Globally most smokers know or at least have a strong inkling their habit is bad idea. They may have lost family and friends to cancer or some form of lung disease. They themselves may now be easily out of breath where once they were active sportspeople. They tell researchers they want to quit. But millions don’t. Why?
Traditionally, tobacco regulation has majored on controlling access to cigarettes through taxation, advertising bans and packet warnings, bans on public smoking and youth access and all the panoply of regulation to reduce the death and disease toll from the most dangerous way of consuming nicotine.
We are now used to hearing experts of all disciplines, from virologists to behavioural psychologists, interviewed in the media about COVID-19. There is general agreement on personal safety measures like social distancing and hand-washing. But even at this basic level, questions arise. As it becomes clear that the virus can be carried in airborne droplets, should the recommended distance in the UK remain at 2 metres rather than I metre plus or even 3 metres?
This blog is inspired listening to Mark Carney, former Director of the Bank of England give the BBC 2020 Reith Lecture named after John Reith, the first Director-General of the BBC.
Carney’s theme was how moral values have morphed into market values, a way of economic and financial thinking which ultimately led to the financial crash of 2008. Years of uninterrupted economic growth led bankers to believe they were masters of the universe, that markets were always right. Unlike say teachers and farmers who can directly see the impact of their work through the development of children and the growth of crops respectively, those in the financial world became entirely disconnected from the communities, small businesses, and families they ultimately served. They became fixated on the numbers appearing on their screens, it was all about ‘we win, you lose’ in the financial game. Such tunnel vision corroded any notion of trading ethics.
COVID has accelerated the speed of fake news around the world much to the delight of the dangerous and delusional. In such times, the lay person could be forgiven for thinking that when the media cite ‘peer-reviewed’ papers, the publishing journals in which they appear would be an oasis of unbiased evidence and probity. The expectation is that the editors would have sufficient gravitas to weed out those papers which should never see the light of day. If only.
Richard Smith is the former editor of the British Medical Journal. On leaving his post, he wrote a refreshingly honest book entitled, The trouble with medical journals. Commenting on the quality of much research that manages to get into print, often after multiple rejections. he quoted Drummond Rennie, deputy editor of the Journal of the American Medical Association who observed,
As we have seen with the Trump playbook, seeding the media with conspiracy theories is the last gasp of the desperate and deluded. This is a favoured tactic of all anti-tobacco harm reduction organisations: anybody supporting THR must, by definition, be in the pocket of Big Tobacco and/or be a part of a ‘front organisation’.
A front organisation is a body set up by and controlled by another organisation. Front organisations can act for the parent group without the actions being attributed to the parent group, thereby allowing them to hide from public view. The intelligence services and groups like Scientology have a long track record of setting up front organisations – these organisations appear to be independent and make no mention of the parent body, yet they are entirely controlled by the parent, often with members or former members of the funding/parent body on the board. By implication, front organisations are dark and sinister bodies, whose activities can sometimes sail close to the borders of legality.
Fans of the rock band Queen will instantly recognise this blog title as the title of their 1974 album. Fear not though; what follows is not an attempt to link rock ‘n’ roll with the development of tobacco harm reduction. Instead it is a rather neat (or clumsy, depending on your view) way of exposing yet another increasingly tiresome example of how international scientific and medical organisations put the lives of millions of smokers at risk, by continuing to peddle fabrications about the ‘dangers’ of safer nicotine products.
The term was coined by an economist to explain why those with seemingly opposing interests can sometimes find themselves in accord with one another. His example was how those campaigning for Prohibition found unwitting common cause with bootleggers whose fortunes were made with the passing of the Volstead Act. Regarding the battle over vaping, it’s more to do with the Baptists aiding the bootleggers to preserve their existing mega bucks.
The narrative constructed by those who oppose tobacco harm reduction (THR) through the use of safer nicotine products (SNP) is that the whole business is a Big Tobacco ploy to hook kids on nicotine through the promotion of cool products in order to compensate for falling cigarette sales. Campaigners, the medical establishment and politicians have convinced themselves that prohibition of SNP will be a notable victory against Big Tobacco machinations.
Imagine the shock waves reverberating around the world if the WHO announced that every man, woman and child in Brazil, Bangladesh, Nigeria, the Philippines and Indonesia has been wiped out by COVID-19. That’s around a billion people – the same number the WHO continue to estimate will die from a smoking-related disease by the end of the century. The lack of immediacy and topicality of smoking death stats make them less politically explosive, but no less shocking. The big difference is that, at least currently, we can’t stop the spread of coronavirus, but we can do much to lessen the predicted death toll from smoking.
1. Keep faith in a strategy that is failing millions
The primary concern of tobacco control should be to tackle the extent of the current adult smoking epidemic. This means tackling the projected toll from death and disease which will worsen as populations grow in those lower and middle income countries (LMIC) which already have the highest numbers of smokers.
But by the WHO’s own admission, overall, the impact of its MPOWER tobacco control strategy in actually getting smoking under control has been limited. Simply having laws in place is not enough.
There exists a bunch of pirates, ostensibly independent NGOs and medical and public health organisations who, flying under a flag of convenience called ‘tobacco control’ are sinking the evidence base for tobacco harm reduction (THR), in the process denying potentially life-saving products for millions of current smokers who can’t or do not want to give up nicotine while knowing full well the damage caused by cigarettes.