• May 27, 2024

The limits of People Power

 The limits of People Power

Carl V. Phillips was a pioneer of tobacco harm reduction as a professor of public health and later as an independent researcher and under CASAA auspices. His scholarly work spans economics, policy analysis, epidemiology, and the history and philosophy of science. At the time of writing this article, he had no institutional affiliation.

The voices of vapers and other tobacco/nicotine consumers are being heard more than ever, but we might be overestimating the implications.

By Carl V Phillips

Carl V. Phillips was a pioneer of tobacco harm reduction as a professor of public health and later as an independent researcher and under CASAA auspices. His scholarly work spans economics, policy analysis, epidemiology, and the history and philosophy of science. At the time of writing this article, he had no institutional affiliation.
Carl V. Phillips was a pioneer of tobacco harm reduction as a professor of public health and later as an independent researcher and under CASAA auspices. His scholarly work spans economics, policy analysis, epidemiology, and the history and philosophy of science. At the time of writing this article, he had no institutional affiliation.

Social media and enthusiasm about vaping have created an unprecedented consumer voice for tobacco/nicotine product use. Tobacco-control messages from government and anti-tobacco organizations are met with floods of opposing responses. Vapers rallied to soften the restrictions on vapor products in the EU’s revised Tobacco Products Directive. There is a resurgence of smokers’ rights, such as NYC CLASH’s “Smoking is Normal” campaign, pushing back against “denormalization.” The expanding nanny state has inspired wider sympathy for those who were once its main targets. With the exception of smokeless tobacco users, who remain as voiceless as ever, there is a heady belief that a “people power” revolution is changing everything.

Unfortunately, history shows that people power seldom generates more than a show of enthusiasm, and for good reason. The rational choice for any individual is to not donate the time or money needed for ongoing advocacy. If everyone did so, they could all come out ahead. But each decides only for herself and so cannot reasonably hope to influence the outcome. Even adamant belief in a cause is seldom enough to inspire actions if they are not either trivial (e.g., clicking to send a form letter) or personally rewarding (e.g., testifying at a hearing or attending mass protests). This collective action problem means that even with strong consumer support for a goal, it is organized interests—collective actors who have more at stake, are able to act in a focused manner and do not have life’s million other problems to worry about—who dominate the fight. To say that issue advocacy is a marathon, not a sprint, grossly understates what a slog it really is, as well as how tactically complicated it is.

So what can we say about the successes of consumer advocacy?

First, a barely organized mob can play pretty good defense against even a focused opponent. Picture Lionel Messi trying to get through a hundred amateur defensemen (American readers who do not get the reference can substitute the grief a restive population can inflict on an elite occupying army). For several years, The Consumer Advocates for Smoke-free Alternatives Association (CASAA), where I was chief scientist from 2012 until earlier this year, marveled at our success in mobilizing vapers against U.S. anti-vaping legislation. We saw the defeat of almost every restriction at the state level (where consumer voices have the most impact) and most of the local ones. Unfortunately, the political science research on state and local legislation suggests that widely adopted regulations usually experience a yearslong lull, with only a few early adopters, followed by an explosion of what gets called “diffusion,” with an accelerating feedback process like a contagious disease. This pattern seems reasonably likely in the present case. A temporary victory is better than none, but the purely defensive nature of those successes means nothing is secure. A victory that consists stopping a stroke of the pen can be undone with the next stroke of that pen. The clock keeps running, and the attackers only need to find the goal once.

Second, consumer activism carves out a wider Overton window for organized interests (i.e., industry) to act. Consumer advocacy changes what is considered normal and acceptable to claim. Enthusiastic support for vaping or smoking makes it much easier for industry to portray its organized political efforts as defense of consumer choices and rights. Of course, the attackers will always pretend otherwise, but those open to the evidence cannot help but notice the genuine consumer interest.

Third, the constant pushback against anti-consumer rhetoric and proposals prevents anti-tobacco activists from fully controlling the mindspace as they did for decades. Unfortunately, the disorganized approach, while far better than no voice, is losing ground. Public opinion about vapor products is trending negative in most places (for cigarettes there was really no room to drop any further). There are a lot of social media retorts but few carefully crafted letters to media outlets or politicians who make anti-consumer claims. Organized anti-tobacco interests, by contrast, send out their boilerplate replies systematically. Once again we see the collective action problem: Clever retorts on social media have consumption value (i.e., in addition to being useful, it is a fun way to spend two minutes), but the thankless task of sending out ten formal communications a day, most of which will never appear publicly, does not.

The few victories that we can really “put in the bank” clearly owe more to organized industry efforts than to consumer advocacy.
The few victories that we can really “put in the bank” clearly owe more to organized industry efforts than to consumer advocacy.

Missing from this list of accomplishments is any actual turning of a corner, away from playing only a desperate reactive defense. In issue politics, people power seldom accomplishes this without first coalescing into an organized interest, providing the strategic leadership that is required for going on the attack and also overcoming the collective action problem. In the U.S., far more people oppose animal cruelty or erosions of civil liberties than oppose restrictions on tobacco/nicotine products, but it is not the public clamor (and certainly not the ballot box) that wins political and legal battles. It is organized interests like the Humane Society and the American Civil Liberties Union. In the vapor advocacy space, numerous groups have risen, declined, merged and disappeared. But the credible organizations have conspicuously avoided trying to play any strategic leadership role. None appear able to turn the corner, creating an organization that transcends the volunteered efforts of a tiny group of highly dedicated individuals. The few victories that we can really “put in the bank” and build upon—which arguably consist only of blocking total or near bans of vapor products—clearly owe more to organized industry efforts than to consumer advocacy. A mob can defend its goal, but it is unlikely to put any points on the board.

The most organized consumer advocacy group, the smokers’ rights group Forest, offers a useful contrast. Forest is a constant proactive voice and thereby established itself as a go-to source on tobacco consumption issues in the U.K. and Ireland. It is leading the call to reintroduce smoking rooms in pubs, something that might succeed with the push from relevant industries and is enabled by the consumer activism. If that succeeds, it will be an important turned corner, an actual rollback of anti-consumer rules. A key difference between Forest and other consumer groups is that it receives adequate funding from industry to function as an organized interest. This does not make it less a legitimate voice for consumers (though anti-consumer interests insist otherwise), but it bypasses rather than solves the collective action problem. An unorganized mob of smokers’ rights advocates plays the same roles as vapers’ rights advocates (albeit rather less effectively). But the strategic organized interest, much like the organized interests supporting drug legalization, depends on funding from other organized interests.

Perhaps no solution to the collective action problem is even possible. As a percentage of the population in Western countries, tobacco/nicotine consumers are at their lowest ebb. But that larger historical population of smokers was never mobilized as an effective political force. We can hope that because vapers are “born” empowered—in contrast to smokers who were slowly boiled, like the proverbial frog, into self-loathing and political weakness—it might be different. However, the material harm vapor enthusiasts suffer from vaping restrictions is really not much different from the accumulated annoyances suffered by smokers.

When the U.S. Food and Drug Administration (FDA) dragged its heels on possible HIV/AIDS treatments in the 1980s, protesters stormed meetings and took to the streets. They were highly motivated since the FDA could effectively block the development or availability of treatments they desperately wanted. While the talk about the FDA threatening lifesaving vaping sounds similar, the motivation level is very different. Motivated vapers have figured out how to access alternative supplies—via a combination of black markets, shadow markets and do-it-yourself manufacturing—in jurisdictions where e-cigarettes are severely restricted. Restrictions will impact smokers who might have switched products, and they could devastate the e-cigarette industry, but restrictions do not create the consumer desperation that can overcome the collective action problem. Vapers who are most motivated to take action are also best prepared to subvert any restrictions. Imagine how much sooner cannabis sales would have been decriminalized if the well-functioning black market did not make it easy to not care it was criminalized.

What happens to consumer advocacy if it cannot be transformed into an organized interest?

British and some other European vapor advocates seem to be pursuing a strategy of subsuming the consumer movement into existing organized interests, specifically public health power bases in universities and organizations that are sympathetic to vaping. There are some individuals actively trying to engineer this, though it appears to be mostly inadvertent. The people power evolved organically, and those interests happened to be in a position to run with it—or co-opt it, depending on one’s point of view. This might prove an effective way to turn a corner, creating a persistent voice that already has sufficient funding and visibility. However, there are concerns this comes at the expense of empowering an organized interest that shares some consumer interests (keeping vapor products available for smoking cessation) but clearly not all (making vapor products generally available, high quality and unburdened by many of the restrictions faced by smokers). Perhaps more importantly, it reduces the incentive to create an independent power base that is not subject to the shifts in political winds that could end support for vaping among institutions, a problem that snus users in Sweden recently discovered the hard way.

In the U.S. no such strategy is available due to the unified opposition from “public health” organized interests. There have been moves by at least one radical-right anti-government organization to capture vapers as part of its constituency, and some advocates have endorsed this, but it is unlikely to get traction. The only organized interest for semi-organized consumers to ally with is industry, and that is just what has occurred worldwide.

This is the common story of consumer advocacy. Consumers speak up, but it is the companies that can profit from consumer demand that function as organized interests, either individually or collectively, after solving their own (much smaller) collective action problem. Industry interests are hardly perfectly aligned with consumers, but healthy market competition keeps most of the misalignments in check. Across many product sectors, industry is the only organized interest that mostly defends consumer interests. But as with most everything else in the tobacco sector, that relationship is rather more complicated. Many smokers despise industry for “getting them hooked” or for seeking arrangements with tobacco control at consumers’ expense. Many vapers blame the traditional tobacco companies for anti-vaping efforts. There are at least three tiers of producers in the vapor product space with radically different incentives and relationships with consumers, which creates serious collective action problems.

Most important—though discussed far too little—is that in other sectors government regulation and a few organized watchdog organizations diminish the misalignment between consumer and industry incentives. Government forbids various profitable but consumer-harming choices industry might make, and the watchdogs investigate and highlight problems that government is too slow or too captured to address. But in the tobacco/nicotine sector, so-called regulators are really crypto-prohibitionists, adamantly opposed to consumers’ real interests rather than attempting to protect them, and the usual consumer watchdogs are, at best, indifferent about tobacco consumers. To “regulators” in this sector, the harm done to consumers by oligopoly pricing, for example, is a feature, not a bug. Consumers who are desperately defending their rights against government and its allies can spare little attention to defend themselves against industry behavior that harms them.

It is from this complex muddle of incentives and challenges that advocacy for consumers’ interests sufficient to resist the enormous power of the attackers must emerge. Or not. It is difficult to be optimistic. Echo chamber-fueled optimism about people power is further reason for pessimism because it reduces the motivation to somehow create effective organized interests. Industry seems to be floundering about how best to use people power as an auxiliary for its (not terribly) organized efforts, employing astroturfing and sometimes cheerleading for consumer groups, but not enough to really empower them. The Forest model—independent consumer voice but openly industry-funded—is the only proven model, but there is little sign of industry interest in replicating it.