Thoughts on GFN20
Saturday, June 13, 2020 at 15:15 As a registered participant I received an email this morning asking for feedback on the Global Forum on Nicotine that took place this week. So here goes:
For years people have said I should head over to Warsaw for this annual tobacco harm reduction event and every year I have looked at the programme and thought, “No, thanks.”
Listening and observing from afar, it struck me that consumers who don’t want to quit smoking were being eased out of the picture, and when the organisers declined to discuss a report - funded by Forest - that addressed why many confirmed smokers won’t switch to e-cigarettes (a subject that ought to interest delegates), my suspicions were confirmed.
In recent years it has also been possible to follow the event online without leaving home and that suited me just fine.
This year, for obvious reasons, the conference was exclusively online and it vindicated, I think, my previous decisions not to go.
Although it’s not self-righteously or aggressively anti-smoking in the way that many public health conferences are, it’s nevertheless a relentlessly one-note event, with little in the way of proper debate or alternative views.
Compared to the Global Tobacco and Nicotine Forum, for example (which itself has become a little too anti-smoking for my taste), there is an extremely limited and unambitious range of speakers.
Technically however GFN20 worked really well. Every speaker had recorded an eight-minute address and these were shown, one after another, under various session headings.
Over 1,000 delegates had registered to attend and at any one time the number logged in seemed to average about 500 (more on the first day, fewer on the second).
The programme included virtual lunch and coffee breaks but I’m not sure that was a good idea because I can imagine that some people logged off for the longer lunch break and didn’t return, much as they would at many ordinary conferences.
I’m guessing too that some people did what I did and had the conference on in the background while I got on with other work.
The problem was, GFN20 was just a bit ... dull.
Occasionally a speaker would grab my attention - the excellent Marewa Glover or the combative Dr Konstantinos Farsalinos - but mostly it was same-old same-old. There were some new faces but no surprises or headline-grabbing keynote speakers.
It’s inevitable, I suppose, that the same speakers pop up again and again but there are only so many times I want to hear the same people saying pretty much the same thing year after year.
The e-cigarette ‘panic’ in America last year and this year’s global pandemic offered new angles for discussion, but I can’t honestly say I learnt anything new or was gripped by any single presentation.
The session that worked best for me was the Friday Q&A chaired by Caitlin Notley of the University of East Anglia.
One, it had a panel of four (five if you include Notley) and offered greater diversity of opinion, although the credit for that goes entirely to Dr Farsalinos.
Two, it was live and as a result felt less stage-managed.
Dr Farsalinos’s comments on smoking, vaping and Covid-19 were wonderfully off message and it was joy to watch moderator Caitlin Notley struggling not to roll her eyes. (I’m with Dr Farsalinos, btw.)
I completely get why the speakers recorded their contributions in advance but I felt the event only came ‘alive’ when it went live, although the whole thing was very well managed.
Did watching GFN online over two days persuade me to attend the event in person next year? The answer, I’m afraid, is no.
Most conferences, not just GFN, are generally quite tedious, as I’m sure many people would agree.
Why put yourself through all the hassle of international travel (at least two flights, more if you’re travelling from outside Europe) for three days in the potentially stifling heat of Warsaw in June?
Oh wait, I know why. The attraction of GFN, like many conferences, is the socialising but in my experience conference delegates mostly socialise only with people they already know and probably see several times a year, so why travel to Warsaw or anywhere else to chat to the same people?
Like almost every conference I can think of, the programme of speeches and officially sanctioned ‘discussions’ is the least enticing reason to attend.
Listening to a genuine debate is almost unheard of. Most discussions are strictly controlled with relatively little difference of opinion and GFN falls firmly into that category.
The only tobacco or nicotine-related conference I have attended regularly over the years is the Global Tobacco and Nicotine Forum (previously the Global Tobacco Network Forum).
When I attend GTNF I make a point of going to a reasonable number of sessions if only to justify my being there.
I know some delegates however who miss 70 per cent of the programme in favour of propping up the bar with other miscreants. Fair play to them. It’s a toss up who gets most out of the event but I suspect they enjoy it more.
Btw, if you are asked to speak at a conference I suggest you engineer a spot on the first morning. In my experience that’s the only time you’re guaranteed a full room and won’t be speaking to empty seats.
Come the second or third days all but the most committed delegates will be found in a nearby bar or cafe, or they’ll be sleeping off a hangover. Trust me, it’s the law of diminishing conference returns.
Anyway, online may be the future because a regular and enthusiastic GFN delegate told me this week, “I miss far more when I attend in person!”
To sum up, GFN20 was fine as far as it went, but it could be so much more if the organisers were prepared to welcome a wider range of opinion from outside the little bubble they have created for themselves.
It may also explain why the rise of vaping has stalled in some territories. Create an echo chamber and you end up talking only to yourselves, which is what I sense is happening here.
I do however applaud the organisers for not giving up on the event and for overcoming all the difficulties they must have faced. In that respect GFN20 was a triumph.
The problem they seem unwilling to address however is this. Preaching to the converted is rarely an effective long-term strategy.
Where were the politicians and public health campaigners who are committed to eradicating all forms of nicotine use, including vaping?
More important, where were the consumers? Apart from Greg Conley, representing the American Vaping Association, and Clarisse Virgino representing the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates (CAPHRA), I saw no other consumer representatives on the list of speakers.
‘Nothing about us without us’ is one of the most irritating slogans ever, but if you’re going to support that mantra you have to back it up by giving consumers a platform and I rarely see that at GFN which appears to be driven not by consumers but by public health and tobacco control campaigners (albeit the slightly more liberal wing).
Instead of being players, consumers are largely restricted to a more passive, observer role.
Ironically, while GFN was taking place, it was Forest, a ‘pro-smoking’ (sic) group, that invited consumers to explain what they enjoy most about smoking, vaping or snus.
Speakers and participants described the Forest event as “great fun” which is not a word you generally hear in relation to public health or THR conferences, not the formal part anyway.
Harm reduction and tobacco control are serious issues - I’m not suggesting they should be comedy events - but the pleasure of smoking/vaping/snus is a legitimate issue that needs to be discussed, not swept under the carpet.
The pleasure of vaping is one of the strongest arguments in its favour as a reduced risk alternative to smoking, so let’s hear more on the subject at GFN and other THR conferences.
To be fair, Louise Ross, a smoking cessation advisor who gave the keynote Michael Russell Oration speech, did mention the pleasure of vaping, but hers was a lone voice on this key subject and she didn’t dwell or elaborate on it.
Banging on about harm reduction and the risks of smoking are not enough to convince more smokers to switch.
If you want more smokers to switch to vaping, vaping advocates - and that includes the organisers of conferences like GFN - have to put pleasure at the heart of their programme, alongside harm reduction. It can’t be an afterthought.
The pleasure of smoking is an equally important issue to address because it explains why many confirmed smokers are reluctant to switch. Instead of acknowledging this, and asking ‘How can we make vaping a better experience for more smokers?’, most vaping conferences ignore the issue, confident that if only more smokers were better informed they too would switch.
I’m sorry, but it’s far more complicated than that. Year after year however the organisers of GFN choose not to address it. Why?
I would attend GFN21 in Warsaw but on one, not unreasonable, condition - that the organisers invite me to moderate a debate/discussion on ‘The Pleasure of Smoking, Vaping and Snus.
This can be done as a serious discussion (my preference) as part of the daily programme. Or it can be an add-on, a light-hearted balloon debate at the end of the day.
That’s my offer. I expect it to fall on deaf ears because not once have the organisers of GFN reached out to us, and I don’t expect them to now, but you can’t say I haven’t tried.
And they did ask for feedback!
See also: GFN - just another echo chamber? (June 2019)
Update: The videos from GFN20 are online here.
Reader Comments (4)
"Instead of being players, consumers are largely restricted to a more passive, observational role."
I remembered reading this some years ago before the threat of smoking bans and vaping as a possible solution to them, appeared. Now apparently, they too are trying to save my life.
The arrogance of preventive medicine
"Preventive medicine displays all 3 elements of arrogance. First, it is aggressively assertive, pursuing symptomless individuals and telling them what they must do to remain healthy. Occasionally invoking the force of law (immunizations, seat belts), it prescribes and proscribes for both individual patients and the general citizenry of every age and stage.
Second, preventive medicine is presumptuous, confident that the interventions it espouses will, on average, do more good than harm to those who accept and adhere to them.
Finally, preventive medicine is overbearing, attacking those who question the value of its recommendations."
https://www.cmaj.ca/content/167/4/363.full
I couldn't agree more.
Hi Simon, you ask where were the consumers in GFN 2020. You mention only Greg Conley and Clarissa Virgino. Unfortunately you seemed to have missed my talk: "Nicotine use: the consequences of bad science for consumers". I also spoke on behalf of Pro Vapeo Mexico, which is non-profit a vaping consumer association. My talk dealt only with vaping consumers and vaping in COVID-19 lockdown, since the relation between COVID-19 and smoking was covered by Farsalinos and Polosa (in the same session).
My talk was aimed at providing to vapers scientific arguments to counter misinformation spread by health authorities: (1) that vaping is a major risk factor for hospitalization and serious COVID-19 illness and (2) that special interventions are needed to prevent SARS-COV-2 contagion through environmental vapor. I showed on the basis of evidence and scientific arguments that the answer to both questions is NO. I also reviewed a cross sectional internet poll on smokers, vapers and non-users of nicotine under lockdown. The result: 10.2% of all non-consumers of nicotine has symptoms meeting COVID-19 diagnosis, while only 3% of all vapers and 4% of all smokers did (this supports a protective effect by nicotine). I concluded by stating that 'bad science' affects consumers (vapers and smokers) and scientists doing this 'science' have to be aware (and be accountable) because it affects real people, it is not just an academic issue.
I fully agree that anti-smoking excesses of some vapers are wrong and self defeating. I also agree that many (in not most) smokers do enjoy smoking (I still smoke and enjoy a cigar/pipe every 2-3 days). For the record, I have publicly opposed smoking "denormalization" and support smoking rooms in bars and restaurants. I have publicly opposed anti-smoking junk science about second hand smoke and that anti-science called "third hand smoke".
You mention that the GFN has become an echo chamber. Yes, those who participate are aware of this. To correct it organizers have invited anti-vaping crusaders of all sorts. I would love to debate them, but they never come. In fact, in some "orthodox" tobacco control meetings the mere assistance to GFN merits your rejection (you cannot even register). Also, a paradox of the EVALI crisis is that some anti-tobacco crusaders are now preferring smoking to vaping. There are more jurisdictions in this world (specially Asia) where you can smoke legally but vaping is banned and punished. If I ever visit Thailand or Singapore I'll leave my vaping gear and take only my cigars and pipes.
Dear Roberto,
Many thanks for your response. I appreciate too your public opposition to the "denormalization" of smoking, your support for smoking rooms in bars and restaurants, and your opposition to "anti-smoking junk science about second hand smoke" and so-called "third hand smoke".
To the best of my knowledge however these issues are never raised at GFN which appears to focus exclusively on harm reduction (a very legitimate cause) and largely ignores issues that concern those who continue to smoke.
This is monumentally short-sighted because it ignores the fact that the same strategies used against smoking will also be used against vaping (and already are in many countries). It also effectively shuts confirmed smokers out of the debate when there is a lot that could be learned from them
For an event that incorporates the word 'nicotine' in its title it's bizarre that it chooses to ignore the millions of consumers who enjoy the consumption of nicotine via combustible products. How is GFN going to influence them to switch if all they see is yet another tobacco control conference that doesn't address issues of immediate concern to them?
Risk reduction is something Forest supports wholeheartedly (we are also active in defending the rights of consumers to vape in public places), but choice and personal responsibility are important too. It appears however that the only rights the organisers of GFN are willing to discuss is the right to switch to alternative harm reduction products.
I'm not the first person to make these comments yet nothing ever changes. The organisers have never contacted me other than to complain that I "write and tweet a lot of inaccurate stuff about GFN". When I replied at length and, I thought, constructively, to that complaint I didn't even get a reply.
In many ways GFN is a very successful event, well organised and with a loyal following, but I suspect that has led to some complacency. GFN does not have to be an echo chamber but many people would agree that it is and that seriously restricts the broader influence it could and should have.
Meanwhile, why can't the organisers have a panel discussion about smokers' and vapers' rights? Four panelists representing a wide range of opinion. Or, as I suggested, a panel discussing the pleasure of smoking, vaping and other other alternative products including snus. Both would be informative AND entertaining.
I would be happy to organise it and book the panelists. If the organisers are not happy with that suggestion perhaps you and I could work on it together. It won't happen though, will it?
PS. This is The Pleasure of Smoking: The Views of Confirmed Smokers report I mentioned in my blog post. It was funded by Forest but the research was conducted by Neil McKeganey of the Centre for Substance Use Research who also wrote a related peer-reviewed paper Why Don't More Smokers Switch to Using E-Cigarettes: The Views of Confirmed Smokers.
Neil has spoken at GFN but neither he nor I were ever invited to discuss the important issues raised in his report/paper and it has never been explained to me why not. Frankly I have no great wish to travel to Warsaw in June but I do think it shows a lack of imagination on the part of the organisers that they won't discuss some of these issues.
Best wishes.
I fully agree: smokers must have a voice in tobacco harm reduction.
E-cigarettes must be an option to all smokers, not a stick to stigmatize them. Many smokers are bound to try them, either switching completely or becoming dual users or occasional vapers, but this is something that has to be decided by the smokers acting with full personal autonomy. The health argument is undeniable, absence of combustion dramatically decreases inhaled toxic compounds, but as you rightly say, besides being safer products e-cigarettes should also be enjoyable as consumer products in their own right. E-cigarettes should not be reduced to "stop smoking kits".
Bear in mind that outside the UK (and specially in the USA) health authorities and mainstream tobacco control are putting much more efforts in spreading misinformation against vapes than against smokes. This means that many smokers will not try the products not (necessarily) because they are not enjoyable, but because they have been scared about them (most Americans believe that "EVALI" was caused by Juul and nicotine vapes).