Thoughts on A Billion Lives
Sunday, October 30, 2016 at 1:00
Simon Clark

The most poignant moment in the pro-vaping documentary A Billion Lives takes place towards the end.

Vince, an Australian who was successfully prosecuted for selling e-cigarettes and could lose his house as a result, stares directly into the webcam on his laptop and declares:

"Don't let the bastards win."

Even my wife, who has no interest in the subject, felt for Vince and considered his treatment harsh and unjust.

A Billion Lives should have made more of Vince because his is a genuine human interest story. Instead he's just one of many talking heads, some more interesting than others.

The first third of the film focuses on the history of the cigarette, the health risks of smoking and the role of the tobacco industry that was eventually forced to admit - decades after evidence first emerged - that smoking was a potentially deadly habit.

A familiar tale illustrated with archive footage, it wasn't uninteresting but I'm not sure it achieved much apart from reaffirming Big T's less than glorious history for openness and transparency, which most people know about anyway.

Eventually, almost 30 minutes in, A Billion Lives finally addresses the issue of e-cigarettes.

As readers know, I've been uncomfortable with the 'billion lives' messaging ever since I saw the inaugural trailer in November last year. Far from being toned down, in the film it becomes a mantra, repeated ad nauseum:

"A billion lives are at stake."

"A billion people are going to die."

"A billion people are being condemned to death."

"A billion people are projected to die of smoking."

"A billion people will die early from smoking cigarettes this century."

"This is a battle for a billion lives."

Yeah, yeah, we geddit.

The problem is this. Pro-vaping evangelists like Biebert accuse the World Health Organisation of lying about e-cigarettes. What he seems to have overlooked is that the title and recurring message of A Billion Lives is based on the same organisation's highly contentious estimate of the number of people who will die prematurely this century if smoking is not eradicated.

You can't have it both ways. I don't dispute that electronic cigarettes are a significantly 'safer' alternative to combustible cigarettes but if WHO is lying about e-cigs why should we assume they're telling the truth about the global impact of smoking?

Despite this Biebert seems happy to believe that a billion lives would be saved if only smokers quit or switched to vaping. It's an extraordinary leap of faith based more on hope than evidence.

Another misstep is the conceit that "a billion people find themselves trapped" by smoking. Trapped? The implication that all smokers are victims of their habit is another generalisation that drives this well-meaning but flawed film.

Biebert may have discovered an affinity with vapers but his understanding of those who choose to smoke and don't want to quit seems minimal.

We're told the film is "about freedom, about corruption" but the freedom to smoke is never acknowledged. Instead it's all about the freedom not to smoke.

However, the message that really undermines A Billion Lives is the suggestion that the war on vaping is some sort of conspiracy.

According to Biebert, during Prohibition in America there was an alliance between the bootleggers and what he calls the preachers - the temperance movement and, I think, the authorities. (It was dark in the auditorium and I was struggling to write notes!)

He now invites us to believe that Big Pharma, Big Tobacco and Big Government are working together, deliberately or otherwise, to destroy a product that could save a billion lives.

The argument, I think, goes like this. Today's bootleggers are Big Tobacco, who don't like competition from e-cigarettes; Big Pharma, who want to protect their own harm reduction business; and governments that, thanks to tobacco duty and the enormous amount of revenue it raises, are effectively the biggest shareholders in tobacco.

The preachers in this modern day analogy are bodies like the US Food and Drug Administration (FDA) and the World Health Organisation.

According to Biebert it's one of the most "fascinating alliances in history" and it's based on the principle that "the enemy of my enemy is my friend."

Public health advocacy, the film adds, is a multi-billion dollar business. Tobacco products are being protected, sending smokers to an early grave. Everyone is lying, government is corrupt.

There may be some truth in this, I don't know. Unfortunately conspiracy theorists don't have a great track record and the message is rammed home with the subtlety of a sledgehammer.

Much has been made of the many public health bodies that declined or ignored invitations to be interviewed for this film. A list appears in the closing credits.

What has been overlooked is the fact that similar requests do not appear to have been made to representatives of Big Tobacco, an industry that clearly has a huge role to play in the development of e-cigarettes and other harm reduction products.

Like it or not the tobacco companies are part of the vaping revolution and there are some very articulate advocates for e-cigarettes and other harm reduction technologies within their ranks.

Finally, ever since I saw the film on Wednesday, I've been struggling to work out the target audience.

Vapers? Probably not. Yes, it might inspire some to become activists but consumers are notoriously apathetic when it comes to fighting political battles. As we have seen in the UK, getting vapers to support even a few screenings has been harder than pulling teeth.

Smokers? Unlikely. A Billion Lives might attract a handful who would like to quit and want to know more about vaping. The problem is they won't learn much because no-one ever really explains the appeal of vaping beyond harm reduction – and for many smokers that will never be enough to convince them to switch.

In the film Dr Atila Danko, a GP and ex-smoker, describes vaping as "something exciting, better than smoking" but there's little to support this. I longed for an enthusiast to explain the appeal of e-cigarettes as a recreational device. Where are the Jilly Goolden or Oz Clarke figures who could have described the flavours and sensation of vaping to a wider audience?

Instead the film devotes much of its running time to a number of rather dry pro-vaping public health advocates.

The most colourful commentators are Dave Goerlitz, the former Winston Man, and Bill Godshall, founder and executive director of Smokefree Pennsylvania, but they appear so often they eventually become irritating.

By the end (and this may surprise you) I wanted to see less of them and more of Clive Bates, the former director of ASH, whose contribution felt relatively minor in comparison – a pity because, despite our differences, I acknowledge Clive to be one of the most authoritative and articulate pro-vaping advocates.

When it came to interviewing vapers, why weren't they filmed in pubs or bars? The handful of vapers who were given the opportunity to comment were invariably shot via webcam at home so instead of vaping being seen as a social habit, they appeared as solitary souls, home alone with their gadgets and gizmos.

If the target audience is politicians and public health professionals are you really going to have a positive impact on policy making by accusing them of being involved in a conspiracy that will prematurely kill one billion people?

The best you can hope for is that the media will start asking questions but in my experience journalists are even more sceptical of conspiracy theorists than the general public.

According to its director, A Billion Lives is "more than just a movie, it's a movement". I admire what Aaron Biebert has achieved and the energy with which he is promoting his documentary, but a cooler more objective head would avoid such hyperbole.

The rise of the e-cigarette is a story that doesn't need embellishment. Both the science and the testimony of consumers speak for themselves.

In short, anyone who expects a balanced, unbiased documentary will be disappointed. However, as a starting point for a debate about vaping, public health and the role of government, A Billion Lives is worth a look.

Click here for details of forthcoming screenings in the UK.

Update: In addition to the screening I attended in Glasgow last week, A Billion Lives premiered in Los Angeles (Wednesday) and New York (Friday).

Before posting my thoughts I avoided reading any reviews but now that I have here are three you might like to read too:

Pro-vaping documentary 'A Billion Lives' makes a compelling case (Los Angeles Times).

‘A Billion Lives’ Claims There’s a Conspiracy Against Vaping (New York Times).

'A Billion Lives': Film Review (Hollywood Reporter).

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