What crisis of smoking should have taught us
A 20th century health risk mirrors pandemic, writes Daniel Robinson
My mother-in-law is in the hospital with COVID-19. Across the street, maskless workers are building a house. Cases remain high, and hospitalizations and deaths are soaring.
Having spent years researching Canada's smoking epidemic, I am not surprised by this state of affairs. Canada, with the exception of Atlantic Canada, has largely failed the COVID -19 test.
This is, in part, due to historical public health amnesia, coupled with wishful thinking by elected officials that moral exhortation and public education can be the main drivers for beating the pandemic.
Governments have already forgotten “historical” lessons from last spring — when hard lockdowns and serious measures drove down cases — so lessons learned from Canada's previous public health issue, smoking, are, not surprisingly, being ignored.
But links can be drawn between last century's cigarette health crisis and today's global pandemic. First, people routinely minimize health risks.
Second, disinformation and misinformation are the bedfellows of epidemic disease. And third, governments respond tardily and tepidly to public health crises, guided more by political calculus than proven public health measures.
Smoking 's causal link to lung cancer first appeared in scientific journals and news stories in the early 1950s.
By 1960, scientific consensus held that cigarettes were extremely harmful, prematurely killing about 40 per cent of regular smokers. But again, in the early 1970s, pollsters found that more than four in 10 people were undecided or disbelieved that smoking caused cancer. Smokers thought they were more likely to die from a car accident than from cigarettes. In 1977, smokers were asked if they agreed that “smoking cannot be all that dangerous because I know people who smoke two packs a day and are still going strong.” Fifty-two per cent agreed.
The need to minimize health risks is emblematic of “motivated reasoning.”
This psychological theory posits that people engaged in dangerous behaviours adopt justifications and arguments to minimize the perception of these risks.
Tobacco companies promoted science denialism with a 40-year campaign of disinformation.
They routinely disparaged tobacco epidemiological evidence as not properly clinical or experimental and blamed air pollution and viruses for rising lung cancer rates. The industry marketed doubt alongside cigarettes.
The Big Lie of Big Tobacco offers a template for today's COVID-19 deniers.
No matter how scientifically dubious the point, saying it often and loudly produces the desired effect: seeding doubt in people with underlying motivations to attend house parties or go mask-free.
Ontario MPP Roman
Baber said in a recent open letter that COVID-19 had a “99.98 per cent” survival rate, better than the seasonal flu. Hospitals were doing just fine, while lockdowns were “killing lives.”
Baber was rightly bounced from the Tory caucus. But his letter circulated widely on social media, expanding and bolstering the ranks of anti-maskers and Returnto-2019 aspirants.
To combat denialism and misinformation campaigns, robust government action is needed. Government responses to the smoking-and-cancer crisis, however, were especially flat-footed. For two decades, the federal government did little. In 1970, the Pierre Trudeau government, finally, introduced a bill banning most forms of cigarette advertising, only to backtrack in the face of tobacco opposition.
A few months later, the bill was quietly withdrawn.
Some cabinet members opposed the bill, citing individual freedoms.
The Trudeau government had recently decriminalized homosexuality and abortion. Since Ottawa would no longer police the nation's bedrooms, neither should it come between Canadians and their cigarettes.
In the last century, the cigarette health crisis factored in the death of more than 100 million people globally. Government failure to learn from that health crisis is putting lives at risk today.