When we study public health or medicine, we subscribe to the mantra “follow the evidence.” Evidence-based medicine is the hallmark of good science, rational thinking, and sound public health practices. Yes, the evidence is there. Tobacco use in every form harms the physical health of the user and anyone subjected to secondhand smoke. In fact, the evidence is pretty darn overwhelming and has been accumulating since the 1950s. Yet notwithstanding good science, tobacco companies have continued to advertise their wares extensively on radio, television, billboards and now on the internet, targeting especially young people with ads about being “cool” and offering new electronic nicotine delivery devices as cigarette alternatives.
We’ve made some progress in the U.S. and these days can walk comfortably through smoke-free airports, train stations, restaurants, bars, office buildings, hospitals, and more. But what brought this sea change was the power of the people. People began to organize and persuade scientists and governments to act. First they organized around smoking cessation as an individual act to preserve their personal health. Then advocates and health departments pressured their legislators for smoke-free facility policies, warning labels, age restrictions on the sale of tobacco products, and flavor bans and price increases to deter youth tobacco initiation and reduce adult consumption. Then the legal community kicked in with lawsuits, seeking to hold tobacco companies liable for health damage caused by smoking. The smoking cessation movement was not led by a mere few charismatic leaders, but rather it was a groundswell of individuals who, like me, saw their parents and friends ruin their health and die as a result of smoking, and who became determined to do something about it.
Thus the tobacco control movement in the U.S. was one of the very first community “resistance” movements. It involved mobilizing against corporate greed, and a willingness to subvert public good to private will. So much was achieved in a relatively short time, but much remains to be done. Tobacco companies continue to flourish in developing countries, and even in the U.S. there are newer ways to promote tobacco use.
While there is still so much to do, on World No Tobacco Day 2017 let us honor how much has been achieved by people collectively speaking on behalf of their own health and welfare. Let us continue the good fight to end all tobacco use and phase out the sale of all tobacco products forever.