21 February 2008

A new wheeze tease: tobacco ads return to Canadian magazines

I should have been better prepared to have my flabber gasted, but I don't know what confounded me the most: learning that cigarettes are once again being peddled in Canadian magazines or the jarring use of the word "anyways" in the Canadian Medical Association Journal report that brought this depressing news to my attention [1]. Of course, the smelly reality of tobacco hawking gets a higher ranking in the shocked-and-appalled section of my catalogue of outrage. Vocabulary concerns aside, I am forced to reflect on the putrid fact that, like zot skunque de terriblay odeur, tobacco ads are back. I feel like poor Penelope Pussycat, squirming madly to escape the foul embrace of a love-struck Pepé Le Pew. L'amour toujours.

Having squandered my youth on the "fuliginous moyste vapours which trouble the harte and strike up into the head" [2], I can say I was duly formed (and possibly stunted) by cigarette culture. Surrounded by the floating signifiers of its advertising — and the choking fumes of its products — I coughed my way through the cloudy expanses of Marlboro country, trying every filter, flavour and flip-top box on offer. Now in my winded late middle age I can breathe a sigh of relief that I parted ways with the sacred herb years ago, and that my loved ones and I are no longer subjected to the throaty blandishments of cigarette commercials in smoke-filled rooms. At least, that's what I thought until I received this week's My NCBI update with the latest from CMAJ.

Le mew? Le purrrrr? Non, c'est le terriblay skunque fatale!
The otherwise grammatical CMAJ article informs us that, without fanfare and with little controversy, one of the Canadian tobacco industry's "big 3," JTI-Macdonald Corp. (the other two are Imperial Tobacco Canada Ltd. and Rothmans, Benson and Hedges Inc.) recently opened a new front in the ongoing tar wars. The makers of my former favourite wheeze tease are launching new products by advertising them in entertainment magazines such as Montreal's Mirror and Vancouver's Georgia Straight, and in the less-entertaining Canuck edition of Time. Yes, Canadian mags are rolling their own again. The smell of dollar bills and tobacco leaves has always made a good blend. Roger Collier, the journalist responsible for the CMAJ article, first reported last December on this new phase of tobacco shilling in the Ottawa Citizen.

I read with a creeping sense of unease about the new Mirage brand of smokes now being offered for our delight and delectation. Armed with their Exocets of nicotine and carbon monoxide, these new-fangled cigarettes are supposedly scented with vanilla so that they emit a "less lingering tobacco smell in an enclosed area." Through one of those grotesque coinages of the advertising industry this celebrated feature is termed "unique Less Smoke Smell (LSS) Technology." The only thing I smell here is a skunk. I submit that LSS will turn out to be about as effective at dispersing stinky cigarette smoke as my past practice of spraying Lysol and furiously swiping an open palm back and forth in the boys' room. You might as well try dousing Pepé Le Pew with Chanel No. 5.

Scent-imental over you
Way back in the wild and primitive days of my shaggy-haired youth, when Keith Richards could walk — and Elton John could pass for — straight, I also made liberal use of incense in my bedroom to hide the stench of my two smoking habits, and, like Elton, fooling nobody. How I and my friends must have reeked at our happenings, sit-ins, be-ins, and in-ins, daubed with patchouli oil, chewing Chicklets, and flourishing our trendy Gauloises. I confess to a certain nostalgia for that time. We would-be intellectuals frequented smoky coffee shops to gesticulate with glowing ash, listen to sitar music and talk about poetry, pointillism and proletarian revolution. Nowadays, it seems young people frequent fume-free coffee shops to listen to their mobile devices and talk about — coffee.

An aside. In a recent Lancet article [3] on the social commentary implicit in Dickens' Little Dorrit, James Horton too betrays a certain nostalgia for pipe and plume:

Little Dorrit is also Dickens' striking tribute to tobacco, his great smoking novel. From the opening pages, tobacco is rolled, lit, inhaled, smoked down to the fingers, stuffed into English and Eastern pipes, presented as cigars, traded in "snug" businesses, and used as refreshment and as an idle accompaniment to long journeys. Smoking, or rather ceasing to smoke, is the one means by which [Amy Dorrit's] father signals, even celebrates, the freedom of his new life after leaving the Marshalsea [debtor's prison].
Who scent you?
But that was then, and this is now. Physicians for a Smoke-Free Canada would like to stick it to Japan Tobacco and have called upon Health Canada and Health Minister Tony Clement to end JTI's advertising campaign, claiming that it is misleading and contravenes the 1997 Tobacco Act. In this country it is against the law to promote tobacco products by means "that are likely to create an erroneous impression about the characteristics, health effects or health hazards of the tobacco product or its emissions." Erroneous doesn't even begin to describe the breathtaking mendacity of the Mirage campaign. Tobacco ads are so offensive to good taste and common sense, they should be banned for that reason alone. Kel terriblay odeur!

Past perfumance
In June of last year the Supreme Court of Canada upheld the legal restrictions on tobacco advertising, dismissing an expensive, decade-long court battle which argued that such laws violate the right to freedom of expression. However, the court did admit that there is still a window of legitimate advertising in this country, through which the tobacco companies have now nimbly climbed with their glossy adverts and website bromides, after a long silence. For a decade big Canadian tobacco refrained from huckstering in mass-market publications, arguing that the restrictions were so limiting as to constitute a ban. Until 2003 they confined their efforts to "lifestyle" marketing through sponsorship of music festivals, car races and the like, until that route was closed off when a general prohibition on such stealth advertising came into effect. The Tobacco Act actually allows cigarette promotions that are "information advertising or brand-preference advertising," directed at adults in various ways, in "a publication that has an adult readership of not less than eighty-five per cent." Now that the Supreme Court has settled matters, the tobacco companies seem to have decided to exploit whatever opportunities are left to them. Hence the magazine advertising campaign. The three mags mentioned in the CMAJ article have a relatively large circulation. I'm not sure how it is determined that a particular publication's audience consists mostly of adults; although there would probably be general agreement that Time is not exactly at the top of a teenager's list of must-reads. Regardless, there is no doubt that tobacco's new ad offensive will increase the likelihood that kids will start to smoke [4] or (eww!) chew [5]. We can expect more clever and costly promo campaigns in the future. Come viz me to ze Cats-bah!

The ultimate target. "Eet ees possible to be too attractive, no?"
In the past ten years that the Tobacco Act has been in force, smoking prevalence in Canada has dropped from about 30% to 18% for Canadians 15 years of age and older. That's far too many clean sets of adolescent lungs to be endured. Air pollution can't finish the job properly. Something has to be done. Perhaps LSS "technology" will be the prime coolness factor, the lure that brings more lips to butts. As the insidious infiltration of tobacco advertising continues (see my post of 30 Dec 2007) my six young nephews are a pretty easy target. Alert to every nano-variation of current coolness, they have been firmly indoctrinated in the principles of our feckless, thoughtless, throw-away society. Critical thinking is still a great effort, so they prefer to let media dictate their needs. Like many males their age they are stolid, taciturn, twitchy with misfiring hormones, occasionally surly, mostly funny, optimistic, absurdly affectionate, and hopelessly normal. Their heads full of turbid, TV-fed fantasies of sex, slugs and pelf, they are paradigmatically unaware of the civilizing effects of etiquette, self-discipline and soap — I love them dearly. The three oldest are smokers, the other three probably will stay tobacco-free. But their luck so far in avoiding those nicotine-fuelled Exocets will start to run out as more ads for Camel, Craven A and Mirage start popping up like love-sick skunks around them. Whether for smoking or expectorating, tobacco products are ultimately designed for and promoted to youth. That's because adult users have the unfortunate habit of dying off. Here's hoping that as a member of WHO'S Framework Convention on Tobacco Control, Canada will follow Australia's example and ban all tobacco product peddling by 2010. Otherwise we'll all be singing Louvre come back to me.

For those who follow this sort of thing, over at the Scientific Misconduct Blog there is an interesting post on another kind of questionable magazine advertising, this time in the venerable British Medical Journal. In the 16 Feb 2008 issue 88.4% of ads are by pharmaceutical companies. Kel terriblay odeur, indeed.

Now that they have begun to deploy their substantial forces, CMAJ's report concludes, keeping Canadian tobacco companies out of the ad game won't be easy. Richard Pollay, a University of British Columbia marketing professor who has followed tobacco marketing for twenty years, provides the closing remark: "The industry is endlessly creative, not only adapting to new legislation or changing public sentiment, but anticipating them. They're playing chess when everyone else is playing checkers." The next move is up to us.

Chess is as elaborate a waste of human intelligence as you can find outside an advertising agency. ~ Raymond Chandler


1. Collier R. Cigarette ads return to Canadian magazines. CMAJ. 2008 Feb 12;178(4):384-5. PMID: 18268258

2. Gratarolo G, Newton T. A direction for the health of magistrates and studentes, namely suche as bee in their consistent age, or neere thereunto: drawen as well out of sundry good and commendable authours, as also upon reason and faithfull experience otherwise certaynely grounded. London: Imprinted by William How for Abraham Veale; 1574

3. Horton R. The resistance of Little Dorrit. Lancet. 2008 Feb 9;371(9611):468-9. PMID: 18271080

4. Lovato C, Linn G, Stead LF, Best A. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003439. DOI: 10.1002/14651858.CD003439

5. Morrison MA, Krugman DM, Park P. Under the radar: smokeless tobacco advertising in magazines with substantial youth readership. Am J Public Health. 2008 Jan 30. PMID: 17600263

11 February 2008

Are shy people mentally ill?: the DSM and SAD

... because I'm good enough, smart enough, and — doggone it — people like me! ~ Stuart Smalley

I was born the year they first published the Diagnostic and Statistical Manual of Mental Disorders (DSM), now in its fourth edition as DSM-IV. I was a shy little boy. In fact, I was so shy, instead of wishing the ground would open up and swallow me, I dug my own little foxhole and crouched there for most of my childhood. Little did I know that the majestic architects of the DSM's careful categories and checklists would some day cast concerned looks at trembling little me in my hiding place and see another instance of a treatable social anxiety disorder. Nor could I have imagined how one day pharmaceutical companies would promote the idea that things like diffidence and embarrassment are ameliorable through drug therapy, that by swallowing a little green and white pill I could feel as if I had just aced the Endtime and placed my conquering toe upon the Mount of Olives.

What pill would they prescribe for the timid and empty-headed Georgiana Podsnap of Our Mutual Friend, who is so painfully shy she squeals like a panicky toddler at the prospect of being introduced to strangers?

Oh there's Ma speaking to the man at the piano! Oh there's Ma going up to somebody! Oh I know she's going to bring him to me! Oh please don't, please don't, please don't! Oh keep away, keep away, keep away!' These pious ejaculations Miss Podsnap uttered with her eyes closed, and her head leaning back against the wall. ... 'Oh there's Ma being awful with somebody with a glass in his eye! Oh I know she's going to bring him here! Oh don't bring him, don't bring him! Oh he'll be my partner with his glass in his eye! Oh what shall I do!' This time Georgiana accompanied her ejaculations with taps of her feet upon the floor, and was altogether in quite a desperate condition. (Charles Dickens, Our Mutual Friend, Chapt. 11, Podsnappery)

What about the terribly bashful Edward Ferrars in Sense and Sensibility, with his awkward silences and stiff politesse? What if he were popping Zoloft to make it through high tea with his formidable relations?

Edward Ferrars was not recommended to their good opinion by any peculiar graces of person or address. He was not handsome, and his manners required intimacy to make them pleasing. He was too diffident to do justice to himself; but when his natural shyness was overcome, his behaviour gave every indication of an open, affectionate heart. His understanding was good, and his education had given it solid improvement. But he was neither fitted by abilities nor disposition to answer the wishes of his mother and sister, who longed to see him distinguished - as - they hardly knew what. They wanted him to make a fine figure in the world in some manner or other. His mother wished to interest him in political concerns, to get him into parliament, or to see him connected with some of the great men of the day. Mrs. John Dashwood wished it likewise; but in the mean while, till one of these superior blessings could be attained, it would have quieted her ambition to see him driving a barouche. But Edward had no turn for great men or barouches. All his wishes centred in domestic comfort and the quiet of private life. Fortunately he had a younger brother who was more promising. (Jane Austen, Sense and Sensibility, Chapt. 3)

Fewer Eeyores, more Tiggers

Would we say that Georgiana and Edward, with all their social faults, were mentally ill and in need of medication? For those of us who have no turn for great men or barouches — who would rather stay home with the cat and The Cask of Amontillado than kiss cheeks at a cocktail party — our shyness may be limiting at times. It may be, as some say, merely egotism out of its depth; but it doesn't feel like a disorder. It's more like the way being myopic keeps one from taking up skeet shooting, or being dyslexic makes reading The Faerie Queene an exercise in futility. Life goes on, even if you're not a hotshot Spenser scholar.

Like many other normal human imperfections — stretch marks, baldness, flat feet — shyness is a fact of life you accept, if not embrace. Just as there are many bumptious bigwigs conquering the world on white horses and donning their crowns of laurel, there are also all the little shy people who are modestly content to pluck their bouquets of wallflowers and violets. Of course, introversion can occasionally get in the way of things; but we introverts have our various means of coping: bathroom mirror self-assertion, transcendental meditation, unlisted numbers, pimple cream, tequila.

But it appears that some DSMmers out there would claim I was mentally ill until, somewhere in the dirty bottom of the 1970s, I left my mirror, emerged into the sunshine, and realized that — doggone it — people liked me. Eeyore had turned into Tigger.

Toastmasters or Paxil?

Brian Cox holds a Canada Research Chair in mood and anxiety disorders at the University of Manitoba, so he is probably as qualified as anyone to comment on the health of the timid and insecure. In his review of Christopher Lane's new book, Shyness: how normal behavior became a sickness [1], which appeared in the January 31 issue of the NEJM [2], Cox agrees with Lane that psychiatrists should stop pathologizing and medicating shy children:

I find it interesting that the term "social phobia" has increasingly been replaced by the term "social anxiety disorder" in the official nomenclature. I don't believe that this is purely coincidental. Rather, it seems to me that if a general physician sees someone with a social phobia, the physician may recommend that the patient see a psychologist for behavior therapy, participate in Toastmasters, or use another self-help resource. However, if the same person receives a diagnosis of social anxiety disorder, a term that sounds far more serious, the physician might recommend more aggressive medical attention such as pharmacotherapy.

Shyness is not a "sickness" or a psychopathology, argues Cox, who conducted a study [3] a few years ago which found that many with extreme childhood shyness didn't meet the criteria to be diagnosed with an anxiety or mood disorder. Conversely, half the adults with severe social phobia did not view themselves as very shy when growing up. In his NEJM review, Cox states his conviction that it is important not to view shyness in young people as a form of mental disease requiring medical intervention, thereby potentially damaging their self-esteem and self-confidence. In other words, the kids are all right.

"Is she just shy? Or is it Social Anxiety Disorder?" (Advertisement for Zoloft in The American Journal of Psychiatry, August 2003)

The day I ran across Cox's book review I happened to be reading the 6 December 2007 New York Review of Books, which contains a beautifully written article, Talking back to Prozac [4], by the irreverent Frederick Crews, Professor Emeritus of English, UC Berkeley, and author of The Pooh perplex. Crews discusses three books that are critical of the mental health establishment and its relations with Big Pharma, one of them being Lane's Shyness. Also reviewed are Horwitz and Wakefield's The loss of sadness [5], and the release in paperback of David Healy's well known Let them eat Prozac [6], first published in 2004.

Crews begins with a fascinating anecdote about the 2002 appearance of star football player Ricky Williams on The Oprah Winfry Show. The brawny athlete went before the cameras to spill in a major way. He revealed that he suffered from social anxiety syndrome. Very touching. What didn't show up in the credits, however, was that Williams was a paid shill for Glaxo-SmithKline — not to do anything so flagrant as to tout its own product, Paxil, but simply to do a little "condition branding" by persuading Oprah's gullible glued eyeballs to believe that being "a shy person" could actually be a disorder requiring antidepressant medication.

Crews launches into an acerbic critique of the happy-drug industry. His verdict: "[O]ne thing is certain: the antidepressant makers have exploited our gullibility, obfuscated known risks, and treated the victims of their recklessness with contempt." As for the mental health industry, Crews wants a DSM that is "scientifically respectable; its users, instead of regarding disadvantaged classes as infested with mental illness, will gain an appreciation of socioeconomic reasons for unhappiness; and a brake will be placed on the expensive middle-class hypochondria that the drug companies have so assiduously encouraged and exploited."

These three books point us, as Crews asserts, "toward some uncomfortable insights about American psychiatry and its role within a far from rational health care system." He goes on to suggest the deeper significance of psychiatry's inability to settle on a discrete list of disorders that can remain impervious to fads and fashions. In a perfect storm of hypocrisy, for bureaucratized psychological treatment, and for the pharmaceutical industry that is now deeply enmeshed in it, confusion has its uses.

Now, I understand that there are some who suffer from debilitating fear of social situations and who may need to seek medical help, including drugs that moderate their symptoms. However, the tendency towards untrammelled use of expensive glamour drugs to medicate away what is simply an aspect of the human condition — that looks like the devil's bargain.

Long before Ricky Williams made his public confession on Oprah, an article appeared in The New York Times which made mention of Williams' "shyness syndrome," adding interesting details like the fact that he kept his helmet on during rookie-year media interviews. No indication yet of the money flowing from the stealth marketing Paxil pushers into the football player's bank account. But we are offered this shrewd comment: "[I]t is much easier to turn on the spigots of empathy and attention these days when you can cite a diagnosed imbalance in brain chemistry rather than an eccentricity, a character flaw or an economic disadvantage." Much easier as well to market your designer drug. Successfully hyped by socially anxious celebrities like Williams, Donny Osmond and David Beckham, social anxiety disorder has become a widely recognized "condition." Those who have the money can now buy happiness. Shyness is for losers.

The company accountant is shy and retiring. He's shy a quarter of a million dollars. That's why he's retiring. ~ Milton Berle


1. Lane C. Shyness: how normal behavior became a sickness. New Haven: Yale University Press; 2007.

2. Cox BJ. Shyness: how normal behavior became a sickness [book review]. N Engl J Med. 2008 Jan 31;358(5):539-540.

3. Cox BJ, MacPherson PS, Enns MW. Psychiatric correlates of childhood shyness in a nationally representative sample. Behav Res Ther. 2005 Aug;43(8):1019-27. PMID: 15967173

4. Crews F. Talking back to Prozac. The New York Review of Books. 2008 Dec 6;54(19):10-14.

5. Horwitz AV, Wakefield JC. The loss of sadness: how psychiatry transformed normal sorrow into depressive disorder. Oxford: Oxford University Press; 2007.

6. Healy D. Let them eat Prozac: the unhealthy relationship between the pharmaceutical industry and depression. New York: New York University Press; 2004.

05 February 2008

Revised research on Iraq casualty statistics

ORB (Opinion Research Business), the independent UK-based polling agency, has produced more research on deaths in Iraq:

Following responses to ORB’s earlier work, which was based on survey work undertaken in primarily urban locations, we have conducted almost 600 additional interviews in rural communities. By and large the results are in line with the 'urban results' and we now estimate that the death toll between March 2003 and August 2007 is likely to have been of the order of 1,033,000. If one takes into account the margin of error associated with survey data of this nature then the estimated range is between 946,000 and 1,120,000.
The ORB survey makes no claim to be as rigorous as the two Johns Hopkins studies, Lancet 1 (2004) and Lancet 2 (2006) [1,2]. In contrast to the recent absurdly low mortality figures compiled by the Iraqi Ministry of Health and published in the NEJM [3], which I discussed in a recent post, the ORB statistics look like the best available until another thorough Lancet-style epidemiological survey is carried out.

The press release [DOC] of 28 January 2008 gives a more intimate perspective on these ghastly numbers:
Among the over 2,160 respondents who answered the question 20% said that there had been at least one death in their household as a result of the conflict which started in 2003. Within these households the average number of deaths was 1.26 people.
The data tables found in the New Casualty Tabs [PDF] break down the sources of death in a fashion approximately similar to Lancet 2 [PDF]. The responses to Question 2 ("How were they [members of the household] killed?") are interesting. They are divided into nine categories:

Car bomb
Other blast/ordnance
Aerial bombardment
Sectarian violence
Kidnapping and killing
Don't know/refused

Note the separate category for sectarian violence to which 4% of violent deaths are attributed. It is difficult to see why this was included. One is led to question the method by which the figures were derived. How is a "sectarian" death by gunshot separable from an "ordinary" death by gunshot? It is necessary to distinguish between the means of killing and the mode of killing. Otherwise there should be categories for "Killed by coalition forces," "Killed by mercenaries," "Killed by police," etc. The presence of sectarian violence as a category on this list is confusing and invites criticism.

After gunfire (40%), the largest number of deaths is attributed to car bombings (21%). That amounts to roughly 200,000 deaths resulting from this grisly tactic. The use of what the Pentagon refers to as "Vehicle Borne Improvised Explosive Devices" draws more attention than other forms of death. In Iraq we see it applied in the deadliest, most spectacular way. As Mike Davis tells us in his recent book Buda's Wagon: A Brief History of the Car Bomb [3], it is a technology that has proliferated incredibly since its first deployment in 1920 when a horse-drawn wagon was exploded by the anarchist Mario Buda near New York's Wall Street. No continent, save Antarctica, has been spared the car bomb's devastation. Davis describes it as a weapon whose use is "guaranteed to leave its perpetrators awash in the blood of innocents," a "categorical censure" that applies "even more forcefully to the mass terror against civilian populations routinely inflicted by the air forces and armies of so-called 'democracies'."

ORB, a non-government-funded group founded in 1994, conducts research for the private, public and volunteer sectors. According to a 30 Jan 2008 Reuters report, the director of the group, Allan Hyde, said it had no objective other than to record as accurately as possible the number of deaths among the Iraqi population as a result of the invasion and ensuing conflict. And the numbers are staggering. So far, most of the mainstream media continue to ignore this objective attempt at a just accounting of mass death in Iraq.


1. Roberts L, Lafta R, Garfield R, Khudhairi J, Burnham G. Mortality before and after the 2003 invasion of Iraq: cluster sample survey. Lancet. 2004 Nov 20-26;364(9448):1857-64.

2. Burnham G, Lafta R, Doocy S, Roberts L. Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet. 2006 Oct 21;368(9545):1421-8.

3. Davis, Mike. Buda's wagon : a brief history of the car bomb. London : Verso; 2007

03 February 2008

"Like snapping at flies": the rubber librarian hears from the condom makers

Once again Winnipeg is experiencing that most rigorous of winter's many onslaughts, a cold snap. It's so cold there's an air of conspiracy about it, because it doesn't seem real. On the other side of my frosted-up window it's as cold as a campground privy on the dark side of Pluto. Lip-crinkling, flesh-withering, molecule-slowing winds that seem to have blown across the vacuum of space before reaching us, testing the lower depths of the Kelvin scale. With weather like this it is perhaps appropriate to return to the troubling question that has concerned the public health authorities here. What effect does Winnipeg's cold weather have on latex condoms?

I have an update to my two previous posts about this issue. In my last post I reported on the initial response from the condom manufacturer to the question whether condoms can be stored safely in the cold.

Here is that first reply that came to public health officials:

Latex condoms are made of natural polyisoprene, 99+%, with trace amounts of residual vulcanization chemicals. This is a stable organic polymer and contains no water. As well, there are no mixtures or emulsions. As such, there is nothing in a latex condom to be affected by cold temperatures. Indeed, a sealed, opaque packaged condom place [sic] in a cold environment may well be preserved.

Problems may occur in the thawing process if extra heat is added. Should condoms freeze, they must be left to thaw gradually at room temperature.
A follow-up email was sent to the company asking why, if this is the case, cartons of condoms purchased in bulk bear printed instructions not to store their contents in extreme heat or cold. The carton warning reads: "Store at room temperature. Protect latex condoms against prolonged periods of exposure to: extreme low or high temperatures, moisture, direct sunlight, fluorescent light."

There certainly is sufficient research to support all the other warnings. But the fruitless search I did for the Healthy Sexuality and Harm Reduction department of the Winnipeg Regional Health Authority showed that the risk of extreme cold to the physical integrity of the condoms is still unknown. Yet we have a printed warning about exposure to extreme cold printed on every box of condoms manufactured in a southern American state where cold normally means how you like your tea. The cryogenic frigidity of a Prairie winter is not even conceivable where these condoms are made. One begins to juggle with the questions that pop up. What, then, would warrant the printed warning on the condom packages? What exactly is the nature of the risk so obliquely referred to. Is it a risk to the plastic wrap or the condom lubricant? What rationale, we must ask the manufacturers, is there for this warning?

Perhaps this left them with too many balls in the air, for it was only after a considerable delay that a reply was finally received from a spokesperson:
Please forgive the delay in responding to your inquiry but I took the time to review it with the regulatory officials in case anything had changed since my last investigation into this matter.

The warning against prolonged cold is just a precaution. There is nothing about cold that will harm the latex as long as the condoms are thawed before use. Extreme cold can make latex hard and brittle, just as it does many items. We have no literature references immediately at hand for you on this subject, but we have tested frozen condoms in the past and we have laboratory data to sustain this claim [data not supplied].

The warning against prolonged heat and light exposure is NOT just a precaution. Both will shorten the life of condoms and ultimately destroy them. Heat is used in accelerated aging protocols. A [sic] opened condom exposed to light will be compromised in a [sic] little as a week. As you mentioned, there is literature available to sustain this claim.

The moisture warning is for the boxes and film only as moisture has no impact on the condom itself. The box, however must remain intact to help protect against light and temperature fluctuation.

Plastic wrap for condoms is fine for the shelf life of condoms, as long as the seals are intact. There is absolutely no cause for concern regarding the plastic film.

Films and especially seems [sic] can suffer water damage. Condoms that have been flooded could be compromised if the seems [sic] of the films or foils are not intact or have been damaged and water may have infiltrated. Again, we have no literature references immediately at hand for you on this subject but such incidences have occurred.

I regret that I am unable to provide the literature you were hoping to receive. Until Health Canada mandates manufacturers to test for these specific issues, I doubt that any such literature will be made available.
Speaking out of both sides of their mouth and saving both their faces, the condom manufacturers claim to have "tested frozen condoms in the past." But at present they "have no literature references immediately at hand" on this subject. At the same time, they do have "laboratory data to sustain this claim." However, they are unable "to provide the literature you were hoping to receive." The warning against prolonged cold is "just a precaution" they tell us. (Against what?) And they will take no steps to release existing data, conduct any further research, or answer any more questions about this matter unless forced to by government regulators.

As a society we place a great deal of trust in manufacturers of products designed to keep us and our children safe. One would think that a respected condom manufacturer would have resorted to keeping fewer balls in the air and taken slightly more time and effort to respond to an honest question from a public health official. Why not condescend to show some interest in what is after all an interesting and challenging query? To start with, why not share the so-called laboratory data? Who are the "regulatory officials" who were consulted? Why no promise of cooperation in referring the question to Health Canada? Trying to get a decent answer from Condoms & Co. is like snapping at flies. The answer we finally get leaves such a bad taste, it's like we actually swallowed one.

Note: The opinions stated in this post are entirely my own and do not necessarily represent those of the Winnipeg Regional Health Authority.