In a previous blog, I described a particularly absurd situation regarding tobacco control paranoia about the industry. An anti-smoking NGO operating in Southeast Asia announced an anti-smoking poster competition for young people. Buried in the terms and conditions of entry was the stipulation that entrants could not have any connection with the industry to the ‘fourth level of consanguinity’. In other words, teenagers were barred if their great-great grandfathers had any industry connections.
What were the organisers thinking – that somehow a teenager would sneak a poster lauding the benefits of cigarettes past the judges?? A couple of days ago, it struck me that the basis of this rule was more sinister, while also confirming what I (and many others) have always thought about the basis of anti-tobacco harm reduction propaganda.
I was listening to BBC Radio’s daily five-minute slot devoted to moral or religious issues called ‘Thought for the Day’. Talking about the future of the planet, the speaker referred to a quote in Exodus from the Old Testament warning that God was going to punish down the generations, “the iniquity of the fathers on the children and the children's children, to the third and the fourth generation.” So there it was – the Bible was being hijacked in the service of censorship against the descendants of those with some remote links to industry.
The incontrovertible scientific and clinical evidence against the harms of smoking runs deep and wide, going back decades. Public health has played its part in getting those evidence-based messages across to the public. Religious or moral arguments have played no part in this process. The advent of safer nicotine products has thrown traditional anti-smoking strategies into disarray. Each attempt to vilify these products has been countered by independent evidence. Vaping leads young people to smoke. No, it doesn’t. Vaping damages the lungs and kills people (The EVALI outbreak). No, it doesn’t. There is a vaping epidemic among American youth. No, there isn’t. Lots of experimentation but little evidence of regular use, and even experimentation is stalling or falling. Vaping causes heart damage. No evidence. In fact, studies claiming this have been withdrawn. Nicotine damages the adolescent brain. So how come there is no evidence from decades of tobacco research? Nicotine is addictive. Yes, it is. Its effect on the brain promotes repeat use. But the propaganda use of the word ‘addiction’ deliberately conjures up, in both the public and professional mind, the worst outcomes of alcohol or other drug use. And this is where the public health argument begins to shade into the realm of morality and religion.
To my way of thinking, addiction is habit plus harm. Unless a person has serious heart problems (in which case they should cut out the caffeine), there is no obvious clinical harm from regular consumption of nicotine. So it becomes a lifestyle choice, and one that elements within public health are eager to control on grounds of ideology rather than health. I have been told that the anti-smoking and anti-vaping NGO, the Framework Convention Alliance, has a strong and influential faith-based constituency.
But it gets worse. It is no coincidence that the most vociferous opponents of abortion are faith-based groups. Abhorrent as their views might be, they don’t pretend there is any medical basis for their opposition. But this is the tactic of those who have a moral objection against nicotine – they fly under a bogus flag of science and public health. It should be the Jolly Roger pirate flag. Skulls and bones are the likely outcome for millions of smokers prevented from switching away from smoking.
What we are witnessing is the latest manifestation of the age-old battle between science and religion. And scientists have often fared badly in this fight.
Muhammad ibn Zakariyā al-Rāzī was a medical pioneer from Baghdad who lived between 865 and 925 AD. He was responsible for introducing western teachings, rational thought and the works of Hippocrates and Galen to the Arabic world. One of his books, Continens Liber, was a compendium of everything known about medicine. The book made him famous, but one version of the story is that the book offended a Muslim priest who ordered the doctor to be beaten over the head with his own manuscript, which caused him to go blind, preventing him from future practice.
Michael Servetus was a Spanish physician credited with discovering pulmonary circulation. He wrote a book which outlined his discovery, along with his ideas about reforming Christianity - this was deemed to be heretical. He escaped from Spain and the Catholic Inquisition but came up against the Protestant Inquisition in Switzerland, who held him in equal disregard. Under orders from John Calvin, Servetus was arrested, tortured and burned at the stake on the shores of Lake Geneva - copies of his book accompanied him for good measure.
The Italian astronomer and physicist Galileo Galilei was trialled and convicted in 1633 for publishing his evidence that supported the Copernican theory that the Earth revolves around the Sun. His research was instantly criticized by the Catholic Church for going against the established scripture that places Earth, and not the Sun, at the centre of the universe. Galileo was found "vehemently suspect of heresy" for his heliocentric views and was required to "abjure, curse and detest" his opinions. He was sentenced to house arrest, where he remained for the rest of his life, and his offending texts were banned.
Scientists publishing evidence in support of safer nicotine products have yet to be burned at the stake, although there have been threats that careers and funding could go up in flames if individuals have any dealings with industry personnel, speak at or even attend certain events. No platforming and cancel culture is rife. Papers are rejected by peer-review journals.
The modern representative of the Inquisition (“are you now or have you ever been associated with the tobacco industry?”) is the theocracy at the heart of international tobacco control. The secrecy and paranoia attending every Conference of the Parties to the Framework Convention on Tobacco Control is testament to an organisation operating like a religious cult and is an affront to the democratic process of multi-national action against a global problem.
The founders of the modern public health movement envisaged a world where everybody would be included and empowered to take control of their own public health. Not so in the world of tobacco control. Bereft of any evidence-based rebuttals to the public health benefits of safer nicotine products within the context of tobacco harm reduction, the WHO, its murky NGO allies, and its funders, resort to medieval tactics to push their own quasi-religious ideology.