How wrong do you need to be before people ask questions?

No one is perfect. We all make mistakes in our professional life. But when do simple errors become evidence that you’ve bitten off more than you can chew and that you might not have the marbles for your role?

I was thinking of all of this as I read an article about Canada’s Windsor-Essex County Health Unit (WECHU) taking a stand against nicotine pouches that heavily quoted the region’s Medical Officer of Health, Dr Mehdi Aloosh.

He’s youthful, new to the job (2022), and he seems like a nice enough guy. But his take on nicotine pouches was so bad that it calls his overall competence into question.

Let’s dive in.

The good doctor

First of all, I’d like to say that I have a lot of respect for doctors. The dedication, sacrifice, hard work, and aptitude required to qualify are all admirable. Yes, we’ve all known a few who carried themselves with the swagger of peak Mick Jagger, but overall, it’s a tough gig, and they more than earn that salary.

People like me, who have no medical training, must put our trust in doctors. Not because we think they’re infallible but because there is only so much time in the day.

We do this all the time with fields like physics and history. Someone says something, and even if it doesn’t make sense to me, I can’t fire up machines in a lab or go on some archaeological dig to verify their statement. At best, I can see what other experts have said on the same matter and aggregate the information. But it still requires a leap of faith.

But that system — or at least an individual’s doctor’s role within it — totally breaks down when they dirty their bid with inaccurate statements that are easily fact-checked.

At what point does everything else they say become suspect? In the case of Dr. Mehdi Aloosh, I’d say we’re getting dangerously close.

Dr Mehdi Aloosh fact-checked on nicotine pouches

Statement 1: One small pouch contains as much nicotine as two cigarettes.

We wrote recently about Canada’s approval of ZONNIC nicotine pouches. These pouches contain just 4mg of nicotine, which was necessary to have them approved under Natural Health Products Regulations. It was the first time Health Canada authorised a pouch.

In comparison, cigarettes contain around 12 to 15mg of nicotine.

While there are pouches with twice the nicotine of cigarettes, they were banned by Health Canada in 2020.

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Statement 2: “Nicotine is very addictive.”

It’s not too much to ask that a Medical Officer of Health can tell the difference between addiction and dependence.

While substance dependence is no joke, an addiction is “defined as a chronic, relapsing disorder characterised by compulsive drug seeking and use despite adverse consequences,” according to the NHID.

Nicotine, by itself, isn’t hospitalising or killing anyone. It’s relatively harmless, per the NHS. Dr Aloosh may be mixing nicotine up with combustible cigarettes.

Words matter, my friend: another swing and a miss.

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Statement 3: “This is not just about nicotine, it’s a gateway to start tobacco, smoking cigarettes.”

Ah, yes, that old canard.

Common sense: If this were true, where are the smokers who’ve passed through the gate? Nicotine via e-cigarettes is replacing smoking. It’s not an entry, it’s an exit.

Research: A comprehensive study by Queen Mary University of London refutes this fantastical narrative.

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Three strikes. You’re outta here. Or at least you should be.

Final thoughts

Dr Mehdi Aloosh says he’s concerned about nicotine pouches. However, he doesn’t seem concerned enough to do basic research on the topic. It’s not good enough, and if I were one of the good people of Windsor-Essex County, I’d feel justified in taking his subsequent statements with a grain of salt and a side order of suspicion.