Sometimes the anti-THR lie is just not mentioning THR

by Carl V Phillips

A recent highly touted op-ed in the NYT claimed to offer two ways to eliminate smoking in our society.  It was written by Richard A. Daynard, a law professor at Boston’s Northeastern University who is head of a “public health advocacy” institute.  If that bio leaves you expecting the content to be out of touch with science, ethics, human behavior, politics, and pretty much everything else someone needs to know to recommend policy, you will not be disappointed.

Daynard starts weak, by attributing a substantial amount of smoking reduction

to Dr. Koop’s antismoking crusade as surgeon general, from 1981 to 1989

In reality, of course, smoking steadily declined for over three decades, starting in the mid-1960s, due almost entirely to people’s decision to not smoke once they were educated about the risk (and such education was basically all anti-smoking consisted of during the most dramatic decline).  To the extent that any effort other than that basic education, which was universal by 1981, (and to a much smaller extent, price increases) had an impact beyond the trend caused by the education, it is really too small to estimate.  That does not stop Daynard from attributing the decline to every anti-smoking measure except the basic education and rational decisions by would-be smokers.

But this standard “public health” boilerplate was only window dressing.  He was clearly using Koop’s recent death as an excuse for publishing some pent-up madness he had sitting on his desk.  His real message was:

What we need is an all-out push to reduce smoking rates to well below 10 percent.

Notice the key noun in there: push.  This is not one of those pansy-ass academic lawyers like you might find across town among the Constitutional scholars at Harvard, who believes that Americans are a free people and who wants to help protect them from tyranny and abusive government.  Oh, no.  He believes that proper behavior of the rabble can only be achieved by government force.

One of his bright ideas is basically to just ban smoking (why did no one think of that before?):

no one born in or after 2000 can ever be sold cigarettes. Under such legislation…the vast majority of this cohort — the oldest are now 13 — would never begin smoking.

Of course.  Since everyone who starts smoking does so legally, dutifully waiting until they are 18 to light up, that should do it.  And since he tells us how this idea is supported by one guy in Singapore and political chatter in Tasmania, it must be a widely accepted good idea.

He does not actually argue that this would be wise.  He cannot.  Rather, his main basis for suggesting this is a claim that the FDA now has the authority to impose such a regulation.  Perhaps he does not realize that most governments have always had the authority to just ban smoking if they wanted to, for any age cohort.  I will not insult my readers by pointing out why not even Australia or Singapore has tried to exercise this authority.

At least the ban is just fantasy.  His other plan is potentially quite deadly:

The F.D.A. would be well within its authority to require nicotine content [of cigarettes] to be below addictive levels

This is nothing new, of course.  As Rodu recently noted, that idea traces to people who include the new head of FDA’s Center for Tobacco Products, and it was always a terrible idea.  Most people smoke primarily to get nicotine.  Reduce the nicotine and they will smoke more.

FDA arguably has the authority to do all kinds of things to lower the quality of cigarettes.  Most of them would cause people to smoke less (so long as you are not worried about pesky details like people’s freedom to choose and inalienable right to pursue happiness — since Daynard seems to like Singapore’s and Australia’s way of doing things, I assume he is fine with that).  But he managed to pick the one way to lower quality that will probably cause more smoking.

Of course he probably does not know enough to understand that.  Missing from this entire missive (not surprisingly, given it is written by someone with “public health institute” in his title), is scientific analysis and evidence.  He does use the word “evidence” twice, but it is not clear he knows what it means.  Regarding what would happen if some locality started imposing draconian restrictions on cigarettes unilaterally:

evidence suggests that border-crossing and smuggling would be minimal

And if you believe that….  Well, if you believe that, you are probably a victim of ANTZ lies and apparently not able to actually understand the evidence.  His other misuse of that word is rather more interesting:

if the F.D.A. insisted on the [reduction in nicotine], and cigarettes ceased to be addictive, ample evidence shows that most smokers would quit or switch to less toxic nicotine products.

Wrong again.  It is undoubtedly true that this change would drive some to quit and many to switch.  But this is based on general knowledge about people, and not what would normally be called “ample evidence”.  There is obviously an absence of what is normally called evidence when we are talking about what would happen following an extreme change that has never been tried before.

What is interesting, though is the acknowledgment of alternative products.  The alternative products that would fill the gap — if someone actually tried to implement this rule, and it actually succeeded rather than leading to a popular revolution — would probably be e-cigarettes and smokeless tobacco (assuming FDA did not try to ruin them first).  Some people who advocate THR favor efforts to push smokers into switching, while others believe they should be informed and encouraged, but left free to choose.

But Daynard says absolutely nothing more about the alternative products.  It seems rather unlikely that he actually understands THR, despite his claim of expertise about smoking cessation.  If he did, he would realize that the only evidence-based — and, indeed, proven — method for lowering smoking prevalence to that 10%, and the only conceivable way to do it without ruining a lot of people’s lives, is adoption of THR.  Instead, he proposes approaches that are based on wild speculation and that would seriously hurt a lot of people.  Despite his recognition of alternatives to smoking, his failure to even mention THR, along with the presentation of his radical alternatives to THR as if they were promising and practical, mean that his message is ultimately an anti-THR lie.