Distortion is a Problem
On the question of parroting figures, take the annual death toll attributed to tobacco-related diseases. Over the years, it has been increased a number of times, usually in lots of one million, so it now stands at the nicely rounded figure of 8 million. At the same time, the World Health Organization, which has ownership of this figure, has been claiming success in its efforts to prevent the deaths attributed to tobacco. But even given the world’s population has been increasing, it cannot be the case that the figure for tobacco-related deaths keeps leapfrogging this supposed success.
Why is this important? Because by exaggerating the problems caused by tobacco, some sections of tobacco control have been allowed to distort the picture to such an extent that it becomes difficult to sell the idea of tobacco harm reduction. When tobacco is depicted as being “deadly”—a superlative you often see applied to this product—and that depiction is not challenged, it becomes too counterintuitive even for the uncommitted to imagine that the problem caused by tobacco can be significantly reduced by another tobacco product such as snus. Additionally, because too many people have, for a quiet life, gone along with the U.S. Food and Drug Administration’s airy-fairy idea that e-cigarettes can be “deemed” “tobacco” products, the use of even vaping products as tobacco harm reduction agents can be challenged easily by those who wish to do so.
What we need is honesty. For instance, we need to stop lumping all combustibles together as if the consumption of cigarettes, cigars or pipe tobacco is equally risky. This cannot be the case, especially at a population level. And we have to do the same in respect of smokeless products. For instance, what do we mean by “smokeless”? Are we talking only of the consumption of the final product? Perhaps it’s time we checked out whether some of the tobaccos used in some “smokeless” products are cured using artificial heat—in some cases by burning wood fuel and contributing to deforestation.
It has become fashionable to talk of both individual and population risk, so, in this context, is it OK to reduce the harm caused to individuals by tobacco consumption if the production of the less risky items involves damaging the environment and, by extension, threatening the health of tobacco and nontobacco users alike?
This is a massively complex question, the answer to which would mean a descent into not altogether helpful relativities. One thing seems clear to me, however. If you drew up a continuum of environmental risk caused by tobacco and nicotine products, you would wind up with a picture somewhat different to the continuum of individual consumer risk caused by tobacco and nicotine products, which we are more used to seeing. But one thing would remain pretty much the same. Smokeless products, such as nicotine pouches, snus and chewing tobacco, would be the stand-out products when it comes to reduced environmental risks. What would change, I think, is that the divisions between combustibles in respect of environmental risks would widen appreciably, and vaping products, which are smokeless, while scoring well on the individual consumer risk continuum might well end up in free fall on the environmental risk continuum, something that needs to be addressed.
I’ve seen it said that there should be one set of rules for combustible products and another set of rules for noncombustible products. I think the rules need to be more nuanced than that.