Smoke and Mirrors: Orwellian Echoes of 1984
WHO Promotes “Doublespeak”
Liquid is smoke. Products that do not contain tobacco are tobacco products. If these statements have a familiar ring, it is because you may remember reading George Orwell’s Nineteen Eighty-Four… or at least heard about it. In Orwell’s dystopian future, 1984, the totalitarian government of Oceania promotes “Doublespeak” as a means of thought control.
Doublespeak was a way to communicate Doublethink which, according to Orwell, is “to know and not to know, to be conscious of complete truthfulness while telling carefully constructed lies, to hold simultaneously two opinions which cancelled out…, to use logic against logic, to repudiate morality while laying claim to it…” The most well-known examples of Doublespeak include “War is Peace” and “Freedom is Slavery.”
Strangely, the leaders of the world’s first (and, so far, only) global health treaty are now actively working to revive such “Orwellian” ideas. In the lead up to the 2021 November 9th Conference of Parties (COP9) of the Framework Convention on Tobacco Control (FCTC), the FCTC Secretariat has released background documents. The latest one is a doozy. Its name: FCTC/COP/9/10 “Challenges posed by and classification of novel and emerging tobacco products.” It includes these Doublespeak gems:
- E-cigarettes (which contain no tobacco) are tobacco products,
- Liquid aerosol (vapor) is smoke.
To understand where the FCTC’s Newthink (yet another 1984 term) comes from, we need to try to think as they do. Worldwide, 1 billion people smoke. Despite the FCTC’s best efforts, global smoking rates have not dropped. Smoking kills 8 million people every year, more than HIV, TB and malaria combined. The World Health Organization (WHO) projects that one billion people will die from smoking before the end of this century.
So, obviously, that’s bad. Very bad. Inhaling smoke causes most of those deaths, so smoke is bad. Tobacco products produce smoke — which is deadly — so tobacco products are bad. And, obviously, tobacco companies make tobacco products. So tobacco companies are bad. Very very bad.
So far, so good! Actually, most of us adult ex-smokers who use and advocate for safer nicotine alternatives share these concerns. Our primary focus is on preventing preventable deaths, but more than two thirds of us take a very dim view of the tobacco industry.
Doublethinking Harm Reduction
In almost every other aspect of life (and every other field of global health), the concept of “harm reduction” is embraced because, well… obviously, less risk of harm is good. Condoms reduce, but do not eliminate, transmission of sexually transmitted diseases. Masks reduce, but do not eliminate, the risk of SARS-CoV-2 transmission. Seat belts reduce the risk of death and injury from car accidents, but are not 100 percent effective in preventing injuries or deaths. Bicycle helmets… and so on.
The Joint United Nations Programme on HIV and AIDS (UNAIDS) does a very good job of explaining the concept of harm reduction in its 2019 report, Health, rights and drugs — Harm reduction, decriminalization and zero discrimination for people who use drugs. Perhaps no one in the FCTC Secretariat has read it?
The FCTC Secretariat rejects harm reduction for people who use nicotine. They assume it is propaganda ploy of the tobacco industry (which, as we established above, is bad). Therefore, tobacco harm reduction must be bad. In all FCTC Secretariat speeches and publications, the words “harm reduction” always, and only, ever appear in close proximity to the ominous words, “Industry interference.” Tobacco industry interference would, obviously, be bad.
Industry interference in any public health policy may be profoundly bad for the public good. But let’s set that aside for the moment. Here, we are just trying to understand the FCTC worldview as it relates to tobacco harm reduction (THR):
FCTC Secretariat Worldview
Tobacco smoke is deadly
Therefore: Tobacco smoke is bad
Therefore: All tobacco is bad
Therefore: The tobacco industry is bad
Therefore: Tobacco industry interference is bad
THR is industry interference
Therefore: Tobacco harm reduction is bad
There are some curious problems with that logic. For example, one of the top makers of snus, a smokeless tobacco that is at least 98% safer than smoking (i.e., THR) was the first tobacco company on Earth to stop selling cigarettes. And that’s not bad. And nicotine vape products (“e-cigarettes,” which are also THR) were not invented by tobacco companies. Most vape firms are independent of big tobacco. And while some tobacco companies have now acquired e-cigarette product lines, that does not logically imply that the whole product category should be painted with the same “bad” brush.
The logical scheme described above is a good summary of the FCTC Secretariat’s worldview. It is problematic, so they now find it necessary to resort to Orwellian Doublespeak. The first step then, was to call all “novel and emerging nicotine products” tobacco products. Once the public, journalists and policy makers understand this, the next logical step should be to tax, ban and stigmatize them accordingly.
Is Nicotine Bad?
Twenty years ago, when the FCTC was negotiated, there was only one safer nicotine consumer alternative: ultra-low nitrosamine (low-carcinogen) snus. Snus had been used safely in Sweden for decades (coincidentally, Sweden now has, by far, the lowest smoking rates, and smoking-related disease rates, in the European Union).
There were also some safer nicotine pharmaceutical products: Nicotine patches, nicotine gum and (more recently) nicotine lozenges. In most high-income countries, these Big Pharma products are available over-the-counter in every pharmacy. They are on the WHO’s Essential Medicines List.
Post-marketing surveillance shows that these nicotine replacement therapies (NRTs) do not cause cancer, heart or lung disease. The US Food and Drug Administration says that they are not dependence-forming or subject to abuse. However, as with any medicine, the small print on NRT packaging identifies numerous potentially harmful side-effects. These safer nicotine products for adult smokers are not harm-free. So they, too, are tobacco harm reduction (THR) products.
It is important to point out here that nicotine gum and lozenges are both, literally, candy. They come in fruit, cinnamon, mint and menthol flavors. There is no tobacco-flavor because, presumably, pharmaceutical companies know that no smoker who wants to quit would ever buy that.
Vapor is Smoke
Over the past 15 years, innovation has led to an increasing armamentarium of safer nicotine consumer product alternatives for adult smokers. These now include nicotine pouches (tobacco-free snus), heat-not-burn tobacco products, and nicotine vapes (“e-cigarettes”). Since every smoker is different, it seems logical to assume that more options to quit should be good for public health.
Of all these relatively new safer nicotine options, nicotine vapes (“e-cigarettes”) are by far the most controversial. They have been used safely for 15 years now, and the best current estimate is that there are 68 million adult nicotine vapers worldwide. E-cigarettes deliver a liquid aerosol which is most commonly called “vapor.”
So, let us return to FCTC Doublespeak: Because nicotine vapes are harm reduction, and harm reduction is “industry interference,” the FCTC Secretariat now proposes to redefine vapor as smoke. Presumably, this will help influence (control) the thoughts of the public, journalists and policy makers. Here is their argument that liquid vapor should be re-classified as smoke:
Can the aerosols of novel and emerging tobacco products qualify as “tobacco smoke”?
11. Yes. In general, smoke is produced whenever substances are heated beyond a temperature at which pyrolysis occurs, whether such temperatures are achieved through combustion or other means. For example, heating cooking oil to high temperatures in a cooking vessel …on an electric stove, that is without combustion. …Aerosols emitted by heated cooking oil are a health concern because they include toxic thermal degradation products, such as volatile aldehydes…Another example is provided by electrical cables that are overloaded; the aerosol emitted by the insulating plastic is called “smoke”, even when no fire is present. Thus, strictly speaking, visible aerosols deriving in whole or in part from thermally driven chemical reactions qualify as “smoke.”
NOTE: “Pyrolysis” is the thermal decomposition of materials at elevated temperatures. It comes from the Greek words “pyro” (fire) and “lysis” (separating). Obviously then, steam from a teapot is a “pyrolysis product” — which, when you put it that way, makes it sound scary.
Here is the logic behind this Newthink: Solid particulates from burning tobacco leaves, and liquid droplets (aerosol) from nicotine vape devices, are both “smoke.” Vapor is now smoke. And since smoke is bad, vapor from e-cigarettes (which, by the way, are “tobacco products”) must be bad. Very bad.
Got that? It does require some mental gymnastics. And yes, it is a simplistic and puerile worldview, but this Newthink to control thought is justified for the public good. They must understand there is no “continuum of risks,” and all nicotine products are equally “bad” … with the exception of nicotine in NRTs, which is obviously good (but pay no attention to the man behind the curtain).
Where does this logic lead? If gizmos that deliver nicotine without smoke are all tobacco products, then everything that contains nicotine should be called a “tobacco product.” That would include not only NRTs, but also chili peppers, cauliflower, potatoes, tomatoes and eggplants. If the molecule, nicotine, is a tobacco product, then potassium pills (dietary supplements) are banana products. If all products of pyrolysis are “smoke,” then exhaled breath on a cold winter day is also smoke.
Why Does FCTC Thought Control Matter?
The FCTC Secretariat’s recommendations to the 181 countries that ratified this global health treaty have a profound impact on laws in those countries, and regulations they enforce. The Secretariat also advises the WHO on tobacco control. The WHO has Country Offices in every country, and five Regional Offices around the world. All of these offices advise local governments.
In early November 2021, the week-long COP9 event will be virtual (due to COVID-19). Using the virtual nature of the event as an excuse, the FCTC Secretariat has unilaterally decided that there will be no discussion or debate on substantive issues such as:
- Whether nicotine vapes (“e-cigarettes”) are safer than smoking
- Whether snus and nicotine pouches are safer than smoking
- Whether heat-not-burn products are safer than smoking
- Whether all these products help smokers quit
NOTE: If the answer to any of the first three questions is “yes,” and the answer to the fourth question is also “yes,” then these products are profoundly different from recreational psychoactive drugs like alcohol or caffeine. In that case, rational public health leaders should embrace these safer nicotine options if they want to prevent horrible death from toxic forms of tobacco.
Since there will be no substantive discussion this November, the FCTC Secretariat’s Orwellian determination that liquid aerosol is smoke, safer nicotine alternatives are all tobacco products, and “harm reduction is bad,” will stand — uncontested — until COP10 in 2023.
This position contradicts the original intent of 168 countries that signed onto the world’s first public health treaty, and 181 countries that are now “party” to the Convention. The FCTC Secretariat is now taking unilateral steps to reject the language those countries negotiated and agreed to as part of the very definition of tobacco control:
(d) “tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke; (emphasis added)
Not to put too fine a point on this: The FCTC Secretariat has now gone off the rails. Their current position contradicts the position of 15 past-Presidents of the world’s foremost professional society in the field of tobacco control (all veterans of the war against big tobacco). It contradicts public statements from more than 60 respected scientific and public health organizations. And it flies in the face of the lived-experience of millions of adult ex-smokers who use safer nicotine.
The growing consensus among experts who have reviewed all the evidence is that nicotine vaping is significantly safer than smoking, and helps smokers quit. And it’s worth noting that the one country that takes the most favorable position on these questions, the United Kingdom, is, according to ExposeTobacco, is among the world’s countries least influenced by the tobacco industry.
The FCTC Secretariat’s recommendations to 181 FCTC signatories and parties to the world’s first-and-only public health treaty is, increasingly, Orwellian. Rejecting harm reduction alternatives for smokers is indefensible. It looks increasingly strange and divorced from reality. And just to be clear: If the FCTC gets this wrong, millions of people will die.
FCTC leader’s worldview is a strange mental pretzel that might be appropriate in Oceania, in 1984, but will be lethal in the real world. Safer nicotine alternatives compete directly with Big Tobacco’s main cash cow: Cigarettes. So, ironically, the FCTC Secretariat’s Doublespeak recommendations protect cigarette sales. And cigarettes kill. And that’s bad. Very bad.
In 1997, economist Bruce Yandle famously explained how national movements to prohibit and regulate “sinful behaviors” have often involved a convergence of moralists and industries that stand to profit from those prohibitions and regulations. His seminal paper introduced the term “Baptists and Bootleggers.” And this is where we are today. Unfortunately, history repeats.
Because of their moral animosity toward tobacco and tobacco companies, the FCTC Secretariat now seeks to blind the public to the original and laudable goal of the FCTC: To reduce tobacco-related death and disease. To push Newthink, as a means of thought control, they have invented a form of Doublespeak that, ironically, protects their arch enemy, Big Tobacco.
This is not 1984. It is 2021. Innovation has given us new options to help smokers, and people who use other toxic forms of tobacco, shift to safer nicotine alternatives. If we hope to avoid a dystopian future with a billion deaths this century, tobacco control’s Newthink needs a serious rethink.
Disclosure: INNCO is a non-profit organization that supports the rights of 98 million adults worldwide who use safer nicotine to avoid toxic forms of tobacco. INNCO is funded by individual contributions from thousands of adult ex-smokers, and by a grant from the Foundation for a Smoke-Free World (FSFW). The Foundation is a US nonprofit 501(c)(3) private foundation with a mission to end smoking in this generation. For more information, see their website. FSFW had no role in the planning or execution of this document. INNCO is independent of FSFW. Our mission, purpose and goals are driven by our Member Organizations all over the world. Those organizations are led by unpaid volunteers (ex-smokers) who, as a condition of membership, agree not to accept funding or direction from industry. The contents, selection and presentation of facts in this article are the sole responsibility of the authors.