There’s no debate allowed on vaping in Australia, says Dr. Colin Mendelsohn, founding chairman of the Australian Tobacco Harm Reduction Association and practicing tobacco treatment specialist. Tobacco control is “impervious to evidence” and quick to cancel anyone who speaks to the positives of vaping.
Featuring:
Dr Colin Mendelsohn
Founding Chairman Australian Tobacco Harm Reduction Association
Practising Tobacco Treatment Specialist
@colinmendelsohn
Transcription:
Hi everybody, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.TV.
We're here in Warsaw, Poland for the Global Forum on Nicotine, the annual conference promoting
safer nicotine products and tobacco harm reduction, and I'm here with Dr. Colin Mendelsohn from
Australia.
How's it going?
Thank you, Brent.
It's great to have you back on the show.
Let's start.
Tell us a little bit about your battle for THR in Australia.
Look, I've been working with smokers for nearly 40 years, and it's been a very frustrating
area.
I'm supposed to be an expert on smoking, and even for me, the success rates have been very
low.
I'm also very aware of the huge harm smoking has caused my patients.
I've seen people die from lung cancer, heart disease, people who've tried to quit.
I became passionate about vaping back in 2014 when I saw people quitting who otherwise hadn't
been able to with vaping, who'd tried all the best treatments available.
I went to the UK that year and met with Clive Bates, Martin Dockrell, Peter Hayek, and they
confirmed my impressions, and I've followed the literature very closely ever since.
The evidence is growing stronger and stronger that vaping is not completely safe, but far
safer than smoking and an effective quitting aid.
I've found in my own practice that it's saved many thousands of people who were otherwise
unable to quit, and I'm incredibly frustrated that the government is not seeing that evidence.
The research evidence is now stronger and stronger, and it's being resisted, which my
public health point of view is, I think, untenable.
Now, I mean, it's a good word, I believe, in this context, is you're a bit of a crusader.
I mean, you are out there.
You've put your reputation on the line for this issue.
You said that you're considered an expert.
Has that consideration been hurt because of your support for vaping?
I've been attacked regularly for my position on vaping.
I've often been told that I'm paid by Big Tobacco for everything I say, so on National
Radio several years ago, one of Australia's richest men said, oh, that Colin Mendelsohn,
he should declare his tobacco funding.
Every time he speaks, they pay him.
We got a correction for that.
Recently, there was a television program which made it very clear that they thought I was
funded by Big Tobacco and I was defending them because of financial consideration.
There have been lots of stories, so yes, I'm very aware of that, and that's irritating.
In terms of being a crusader, I know I'm on the right side of history, so these insults
don't bother me because I know we'll be proven right, and I think the more important issue
is I'm in this to save lives.
I'm in this from a public health point of view, so I think vaping will prevent cancer,
heart disease, lung disease, and as a doctor, that's my priority, and yes, I'm insulted
and attacked regularly.
Normally, that would bother me.
I'm at that stage in my career where it doesn't so much.
I don't like it, but I'd rather persevere with what I'm doing.
It's maddening, or you must feel like it's maddening.
Yes.
What I'm frustrated with, Brett, is that as a scientist, there is a scientific method.
We look at the evidence, we discuss it, and we come to conclusions that we act on.
In this area, we have our health minister and his advisors in a bubble who are looking
at the evidence that they think is right, and they're not willing to look at the other
side of the argument.
That's not how science works.
With science, with open science, you discuss the pros and cons, you have a debate, and
then you make a decision.
There's no debate in Australia.
Now, people say, well, you're the outlier.
In fact, not really.
I make more noise than most people.
Just recently, we prepared a letter to the health minister, an eight-page or 20-page
letter, signed by 44 Australian experts, saying to the health minister, look, you're on the
wrong track here.
This is not working.
Clearly, this is the wrong approach, and this is why.
These are the arguments that you've said that justify your policy.
These are the arguments against that.
We haven't heard back from that, but I guess the point is that these were 44 eminent, leading
Australian and New Zealand tobacco experts who agreed with me.
Now, they're not generally vocal and verbal, so in a way, I feel like I'm a bit of a spokesman,
which means I cop all the flack, and occasionally, I have to organize other people to get that
information presented.
You know, that charge that every time you speak, you're getting paid by big tobacco,
is there malevolence involved in that accusation?
Look, I think the people who were opposed to vaping have locked themselves into a position.
I think it's a threat to them vaping.
I think it's a threat to their income, their research funding, their prestige.
This is the way they've decided to do it, and they know best.
And so, I'm often described as that pesky general practitioner who clearly knows nothing,
and look, in a way, that motivates me even more, but I think they see it as a threat,
and I think they're impervious now to the evidence.
They've locked themselves into that position, and I think we need to keep hammering them
about it.
So, then, does vaping threaten a tobacco control industrial complex?
Very much so.
I think tobacco control has a traditional way of doing things.
They're the experts, they've always said, we're going to do it this way, people need
to quit, and we're very important because we've had very good success with tobacco control.
And now they've come up with something that we didn't think of, and this is a threat to
our prestige.
This is not what they say, of course, but I think that's behind a lot of the opposition,
because it otherwise doesn't make any sense.
If you're an expert in tobacco control, you would have looked very carefully at the evidence,
you would allow it to be debated.
We're not allowed to debate vaping in Australia.
In fact, tobacco control shuts down vaping.
They shut down vaping.
So, they'll ring conferences and say, you've got that Colin Mendelsohn speaking at your
conference.
Well, you know, he's a tobacco company shill, or he's an activist, and you need to cancel
that.
And I've been cancelled from speaking at one major teaching hospital in Sydney, asked me
to speak at their Grand Rounds.
And the particular professor of medicine wrote to them and said, you can't have him speak,
and it was cancelled.
And what I was hoping to do was present the evidence, and I said, well, look, I'm happy
to present my side of the story, perhaps he could present his.
And they said, well, no, we've decided, look, it's a very contentious issue at the moment,
and the kids are vaping, but there's clearly shutting down debate.
That's astonishing.
I know, I know.
It happens all the time.
And getting something published in the Australian medical media is even more astonishing.
We recently wrote a letter to the Medical Journal of Australia, for which we had to
do eight revisions, until it said something closer to what they wanted.
The Australian and New Zealand Journal of Public Health, I sent them an article in response
to something they'd published, they refused to even send it for peer review.
I had to get 21 Australian experts to sign the letter saying, look, you can't do that,
you've got to consider this.
Then they immediately said, oh, okay, we'll publish it.
Clearly, they didn't want to.
Three months after it was published, they said, oh, look, we're going to retract your
article now, retract the article.
That was because someone had written to them regarding a spurious conflict of interest
claim, which allegedly hadn't been declared.
Now, it wasn't.
It wasn't a genuine claim.
I wrote to them with all the evidence saying, this has nothing to do, there was no conflict
of interest.
But they still said, well, we're going to retract it anyway.
So I had to engage a lawyer to write to them and say, well, this is unacceptable, you can't
do that, these are the guidelines.
In the end, they backed off.
They didn't close the case, but they said, we'll leave it for the moment.
That's what we're up against in Australia, even in academic circles.
Again, as a scientist, I find that very disappointing.
What does it say about science if that ... I mean, obviously, clearly, the scientific method
is not applying here.
It's not.
It's not.
It comes down to an agenda that's driven by politics, ideology, vested interests, fear
of new technology, finances, tobacco taxes, all sorts of other factors that are behind
this.
And I think there's a groupthink where all the organisations have made a position, it's
very hard for anyone to step out of line and say, well, maybe we were wrong, because that
creates all sorts of problems.
So they're holding their line in spite of the evidence, but they can only hold it for
so long, I think.
So this concept that I grew up with, which was a marketplace of ideas, that doesn't exist?
It doesn't in this area, which is amazing to me.
There was a ... homeopathy isn't widely accepted, but the NHMRC did a report on homeopathy,
and like the report they did on vaping, it was scientifically flawed, misinformed, and
clearly biased.
It's gone to our ombudsman, who takes issues like that and analyses them.
It's been now held off for about five years, because even the NHMRC is being questioned,
because when it has an agenda, it appears not always to be totally science-based.
That's very disappointing, because that's our peak scientific body.
Do you think that some of this is all stemming from the WHO's position on this topic, and
Article 5.3, and so forth?
Look, Britt, would you believe that the environmental issue is a big issue with vaping?
Now we have kids using disposables, throwing them everywhere, and that's a concern.
A couple of us wrote a discussion paper on how to address this in Australia.
We approached the Department of the Environment to say, we've got this discussion paper, how
we can resolve this problem.
You're all worried about recycling, and the environment, and there are programs to deal
with this, but for vaping there's nothing.
And they said, well, we can't talk to you.
And we said, excuse me?
You're involved with the e-cigarette industry.
Yes, when we were involved, we had one of the members of our committee was a manufacturer.
We needed to talk to manufacturers, talk to vapers, we talked to all stakeholders.
We said, OK, then, well, how about you talk to me and Alex Wodak, who's an independent
physician?
They said, well, no, this breaches the FCTC.
Why is that?
Because we're talking about e-cigarettes.
And we said, well, that's nothing to do with the FTCC, FTCT.
And they said, well, that's the position that we have.
And of course, we could have gone public about that, and we could have taken it, written
letters.
But we knew that would get us nowhere.
But that's the stupidity that we're facing, I mean, refusing to talk about recycling because
this was about e-cigarettes, which were linked to tobacco somehow in their disturbed minds,
and yet it was a major, major issue.
In a way, it's as if they want to have an environmental problem, because then they can
campaign better against it.
Well, it's been a pretty fortuitous issue to gin up some hysteria around vaping in areas
where things were starting to cool off.
Look, the UK, the environmental issue actually really energised the argument in the UK.
Yes, it has.
And look, they're finding solutions.
In Australia, we realised we had to find a solution.
It was better if we did it.
And we worked out a model run by the government, oversized, and with the manufacturers involved
in paying for it, and the retailers involved.
And we thought we had quite a good model, but we needed some government support.
And they refused to talk to us about it.
So that's how irrational this has become.
So of course, coming up later this year, the WHO's Framework Convention on Tobacco Control
is hosting COP10, the Conference of the Parties, and they're very much going to be discussing
e-cigarettes at this event.
What is your message to them?
If you could speak to the delegates, what would you say?
Yeah, I don't think it would make any difference.
I think they've made up their minds, and they're the World Health Organisation.
They get too much money from we all know who, and I'm not sure that the evidence really
is what is going to make their mind up.
In Australia, of course, they have less influence, although they're often quoted.
So the NHMRC and various government organisations in their reports will say, oh, well, the World
Health Organisation says this.
But it's a big problem for low- and middle-income countries, and much more than it is in Australia.
But clearly, they're on a rogue path, and it's very disappointing.
And I think they've lost a lot of confidence from people in public health because of that.
So Australia definitely are a pick-and-chooser.
Yes, exactly.
Exactly.
We'll accept overseas evidence if it agrees with what we've already decided.
And so in some situations, we'll say, well, we're doing this because, well, the World
Health Organisation and the American government have said we should do it.
It's the right thing to do.
But when other countries are doing things we don't want to do, we say, well, what would
they know?
We do what's best for Australia.
So it is very much pick-and-choose.
So Australia appears to be not the most friendliest, warmest place, you know, to have these conversations.
And then you come to Warsaw for Global Forum Nicotine.
What's the difference like?
Oh, it's like coming home.
In Australia, you know, the man in the street thinks, well, vaping is much more dangerous
than smoking.
Why would you smoke?
People just don't know what you're talking about.
You give them the evidence and say, yeah, of course, obviously.
It's just wonderful to see that people get it.
And it's very invigorating to get that support.
It charges you up to go back and talk about this at home.
So it is discouraging to repeatedly get those negative messages, to see those negative headlines
in the media, to read the press releases from the Cancer Council and the AMA, which are
such nonsense and so misleading, to see the misleading education campaigns which put out
so much misinformation.
But to come here and see people talk about things, talk about the research, to understand
that the public health benefit, it's really refreshing.
You know, it's a strange question because, of course, it's validating.
And you know, you're one of the leaders, I would say, of course, in this whole campaign.
But yet still, boy, just physically being around other people that think the same way.
Do you think it's groupthink here or we're just on the other side of groupthink?
Yeah, that's a very good question.
And I think it's very important for all of us to question our own thinking.
And when I read a clinical paper, I try and look at it from both sides.
It's very easy to look for the things that support what you think, but I do try and look
for the counter-argument.
So there's always a risk of that, none of us are perfect at it.
We tend to look for information that confirms our beliefs, for sure.
Do you think in some manner, tobacco controls got their nose out of joint because they got
a problem with capitalism?
They've got a problem with the market?
Yes.
I think the free market doesn't fit with their worldview.
I think, yeah, I think they don't like to see people making money.
There are certain tobacco control experts in Australia who feel that people should just
quit cold turkey and none of these treatments should be used.
And I think they have the ear of the government.
So that would include vaping.
So I think there's definitely an issue with people making money.
And I think it's partly driven by the tobacco companies that have made a lot of money and
have forced the issue, often dishonestly.
But we've got to be able to move away from that just because they've done that in the
past.
And yes, there's been the light and the filter campaigns, which were misleading and we got
sucked in by that.
It doesn't mean that anything to do with making a product that makes money isn't good for
public health.
In the past, there is a thing about authoritarian governments is they don't like to have their
citizens enjoy simple pleasures.
If you can steal away a pleasure that's just your own, somehow that goes against the state.
Is some of that wrapped up in this?
I think it is in some people and there's a quote going around and I can't remember exactly
how it goes.
But the quote is that the particular person who I won't mention secretly fears that somebody
somewhere is having a good time.
And I think one of the problems with vaping is that people enjoy it.
It does create pleasure.
And somehow the tobacco control gurus don't believe that they should be allowed to enjoy
it.
They should just stop it because it causes harm.
And I think we don't bring up pleasure when we discuss the issue, but it should be allowed
to be.
It is part of the debate.
People should be allowed to enjoy themselves, even if it involves a small measured risk
that they're prepared to take.
And we do that all the time in society.
Well, I'm just hoping that the rest of the world wakes up to this because they're coming
for your beer and wine next.
Yes, exactly.
Exactly.
Vaping today, how can they justify allowing people to do these other things that we know
are harmful?
With vaping, we're really not particularly concerned.
We know, yeah, alcohol is dangerous and so many other things people do.
Driving cars.
I mean, for goodness sake, whether you stop.
You know, when I went through a time of quitting smoking, moving to vaping, then kind of going
back to smoking for a little short period of time and then back to vaping, there was
a time there not that long ago, you know, in 2012, 2013, where I looked at a pack of
cigarettes needing, wanting to know what the tar was and wanting to know what the nicotine
levels were and stuff.
And I was flabbergasted to not find that information on any pack of tobacco in Canada.
And I'm like, I spent years, I spent 25 years smoking and had information on the packs and
could make choices.
And then for some reason in the 2010s or something like that, Health Canada decided, no, we're
not going to provide that information anymore.
That's interesting.
And it's because they found that people compensate it.
So you might have a low nicotine cigarette, but you might smoke more heavily.
So it's like with vaping, the amount of nicotine you get depends on not just the concentration
in the liquid, but the device and the way you use it.
So they decided, they felt that low tar, low nicotine cigarettes gave people false
confidence and false reassurance.
But what's interesting is that in vaping products, there's this requirement increasingly to have
all the ingredients listed on the product.
But there's never any requirement to have all the ingredients listed on the cigarettes.
I mean, they should have an insert in the pack with 7,000 ingredients, because what
really counts is the relative risk.
OK, there's 100 ingredients in a cigarette, in an e-cigarette vapor, mostly at minimal
levels.
But there are 7,000 chemicals at high doses in a cigarette.
People need to know about that.
People need to be informed to make logical decisions.
And they just don't want to let that happen.
They don't want that to happen.
They just want to keep those deadly e-cigarettes out of reach.