Lancet blames tobacco for everything, others more realistic

Let's get The Lancet out of the way first.

Even its headline is ridiculous: 'Tobacco control: where economics trumps health'. Its opening line is: 'Tobacco makes a lot of people a lot of money.'

While I couldn't agree more that the profit motive is no friend to public health, both the headline and the opening suggest that tobacco is almost unique in providing its executives with the kind of livelihood that renders them entirely indifferent to the consequences of their activities for public health. As if tobacco production is the only economic activity that makes people money. As if the interests fighting tobacco control had no financial interests at stake. (The health versus wealth dichotomy, applied to tobacco and its opponents, is an entirely false one.)

Following this ignoble opening, The Lancet continues its loaded argument, pouring derision on the idea that the government should need any more evidence before bringing in plain packaging. Let's just accept that the medics are the good guys and attempts to bring down the smoking rate or introduce plain packaging are opposed only by cynics of malevolent intent. The article concludes by urging advanced countries to show less developed countries what can be done to fight tobacco when things are done properly. (It fails to showcase the tactics of Anna Soubry as an example to the politicians of less developed countries in how to pursue tobacco industry goals – I'll give it that.)

And I thought The Lancet was a reputable science paper.

The trouble with The Lancet is that its views are so out-of-the-box absurd. It recommends citing a 'mantra' (that tobacco production earns people money) when discussing tobacco, as if such a mantra were relevant to the harm that tobacco causes, especially given that much human activity generates money, and that the whole economic basis of the Western world rests on the ability to make money.

A little more perspective is gained from Junican's blog post from Wednesday, where he links to a discussion about how damaging tobacco is at the F2C blog, and also discusses both Eysenck's paper (which shows how it is actually impossible to quantify the risks of smoking because of the variability and coincidence of other factors) and a paper by Kitty Little (which observes how lung cancer correlates with both diesel emissions and static weather conditions).

So much for whether tobacco is responsible for all the ills in the world. Clearly it isn't.  As for the other thing that The Lancet was complaining about, namely tobacco industry influence on government policy, a Scotsman article from Joyce McMillan comes in with a different perspective on this that is more mature than some I have read in relation to the supposed influence of Tory campaign manager Lynton Crosby:

For behind the sound and fury of this row about lobbying, there lurked one of those elephants in the room that are becoming such a striking feature of Westminster politics; the fact that when it comes to influence-peddling at the upper levels of British government, lobbying has almost nothing to do with it. Lobbying is, after all, a perfectly legitimate activity; charities do it, campaigns do it, companies do it, and even trade unions do it, although usually with very little success.

When major commercial interests seriously want to change policy, though, the best-organised of them know that straightforward lobbying and argument is merely the tip of the iceberg. What’s needed, to achieve real results, is a cohort of politicians and public servants, at the highest possible level, who will support these companies’ positions as a matter of course; and that is achieved not so much by presenting them with arguments, as by co-opting and employing them, and making sure that a large part of their own present or future well-being is dependent on their continuing harmonious relationship with the industry in question.

I am not sure that any of this is deniable. The fact that it goes on even though the government in Scotland won't speak to the tobacco industry is proof that tobacco is not the only industry that seeks to influence policy. (If it doesn't happen in Scotland already, it will happen in an independent Scotland, simply because a Scottish government will be a target for anyone wanting to do business in Scotland.)

I don't see what is wrong with trying to inject realism into the debate. How can it serve tobacco control to continue this farcical ideology that tobacco, uniquely, makes people rich at others' expense and tobacco, uniquely, influences politicians in ways that are unethical?

And how crazy is it mainstream media fails to report on Soubry, a politician who breach parliamentary procedure in her zeal to pass tobacco legislation, because they are worried that a Conservative party employee who worked for Philip Morris might have  talked to the party leader?

Good grief.