30 December 2010

Magic saunas, e-cigs, and the meaning of science, "green", Christian (really!)

My mother won a gift certificate for one of those "alternative" health specialty stores (you probably know the type) so picked up a combination of some useful basics (bath supplies are bath supplies) and gag gifts.  One item (for which she just collected the brochures – a dozens of pages!) seemed worthy of mention in an epidemiology epistemology blog.

The amusing claim in question is for a far infrared sauna, which is basically a chair, a human-body-sized tent with a head-hole in the top, and some heating elements.  It is reported to "remove toxins, reduce body fat, boost metabolism, experience deep relaxation, and slow down aging!"  I believe the bit about relaxation.  What makes the usual nutty claims interesting, though, is that according to the brochure this is an U.S. Food and Drug Administration approved medical device (they provide a file number and everything), and the the FDA vouches for the claims about far infrared radiation (which is simply low-frequency light that we normally call radiant heat).  Keep in mind that this is the same FDA that tried to shut down the e-cigarette market because some manufacturers were allegedly claiming that using e-cigarettes instead of smoking means that someone is no longer smoking (which is the natural language way of saying "it is a smoking cessation aid"). 

The sauna manufacturer goes on to offer such gems as:

-far infrared "pulsates the water molecules in the body" (apparently there is a microwave in it, which just does not sound like a good idea at all) and reaches "the depths of the body" – these are the bits they say FDA specifically endorses

-produces 2.3 times as much sweat as other saunas (spontaneous generation of water from the human body!)

-heals diabetic ulcers

-reduces percent body fat by 2 percentage points between "before" and "after" (for a single use? not clear, but since duration is not what stands between this claim and the truth, it probably does not matter)

-removes heavy metals from the body

-you can burn 600-1200 calories per session (I guess they assume you are going to generate the electricity for it by running on a big hamster wheel)

-it is the only sauna that uses "a special technology, i.e., a semi-conductor chip" (because computer-controllers are such an exciting innovation)

-and best of all, it cures hepatitis C

Reading even a little carefully, it is apparent that FDA probably did not endorse most of these claims, though the authors certainly make every effort to imply it.  But, at best, FDA (a) approved one or more of these claims to let this glorified toaster oven be classified as a medical device, (b) is content to allow all the other claims to be made, and (c) has not even objected to the implication that they are endorsing most of these claims.  Perhaps (b) and (c) are simply the result of inattention:  If you spend all your time trying to create a nanny state, after all, how can you be bothered to, say, have a web bot looking for blatantly false health claims being made in your name.  But (a), along with the e-cig fiasco, seems to really illustrate what is fundamentally wrong with FDA, how they simply do not understand scientific inference.

Presumably someone ran a few highly artificial experiments (aka clinical trials) and managed to get one of them to show that the sauna had some trivial effect on some Official Medical Condition (presumably because it makes people warm for a while).  And, voila, it is an FDA Approved Medical Device.  Meanwhile we have all the evidence any real scientist would ever need to prove that e-cigarettes are effective at aiding smoking cessation:  Observation 1:  Someone who is using e-cigarettes as a substitute for smoking is not smoking.  Observation 2:  Testimonials and surveys of users show that pretty much 100% of them use e-cigs as a substitute for smoking, most reporting that they had tried to quit smoking using other means and failed.  That is all we need to know.  Would we know more if we had a clinical trial?  No, not really.  The artificial situation created in the trial would mean that it would provide far less informative than either of the two above observations.

The problem seems to be that the so-called scientists at FDA (like most people doing epidemiology) are really glorified technicians.  They only understand how to plug something into their machine (the clinical trial process).  If the machine spits out a result of a certain type then it is declared, say, that anti-smoking drugs are FDA Proven Effective (because under optimized highly artificial conditions they work for a few percent of the population) and the sauna tent is a proven medical device.  If it is not possible to jam something into their machine, however, they are incapable of drawing even the most obvious conclusions about it.  This includes anything that is primarily a social phenomenon or a matter of consumer economics, such as recreational substance use.  They simply have no understanding of what constitute science in such cases.

And finally, an aside.  My mom reported that upon going into the "alternative" store and being asked who she was shopping for, she reported that one or more of us was described by "vegetarian", "vegan", "green", "buys organic".  Apparently the proprietor thought that this meant that they could sell us any nutty product on the shelf.  Which leads me to ask, with some affrontedness:  Why is it that being knowledgeable and scientifically literate enough to be horrified by the way animals are factory farmed and/or to be concerned about habitat destruction and other natural resources -- and being willing to act/buy differently in order to reduce one's contribution to these horrors -- translates into "clueless enough about science to believe any nutty health claim so long as it is counter to the mainstream"???  But I suppose, it is not much different from the common assumption, in this country, that if someone is described as "Christian" then they display tribalistic intolerance, favor solving problems with weaponry, oppose helping the poor, and have other characteristics that seem to be the flat-out opposite of what Jesus reportedly taught.  Somewhere in there are some interesting thoughts for the Christmas and New Year's resolution season.

24 December 2010

And to all a good night

I got too busy and never followed up on my posts about the FDA gunning for drinks that are roughly a combination of Red Bull and alcohol, cut with sickly sweet soda.  As you may know, everything has followed the predicted course of action:  Cans containing five beers' worth of sweetened alcohol are still being sold, with some still including various dicey stimulants, but if the kids want a modest amount of caffeine too they will have to spring for another 50 cents worth of coffee.

Another non-solution to media-frenzy pseudo-problem brought to you by the nanny state.  Now if only the FDA could do something about kids wanting to rapidly down five beers in the first place the world will be a better place.  (Hint:  Don't hold your breath for our health masters to figure out a solution to that one.)

Anyway, the reason I decided to post about this is that I just wanted to thank the FDA for its combination of arbitrariness and wimpiness, in going after cheap caffeine-alcohol combinations that are liked by powerless drunken young people wanting to save a few bucks on their buzz, but mysteriously ignoring the higher end stuff.  As usual, nanny statism mostly only hurts the less well off, and not those who like the occasional holiday evening downing Kahlua and Vanilla Silk (or for the fans of the really cloying, Kahlua and Silk Nog).

Perhaps there should be some kind of interlock that prevents blogging under the influence.  Oh well.

Happy Xmas or whatever version of the solstice holiday you prefer.

18 December 2010

A backdoor to mandating supposedly health activities

The recent ruling by a Virginia court and writings about it (see this good one by law prof Jason Mazzone in particular) has brought up interesting questions about liberty with regard to commerce, but also health.  Background:  The new U.S. health care financing law has, at its center, the requirement that everyone buy health insurance from private companies.  This sort of addresses a few problems of the insurance market, though not nearly all of them (I have written about that before, but will not go into it because it is not the point today).  But because Obama is so easy to roll, there is no "public option" of the government acting as insurer and giving people the opportunity to buy into that program.  Thus it is not possible to claim something like "this is a standard government program where you are paying money (call it taxes or not) and getting services, but you have the option of steering your money to a private provider instead".

Thus, people are being told the must spend money on a particular product from a private merchant, unconditionally.  While such conditional requirements are nothing unusual (you must buy liability insurance if you are going to drive a car; you must pay for various services to engage in complex transactions like owning a house), it is not clear if there is any precedent for such an unconditional universal requirement for a rather major expenditure.

Of course, it does really make any difference how things are labeled.  This is not actually different from imposing a health care financing tax, outsourcing administration of the service, and offering some program choice.  But people do make a big deal about labels.  After all, the standard fiction is that the Master Settlement Agreement was a big award paid by tobacco companies when actually it was an extra-legal sales tax on future consumers (smokers).  But the press consistently misses this (probably due to naivety) and the rich anti-tobacco organizations that benefit from MSA money, as well as the states who benefit even more, (probably due to self-interested cynicism) never mention that their funding is coming from a sales tax on smokers that is hidden (making it easier to raise taxes even higher and pretend that smokers create net cost for the rest of society when the opposite is true), arguably unconstitutional in most jurisdictions (taxes generally require legislative action, but this was negotiated by a bunch of private lawyers who got very rich from it), and terribly regressive.

The MSA was ugly public policy because those who benefit from it pretend it is something it is not.  If the health insurance mandate survives court challenges, however, it will be because it was judged as what it functionally is (a new tax and government service, privately administered) rather than what it pretends to be (a private transaction). 

But then the fun really begins.  The nanny statists who work to prohibit various choices in the name of protecting people from themselves will have a brand new arena.  They will have the precedent of forcing people to buy insurance to protect their health (though really the rule exists to protect the health of the financing system by not letting people with low risk opt out of it), and so will no longer feel constrained to merely prohibit actions they do not like.  They will feel empowered to mandate actions they do like. 

Just wait.

12 December 2010

Extremists' use of terminology to bully e-cig community

One more thought about the new UC Riverside extremist-propaganda-pretending-to-be-a-scientific study.  We have already written about the main substance of it, as has almost everyone who writes about the topic.  But one point that seems to have been overlooked is the use of pseudo-scientific jargon as a schoolyard bullying tactic. 

The authors of that pseudo-study and others in the anti-tobacco extremist community have decided to start calling e-cigarettes Electronic Nicotine Delivery Devices (ENDS).   There are several legitimate good reasons why it is useful to invent a neologism for scientific or other purposes.  Pretty much all of those involve cases where there is not already a word for the category of objects/concepts/whatever you are trying to describe.  The most obvious need is when there is simply no natural word for a category.  For example, it is useful to have a collected term for smokeless tobacco, e-cigarettes, and other extracted nicotine products.  I tend to use “low-risk nicotine products”, but there is not a settled term since others prefer to "smokeless" and "smoke-free" nicotine products.  I prefer "low-risk" because it explicitly captures the reason for creating the category, but smokeless is certainly accurate and effective.  (Some people insist that there is some difference between smokeless and smoke-free, though the distinction escapes me.)

In other cases, a neologism is needed because the present term does properly describe a category.  For example, “anti-tobacco extremists” is a created term (by us at TobaccoHarmReduction.org) that was needed to avoid the absurd use of “public health” to describe a political faction that is primarily or exclusively committed to the elimination of all tobacco (and now e-cigarettes) per se, regardless of the public health implications, and indeed is doing substantial damage to true public health in pursuit of that end.  The term that was being used included a broad group of unrelated people, so a new term was useful for specificity alone, but more important the extremists were no longer part of the true public health community, and using "public health" as a shorthand for them was insulting to public health and gave the extremists credit that they do not deserve (but take advantage of to fool the public).

But there is no need to create a new term that includes exactly the same category of items that is already covered under “e-cigarettes” (which most everyone uses for all such products, including those with variant shape that make them look cigars, pipes, or marker pens rather than cigarettes).  And if for some reason an author does not like the preferred standard term, a second established term is “personal vaporizers”, which is wonky enough to appeal to those who think that e-cig is far too plebian for them to use.  No term is needed.  It is not as if there are other devices other than e-cigarettes that they are trying to capture in their category, or things that are called e-cigarettes that they are trying to exclude, and thus actually need a different word.

Why did they invent a new term, then?  For the same reason that George Bush created nicknames for most everyone he knew, or that schoolyard bullies or fraternity leaders do the same:  To try to assert power over people by denying them that most basic right of choosing their own label (or choosing to keep using the one that someone else chose ages before).  Evolved nicknames are typically friendly; forcibly assigned nicknames are psychologically violent.

Perhaps the present case is not quite so bad as individual bullying since the “them” in question is an “it”; the e-cigarettes themselves will not mind.   But anti-tobacco extremists are trying to assert ownership of discourse about e-cigarettes by relabeling them, which is damaging and inappropriate at many levels.  Moreover, there is still an attempt at inter-personal bullying here since there is a large established community of real people who are active aficionados of, advocates for, merchants and makers of, and even researchers of e-cigarettes.  It is this group that owns the terms and concepts.  For the extremists to intentionally ignore that they (we) have an established term is a way for them to say, "your own view and understanding of your own practice is of no more consequence than the self-perception of infectious disease agents, criminals, insect pests, or terrorists; we will study and write about you without even considering that you are anything other than something that needs to be controlled."  Even for those who might not have that view (though I would guess that it predominates), the most charitable interpretation is, "you are like young children, pets, or (from an unenlightened era when most researchers acted like those who write for Tobacco Control) savages -- "we do not wish you dead, but we certainly are not going to consider your views to be of any interest."

Of course, since the extremists have made clear that something in this range is their attitude toward smokers and anyone who supplies or defends them, there is really no reason to be surprised that they have taken this attitude toward vapers (another word I suspect they will not use).  But though not surprising, it is is worth noting:  We should avoid becoming so used to this behavior that we start to think that it is reasonable.  It tells us a lot that these people – in contrast with real public health advocates – show no apparent compassion or respect for those they pretend to be trying to help.

06 December 2010

There are no analog cigarettes (or digital ones)

I have been a bit busy and have missed some good blog topics.  Maybe I will get back to those after I finish on major project, but I will ease myself back with a quick post about a pet peeve:  The word "analog" (used in the context of technology) does not mean "non-computerized" or simply "old technology".

[Of course, that's "analogue" to my readers in the UK and you others who have decided to not throw off the yoke of monarchy -- I'm talkin' to you, Canada.]

I realize that this complaint/recommendation borders on Academie Francaise-style attempt to resist the evolution of language.  But this one reflects deep and potentially harmful ignorance.  Analog computing, data storage, or input/output refers to technologies where values are represented by something that varies continuously in a way that is analogous(!) to the value it is representing.  Digital refers to methods where the information is represented by discontinuous markers that arbitrarily represent particular real values.  The simplest example is that a readout that has a dial (clock with hands, car speedometer with a turning needle) is analog, because the position of the dial is analogous the the value of time or speed.  A readout with digits(!) is digital, since they are arbitrary symbols that represent a particular exact value.  An important difference is that if the hands or needle moves a little bit it represents a slightly different value, while if the displayed digits are slightly altered they still mean exactly the same thing.  This has several implications, most notably that slight errors in analog systems can accumulate (because they "count") while slight errors in digital systems disappear (because when a computer is storing something as either a 1 or a 0 -- typical digital storage -- and it is off by 5%, it is still treated as the original 1 or 0).

Computers can be either analog or digital.  Low-tech devices can either be analog or digital.  This printed page -- whether you are reading it on a screen or you print it out (though I cannot imagine what would possess you to do that) -- is digital.  That is not because I am writing it on a computer but because these little squiggles have a fixed arbitrary relationship to particular concepts and slight variations on how they appear  do not change what they represent.  So, a book is digital, as is an old mechanical adding machine. So is a cuneiform table or doing long division with pencil and paper.  But something that does not store, process, or display data is neither analog nor digital in this sense.  This knowledge should be part of basic literacy in this age, thus my peeve about linguistic drift obscuring the knowledge.

This morning I heard a news story about new Barbie dolls that have some kind of web-publishing camera built in.  (The story was about how this was new and scary and will facilitate kiddie porn -- I am agnostic about that concern.)  The old Barbie was referred to as "analog".  Now I will admit that I do not have direct experience with Barbie dolls, but I am pretty sure the old ones did not do any kind of data manipulation, analog or otherwise.  Of course, all dolls are analogs in the sense that they are anthropomorphs -- they are analogs of human bodies -- another useful sense of the word that will be misunderstood by the next generation if "analog" comes to mean "old".
Those familiar with my usual area of work will guess that I am particularly annoyed by some aficionados of electronic cigarettes referring to real cigarettes as "analog cigarettes".  C'mon people, there is nothing analog about them -- there is no data involved at all, and they are not even analogs of something like Barbie is.  Indeed, e-cigs can be considered digital only by really stretching the term; they are digital only in the same sense that a lamp is -- the switch is either on or off, digital values.  Actually, it is the somewhat higher-tech lights -- those with a dimmer knob -- that are analog!
Of course, language precision suggests the new devices be called electric cigarettes, since a heating element and simple switch does not make the cut for being electronic, usually reserved for actual computation or data storage (we say "electric stove" not "electronic stove", and an e-cig differs from a hotplate primarily only in its miniaturization and non-electric accoutrement).  But that one does not seem too harmful.  Confounding the concepts of analog and digital, though, does not seem healthy for a population that is trying not to fall too far behind in its command of 21st century technology.