In the global race to eliminate tobacco smoking, New Zealand was first out of the stalls with its 1990 Smoke-free Environments Act. The law banned smoking inside public buildings such as schools, in workplaces and on public transportation. It extended restrictions on advertising and established an agency to replace tobacco-industry event sponsorship. It remains a milestone achievement that the law became an exemplar during the writing of the United Nations’ Framework Convention on Tobacco Control.

Since then, other countries have snuck past us. But the home of the all-conquering All Blacks rugby team does not like to be outstripped. The original law has been amended several times to keep up.

On December 9, the government proposed changing the law again to arrive at its Smokefree 2025 goal (smoking prevalence of 5 percent or below) as fast as possible. A raft of new measures will include continually raising the age at which people can buy cigarettes. From 2027, the legal age to purchase tobacco would rise year-on-year from the current 18. This means that children now aged 13 and below face a lifetime ban on legally buying tobacco.

The new law will introduce a licensing system for tobacco retailers, reducing the number approved to 5-10 percent of the current estimated 8,000 outlets. The law will also ban filters and other characteristics of cigarettes that researchers claim make smoking appealing or palatable, such as flavors.

A person would have to smoke 20 of these ultra-low nicotine cigarettes to get the same amount of nicotine.

Another startling proposed change will abruptly cap the nicotine level in cigarettes so low that it is said smoking will no longer be sustainable for people who rely on nicotine. Whilst the government has not revealed the level, academics who wrote the plan recommended that the nicotine yield from a cigarette should be no more than 0.05 percent. Compared to an average cigarette currently on sale in New Zealand, a person would have to smoke 20 of these ultra-low nicotine cigarettes to get the same amount of nicotine. US tobacco company 22nd Century, the main supplier of very low nicotine cigarettes used in local trials, was quick to applaud the plan. It has been recommended that the price of these is set at a prohibitive minimum.

With only three years to hit a target of a smoking rate of 5 percent or below, any consideration for people who smoke has been tossed aside. All that matters for New Zealand tobacco control is glory.

The New Zealand Smokefree 2025 goal started out as a “dream.” In 2011, it became “an aspirational goal.” The government at that time did not have any evidence that the demanded 5 percent was achievable. Given the vast inequity between the daily smoking rates of the dominant NZ-European population (14.6 percent) and the Indigenous Māori (37.6 percent), the risk was that an overzealous tobacco control might further marginalize Māori, who are overrepresented among the most deprived groups and make up over half of people imprisoned—despite being only 15 percent of the population.

Since 2015, the switch from smoking to vaping has steadily increased. New Zealand’s latest figures strengthen the evidence that vaping triggers increased smoking cessation. We now have the same perfect inverse association between smoking and risk-reduced products that’s seen in the United Kingdom (also with vapes); in Japan and South Korea (with heated tobacco products); and in Norway, Sweden and Iceland (with oral snus).

Source: Ministry of Health. (December 2021). New Zealand Health Survey. Annual data explorer. 

Harsh Consequences for Māori

Māori still have high smoking rates but we are seeing a more rapid drop in prevalence. Daily smoking in 2020/21 among Māori has dropped to 22.3 percent. The inequity in smoking between Māori and NZ Europeans remains constant, however. Just over 8 percent of NZ European adults aged 15-plus now smoke daily. If their transition from smoking to vaping is not interrupted, hands down they will pass the 5 percent mark.

With success on the way using a harm reduction approach, why take the whip to Māori and risk unintended negative effects? Support with aroha (love) has always been our preferred cultural way. And there’s the rub. It is the dated white-Western global tobacco control sector, intent on complete elimination of all tobacco and nicotine use, that wields the whip. They’ve been looking for a real-world environment where they could test their worst ideas, and New Zealand’s isolation makes us a perfect petri dish.

Māori, heavily overrepresented among lower-income groups with the highest smoking rates, will bear the brunt.

Taking advantage of a political party mostly new to governance and keen on authoritarian rule, prohibitionists have had their complete wish list adopted. As with much recent legislation, the new Smokefree law is likely to be pushed through parliament next year under urgency.

And make no mistake, the negative consequences for Māori, at a time of increased racial tensions, are likely to be severe. Every previous form of drug prohibition around the world provides a case study. People won’t all just stop using what’s banned; they won’t all just switch to vaping when we know that it can take people years, and that many never do.

Illicit markets will scale up to fill the void where there should be a regulated market. Competition over such markets can bring violence, and Māori, heavily overrepresented among lower-income groups with the highest smoking rates, will bear the brunt. The government response to illicit sales will mean criminalization and arrests, further swelling the grossly disproportionate numbers of Māori who are incarcerated.

With smoking rates highest among the most deprived groups, there is a clear prospect that they, and people who resist being bullied to change, will experience increased marginalization. The illicit tobacco market here has already grown due to the high price of tobacco. In anticipation of its further expansion, the proposed law will ramp up policing and fines.

A recently passed law banning smoking, vaping and use of smokeless products in vehicles when minors under 18 are present set a precedent for fining consumers directly. It is likely that we will now see more people fined for sharing their tobacco with partners or family members, for example, who fall under the legal age for purchase.

Though not indicated, it is likely that the final wording of the law will additionally ban growing or importing tobacco for one’s own use, both of which are currently allowed. Purchase of nicotine will likely be restricted too, to prevent people from doctoring low-nicotine cigarettes, and this will affect some people who mix their own e-liquids.

Our sizable Indian and Asian communities will be hurt economically, as they own the majority of the small retail businesses that sell tobacco. When raised tobacco taxes made cigarettes unaffordable for a large proportion of people who smoked, we saw a surge in aggravated robberies of such stores, in an illustration of ignored unintended consequences.

The abrupt cut in the nicotine strength of cigarettes will cause hundreds of thousands of people to go into withdrawals. Whilst some people experience mild nicotine withdrawal symptoms like restlessness, sleep problems and difficulty concentrating for a short period of days, others can experience severe symptoms. People with mental health conditions have disproportionately high smoking rates. For them, abrupt nicotine withdrawal could exacerbate their condition. Rather than days of discomfort, some people could experience an increase in depression and anxiety over weeks. People taking psychiatric medicines may need ongoing monitoring and dosage adjustments.

A legal risk-reduced product market can effectively eliminate smoking without prohibition and punishment. New Zealand was on track to do that.

Yet discussion of any negative effects of Smokefree 2025 is being ridiculed and suppressed in New Zealand, with the prohibitionist choir all singing from the same song sheet. They claim that society has reached a consensus that the proposed prohibition is socially just, progressive, even morally right. Only selected yes-men and women, dedicated prohibitionists or naïve newbies unschooled in critical thought, are “consulted” or given credence. Consumers are absent or ignored.

There is nothing kind about the plan. It is a dangerous precedent that will no doubt be copied to address other public health targets, such as sugar, fried food and alcohol.

As proven in Sweden and Norway, a legal risk-reduced product market can effectively eliminate smoking without prohibition and punishment. New Zealand was on track to do that. It is now taking a disastrous wrong turn.

Photograph by Marc via Flickr/Creative Commons 2.0

Both The Influence Foundation, which operates Filter, and the Centre of Research Excellence: Indigenous Sovereignty & Smoking, which the author founded, have received grants from the Foundation for a Smoke-Free World.

The post Desperate to Win the Smokefree Race, New Zealand Resorts to Prohibition appeared first on Filter.

We know now (mostly) the source of the bacteria or viruses that ravage young or old, well or ill, seemingly at random. But for much of known history, no doubt even before the Athenian Plague 2,450 years ago, shock waves of crippling and often quickly fatal infections were thought to be divine acts of retribution. 

Many reactions to the current pandemic mirror the psychological responses of our ancestors to similar threats.

Sometimes entire societies were obliterated, perceived to have been punished for their sinful way of life. Outcast segments of society—marked for some difference or disobedience—were often blamed. The Black Death and other plagues were a convenient rationale for the extermination of folk seen as pests by the dominant.  

Many reactions to the current pandemic mirror the psychological responses of our ancestors to similar threats. The fear of contagion and death raced ahead of the actual virus, as it did in times past, shocking politicians and the public into the most extreme act of mass quarantine ever. Everyone was marked a potential carrier. This didn’t stop the urge to scapegoat: China, immigrants and ethnic minorities, people who smoke or vape, and many other groups have become convenient targets.

Fear of infection, or worse the sense of panic that your child, partner or parent might be touched by the invisible COVID-19 wand of death, combined with uncertainty about the future, was stressful enough for anyone. But people higher up Marmot’s social ladder stocked the cellar, bunkered down and ordered in anything they needed. Some cheered for the lockdown and the mental space and family time it offered. They might clink their glasses together a bit more than usual during lockdown, but psychologically they’ll be fine. 

Not so, the communities who are always last to benefit from the advantages of living in societies. Not so, the people who can barely protect themselves from everyday threats common at the bottom rungs of the ladder, where stress and powerlessness are life. Especially hard hit are the people who didn’t have jobs that could be done remotely and the workers laid off en masse. Add the extra threat of disease and it’s just one more reason to smoke, have another drink or use other drugs to cope.

We’ve long known this. Research* on the effects of the 9/11 terrorist attack on the World Trade Center and Hurricane Katrina and other disasters around the world has shown that smoking, alcohol and other drug use (if supply hadn’t been cut off) went up during, and for a long time after, these disasters. 

To check if this happening again, my organization is conducting an international survey—which you can do here. We think public health could have done more to advise governments on how to lessen the negative impacts of the pandemic on mental health. 

Instead, prohibitionists within the public health sector seized the chance to advance their preexisting agendas. Around the world, they called for tobacco, vaping products and alcohol to be deemed “non-essential”—in the case of nicotine products, they claimed, without evidence, that they exacerbated the virus.  

This caused more panic among vulnerable populations who use these products at higher rates—increasing the triggers to smoke and drink. Despite protests, the government of South Africa completely banned the sale of tobacco and alcohol during lockdown forcing up to 20 percent of the adult population who smoke into mass withdrawals. Many more than that drink alcohol, and the natural outcomes of prohibition have occurred: looting of shops, disregard for lockdown rules as people are forced to go out hunting for alcohol, and harms associated with people brewing their own. 

Should we be surprised that it is the most marginalized communities who will be disproportionately impacted by both drug and lockdown rules, and that they will be further beaten down by enforcement, fines, criminal records? Not if we’re familiar with history. 

Denying people a vape, a tipple, or access to any drug they are dependent upon—with potentially lethal impacts—has nothing to do with preventing the spread of the coronavirus! It is no different to those acts of old when some people in power took the opportunity to throw a few extra bodies onto the pile of the infected. For people already clinging to societies’ lower rungs, it could turn out that the overindulgence in power by politicians and bureaucrats becomes the bigger killer. 

*Nandi A., Galea S., Ahern J., & Vlahov D. Probable cigarette dependence, PTSD, and depression after an urban disaster: Results from a population survey of New York City residents 4 months after September 11, 2001. Psychiatry: Interpersonal and Biological Processes, 68, 4, 299-310. 2005. 

*Erskine N., Daley V., Stevenson S., Rhodes B., & Beckert, L. Smoking prevalence increases following Canterbury earthquakes. Scientific World Journal. 1–4. 2013.

The Centre of Research Excellence: Indigenous Sovereignty & Smoking, of which the author is director, has received grants from the Foundation for a Smoke-Free World (FSFW). The Influence Foundation, which operates Filter, has also received grants from FSFW.

Photo of a miniature by Pierart dou Tielt, circa 1353—“The people of Tournai bury victims of the Black Death”—via Wikimedia Commons/Public Domain. 

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Sara Greene, associate professor of law at Duke University, thinks there is. She argues that too often state and local governments impose laws and regulations that cumulatively⁠—and too often “invisibly”⁠—hurt the very people we ought to be trying to help. From driver license suspension to eviction laws, these revenue-generating punishments disproportionately criminalize poor Americans and perpetuate the spiral of poverty.

One such new example is the trend toward criminalizing the ownership and use of e-cigarettes and other vaping products. With an uptick in teen vaping, lawmakers across the country have been proposing everything from excise taxes to flavor bans as a means of curbing teen access. Some municipalities are taking even more drastic steps. Both large cities like San Francisco—as well as smaller townships like Morristown, New Jersey—have introduced legislation to ban the sale, or even the possession, of e-cigarettes. The town of Brookline, Massachusetts, passed a provision this month to ban e-cigarettes—yet left traditional cigarettes on the shelves—creating yet another way otherwise law-abiding citizens may find themselves in trouble.

Applying Greene’s theory, bans on e-cigarettes and vaping products will contribute to a snowballing strain on those who can afford it least.

Certainly the problem of teen vaping is something to take seriously; but vaping is intended to be a safer alternative for adult smokers. By making it harder to access a product like e-cigarettes, government doesn’t eliminate the need for vaping—it simply forces customers to turn either to an easier product to purchase (ironically, cigarettes), or to an illicit market (which is what’s happening in Australia). When individuals start operating outside of a regulated marketplace, however, it almost certainly leads to overactive policing, as well as the increase of civil penalties in the form of fines, or even criminal penalties.

Applying Greene’s theory, bans on e-cigarettes and vaping products will especially affect the poor, contributing to a snowballing strain on those who can afford it least. In addition to the penalties some might face, vaping bans will have a detrimental effect on public health—especially among these poorer communities.

Out of the nearly 500,000 deaths caused each year in America by smoking cigarettes, low-income people are disproportionately affected. According to the CDC, “people living below the poverty level and people having lower levels of educational attainment have higher rates of cigarette smoking than the general population.”

The Cato Institute echoed this sentiment in a recent policy paper. The author comes down hard on “regressive regulation” like e-cigarette excise taxes and notes that, “smokers earning less than $30,000 per year spent 14.2 percent of their household income on cigarettes.”

What’s more, people who are poor are the most likely to use e-cigarettes. A study published by the International Journal of Environmental Research and Public Health found that more than 10 percent of houses with a family income of less than $19,000 have used e-cigarettes, whereas only 5 percent of families with an income of $75,000 or more use e-cigarettes.

All of this is significant because e-cigarettes are a leading form of harm reduction for adult smokers. In 2015, Public Health England determined that e-cigarettes are 95 percent less harmful than combustible tobacco. This year, a study published in the New England Journal of Medicine found that e-cigarettes were almost twice as effective as other nicotine replacement products. Switching from traditional cigarettes to e-cigarettes can dramatically improve public health—especially among the poor.

State and local taxes contribute to what Associate Professor Greene describes as a “mechanism through which poverty is perpetuated and upward socioeconomic mobility is stunted.” Banning vaping products outright will put more individuals who are choosing to use a healthier alternative to cigarettes at risk of committing a potential violation of the law.

In the case of e-cigarettes, when the poorest in society are those most affected by the harmful effects of cigarette smoking, we ought to be seeking ways to help people quit, not ways to increase financial strain—a key driver of smoking.

This article was originally published by InsideSources.

Photo by by Airman 1st Class Erica Crossen via US Air Force

The post Criminalizing E-Cigarettes Perpetuates the Spiral of Poverty appeared first on Filter.

Concept: M Glover; Artwork: Burnt Orange Ltd

Having found an offender, depending on their biases and mood at the time, the officer can choose whether they just give a warning, give stop-smoking advice and a referral to a cessation support service, or issue a NZ$50 fine.

Over half of women in prison in New Zealand are Māori. Smoking rates among Māori mothers of children under 18 are the highest in the country.

The latter is the most likely outcome for Māori women, given the well documented problem of racial profiling by police. Over half of women in prison in New Zealand are Māori. Quite apart from that, Māori women will be disproportionately harmed by this law change purely because they are over-represented among the most vulnerable and poorest groups in society, who smoke the most. Smoking rates among Māori mothers of children under 18 are the highest in the country, and depending on the socio-economic area, will range upwards from the Māori female average of 38-50 percent or more. For context, only 12 percent of European (mainly white) New Zealand women now smoke.  

The proposed law will also require police to check parked cars. In New Zealand—where smoking is banned in nearly all indoor places, many outside town centres, parks, beaches, hospital grounds and university campuses—cars have taken on new significance for people who smoke. Vaping, a crucial form of non-coercive harm reduction, has also been banned, or is set to be, in all these places. With the law change, smokers might close their car windows when smoking, potentially increasing the potency of the sidestream smoke for the occupants.

New Zealand society, the government claims, wholeheartedly supports the proposed law change. A range of surveys report from 63-96 percent support. But the survey questions were all highly leading, providing no hint of the negative consequences that could result if the law was passed—including jail time for failure to pay fines—or the certainty that these consequences will be racially disproportionate. Participants were led to think only of very young children, and were not told they’d also be supporting banning vaping in cars. Any fair-minded but uninformed person would be likely to tick “yes” to questions framed this way.

Neither were respondents asked to ponder the opportunity cost of making the police enforce such a law—the cumulative effect of the time and money that will have to be redirected away from other things the police could be doing. Like investigating violent assaults against women.

Adopting positively focused measures like encouraging risk-reduced alternatives to smoking would be far more effective at reducing harms.

New Zealand has a great reputation for being a very safe country to visit and live in. We do however, suffer shockingly high rates of child abuse and suicide. Violence against women is a persistent scourge.

When victims of crime have to take to Twitter to get police to investigate an aggravated home invasion, or protest naked on the streets—not just for themselves, but for all victims of violence who are being waved away like annoying flies—we have a major problem with our priorities.

Appropriating police time to selectively harass, criminalize and punish vapers and smokers and foist cessation advice upon them—as if it would be likely to work in that context—for something that is a dwindling cause of harm is seriously warped. Doing so at the expense of police work that should be prioritized is a failure of justice.

Adopting positively focused measures like encouraging risk-reduced alternatives to smoking would—as we have seen in countries like the UK—be far more effective at reducing harms without increasing the racially biased trauma of heightened police intervention.

Top photo by Michael Skok on Unsplash

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Shouldn’t this be equally true when it comes to tobacco? That not only should we seek to reduce harm caused by smoking or chewing tobacco, we should also seek to reduce harm caused by tobacco control policies? Because believe me, those harms are real and severe.

Progress will be difficult. The relationship between tobacco harm reduction advocates and tobacco controllers legislating against snus and vaping is badly strained. We both started with the same desire to reduce the number of people suffering from tobacco-related illnesses. That was the purpose of the World Health Organization’s Framework Convention on Tobacco Control.

Where we have diverged is over what we are willing to do to people in order to stop them smoking.

International Punishments for Smoking

There are some extremes that both sides oppose. For example, it is unlikely anyone today would support the use of the death penalty for smoking tobacco. Ming Dynasty Emperors in the 1630s thought execution was an acceptable deterrent for possessing or using it. Perhaps Emperor Chongzhen had a dream one night showing him the future when China would have the most smokers in the world, with 1 million of them a year dying prematurely as a result.

But how about something less extreme? Being separated from your child, for many people, is a living hell. Forcibly removing a child from their parent can be traumatic, and can lead to ongoing psychological distress for both parent and child. Surely no one today would condone removing children just because the parent smoked?

Actually, the fact that a parent smokes has been used to influence custody decisions, particularly when the child had asthma. In some jurisdictions, adoption applications from smokers are rejected. Smoking is also used as a reason to deny people access to fertility treatments that could help them have a child.

This was a brutal signal that Australian tobacco control had fallen into a draconian abyss.

Another way in which parents who smoke can be separated from children is through incarceration. Obviously, people only get incarcerated if they’ve committed a crime, or are accused and awaiting trial. No one is sent to prison for smoking tobacco. Or are they?

In June 2017, a Tunisian man was jailed for a month for smoking in public during Ramadan. And a few other countries are threatening smokers with prison sentences; for example, South Africa is considering a three-month sentence if a smoker lights up in a public no-smoking area!

A sign in Japan threatens a fine for smoking in the street.

To compound matters, many countries fail to distinguish between smoking a cigarette and vaping, and they’re fining people for doing either in smoking-restricted areas.

Thailand is notorious among vapers who travel for its ban on even possessing an electronic cigarette. In 2017, a Thai woman was violently arrested when a vaporizer and a bottle of e-liquid were found in her car. In January this year an elderly Israeli couple travelling in Thailand were detained and fined for vaping.

In 2011, West Australian police raided the online Heavenly Vapours operator Vincent Van Heerden’s home. His stock was confiscated and he was convicted and fined for possessing and selling vaporizers and non-nicotine e-liquid. This was a brutal signal that Australian tobacco control had fallen into a draconian abyss.

Over the Tasman Sea, where I live, the New Zealand Government, which historically has entertained Australia’s advice, at first said nicotine e-liquid was banned. The two countries had a loose agreement to align their tobacco control policies. Thankfully, New Zealand veered away from prohibiting smokers’ access to hugely risk-reduced alternatives to smoking.

Unintended Consequences of Excessive Taxation

New Zealand and Australia are aligned, however, on gouging taxes. Tobacco downunder is the most expensive in the world; for instance, a leading-brand pack of 20 cigarettes costs AU$28.95 (US$20.92) in Aussie.

As we see in many other areas of drug policy, badly conceived laws have negative unintended consequences. Unsurprisingly, trade in illicit, untaxed tobacco is booming in Australia, while overall smoking rates are barely shifting, and for some groups are increasing.

People instead began looking for cheaper tobacco and chop chop. But the unintended consequences didn’t stop there.

The equivalent illicit market in NZ has been limited, due to our being a relatively small island nation with vigilant border control. Bringing back cartons of duty-free cigarettes from abroad has long been a common way for NZ smokers to get around the high tax on tobacco at home.

In 2015, however, the duty-free allowance was cut from 200 to 50 cigarettes per person, and customs also cracked down on carrying tobacco other than for personal use. Months later, in 2016, New Zealand applied yet another tax hike to tobacco. A pack of 20 of the same leading-brand cigarettes now costs NZ$28.90 ($US19.92)—almost identical to Australia. That turned out to be a tipping point.

Legal tobacco was now unaffordable for many more already financially stretched people. Did they miraculously just quit, like public health campaigners said they would? No. They either had tried and tried and hadn’t been able to quit, or they didn’t want to stop smoking.

People instead began looking for cheaper tobacco and chop chop (home grown). But the unintended consequences didn’t stop there.

A craze of aggravated robberies of convenience stores and petrol stations for tobacco began. Gangs of youths drove stolen cars up to or into shops. If shopkeepers wouldn’t open the locked tobacco cupboard, they were threatened and occasionally bashed until they did. All over the country, people began to be caught, fined and sent to jail for stealing, selling or smuggling tobacco.

Lack of affordable tobacco for people who can’t stop smoking, or don’t want to stop—a form of financial prohibition—became a significant new cause of crime, just as general drug prohibition has been shown to drive violence and crime.

Criminalization and Racial Targeting

Some other extreme tobacco control policies that Australia has already implemented are being heavily pushed in New Zealand. Criminalizing and fining smokers who puff up in cars when under-18s are present is one.

New Zealand has not yet fined a smoker for lighting up in a legally designated smokefree area. We used to understand that smoking is a highly addictive behavior, so fining people for smoking could have seemed a bit unsympathetic and that’s not very Kiwi. Being downright psychopathic towards smokers would have lost us public support for the Smokefree 2025 dream (a smoking prevalence of 5 percent or below). The onus, and if necessary fines, were instead put on organizations and employers. It was up to them to make it clear when an environment was smokefree. Similarly, it is retailers who sell tobacco to minors—not the minors trying to buy the tobacco—who are fined.

The new approach heads in the opposite direction. Criminalizing people who smoke, in their vehicles in the presence of a minor, for instance, represents a complete paradigm shift from provision of care to policing health. It reframes smoking as a criminal act rather than the public health problem that it is. It denies smokers their rights under our Health and Disability Act to be treated with respect, to be supported to choose between a range of evidence-based interventions, like vaping.

Māori mothers will be disproportionately penalized.

Criminalizing smokers also risks widening the social and economic disparities between the politically dominant white population and the large Māori (indigenous) and Pacific Island groups in New Zealand. Due to colonization and historical and systemic discrimination, Māori are over-represented among the poorest and most marginalized groups. As a result, Māori women have NZ’s highest smoking rates (38 percent) of any adult ethnic male or female group. Rates are highest among 18–to-50-year-olds—that is, people who tend to be parents.

A further problem for Māori is exacerbated by a move toward policing smokers: racist profiling by police. Half of the women imprisoned in New Zealand are Māori. If the government moves to fine smokers, it’ll be Māori mothers, likelier than men to be driving children around, who are disproportionately penalized. And what happens if you can’t pay your fines? Imprisonment.

People Can Know Better

Surveys presented to politicians suggest that up to 95 percent of people support banning smoking in cars when minors are present. The participants, however, were given limited tick-box questions stripped of context. They were not told of the potential harm the policy could do, especially to Māori. They were not told that Māori women smoke at three times the rate of their white female counterparts, and are therefore disproportionately targeted by such a proposal.

The politicians weren’t told of the glaring biases inherent in the surveys: that the questions were leading, that the people who would be hurt the most by the results were under-represented among respondents; and that social desirability bias would have been through the roof.

Only 16 percent of New Zealanders smoke. After 40 years of anti-smoking campaigns like the one above, designed to destroy any shred of empathy for people who smoke, a biased survey could probably net 95 percent support for the harshest of punishments, including taking children away from their parents.

I refuse to believe, however, that fully informed New Zealanders would support a policy that will become just another gateway to prison for young, poor and marginalized Māori.

The widespread support for legalizing harm-reduced alternatives to smoking shows that the New Zealand public are woke on this. A harm reduction approach is seen as sane and reasonable. It’s also seen as logical to give the new way a go. To do that we’ll need to make sure the poorest and most vulnerable high-smoking groups get access to risk-reduced alternatives. Public health campaigns, too, could switch—from stressing how tough it can be to quit, to showing how easy it can be to vape instead.

Consistent with a harm reduction approach, the draconian policies should be binned. Why hurt people if you don’t need to?

Top photo by JEFF VRBA on Unsplash

The post We Need to Reduce the Harms of Draconian Tobacco Policies appeared first on Filter.

Of course not! I said. Smoking is totally different to obesity! Most people who drink alcohol aren’t addicted! I thought they were being misled by industry lobbyists.

How naive was I?

This year’s World Health Organization (WHO) Conference of the Parties (COP8) is currently taking place in Geneva. Dr. da Costa e Silva is head of the secretariat of the WHO Framework Convention on Tobacco Control (FCTC)—which was adopted in 2003, came into force in 2005 to restrict all forms of tobacco use, and is legally binding in 181 countries.

She reportedly said: “We hope [COP8] will be the starting point [for] a wider application of the FCTC as an international Treaty that extends beyond tobacco control to support strategies aimed also at promoting [Social Development Goals] & protecting environmental resources.” (My emphasis.)

“We hope the #COP8FCTC will be the starting point x a wider application of the FCTC as an international Treaty that extends beyond tobacco control to support strategies aimed also at promoting #SDGs & protecting environmental resources”-Dr. @vera_dacosta Head WHO FCTC Secretariat pic.twitter.com/BFSWurGIkP

— WHO FCTC (@FCTCofficial) October 1, 2018

The FCTC was the first international treaty addressing a health issue. The WHO, with the support of public health academics, was able to launch such a ground-breaking global initiative because there was robust scientific evidence that smoking tobacco caused disease.

The evidence is simply not there to support using a heavy-handed international juggernaut like the FCTC to demonize sugar like we demonized nicotine—to ban wine (watch out, Italy), or to deny people jobs, accommodation and a day at the beach because they’re now classified as obese.

Imagine how Thailand would enact a FCTC-like treaty aimed at reducing obesity. Perhaps threaten 10 years’ jail for possession of donuts? It sounds ridiculous. But that’s what they do now to people caught with an electronic cigarette!

In Australia, they’d run multi-million dollar fat-shaming campaigns, saying “Every sausage roll is doing you damage.” You think I’m joking. But the campaign exists now, though it’s confined to Western Australia. Thankfully, academics concerned about the ethics of stigmatizing overweight people have stopped the campaign from going national.

No one cared about ethics when we did the same thing to smokers. Our campaigns inciting hatred towards cigarette smoke were so effective that no one cared if we completely banished smokers from society. They’re all weak-willed losers anyway—that’s what tobacco control campaigns taught the public, politicians and doctors.

Two generations on, the FCTC is a runaway train. The newcomers to public health, that we veterans trained, uncritically swallowed our exaggerated health warnings. They were only too ready to pillory smokers and win awards at global conferences for doing it. They didn’t need to read the research; we’d done that for them. Now they seem to have foregone that skill altogether.

Twenty-five years ago, the much smaller tobacco control community that I joined was already working towards the foundation of the FCTC. Large international consultation meetings were held with different interest groups. In the late 1990s I attended the women’s meeting in Osaka, Japan. The focus then was on reducing morbidity and mortality—on reducing the incidence of lung cancer, cardiovascular disease, stroke and oral cancers. The initial purpose, and the mandate for the FCTC to be established, was that it would reduce harm.

It’s a very different world today. Technology has advanced everything we do. Cessation products have come and gone. But today, we have a wide range of tobacco and nicotine-delivering products that don’t result in the suffering and premature death that we railed against in the past. A new industry, built by ex-smokers turned to vaping, presented the first real threat to the traditional tobacco industry, whose profits had previously been largely unaffected by our glacially slow progress of reducing smoking by an average of 0.5-1 percent per annum.

There was a knee-jerk reaction to ban their new products, and if necessary, punish smokers for using them. We didn’t want to get sucked in again like we did when the tobacco industry sold everyone on their “light” and “low tar” products, which didn’t end up reducing harm at all.

The full weight of the WHO and billionaire philanthropist Michael Bloomberg have been called upon to stamp out what has been incorrectly portrayed as just another tobacco industry tactic. Reportedly, the countries signed up to the FCTC have agreed that “all harm reduction is industry interference”!

Q: Why was @INNCOorg ejected from @FCTCofficial #cop8? They applied formally and met all criteria.

A: FCTC knows they embrace “new products” that claim to be “harm reduction products.” And all harm reduction is “industry interference.”

— Charles A. Gardner, PhD (@ChaunceyGardner) October 2, 2018

Any group known to support “new products” are marked as “industry,” even consumers. All non-medicinally approved tobacco or nicotine products, regardless of their risk profile, are deemed to be the same as the combustible commercial cigarette. Now this is ridiculous.

Ironically, it was this kind of public-health sabotage of the fledgling vaping industry that gave the cigarette companies enough time to catch up and release their own range of risk-reduced alternatives to smoking.

The new world of relatively harmless (certainly compared to smoking) recreational nicotine use has arrived. The big players driving smoking prevalence down at rapid drops like we’ve never seen before are—shock horror!—companies that make vaping products. They don’t describe vaping as “cessation,” of course, because we don’t allow them to make any health claims. God forbid that they should actually help anyone quit smoking.

The “conversion rate,” as they call it, of smokers to risk-reduced nicotine users makes my eyes water. Using a retail model, salespeople and peer-to-peer coaching to ensure successful complete transition, tens of millions of people now snus, vape, or heat-not-burn their tobacco rather than smoking. This exodus, in countries and cultures as diverse as Iceland, Japan, France, the USA and the UK, is so massive, so quick, that smoking prevalence statistics are out of date before they go to print.

The FCTC, penned last century, is seemingly stuck there. It’s time it was thoroughly overhauled—not copied to be inappropriately applied to dissimilar concerns. And this should be done not by people stuck in a past that doesn’t exist anymore, but by scientists, innovators and leaders who can see that a smoke-free future is within our grasp.

I’m proud that New Zealand has that vision. Our delegation reported to COP8 that New Zealand will be introducing risk-proportionate regulation. Adoption of a harm reduction approach is also well underway. Will this cause delegates from other countries to question the FCTC Secretariat’s prohibitionist guidance? In the short-term, probably not. The dictates to come out of COP8 will likely rattle with extremism typical of a despot who knows their time has come. Why else would they start laying the ground for a future direction “beyond tobacco control”?

[The main image shows signatories (green) and parties (orange) to the FCTC.]

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