Quit or Die: The anti-tobacco industry's history of opposing harm reduction
There is perhaps no area that better exemplifies Tobacco Control's tactics -- as well as their disdain for honest science and their fundamental lack of concern for human welfare -- as their responses to efforts to reduce the risk from tobacco/nicotine use. Their ongoing opposition to risk reduction (aka harm reduction; tobacco harm reduction (THR)) makes clear that while they might be part of "public health" (the political movement that has taken that name) they are not particularly concerned with public health.
The concept of harm reduction, which is generally accepted as wise practice in public health, refers to developing and encouraging methods that let people continue a chosen behavior (or a minor variation on it), but with much lower risk than it might otherwise have. The term developed in the context of drug use, where the clearest example is encouraging the use of clean needles among injection drug users, and providing needle exchanges to make this possible. Clean needles reduce to almost zero the risk of transmitting blood-borne disease, and thereby dramatically reduce the health risk from injecting drugs without requiring users to end the behavior. But harm reduction also describes seat belts and other safety features in cars, which reduce the risks of major injury or death from a risky behavior (motorized transport being one of the most risky voluntary activities most of us undertake) by more than half, without requiring that we give up or even reduce our driving.
But while public health advocates strongly support harm reduction interventions in activities that range from the use of cars to the use of heroin, the anti-tobacco industry has aggressively fought against harm reduction in the use of tobacco. Their position has been, and mostly continues to be, that smokers should just quit, and if they do not comply with that, then they should just be allowed to die from their behavior.
Genuine public health advocates have been arguing since the 1970s that encouraging the substitution of consumer-friendly, satisfying smoke-free alternatives (which until fairly recently was limited to smokeless tobacco) as a method of reducing the harm from smoking. By the start of the century, there was no doubt that any health risks from modern Western smokeless tobacco were trivial compared to smoking, and during this century a major tobacco harm reduction movement has arisen to educate smokers about these alternatives. However, those efforts have had limited impact, largely due to the mobilization of a concerted campaign of pseudo-scientific disinformation, regulatory interference, and personal abuse and intimidation by Tobacco Control. Switching to smoke-free alternatives does not appeal to many smokers, though many have never had a chance to possibly discover the appeal, thanks to anti-harm-reduction efforts by Tobacco Control. (Analysis of Tobacco Control's anti-THR tactics is continued via the preceding link.)
The anti-tobacco industry also has a history of resisting efforts to make less harmful cigarettes (e.g., the story of Gio Gori's efforts in the 1970s). Ironically, the one attempt to reduce the risk from cigarettes that Tobacco Control embraced, light cigarettes, turned out to be a failure, and the current support from some corners of the anti-tobacco industry to reduce smoke toxicity appear to have little to do with helping smokers (further details available via the links). Tobacco Control has also played a role in minimize research efforts to develop better detection and treatment for lung cancer.
There are several explanations offered for this behavior, and all are probably true to some extent. An obvious explanation is that the anti-tobacco industry is closely tied to pharmaceutical interests who would lose business for both their own low-risk (but generally low-quality) nicotine products as well as smoking cessation drugs. Additionally, many in Tobacco Control have become, or perhaps always were, more driven by hatred than compassion: They are more interested in harming the tobacco industry (parts of which would undoubtedly benefit from the replacement of cigarettes with low-risk tobacco products and reduced risk cigarette) than they are in helping smokers or even those who are exposed to ETS. Beyond that, many in Tobacco Control are not interested in people's welfare, people's health, or people at all -- they just want tobacco use eliminated out of some sense of religious fervor. The more intelligent among that faction realize that if low-risk tobacco products become popular, they will be here to stay (indeed, that already seems to be the case). Finally, there are a some who have devoted their lives to the Tobacco Control cause, and consciously or subconsciously do not want its supposed goals (reducing the harm caused by smoking) to occur in spite of their efforts rather than because of them; they would rather the efforts fail.
All of these motivations have one thing in common: They create the incentive to oppose anything that reduces the harm from smoking. Only by keeping the harm as great as it is can they justify their existence, but also that is the only way they have any chance of eliminating tobacco use. Smokers have an obvious major motivation to quit. Users of low-risk alternatives do not.
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