Is tobacco control the new Big Tobacco?

In their frantic opposition to safer forms of nicotine use, the tactics of tobacco control activists seem eerily familiar.

Yes, you are…

How should we understand the widespread hostility to tobacco harm reduction in the mainstream tobacco control community and much of the public health community?

I don’t think we can ignore it any more… the symmetries and parallels with the worst excesses of “Big Tobacco” of the 1970s can no longer be ignored. The methods, ethics and consequences are all too similar, and becoming increasingly common.

Let us consider ten examples of parallels and symmetries:

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South Africa’s self-harming anti-vaping legislation

South Africa’s parliament is consulting on anti-vaping legislation that is so extreme and ill-designed that it would, if enacted, cause more harm than good. What’s wrong with it, and who is influencing it?

Flag of Aouth Africa

South Africa’s parliament is scrutinising new tobacco and nicotine legislation that would throttle harm reduction approaches for its citizens. South Africa has a high prevalence of smoking (25.8% – see chart), especially among men, and low rates of vape use (2.2%). Yet the legislation is designed to obstruct South African citizens from switching from high-risk cigarettes to low-risk vape products.

Chart of smoking prevalence by age and sex showing overall smoking prevalence of 25.%, male smoking prevalence of 41.2% and female 11.5%.
South Africa has very high smoking rates ay all ages, especially among men.
Source: GATS factsheet, 2022

Why is there such hostility to a strategy that could work especially well in South Africa? Harm reduction relies on consumers and producers acting in their own interests and at their own expense to radically reduce disease risks and improve their welfare and wellbeing. It does not require significant public expenditure or public sector capabilities. The post below, (1) includes links to our analysis of the Bill, (2) raises concerns about the role of foreign influencing operations, and (3) ends with a call for greater transparency.

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World Health Organisation exploits tobacco farmers, the hungry, sick and poor in its crude activism

On World No Tobacco Day, the WHO launches a campaign to “grow food, not tobacco” supposedly to address hunger and tackle tuberculosis (TB). None of it makes any sense.

WHO continues its mission to become the most foolish and inept international organisation to bestride the globe. This time with an absurd ill-judged campaign about tobacco farming.

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One of the worst ever tobacco control papers is ‘corrected’

Researchers were told their allegations were false, but they still went ahead and attacked a leading vaping company with baseless claims

Papers by tobacco control academics are often truly awful – thinly disguised self-serving polemics masquerading as objective inquiry. But sometimes, the scientific paper and research conduct are so terrible that they become usefully revealing. This blog looks at a case in point.

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My application for Editor-in-Chief of Tobacco Control

A vision for a journal covering all aspects of nicotine in society based on open science, curiosity and organised scepticism

I saw the advert for the Editor-in-Chief of the journal Tobacco Control.

I must apply!

What follows is my application for the position in pre-print form. Following helpful comments and critical reviews, I will finalise and submit by the deadline of 31 January 2023.

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Using models disconnected from reality to justify huge ‘endgame’ interventions

New Zealand is planning to introduce so-called ‘endgame’ measures, including the removal of nicotine from legally available tobacco. We examine and review the modelling used to justify the measure and find multiple fatal flaws.

With thanks to Dilbert @SottAdamsSays

In this blog, we take a look at modelling used to justify ‘endgame’ legislation under discussion in New Zealand. Among other things, this would reduce nicotine in cigarettes and other tobacco available through legal channels to minimal levels. We find the modelling and data assumptions bear no relation whatsoever to the underlying processes and the effects that such legislation would trigger. Deep cuts in smoking are assumed as inputs to the model. Unsurprisingly, therefore, the model results show deep cuts in smoking, and this determines the resulting health benefits. But the assumptions have no grounding in reality and misinterpret and misuse trial findings.

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Chaos, waste and failure: what is wrong with FDA tobacco regulation, and how could it improve?

This is my response to the operational review of the performance of the FDA’s Center for Tobacco Products by the Reagan-Udall foundation. The heart of the problem is the lack of a coherent regulatory strategy, grounded in real-world understanding

…and now we go live to Silver Spring, Maryland

The Reagan-Udall foundation is conducting an “operational review” of the FDA’s handling of its tobacco and nicotine brief. The review was commissioned by Robert Califf, the FDA’s Commissioner. I have submitted comments through the stakeholder portal. Please consider making your own submission – it’s easy.

My contribution is available below, in a formatted PDF version and via the stakeholder portal.

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A powerful declaration makes a compelling case for tobacco harm reduction

Spain has a vocal and well-funded tobacco control establishment. But the data suggest its traditional approach is failing. 170 national and international experts call for a rethink and make the case that Spain embraces tobacco harm reduction as a real-world public health strategy.

Prevalence of daily tobacco use in the last 30 days in the population aged 15-64, by sex
and age (%). Spain, 2019/2020 EDADES, 2021 figure 1.1.13 (Full report PDF)

The post provides the text of a letter sent to the public health authorities in Spain and related commentary. To go straight to the letter in PDF format, it’s here: Less Harm: International Declaration for a Smoke-free Spain, in English and en español.

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Rethinking U.S. tobacco and nicotine regulation (part 1)

A fundamental rethink of U.S. regulation of reduced-risk products is now essential and urgent. This introductory post looks at a set of 11 possible principles that could guide a revised regulatory framework. Readers’ views are solicited.

Here is a proposal to reshape U.S. regulation of reduced-risk tobacco products:

A science-based regulatory framework for implementing tobacco harm reduction should conform to the following 11 principles:

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From FDA to PMI – a sell-out or a bold move for public health?

Matt Holman resigns as Director of the Office of Science at the Center for Tobacco Products at the FDA. He is moving to the tobacco company Philip Morris International to be Vice President of US Scientific Engagement & Regulatory Strategy. What to make of this? I write him an open letter.

Dear Dr Holman

You are making an interesting move at an important time, and I want to write an open letter to you to remark on its significance.

I am sure many will criticise your move as treachery or a sell-out, but this is a predictable knee-jerk reflex and overlooks the public health fundamentals. I hope you ignore the inevitable criticism and remain focused on the enormous public health prize that you can pursue in your new role. I think it is an ethical and high-integrity move, and I hope you make the most of it.

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