Professor Sir Chris Whitty, the UK government’s Chief Medical Adviser, lays it on thick. At a recent symposium on medical ethics, after reminding us that ‘Smoking is an appalling way to die, it kills people in multiple ways,’ he is reported as saying that ‘getting smoking down to zero and destroying the cigarette industry should be an aim of public health.’ (My emphasis.) Source: ASH Daily News, 4 November 2022.

I sympathise with Professor Whitty’s evident hatred of the tobacco industry and his apparent desire to grind its face in the dust, so to speak. But how does he propose to achieve this laudable aim? Mount assaults on the headquarters of all the cigarette manufacturers in the UK, drag out their CEOs in chains, and arraign them on charges of crimes against humanity?

Making Smoking Obsolete
Another rather impractical approach to the tobacco problem is evident in the June 2022 review by Dr Javed Khan, Making Smoking Obsolete, to which I shall now turn.

Dr Khan – his doctorate is honorary – trained as a teacher, he has a degree in mathematics, and was until recently the CEO of Barnado’s, the UK children’s charity. He does not appear to have any experience in what is called tobacco control. It is, therefore, unclear what his qualifications were to be commissioned for the above-mentioned review which is of the government’s ambition to get smoking prevalence in England down to 5 per cent by 2030.

For a flavour of Dr Khan’s 101-page document, let’s take a sentence from page 13, repetitively headed, ‘Quit for good – encourage smokers to quit, for good’:

My priority is to help people quit smoking as quickly, completely, and permanently as possible.

He could simply say, ‘My priority is to help people quit smoking.’ Obviously, if smokers achieve the happy state of being non-smokers again, by definition it will be permanent and complete. But if you qualify the absolutes of permanency and completeness with as possible it leaves room for people to continue smoking since they could say they haven’t managed to quit completely or permanently. Similarly, if smokers are given encouragement to quit as quickly as possible they will have an excuse to carry on smoking for the time being, which may well be a long time, because they could similarly claim it hasn’t been possible for them to quit yet.

This is merely a sample of Dr Khan’s evident inability write good English; the review abounds in grammatical infelicities. Here’s another example:

There is lots of confusion about vaping. (There is a lot of confusion about vaping.)

He can’t resist an attempt at humour, misplaced though it is:

But as the smoke clears, the facts are… (The facts are…)

Even though Dr Kahn recognises the seriousness of smoking, he says:

When used exactly as recommended by the manufacturer, cigarettes are the one legal consumer product that will kill most users.

The manufacturers – unfortunately there’s more than one – of cigarettes do not recommend how they should be used. He means, ‘when used as intended by the manufactures’. (The word ‘exactly’ is redundant.) Many other examples are trotted out of the devastation smoking causes but he’s preaching to the converted. Let’s note, however, that:

Smoking is an addiction promoted by an industry with no concern for life or health.

He goes repetitively on:

In this review I have looked at our current smokefree [sic] policy, along with looking at the very best practice from around the world. (Best practice, never mind the very best practice, at what?)

It’s clear that we have been a world leader in reducing smoking over the last few decades but are now at risk of stagnating. The government needs to raise its ambition if it wants to continue leading the way.

It’s not its ambition that the government needs to raise. The government might have the high-flown ambition, for example, to abolish unhappiness for the whole population, though it would be unlikely to succeed in such an aim. Presumably Dr Khan is trying to say that the government needs to put more effort into achieving its ambition to make England smoke-free.

Now he gets into his stride:

To truly achieve a smokefree society in this great country of ours, smoking should be obsolete.

It would be better to leave out the self flattery, get rid of the split infinitive by removing the redundant ‘truly’, and say clearly what he means, such as like this: ‘To achieve a smoke-free society, smoking should be made obsolete.’ The question, then, is how should this should be done? These are Dr Khan’s ideas:

[More needs to be done] to protect future generations from this highly addictive and deadly product. Along the way, the government should do all it can to dissuade the tobacco industry from selling tobacco products.

The government certainly needs to do more to protect future generations from this highly addictive and deadly product (singular). And Dr Khan’s suggestion? ‘Along the way the government should do all it can to dissuade the tobacco industry from selling tobacco products (plural).

So this is the answer? The government apparently isn’t doing enough, along the way, to dissuade the tobacco industry from selling tobacco products and putting itself out of business. How about Dr Khan following up my oft-repeated suggestion for the government to enact legislation to force the tobacco industry to stop selling tobacco products, by banning them?

Apart from these irritations, the writing in my opinion shows he hasn’t sufficiently thought through the problem: the solutions he proposes contain nothing new and ignore the obvious one mentioned above.

Let’s look at one more example of Dr Khan’s lack of understanding of smoking:

Stop smoking services should follow up [smokers] after every quit attempt.

There’s no such thing as a quit attempt: either you smoke or you don’t. There’s only failure to quit and this is demonstrated every time a smoker lights another cigarette.

I’ll take two more of Dr Kahn’s recommendations, on page 12.

5. Enhance local illicit tobacco enforcement by investing additional funding.

More careless writing. At first glance it looks as if he wants to enhance local illicit tobacco, but what he presumably means is: ‘Provide additonal funding to enhance the enforcement of laws against illicit tobacco trading.’

6. Reduce the appeal of smoking by radically rethinking how cigarette sticks and packets look.

This is another example of Dr Khan’s curious phraseology. It doesn’t matter how much thinking, or even radical thinking, goes on: this will do nothing to reduce the appeal of smoking. What he seems to be trying to say is that the appearance of cigarettes and cigarette packs should be radically re-thought to reduce their appeal. Such as? He leaves us up in the air. Perhaps what he has in mind for cigarette packs is something like this:

DANGER
CIGARETTES ARE POISONOUS
IF YOU SMOKE YOU MAY DIE
YOU HAVE BEEN WARNED
DON’T DO IT!

Conclusion of Dr Khan’s review
The first thing he says is:

Smoking kills and ruins lives. But it doesn’t have to be like that.

It’s only too true that smoking kills; he hardly needs to say it ruins lives as well. But if it doesn’t have to be like that, does he mean that it’s possible to smoke in a less harmful way?  Similar confusion is shown by what he says next:

We now need to make it as hard as possible to smoke, and as easy as possible to quit, leading to a smokefree generation.

Here we have two more instances of the as possible solecism. It means there will still be some people who smoke, hard though it might be, and some people who cannot quit, easy though that might be.

Next, Dr Khan sets out ‘4 critical interventions’. The first is an appeal for the government to provide at least an additional £125 million a year for ‘comprehensive smokefree interventions’, whatever that means. Now let’s look at the others:

2. Increase the age of sale for all tobacco products from 18, by one year, every year, so we achieve a smokefree generation in this country.

This would mean that it would be illegal to sell tobacco products to people below a certain age: 18 today, 19 next year, 20 the year after that, and so on. Now, if we assume no one would want to start smoking after age 60, it will take forty-two years until there would be no one to whom tobacco products could legally be sold. And in the meantime, would tobacco products continue to be on sale, as at present, in every corner shop and supermarket? Would potential purchasers of tobacco products have to prove their age to the shop staff? If so, why should the burden of deciding who is eligible to buy tobacco products be put on them? And what would be acceptable as proof of age? Would smokers have to produce their passport or birth certificate? Or would smokers have to obtain a special document with a recent photo to show to purveyors of tobacco products before being allowed to buy them? The question then arises whether these merchants would find it too burdensome to act as tobacco police and decide to stop selling tobacco products altogether, or is that the aim of this cock-eyed proposal?

3. Embrace the promotion of vaping as the most effective tool to help smokers quit.

Vaping could be promoted or embraced; it doesn’t need to be promoted and embraced. And can’t he think of a better word than ‘tool’? How about way, method, means, approach, or technique? And if something is effective, that will suffice; it doesn’t have to be the most effective, etc. Thus, he could simply say, for example: ‘Promote vaping as an effective way to help smokers quit.’ But he’s not going to promote or embrace an ineffective way, so he could simplify the sentence further to: ‘Promote vaping as a way to help smokers quit.’ However, as I discuss in my book, this is a counsel of despair and almost an insult to smokers. In any case, the best way to quit smoking is not through some or other product or technique, but just to quit. For those who find this too difficult, the Symonds Method can show you how to do it without a struggle.

4. Prevention must become part of the NHS’s DNA.

What is this supposed to mean?

Finally, Dr Khan wags his finger at the government:

If implemented in full, I believe these actions will get the government to its 2030 target and then lead to a smokefree generation. But to get there, there can be no short cuts, no quick fixes, no excuses.

All right, Mr Schoolmaster.

Tobacco control is an imperative!
Thus sayeth Professor Nick Hopkinson in the title (paraphrased) of a similarly wrong-headed opinion piece in The British Medical Journal (22 October 2022). He doesn’t mince his words:

The tobacco industry robs individuals of the ability to live a life of adequate length, free from disability, and able to pursue the goals they value. It robs them of parents and grandparents, denying the capability to enjoy family life.

Why is this robber – the tobacco industry – not locked up? Why is it allowed to carry on virtually unhindered making and selling its poisonous products? Why talk only of tobacco control rather than abolition? One of the solutions Professor Hopkinson proposes is that a licence should be required to sell tobacco products. How about requiring a licence to smoke tobacco products?

He also says smoking is ‘a habit driven by addiction’. Well, is it habit or an addiction? It can’t be both. Those who engage in the abnormal and potentially harmful behaviour of smoking do so because they’re addicted to nicotine. The availability of this drug, at least in the form of smoked tobacco, should be cut off at source.

Why is the tobacco industry regarded as untouchable? Tobacco products should be banned.

Text © Gabriel Symonds

Photo credit: Robin Jonathan Deutsch on Unsplash
The skull and crossbones image is from Wikimedia Commons