I’m always wary of calling a new low in public health, given the competition down in its murkiest, most depraved depths, but here is a strong contender…
Today I saw an article about e-cigarettes in China in which Dr Margaret Chan, Director-General of the WHO called for national governments to ban e-cigarettes.
“Margaret Chan, the WHO’s director general, expressed concern and urged caution. “E-cigarettes will prompt young people to take up smoking. I recommend that national governments ban, or at least regulate, them” she said. Tough controls urged for e-cigarettes in China – China Daily (p2)
Dr Chan is the most senior health official in the world. Assuming she was reported correctly, this is the most despicable and casually irresponsible thing I have ever heard from a senior official in public health. And that’s a high bar. This statement will cause thousands of needless deaths if governments do actually follow her advice and ban e-cigarettes – let’s hope they have more sense. The term for the causal pathway between a bureaucrat’s statements or actions and a premature death that happens as a consequence is ‘desk killing’.
Fact: Dr Chan does not call for banning actual cigarettes, products that are 20-100 times more dangerous than e-cigarettes and kill 1 in 2 long-term users and maybe a billion people in 21st Century, according to, er, WHO. Nor should she, and it would be futile to try – the reality of prohibition is inevitably miserable failure.
Fact: the world e-cigarette market is about $6 billion, though growing rapidly, whereas the world cigarette market is about $800 billion retails sales (Euromonitor). She would like to kill off a disruptive technology in its earliest stages and leave the huge and still-growing cigarette market intact.
Fact: 49% of men in China smoke and China accounts for about one-third of world cigarette consumption
Fact: most of the world’s e-cigarettes are made in China
Fact: there is no evidence anywhere that e-cigarettes ‘prompt young people to take up smoking‘ or cause any material harm at all. They do however offer very good options for smokers who wish to radically reduce their risks, but not give up some of the harmless things they like about smoking. Why does the head of WHO know so little – or care so little about facts? Note: the recent papers in JAMA and JAMA Paediatrics provide no such evidence; see here and here.
Fact: there is no ethical justification for restricting Chinese, or any, consumers to only the most dangerous ways of taking nicotine. Nor is there any obvious justification for protecting the Chinese national tobacco monopoly from competition from innovative pro-health alternative businesses, including from other firms in China.
Fact: Dr Chan is almost completely unaccountable and bears no responsibility for the consequences of statements like this, even if they are factually wrong and highly likely to cause harm to health, damage good businesses and violate ethical and legal principles. Poor accountability is the only way that statements like this can be explained.
Fact: Dr Chan is in her second term and we are likely to be blessed with her leadership until 30 June 2017.
But really? What is the point of WHO if it carries on like this? WHO needs to see the huge opportunities rather than be obsessed with theoretical threats. And it needs to stop propping up the cigarette business right now – it’s not that hard to understand how banning e-cigarettes might just do that.
I just get the feeling that since cigarettes are the most dangerous, they get to stick around because they are so easy to demonize and regulate with whatever means PH people come up off the top of their heads. Not to mention taxation.
E-cigarette users though, seem far harder to control in this manner.
Shouldn’t WHO be recommending that tobacco smoking products should be banned? Not a safer alternative to these products? Ohhh, we don’t know the long term effects!! But we do know the long term effects of smoking….. death!!! How much money has Big T paid into your bank account Margaret??? ?
That’s what you get when a whole multi-billion industrie has been developed for decades against tobacco around the central theme that you can say whatever idiocy you like in the name of science without being criticized because it’s politically not correct to disagree.
Someone needs to institute criminal proceedings against this woman, this SO-CALLED doctor; she needs to lose her medical credentials ASAP — she needs to be ejected from the planet into space!
After smoking for 40 years, the ONLY product which allowed me to STOP smoking is Vaping. My health is 100% better in just one year. This so called doctor should have her degree ripped up in front of the entire WHO delegation. She takes the meaning of Idiot to a whole new level.
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This is deeply depressing. How she can say “E-cigarettes will prompt young people to take up smoking” is utterly beyond me. People quote “peer reviewed litereature” but the fact that these studies show a correlation between ever tried e-cigs and ever tried cigarettes does not support this statement. If there was a single study showing that never smokers become regular e-cig users and then move on to be regular cigarette users (let’s ignore for a moment the small matter that they might have gone on to be regular smokers anyway), that would be different. But the truth is that never smoker, regular e-cig users are as rare as hens teeth, so no-one could find enough of them to do that study with meaningful numbers. she should have the sense to be able to intelligently critique the data, not just refer to these deeply flawed peer-reviewed studies.
This woman is evil. Full stop. Come the revolution, she is first up against the wall.
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Beam me up scotty I live in a world ruled by corrupt fu king wan kers
The internet is a disruptive tecchnology that is dismantling newspapers, magazines, copper phones, and the movie and music businesses. Likewise ecigs are going to end the Tobacco Age and for the same reaons, economics. I used to spend $240 a month on cigarettes. Now I mix e liquid at home for $3.60 a month. Besides being better for my health it’s a superior experience. Cigarettes are obsolete.
Charlie – agree completely with you. It is a true disruptive technology with the potential to see off smoking without compelling anyone to do anything or otherwise coercing them into quitting – but only if the likes of WHO don’t stamp it out first… see my new post Regulating disruptive technologies – 3 papers
Many people, due to political or personality reasons, are prone to seeing risks rather than benefits and obstacles rather than opportunities. This risk averse nature somehow causes them to see potential/unlikely/theoretical/manageable risks in innovative products as a threat to be thwarted without adequately considering the benefit of changing the status quo. When automobiles were first introduced many jurisdictions opted to introduce Red Flag Rules, whereby someone had to walk (slowly) in front of any such vehicle waving such a flag. Eric Schmidt and Jonathan Rosenberg, in their book How Google Works, address this issue at p255:
“. . . governments should resist the impulse to enact highly restrictive regulations, similar to the UK’s nineteenth-century “red flag” law, that force the new technology to jump through much higher safety hoops . . . . If data empirically show that a new way of doing things is better than the old way, then the role of government isn’t to prevent change but to allow the disruption to occur.”
Innovation not only changes the world, but is doing so ever more rapidly. When the status quo for tobacco/nicotine is a billion deaths this century surely there is a case for working with rather than against the disruptive innovation that could finally make cigarettes obsolete.
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