If a doctor’s obese patient starts exercising a little and eating less, and losing some weight, that doctor will be pleased. And if they have a smoker who has cut their smoking in half, they will praise that patient. And if on a national scale obesity levels dropped by half, it would be cause for drinks all round. But though smoking has dropped as much the news and public health authorities have portrayed this positive turn of events as some sort of failure.
There could be good tobacco related news every day but all the good news is given a negative spin and any bad news is exaggerated. And this is why this column ends up being so argumentative all the time; those of us active in tobacco harm reduction are faced with this unending grimness, this little pocket of health where the traditional approaches and philosophies are all discarded in favor of prohibitionism.
Just once, I would love to see a headline like the one above followed by an article highlighting quotes from some of the big names in public health saying something like:
You know I’ve always hated tobacco and I always will but the fact is that whenever smokers switch to snus or e-cigarettes they are cutting their disease risk dramatically. We are happy when people take in a little less sugar, when they exercise more, and we should be happy about this We should get behind this and encourage it because damn it, it means people will be living longer and better.
If we can get everyone behind these products it could be the greatest advance in public health since the discovery of insulin. If most smokers switched to snus or electronic cigarettes, we could end up recategorizing tobacco associated illness as almost negligible and use those billions of dollars we have been using to war against these panaceas for other more worthwhile causes.
But you know they could have had those same kind of headlines about the drop in smoking rates but somehow that did not qualify as momentous. For a more recent example when Katherine Heigl appeared on Letterman and showed how she had finally quit smoking, most of the news after was not to congratulate her, or to praise the now higher profile of this safer alternative but to question her method and her motives. It seems that political correctness matters even when you are trying to quit smoking.
Well, it is unlikely that there will be any sea changes in the near future when the dark forces have managed to convince most everyone that their death maintaining policies are in the public interest, that safer products are actually more dangerous than the harmful one and that smoking is the prime threat to everyone’s well being.
It does not bode well when you have Sweden, a country with the lowest tobacco related disease rates in the developed world, not coincidentally since their dominant form of tobacco use among men is snus, and even there, anti-tobacco sentiment runs high within the public health authorities. In 2008, Gunilla Bolinder was recognized by WHO for her efforts to restrict domestic and international availability of snus -rather bizarre when you know that she comes from a country that has strong population level evidence that snus substitution for smoking has resulted in many saved and healthier lives.
-Paul L. Bergen