Category: Uncategorized (Page 6 of 7)

The past month has been extremely disruptive to my normal work, but one positive outcome is that I’ve had much more time for writing. I’ve also joined the trend, a few years late, of writers starting newsletters. The Liquidity Preference newsletter is going out 1-2 times a week with links to my work, discussion of COVID-19 and its economics fall out, and tips for making social distancing a little more tolerable. You can subscribe here or check out the archives for a taste of what to expect.

For the Neoliberal Project’s Exponents magazine, I took a look at the decades long campaign to stigmatize smokers via the dubious science of thirdhand smoke:

Now that we are all compelled to practice social distancing, we know too well what it’s like to live in a world where the air itself is suspect, where valued social spaces have been closed off to us, and where every brief encounter with another person requires undertaking a wary risk assessment. Despite the real effects of stigma experienced by smokers, it would be too much to suggest that they live in that world all the time. This is to the credit of ordinary people whose common sense leads them to ignore alarmist claims about thirdhand smoke; it’s certainly not for lack of trying on the part of anti-smoking activists or the journalists who uncritically amplify their fear-mongering.

The weblog is Truth on the Market is hosting a symposium on “The Law, Economics, and Policy of the COVID-19 Pandemic.” They invited me to contribute a post on how FDA regulations are preventing small distilleries from producing hand sanitizer:

In general, the redirection of craft distilleries to producing hand sanitizer is an example of private businesses responding to market signals and the evident challenges of the health crisis to produce much-needed goods; in some cases, sanitizer represents one of their only sources of revenue during the shutdown, providing a lifeline for small businesses. The Distilled Spirits Council currently lists nearly 600 distilleries making sanitizer in the United States.

There is one significant obstacle that has hindered the production of sanitizer, however: an FDA requirement that distilleries obtain extra ingredients to denature their alcohol.

I’ve also begun writing for the website Inside Hook. My first article advises what to make with some of the dusty bottles that may be taking up space in your liquor cabinet: Galliano, Drambuie, Jagermeister, and more. My second piece details my experiments making infinity bottles, including my 50+ ingredient Infinite Negroni:

As I write this, I’m sipping on a rum that’s not quite like any other I’ve had before. It’s funky and tropical on the nose, with notes of banana bread and fermented fruit. The palate is slightly sweet with vanilla, but also hot and high-proof, and hints of cinnamon and spice linger on the finish. If you’d like to try it, I’m afraid you’re out of luck: this rum exists only in my apartment, and it will taste different the next time I sample it, too.

The rum was poured from my favorite of my “infinity bottles.” The infinity bottle is a trend that has taken hold among spirits nerds as a way of creating a unique blend at home. The idea is pretty simple: You take an empty bottle and start creating your own personal blend of a chosen spirit, typically a whiskey. Then you keep adding to it over time. If you have an infinity bottle of bourbons, for example, you might drink some of it one night and then top it off with something new, creating a blend that continually evolves in the bottle.

Lastly, I’ve finally made The Rediscovery of Tobacco available on Apple books, so if you prefer reading on an Apple device, you’re out of excuses for not ordering it! I’ve also made the introduction available for free online.

“You’re overreacting. Look at how many people die from the flu every year,” my mom said. This was a couple weeks ago, and we were on the phone discussing my plans to visit home. My parents live in Houston, I live in Portland, Oregon, and my annual work trip to SXSW in Austin presented an all too rare opportunity to visit Texas. I was expressing my doubts that the trip was going to happen. There was this new coronavirus, and it sounded serious.

My mom, like many at the time and some even now, thought the media might be blowing the whole thing out of proportion. She mentioned my own writing, which has often focused on debunking media-driven health panics. Could this be more of the same? At first, it seemed unthinkable to cancel an event as massive as SXSW. Then it began to feel inevitable. Today, the idea that they could have done anything less feels recklessly irresponsible.

The events I’d been planning for months were called off, but I still had plane tickets and an expensive, non-refundable hotel room. I still had parents who wanted me to visit. I still had a hunger for breakfast tacos and Texas barbecue. But I also had vague yet evocative memories of a book I’d read eight years ago, a book in which ordinary people pick up extraordinary diseases, with often fatal consequences for themselves, their loved ones, and the doctors and nurses who care for them. Transporting my body and its invisible passengers into my parents’ house, where any sneeze, cough, or lick from an affectionate terrier could spread contagion, didn’t feel worth the risk. And so, as my flight departed to Austin, I stayed home revisiting David Quammen’s prescient book, Spillover.

David Quammen is among a handful of authors whose books I’ll order as soon as they’re announced, regardless of whether I have any previous interest in the subject matter. (Perceptions of man-eating predators? I will – hopefully – never be devoured by a bear, but Monster of God was an engaging read nonetheless.) His 2012 book, Spillover, is devoted entirely to infections that make the leap from other animals into humans. In technical parlance, “zoonosis.” The list of previous zoonoses is long: AIDS, Ebola, Marburg, rabies, Nipah encephalitis, Lyme disease, too many more to mention. Some, like flu, have become an ever-fluctuating part of our familiar viral landscape. Others, like SARS, flare up, run their course with terrifying intensity, and burn out. Our lives move on. But Quammen’s book wasn’t intended as a curious catalogue of past events. It was a warning. Zoonosis, he cautioned, “is a word of the future, destined for use in the twenty-first century.” Eight years later, that future has arrived.

Is this new coronavirus the “Next Big One” that epidemiologists have been fearing? If not, it’s certainly big enough, and it’s exposing how unprepared we are for it. Though Spillover is too dense to cover fully, here are three points that stood out while re-reading it during the current pandemic.

“Everything comes from somewhere”

One of the things I appreciate about Quammen’s books is that he situates his topics in evolutionary and ecological contexts. “Although infectious disease can seem grisly and dreadful, under ordinary conditions it’s every bit as natural as what lions do to wildebeests and zebras, or what owls do to mice.” We are not separate from nature. We are not even fully human; each of us is an ecological niche unto ourselves, home to uncountable microbes. So is every other creature. Through the long, relentless pressure of evolution, most of these relationships become manageable, sometimes even beneficial. Occasionally these microbes find themselves outside of the reservoir hosts to which they’ve become adapted. And then? A dead end, typically. But also opportunity. Nearly 8 billion opportunities in the case of humans, an efflorescence of new environments packed densely into cities and connected by global travel. And while most of us in wealthier countries rarely come into contact with live animals other than our pets, we interact with them indirectly through farming, trade, and encroachment into wild habitats. “Shake a tree,” as Quammen writes, “and things fall out.”

From a microbe’s eye view, we humans are high-risk, high-reward. They may infect our bodies and ravage us so thoroughly that they are unable to spread, their path blocked by human response strategies or their own excessive virulence. That’s the Ebola story, so far: a handful outbreaks, extremely high fatality rates, but ultimately, containment. In other conditions, the microbe may take hold and find itself capable of transmitting from host to host indefinitely, keeping the humans it infects alive long enough to spread it to others. That’s HIV, a virus that jumped from the blood of other primates to a person. The circumstances are contingent; it might have happened lots of times, eventually fizzling out. It only had to break through once. (In actuality, it probably succeeded multiple times.)

You don’t have to slaughter a chimp or eat a bat for zoonosis to happen. Disease could spring from racehorses (Hendra), pigs and chickens (swine and avian flu), domesticated goats (Q Fever), cattle (“mad cow”), parrots (psittacosis), ticks (Lyme disease), or Old Yeller (rabies). Reasonable steps can be taken to prevent spillover, and the present epidemic will likely result in some reflection on how to do so, but there’s no way to stop it entirely. The next disease is out there, uncharted. The question is how to prepare for it.

SARS should have prepared us

Eight years after first reading Spillover, there were a few specific cases described within it that lingered in my memory. The Australian horse trainer who came down with Hendra. The Dutch tourist who picked up Marburg during a ten-minute venture into a Ugandan cave. And most relevant to the current epidemic, the “superspreaders” who inadvertently transmitted SARS far beyond its initial entry into the human population.

A surprising number of these cases can be traced to a single hotel in Hong Kong, where a professor from Guangzhou arrived for a wedding. He’d been ill two weeks before, then felt well enough to travel. At the hotel, he felt sick again. He stayed on the ninth floor. So did a seventy-eight-year-old grandmother from Toronto, who overlapped with him for one night. So did a young woman from Singapore. Within a few weeks, the professor had died. The grandmother died, too, after flying the virus back to Canada, where it killed thirty-one. The young woman returned to Singapore. She survived, but her mother, father, uncle, and pastor did not. A woman infected by the grandmother brought SARS to the Philippines; a man infected by the young woman took it to Germany. In the end, SARS infected 8,098 people and took the lives of 774.

This web of infections, vaguely remembered, is what was on my mind as I contemplated my forthcoming trip to Texas. The United States had restricted travel from China, but the new coronavirus was already here. Never mind the Chinese; I fit the profile of a superspreader. I’d just been to New York, cramming onto subways, squeezing into airplanes, massing at the rails of the Staten Island Ferry as we passed the Statue of Liberty. Then back to Portland, where I went to bars and restaurants, played soccer. And then? To Austin, where I would interact with thousands of other travelers who had non-refundable tickets? And on to the home of my parents, who are in their sixties? No, thank you. Better to stay in Oregon reading popular science books.

Another thing about SARS: It was also caused by a coronavirus, SARS-CoV, namesake for the virus you’re currently worried about, SARS-CoV-2. As frightening as the original SARS outbreak was, its spread was limited. Perhaps that’s part of why some people are downplaying risks now. We’ve had outbreaks like this before, and they weren’t that bad in the scheme of things. That’s the wrong way to think about it. A better question to ask is, “Under what conditions could SARS have been much, much worse?”

The fortunate thing about SARS is that the infected typically endured recognizable symptoms before they became highly contagious. That made it possible to contain it. “This was an enormously consequential factor in the SARS episode – not just lucky but salvational,” writes Quammen. For some other viruses, such as the flu, infectiousness can precede symptoms; that’s part of why they spread so easily. So, what’s scarier than SARS? SARS that spreads like the flu.

That’s not exactly what we’re facing now, but there are similarities. Toward the end of Spillover, Quammen recounts an interview with epidemiologist Donald S. Burke, who had given a lecture back in 1997 on the groups of viruses most likely to lead to the next pandemic. Coronaviruses stood out as a probable candidate even then, given their propensities toward infecting animals and rapidly evolving. The genomes of coronaviruses are encoded in error-prone RNA. That means they mutate often; they adapt, they evolve, the replicate in huge numbers. We were warned about this before SARS. SARS proved that the danger was real. Less than two decades after the initial SARS outbreak, the danger is here.

What we do now matters

I’m not writing this post to sound fatalistic. Yes, zoonoses are to some degree inevitable (though we can alter practices to prevent them). Yes, a bad one has arrived. But there’s a reason there are nearly eight billion of us: We are smart and we can change our behavior in light of new information. Toward the end of his book, Quammen considers how much that matters. “[Individual] effort, individual discernment, individual choice can have huge effects in averting the catastrophes that might otherwise sweep through a herd.”

Here in the United States, we’ve squandered our early opportunities to prevent the spread of this new coronavirus. Due to a lack of testing, we’re not even sure how many people have been infected. What happens next depends on a multitude of factors: how deadly the virus turns out to be, how many people get it (especially in vulnerable populations), and whether our hospital systems are able to deliver care without being overwhelmed by new patients. Under the rosiest estimates, deaths will be in the hundreds or thousands. If things don’t go well? Hundreds of thousands. If this goes very badly? More than a million.

The worst-case scenarios are not inevitable. But they are plausible. They are realistic. You should take them seriously. Even now, I feel like many people I talk to or interact with online are still complacent about how rapidly things can change. Here are the two points I think cannot be emphasized enough:

First, this is not something that only happens over there, or to other people. It’s not just the flu. You need to be thinking of this as something that could very well take the life of someone you care about.

Second, think about what you, as an individual, can do to prevent the worst-case scenarios from happening. Don’t be a superspreader. Try not to be a mediumspreader, either. Cancel your trip, cancel your events, cancel your parties. Work from home, if you can. Practice social distancing. How extreme? Honestly, I can’t tell you, but do think about it. If you’re reading this on your phone while waiting in line to get into a crowded bar, you’re doing it wrong.

What’s next?

What’s next, when the worst of this is over? I don’t mean next for this virus, or even for diseases generally. I mean what other disasters have we been warned about that many of us blithely ignore? That’s another thing I think about reading Spillover now. There’s climate change, obviously, which could spiral out in all sorts of terrible ways. Living in the Pacific Northwest, something more specific comes to mind: the other Next Big One, the earthquake and tsunami that will likely be triggered by the next great shift in the Cascadia subduction zone.

When Americans think of destructive earthquakes, we generally think of the San Andreas Faultline because it’s the most active. Due to all that activity, the cities along it are prepared. Little earthquakes and big earthquakes happen with too much frequency to ignore. The Cascadia subduction zone is different. Until fairly recently, scientists didn’t even recognize it as seismically active. That stillness belied a more frightening truth: The pressure is building up. Rather than releasing it gradually and actively, like the San Andreas, the CSZ releases it all at once in massively destructive megaquakes.

Based on current estimates, these megaquakes occur about every 243 years. The last one has been dated precisely to January of 1700. That’s… 320 years ago. You get the picture. I won’t go into detail here, but you can read grim predictions of what’s coming. Outside magazine devoted a feature to it in 2011. The New Yorker in 2015. Vice in 2016. The narrative structures differ but the basic story is always the same. The megaquake is coming and it’s going to be very, very bad.

Like many people living in the region, I read these stories when they were published. And like many of us, I haven’t done enough to prepare. There’s a suggestive parallel to COVID-19. Places with recent experience of respiratory disease outbreaks, particularly in Asia, knew to take it seriously and had plans in place for dealing with it. It’s similar to how cities that experience minor earthquakes are more prepared for the big ones. In the case of the Cascadia subduction zone, we are not the places prepared for coronavirus like Taiwan or Hong Kong or Taiwan. We’re Italy or the US. If you live in the Pacific Northwest and are currently lamenting the hardship of missing events or scrambling to find toilet paper because of the current epidemic, start thinking about what you can do now to be ready for the next disaster. We can’t say nobody warned us.

As someone who’s naturally contrarian, and who is friends with or follows a lot of other contrarians, it’s interesting to follow how people are evaluating the risks of coronavirus. One potential split noted in this Tyler Cowen column is between “base-raters” and “growthers.” Another is partisanship: right-leaning people seem to be more dismissive of the risk, perhaps taking their cue directly or indirectly from Trump himself. (The response is far from uniform; see Michael Brendan Dougherty at NRO, for example.)

Much of my own writing has focused on debunking health panics: on secondhand smoke, on vaping. You might expect I’d take a similar position on this, too, and conclude that fears of coronavirus are overblown. But facing the decision of whether or not to travel this week — I planned to work at SXSW in Austin and visit family in Houston — I’ve been reading about it obsessively, and I’m persuaded right now that the case for taking preventive measures is strong. I’ve cancelled my own trip in part because of the virus. Though I’m not an authority, I’ve talked with a lot of other people who are unsure how to plan and I thought it worth writing out my reasoning. Some reasons I’m in the “growther” camp who’s worried that the US is not yet taking this epidemic seriously enough:

1) Potential spread of the virus is exponential. From data published by Max Roser and Hannah Ritchie at Our World in Data, the case doubling time is currently 5 days in some contexts, excluding China which has taken extreme measures to restrict its spread. (The page at Our World in Data is one of the best resources I’ve found for understanding the virus.)

2) Rates of testing have been extremely low in the US and there is evidence of community spread. Oregon, where I live, can test only 40 people per day. Over the weekend, the amount of known cases doubled twice. The absolute number of known cases is still low, but one has to wonder how many additional cases are out there.

3) The fact that many cases exhibit mild symptoms increases the chances that people may unknowingly spread the disease. Viruses with higher, faster fatality rates can seem scarier, but a virus that doesn’t kill its hosts quickly with debilitating symptoms has potential to spread more widely, doing more damage in the long-run. Relatively mild symptoms plus a long period of shedding may combine to make this virus difficult to contain.

4) Dismissive comparisons to the flu are unconvincing. First, the flu is quite bad to begin with! Second, even some optimistic case fatality rates for COVID-19 are about 10 times that of the flu. Unlike the flu, we do not have a vaccine for COVID-19. Also unlike the flu, it’s uncertain whether it will be seasonal. Absolute mortality is lower than the flu now, but given the factors above, there are plausible scenarios where it will grow alarmingly quickly. (See, again, Our World in Data.)

5) As a relatively young and healthy person, I’m not particularly worried about my own risks. I am worried about transmission to others. Observed fatality rates increase dramatically with age and certain medical conditions. Potential mortality among older populations is one of the most compelling reasons to take steps now to prevent the spread; see conditions at the Life Care nursing center in Washington or in Italian hospitals.

6) In addition to the direct risks of coronavirus, there will be second order effects if the medical system is overwhelmed. Patients suffering from other illnesses or accidents will be unable to get the care they need. If medical staff are also exposed to the virus, these patients then face even more risk, and challenges to the medical system will be compounded by shortages of doctors, nurses, and other staff. One thread on Twitter memorably describes this as “The Pinch.”

7) Perhaps, like the president, you believe that fear of the coronavirus is the product of the “Fake News Media and their partner, the Democrat Party.” Perhaps you distrust the media. Do you also distrust markets? Stocks have fallen and the 10-year bond yield fell to a record low. It’s not always possible to read the message of the markets, but right now it seems pretty clear: investors expect coronavirus to have large, lasting detrimental economic effects, and they are flocking to the safest assets.

8) Given all of the above, there’s a compelling case for mitigation. The below image, also from Our World in Data, is an abstract visualization of the benefits of slowing the spread of the virus, a.k.a “flattening the curve.” This prevents the hospital system from being overwhelmed and buys time to develop treatments and hopefully an effective vaccine.

9) I see a lot of discussion about what the “real” case fatality rate of this virus is, as if that is an independent fact about the virus rather than a figure at least partially determined by the resources available to treat the sick. The rate is contextual and preventing the hospital system from being overwhelmed is one strategy for keeping it low.

10) We’re still learning what methods are effective for mitigating the spread of the virus, but improved sanitation and social distancing are smart approaches at minimum. Forgoing unnecessary travel strikes me as an obvious response, and it’s one reason I’m not going to Texas this week as I’d planned. Avoiding and cancelling mass gatherings, as costly as it is the short-run, is also the responsible decision right now. (See Yascha Mounk, “Cancel Everything.”)

11) I haven’t yet figured out how to incorporate this into the rest of my daily life. I expect a lot of people who can will start working from home. I have that option with writing, but all of my other work is public-facing to some degree. Even for my writing, events sell books. My other work is related directly or indirectly to hospitality: I tended bar last night. I have several small events planned or in the works. I still play soccer on weekends, though I suspect that may not last. How much of that is going to seem foolish from the perspective of a few weeks or months from now? I’m not sure. I’m arguing against interest by advocating for social distancing — my non-writing work is premised almost exclusively on encouraging the opposite of that — and I expect the next few months will be challenging. But at least I have writing! Many of my friends own or work in bars and restaurants full-time, and this is going to be very hard on them.

12) It’s possible that I’m overreacting. But as Yascha Mounk concluded in his own thread about this on Twitter, “If we all do the right thing, corona might yet pass without mass casualties. Like Y2K, it’ll become a punchline. (Let’s hope it will!) But consider two points: • Y2K passed without a hitch in part because we invested vast resources into preventing problems. • It’s rational to invest in avoiding the tail-end risk of a catastrophic outcome even if it pretty—or very!—likely that it’ll never come to pass.”

The cover story of this week’s issue of New York Magazine is all about vaping. The publication employs smart, talented writers, so despite the alarmism of the cover tease – “The making of a health crisis that’s only just begun” – I was hopeful that the story itself might offer more nuance. Regrettably, it’s a one-sided mess that fails to convey the complexities of the issue and pays virtually no attention to the needs of current and former smokers whose lives are risk.

Mainstream coverage of vaping tends to focus on the latest fears rather than the long-term case for harm reduction. Stephen Hall’s New York article is hardly unique in that respect. It is unique in that it manages to maintain this bias at such length. I’ll say this for his cover story: There certainly is a lot of it. It stretches on for a luxurious 6,000 words, providing copious detail, original reporting on the outbreak of lung illnesses, and quotes from leading figures in tobacco control. Yet despite all this, and regardless of Hall’s presumably good intentions, it essentially amounts to a hit piece.

The article opens, predictably, with scenes from the mysterious lung illness that dominated headlines since last summer. It’s been clear for months that a contaminant in cannabis cartridges is behind the outbreak, with vitamin E acetate recently confirmed by the CDC as the most likely culprit. The story of how this additive entered the THC market has been reported previously, most notably by the cannabis website Leafly, whose coverage has been far superior to that of most national news publications. Rehashing the story in New York serves mostly to provide drama and color. Which is fair: A feature story needs drama and color. But Hall devotes nearly 3,000 of his words to THC and the lung illness, taking up about half the article. For a writer who purports to have something important to say about the potential dangers of nicotine vaping, this is a dubious narrative decision.

The conflation of nicotine and THC vaping by government agencies and the media has caused immense confusion in the debate over e-cigarettes, which many of us who follow the issue have been striving to correct. New York muddies things up again by threading together two ideas that, taken separately, would be unobjectionable, but that combine to mislead the reader. The first is that contaminated THC cartridges have caused a truly frightening pulmonary illness that has tragically sickened and killed people who use them. The second is that the long-term health effects of nicotine vaping are not yet completely known. These are both valid stories, but they don’t have much of anything to do with each other. One is a short-run story about the illicit drug market. The other is a long-run story about the potential risks of vaporizing nicotine. The products vaporize different liquids, rely on different supply chains, are sold in different venues, are regulated (or not regulated) by different agencies, and appeal to different consumers. Mashing these stories together with the implication that fear of one should inform our response to the other generates more confusion than clarity.

Despite acknowledging the role of vitamin E acetate, Hall speculates that since not every case of lung illness has been definitively linked to it, perhaps nicotine e-cigarettes actually are causing some of the cases. While it’s impossible to rule out that someone, somewhere may have ended up with a contaminated e-cigarette, this would be extremely aberrant. E-cigarettes have been used by millions of people for more than a decade in multiple countries, raising the question of how they would trigger lung illnesses that are geographically and temporally clustered. There was clearly something new at work that was not inherent to e-cigarettes, and it would be a major a coincidence if a different contaminant causing the same symptoms just happened to enter the nicotine supply at the same time that vitamin E acetate was contaminating THC carts. The parsimonious explanation is that THC contaminants are the primary and perhaps exclusive cause of the outbreak, and that if any cases ever do get conclusively tied to e-cigarettes, they will be very weird outliers in the nicotine e-cigarette market.

By suggesting that killer e-cigarettes may be lurking behind any corner, suddenly striking down vapers by some unknown causal mechanism, New York Magazine exceeds the alarms of the CDC. The agency’s current guidance is that people should not “use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers.” It advises further that “[adults] using nicotine-containing e-cigarettes or vaping products as an alternative to cigarettes should not go back to smoking.” Also, “E-cigarette, or vaping, products should never be used by youths, young adults, or women who are pregnant. Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products.”  The CDC is generally antagonistic to e-cigarettes, and the agency rightly advises that minors and non-smokers shouldn’t go taking them up for fun. But it also recognizes that the alternative for many vapers is not abstinence, but a return to smoking combustible cigarettes. Which brings us to the bigger problem with New York’s coverage: it almost completely disregards the health of smokers.

I was alerted to Hall’s article on Twitter by CBS journalist Tony Dokoupil, who compared its alarmism to “old school pot coverage.” More to the point, he noted that it “shows little regard for [34 million] adult smokers who might benefit from a safer alternative” and “reeks of class judgement.” Tony could have also added that more than 400,000 of those smokers will die in the United States this year, or that 7 million annual deaths worldwide are attributed directly to tobacco use. Hall doesn’t mention these figures in his story, either of which would have helped put the 60 deaths due to lung injury that he does cover into perspective.

Hall wants readers to fear the long-term effects of vaping, which he describes as a potential epidemic in the making. What these risks may turn out to be is of course a vital concern, but the stakes are wildly different for smokers and non-smokers. A non-smoker who takes up vaping is increasing their risk; a smoker (or potential smoker) who takes up vaping is reducing it. At the population level, the degree to which these effects offset each other depends on the relative risks of smoking and vaping. If the latter is vastly lower-risk than the former, then vaping can be a net good for public health even if a substantial number of non-smokers become vapers and even if vaping is not “safe” in an absolute sense. This simple relationship (the “risk/use equilibrium”) is one of the main things that has convinced many health researchers that tobacco harm reduction holds promise.

The concept of harm reduction gets short shrift in Hall’s reporting. When he does mention it, it’s only to discredit it shortly after. He notes the influence of estimates from Public Health England and the Royal College of Physicians that the harms of vaping are unlikely to exceed 5% of those caused by smoking cigarettes, then immediately quotes Jeffrey Gotts of the University of California, San Francisco denouncing them as “ludicrous.” Similarly, the founders of Juul make an appearance in secondhand reporting about their goal of replacing smoking, only to have theirs aims immediately dismissed by Stanton Glantz, also of UCSF. Readers of New York Magazine wouldn’t even finish the piece with a clear idea of whether e-cigarettes are safer than smoking; “Now I think they’re about as dangerous as a cigarette,” says Glantz in one of the few paragraphs that addresses the question.

That Gotts and Glantz are both affiliated with UCSF is no coincidence. You’d be hard-pressed to find a research center more institutionally opposed to nicotine or tobacco use in any form. Glantz in particular wears his ideology on his sleeve. His career has long combined research and activism, aiming in his own words to define “smoking as an antisocial act,” and he has a demonstrated willingness to make ludicrous claims of his own when they suit political ends. (See, for example, his infamous Helena heart miracle study.) The other expert Hall cites repeatedly is Matthew Myers of the Campaign for Tobacco-Free Kids, who is an effective lawyer and activist, but far from a neutral source.

Quoting Gotts, Glantz, and Myers is a defensible editorial decision; they’re all significant figures in the field. What’s not defensible is to do so while ignoring the substantial scientific literature making the case for tobacco harm reduction. I’ve covered much of this elsewhere – at greatest length in chapter seven of The Rediscovery of Tobacco – but suffice to say that there’s a great deal that New York omits, from projections that widespread switching to e-cigarettes could prevent more than 6 million premature deaths in the United States to a large randomized control trial finding that smokers given e-cigarettes successfully abstained from smoking at nearly twice the rate of smokers provided with traditional nicotine replacement therapies. There are impeccably credentialed advocates of harm reduction in the United States, Scandinavia, Europe, and around the world whom Hall could have cited to present a more balanced view of the debate.

Similarly, If Hall bothered to interview smokers, vapers, vape shop owners, or vaping advocates, there’s scant evidence of that in the final product. There are more than 3 million ex-smokers who currently vape in the United States and millions of current smokers who struggle to quit. I’ve come to know many of them in person or online, and they beg to make their voices heard and to preserve access to products that have helped them quit smoking. Why are their stories overlooked while teenage drug dealers in Wisconsin take up thousands of words of coverage? This narrative decision reflects poorly on New York Magazine. As rates of cigarette smoking have declined, the practice has become concentrated among the financially worse off and less educated, which has made it all too easy for other Americans to dismiss their interests. Persuading smokers to change their behavior and providing them with tools to do so is among the most vital needs in public health. Yet notably absent from New York’s coverage is any suggestion for how to help them. The magazine hypes speculative fears about dangers of vaping that might appear decades from now, while neglecting the completely unspeculative deaths of more than 1,000 Americans every single day.

To be clear, worries about the long-term effects of vaping are absolutely a valid concern. I’m not suggesting that vaping is perfectly safe, that reasonable steps shouldn’t be taken to curb youth uptake, or that journalists shouldn’t explore the potential risks. As a physician friend of mine likes to say, “If you want lungs that outlast your hair, don’t inhale things that are not air.” Sound advice. But we also know that many people will inhale things that are not air, as they have done throughout human history. Taking their interests seriously requires contemplating trade-offs. Throughout his article, Hall instead maximizes every possible harm while minimizing every possible benefit. (One example: He cites the scariest figures about youth vaping but doesn’t mention that these refer mostly to occasional use or that youth smoking rates have fallen to the lowest levels ever recorded.) Regardless of what one thinks of the Royal College of Physicians’ estimate of the risks of vaping, one should heed their reminder that excessive risk aversion can itself be harmful: “If this approach also makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, or inhibits innovation and development of new and improved products, then it causes harm by perpetuating smoking.” New York evaluates vaping as if smokers did not exist.

Journalists, academics, and policymakers too often fail to treat nicotine consumers with dignity, respect, and genuine concern for their well-being. By choosing fear over nuance, absolutism over trade-offs, and ideologically-driven sources over balanced reporting, New York Magazine botched its opportunity to publish an informative feature that could improve the debate over vaping. The 34 million smokers and 10 million vapers in the United States deserve better.

National press is starting to come in for The Rediscovery of Tobacco. First up, Jacob Sullum reviews the book alongside Sarah Milov’s The Cigarette for the new issue of Reason. From the opening:

When Clara Gouin started running the Group Against Smokers’ Pollution (GASP) out of her College Park, Maryland, living room in 1971, she was rebelling against social norms she deemed oppressive. “Gouin was a housewife and the mother of two daughters, the youngest of whom had an allergy to smoke,” University of Virginia historian Sarah Milov writes in The Cigarette: A Political History. “The child’s reaction to cigarettes was so severe that it prevented the family from going out to eat. Even worse than being restricted in public was the expectation that nonsmokers had to accommodate smoking guests in their own homes. Ashtrays in the homes of nonsmokers were monuments to smokers’ supremacy. ‘What doormats we were!’ Gouin recalled thinking as she lay awake one night contemplating nonsmokers’ powerlessness.”

The understandable grievances of put-upon nonsmokers like Gouin gave birth to a movement that ultimately banished smokers from nearly every place they might want to light up. In many jurisdictions, that includes outdoor spaces. Sometimes it even includes smokers’ own homes. Half a century after Gouin founded GASP, as Jacob Grier shows in The Rediscovery of Tobacco, the dwindling minority of cigarette smokers (15 percent of American adults in 2019, per Gallup, down from 45 percent in 1954) is the group with the more plausible complaint of oppression.

Sticking to that theme, while in New York last fall I sat down for an interview with Monica Burton of Eater to discuss whether smoking bans in hospitality spaces have gone too far. You can read that here.

My New Year’s resolution for 2018 was to finish writing my book on smoking. As it turned out, I needed to make the identical resolution for 2019, and this year I finally followed through. As a result, much of my reading this year remained focused on books and articles in that area, as well as on reading and revising my own writing until I could no longer stand the sight of it. The product of that labor is The Rediscovery of Tobacco: Smoking, Vaping, and the Creative Destruction of the Cigarette, which I published at last in September. Though I no longer have any desire to read it again myself any time soon, if you’ve come to this post looking for book recommendations, I’ll immodestly lead with that one.

In my free reading time, most of my non-fiction selections reflect the present dismal moment in American politics and a re-evaluation of how I define my own. My views have gone somewhat leftward over the past decade, but in the past few years, especially, my perception of who my allies are has shifted even more pronouncedly left. When I came into the libertarian movement in the early 2000s, the Cold War fusion of libertarians and conservatives was already straining. With the rise of Trumpist nationalism, that break feels complete.

When I worked in DC, it wasn’t uncommon to hear from other libertarians that it would be easier if we could simply refer to ourselves as “liberals” without the stuffy “classical” modifier and without the confused meaning “liberal” had taken on in the United States. With the Trumpian takeover of the Republican party, defending liberalism writ large — in the broad sense that encompasses libertarians, much of the democratic left, and those on the limited government, free market right — has become an urgent cause. The current trajectory of American and global politics has served to increase, for me personally, the salience of the longer, wider, tradition of liberal thought relative to the narrower libertarian movement, even though I situate my own views within both of them.

At the same time, more people on the left now describe themselves as “socialist” or “progressive,” perhaps even viewing liberalism with disdain. The word “liberal,” therefore, seems up for grabs, and feels increasingly comfortable for me personally. This is not a renunciation of the libertarian label — as evidenced by one of the recommendations below, I remain open to even more radical approaches to libertarian thought than I’ve adopted in the past — but I am more willing of late to use the terms liberal and libertarian interchangeably as accurate self-descriptors.

With that digression out of the way, these are the books that stood out for me in 2019. As always, these are books I read this year, not ones that necessarily came out this year.

The Revolt of the Public, Martin Gurri — This was one of the most consistently recommended recent books among people I follow online, and with good reason. Originally published in 2014 and re-published in 2018, it offers a strikingly prescient analysis of politics through the lens of a technologically empowered public striking out against delegitimized elites. A chapter in the new edition looks back on Trump and Brexit, and considers two possible ways forward: destructive nihilism, or a more decentralized, modest liberal democracy. Thought-provoking throughout, and I highly recommend it; see also this review from Noah Smith and a new post from Gurri examining the events of 2019.

Open, Kimberly Clausing — The subtitle describes this as a “progressive case” for free trade and immigration, though much of it could be aimed just as squarely at trade-wary Trump voters as to Bernie Bros. Clausing persuasively acknowledges the difficulties some parts of the US have suffered adapting to trade, while arguing that new restrictions would only exacerbate their woes. I’d suggest this without hesitation to my progressive friends, but to conservatives as well.

Open Borders, Bryan Caplan and Zach Weinersmith — I loved this book, which is both a compelling argument for immigration and a demonstration of how effective the graphic novel format can be for something like this. (While reading it, I couldn’t help imagining how fun it would be to do a similar treatment of tobacco.) It’s not just economics: It’s also funny and a joy to read, with subtle jokes appearing in the illustrations, and forcefully makes the philosophical and moral case for immigration in ways that economics writing often shies away from.

Why Liberalism Works, Deirdre McCloskey — As an avid reader of McCloskey’s Bourgeois trilogy, I was eagerly anticipating this as a more approachable introduction to her writing and the benefits of what she calls the “Great Enrichment” for those unwilling to take on such lengthy tomes. And it is that, but as a collection of assorted essays rather than a tightly structured argument begun from scratch, I wonder how well it will be received by those not already primed to enjoy her work. Recommended with that caveat.

Technology and the End of Authority, Jason Kuznicki — Part political theory survey, part quietly radical argument for decentering the state’s role in our thinking and using technology to reduce its scope. One of the most provocative paragraphs I read this year: “In any case, however, the state should be understood as a last resort. We ought to be embarrassed rather than proud whenever we reach for the apparatus of government to solve a problem. The use of the state is always an admission that either our other social technologies have failed us or we have prematurely abandoned them.”

Achieving Our Country, Richard Rorty — My first dive back into Rorty in well over a decade, at the recommendation of Adam Gurri. Though published in 1998, the discussion of how to balance national pride and shame in a nation’s failings in a way that encourages reform is every bit as relevant today. My preferred reforms would not be Rorty’s, but I found this no less valuable a read for that. (As Adam notes, the book is also a thematic complement to questions raised in The Revolt of the Public.)

Ordinary Vices, Judith Shklar — I was unfamiliar with Shklar’s work until this year, when I picked this up after multiple recommendations online by Jacob Levy. Of most interest here was the essay “Putting Cruelty First,” emphasizing awareness of the potential for cruelty as a fundamental guide for liberals. Or as Levy describes her approach, “Shklar’s was a liberalism motivated not by a summum bonum, an ultimate good, but by a summum malum, an ultimate evil, something to be avoided: namely, cruelty and the fear it inspires.” Compare this with Adam Serwer’s Atlantic article last year, “The Cruelty is the Point.” Of Trump’s many illiberal aspects, his embrace of cruelty and its acceptance by his supporters is the most repulsive.

The Cigarette, Sarah Milov — This history of the cigarette was released within a couple weeks of my own book on tobacco. Points of disagreement will be obvious to anyone who reads them both, so I’ll mention a couple ways in which I think they complement each other. While my book agrees that the shift away from ubiquitous smoking is a good thing, Milov’s more vividly illustrates how difficult earlier decades were for sensitive non-smokers. And though Milov briefly gestures at the downsides of stigmatizing smoking, mine spends much more space exploring the detriments of the anti-smoking movement’s illiberal turn. Reading them together will provide a fuller picture than reading either in isolation. Milov also provides the most in-depth look at the farming side of the cigarette industry that I’ve come across in any books covering the history of tobacco in the United States.

Finally, some brief recommendations for fiction: I loved Charles Portis’s The Dog of the South, guided by this review from The Ringer. The Dispossessed and The Night Manager were my long overdue introductions to Ursula K. Le Guin and John le Carre, respectively, and I plan on reading more Le Guin in particular this year. I read Mirror, Shoulder, Signal by Dorthe Nors on a trip to Denmark and enjoyed its portrayal of a conflicted woman from Jutland trying to make a life in urban Copenhagen. The Final Solution is a charming, affecting mystery from Michael Chabon starring a familiar detective, veering into a chapter told from a very surprising perspective that he pulls of remarkably well. Update: I’d meant to include Colson Whitehead’s The Underground Railroad, too, which is as good as everyone says it is.

New from me at the Washington Examiner:

As the federal government has backed away from a ban on flavored e-cigarettes, opponents of the products are shifting their attention to state and local levels. It’s easy to understand the reasons for concern: Vaping is novel, we’re protective of the youth, the wave of lung illness is frightening, and the carnage caused by cigarettes has made us wary of nicotine in any form. But getting risk right requires taking a step back, calmly evaluating the evidence, and not giving in to panic.

Read the rest for my op/ed-length case for refraining from banning e-cigarettes.

Will panicked reactions to the so-called “vaping lung illness” result in more premature deaths than the illness itself? Today at Slate, I explain how fear-driven responses to events like terrorism, nuclear disaster, and the current outbreak can lead to policies and behaviors that actually end up increasing risk:

In a paper from 2002, psychologists Paul Slovic and Elke Weber describe these sorts of reactions to frightening events as the “social amplification of risk.” They note that when an unexpected danger arises, “the adverse impacts … sometimes extend far beyond the direct damages to victims and property and may result in massive indirect impacts such as litigation against a company or loss of sales, increased regulation of an industry, and so on. … Thus, the event can be thought of as a stone dropped in a pond. The ripples spread outward, encompassing first the directly affected victims, then the responsible company or agency, and, in the extreme, reaching other companies, agencies, or industries.” Through this process of social amplification, relatively minor risks can result in disproportionate or mistargeted responses.

Read the rest here.

Also, while I was in DC last month I sat down with Trevor Burrus of the Free Thoughts podcast for a discussion of my new book, The Rediscovery of Tobacco. Listen here or read the transcript.

Better late than never, I’ve finally arranged a book release event for The Rediscovery of Tobacco. After giving some thought to the venue, I realized there was only one ideal spot to host it: The Horse Brass Pub, whose former owner Don Younger was the most outspoken opponent of Oregon’s smoking ban. He and his bar feature in chapter five of the book, which focuses on the spread of smoking bans and the ways in which class influences who is forced to abide by them. Much against Don’s wishes, the Horse Brass is now smoke-free by fiat of the state, so attendees won’t have to worry going home smelling like smoke. I’ll be selling and signing books from 6:00-8:00 pm on Monday, November 4th. For those so inclined, we’ll likely head elsewhere after for celebratory cigars.

My most recent piece for Reason draws on themes in my book to explain how the previous decade’s debates over smoking bans illuminate today’s moral panic about vaping. Read it here.

While I was in DC recently, I had the pleasure of recording a live podcast with Caleb Brown of the Cato Institute, which is now available for streaming online. I’ve also spoken with Mitch Kokai of the John Locke Foundation and Brent Stafford of RegWatch.

Finally, the first local coverage of my book has come from Mark Fogerson of Portland Monthly, who met with me to discuss cigarettes, cigars, smoking bans, vaping, and related issues.

It’s called The Rediscovery of Tobacco: Smoking, Vaping, and the Creative Destruction of the Cigarette. It looks like this:

Here’s the brief description:

The cigarette is the most lethal consumer product in history. The movement to extinguish smoking, however, has become alarmingly illiberal. Smoking bans have spread beyond restaurants and bars to parks, beaches, and sidewalks; rising cigarette taxes rob the wages of society’s least well-off; moral panic threatens smokers’ access to potentially life-saving e-cigarettes; and smokers are discriminated against, stigmatized, and made to feel unwelcome in society. What if there’s a better way? The Rediscovery of Tobacco is a moderate manifesto against the extremes of the anti-smoking movement. This contrarian take on smoking makes the case for respecting the choices of consenting adults, acknowledging the genuine pleasures of pipes and cigars, and encouraging an innovative market for lower-risk competitors that will finally end the deadly reign of the cigarette.

This has turned out to be an eventful week to release the book. Michigan, New York, Washington, DC, and other jurisdictions are enacting or contemplating bans on flavored e-cigarettes. The FDA has announced its intention to ban them nationwide. In Michigan, anyone found in possession of four or more flavored vapor devices could be imprisoned for up to six months. India — a country with more than 100 million smokers — has just banned the sale of vapor products, with penalties for offenders reaching up to three years in prison.

How did things get so bad, so quickly? Well, that’s part of why I wrote the book. The evidence that the anti-smoking movement has become dangerously illiberal has been mounting for years. For the past two decades, this has manifested primarily in alarmist claims about secondhand smoke and boundlessly expanding smoking bans. As smoking has become concentrated among the least well-off, it’s been easy for most people to ignore the stigma that now attaches to the habit and the ways that we increasingly infringe on smokers’ liberties. But as governments react to the moral panic over vaping by banning lower-risk alternatives to the cigarette and threatening to imprison sellers of nicotine products, it has become imperative to question the dominant, dogmatic approach of professional tobacco control.

After years of ignoring smoking and smokers, vaping has suddenly brought nicotine back to the public’s attention. Unfortunately, the contemporary debate often lacks the historical context needed to make sense of the conflict. Hence, The Rediscovery of Tobacco takes a longer and wider view, tracing tobacco back to its origin in the Americas and the diverse ways it was put to use around the world. It turns next to how a single product — the manufactured cigarette — came to take over the market, with disastrously lethal consequences. From there it explores secondhand smoke, smoking bans, and the ways in which the anti-smoking movement began replacing rigorous science with ideological fervor. It then moves on to the changing landscape of tobacco regulation, detailing how the biggest tobacco companies shape seemingly public-spirited laws to work to their advantage. This leads into the heated question of tobacco harm reduction and why many leaders in public health are so hostile to products that massively reduce users’ exposure to toxic tobacco smoke. Finally, the book concludes with a case for a more liberal, tolerant, and open approach to nicotine and tobacco use, in opposition to the increasingly authoritarian and technocratic demands of tobacco control.

This is not a book about vaping per se, although it does devote a lengthy chapter to that topic. Reading it may, however, challenge the way you think about the current debate. Its arguments are contrarian, and I don’t expect them to be convincing to everyone. But they are made in good faith, and if you approach them in the same spirit, I’m optimistic that you’ll find them worth engaging.

As I write in the book:

More than 34 million Americans over the age of 18 currently smoke. Around 10 million use e-cigarettes. To avoid the mistakes of previous prohibitions and drug wars, it’s necessary to recognize these people not as pathological addicts but as equal citizens.

The Rediscovery of Tobacco is my attempt at elucidating what that entails and the various ways we often fall short of that ideal. The book is available for order right now in hardcover, paperback, and digital. More purchasing options will be coming soon, and I’ll update this post as they go live.