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Imagine the shock waves reverberating around the world if the WHO announced that every man, woman and child in Brazil, Bangladesh, Nigeria, the Philippines and Indonesia has been wiped out by COVID-19. That’s around a billion people – the same number the WHO continue to estimate will die from a smoking-related disease by the end of the century. The lack of immediacy and topicality of smoking death stats make them less politically explosive, but no less shocking. The big difference is that, at least currently, we can’t stop the spread of coronavirus, but we can do much to lessen the predicted death toll from smoking.

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1. Keep faith in a strategy that is failing millions

The primary concern of tobacco control should be to tackle the extent of the current adult smoking epidemic. This means tackling the projected toll from death and disease which will worsen as populations grow in those lower and middle income countries (LMIC) which already have the highest numbers of smokers.

But by the WHO’s own admission, overall, the impact of its MPOWER tobacco control strategy in actually getting smoking under control has been limited. Simply having laws in place is not enough.

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There exists a bunch of pirates, ostensibly independent NGOs and medical and public health organisations who, flying under a flag of convenience called ‘tobacco control’ are sinking the evidence base for tobacco harm reduction (THR), in the process denying potentially life-saving products for millions of current smokers who can’t or do not want to give up nicotine while knowing full well the damage caused by cigarettes.

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I had in mind to do a reflective piece when I reached blog 100, not imagining that by the time I arrived here, millions of people across the world would have more time for reflection than they can cope with.

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Just when you thought that the ‘public health’ authorities could not sink any lower in their attempt to undermine tobacco harm reduction, they take advantage of one virus to spread a contagion of virulent lies and propaganda.

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At the start of the year, the storm clouds of anti-tobacco harm reduction (THR) were darkening, threatening as ever the lives of smokers looking to switch or stop. But in the bleak mid-winter, rays of reason have shone a light on those that needed to be called to account.

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I am indebted to my good friend Roberto Sussman for the title of this blog. Roberto lives in Mexico and is an unlikely combination of astrophysicist and ardent, eloquent tobacco harm reduction activist. He gave a speech in London on 23rd January 2020 at the launch of the Tobacco Harm Reduction – the Right to Health briefing published by Knowledge•Action•Change and available here: https://gsthr.org/report/2020-briefing-paper

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On 10th  December 2017, the Director General of the WHO Tedros Ghebreyesus released this statement on Human Rights Day. It was headed “Health is a fundamental human right”. He said:

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Anti-tobacco harm reduction campaigners backed by US Federal and state authorities, supportive media and large wodges of Bloomberg cash are about to deliver the worst possible news for millions of American smokers who wish to continue using nicotine while significantly reducing the risk of a premature and painful death.

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There is a new tobacco harm reduction (THR) activist group that has started up called ETHRA – European Tobacco Harm Reduction Advocates, currently with fifteen partners - https://twitter.com/europethra. This is the latest THR advocacy group following in the footsteps of groups now spanning the globe, in Australia, New Zealand, Latin America, India, Canada, USA, Asia and Africa, as well as other European-based organisations and the international agency INNCO.

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Not sure if this riff goes anywhere, but with the Amazon on fire, huge storms battering the Caribbean, a memorial service in Switzerland for melting glaciers, animal species lost forever as habitats vanish and thousands out on the streets protesting about climate destruction (forget ‘change’), there are some synergies around the refusal of world health leaders, governments, health practitioners and academics of every stripe, to accept the reality that right now we have a world smoking pandemic that could be massively helped by encouraging the uptake of safer nicotine products. Not only are they sitting on their hands, they are actively lying to the general public and colleagues with all their Big Tobacco (BT) conspiracy theories, fake science, scare-mongering and ad hominin attacks. And anybody who fights back with what used to be called ‘evidence’ is simply dismissed as a BT stooge.