Disruptive force
The genie ’ s out of the bottle – embracing tobacco harm reduction could end smoking within a generation , says Knowledge Action Change . DDN reports
S moking causes at least 8m deaths every year – more than from HIV / AIDS , tuberculosis and malaria combined . Despite this global public health crisis , the number of smokers worldwide has remained static at 1.1bn over the past two decades .
In The right side of history , Knowledge Action Change ( KAC )’ s third report in a series on the global state of tobacco harm reduction , Harry Shapiro looks at past , present and future . Why have there been so many false starts to find safer ways to use nicotine ? How have consumers themselves influenced the development of tobacco harm reduction ? What ’ s been the response of public health and tobacco control organisations ? What role has the tobacco industry played in all of this ? And the key question : ‘ Are we now going to see the opportunity to end smoking slip away – leaving the tobacco industry to continue profiting from the sale of combustible cigarettes ?’
The report is a fascinating and disturbing read . It ’ s a story of innovation , but equally a story of ignorance , greed , corruption , neglect , inertia and privilege as we see the emergence of much safer products being regulated and dismissed to further confirm deadly combustible cigarettes as the number one choice . As we read about the burden of tobaccorelated death and disease falling disproportionately on people who are poor , vulnerable and disadvantaged , we are reminded of tobacco companies ’ sham promotion of ‘ safer ’ cigarettes ( for which they were penalised in the 1990s ) with a filter that was
BREAKTHROUGH The twist in this story is that the breakthrough in tobacco harm reduction was consumer driven and not the result of public health policy dealt from on high . Individual innovators began experimenting for a safer vaping product , motivated by their desire to quit smoking . An American man came close , but China gave their candidate the backing and a new industry was born . Developing an export market quickly , China offered the world the opportunity to try vaping instead of smoking .
Harry Shapiro , the report ’ s author , explains how interest and excitement spread through internet forums , chat rooms and websites – ‘ what ’ s all this e-cig stuff that I keep reading about in the newspapers ? Is it going to help me ? Are they safe ? Where can I get them ? How much do they cost ?’
Politicians , regulators and lawmakers were all completely caught off guard , he says . ‘ They had absolutely no idea what to do with these products – is it tobacco ? Should we make them medical products ?’ And in the absence of knowledge , they took some bad advice from otherwise credible sources like the World Health Organization ( WHO ). ‘ And of course , if you ’ re going to develop policies on the back of bad advice , what you finish up with is bad policy – and this is what has happened in many countries .’
Just as health and regulatory authorities moved towards restricting the products , consumers – the thousands who had benefited from vaping – began to advocate for their right to use them and this had a direct influence on policy .
But there was still a massive obstacle : the tobacco control establishment had spent millions of dollars over decades to fight the tobacco war – and it was a war against nicotine , not just cigarettes .
SIMPLE LIFE Life was much simpler before vaping arrived on the scene , explains Shapiro . ‘ You had evil nasty tobacco companies over
See U in History / Alamy
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