Tobacco, vaping and harm reduction – a Swedish cliffhanger

What is a good story?

An owner of a vapeshop once told me about a doctor, working in a hospital a couple of blocks from the store. The doctor, he told me, usually sent his patients, those who were smokers, to his shop to try vaping. It happened every other week and had been going on for years.
“Now that´s amazing” I said. “That’s a story I need to write. Can you hook us up?”
The immediate answer was:
“No, he wouldn´t want me to do that”
He made it clear that any kind of publicity would mean the doctor would be out of practice within a month.
“He´d be next to unemployable as well, you know. Blacklisted, going against all recommendations made by the national college of physicians.” Said the vape shop owner.

The one that got away

I think about this story when pondering the ups and downs of my year as a KAC scholar (one of lucky 25 in the world!) developing news coverage and addressing tobacco harm reduction policy in regards to vaping in Sweden. It’s been more or less successful, goals have been met, plenty of news have been produced, satisfying interviews conducted and stories have been told. But it’s always been that feeling of the one that got away. THAT story.

Green meat goblin

As a journalist I have caused some people trouble. Often unintentionally. Like when the owner of a grocery store found greenish meat in his delivery. He wanted to go public, just to raise awareness about how additives in the preservation process of meat sometimes makes it discoloured. It was green.
”But it’s normal and perfectly safe to eat” he said.
He asked me to write an article about it for the local paper, where I was working at the time. And so I did. It made big headlines of course. ”Green meat in local store – proclaimed safe”. And a picture of him holding the green fillet, smiling to the camera. He was very pleased with the article.
Then he lost 75 percent of his customers. He almost went out of business and became forever known locally as ”the Green meat Goblin”. So much for good intentions.
But it was a good story.

Snus, vaping and big tobacco

Tobacco harm reduction is kind of like the green meat of Swedish public health policy. This quickly became clear when I connected with both scientists and politicians. Harm reduction for smokers, in many minds, is a concept connected to the tobacco companies. Especially here in Sweden, where the snus manufacturer Swedish Match are running campaigns to promote it. E-cigarettes even more so, even though not a single brand of vaping devices sold in Sweden are big tobacco products, excluding the rare IQOS.

Knowledge and education futile

This is peculiar. And symptomatic of a one-sided story being the only one told. Tobacco harm reduction is not a scientific subject here. It´s a a tactic to sell more nicotine products, according to the the opposition. This is reflected in a strict narrative, replicated by ideologically driven scientists, doctors and well known health organizations in Sweden. They advocate against tobacco companies, no more, no less. I asked another doctor, and well known swedish snus advocate, about this.
“It´s a cluster of doctors and scientist working together to drive policy. Many practitioners are aware of tobacco harm reduction and support it. But they won´t say that in public. They risk to lose both financing and jobs” he said.

Vaping and snus are considered “smoking in disguise” and anyone who claims to know better is by definition an advocate for harm. Like our elusive doctor sending smokers to a vape shop – just another “Green meat Goblin”. Knowledge and education is futile – or unwanted. And that’s the end of the story.

Unwilling vaping advocate

This also became to evident in my project to address THR and vaping among swedish politicians.
During the period of the KAC scholarship I reached out to eight parties in the swedish parliament. 6 answered my questions.
Well, almost.
I realized when talking to Swedish politicians on the topic of vaping and harm reduction, that the pure question-answer format (as is custom for me as a reporter) often failed. Interviews became ”reversed”. Answers became questions. I was being interviewed. What is vaping like? Why do you want a fake cigarette? And so on. I became the informant, an unwilling advocate.
Good for lobbying. Not ideal for a news story.

Flavors, flavors, flavors

I´ve conducted well over 15 interviews, written over 20 articles on Swedish topics during these 12 months of my KAC scholarship. My conclusion is that Swedish politicians are interested in harm reduction no doubt, but when it comes to vaping – a majority knows next to nothing about current research, user habits or anything related to smoking cessation with vaping.
But they do care about flavors. A majority want them banned.
“It’s obvious the tobacco industry is targeting kids or just other non-smokers with all of them fruit flavors. Don´t you see that? What kind of a smoker would even consider trying a strawberry gum flavor?”
Asked the representative of the Swedish leftist party, who cooperates with the ruling Social democrats in parliament. And they are, together with the government, all for a sweeping ban of e-cigarette flavorings.

The good story

I asked the representative if this is what she would tell the well over 100 000 swedes (i.e. voters) who are using e-cigarettes to quit smoking.
“But they don´t use these flavors do they? I can´t imagine they want anything but tobacco flavors. Right?” she asked me.
“I would imagine they do” I said ”They buy them in heaps. And they are smokers. They want to quit cigarettes and they use many different flavors. What do you want to tell them?”
There was silence. Unusual for this particular politician. She talks. A lot.
“Ok” she said. ”I realize this is a complicated issue. Maybe we need to know more. Could you mail me some information and I´ll have my secretary look in to it?”
And that was the end of the interview. Maybe she should talk to that elusive doctor? I thought. We actually met a couple of months later. In a vapeshop. Turns out her husband was (is?) a smoker. She listened. At least for a while.

But that´s a good story. Right? Or is this just another case of a green meat goblin in the making? We´ll never know. I haven´t written that article yet. Probably never will.

A cliffhanger

Coming to some sort of conclusion, the story of my KAC scholarship is one of hope and despair. And part comedy, even though, as I’m writing this report, the Swedish government is preparing to ban all flavors except tobacco in e-liquids and e-cigarettes (even those without nicotine). I wanted to cover the Swedish stance on vaping and THR and my timing couldn´t have been better.
And it absolutely makes for a good story. But with a cliffhanger.

Importance of presence

The KAC scholarship made this possible. The scholarship, with educational and knowledge support has been invaluable to me, as a reporter and as a THR educator. By developing Vejpkollen as a platform, I have connected to both politicians and organizations involved in tobacco harm reduction. This presence will be important for the coming year and in the development of Sweden’s new Vaping Consumers Association (an organization formed primarily to fight the flavour ban). Vejpkollen will definitely be a part of this and hopefully this is the start of something great for vapers in Sweden.

Yes, I would gladly take your money

And last but not least. If you want to support my efforts to produce information on vaping and harm reduction in Sweden: consider becoming a Patreon. I promise to deliver quality material, available for all who have an interest in these issues (and of course those who chose to quit smoking through vaping in order to reduce the harms of combusted tobacco in their lives.) International support is very much appreciated!

Regards
Stefan Mathisson
Editor-in-Chief of Vejpkollen
KAC Scholar 2020-2021



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