Tag Archives: economics

Public health (heart) lung cancer

by Carl V Phillips

Tobacco control and “public health” have the same attitude toward lung cancer as homophobes do toward AIDS. In both cases, they are motivated by “moral” objections to particular behaviors and are desperately frustrated that people fail to just stop doing what they personally consider sinful/disgusting/unappealing (those are fairly interchangeable concepts for this sort of person). Thus many of them are happy that there is a disease that disproportionately punishes the sinners. Of course gay bashers (as well as also those who object to all sexual promiscuity and the relatively smaller group who hate injection drug users) do not pretend to care about the physical health of the targets of their opprobrium, so they are merely vile; “public health” people are also hypocrites.

About ten years ago, I coined the term “anti-tobacco extremists” to refer to those who take the most extreme view of tobacco use. This was an attempt to push back against anti-THR activists being inaccurately referred to as public health, given that they actively seek to harm the public’s health. I have since given up on that, and recognize that “public health” is an unsalvageable rubric, which should just be relegated to being a pejorative. But the extremist concept remains useful. The test for anti-tobacco extremism is the answer to the following question: If you could magically change the world so that either (a) there was no use of tobacco products or (b) people could continue to enjoy using tobacco but there was a cheap magic pill that they could take to eliminate any excess disease risk it caused, which would you choose? Anyone who would choose (a) over (b) takes anti-tobacco to its logical extreme, making clear that they object to the behavior, not its effects. Continue reading

Tobacco abstinence is not a safe alternative to harm reduction

by Carl V Phillips and Elaine Keller

In honor of the birthday of one of us (EK), we are using the great title that the other of us wishes he had thought to use for his 2009 paper. In acknowledgement of her birthday, Elaine posted this yesterday on the Facebook CASAA members group:

Today is my birthday. My birthday wish is that e-cigarettes had been invented in 1983 instead of 2003. I was reluctant to share with the world that I was diagnosed with lung cancer last summer. I was afraid that some tobacco control liars might use that information to falsely accuse e-cigarettes of causing cancer. But an important fact is that for ex-smokers, the excess risk for lung cancer doesn’t go away the day you quit. In fact, it hangs around for a good TWENTY YEARS after you quit smoking.

So if I had been able to quit smoking in 1989 instead of 2009, perhaps I would not have needed to have the lower left lobe of my lung removed in July, and to go through chemotherapy. I’m happy to share with you all that my follow-up CT scan on December 4, showed no evidence of cancer. So I am officially in remission. To those who want smokers to wait around for 10 or 20 years for scientific proof that e-cigarettes are 100% safe, I say this, smokers don’t have that luxury.

Dr. Carl Phillips, CASAA’s Chief Scientific Officer, brilliantly analyzed the difference between being able to quit smoking immediately via switching to a reduced risk alternative source of nicotine (Tobacco Harm Reduction – THR) and postponing quitting until ready to “quit completely” (e.g., not needing to earn a paycheck after reaching the age of retirement) in “Debunking the claim that abstinence is usually healthier for smokers than switching to a low-risk alternative, and other observations about anti-tobacco-harm-reduction arguments.”http://www.harmreductionjournal.com/content/6/1/29

Most lung cancers are not diagnosed until Stage 4, when survival rates are grim. I thank God, and credit e-cigarettes, for the fact that mine was caught at Stage 1.

Continue reading

Economic illiteracy about tobacco, from the antepode

by Carl V Phillips

The most fundamental lie of the tobacco control industry (TCI) is what I have dubbed the “demonic possession” theory of tobacco use. It is the myth that no one likes to use tobacco products.

It is obvious why they need this. If they admitted that people derived benefits from consuming tobacco, then they would have to balance the (supposed) benefits of their actions against the loss of benefits caused by the actions. More important, and the reason this myth is fundamental, is that if they admitted the truth they would have to admit to themselves that most of what they do inflicts harm — serious harm — on the hundreds of millions of people who they pretend they are trying to help. While many in the TCI are truly evil, and would not be bothered by this, many are not, and so need to preserve this fiction to be able to sleep at night. (And, no, “evil” is not hyperbole. It is clear that many people in tobacco control derive pleasure from inflicting pain on people who they consider to be The Other, exactly the same evil impulse that causes racism, homophobia, etc.) Continue reading

Predicting the black market in e-cigarettes

by Carl V Phillips

The anti-tobacco movement is fundamentally dishonest and unethical, and it is also led by minimally-skilled people who isolate themselves in an echo chamber that avoids scientific review.  As a result, it is frequently difficult to determine whether one of their false scientific claims is an intentional lie or blatant ignorance.  Most of their epidemiologic claims seem to fall into the former category.  But most of their economics-related lies seem to stem from an utter failure to understand even first-semester level economics.  Snowdon and I (mostly at EP-ology including a few days ago, but also on the present blog) have documented this extensively.

One of their fundamental failures in this area is the apparent belief that — contrary to all we know from the results of the Drug War, to say nothing of all other observations of supply and demand — that bans will eliminate supply even when there is huge demand.  One critical appearance of this ignorance relates to the current U.S. FDA draft regulation of e-cigarettes.  FDA has clearly made no attempt to consider what the real — as opposed to fantasy idealized — results of their proposed e-cigarette ban would be.  It is not difficult to understand that there will be a continuing market in e-cigarettes — mostly not actually “black” despite the shorthand in the title. Continue reading

Demonization of tobacco users (or, just because it is a puff piece does not mean I cannot analyze it)

by Carl V Phillips

Vapers are delightedly tweeting this bit of satire from The Daily Mash, entitled,”Put cancer in e-cigarettes, say non-smokers.”  The conceit is that THR causes non-smokers to lose their feeling of superiority, forcing them to frequent crack houses to recapture that old feeling (a gateway theory?).  I saw it tweeted as “anti-smokers” rather than “non-smokers”, but this actually missed the point:  The characters in the story are not anti-smoking; they like smoking and its ill-effects due to the schadenfreude.

This contrasts with professional anti-smokers — or more accurately, the tobacco control industry, anti-tobacco extremists, or ANTZ — who also favor keeping tobacco use harmful, but for somewhat different reasons.  As noted from the start in this blog, anti-THR has several motives, all of them perverse, and none of them having to do with health even though the anti-THR liars cloak themselves with the title “public health”.

The anti-THR activists consider tobacco use to be some kind of moral failing or otherwise just want to eliminate it, and thus prefer to keep it as harmful as possible.  For the less-bright majority of that crowd, this is for motives as base as those in the Daily Mash story:  They are annoyed that tobacco users will not obey, and want them to suffer for their temerity.  But the smarter tobacco controllers, those who talk about “endgame” or “tobacco-free by 2030″, know that low-risk alternatives guarantee that they will fail:  So long as tobacco use is highly harmful (i.e., smoking), everyone has a good reason to quit.  While it is unlikely they will all do so, there is a chance.  But low-risk tobacco products have benefits that greatly exceed their costs, and so people do not have an incentive to quit, and sensible politicians have no reason to support measures to discourage use.  Moreover, the realization that tobacco use is becoming low-risk will inevitably cause a backlash against the entire anti-tobacco industry and their lavish use of our tax money.

But unlike the characters in the Daily Mash story, the tobacco control industry cannot ever admit their motives.  Even if they preferred telling the truth over lying (though there is no evidence that suggests this is the case), they would have to lie about this one.  The mere admission of their real motives would derail the entire enterprise.  Of course, the cannot make e-cigarettes more hazardous than they are, like the characters in the story wish, but they can try to trick people into believing that e-cigarettes and smokeless tobacco are high-risk, and thus encourage them to smoke instead.  As long as most tobacco users are smoking, the tobacco control industry can continue to profit and dream.

In a less puffy piece that also pursued the theme of people feeling superior to smokers, the New Republic called for an end to campaigns to stigmatize smokers.  It likened the stigmatization of smokers to the stigmatization of people with HIV/AIDS.  This is a valid moral equivalence.  In both cases, it is about a behavior that someone is choosing to engage in, which happens to be something that a tiny minority violently objects to as immoral.  In both cases, that tiny minority uses the health risk (and the grossly exaggerated tiny spillover risk to others) as a convenient tool for making it appear that their motives are something other than hatred.  This allows them to enlist the support of others who vaguely disapprove of the behavior, but not so much that they would deny others their free choice based on that disapproval, let alone would intentionally inflict punishment on the “sinners”.  The article seals the comparison by looking at the stigmatization of lung cancer victims.

The article fails to note that the portion of lung cancer is caused by smoking is smaller than the portion of HIV infection that is caused by various demonized behaviors.  Nor does it point out that anti-smokers are exactly the same violent and hate-fueled people as gay bashers — which of those two a particular person turned out to be is just an accident of what subculture he grew up in.

Unfortunately, some of the analysis is the article is not so good.  It suggests that tobacco control efforts have played a large role in reducing smoking, when actually almost all the credit goes to simple knowledge and rational consumer choice.  It also conflates genuine effects of smoker demonization with statistics like “Most non-smokers would be reluctant to date someone who smokes (72%).”  There are perfectly legitimate reasons for making that personal choice that do not imply a dislike of smokers, let alone a desire to inflict psychological violence on them or schadenfreude.

The hook for the New Republic story, and a companion piece, was the CVS move to stop selling cigarettes.  The quotes about that in the articles, and to a lesser extent the articles themselves, show more of the naivety about it explored in my previous post.  It is amusing that those praising the move simultaneously describe it as “courageous” and “principled” and also claim it will be good for business (or naively believed that because CVS stock price upticked, it proves it was good for business).  I suppose it is not too shocking that those innumerate people cannot figure out the laughable contradiction there.

Of course, that does not explain why removing a product from the shelves — with a predicted substantial loss in revenue — is good for business.  As I noted before, it appears that the answer is that it gets them more corporate customers for their much-higher-margin medical service businesses.  But why? Basically because the business leaders have been strong-armed by the tobacco control industry (particularly including its units in government) into pushing their medical service suppliers to not sell cigarettes.

This creates an amusing contradiction for the doctrinaire free-marketeers, some of whom praised the CVS decision as a free choice of a business in the market.  When market decisions are caused by tax-fueled campaigns to force companies to change their behavior, what exactly does “free market” mean? Also, how perfect is the market if the CVS customers who are companies make decisions based on non-market influences that would not affect individuals (there cannot be 1000 people in the country who avoid buying from CVS when they offered the best value, just because they sell cigarettes)?

But while the free-market extremists get a lot of things wrong, the core points about markets are right.  In particular, the more merchants stop selling cigarettes, the greater the profits for those who still do (volume will clearly increase, and per-unit profit will also inch up due to the reduced competition). Thus, however much political pressure there is to make the “free” decision to stop selling cigarettes, there will be an equilibrium when that is not enough to offset the available profits and cause more merchants to exit the market.  My suspicion is that the “endgame” types have no idea that this is the case.

Finally, for those who have been missing my writing about THR for the last week and a half, it is because you are not reading EP-ology, where I posted two pieces on the topic (as well as other interesting stuff).

CVS and cigarettes, an embarrassing Rorschach test

by Carl V Phillips

Presumably anyone who reads in this area is already aware that the CVS drug store chain announced that they will stop selling cigarettes and other tobacco products.  The practical consequences of this are almost nil, but the response to it are rather educational.  It is a veritable Rorschach test (though not exactly the same, since no one seems to have said “it looks like a butterfly” or likened the announcement to some bit of the female anatomy).

The immediate practical consequences of the move are:  (a) CVS will lose $2 billion/year in revenue, by their own estimate; (b) some smokers will have to make an extra stop if they want to buy both toothpaste and cigarettes; (c) C-stores and other competitors will thus gain about $2 billion/year in revenue; (d) some C-store may also increase their profit margin on cigarettes because they no longer have to price-compete with a nearby CVS.  It is probably also the case that: (e) tobacco companies will increase their profits a bit because CVS’s size allowed it to negotiate better wholesale prices for cigarettes than their average competitor.

Of course, none of those could possibly be the motive for the decision.  To the extent that I have seen cogent explanations of the motives, it appears to have happened because CVS’s biggest cash cow and growth area is not retail, but providing insurance-like services to big companies.  Apparently their clients and potential clients (presumably strong-armed by the tobacco control industry) pressured CVS into making the move.  Assuming this is true, it was a symbolic gesture in which they decided to take something away from their peon retail customers in order to please (not even materially benefit) their big corporate customers who offer much bigger margins.

Of course, that is not how they spun it to the public.  It very convenient when you can spin a sacrifice you are forced to make (in order to get some benefit) as a good thing in itself rather than a price paid.  So, of course, CVS claimed exactly that in their (transparently false) public statements — it was a principled decision because they did not feel that people should be buying cigarettes the same place they are buying medicines.

The most obvious hypocrisy in that spin has been pointed out by pretty much every commentator on the topic, even those that know little about tobacco:  CVS sells — right up front in their most prominent displays — unhealthy snack foods, “energy drinks”, candy, and so on, so this is clearly not about removing products because they are unhealthy.  A more sophisticated take on the hypocrisy comes from the observation that they are removing not just cigarettes, but smokeless tobacco.  If this were really about health, they would have kept the latter and steered would-be cigarette purchasers to this low-risk alternative.

What is most interesting, however, is how the tobacco control industry went gaga over this move that had only symbolic consequences.  The Robert Wood Johnson Foundation added it to their animated timeline of the most important moments in the history of tobacco control (and apparently did so within minutes of CVS’s announcement — not that this proves that the surprise announcement was actually an orchestrated conspiracy or anything).  Then @RWJF_PubHealth tweeted about this addition approximate once per hour, and even paid to promote the tweets (must be nice to be able to pay to get people to look whenever you update your website).

The Rorschach test tells us the tobacco control industry is so starved for anything they can call a victory that they celebrate this useless gesture.  They are beside themselves with delight that smokers who are shopping at CVS will now have to go cleeear to the nearest C-store to buy cigarettes. To the present generation of tobacco controllers, this is all they can add to the list that includes such genuinely important moments as the 1964 Surgeon General report, the groundbreaking epidemiology on smoking from the 1950s, and….  Well, actually those are really the only things that ought to appear on a story of the great moments in anti-smoking.

Of course, that RWJF timeline is not actually about successes of tobacco control (i.e., events that reduced smoking), but successes of the the tobacco control industry (i.e., events that demonstrated and/or increased their power and wealth, or inflicted punishment on tobacco users for their sins, even though almost all were inconsequential in terms of reducing smoking).  In that sense, I suppose, this was a victory for them.

While desperation for something to claim as a victory, along with boasting about their ability to exercise power, probably explain most of the TCI reaction, to some extent it is genuine innumeracy (albeit intentionally-cultivated — i.e., lie-based — innumeracy).  Notice that the above list of consequences of CVS’s move did not include “there will be less smoking”.  This is because of the obvious fact that one fewer retailer of cigarettes has absolutely no effect on the demand for cigarettes, and it is the demand that matters.  Or, as I tweeted about it, “#CVSQuits selling cigarettes. Tobacco controllers demonstrate their continued failure to understand supply is not demand by celebrating.”

Part of the core myth of tobacco control is that there is no demand for tobacco, and that the reason people consume it basically demonic possession.  So, the “reasoning” goes, since demand is not causing consumption — contrary to what anyone with a modicum of knowledge about economics or human beings would conclude — then it must be supply.  Ergo, eliminate some of the supply and you eliminate some of the consumption.

But it is not just the TCI who saw what they wanted to in CVS’s move.  NJOY and other e-cigarette companies, as well as many vapers, celebrated this as a victory for e-cigarettes.  Huh?  There are some reports that CVS specifically promised they would also not sell e-cigarettes after the removal date, though there are also contrary reports on this point.  But either way, the fact that they are removing low-risk tobacco products along with cigarettes does not exactly suggest that they will be restocking the back wall with a different low-risk tobacco product.  Moreover, it is not as if the TCI bullies who leveraged this move in the first place are going to let up on e-cigarettes, and so CVS will probably be pressured into not selling them either.  E-cigarette merchants and cheerleaders need to figure out that each restriction on cigarettes should be interpreted not as “more for us”, but as “you’re next”.

Indeed, the backlash resulting from a (very hypothetical) principled stand by CVS — were they to insist that e-cigarettes are pro-health and therefore they are going to sell them — would probably be increased as a result of them already caving on cigarettes.  Once you cave to someone’s political pressure — giving up billions in revenue to get some goodwill — they own you.  The revenue is gone, but they can still take away the good will that justified the loss, and so they have even more power over you than they did before.

So while it is possible that CVS will be stocking e-cigarettes instead, it seems ridiculously optimistic to assume they will, or even to conclude that it is more likely to happen given the removal of cigarettes than would be the case had they kept them.  And this is to say nothing of the fact that it is better to have e-cigarettes displayed next to where people are buying their cigarettes so they might spontaneously choose to try the former.  Bottom line:  What some elements of the e-cigarette community saw in the inkblot also suggests they suffer from some of the same problematic thinking as the TCI — not nearly as badly, for sure, but remarkably similar.

The final category of reaction I will note is that of every single smoker who was quoted in the mandatory “we asked this random shopper” section of news reports about the move.  Unsurprisingly, the reaction was basically, “Really? Oh well, I guess I will have to buy my cigarettes somewhere else.”  There were barely even any hints of annoyance.  You could almost hear the subtext: “My dry cleaner does not sell cigarettes. My bank does not sell them, nor does McDonalds.  Now my usual drug store won’t either.  But so what?  It is not like I can’t go to a gas station / 7-11 / other drug store / etc.”  In this population — the people who know best, after all — it never even crossed their mind that change in one source of supply would have any effect on demand.

What to do with tobacco taxes?

by Carl V Phillips

This is tangential, but goes to some big-picture issue, and it is bugging me so much I want to complain about it.  It also relates to those anti-THR liars at the American Lung Association (ALA) and the Campaign for Tobacco Free Kids who seem to be spearheading these lies about economics.

Presumably due to the not-so-secret secret coordination of the ANTZ and their pet reporters, trying to create the illusion of spontaneous expressions of concern, there have been a spate of articles recently about how the government is not giving the tobacco control industry (TCI) what they think they are owed.  In this piece (a random selection from any of a hundred I could have chosen), an ALA representative suggests that all the money the states collect from the Master Settlement Agreement (MSA) should be spent on the TCI.  The mind boggles at what the TCI would do with the literally billions of dollars more every year this would represent.

The MSA is often described as a fee paid by the cigarette manufacturers, but this is a carefully engineered lie.  It is really a hidden sales tax on the price of each pack of cigarettes, that happens to be collected by the manufacturers before being paid to the government — it is paid by smokers, not industry.  This probably annoys those who do not really care about health, but only about hurting the industry (though most of them are probably too dim to see through the lie).  But it actually serves a purpose for those who want to reduce smoking rates, since like any sales tax or other price increase, it discourages consumption.

Now setting aside the question of whether such taxes are ethical and otherwise proper, let us assume that the total taxes are set at the “right” level (also setting aside the question of what that means, and the ethics and question of whether governments should even be doing this) for this goal.  Does this mean that the amount collected is exactly the “right” level (same caveat) to spend on anti-smoking efforts?  Obviously not.  There is no reason to expect any relationship whatsoever between those numbers.

You do not need a degree in economics to see that.  It is clear that even if one likes what the TCI tries to do, much of what is spent on their research and social manipulation projects is already wasted.  They have no idea what to do with the money they have.  The mind-blowing massive increase that would come from spending all tobacco taxes on them would clearly be wasted.  Of course, they would love to quintuple their salaries, but I think most everyone else would agree this counts as a waste.  [UPDATE:  I should have noted here that even the American Legacy Foundation, the anti-tobacco “charity” created with billions of dollars of MSA money, agrees that there is nothing useful to spend the money on.  They have just been hoarding the money, and spending it on lavish salaries for their executives, rather than spending it on marketing, programs, or research.  There is no clearer evidence that there simply is nothing useful (by their own measures) in anti-tobacco that is not already over-funded.]

What should the extra money be spent on, then?  It does not matter.  The TCI people are specifically complaining that it gets spent on fixing bridges.  (They are idiots.  We need to spend more on fixing bridges.  But that is not the point…)  But it does not matter whether it goes into the state’s general coffers, or is used to reduce income taxes, or is doled out to the people, or whatever.  No matter which, it has served its real purpose (caveat again).

This can go the other direction too.  As I show in this paper, the optimal tax on smokeless tobacco or e-cigarettes — optimized from any of several perspectives, including maximizing the population health effects — is zero.  (It is actually negative — that is, a subsidy — but that is unrealistic to even suggest.)  So does that mean that the optimal expenditure on efforts to discourage use of these products is zero?  The TCI certainly does not think so, and even non-ANTZ might see some value in putting a few resources into discouraging non-smoking children from using these products.

So this claim that they ought to get a larger share of the taxes, just because those taxes happen to be tobacco sales taxes, is just like most of their anti-tobacco rhetoric:  it is complete fiction and demonstrates their lack of honesty; it shows contempt for people’s understanding of science (which might be justified as a practical matter); it tries to increase people’s misunderstanding of science (which is clearly not justified as an ethical matter); and it shows their fundamental self-centeredness and general contempt for humanity.

Perhaps if they are so sure that these numbers should match, someone should propose making them match — by lowering tobacco taxes by more than 90%.  Their “logic” supports that solution to the disparity just as effectively as it supports their personal enrichment proposal.

Biking harm reduction

by Carl V Phillips

I just got done talking to two reporters about e-cigarettes and THR.  In one of those I had the nice rare opportunity to be able to reply to the comments of the apparently mandatory interviewee for these stories: a medic who seems to understand neither the products nor humanity, but insists on opining on them anyway.  Re the lack of understanding of humanity, I pointed out to the reporter that — contrary to the views of that physician — people care about things other than just minimizing health risks (something I almost always have to do, in spite of the fact that most people I talk to are people, and so should already know this).

Of course, the entire “public health” iron triangle[*] (not to be confused with real public health) is premised on the notion that the only thing people care about is maximizing their longevity.  Or perhaps their view is that people owe their lives to The State or to The Community (dare I say, to The Collective), and thus only productivity and costs-savings — not pesky little matters of happiness — matter.  Either way, they never defend their position.  They just take it as a premise and run with it, perhaps knowing that it is indefensible but trying to make people forget that they have no foundation by creating a huge edifice without one.

[*For those who do not know, “iron triangle” is the generalization of Eisenhower’s “military-industrial complex”, as applied to self-perpetuating, self-enriching special-interest industry/government/academia institutions other than the military.]

But having gone through that thought process, I came out the other side thinking about where “public health” people, along with those medics who think of patients as their serfs rather than their customers, recognize that maximizing longevity is the only thing that matters.  I do not recall — in all my years of hanging out with people who engaged in these activities –ever hearing about a physician or “public health” type advising them to give up mountain climbing or commuting by bicycle.  Each of these activities is far more dangerous than using low-risk tobacco products.  The former (among those who do it seriously) is more dangerous than smoking.  And yet not a peep from those who would ban large sodas or whose attitude toward THR is that (even if they acknowledge that is healthier than smoking) it is a poor substitute for the always-better choice of avoiding the behavior entirely.

Of course, I can hear the inevitable response to that, “but they are good exercise”.  Trust me, you only hear that from people who have not done those activities.  They are certainly exercise, and as such better than no exercise at all.  But they are fairly lousy as exercise (which is clearly not the main motivation to do them), with a lot of fitness-inefficient starting and stopping, brutalization of tendons and other body parts that you might discover that you need later, and furious inhalation of bad air (either not enough of it or far too high a concentration particulate matter and toxic gasses from burned gasoline and diesel).  That is to say nothing of the trauma risk.  But can you even imagine a medic advising someone, “instead of commuting by bike, you would be better off driving to the gym, riding the stationary bike there for half an hour (during which you can get some reading done for the good of The Collective, something you cannot due while commuting), and then continuing on to work.”  By “better off”, they of course mean healthier — what else matters after all?

If you actually had this discussion with a “public health” type special interest activist, you could count on them also responding that just commuting by bike, rather than switching to that reduced-harm version, is better for the environment.  To which I say: Aha!  So even if you do not care about people’s pleasures, health concerns do not trump all other human wants, do they!?

To head off some of my experience from my last post, of comments and nasty notes from people who know nothing of my work, I will point out that I am aware that “public health” types and activist physicians are generally authoritarian elitists who think of the plebs (and the environment) as helpless kittens who need to be protected.  That is the charitable interpretation; the less charitable version being that they think of the plebs as savages who need to be civilized into proper moral behavior so they can be good members of The Collective.  The people who they encounter who commute by bike and climb tend to be fellow elites, who can be trusted to make their own decisions, while the peasants who use tobacco need to be civilized.  (What about the people who commute by bike — sans carbon fiber, lycra, and helmet — because they cannot afford to drive to their jobs, often on particularly unsafe roads?  The “public health” types do not really care because that highly unhealthy activity is not “immoral”, and the physicians who are willing to see them understand that they probably have bigger health concerns.)

Still, we can ignore all that subtext and perhaps find a vein of good rhetorical fodder.  When responding to an authoritarian who takes the “you would be better off not doing it” attitude, whether in an interview or personally, perhaps it would be useful to ask “so, do you recommend that people give up hobbies/sports that are just as hazardous in favor of just riding a stationary bike?  Why not?”