I did not plan to make a running theme of this when I first posted about analogies between my work on tobacco harm reduction (THR) and the attempts to introduce some Keynesian sanity into current discussions government economic policy. But I just keep seeing more and more parallels.
A recent analysis by Christopher Hayes included a point that was picked up on and extended by Paul Krugman: Regarding the current economic situation in the West, their fear is that eventually everyone who is remotely honest will have to come to realize and admit that push to constrain government spending to reduce deficits right now is a bad idea. Krugman and Hayes each offer comparisons to the run up to the Iraq War which struck me as also being good metaphors for anti-THR.
Krugman points out that the people who are demanding austerity in the face of a liquidity trap and devastating unemployment are the ones who are currently considered the Serious analysts, in contrast with those calling for more stimulus, even though the latter position is better supported by the science as being good for the economy and certainly more humane. He likens this to the war where it was quite clear as the invasion approached that the justification was flawed, the potential for disaster was great, and the upside was sketchy. But after it became clear that the justifications were bogus and the overall experience was a disaster, we have a situation where only those people who originally supported the war and then reluctantly came to accept concerns about it after they were absolutely impossible to ignore are considered Serious, while analysts with the sense and honesty to understand and testify that it was a bad idea from the start are considered “flaky and unreliable”.
This seems quite similar to the experience with THR. Among those who support THR are several people and organizations that once were part of the “tobacco control” – aka anti-tobacco extremist / “quit or die” / abstinence-only – community before recognizing that harm reduction is a more effective way to promote health or recognizing that promoting THR is demanded by any accepted standard of social ethics. (Most often only the the former – these individuals usually support only a narrow form of THR, caring only about health outcomes, rather than fully embracing the harm reduction principle of improving welfare.) For some reason, their analyses on the subject are taken more seriously than analyses by those of us who were never active in the abstinence-only community and recognized the value of harm reduction from the time we first contributed any substantial work on smoking and public health.
Even casual vague assessments by these actors are often taken more seriously than careful, scientific, in-depth analyses by those of us who have focused on THR from the start. Perhaps the most absurd example of this is how a baseless and obviously wrong figure about the comparative risk of smokeless tobacco versus smoking – that appears to be little more than guesswork, but was produced by people who were part of the extremist camp – is cited more than the much more accurate estimates (based on actual calculations that anyone could verify) by those of us who take THR seriously. This strange bias seems to favor even more strongly those who have done a bit to support harm reduction but ostentatiously claim to waver on the topic. Their tendencies to bury everything they say in tortured caveats and calls for more research that is clearly redundant or irrelevant, as well as to half cling to incommensurate extremist position (usually, it seems, because that is where all the money is and they do not want to risk their gravy trains), are treated as a reasons to trust them.
Why is having been badly wrong, let alone refusing to distance oneself from the false claims after making it quite clear that one knows they are false, a source of credibility?
Just to clarify, a few of the aforementioned people are my friends and/or colleagues I respect greatly, and I am not suggesting their actual contributions to the discourse are faulty. But their contributions are valuable because they are good, not because the author was wrong before. I would even say that the contributions are good despite the author being wrong before.
I also wonder about the possible future that some of us predicted for years (see, e.g., the Introduction of Tobacco Harm Reduction 2010), wherein current opponents of THR figure out a way to take credit for the inevitable march of THR. I wonder if, when THR happens despite the efforts to stop it, those who were trying (lying, maneuvering) to stop it will become the Serious People whose opinions about it are considered most reliable.
Hayes also points out a rather different point, that the leaders of the forces supporting the Iraq War or the current calls for austerity undoubtedly knew that there was no real worry about weapons of mass destruction or that trying to reduce budget deficits while in a slump is counterproductive, but just used the claims (about WMDs or deficits) as sellable and popular stalking horses for their rather more oligarchic aims (imperialism and securing oil wealth; further shifting wealth from the poor to the rich). Thus, even though the facts did not support their claims they do not really care, because what they were claiming was never actually what motivated them. This again rings familiar. It is pretty clear that the thousands of naive foot soldiers for the leading anti-THR activists – local health officials, politicians, teachers, clinicians, and others who really do not understand what they are saying but blindly trust influential people who (dishonestly) claim to be on the side of public health – do not actually favor anti-tobacco extremism over public health and human welfare, but they have been tricked. Unlike the extremist leaders who undoubtedly know better and are just looking for a way to rationalize their policies, their followers actually believe that no one benefits from nicotine use, universal abstinence is coming soon, and that low-risk nicotine products are 100 times more harmful than they really are. It is much the same as the lower-middle class conservative families – those whose members paid almost all the human costs, and more than their share of the financial costs, of the Iraq war – blindly supporting the oligarchs.
I am open to the possibility that I am exaggerating the parallels of the current socio-economic fights and the struggle for THR. Seeing connections everywhere is an occupational hazard when one is immersed in particular topics, so I invite my readers to point that out to me if it seems to be the case. But I just cannot help but see the same right-wing playbook being used in both cases.