Much like the phrase “mind control” tobacco control connotes persuasion, domination and unwilling conversion to an alien agenda. The recent issue of Tobacco Control returns to the idea of the endgame, the insistence that if there is the will, tobacco and nicotine use can be eliminated entirely.
What is notable in these opinion pieces is that the focus remains on reducing nicotine use rather than reducing the health costs associated with nicotine use. They just don’t seem to get the distinction.
When they do mention harms they make the strange suggestion that if an outside agency were given power over the tobacco industry that they could make it conform to the goal of reducing the harms of using nicotine (see Cynthia Callard).
Guess what Cynthia, there are controlling outside agencies such as the FDA and the FCTC and they have spent a lot of time and effort, much like yourself and almost every one of your colleagues, making it nigh impossible to bring lower harm nicotine delivery systems to market.
And when these contributors accept the concept of lower harm (they will never accept the idea of safe enough) nicotine use as part of the extinction plan (see Ron Borland).
They spend a lot of time claiming responsibility for their punitive policies resulting in lower smoking rates (see the always entertaining Matthew Myers) with the conclusion that we need more of the same. But as I already pointed out the aim of these policies is to reduce nicotine use independently of disease associations.
However when it comes to smokers quitting, it must be particularly galling to tobacco control cadres that their sticks are poor matches for the carrots of smokeless tobacco and e-cigarettes. How can the pure cost of quitting nicotine (an absence, a void, an annoyance, and a loss of comfort not to mention the cognitive impairment) compare with smokeless nicotine (retaining the benefits but without the health worries).
The major decline in smoking and thus smoking related disease will come as a result of the desire for nicotine rather than the desire to quit.
The fiction has been that every smoker wants to quit. The meme has been strong enough that just about every smoker confesses to being a sinner but in their heart of hearts just wants a better way to consume nicotine. And once smokers try these other forms, superior in so many ways (better flavor, easier on the throat and lungs, no smell on the clothing, fewer restricted areas of use), why would they ever go back?
They will stay off cigarettes precisely because they are getting nicotine and in a more pleasurable manner rather than relapsing or failing because they cannot quite get the pleasure of going without.