Mr Podsnap is a minor character in Charles Dickens’ novel Our Mutual Friend. Mr Podsnap was “well to do, and stood very high in Mr. Podsnap's opinion”. He was noted for his ignorant and wanton dismissal of anything he disagreed with – “I don’t want to know about it; I don’t choose to discuss it; I don’t admit it … I have also said that if [such things] do occur (not that I admit it), the fault lies with the sufferers themselves”.
I came across this reference reading the letters of the famed neurologist Oliver Sacks. His work on encephalitis lethargica or ‘sleeping sickness’ was immortalised in the movie Awakenings starring Robin Williams and Robert de Niro. But Sacks was no hero to many in the medical establishment. He was the butt of much criticism for his published research on migraine, Parkinson’s disease and for the use of the Parkinsonian drug L-DOPA to bring his sleeping patients back to awakening.
In an unsent letter to the editor of the Journal of the American Medical Association in 1971 he accused the peer reviewers of not taking his work on L-DOPA seriously. His point was that because they could not offer any substantive criticism of the work, these reviewers descended into “petty jibing, pomposity, vapid rhetoric – in a word Podsnappery”. The word appears in the Oxford Reference book defined as “insular complacency and blinkered self-satisfaction”.
The response of much of the global medical and public health establishment to tobacco harm reduction using safer nicotine products smacks of Podsnappery. Witness the refusal to acknowledge the glaringly obvious public health benefit of millions of smokers who can’t or don’t want to quit using nicotine, switching to safer non-combustible products. The Podsnaps of medicine and public health either ignore the evidence and refuse to engage and/or write it off as big tobacco proxy research. Meanwhile having done their best to sabotage the publication of research which undermines their group think, their own anti-THR research, as forensically exposed by Clive Bates, has Swiss cheese-size holes in it – a suitable analogy given the home base of the WHO. Attached to flawed research come completely unconnected exaggerated claims about teen vaping or a clamour to hitch a lame horse and cart to the environmental caravan.
The disruption of THR to the tobacco industry and to the foundations of international tobacco control has been well documented, not least by the publications of KAC. What is less acknowledged I think is the disruption to the tradition of clinical research into the dire effects of smoking going back to the early 1950s. Since then, generations of doctors and academics have built careers, reputations and sizeable incomes (both in salaries and funding) by focussing on the malign narrative of smoking. The game changing revolution of THR, the ability to consume nicotine absent of all the most dangerous aspects of smoking, has driven many professionals to build the barricades of denial and self-preservation. This is staggering malfeasance given the scale of death and disease from smoking which shows no sign of abating.
Even where there is grudging acceptance that the new nicotine products might be to some degree safer than smoking, there remains another ace up the sleeve - repugnance at the idea of somebody being ‘addicted’ to nicotine even if that ‘addiction’ is no more harmful than caffeine. But maybe in the dead of night they (along with well-funded anti-THR NGOs) might quietly acknowledge that the primary danger of vaping is not to health but to wealth.