DEATH, MOST OF us can agree, is best delayed. But cigarette smoking is a major impediment to achieving such a delay. Indeed, cigarettes kill over 100 people in Ireland on a weekly basis, or about 30 times the still horrendous toll of Irish road deaths.
With cigarette smoking being by far the leading cause of death in the country, rushing such a product towards its own doom should be a national priority. All the more so if we could do so relatively easy while empowering rather than punishing people who currently smoke.
Well, the time to begin to finally stub out cigarettes might have arrived. It is based on three very straightforward facts and the application of some of the political vision that has brought us a host of past public health revolutions.
People smoke for the nicotine but die from the smoke
First, people smoke for the nicotine but die from the smoke. Cigarettes are a very dirty delivery system for a relatively low risk drug. They are the equivalent of getting caffeine by smoking rather than brewing tea leaves, or heating a building with an open fire but no chimney. The repeated inhalation of smoke, not the pursuit of nicotine, caffeine or warmth, ultimately kills.
Second, it is now entirely possible for people who currently smoke to get their nicotine from consumer acceptable products that obviate the inhalation of the products of combustion.
Vaping, also known as electronic cigarettes, is already very popular as a substitute for lethal cigarettes. These products are getting constantly better, and are used by ever growing numbers of people who seem to appreciate the advantages in saving both money and years of life. But there are many other options that could also be available.
These include existing products, such as the smoke-free tobacco product called snus that has given Sweden the lowest smoking rate in Europe, and products that heat tobacco rather than burning tobacco, that have now given Japan the world’s fastest decline in cigarette use. But there are also additional products soon to be introduced into the marketplace, and we can expect a plethora of additional ones as regulators seek to facilitate rather than stymie the transition away from lethal cigarettes.
Information is a powerful thing
Third, information is a powerful thing. People can only make as good a decision as the information available to them allows. To date it has been both unfair and outrageous that those pursuing an abstinence-only approach to nicotine have created undue fears about alternatives to cigarettes, and then held people who smoke to blame when they contract illnesses that could have been prevented had they switched.
Hence the need for political visionaries. Imagine if people who smoke were given truthful and non-misleading information on the relative risks of cigarettes compared to the various smoke-free alternative products. Imagine if these alternative products were at least as available as lethal cigarettes.
Imagine if highly differentiated taxation and differential marketing limitations were to give these massively less hazardous products a big marketplace advantage. Imagine if Big Tobacco had it made clear that failure to move expeditiously to provide their customers with these safer and less addictive products would lead to existential litigious and legislative repercussions.
We have an opportunity to do an amazing thing
Every so often, we get an opportunity to do something amazingly good for humanity. Ridding the world of smallpox was like that, as is the nearly-achieved effort to do the same to polio. Dealing with the carnage caused by cigarette smoking can now join such exalted company.
We have motivated consumers, viable existing products and ever better additional products under development. We have effective ways to communicate life saving information, and we have the policy tools to nudge the market towards far less hazardous products.
We have an opportunity to do an amazing thing for Ireland, and to help set precedents for the rest of the planet. We can enlist consumers and market forces into what can be the rapid demise of cigarettes. We can empower people to make healthier personal choices, thus ensuring that cigarettes meet their match.
Most importantly, we can assist hundreds of thousands of people in Ireland to significantly extend the length and quality of their lives. And that’s about as good a use of our own time and imaginations as we are likely to find.
David T Sweanor has worked globally for decades on policies to reduce cigarette smoking, and has also received Ottawa’s Outstanding Individual Philanthropist award in 2016. He will be chairing a public seminar in Dublin on 24 October at the O’Callaghan Davenport Hotel, Dublin 2. The speakers will include Martin Dockrell of Public Health England, and Gillian Golden of the Irish Vape Vendors Association. The event is free to attend, but registration is required. For more information and to register your place, click here.
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