Public Health has a Tobacco Problem

Image taken from page 855 of '[A series of original Portraits and Caricature Etchings by ... J. Kay; ... with biographical sketches and illustrative anecdotes. [Edited by H. P.]]'The widely circulating media reports that compare bacon to tobacco in terms of its capacity to cause cancer reveals the “tobacco problem” with public health communication.

By “tobacco problem” I don’t mean that researchers or communicators are on the take from “Big Tobacco” or that they have got the facts wrong about its association with cancer. The tobacco problem is that the success of tobacco control has produced a conceptual and political myopia. Or what I call a “tobacco control style of thought”.

Ian Hacking describes a “style of thought” as a particular way of seeing the world or problem that allows some ideas to be thinkable and actionable, while rendering other ideas as unthinkable. The success in linking smoking with cancer and the implementation of controls to regulate its use have contributed to a tobacco control style of thought.

The effect is that all public health issues are shoe-horned to fit the tobacco control model.

Eating bacon and red meat, drinking soda or frequenting fast-food restaurants, or sitting in a chair for too long are all equated with smoking. Why? Because saying bacon is like tobacco means that the problem and corresponding solution is well understood by the public and policy-makers.

Except it isn’t. All of these activities are extremely different from smoking. Eating bacon is not the same as smoking cigarettes. Everyone outside the tobacco control style of thought can see this.

The Australian Agriculture Minister Barnaby Joyce said it is a “farce to compare sausages with cigarettes“. Does Barnaby have financial and political interests in saying that? Yes. Is he wrong in saying that? No.

Sure, saying “bacon causes cancer” generates headlines, but it also distracts from focusing on the actual research on the health effects of processed meats. Public health Image taken from page 277 of 'Lilliput Lyrics ... Edited by R. Brimley Johnson. Illustrated by Chas. Robinson'communicators and researchers need to break out of the tobacco control style of thought that makes bacon or soda look like tobacco.

Public health is currently in a battle with libertarians who cry “Nanny” every time they are told that an activity or behaviour should be regulated. However, in equating activities like eating processed meat or sitting at a desk with smoking, public health communicators give the appearance of legitimacy to the “Nanny State” cry. This does real damage to the credibility of public health research and erodes public understanding of risk factors and epidemiology.

Like the boy who cried wolf, if public health communicators continue to compare everything to smoking, soon people will stop listening.