Just Stop Tobacco! Nicotine Monkey

When I first glanced at an editorial headline in the venerable The British Medical Journal (BMJ) of 4 May 2024, I thought common sense was at last beginning to appear in dealing with the smoking problem. It said, ‘Stop tobacco…’ Perhaps they were following in the footsteps of those environmental campaigners who make such a nuisance of themselves with their ‘Just Stop Oil!’ antics. But no. The full headline reads: ‘Stop tobacco companies sponsoring CME’. (CME means ‘continuing medical education’.)

We learn that the tobacco giant, Philip Morris International (PMI), has been sponsoring ‘a series on smoking cessation’ through a CME company called Medscape.

Now, let’s imagine – just imagine – that PMI and all other cancer stick manufacturers were henceforth banished from Medscape, and good riddance. That hasn’t happened yet, but what does the Medscape series on ‘Nicotine Addiction Treatment & Management’ consist of anyway?

It’s centred on the defeatist notion of ‘harm reduction’, rather than on harm abolition, which could be achieved by stopping smoking and all nicotine use. Harm reduction means substituting the most dangerous way of putting nicotine into your body, by smoking, for allegedly less dangerous ways of putting nicotine into your body, such as with e-cigarettes (vaping) or using so-called nicotine replacement products (gum and patches). So far, so bad. But where the dastardly PMI come into the picture is that they have sneakily got Medscape to recommend, as part of the harm reduction strategy, that smokers should consider using a ‘smokeless’ tobacco product with the unpronounceable name of Iqos, made by…er…PMI! Very wicked.

Are smokers really concerned about how merely to reduce their lung cancer risk? If so, how much of a risk would they find acceptable? And what about the risks of strokes, heart disease, bladder and oesophageal cancer, and lung diseases like COPD, to mention but a few other hazards of smoking?

The BMJ editorial laments that PMI’s involvement may distract doctors from pointing out that one of the options ‘for patients concerned about how to reduce their lung cancer risk’ is – wait for it – quitting smoking! Furthermore, if PMI is allowed to promote its products as a smoking harm reduction strategy, it could be ‘a direct challenge to the rising interest globally in planning for a commercial tobacco endgame [sic].’ The reference for this curious concept is to a paper in Tobacco Control of 2015.

I have been calling for the abolition of tobacco sales for years, but no one seems to take any notice. Now the BMJ refers to this obvious idea as a kind of game, or ‘endgame’. Getting people to cease poisoning themselves with tobacco fumes and to prevent them from ever starting this idiotic behaviour, is not a game – it’s deadly serious.

Now let’s look at the above-mentioned paper in Tobacco Control. It seems there are different ways of playing the endgame, or, as they put it, ‘a variety of policy approaches’, all supported to varying degrees by ‘evidence’. At least they talk of ‘seeking to end the tobacco epidemic,’ rather than to control it,’ and aver that ‘this has become a focal point for national and international meetings and has spurred longer term planning,’ etc. Now, this document refers to a report commissioned by Cancer Research UK in 2014 in which we find various ideas set out, including the following:

Develop initiatives designed to change/eliminate permanently the structural, political, and social dynamics that sustain the tobacco epidemic, in order to achieve within a specific time an endpoint for the tobacco epidemic
Convene a summit to develop a comprehensive, integrated tobacco endgame strategic plan and timeline and prioritize research, education, and practice needs
Develop, test, and fund a phased, sustained mass media-supported tobacco industry denormalisation campaign aimed at laying the groundwork for future endgame initiatives

Dear reader, as you still awake?

It seems what they have in mind is convening a summit to develop, test, and fund a sustained mass-media supported campaign aimed at laying the groundwork to change the structural, political, and social dynamics for an initiative to abolish the tobacco industry.

How about campaigning for the government to ban the manufacture and sale of tobacco products?

In the meantime, if you’re a smoker who’s looking for help to become a non-smoker again, you can find it here.

Picture credit: Arun Anoop on Unsplash