"I'm not that kinda doc" is something I say often, usually when someone mistakes epidemiologist for dermatologist and eagerly rolls up their sleeves to get my opinion on a peculiar mole.
I like this post. It makes a lot of sense. I resonate with it due to differing personal views which I believe are correct but appear as disbelieved or not taken seriously by a great deal of people. Unfortunately, I have been a cigarette smoker for a long time but have never heard of Snus. I do see peers and coworkers ( a few) using e cigarettes, though, and others in public. Kudos to a good use of your instinct. (I am a RN but also worked for many years providing direct patient care).
Snus was\is basically a product from Sweden. Supposedly less harmful than "chewing tobacco". I knew people who chewed and then spit into cups. The main problem was they would invariable spill the cup. Disgusting doesn't quite cover it. If Snus cut down on that it was worth it. Supposedly also lessened the chance of oral\gum cancer as opposed to chewing. Snus use (why do I feel like I'm typing a Dr. Seuss joke) is attributed to less cigarette smoking in Sweden and less cancer deaths, therefore a positive. Might be interesting to find out if e-cigarettes have cut into the Snus consumption in Sweden.
Interesting indeed but not surprising…if you are not fully in charge…at the top of the ladder…incompetence runs amok thru out the info world…people who are truly one dimensional. I have seen it on major aircraft of crash investigations with loss of life…and revealing with facts a total loss of credibility of an “ expert” only to have a “Judge” say the opposite…I have lost faith in medicine particularly after the silence during the covid scam and the “vac”.
JAMA Oncology calculated that six million cancer deaths have been prevented since 1975. 3.5 million were from "tobacco control" ie public health. So public health prevented more cancer deaths than all cancer screenings and all oncology treatments combined.
"Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020" December 5, 2024
My dad used snus now and then. When he went hunting (in the 1960s in Missouri) with friends, he'd buy a pouch of Beech-Nut Chewing Tobacco. My mom detested this as low class but was too timid to toss it out herself when he came home with the habit. She paid my older brother a buck to do the job and be sworn to secrecy.
Keep up the effort, Dr. Ayers. But I would not expect any rewards for challenging medical orthodoxy in this world. Medical and public health groupthink and conformity show no signs of abating. Dr. Fauci is the ultimate Wizard of Oz, and the medical/public health establishment continue to worship at his altar. To date, they have learned virtually nothing from the covid fiasco.
I'm not sure when this problem started, but the pandemic (really, the entire Trump presidency) has shown us that a significant portion of physicians allow emotion and politics to color their entire thought process and thus professional judgement. Data and science be damned!
The best line you wrote was "put science, not ego, at the center." It is a principle that can—and should—apply well beyond medicine. Thanks Dr. Ayers! PS I had never even heard of snus!
I had to look up snus. Back in the day (50-60s) lots of midwestern blue collar & farmer types used snuff (which was sometimes called "snoose"). Medical nomenclature has always been rather complex! :- P
I'm into empowering people to making informed choices. The paternalism in public health... typically accompanied by coercion of softer or harder sorts... Let alone the inhumane visitor policies during COVID... I loathe and have no respect for epidemiology or public health.
This is the problem with tobacco control: they have gone particularly far off the rails. They seem to be focused on ending nicotine use entirely, rather than saving lives by moving folks to safer alternatives (since people seem to like nicotine, and some insist on using it).
I would invite you to look at https://safernicotine.wiki/mediawiki/index.php/Main_Page, which explores tobacco harm reduction (THR) products that are far less deadly than tobacco cigerettes. (The site is a Wikipedia clone, entirely user-funded, and the content is user-submitted.)
E-Cigarettes/Vapes are a vastly safer, yet acceptable product that is roughly 95% safer than tobacco smoke. Importantly, they can compete with tobacco sales, and tobacco cigarette users find them an acceptable alternative. Reducing the harmful use of cigerettes is the goal.
The site quotes credible sources; it links directly to peer-reviewed papers (often on government e.g. NIH, or the publishing journal). On the public health page, there are > 20 papers linked; please do check them yourself.
If you have an issue with any of them, why not post the reason and the paper in question? Thanks.
Yes, the only valid question to ask is: Are policies that restrict access to or enjoyment of the mild stimulant that is nicotine unless it's in its most dangerous form (cigarettes) or in unsatisfying or ineffective forms (NRTs and pharmaceuticals) going to lead to better public health outcomes? There is no evidence anywhere that entire populations will eschew the use of nicotine so the sensible answer is 'No'. Reducing the harm from its use must be the goal.
There has always been a core of certain held “beliefs” in mainstream stream medicine where reasonable evidenced based voices in the wilderness get caste aside if not outright derided. Your epidemiological examples are one of many. In the last 5 or so years every conference has a review of the importance of the gut biome affecting a vast array of metabolic functions and a source for the growing number of autoimmune and other complex disorders in children. 30 years ago my wife who trained in Traditional Chinese Medicine, Herbal medicine and acupuncture (boarded both by the state and nationally) explained to me the concept of leaky gut and how it affected the immune system (the terms were in Chinese medicine “blood chi” rising liver phlegm” etc. but the principle of mucosal barrier breakdown and large molecule which normally should not cross the villi were interacting with the gut lymph system, not in a good way. I started looking into the literature of naturopaths and they too were saying the same thing. Mainstream medicine labeled all of this as voodoo quackery. Now it’s the hottest topic in pediatrics. The unwillingness of cardiologists to leave Framingham and statins and consider triglyceride/HDL ratios as a better marker for CAD, is another area where evidence is not turning the mainstream. Semmelweis was abused and ridiculed into insanity by his mainstream contemporaries but I don’t know any of their names!
I don't endorse using any medication long-term for managing obesity. GLP-1 agonists and medications like phentermine can be helpful short-term as long as you put them on a monoamine neurotransmitter supplement like CARB-22. Taper them off the meds in 4-6 weeks and continue CARB-22: https://carbsyndrome.com/product/carb-22/
If your cravings are intense, throw in some extra L-glutamine, the poor man's GLP!
As an attorney, I can state with clarity that clients think lawyers are shysters, but docs are fabulous purveyors of all things curative. They challenge us at every turn, as they watched Law and Order, but doctors are above reproach. Nice gig you all built vis a vis the propaganda mill. I would rather eat hot coals for a remedy, than depend on a "medical professional".
I like this post. It makes a lot of sense. I resonate with it due to differing personal views which I believe are correct but appear as disbelieved or not taken seriously by a great deal of people. Unfortunately, I have been a cigarette smoker for a long time but have never heard of Snus. I do see peers and coworkers ( a few) using e cigarettes, though, and others in public. Kudos to a good use of your instinct. (I am a RN but also worked for many years providing direct patient care).
Snus was\is basically a product from Sweden. Supposedly less harmful than "chewing tobacco". I knew people who chewed and then spit into cups. The main problem was they would invariable spill the cup. Disgusting doesn't quite cover it. If Snus cut down on that it was worth it. Supposedly also lessened the chance of oral\gum cancer as opposed to chewing. Snus use (why do I feel like I'm typing a Dr. Seuss joke) is attributed to less cigarette smoking in Sweden and less cancer deaths, therefore a positive. Might be interesting to find out if e-cigarettes have cut into the Snus consumption in Sweden.
Interesting indeed but not surprising…if you are not fully in charge…at the top of the ladder…incompetence runs amok thru out the info world…people who are truly one dimensional. I have seen it on major aircraft of crash investigations with loss of life…and revealing with facts a total loss of credibility of an “ expert” only to have a “Judge” say the opposite…I have lost faith in medicine particularly after the silence during the covid scam and the “vac”.
JAMA Oncology calculated that six million cancer deaths have been prevented since 1975. 3.5 million were from "tobacco control" ie public health. So public health prevented more cancer deaths than all cancer screenings and all oncology treatments combined.
"Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020" December 5, 2024
My dad used snus now and then. When he went hunting (in the 1960s in Missouri) with friends, he'd buy a pouch of Beech-Nut Chewing Tobacco. My mom detested this as low class but was too timid to toss it out herself when he came home with the habit. She paid my older brother a buck to do the job and be sworn to secrecy.
Fantastic article, John. Thanks for this.
Keep up the effort, Dr. Ayers. But I would not expect any rewards for challenging medical orthodoxy in this world. Medical and public health groupthink and conformity show no signs of abating. Dr. Fauci is the ultimate Wizard of Oz, and the medical/public health establishment continue to worship at his altar. To date, they have learned virtually nothing from the covid fiasco.
More here:
https://press.princeton.edu/books/hardcover/9780691267135
I'm not sure when this problem started, but the pandemic (really, the entire Trump presidency) has shown us that a significant portion of physicians allow emotion and politics to color their entire thought process and thus professional judgement. Data and science be damned!
The best line you wrote was "put science, not ego, at the center." It is a principle that can—and should—apply well beyond medicine. Thanks Dr. Ayers! PS I had never even heard of snus!
I'd never heard of "Snus" either! I kept thinking "isn't that a bassinet thing for babies?"
I was glad when he finally let us know what he was talking about.
Rather than snus, I'd say the issue today would be a Zyn pouch!
I had to look up snus. Back in the day (50-60s) lots of midwestern blue collar & farmer types used snuff (which was sometimes called "snoose"). Medical nomenclature has always been rather complex! :- P
Yes!
I'm into empowering people to making informed choices. The paternalism in public health... typically accompanied by coercion of softer or harder sorts... Let alone the inhumane visitor policies during COVID... I loathe and have no respect for epidemiology or public health.
This is the problem with tobacco control: they have gone particularly far off the rails. They seem to be focused on ending nicotine use entirely, rather than saving lives by moving folks to safer alternatives (since people seem to like nicotine, and some insist on using it).
I would invite you to look at https://safernicotine.wiki/mediawiki/index.php/Main_Page, which explores tobacco harm reduction (THR) products that are far less deadly than tobacco cigerettes. (The site is a Wikipedia clone, entirely user-funded, and the content is user-submitted.)
E-Cigarettes/Vapes are a vastly safer, yet acceptable product that is roughly 95% safer than tobacco smoke. Importantly, they can compete with tobacco sales, and tobacco cigarette users find them an acceptable alternative. Reducing the harmful use of cigerettes is the goal.
A good public health overview is available here https://safernicotine.wiki/mediawiki/index.php/ENDS_Public_Health
Please quote credible sources—the article focuses on science vs what people believe.
The site quotes credible sources; it links directly to peer-reviewed papers (often on government e.g. NIH, or the publishing journal). On the public health page, there are > 20 papers linked; please do check them yourself.
If you have an issue with any of them, why not post the reason and the paper in question? Thanks.
Yes, the only valid question to ask is: Are policies that restrict access to or enjoyment of the mild stimulant that is nicotine unless it's in its most dangerous form (cigarettes) or in unsatisfying or ineffective forms (NRTs and pharmaceuticals) going to lead to better public health outcomes? There is no evidence anywhere that entire populations will eschew the use of nicotine so the sensible answer is 'No'. Reducing the harm from its use must be the goal.
Bravo.
And I'm humbled by your journey out of the tobacco fields.
It sounds right out of "Demon Copperhead."
Im so happy I read this. Thank you. 🇨🇦
There has always been a core of certain held “beliefs” in mainstream stream medicine where reasonable evidenced based voices in the wilderness get caste aside if not outright derided. Your epidemiological examples are one of many. In the last 5 or so years every conference has a review of the importance of the gut biome affecting a vast array of metabolic functions and a source for the growing number of autoimmune and other complex disorders in children. 30 years ago my wife who trained in Traditional Chinese Medicine, Herbal medicine and acupuncture (boarded both by the state and nationally) explained to me the concept of leaky gut and how it affected the immune system (the terms were in Chinese medicine “blood chi” rising liver phlegm” etc. but the principle of mucosal barrier breakdown and large molecule which normally should not cross the villi were interacting with the gut lymph system, not in a good way. I started looking into the literature of naturopaths and they too were saying the same thing. Mainstream medicine labeled all of this as voodoo quackery. Now it’s the hottest topic in pediatrics. The unwillingness of cardiologists to leave Framingham and statins and consider triglyceride/HDL ratios as a better marker for CAD, is another area where evidence is not turning the mainstream. Semmelweis was abused and ridiculed into insanity by his mainstream contemporaries but I don’t know any of their names!
I know how you feel. We are in the middle of a massive obesity epidemic, and I believe the experts got it wrong:
https://carbsyndrome.com/obesity-it-is-all-in-your-head/
After all, you can't fix something that you don't understand, and we clearly are losing the war against obesity.
And creating more problems with the long term use of GLP-1 drugs with no data to support it.
I don't endorse using any medication long-term for managing obesity. GLP-1 agonists and medications like phentermine can be helpful short-term as long as you put them on a monoamine neurotransmitter supplement like CARB-22. Taper them off the meds in 4-6 weeks and continue CARB-22: https://carbsyndrome.com/product/carb-22/
If your cravings are intense, throw in some extra L-glutamine, the poor man's GLP!
As an attorney, I can state with clarity that clients think lawyers are shysters, but docs are fabulous purveyors of all things curative. They challenge us at every turn, as they watched Law and Order, but doctors are above reproach. Nice gig you all built vis a vis the propaganda mill. I would rather eat hot coals for a remedy, than depend on a "medical professional".
Excellent piece!