Pro-THR consumer groups and other bodies are often accused of being front organisations for the tobacco industry. Historically, the industry did establish at least one front organisation, the Tobacco Advisory Council, which did its best to undermine the true science about combustible tobacco. But to smear and vilify consumer groups looking simply to promote evidence-based public health is both cheap and contemptible. Of course, especially for anti-tobacco campaigning groups in the USA (ground zero for these tactics), their reason for existence is going up in smoke as smoking rates among adults and young people continue to fall. But instead of looking to support new ways to help smokers switch away from cigarettes, they have instead found new ways to spend huge amounts of somebody else’s money (clue: a very rich businessman) while acting against all the principles of public health.

No doubt, the advent of HIV and the subsequent safer sex campaigns increased profits for Durex. But I really don’t recall those in the gay community looking to promote safe sexual practices and save lives being accused of being part of ‘front organisations’ for Big Condoms. Nor were those among the drug using community looking to promote safer injecting practices and opioid substitute therapy accused of being fronts for syringe manufacturers, or the pharmaceutical companies supplying methadone.

Like the origins of both drug and HIV harm reduction activism, it was the community of smokers, knowing full well the dangers of smoking, who were looking for the way out, while at the same time continuing to enjoy nicotine as much as they enjoyed the morning coffee brew. Consumer groups continue to proliferate around the world as the number of safer nicotine product users reached 100m in 2020, far in excess of the most optimistic market forecasts.

To call these groups ‘front organisations’ – and so, by implication (unlike anti-THR agencies), well-funded – is utterly ridiculous. Most consumer activism around the world is undertaken by tiny organisations and many individuals working from home in their own time for no money. They are fronts for nobody apart for the millions of smokers denied access to potentially life-saving products.

In the fight against sex and drug-related HIV, there was a healthy relationship between public health and commercial interests. Nobody was a ‘front’ for anybody else, but instead there was a perfectly transparent interaction whereby companies sponsored conferences and publications, in order to help spread the message about harm reduction. Of course, there was mutual self-interest, but for most of these companies, the products beneficial to drug and HIV harm reduction efforts were a fraction of their overall business.

The same applies to tobacco harm reduction. Despite the rantings of THR-denyers, all the independent science supports THR in all its manifestations. There are mutual interests between consumers and industry, but once again the relevant THR products are simply a niche within a broader and far more lucrative product portfolio which, in this case, the world could well do without.

There is a stereotype portraying those engaged in online trolling as overweight young men, sitting in their underpants eating pizza in front of a screen located in the basement of their parents’ house. Anti-THR activists should stop looking for conspiracies and front organisations and re-engage with what they are supposed to be doing – tackling the smoking epidemic while dialling down on the pizza. But egregiously, it goes something like this: