by Carl V Phillips
In what Dick Puddlecote called “A New Low for Tobacco Control” (perhaps an overstatement given that is an incredibly high — or perhaps call it low — bar that is nearly impossible to achieve, but I see his point), Stanton Glantz and a few others told the New York Times that the reduction in the US smoking rate is due to such factors as removing smoking from movies and has nothing at all to do with THR. Since the headline and the topic of the story were “Why Smoking Rates Are at New Lows”, you might expect that the reporter would have learned something and talked to people who do not lie about THR. Of course, if you thought about it a little more, you would amend that to “the NYT reporter should have learned something about the topic and talked to real honest experts, but unsurprisingly, did not”.
The first thing to note is that about 90% of the time when news outlets with the biases of the Times (and by that I do not refer to usual erroneous claim that they are “liberal” in the political spectrum, but rather that the corporate media act as uncritical transcriptionists for what government and allied actors want the people to believe) report a reduction in smoking, they are just making a big deal about a statistical blip. There are many surveys that estimate smoking prevalence, and so in most any quarter it is possible to report on the “exciting new reduction in smoking” based on one of them. It is also possible to report quarterly on the “exciting new increase in smoking” when the statistical blips go upward — but, of course, no one does that.
That said, there is every reason to believe that there is real downward move in prevalence because of the growing popularity of e-cigarettes. Since almost all e-cigarette use is as a substitute for smoking, it is not hard to do the math. It is also worth noting that the very modest downward trend in smoking in the US for the decade or so before e-cigarettes started to become popular matched almost perfectly the increase in the use of smokeless tobacco (which remains more common than e-cigarette use).
In other words, it is very plausible to claim that basically all of the reduction in US smoking rates in this century is due to THR. Certainly if those of us who support THR were as innumerate and unethical as the tobacco control industry (TCI), we would be insisting that this was a definitive fact. This would be too bold a claim, but it is actually much better supported than the usual TCI claims, including most everything that appears in this article. As good scientists and ethical people, we can claim that THR might explain all of the reduction this century, and that it almost certainly did cause a large fraction of it.
With any legitimate conclusion based on statistics it helps to have a worldly story that is observable in the data, not just hand-waving stories about what a number represents (and only wild guesses about whether the data is accurate). For the most recent figures (as opposed to the statistical errors that created trumped-up claims for the previous decade), there is a very good reason to believe the decrease is real because we can see exactly what is happening: Many smokers are switching to e-cigarettes, and very rapidly.
So what do Glantz and the other “experts” that the NYT talked to attribute the decrease to? Hand-waving stories, of course.
As proof that the NYT reporter, Sophie Egan, was just acting as an unquestioning transcriptionist, note the mention of the claim that “researchers” say that seeing smoking in movies is a major cause of smoking, and thus Glantz’s campaign to reduce such images somehow has something to do with the reduction. Of course, it does not appear that anyone other than Glantz and his beholden useful idiots actually believes that, and even hard-core TCI people have pointed out that it is nutty.
On the reality-based side, higher taxes are identified as a barrier to smoking. Of course, in some places they are also a barrier to THR, but I am sure nuances like that are well above the understanding of the author or interviewees. Also, given that this is an article about a prevalence statistic, it would have been nice to see (but obviously way too much to expect, given the limited sophistication of those involved) some mention of the concern that use of the black market created by those taxes may increase measurement error on the surveys (i.e., it is plausible that people who buy contraband will wisely choose not to admit that when the government asks, though we do not know).
Someone other than Glantz reported the plausible claim that smoking place limitations result in the reduction in the number of cigarettes smoked by smokers. The obvious point that this does not actually relate to the thesis of the article — about prevalence being down — seems to elude Egan. But though a tangential point, it does seem to be real and the reduction is better for smokers’ health. Funny, though, that there is no mention that Glantz is the one leading the charge to deny that reducing smoking is good for your health. This does not mean that the restrictions are better for smokers’ overall welfare, in contrast with THR. Of course, to Glantz, their suffering is a good thing, which in the article he notes with, “It also creates environments that make it easier for people to quit smoking.” Yeah, that’s it — easier. As in “the beatings will continue until morale improves, because beatings make it easier for you to decide you had better obey.”
But the most important lie in this article (again, reported by Egan in her role as an unthinking transcriptionist) can be found here:
“The fact that we’re below this theoretical sound barrier of 20 percent is important,” says Stanton A. Glantz, a professor of medicine at the University of California, San Francisco, and director of the university’s Center for Tobacco Control Research and Education. “This data shows that the whole premise that there is this hard-core group, where no matter what you do you can’t get them to quit, is just not true.”
That “20%” claim sounds rather like the observation I have been pushing for a decade. But, if that is what Glantz is invoking, he (unsurprisingly) does not seem to understand it. What I have been claiming (and what one of my colleagues wanted to label “Phillips’s Law”, but since I am really averse to naming transitory social science observations “laws”, I vetoed that) is that once smoking becomes popular in a population, it is nearly impossible to reduce it below 20% of the population except as a result of product substitution — i.e., THR. That is, a huge body of data strongly suggests that roughly 20% of the population gets such great benefits from smoking that they will continue to choose to do it even though it is very expensive (in terms of both health and taxes) and highly vilified — unless they discover a substitute that allows them to keep most of the benefits without the health costs. (Note that this observation refers to natural populations, and not highly unusual or self-selected subsets (e.g., Manhattan residents, university professors) or people whose liberties are seriously constrained (e.g., people living in psychiatric clinics, prisons, or submarines).)
[I should point out that I have no idea if this is what Glantz is actually referring to. Perhaps the TCI people, in their secret cabals, have their own notion of a "barrier of 20%". But if so, their version presumably does not recognize that THR (and only THR) offers that promise of blowing past the "barrier" -- perhaps they do not like that it does so without coercion. If so, their version is simply wrong and has been clearly wrong ever since snus became dominant in Sweden. TCI people like to pretend that Sweden does not exist, but I have been there so I am pretty sure it really does.]
So, when quoting my observation correctly, the US statistics tend to confirm it, not contradict it. Smoking prevalence perhaps edged below 20% in the 2000s (depending on which statistics you believe — it might be considerably higher), but substitution of smokeless tobacco accounted for more than the gap between the prevalence rate and 20%. And thanks to e-cigarettes, it might have dropped another percentage point since then. The whole point of the 20% observation is not that it is impossible to torture a population into reducing tobacco use below 20% if you get draconian enough, but that it is easy to get well below 20% if THR becomes popular.
People like Glantz and the NYT editors are dead-enders, fiercely fighting an already-lost war against THR. By fighting on, they continue to kill people (the war is metaphorical, but the killing is literal) even though there is clearly no chance they will achieve their dream of a tobacco-free world. Indeed, there is no evidence that they have accomplished anything positive in the USA and similar populations for many years. All of the gains they claim credit for seem to be best explained by the growing success of THR.