Why is there anti-THR? (1) The importance of narrative and Opinion Leaders vs. Useful Idiots

by Carl V Phillips

[This series continues with:
(2) “Not Invented Here” syndrome
(3) Anti-tobacco extremism
(4) Money, money, money

(5) Needing an enemy and control for its own sake


…more to come…]

Prologue [update (Sept 2016)]: In retrospect, I realize the title of this series does not quite match the subject matter that evolved. To correct the ambiguity: In the title and most places in the text, I use THR as a shorthand for a single aspect of THR, the substitution of low-risk products for high-risk ones. I am not going down the paths of other aspects of the harm reduction approach in this series. I and others often employ this shorthand when the context is clearly about product substitution, but there is no such context here, and thus this was probably a mistake.

This matters because there is an unfortunate tendency to think of harm reduction as being only about technical fixes like product substitution, seat belts, and needle exchanges. These are usually the most tangible and discussed aspects of harm reduction, and thus tend to “capture” the term, but they are not at its core. The shorthand has the harmful effect of distracting from the bigger picture. The core principle of harm reduction empowering people (with information and rights) to make their own best choice. Technical fixes are not even the most important concrete step in harm reduction, which is ending caused-harms. I have discussed these points recently, here and here.


The average person, upon learning that there is violent opposition to tobacco harm reduction (THR), is quite reasonably baffled. It is difficult for them to fathom that an entire (taxpayer-funded) industry could be devoted discouraging smokers from switching to low-risk alternatives, or even to discouraging people from making the free choice to use a low-risk product rather than being abstinent. It is more difficult still to believe that their leading tactic is promulgating blatant and easily-refuted lies. To any caring and honest person — no, make that any caring or honest person — this seems to be either insanity or pure evil. Indeed, it seems so crazy, that most people just assume the blatant lies must be plausible claims. After all, if they were not, why would anyone oppose THR?

Almost every time I talk to a reporter, and much of the time I talk about THR with anyone who is interested and attentive, I end up explaining some of the reasons why anti-THR exists. When someone lacks an explanation for the behavior of the anti-THR liars, it is difficult for them to really believe the truth, even when it is backed by overwhelming evidence. Understanding this phenomenon is fairly intuitive, but there is also an extensive political science literature showing that people tend to continue to believe a narrative, even when presented with individual facts that flatly contradict it, unless presented with an alternative narrative.

In this case, the default narrative is that the “public health” people are motivated by improving people’s health. Merely demonstrating that their claims are lies and the results of their actions are anti-health is not sufficient to dissuade someone of this premise. I have had countless conversations with smart people who understood and became convinced by the scientific facts about THR, but still could not get over the assumption that there must be some legitimacy to anti-THR. Their subconscious narrative locked them into this conclusion even though they understood, at a more conscious level, the facts that flatly contradict the conclusion.

Thus, it is critical to provide not just the truth, but the alternative — true! — narrative about the liars and why they lie. This series of posts will lay out the true narrative. You will, of course, have to pick and choose some subset of all this to include in any particular conversation, but it is useful to have the whole story somewhere. I have not written it down in this much detail before, and I am aware of no one else who has made a scientific study of it.

Before getting to the reasons, however, it is important to recognize two categories of anti-THR liars and their different motivations. There are those who engineer the anti-THR movement. They genuinely oppose THR, though not for any reason they would admit, and thus rationalize it based on lies. They then endeavor to persuade others to follow them. For lack of a better term, I will call them the opinion leaders. There really are not many of them. I would be surprised if there were more than a couple of thousand such influential true believers in the world.

The much larger population of anti-THR activists and actors are useful idiots, people who would not actually support the cause if they understood the true motives and goals of their puppet masters, but are tricked by the prevalent lies. (This term is generally attributed to Lenin. Though there is no clear historical record to support that, it is certainly an apt description of the movement he mobilized.) These should not be confused with the tens of millions of innocent victims who believe the lies and perhaps casually repeat them, though they too might fit the Leninist use of the term. I am using the term to refer to those who actively support anti-THR for what they think are honest reasons. They are characterized by being sufficiently involved in the topic that they have been exposed to accurate information, but are willfully ignoring it. Alternatively, they are not expert enough to even understand what claims are accurate, but are publicly pontificating as if they were (one of the definitions of “liar” for purposes of this blog).

There is, of course, no bright line between opinion leader vs. useful idiot or between useful idiot vs. the more loud-mouthed of the innocent victims. But the categories seem to represent a fairly clear distinction that is useful for present purposes. The opinion leaders include most leaders of anti-tobacco extremists groups, some professors, and quite a few government and quasi-governmental officials (this extremist group has very effectively captured most relevant government apparatus). The useful idiots include quite a few in those categories also, as well as a large portion of medics, pundits, and reporters.

I belabor this distinction because one common mistake is to confuse the two groups. Trying to communicate with an opinion leader as if he were making honest errors is fruitless (and somewhat embarrassing, really), whereas it can be effective for the innocent victims and has some potential with a useful idiot. However, to make the latter effective requires understanding that someone created that useful idiot, and how they did it and why. Similarly, condemning the useful idiots for sharing the true evil that exists at the core of anti-THR — tempted as we all are to do it sometimes — can be counterproductive. Explaining the full narrative to a genuinely interested observer requires explaining why there are those who truly oppose THR and why it is so easy for them to enlist so many useful idiots.

I will address both of those in the subsequent posts.

18 responses to “Why is there anti-THR? (1) The importance of narrative and Opinion Leaders vs. Useful Idiots

  1. Excellent, I am looking forward to it immensely. Hopefully they will also include a fair account of which entities, besides the Cigarette industry, who profit greatly from continued smoking.

  2. As I am fond of saying – ‘truth isn’t a condition of life’. Any acquaintance with history will show you that. Far more important, as you point out, is the narrative or story. TC (and many other areas of Public Health) have undoubtedly a great story full of heroes and villains. No doubt helped along by an inherent distrust and dissatisfaction with capitalism which is shared by many in the media.

    The other factor, fundamental to succeeding in life, is getting along with your fellow human beings. This accounts I think for most of the useful idiots.

    Looking forward to the rest of your posts on this subject.

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