We are now used to hearing experts of all disciplines, from virologists to behavioural psychologists, interviewed in the media about COVID-19. There is general agreement on personal safety measures like social distancing and hand-washing. But even at this basic level, questions arise. As it becomes clear that the virus can be carried in airborne droplets, should the recommended distance in the UK remain at 2 metres rather than I metre plus or even 3 metres?
Beyond that, is mask wearing an effective barrier? If so, what kind and where should they be worn? Do you render the vaccine less effective by extending the time between each dose? How long is the vaccine effective? Can you contract the virus more than once? How strong is the evidence that the new variant is 70% more transmissible? Can you still pass on the virus even if you have been vaccinated but had the virus at the point of inoculation? There have been 23,000 papers published on the virus in the past year, with the numbers piling up every week: those trying to assess the evidence about coronavirus are just as overwhelmed as the hospitals trying to deal with it.
As it grapples with this mountain of evidence, and how best to advise politicians, policymakers and doctors, what the medical and scientific community can certainly do without are the conspiracy theorists. Social media has given new impetus to the cult of anti-vaxxers, with the added frisson of Bill Gates apparently wishing to inject us all with some kind of mind controlling substance, although to what end is unclear. Joining the throng of outliers are those who think 5G masts caused the coronavirus, and virus deniers, including some of the more ‘populist’ delusional politicians who put their citizens at even greater risk.
But the very authorities, in particular the WHO, who rightly condemn such dangerous antics are themselves engaged in a propaganda campaign of epic proportions, potentially putting millions of lives at risk. Just as there is no denying the presence of a highly dangerous virus in our midst, there is no denying the science which shows unequivocally that tobacco can be used relatively safely so long as it remains unburnt. And for more than a decade, there have been products on the market that deliver, more safely, the nicotine that smokers want. That’s it – there should be no controversy about this – and it should be the prime directive of international tobacco control to promote this fact alongside all other public health measures because, like the virus, the smoking epidemic is out of control, primarily in poorer countries.
Instead, a controversy has been manufactured which obscures this central and vital scientific fact which many in the international tobacco control community find so unpalatable. They refuse to acknowledge that, just as the globally polluting car industry can develop electric cars while still selling gas guzzlers, so the tobacco industry (both large and small) can develop relatively safer products. Yes, young people will experiment with vaping products, but that does not translate into the conspiracy theory that Big Tobacco is looking to hook kids on cool vapes. The evidence for this is no more robust than the evidence that Trump was cheated out of the presidential election.
Some people will use safer nicotine products as an offramp from smoking and then nicotine entirely – others won’t and will continue to consume nicotine. As the science shows that nicotine is not a harbinger of deadly disease, so what if people continue to use it? The spectre of addiction is raised as if this was akin to the chaos of a life driven by heroin or crack use. Where there is little or no harm, there is just a habit, not an addiction. ‘We don’t know enough about long-term effects’ is another ‘get out of jail free’ card which fuels ‘the controversy’ and is often played in the game which gambles with smokers’ lives. The scientific gloss on this is the ‘precautionary principle’ which advises caution in allowing innovation which is potentially harmful. But as an EU document on the subject states, “…most experts agree that the precautionary principle does not call for specific measures (such as a ban…)”. And if you are talking about snus – banned throughout the EU – the product is hardly innovative, having been developed 200 years ago. All the recent clinical evidence not only underlines its relative safety, but snus is also credited with plummeting smoking rates in Sweden and Norway and a gold standard decline in smoking-related disease compared to the rest of the EU.
So, as those working in tobacco harm reduction have repeatedly stated, the claim that we don’t know enough about safer nicotine products to promote them in the fight against smoking is both scientifically and morally indefensible.
All this billowing smoke and dazzle of mirrors deliberately confuses the media, health professionals, politicians and smokers into thinking that we know hardly more about safer nicotine products than we do about COVID-19, except that anybody supporting tobacco harm reduction must be shunned.
During this year, the EU will be reviewing the tobacco products directive while the WHO will be holding the biennial meeting of the signatories to the tobacco control convension. The current mood music is that officials controlling both processes will be pushing for tighter controls on safer nicotine products.
To reiterate, the ‘controversy’ gains traction because the ostensibly credible authorities, exhorting people to do the right thing to protect themselves, their families and the wider community in the face of a global pandemic, snap into cognitive dissonance as the architects of the kind of propaganda they rightly condemn in others.