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Mexico’s ban on nicotine vaping leaves consumers caught in the crossfire. While the “tobacco wars” narrative is obsolete, it continues to cause damage, says physicist and tobacco harm reduction advocate Dr. Roberto Sussman. While the tobacco industry today is no longer the villain it once was, public health campaigners continue to wage war, striking disruptive technologies like nicotine vapes that provide safe and effective alternatives to combustible tobacco.

Dr. Roberto Sussman
Sr. Researcher in Theoretical Physics,
National University of Mexico
Vaping Advocate, Member of Pro Vapeo Mexico


00:00:10 --> 00:01:14

Brent Stafford: Hi, I'm Brent Stafford and welcome to another edition of Reg Watch on GFN.TV. Mexico. It's celebrated for its breathtaking beaches, awe-inspiring ruins, and lively nightlife. But if you fancy a nicotine vape as a healthier alternative to smoking, Mexico is not for you. As of 2021, the importation and sale of nicotine vaping products is illegal, and in 2023, amendments to Mexico's tobacco law went into force banning nicotine vaping in all smoke-free areas and public places, including hotels, beaches, and parks. Joining us today to discuss what many say is one of the world's strictest anti-vaping laws is Dr. Roberto Sussman, senior researcher in theoretical physics at the Institute of Nuclear Sciences at National University of Mexico, and member of VAPEO, a non-profit association representing Mexican consumers of non-combustible nicotine products. Dr. Sussman, welcome back to RegWatch.

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Roberto Sussman: Hi Brent, nice to be back with you again.

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Brent Stafford: So let's start with the decree Mexican President Manuel Obrador signed in 2021 that made the importation and sale of e-cigarettes illegal. Roberto, was there a public consultation process that made that happen?

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Roberto Sussman: No, no, there wasn't. I would like to put a little bit of historical context. Vaping, marketing, commercialization has been always banned in Mexico, always. But the Supreme Court in 2015 decreed that the prohibition was inconstitutional. Nevertheless, governments didn't care, they continued. And around 2019, there were several law initiatives to regulate, because the political class in Mexico understands that regulation is better, because otherwise you lose revenue, black markets, things that we already know. So it was an effort, and there were several law initiatives. But in the end, the president, our president, and there's Manuel Lopez Obrador, by short we call him AMLO. That's the initials. AMLO issued a decree in 2020, the first decree, And nevertheless, the legislative activity continued on until they made a very bad leach, which is something that I mentioned in a previous program. And so what happened is that, there was a desire to impose the presidential will on top of the legislative process, because regulation has to be decided by the legislative power, by the houses of Congress in Mexico, not by the presidential power. But, here we have a combination that I might explain with a bit more detail. There was an attempt to have an open parliament to discuss over several initiatives, but there was a vertical imposition by the president, who was advised by the de facto health minister. That's another story. But to answer your direct question, no, it was an absolutely authoritarian, vertical decision. And unfortunately, our president is acting like this in many other issues, not only on vaping.

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Brent Stafford: Yeah, I think a lot of people definitely in the West would have a problem with just a president signing a decree and all of a sudden making something illegal. He's not the king, for goodness sakes. Now, President Obrador said that vaping is harmful to human health and that vaping devices have been designed to appeal to young people. And he said that as he was signing the decree. Where is that kind of information coming from?

00:04:40 --> 00:08:43

Roberto Sussman: Well, that information is everywhere globally. In fact, Andres Manuel Lopez Obrador, doesn't know and doesn't care anything about vaping. He's an ex-smoker. But he doesn't care about this issue. This issue is irrelevant for him. But he's running a very vertical government. A lot of important decisions are made by him, many times on his whims, completely disregarding any technical problem, any technical obstacles. He's ruling by his whims. And he's a very popular president. Don't think that he's acting like a dictator, but he has a lot of support, a lot of popular support. That's another issue. But anyway, he, as in all very authoritarian vertical structures, This authoritarianism goes on at each level of the pyramid, right? So the president completely gave license to Dr. Hugo López-Gatell, who is not officially the health secretary. He's a sub-secretary. But he gave to this man, to this epidemiologist, who was formed in John Hopkins Bloomberg School of Public Health, he gave absolute authority over anything that has to do with health. López-Gatell is only accountable to López Obrado. That's it. So López-Gatell had a free license to impose the policy on vaping, and he follows the script written by a campaign for tobacco-free kids and Bloomberg philanthropy, right? So that was the policy. And Lopez Obrador was convinced by them, and he made that his personal policy. Like, just to give you one example, suppose that Joe Biden, the American president, Let's suppose he doesn't like vaping. Let's suppose he thinks that's very bad. But would you consider Joe Biden or your Prime Minister Trudeau in Canada in a broadcast for millions of people to spend 20 minutes reciting a script written by Bloomberg Philanthropy on vaping, and our president has done that. Even in international meetings, he takes this issue and he starts talking about vaping. So it has become a sort of obsession for the president, but also the president is using this as a scapegoat. Because when people tell him, what about the drug cartels? What about the health system in Mexico that is in such a bad shape? Then he say, yeah, but we're saving youth from vaping. So it is a combination of ignorance and political experience and the influence of Bloomberg Philanthropy in the man that is commissioned that was. Now he's gone. But for more than five years, Dr. Hugo Lopez-Gatell was completely in charge of the health sector. And this was one of his pet policies. We speculate that maybe he wanted to get a nice job in the WHO or somewhere in Bloombergland, but that's speculation. We really don't know. The fact is that this policy was implemented at the level of the law. Let's put that clear. This is the law. That doesn't mean that's the reality.

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Brent Stafford: Roberto, viewers may have noticed a little trouble with your speech. Could you tell us a bit about that? What happened there?

00:08:51 --> 00:10:24

Roberto Sussman: Ah, yeah. Look, you can see that, for example, this side of my face moves. but this side moves much less. What happened is that in the end of 2021, I had a very nasty tumor, a skin tumor that appeared here. And the message for everybody, it was a small thing, could have been removed by surgery. But I say it's a small thing. I'm very busy. No cancer is a small cancer. Please bear this in mind. So in two weeks, it grew behind the skin. It was growing, and it reached this level. So I had to take 40 sessions of radiotherapy, several sessions of chemotherapy. It lasted 3-4 months, the treatment. And as the tumor progressed into my face, it destroyed the facial nerves. These are the nerves that control the motion of your face. So my whole face fell down. And, uh, well, I have a major surgery and also I'm taking therapy. And fortunately, the tumor is gone. So I might not be able to smile with a nice smile, right? But I'm alive, right? I'm alive. So this is what happened.

00:10:24 --> 00:10:30

Brent Stafford: Now, so skin cancer, so I guess totally unrelated to vaping, correct?

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Roberto Sussman: Absolutely. Look... I've been treating the same head oncologist and the radio oncologist for more than 10 years because this is not the first skin cancer I have. I have several ones, different severity and so on. So the oncologist always, when I took my first tumor, I was a smoker, I smoked. They always insisted that I should quit smoking, quit smoking. But then I told the doctors. Please look at my lungs, my heart, my mouth, and tell me if you see any signals. And they never saw any signal of any damage that could have produced by my smoking. My smoking had produced already some irritation in my throat. And since I vape, I have nothing. And I have been really, really, revised medically. Every cell of my body has been revised. They never detected any problem with smoking or vaping. But then, you know, the oncologists don't like vaping. They always tell me, no, no, you should not vape, you should not vape. Look, the New York Times said and University of California said and so on. But they are already my friends. These doctors, I know them and they trust me. They know that I'm a scientist and so on. And I argue with them in friendly terms. I show them, I give them arguments and so on. And they still don't like vaping, but at least they have been informed about that. And they trust me because they know I'm a scientist. They know that I have research on these issues, that I know aerosol physics. And so one of the doctors is even a bit enthusiastic, but he keeps it privately because they are really concerned that not to be identified as promoting vaping or whatever. You know this global phenomenon here, right? So, but I was managed to establish a good connection with these doctors and also with other doctors, but so far it is kept privately. They are unwilling to go public. For example, I asked if I could give a talk about the physics of the aerosols in the hospital. They say, no, no, no, no, no, no. And they constantly receive talks and lectures from established tobacco controllers who, you know, say the same type of disinformation and etc, etc. They are exposed to that constantly, and the hospitals regard this as the mainstream, as the establishment. But I managed to establish connection with them.

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Brent Stafford: Dr. Sussman, the ban on vaping in public places in Mexico, how stringent is that law?

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Roberto Sussman: Well, on paper, it's very stringent, but, there are two processes. One process is a law at the level of the Congress, right? And then there is the details on how the law is going to be implemented, because you can say no smoking in public, but you have to define what's a public place. So the regulation of the law is much more strict than the law that was actually approved. And this is partly the loving of some NGOs that are funded by Bloomberg Foundation, and also by some bureaucrats of the Pan American Organization of Health. They are together. They are around this, Lopez-Gatell, this powerful minister. And they made the regulations very strict. So it is extremely strict. But even in countries where law is enforced, like Australia, or the United States, or Canada, we already know that some laws are simply not possible to implement. Not possible to enforce. And it is really not enforced. Like, let me give you an example. I work in the National University. It's a huge campus. It's maybe like, I don't know, 10 square miles of territory, parks and buildings and so on. The law says that it's forbidden to smoke or vape. They don't mention the word vape. They say emissions, which is a stupid definition because cars are releasing emissions. But they mean emissions from nicotine products. And it's forbidden in the whole campus. In the whole campus! Do you think this is done? It's not implemented. In my own institute, they have an area called Smokers, and you can vape everywhere. And so, no, it is not. And also, that's another important point. In Mexico, the Mexican law has a legal resource. It's a sort of habeas corpus, where you can petition the courts, and it can even go up to the Supreme Court. You can petition that a law that is violating your rights is not enforced on you. It's done individually. And so many people in Mexico have this type of habeas corpus. It's called amparo. And some restaurants, for example, restaurants were forbidden to allow smoking anywhere. Only in some areas, and in those areas you could not even get a glass of water. And the areas had to not to have any roof or wall or anything. But many restaurants have fought that and have won. And many vape shop owners have also won this type of comparison. Because again, it's what I'm telling you. The political class is pragmatic for all parties, even the government's party. They are pragmatic. They know that if what is written in the law and reality are so different, then you have to do something. And one of the reasons why this law is unenforceable is because on top of the pyramid, here stands the president and receiving a prize from the WHO, and then López-Gatell smiling and saying, yeah, we're saving the world, we're saving Mexico. But there is a line of command between them at the top and the bottom of the pyramid, because who's going to enforce this law? Inspectors, mid-level, low-level government officials whose salaries are very low. And they are not committed. They are not anti-divers. They don't think that vaping or smoke, even smoking, is fentanyl or is the menace from the Andromeda Galaxy. No, no, they don't believe that. So there is always arrangements at this lower level of enforcement between the shop owners, the vape shops, and restaurants, and all sorts of public, right? So this is one of the reasons, like Mr. Bloomberg thinks that Mexico is some type of California or some type of Australia. Just to put the law and it's going to be enforced? Well, it's not like that. And look, Mr. Bloomberg might be an arrogant guy or whatever you want to call him, but he's not stupid. He knows that. But he also knows that it's beyond his power to change that, because to make Mexico a law enforcement country requires decades of political activity by the civil society. It's not Bloomberg in his office decreeing and sending lots of money. That's not going to change things, right? So again, this is why the law is not enforced. The law is not really enforced. However, there is a catch here. The police in Mexico tend to be sometimes very predator. And the police is also not very professional and so on. So there has been cases where the police have harassed, but it is young and poor people. Somebody, a poor guy, lower class is vaping and policemen might come. The same policemen do not know very well the details of the regulation, but just to extort the person. That might happen also. But the main problem in Mexico, and I wonder if you would like me to speak about that, or if that's a question you have in mind, is the nature of the black market, because that's very warm.

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Brent Stafford: Yeah, for sure. And before we do that, then talk about the availability of product. Can you get devices and flavors and e-juice as easy as you did before the laws came into effect?

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Roberto Sussman: Well, there has been some disruption on the distribution chain, obviously, because the way these prohibitions work is that at the moment they are enacted, they end up, we're saving Mexico, and there is a lot of activity by the inspectors and so on. Several shops are closed and there is some harassment, but there is a fatigue to that. There comes a point where you return to the equilibrium that I described before and so on. So basically, the answer is yes. I can get practically every device, every e-liquid. There are Mexican e-liquids that are quite good. And some shops have learned how, you know, people, when you have a prohibition, the people that supply the product adapt. So they adapt their stores so that it doesn't look like a vaping store, and they have arrangements with inspectors and so on. So yes, we can still get a lot. Now, maybe tomorrow the president will say, oh, well, the war on vaping, we save the kids and so on and so on. And there will be some frenzy of movement for a few weeks, and then it will decay again. So yes, we can get everything. I have my vaping devices here that I bought in Mexico, and I have very nice liquids and so on. But there is a but always. The situation is not exactly the same as, let's say, four years ago. Why? Because we have now a massive invasion of disposables... Disposables... Now, typically in Mexico we have a gray market. It's an informal market. It's illegal but it's not criminal. And it's semi-legal, and so on. And it was made of small merchants, the vape shop owners, small merchants, etc. It was in a small level. Now, this distribution network, the one I'm describing before, is completely unable to supply the vast amount of disposables that are found in Mexico. So who is doing it? Who is doing it? We don't know. I don't know. Because the whole thing is illegal, so there is no research on that. If there is some research or some investigation on that, it's not public. But I can answer myself. Who is doing that? Well, it's doing the black market, but it's not. The informal market is a criminal market, right? It's doing it. And then we have, well, I'm a veteran vaper, and I am a middle class person, so I buy in stores that I trust. But you have no idea how many people are now buying cheap disposables, rejects from the Chinese industry that are smuggled into Mexico, And now we don't know what people are vaping, right? I think it's a lot of low quality products and that's a problem.

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Brent Stafford: Dr. Sussman, you attended the Global Forum on Nicotine this past summer, where you delivered the Michael Russell Oration. Dr. Russell was a British psychologist who famously advanced the idea that, quote, it's not the nicotine that kills half of all long-term smokers, it's the delivery mechanism. And he did this in his 1991 paper titled The Future of Nicotine Replacement. Dr. Sussman, what was your key message at #GFN23?

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Roberto Sussman: Well, my contribution to... First, I'm a consumer, so I'm tuned into that because I'm a former smoker. I still smoke occasionally, but I'm now a vaper and I felt the effects on my throat, etc. So this is one angle. But another angle is that what Michael Russell said is now put in doubt by the WHO, by a lot of academics, that publish research on the aerosol or on health effects and so on. So I told myself, as a scientist, I would like to strengthen the science behind what Michael Russell said. Because what Michael Russell is saying is that when you smoke, you get into your body a substance called nicotine, which what she said is that the nicotine is not the cause of all the diseases, etc. It is the delivery mechanism, which is tobacco smoke, which is also an aerosol, but it's a very chemically complex and toxic aerosol produced by combustion. Well, these things I know. Because I am familiar with thermodynamics, with fluid dynamics, with aerosol physics. I'm familiar with that. And so I told myself, I would like to reinforce what Michael Russell said in a very rigorous scientific way. Because I am a scientist. I work in hard science. I'm subjected to constant scrutiny. And I have to defend my research in a very hard peer review environment. It's not like in public health where if you agree with a political agenda you can publish all sorts of rubbish and it will be published easily. That's not the case in theoretical physics. Theoretical physics were trained to disrupt the current opinions, but to disrupt them you have to do it very well, otherwise you are not taken seriously. So I would like to see this level of rigor, this level of peer review and revision in the science that deals with vaping and with smoking, right?

00:27:40 --> 00:28:08

Brent Stafford: Dr. Sussman, since 2020, you have published six papers on e-cigarette aerosols, three of them during COVID, dealing with the possibility of virus transmission through environmental vapor. And three are extensive reviews of the literature analyzing emissions, each one focusing on specific toxicants, metals, organic byproducts, and one on heated tobacco products. Dr. Sussman, tell us more about this research you've been doing.

00:28:08 --> 00:31:59

Roberto Sussman: Well, I would add that we also looked, in order to see if the vaping, the exhale vaping, the environmental vaping, can transmit pathogens, you also have to see how toxic it is. You also have to see how much of a pollutant this aerosol is. So we researched all that. We showed that as a polluting agent, exhaled vapor is extremely weak. It is comparable, you know, you compare them with second-hand tobacco, environmental tobacco, that's absolutely obscene to compare it with that. It's a non-comparison. It is overkill. You have to compare it with many household aerosols that we are constantly exposed, like sprays, like kitchen aerosols, and some kitchen aerosols are quite nasty, but with the carpets and with inner pollution. Inner pollution has a lot of aerosols around. And vaping is comparable to these aerosols that we deal with in everyday life. But vaping is intermittent. The exposure times are very small because it disperses and evaporates, right? Pollution, for example, even indoor pollution, you cannot switch it off. It's all the time there. So even if the levels are lower, you're exposed to them all the time. Lately you're exposed to them only when you exhale, because there is no transversal, there is no side stream emission. With cigarettes it's different, because with cigarettes 80% of the environmental emission is produced by the burning tip of the cigarette, right? That's a continuous emission. When the smoker exhales, it's only 20% of the environment. But also, the chemistry is very important because tobacco smoke is made by non-volatile, mostly semi-volatile. That is, it doesn't evaporate. It stays there. It stays there. There are very small particles. The gases evaporate. The gases move away. But the particles stay, and they stay for a long time. So even if smoking is also intermittent, secondhand smoke is not intermittent. It's permanent. But that doesn't happen with vaping. So we explore that and we show that the transmission of a virus, it is not impossible because it's a respiratory activity. So you can, through vaping, exhale viruses. But the amount of viruses that you are going to exhale in vaping, it is minimal. The maximal contribution to the environmental quantity of virus would be one percent on top of what is already there by breathing. So it's insignificant. And that's why I'm also going to publish a material on environmental vaping, because I don't want that suddenly we're not going to be able to vape here and there because they are going to think that we are poisoning people. That's not true. We should not allow tobacco control to treat vaping as they treated smoking. And this is for me a very important issue.

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Brent Stafford: Well, I think it's important to everybody that's concerned about access to safer alternatives to smoking. Let me ask you this, Dr. Sussman, what's your assessment of the World Health Organization's impact on your country?

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Roberto Sussman: Well, you see the World Health Organization has a lot of authority, right? Recently, because of COVID, people, I mean even the political class, are starting to think that WHO doesn't always give a good mark, right? But nevertheless, for health bureaucrats, The health bureaucrats relate to the WHO as if you go to a small town and the Catholic priest will relate to the Pope, to the Vatican. And so, it's a source of authority, but it has been captured by private interest. Like, if you look at the funding of the WHO, a large share of it comes from philanthropies like Bloomberg, Gates, etc., or private institutions, or special issue institutions. and the WHO has to respond to them. It's a political organization. This is what people have to understand. It is partly scientific, but it is also partly, and perhaps most importantly, it's a political organization. Now, in the case of Mexico and other Latin American countries and middle-income, lower-income countries, that the health bureaucrats are completely attuned to the WHO. And some of them, maybe the higher ranking ones, are even dreaming to have a job. You know, you are in Geneva, you have diplomatic status, and so on. So it's also a job for the voice, right? And in Mexico, you know, the WHO is revealed and so on. And in the latest administration, the present administration, the scottery of the NGOs and Lopez-Gatell and some academic, some medics around them, they are in close contact with the officials of the Pan American Health Organization. And they determine policy. And you know that for them, it's, that's the way it is. It's no discussion, no argument. And again, what we see in the WHO is a global technocracy that has become used to dealing with the problem of smoking. They have their own methods. They have built their careers there, their reputations. for decades, and suddenly a disruptive technology comes, and these people simply don't know what to do. Even assuming that they have no bad intention, that they're absolutely not corrupt, it is simply a problem of disruption. And this is why electronic cigarettes and tobacco harm reduction products will have difficulties. In Mexico, it's just even worse than in other countries. And also, I think that this narrative of the tobacco wars, it's an obsolete narrative, because the tobacco industry today is not the same as in the 1980s. In the 1980s, it was a real propagical quest, a real battle against the tobacco industry, waged by medics. By medics, you know, it was really David against Goliath, right? But now that David has become a Goliath as well, right? So who is being harmed? They have been practicing a certain policy to address smoking, but Who has been affected in this tobacco industry? It's okay. They are like Johnny Walker. They are okay. They have not been harmed. Tobacco industry is buoyant. And the tobacco industry is also moving towards harm reduction. And who has been harmed? The consumers. People who smoke. And now people who vape. We are the real... They say, oh, we battle the industry, we save the world from evil, whatever. No. They are damaging consumers. and they are holding to a narrative that is now obsolete. And I resent that because according to institutions in my own country, they libel me, they slander me, they say that I'm a tool of the tobacco industry when I've never received money from the tobacco industry. Okay, I talk to people from the tobacco industry, but that doesn't mean they have me on their pocket. That doesn't mean that I'm a stooge of them. They say, well, it's because you're promoting the interests of the tobacco industry. Because the tobacco industry is selling these products and you are also promoting them, so you favor their interests. You know why I say that? During Nazi Germany, the Nazis were the worst, the most horrible regime in history. The Nazis were promoting cyclism. It's true. They were promoting cyclism. So if you are promoting that people go into their bicycles and become cyclists, does that make you a Nazi? Of course not. So all these rhetorical arguments are arguments of a technocracy that is seeing how the floor moves below them. And the more aggressive they are, the more they show that they're afraid. Because in the end, who makes these things? Not Philip Morris, not British American Tobacco, Chinese industries. And the Chinese, they, the industries are regulated under the Chinese government. And at one point, the Chinese government or combination of them and other industries, and even the political class, will realize that it's a fantastic business to transform 1.1 billion smokers to make them migrate into this. If you sell them, that's a fantastic business. And I think that in the end, this pragmatic approach will defeat the puritanism.