Final word on last week's Global Tobacco and Nicotine Forum in New York (see my previous post, Mandela, moon landings and JFK).
On day one I was on a consumer-orientated panel moderated by Chris Greer, CEO of the US-based Tobacco Merchants Association. The other speakers were Giles Roca, director of the UK-based Tobacco Manufacturers' Association; Alex Clark, CEO of Consumer Advocates for Smoke-free Alternatives Association (CASAA); and Audrey Silk, director of New York City Citizens Lobbying Against Smoker Harassment (NYC Clash).
Genuine consumers, smokers especially, are rarely invited to speak at tobacco conferences (at best they are given observer status) so I was delighted Alex and Audrey accepted our invitation. They each made points that needed to be said and their heartfelt contributions made GTNF a richer, less corporate event (for an hour, at least).
Audrey was certainly in no mood for appeasement and if her forthright view of public health campaigners ("lunatics") was at odds with the tone of the conference it was refreshing to hear her say it.
After the event I asked her for her thoughts. She replied:
Having only spent a few hours at the conference - both actively participating and just taking in the atmosphere - I don't know how fair it is of me to form an impression about its proceedings, let alone judge its value.
That disclaimer aside, my limited presence left me with the taste that, while we all shared our thoughts, experiences, and conclusions about the state of our interests, the question "to what purpose?" was left dangling in the air. Was anything to become of it? I couldn't tell.
While the audience for our well-received panel were "friendlies" (with a few antis strewn among them I would guess), I still felt like I might as well have been testifying at a city council hearing. And we all know how those go. You speak - because the democratic process dictates that they let you - and then ... crickets.
In general though it was a very well put together affair and I was received very warmly. And regardless of what practical impact, if any, will arise from the conference, the greatest benefit was the opportunity to meet, work, and socialize with men like Simon Clark and Chris Snowden and the rest of that particular entourage (women included) who I did not previously know much or anything at all about.
A great group. I had a really good time sitting with them for dinner and confirming that it's our side of the debate who know how to have the most fun. Thanks for the invite, Simon!
Anyway, for what it's worth, here's my contribution to the discussion, Risk and Regulation: Impact of Excessive Legislation on Consumer Behaviour. I spoke directly after Audrey and this is what I said:
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We've heard about consumer attitudes and how excessive legislation can be counter-productive. I’d like to raise two questions that rarely get asked:
One: “Despite the well known health risks and increasingly restrictive regulations, why do so many adults continue to smoke?”
Two: “Despite the significantly reduced risk of using e-cigarettes, why don't more smokers switch to e-cigarettes or other harm reduction products?”
But first, I’d like to introduce you to Jim. That’s not his real name. But he is a real person.
This picture (above) was taken at an annual Forest event called Smoke On The Water. Each year we hire a Mississippi-style paddle steamer and cruise down the Thames under Tower Bridge and past many of London’s iconic buildings including the Houses of Parliament. Guests include politicians, parliamentary researchers, political activists but, most important, ordinary consumers – smokers and vapers.
I love this photo because it illustrates the type of person Forest represents – a gloriously unashamed smoker who enjoys smoking and doesn’t wish to quit or conceal his habit.
Smokers, especially cigarette smokers, are invariably portrayed as victims of a terrible addiction. Does this man look like a victim to you? Of course not. Nor is he alone. There are many, many smokers just like Jim.
Yet when I tell non-smokers – including numerous TV and radio presenters – that millions of people enjoy smoking and don’t want to quit, they look at me as if I’m mad or making it up.
And this leads me to some research that I’m very proud to have played a small part in.
Last year Forest was approached by Dr Neil McKeganey, director of the Centre for Substance Use Research in Glasgow. In his words, "As a result of the overwhelming influence of the tobacco control/public health perspective, the views of smokers have been largely, if not entirely, ignored in medical, scientific, and media discourse on smoking."
Together we compiled a 40-question survey and invited smokers on the Forest database to complete it. The results – which were published in this report, The Pleasure of Smoking: the views of confirmed smokers – were very interesting.
I should add that we invited Neil himself to join us at GTNF but he had a conflicting event in Vancouver, so I’m going to address some of the findings on his behalf.
The online survey ran for three weeks in November 2016. It was advertised primarily to smokers in contact with Forest. 650 smokers completed the survey. It is not and has not been presented as a representative sample of ALL smokers. Instead it’s a sample of what we have termed confirmed smokers – those for whom smoking is seen as a positive part of their lives.
We asked them about their smoking history, their reasons for starting and continuing smoking, what they liked most and least about smoking, their thoughts on what might most influence their smoking in the future and their views and experience of alternative nicotine delivery products (mainly e-cigarettes).
So what did they say? I won’t go through the whole report. I’ll simply highlight a few of the findings:
31% said smoking helped them deal with stress; 35% said smoking was part of their identity; 56% accepted they were addicted to smoking but, interestingly, that didn’t seem to concern them; 77% envisaged smoking well into the future.
Significantly, 95% identified enjoyment or pleasure as their principal reason for smoking. They knew the risks of smoking but they balanced the pleasure it gave them against the risk to their health.
On the subject of e-cigarettes, an over-whelming majority of respondents had used e-cigarettes (and we got feedback on what they liked and disliked about vaping) but very few were tempted to switch permanently.
The authors concluded that:
- The smoking end-game (the so-called ‘smokefree’ world) is much talked about by governments, and even by the tobacco industry.
- Those discussions have been fuelled by the growth of alternative or electronic nicotine delivery systems.
- On the basis of this survey there remains a sizeable minority of smokers who wish to continue smoking, who enjoy the smoking experience, and who see themselvessmoking well into the future.
- The willingness of smokers to try alternative products is evident even if it is principally driven by restrictions on smoking.
- Further transition from combustible to exclusive use of non-combustible nicotine products will rely upon industry developing alternatives to smoking that are closer to the smoking experience than is currently the case with regard to e-cigarette technology.
Why is this survey relevant to this discussion today? The answer is very simple. We believe it is impossible to legislate combustible cigarettes – or smoking – out of existence. For the foreseeable future – and almost certainly long after that – a significant number of people will want to smoke, and ‘public health’ and the tobacco industry need to understand that.
Professional vaping advocates, including the tobacco industry, also need to understand that the current generation of smokeless products, including e-cigarettes, are not sufficiently attractive to the vast majority of confirmed smokers – and it’s not for want of experimenting.
The overwhelming majority of confirmed smokers aren’t stupid. They’ve read the reports and they know that e-cigarettes are significantly less harmful than combustibles.
But they continue to smoke – even after experimenting with smokeless products – because they enjoy it and smokeless products don’t provide the same degree of pleasure.
Confirmed smokers are also resourceful. Many avoid paying punitive tax on tobacco by using the black market; alternatively they will purchase tobacco, quite legitimately, in countries or states where the tax is lower.
Smoking bans don’t stop them smoking either. Most confirmed smokers are extremely adaptable.
Display bans, graphic health warnings, plain packaging – there is no evidence that any of these measures have reduced smoking rates in the countries where they have been introduced.
The point is – excessive regulations do not stop confirmed smokers from smoking. For some consumers, smoking is actually a small act of defiance against anti-smoking legislation.
In short, no matter how far governments legislate, regulations – and punitive levels of taxation – will NEVER stop a substantial number of people from smoking.
Fundamentally, the issue is and always has been about CHOICE. If you want confirmed smokers to switch to a healthier nicotine delivery system, you have to offer not just an alternative to smoking, it has to be a more pleasurable alternative.
Just as important, you cannot coerce smokers to switch to a healthier alternative. For example, when I hear public bodies in the UK call for a ban on smoking outside pubs and bars to encourage smokers to take up vaping, I despair.
One, it’s an attempt to coerce consumers to quit a legal product. Two, it medicinalises vaping by turning e-cigarettes into a smoking cessation tool.
To get confirmed smokers to switch to e-cigarettes and other harm reduction products, it has to be their choice. You cannot impose vaping on smokers through regulation.
Likewise, for e-cigarettes and heated tobacco to replace combustibles, they have to be recognised by all parties as a recreational product that can be enjoyed on their own terms.
Excessive restrictions and regulations on e-cigarettes will undoubtedly do the product irreparable harm. But it will also harm vaping if it is promoted as an attempt to stub out smoking because what consumers want is choice, not a reduction in choice.
Like all the panellists here, I’m sure, I welcome harm reduction and embrace new technology and emerging products.
However, I also believe that if the tobacco industry is to meet the needs and desires of ALL their customers it has to balance the brave new world of electronic nicotine delivery systems (ENDS) with the familiar old world of tobacco.
It should never be a question of one or the other. Just as it is wrong to over-regulate e-cigarettes and discourage smokers from switching to a potentially healthier alternative, it is equally wrong to coerce smokers to switch.
If smokers choose to quit or switch it must be for positive reasons. There is no place for social engineering, whether it be the use of smoking bans or punitive taxation.
I hope therefore that most of the tobacco companies will continue to support the fight for choice, defending the interests of adults who choose to smoke as well as those who choose to switch to e-cigarettes and other nicotine products.
(I am aware, by the way, of the announcement that Philip Morris is to set up a foundation to convert smokers into consumers of devices that don’t burn tobacco. It’s to be called the Foundation for a Smoke-Free World. Perhaps we will discuss this later.)
For many people – not all – risk and pleasure go together. However much we try to reduce risk, in doing so we risk taking away much of the pleasure.
Harm reduction will only be achieved by offering the consumer more choice – not less. You don’t win hearts and minds by banning flavoured cigarettes or reducing nicotine levels. Excessive regulations merely breed resentment.
One final thing I will add is this, and it’s something I’ve been saying for a long time. If anyone thinks the current war on tobacco will end with combustible products, I think they are being very naïve.
We’re told that the goal is a smoke-free world. I don’t believe it. I believe the long-term goal of the anti-smoking industry is a nicotine-free world. Getting smokers to switch to non-combustible products is merely a stepping stone towards that objective.
Finally, if you don’t want e-cigarettes and heated tobacco to go the same way as combustibles – denormalised and regulated to the nth degree – I believe the industry has to publicly support the concept of choice, and defend the rights and interests of all consumers – including confirmed smokers.
Oh, and a suggestion to PMI. Instead of calling your new project the Foundation for a Smoke-Free World, how about calling it the Foundation for the Advancement of Consumer Choice?