[Tikki Pangestu]
Hello, my name is Tiki Pang. I worked for the World Health Organization for 13 years and had many dealings with policymakers in ministries of health. I just want to make a comment on Maria's comment that misinformation is institutionalized amongst the government, amongst our policymakers. And in my experience in dealing with them, By the way, I'm a very strong advocate of THR, but in my experience in dealing with them, I developed sort of a certain kind of sympathy, and I think we also need to perhaps understand where they are coming from. And I just want to end on a quote from Professor Sir Michael Marmot, who was chair of the WHO Commission on the Social Determinants of Health, and this is what he said. Science engages not with blank minds that get made up as a result. Science engages with busy minds who have very strong views about how things are and how things should be. So a little bit of sympathy for the policymakers and our strategies moving forward. I think we shouldn't just say, you are just misinformed, but see where they're coming from. Thank you.
46:58 - 47:02
[Jagannath Sarangapani]
Maria, would you like to add to that? Some observations, perhaps?
47:02 - 48:27
[Maria Papaioannoy-Duic]
I have no problem with the policymakers. I understand. Yes, of course, we're going to have some empathy for them. I don't like feeling sorry for people. I just want to be in their shoes. Where I struggle with is the fact that even though they don't know or they're trying to learn, they're choosing who they learn from. And again, going back to Canada, and in all honesty, I can only give a perspective from Canada, We have lived experience written into policy when it comes to harm reduction and every other sort. So that means meeting with people who use drugs or use alcohol to develop policy. And it wasn't until maybe two, three years ago that they started meeting with lived experience in that space. So we can sympathize, we can empathize with them, but there has to be a pivotal moment where, in whatever country you're at, that they align with their other strategies, especially around harm reduction. I do think many countries do have... I mean, I could be wrong, but I think a lot of people have the harm reduction aspect, whether it be for sexually transmitted diseases, drugs, or whatever. It's about consistency.
48:28 - 49:41
[Konstantinos Farsalinos]
You know, Tiki, I wouldn't particularly feel sympathy or empathy for them, because sometimes I believe that one of the main problems is exactly this arrogance that you mentioned, that they know and they are sure where we should go. And this arrogance that they know everything and they know what the goal is and they truly believe that this goal is sacred and that's the best they can do. For example, in the case of THR, nicotine-free society, something which is completely unrealistic. But that's the goal. And they know where they're going. No, this is arrogance. They are wrong. They need to understand that they are wrong. Someone must tell them they're wrong. Of course, I'm not saying that we should start beating them or start calling them names. Definitely, obviously not. But they are so arrogant that they don't even want to engage into a debate. An open debate, I mean, yeah. With people who will upload them, yes, they are always in a debate. But that's not called a debate. but with people who have a different view and would like to share a more realistic approach in handling smoking, no, they are not willing to engage into such a dialogue. So, that's not something to feel sympathy for, to be honest.
49:41 - 51:59
[Maria Papaioannoy-Duic]
I can use one example of a Canadian politician that comes to mind. She was very, she decided to put her toe into the, I'm gonna ban, I support banning flavors area in Canada, and she just got slammed on Twitter. You are wrong, blah, blah, blah, blah, blah, all this stuff. Her name was Pam Damoff. Anyways, that being said, so... Instead of engaging with us, because I think her Twitter post about flavours being bad and she's supporting the band had about 500 or 600 comments under it, a lot of it being negative, saying you're wrong. Instead of saying, okay, let me meet with these constituents, let me meet with these Canadians, I'm a paid public, I'm an elected public servant, she doubled down and brought people to prove her point right. And again, so you're looking at opportunity of learning versus opportunity of telling. There's got to be, and so we do, technically though, they're not all that bad. I mean, they're not all like that guy over there, Mark Holland. There are so many good politicians that you can learn from as an advocate, and you have to seek and find them. And for me, please don't laugh at me if you know this man's name, but the reason that I have had such a positive experience in this space was the first politician that gave me time was Rob Ford. if you guys know who that mayor of Toronto was, he gave me time and space and he listened to me and I told him about that van in Toronto and I told him how ridiculous it was and he promised me he and his brother would vote against it and he kept his promise. So every time I walk into a room with someone trying to meet a new politician, I think about Rob Ford and say, well, he believed in me. Someone will again. So I just hold on to those positive ones. There's some really good politicians out there. You just have to find them.
52:01 - 52:12
[Jagannath Sarangapani]
Hope is a beautiful thing. Any other questions, if there are people watching online? Yeah, maybe Mark first.
52:12 - 54:30
[Mark Tyndall]
Hi, I'm Mark Tyndall from Canada, so I know Maria well, and thank you very much, Maria, that was great. What's frustrating about this whole misinformation? In science, I mean, I've attended meetings my whole life and there's debates about whether taking a baby aspirin a day is good or bad, or whether HRT is good or bad, or what antibiotic A is better than antibiotic B. I mean, these are legitimate arguments and debates. But we're stuck in this little bubble of fighting back a ridiculous enemy or a ridiculous bear here, because we're not even close. Like, this is, you know, we should not be at a position when we're talking about whether a flavor band's good or bad or disposable. Like, we should be talking about how we're going to get people off cigarettes. And we've been so sidetracked by this, and it's... You have to believe it's a conspiracy or something. How could we be in this position when we have such obvious, solid, common sense, scientific evidence on our side and we seem to be losing? And it's really frustrating that we're spending all of this time trying to dig out of a very deep hole when everything's on our side. What happened? What benefit is it for some cardiologists to be trying to undermine a safer product when their whole career is based on people dying of cigarettes? How can they not get it? I'm just sitting here listening to this and what we're arguing and what we're fighting back in seems just so ridiculous. How could we be in this position in 2025 when We're not having meetings about how to promote safer products. So whether anybody's got any thoughts, is this a conspiracy or like who's behind this? Like how do we find ourselves in this position?
54:31 - 58:21
[Konstantinos Farsalinos]
The problem since the beginning was the lack of dialogue between THR supporters and THR opponents that was not, of course, caused by us, the THR supporters. I'm sure that Jerry and Paddy will remember that in the first or second year of GFN, we invited one of the biggest anti-THR fanatics. And the conference gave him the ability to choose how long he wants to speak. if he wants to accept answers or not, and if he wants to stay for the rest of the conference or leave. And he didn't even respond to the invitation because he knew that this is a conference about THR with THR supporters in the most part. And he just didn't even respond. Then, over the years, the arguments have been, in some cases, so irrational that when the counter-argument is completely lacking common sense, it's completely irrational, it is impossible to engage in a dialogue. For example, the DG Sarsante, which is, let's call him, the Minister of Health of the European Commission, three weeks ago, Inside the European Parliament, I saw the video myself, he started discussing about the disaster of vaping in Europe with so many cases of popcorn lung disease and people dying from vaping. Why? There has been not a single popcorn lung disease case in the world, never in the world, let alone in Europe. Unfortunately, I feel irresponsible because it was my study in 2015 that created this issue of popcorn lung because I mentioned it in the scientific domain for the first time. And everyone talks about popcorn lung besides myself. who brought this issue, and at that time in 2015, I even met the director of NIOS, the organization about occupational safety, who found in the popcorn factories in the U.S. this condition of popcorn lung disease. We had a meeting during an FDA workshop on e-cigarettes, and she was... much more reasonable, and she understood the issue of diacetylene, why it can be a removable potential theoretical risk because it's an ingredient. But everyone else, 10 years later, today, they're discussing about a phantom, something that doesn't exist. And it's been all over the news. There are stories in the media about a girl in the US that had bronchiolitis obliteras, popcorn lung disease, six months ago. So I searched her name on the social media. She was doing videos next to a swimming pool, displaying nice clothes, and I recognized her face. And she didn't look sick at all. Popcorn lung disease is an irreversible disease. It is what happens when a transplant recipient, a lung transplant recipient, rejects the transplant. That's what they develop. They develop borchiolitis obliterans. So it has come to a point that it's so irrational that you cannot even engage in the debate. How can you respond to someone saying that the aerosol is a collection of dust in the air and what you're inhaling is dust that coats the surface of all your organs? And he's a physician. Tell me. How can you engage into and dialogue with this person?
58:22 - 61:00
[Maria Papaioannoy-Duic]
It's impossible. I have a theory. I don't think you have to be empathetic or sympathetic to be in public health or a doctor. I think that just comes naturally. That's just something that is inbred with us, who we are, part of our, I say DNA. I believe that for decades, decades, the strategy to have people quit smoking or not quit smoking was stigmatization, was shame. It is the only addiction that we teach kids to yell at their parents to quit. It's the only addiction that, you know, kids could go up to someone smoking a cigarette and smack that cigarette out of the person's hand and they would be encouraged or maybe rewarded for that type of aggressive behavior. And if we flip that around, if it was a person who was obese and eating an ice cream cone, which would have just as much damage, and that same kid whipped that ice cream cone, there would be a different conversation. So if we don't feel sorry for people who smoke and we have spent a career finding shame, where are we going to find the empathy in this person? And I don't think that people are like you or David or John. I'm just listing people in Canada. Or Ian, where you have this... Inside of you to this empathy and understand and not sympathy empathy So these tobacco control people they're so blinded from hating smoking And they've spent a lifetime teaching people to hate smoking. And that ends up hating people who smoke. And one of the biggest distinctions of this, and I think, to me, this is the thing that I was most proud of, is that we changed the language in Canada through the Minister of Addictions and Mental Health, which we don't have anymore, which is very sad. But those four years were amazing with the two women. We no longer call Canadians who smoke, smokers. The language changed. The tobacco control units, they changed... Sorry, the tobacco control changed their language. They're fighting nicotine, but they're not changing smokers. They're continuing that stigmatization. So I think that's where it is, is that how do you tell someone, I'm not bad because I smoked?
61:02 - 61:45
[Jagannath Sarangapani]
One of the things is listening to Dr. Fasolon is getting... so agitated with misinformation. Being someone who is an expert in this field, you can imagine just how us who are consumer advocates, you know, who their only fault is picking a safer alternative to improve their lives. Imagine the kind of online abuse and so on that we have to battle and deal with. Any other questions? If there's anyone watching as well, please post. Yeah, please. Please, please.
61:46 - 62:42
[Roberto Sussman]
Very quickly, it's what you described, also Konstantinos and Maria, because you are in relatively democratic societies. So even though there is institutional blockage and so on, you still have some institutional paths. But that's not the case in many countries like my own. where institutions are absolutely locked, and Mexico is becoming a dictatorship, and all of Latin American countries and Asian countries have similar situations. So what I would say is we need also different strategies, right? Especially... I cannot describe such a pattern, but we need different ways of communication and different ways to spread the message.
62:47 - 63:42
[Rashidi Mohamed]
Hi, good morning. I'm Rashidi. I'm a primary care physician and an addiction expert from Malaysia. I come across several limitations in promoting harm reduction in social media. I completely concur with the credibility and source verification coming from an expert in the field. It's hard to distinguish the credible sources from industry-backed or biased messages, the public may distrust the harm reduction contents due to perceived links with tobacco or vaping companies. And the echo chambers and polarization of social media algorithms reinforce existing beliefs. So therefore, platforms like Facebook, Instagram, TikTok restrict nicotine-related contents if it's educational or health-oriented. So how do we overcome the algorithm issues?
63:45 - 66:49
[Konstantinos Farsalinos]
Well... You're right. I've thought about that. One of the ways to do that is you don't need to present your opinion in the title or in the text. You should create the question, and that's what I'm doing usually. For example, what's in the e-cigarette? I'm not saying in the text or in the description of the video or in the title that the e-cigarette contents are approved. I'm just saying what's in an e-cigarette. My next video is nicotine, cancer, and cardiovascular disease. From the title, no one can understand if nicotine causes cancer or cardiovascular disease. And that's a way of trying to bypass the algorithm. The algorithm, yeah, it can be tricky because it is a very sensitive issue. And sometimes the algorithm might even detect that you are promoting these products and that's a big problem. So... But, you know, our job is much more difficult for another very important reason, which has to do with the way the human brain functions and the instincts that drive the human brain and human behavior. You know, the first priority of the human brain is to protect the person from hazards, from risks. This is the number one priority compared to anything else. So, when someone hears a bad story about a product, that it is risky, that it is hazardous, that it has this bad thing that will happen to you, the X, the Y, whatever, or it contains this toxin, It gets installed into the memory very easily and it remains there. Why? Because the brain needs this information to help you avoid the risk. When someone else is telling you a positive aspect of this product, but you have also seen the negative story, there is no competition in the brain. The brain will stick to the bad story because the number one priority of the brain is to protect the person from harms. And that's why our effort and our job of trying to present THR in a positive way and in ways that can help people goes against these scaremongering stories of physicians, tobacco control people, legislators who are discussing about popcorn land, which is a myth, but it doesn't matter. People believe it. Vapors believe it and are almost ready to relapse back to smoking. And that's because this is, as I said, the top priority of the human brain. So our job is much more difficult. It's not only a matter of credibility or expertise. It's also the way human psychology works, unfortunately. So we need to triple our efforts in order to fight this, because we are on the most difficult side of the story.
66:50 - 66:54
[Jagannath Sarangapani]
Would you like to add to how you would counter?
66:54 - 66:57
[Maria Papaioannoy-Duic]
I don't understand social media algorithms.
66:58 - 67:03
[Jagannath Sarangapani]
I really don't. I guess that's the reason why your communication has worked, because you have not understood it.
67:08 - 67:50
[Will Godfrey]
Will Godfrey, filter. Hi, Maria. Yeah, as your amazing campaigns in Canada and many other examples illustrate, we know that consumers are the most powerful messengers for THR we have. At the same time, we know that consumers are widely stigmatized, excluded, ignored. We know that consumer advocacy groups around the world are generally underfunded or not funded at all. Great suggestion about the teaming up with scientists. I just wondered what would be your quick summary of what else consumers need, consumer advocates, from this community.
67:51 - 70:20
[Maria Papaioannoy-Duic]
I think the biggest thing is knowledge. And I use that as a education equals empowerment, which returns it with engagement. The more we know, the more confident we are when we walk into a room And we say stats. Like, I don't want to stutter on stats. Like, I look like an idiot. So if I'm worried about the information that I know when I'm walking in and talking to my member of parliament, then I'm kind of screwed. I'm lucky enough or I'm just persistent and consistent enough to be asking people questions. And that's the big thing is that you will not really... If you are an academic in this room, you will not, I don't even know if you understand how much a response to an email or a comment or some sort of thing to an advocate, a consumer, means because that increases our confidence. So education, and one of the things we did at Rights for Vapors, and Dr. F, you did one for me too about flavors, is I reached out to, I figured out what is every single subject that we're gonna need to learn in Canada. And during COVID, that new technology, Zoom, that I didn't even know existed, took advantage of it and reached out to people and said, hey, we're going to do a workshop. And sometimes three people showed up. Sometimes 10 people showed up. And I'm very proud. I even reached out to Health Canada and said, can you tell all Canadians who vape what's going on? And they did a workshop. And that was like 500 people showed up. But again, it's information, it's knowledge. And I think that is the biggest thing is that when the more we learn, the more confident we are in the spaces of talking. Because as constituents, especially close to election, you're, and I always call them public servants when I want to feel good and feel confident, your elected public servant is there to serve your needs. And so if you can go into that room confidently with all the information, absolutely. And then also as consumers, if you need science and stats, look at your trade organizations and ask them as well. They tend to have a lot of scientific stats and stuff like that.
70:21 - 72:11
[Konstantinos Farsalinos]
Maria, the problem with the communication between consumer and academics is that it needs to be done in a more centralized and organized way. If imagine everyone acts as an individual and starts asking academics, we would need more than 24 hours just to respond to a small proportion of the questions that we receive. So we need to have more centralized tools to propagate information rather than expect a response to every single question from every single consumer, which are legitimate and understand their concerns. But there are millions of consumers out there now. Imagine even if a tiny proportion starts asking questions, we wouldn't have time for anything else. So we need to find ways and channels to do it more organized and in a more time-effective way so that both the message propagates faster And at the same time, we're not responding to each individual request. You know, I have comments in my videos. The same comment, for example, are you going to say anything about heated tobacco products? 50 times under the video. Now, imagine if I had 50 people sending me a personal question about it, and being the same and having to respond... to 50 different people on the same question. So we need to do it more organized way. I understand your concern as a consumer that you want to ask an expert because you have a question at that time and something that you feel worried about, but it's not sustainable in the long term. We have to find other more organized ways of creating this link, which is very important that you mentioned at the end of your keynote, the link between the academic community and the consumer community and society.
72:12 - 72:29
[Maria Papaioannoy-Duic]
So Dr. Ruff said don't email him. I'm just teasing. But I totally understand that. And again, we'll figure it out. We'll figure out a way. Maybe everyone emails me and I'll email y'all. How about that?
72:30 - 72:31
[Jagannath Sarangapani]
Yeah.
72:31 - 73:02
[Diego Verrastro]
Question for you. Hello, I'm Diego Verrastro from Argentina. It's not an ask. I want to leave a thought. We cannot continue discussing the very flat earth. We must present our own discourse without entering into the answer to why they live that the flat is, you know that?
73:04 - 74:29
[Konstantinos Farsalinos]
Yeah, I understand what you mean. Instead of answering to all this scaremongering, we just need to create our own message and our own, let's say, communication strategy. But at the same time, you know, we need to understand what the consumer hears and how these misperceptions are being built. There is a reason why these misperceptions exist. So unless we identify the source of this misconception and this misinformation, and unless we identify why they have been so successful, there is no way that we are going to combat that successfully. So we need to monitor what is being sent and what kind of messages are being propagated into the society and into the consumers. And this is another area where the consumers can help. As I said, the reason why I decided to launch the platform was exactly the continuous emails that I received from consumers with links to the videos and the inability basically to respond because it doesn't make sense to go to every video and write a comment. It wouldn't work. It would have been a waste of time and it would have been useless. We need to create the narrative ourselves, yes, but we need to know the concerns, address the concerns, and that's how it's going to be more successful.
74:30 - 75:28
[Maria Papaioannoy-Duic]
I agree. And every social media platform has its own purpose. And what you do on TikTok is not going to work on Twitter. And I think that is... And that is a very... And then... You do have to respond because silence gives credibility, not to the truth. It gives it to the lie that's being spread, and especially on social media. We can't put out every single fire, but we can share factual information. So if I, as a consumer, see another doctor say something, I can go find Dr. F's... TikTok video, grab it and post it there. And that gives content and information to consumers to continue to share or counter misinformation in a more authoritative way.
75:29 - 76:12
[Jagannath Sarangapani]
Another aspect that we need to consider here is that All of us are in various types of silos. In Europe, if you have a problem of flavors, in a country like India, you have an existential ban. While the information still keeps coming, we keep getting thrashed for different reasons, and a lot of our concerns are from various different areas of THR, which is something that we are all worried about. So on those lines, perhaps if you could shed some light on, your experience has been more about banning vapes and THR and working on it, and you've been looking at it from a global perspective. How would you look at it differently?
76:12 - 79:16
[Konstantinos Farsalinos]
I still haven't seen a single country which has successfully banned e-cigarettes. We have here in the audience people from several countries where harm reduction products have been banned. India, Brazil, Argentina. And they can tell us how many hundreds of thousands or millions of users they have there. Using illicit products, which means products of unknown source, unknown quality standards, unknown marketing tactics and attractiveness towards youth which are supposed to be supported. through a prohibition. I remember India, it's been a characteristic example for me because I had visited India before the ban repeatedly for five times. And it was very, it was almost impossible to see someone vaping there. You couldn't find vape stores It was a very rare case to see someone vaping. Well, after the ban, what I hear is that they've become one of the most popular habits you can have. You can find products literally everywhere. I mean, shops, selling, whatever you can imagine, they have a corner with vape devices. So the prohibition resulted in the explosion of the market, but all of it being black market. So it's a typical case of how prohibition creates the exact opposite effect of what you expect to have. And instead of other countries using this example in order to avoid them, now, for example, Bangladesh wants to ban e-cigarettes too. And when I was two years ago, one or two years ago in Bangladesh, and I was telling them the story in India, Their response was, oh, we know very well what's happening in India because all the products are smuggled through Bangladesh. And my response was, so you want to be another India and have your neighbor smuggling the products to you? I mean, it doesn't make sense. No, but it shows. how irrational the approach from some countries and some regulators are that despite knowing that a prohibition not only had no effect, it had the exact opposite adverse effect, they still insist on doing the same thing in the neighboring country. And that's why, as Mark was saying, that's why we are losing the battle. That's why it's very hard to engage in dialogue with them. Now, what can you say after they admit that they know what happened in their neighbor, and now they're going to do the same and face the same problem? How can you fight that? I mean, with common sense and with reasoning. You can't, basically. You're left speechless. And you say, okay, there's nothing more to say. I can't do anything.
79:18 - 81:57
[Maria Papaioannoy-Duic]
I think governments are in the business of starting black markets. In Canada, they did a great job with the cigarette industry. We have a thriving black market for cigarettes. When you look at the e-cigarette industry and vaping products, you can look at the province of Quebec. They did a full-on ban just over 18 months ago. Flavers, huge black market for disposables and stuff like that. But they just, well, we did what we need to do. So we stop here. We did the law, but we're not going to carry because governments don't have money to enforce because it doesn't cost that much to create a law, to put it on paper, but it costs a lot of money to enforce it. So I think, you know, They don't take accountability for what they do. And I think a really funny... I'm just going to share this. So that guy back there, the Minister of Health, when he banned nicotine pouches, I chose to go to his riding and within two kilometres buy as much illegal nicotine pouches that I could. So I spent about $1,000 in two hours. And I had, like... You can see the video on Rights for Vapers on YouTube, and I spent all this money and got every single pouch, except for the legal ones, because we only have one legal one in Canada, within two kilometres, every convenience store, vape shop, you name it, you know, and I recorded it and I put up the video. Within four days, this unit at Health Canada, which I didn't even know exists, called the Central Triage Unit, CTU, reached out to me and asked me for a list of every single place that I bought these. That would have taken hours because I didn't remember they were available everywhere. And I just found, and then they got back to me and I finally responded explaining I don't work for the government of Canada and here's my hourly rate to fill this out and I'm not telling on Public Health Heroes. But I found it very interesting that instead of saying, I made a mistake, we're going to use all of a sudden resources just to track down in one specific area because that guy looks bad. So I don't think they care unless you bring out their mistake to them. And that's what we're trying to do is these mistakes, they need to be held accountable. And I know it's easier here. Like, I mean, I can't imagine Mark Carney, our current prime minister, deciding to make it unconstitutional for vaping products because one of his kids vapes, like happened in Mexico, which still blows my mind.
81:57 - 85:41
[Konstantinos Farsalinos]
Now, I want to use another example because I used examples of low- and middle-income countries. I want to use an example of a high-income country with very little corruption, Denmark. Denmark in 2022, three years ago, banned flavors in cigarettes. The national tobacco and nicotine use survey done by the government in 2024 was revealing. Now, in Denmark in 2024, vaping among young people aged 15 to 29 increased after the ban, from 7 to 12%. And 63% of all vapers were using fruit flavors that were banned two years before. In Denmark, which means that in Denmark the vast majority of of liquids, of vapes, are available in prohibited flavors. In a country with no corruption, very little corruption, a wealthy country which is very well organized. You know what the response from the regulators were? No, they didn't think that, oh, the prohibition didn't work. They want stricter prohibition. I don't know how you can... I mean, a product that has been prohibited, how you can prohibit it more? Because prohibition is prohibition. You can't be more or less pregnant. You can't have more or less prohibition. So they think that they should be stricter in what? Implementing the ban. I mean... I feel that regulators sometimes don't understand basic things. Flavorings cannot ever be banned or disappear because they are all coming from the food industry. The biggest manufacturers of food flavorings, of flavorings for cigarettes, for example, These are food companies. It's the food industry. The raw ingredients are all coming from manufacturers who have been there for years creating flavorings for the food industry. So you can ban... The label saying that it's a flavoring for e-cigarettes, but you cannot ban the flavoring. So probably they don't get it. I had the same issues in Greece. They wanted to ban the sales of raw ingredients, PG, VG, flavorings. And I said, I went to the parliament and I said, in the pharmacy next to the parliament, You can buy one liter bottles of propylene glycol and glycerol because it's used everywhere else. So how can you... It's like saying that I'm banning the sales of this flour to make pizza, but the same flour can be sold to make bread. You can't prohibit anything like that. It's impossible. That's exactly what I said in the parliament. In the parliament, in front of the Minister of Health. He didn't even listen. He didn't care. That's the level of understanding that we're having. But, you know, that's the problem. The stubbornness. They are so ideologically predisposed. They see that the ban doesn't work. No, we need more ban. Can't happen. They see that the ban created a market that didn't exist. No, we don't want to talk about it. India, the government banned public scientists, scientists working in public institutions from doing any research on the products. You can't research on the product. You can't, for example, show that there's a black market. You'll be fined. You'll probably lose your job.
85:41 - 85:54
[Jagannath Sarangapani]
Well, tough as it is, I think we are... very quickly running out of time and closing. So perhaps Maria, you could end with some closing thoughts on this one as we wrap this.
85:54 - 87:16
[Maria Papaioannoy-Duic]
I just want to say if you're out there and you're using these products, continue to share your story. Find someone, and if you're in advocacy, you will just keep at it. Patience and persistence. Keep at it. You'll find the right person to amplify your voice to the right place. You never know who you talk to in a room. And you never know what you can learn and what they can learn from you. And I truly believe that this product... is here to change, is here for a reason, and that reason is to eradicate tobacco-related illness. And we can get there, and we are the public health heroes. We are the ones that are pushing the narrative. We're the ones that have to push the narrative. We're the ones that have to keep moving forward. And I just want to point this out. We've already seen a shift in safer nicotine products from vaping to nicotine pouches. And we're not stopping that shift. And that just in itself shows how open-minded we are and how different we are. So just keep pushing, keep moving forward and be creative and also have fun and also sometimes make fun of people that do stupid things.
87:18 - 88:20
[Konstantinos Farsalinos]
My message is that Maria raised an important issue of creating an interconnection between consumers and scientists. But this, and that's the most important thing, it should be done in an organized way with a strategy, with a plan, and not sporadically. I think this is something that we have missed. GFN represents a perfect example of a strategic and consistent communication on a scientific level, with, of course, some addressing also consumer basis, but the more activistic consumer basis. to approach society and consumers on a larger scale, we need to do what Maria said, but in an organized, cost and time effective way, as much as possible, and as soon as possible. We've been behind that, and I think that one of the main areas which focuses the use of social media, we have underused social media, and we need to find ways to better use them. Thank you.
88:21 - 88:25
[Jagannath Sarangapani]
I don't think I could have wrapped it up better. Thank you for doing that for me.