It’s hard to understand why the public health industry is so irrational about tobacco use. Yes, it’s dangerous to inhale the fumes of burning tobacco. Smoking can be very bad for people. But why vilify tobacco use in all its forms?
The anti-tobacco crusade is a modern-day version of Revivalist religious fervor. It sure isn’t science. And it isn’t about protecting people’s health.
The CDC estimates that 442,000 Americans die from tobacco smoking each year. These estimates are slippery; they’re based on a fairly loose definition of what it means to die “from” a behavior — but let’s agree that a lot of people die sooner than they otherwise would because they smoke cigarettes.
Alternative ways of self-administering nicotine allow users to avoid the disastrously harmful drug-delivery device, the cigarette. You’d think that Big Public Health, 45 years into a campaign to get people to stop smoking, would be promoting all sorts of safe methods of nicotine delivery.
That’s not what happens. Instead, the industry pours anathema on light cigarettes, smokeless tobacco, and other safer-than-cigarettes products.
The latest sermon is an article in this month’s The Nation’s Health — the newsletter of the American Public Health Association (APHA, which has turned into the High Synod of Public Health Religion). The article claims that “New Types of Smokeless Tobacco Present Growing Risks for Youth.”
The title is a double rhetorical turn now (alas) typical of APHA: (1) your kids are going to die, and (2) the “risk” to them is increasing. The piece would seem silly if the author, named Kim Krisberg, weren’t so serious. After all, it isn’t kids who die from smoking, and the risk of smoking-related death isn’t increasing at all. But we’re not in the realm of truth here.
Since Big Public Health isn’t dealing in truth when it comes to tobacco, evidence isn’t part of the story. The head of the Campaign for Tobacco-Free Kids can say “the time to stop the spread of dangerous products is before they become the fad of today,” insouciantly sidestepping the fact that smokeless tobacco products aren’t dangerous. Brad Rodu’s invaluable website Tobacco Truth explains — see Brad’s June 16th post, for instance. Or go to this page at the excellent resource TobaccoHarmReduction, or see this article published in Cancer Epidemiology, Biomarkers & Prevention in 2004.
The public health industry’s animus for tobacco leads it to label as harmful something that is really a boon to public health — the increasing use of products that provide nicotine without burning tobacco. Surely it’s better to have people chewing nicotine-containing products that won’t harm them than to allow them to continue smoking tobacco in order to get a nicotine dose.
Moralistic fervor makes you stupid. Stupid enough to write, as two physicians with FDA’s Center for Tobacco Products did,
As state and local communities across the United States adopt indoor clean-air laws that restrict smoking in public areas and workplaces, the tobacco industry seems increasingly focused on the development and introduction of novel smokeless tobacco products
… as if the tobacco industry were magically making Americans who would otherwise stop smoking suddenly crave smokeless tobacco — and as if that would be bad for them. Drs. Deyton and Cruz, you should know better.
But Matthew Myer with Tobacco-Free Kids isn’t unintelligent. Nor, I assume, are Deyton and Cruz. And I can’t imagine they really want people to suffer.
Still, do they really think that safe non-smoked tobacco products are going to bewitch our kids? Do they believe that apocalypse comes in a package of smokeless tobacco?
Are they just so obsessed with battling tobacco companies that they’ve lost sight of the aim of public health, i.e., to reduce suffering?
Or is it simpler? Has the public health industry’s big-money anti-tobacco campaign allowed too many people to make too good a living by saying stupid things about tobacco?
The cigarette manufacturers have been scurrilous, dastardly, and sometimes appallingly inured to the misery and death their products have hastened. Maybe they deserve the Myerses of the world.
But the public health industry could be a lot more focused on helping people to live less painful lives, and less obsessed with its private demons.
As Carl V. Phillips suggests in a post this week, the FDA will have to break with the public health industry’s moralism if people who use nicotine are going to protect themselves from cigarettes.
If the FDA can’t overcome Big Public Health’s obsession with satanic tobacco rituals, re-introduce truth into the discussion, and re-focus on making real people’s lives less miserable, the zealots are going to turn stupidity into bad policy.
