Gosh, No Idea

Yesterday I saw a tweet which fair astounded me.

Wonder why these harm perceptions just keep going in the wrong direction? Gosh, no idea :( #UKCTAScpd pic.twitter.com/1nqHTl4HLt

— Linda Bauld (@LindaBauld) May 9, 2016

Bauld is no doubt referring to those in her industry who like to spread misleading information, junk science and lies about e-cigs, and she is correct to do so.

However, the world's prime promoter of such things - Mad Stan Glantz - has been a star in the tobacco control industry firmament for a very long time. Bauld and the rest of the UK tobacco control community have known he's a weapons grade lie machine for decades, but have been quite happy to let it all go without comment.

Glantz has been falsifying data and producing jaw-dropping junk research (like this, for example) since many of the current crop of career tax-sponging anti-smoking prohibitionists were in nappies, yet not one of these fine upstanding 'experts' and 'scientists' has ever bothered to pull him up on any of it before.

So there is some vague hint there by Bauld that some tobacco controllers like Glantz have been a bit naughty, but that'll be all it is; a vague hint. To make it any more than that would - quite rightly - call their own expertise and impartiality into question.

@CaeruleanSea His previous junk has been very useful to PH people. They can't suddenly admit that he's a clown.

— Christopher Snowdon (@cjsnowdon) May 7, 2016

Of course they can't, they've feasted on his crap for years and actively encouraged him. And that includes Robert West who produces the Smoking Toolkit study that the slide in that tweet is taken from.

The hypocrisy is staggering enough on its own, but let's consider something else. Y'see, for a long time the tobacco control industry has considered bans on the use of tobacco as being a prime tactic in the 'denormalisation' of smoking. Read World Health Organisation documents and public bans are regularly praised as being instrumental in making smoking unacceptable in the eyes of society.

Here's a good explanation of the concept.

Smoking restrictions, in addition to protecting non-smokers from the harms of environmental tobacco smoke, can contribute to denormalisation because they reduce the acceptability of smoking (Albers et al. 2004;Department of Health and Human Services 1991); in fact, some commentators regard smoking restrictions as the most effective way of denormalising tobacco use (Bell et al. 2010a;Brown et al. 2009). Many countries have now adopted legislation that bans smoking in work-places, restaurants and bars (Mackay et al. 2006) and, more recently, bans in outdoor spaces have also been considered (Chapman 2000; Bloch and Shopland 2000; Thomson et al. 2008;Colgrove et al. 2011). 

One mechanisms through which smoking bans can contribute to denormalisation is by reducing the general visibility of smoking. One study finds an association between the frequency with which youth observe smoking in different locations and the perception that smoking is socially acceptable; the authors conclude by recommending smoking bans specifically as a means of reducing the social acceptability of smoking (Alesci et al. 2003). Smoking bans in bars and restaurants also help undermine the association between smoking and exciting life-styles promoted by tobacco marketers (Hammond et al. 2006). Thus, smoking bans help establish non-smoking environments as the ‘norm’ (Brown et al. 2009). 

In addition, introducing smoking bans can in itself express and promote a negative attitude towards smoking and contribute to its denormalisation. As Glantz suggests, ‘clean indoor air legislation reduces smoking because it undercuts the social support network for smoking by implicitly defining smoking as an antisocial act’ (Glantz 1987, my emphasis).

Yes, that's the same Glantz in case you were wondering, 29 years ago!

The ways in which such bans are communicated can contribute further to these effects. For example,Chapman and Freeman emphasise that smoking bans on flights are announced in a way that emphasises that smokers are addicts:

At the start of every airline flight to, from and within Australia passengers are warned via onboard announcements that smoking is banned in-flight and, evoking memories of warnings given to schoolchildren about toilet-block smoking, an added warning is given that they must not smoke in aircraft toilets … When each flight ends, it is then seen as necessary to remind smokers that they cannot light up until they get outside the airport buildings. Again, the subtext of the message is plain: here are desperate addicts counting the seconds until they can smoke. (Chapman and Freeman 2008).

And there is Simple Simon too, presumably one of the people Bauld would blame for the public perception of vaping due to his Luddite attitude towards harm reduction.

Now, consider recent bans on vaping that we have seen. Erm, where was the public condemnation from those tobacco controllers who claim to be "supportive for quite some time" of e-cigs? They all know very well - because they have plotted for years to make it happen - that the smoking ban is the single most important measure for conning convincing the public that smoking is dangerous to bystanders.

Prior to the UK-wide ban there was an avalanche of articles pumping the line that passive smoking was harmful but the public really didn't care. They went about their daily lives watching soap operas, going to football, attending Weight Watchers, avoiding the news like the plague, all the usual stuff, but the vast majority would have barely read past a headline of a passive smoking article, and most just dismissed it anyway. They still went to pubs, met and socialised with smokers and simply weren't concerned.

There's a reason why ASH and the rest of their tobacco control chums were cock-a-hoop about the implementation of smoking bans in the UK ... because all of a sudden the state had legitimised what the tobacco control industry is well aware is a purposely-created myth. Few bothered to listen to them though, until the power of the state sent a loud message that a wisp of smoke is lethal.

Of all people in our society, ASH and the tobacco control industry are the most acutely aware of how damaging vaping bans are to the acceptability of e-cigs; yet they have sat on their hands and said absolutely sod all as ban after ban is installed. In Wales they even "fully welcome" such things and are unapologetic that the ASH Wales logo is on signs that tell the public that vaping has now been deemed a dangerous and abnormal habit which should be hidden from the eyes of children.

So Linda, if you want to know why "these harm perceptions just keep going in the wrong direction", it's very little to do with a few sparsely-read articles and the quotes of a few lunatics, it is far more the public perception which comes with vaping being banned on trains, buses, NHS premises, pubs, restaurants and just about everywhere else while your fellow "supportive" tobacco controllers do nothing about it. See, I'm pretty sure ASH and others know very well that the rantings of an aircraft mechanic from San Francisco will have far less influence on a housewife in Aberdeen than a vaping ban in a car park which, unsurprisingly, ASH Scotland have stayed staunchly silent about.

So why are those graphs going in the wrong direction while vape-friendly tobacco controllers say nothing? Why is public perception of the safety of vaping deteriorating, all the  while what tobacco controllers know very well is the most powerful denormalisation tool is employed against something they claim to support? Gosh, no idea!