Print version ISSN 0042-9686
Bull World Health Organ vol.90 n.9 Genebra Sep. 2012
The fight to stub out tobacco
Dr Jeffrey Wigand is delivering an anti-smoking message to children and young people. He talked to Ben Jones about his work.
Q: Why did you form Smoke-Free Kids?
A: I formed it with the goal of giving children knowledge, so that they would never try or use any form of tobacco product.
Q: Tell us more about Smoke-Free Kids and its work.
A: I also wanted to use my knowledge, both scientific and business, to work with policy-makers around the world, who would develop and implement policies, laws and regulations intended to protect not only children but others from tobacco-related health hazards. Examples of these policies are smoke-free environments, fire-safe cigarettes and cigarettes without the additives that make tobacco easy to use. Lastly is my role in litigation: using the courtroom to continue to shine a light on the truth and hold the tobacco industry accountable for its actions.
Q: How do you work with young people?
A: With youth my job is worldwide; I've been in classrooms from Japan to Switzerland and Italy. I speak to children and young people from kindergarten through post-graduate school meaning medical, law and business schools.
The content changes. With children from kindergarten through the age of seven or eight, I give them tools to understand why the use of tobacco and its addictive properties will have an effect on their health and life expectancy.
Younger people get a scalpel, tweezers, magnifying glass and microscope, and they basically dissect a cigarette and learn what the components of a cigarette are: the tobacco column, what the filter looks like, the difference between a white-tipped cigarette and a cork-tipped cigarette. So the game is to work out why there is no difference between a light cigarette and a fully-flavoured cigarette and how the industry cheats.
They do a laboratory experiment, so they have to learn how to do multiple things: they have to learn teamwork, they have to learn to dissect a cigarette and separate its parts, they have to learn to do record-keeping. They have a microscope and a magnifying glass so they can count the number of holes in the filter of the cigarette. Then they need to write up what they've learnt.
With medical students, the language goes from informal to the highly sophisticated description of the molecular structure of nicotine: why is it addictive? Why is it both a stimulant and a relaxant, what goes on in the brain? Then they learn about why nicotine irritates the arteries.
Q: Have you ever smoked?
A: Yes, I smoked for about a year when I worked in the tobacco industry. Everyone else was doing it so guess what I did? I tried it!
Q: How does the tobacco industry get kids hooked at a young age?
A: The brand that is chosen by kids is one that is advertised and promoted the most. Joe Camel was chosen by people taking up smoking because he was an icon like Mickey Mouse or Ronald McDonald. Bob the Cowboy appealed to boys. If you talk to the Winston man, it was the excitement of doing male things; if you talk to girls, it was the slim cigarettes. So there's lots of subliminal messaging going on.
The industry uses pricing, it uses peer pressure; it's a whole confluence of various factors. Sixty per cent of people who smoke start smoking with their friends, according to the Centers for Disease Control and Prevention in the USA.
Q: Are there any studies of the effects of the work you do?
A: No. I don't have the resources to do that. I measure it by the number of people who give me their packet of cigarettes after I talk to them or show them something. Do I quantify the number of people who've written to me after watching the movie [The Insider] or seeing my web site? I'm not interested.
Q: Do you get a lot of positive feedback and is it that what drives you on?
A: Positive feedback encourages anybody. The fundamental driving forces are whether you are doing something that you believe is right and whether it makes a difference. You also need to know whether the difference encapsulates a population or you can do it one by one.
Q: Not many people have had their lives portrayed by Hollywood. Has that helped you in your work?
A: I think the movie enhanced my public persona, yes. Would I be here today if it wasn't for the movie? Probably not.
Q: How is Smoke-Free Kids funded?
A: By me giving talks and presentations for which I'm paid. I don't want any other donors. I do what I want to do because I want to do it.
Q: Tell us a bit more about your work with governments. How do you promote the anti-smoking message to policy-makers?
A: I would say they invariably seek me out. I presume that's because I have a public persona. They ask 'what would you do if you were me?' That's how I started with Allan Rock, who was Canada's minister of health from 1997 to 2002. We developed a programme in which we changed the packaging and pricing and introduced smoke-free environments.
I've been to Norway, Malta, Iceland. There's not too many places that I haven't been.
Q: Which factors ensure that people don't start smoking?
A: There's no foolproof way. Everybody's autonomous they have their own free will. I have no domain or control over that. That's the purpose of education. Education provides people with cognitive capacity to make good decisions.
Q: Which government policies work when it comes to stopping children smoking?
A: I think government policies provide the environment for people to make better decisions, I don't think government tells anybody what to do and how to do it. What government does is provide the environment for people to behave in a certain way. In the case of price increases, people say: 'If I can't afford it, I won't smoke'.
Q: Which governments are doing a good job in the fight against smoking?
A: The Canadian government has distinguished itself and the Australian government has distinguished itself, with measures such as smoke-free environments, changes to packaging and counter advertising. They're all part of changing the environment in which smoking has been endemic.
Q: Is public health winning the battle against tobacco? Has the tobacco industry changed?
A: No, I don't think the leopard has changed its spots. It's just becoming much more sophisticated in developing and delivering nicotine products, whether they're dissolvable, cherry-flavoured cigarettes, or whatever. They continue to use their tentacles in government circles to protect the industry. I don't think that's changed dramatically yet. I think it will change, because public health concerns over disease and death are becoming much more influential. It costs governments more money, more businesses lose productivity; ultimately they say 'this thing is no good for us'. What's happening is we're having a 'de-normalization' of a two centuries-old product: it's not part of everyday life. It's evolutionary: we're undoing two centuries in a decade.
Q: Why do you want governments to take additives out of cigarettes?
A: Because it would make tobacco taste disgusting. If I put something in my mouth that tastes disgusting, then I'm not going to use it.
Q: Tell us about your involvement with litigation.
A: I appear on behalf of a plaintiff who has been harmed, or for a government who is seeking to recover the cost of health care [from smoking-related diseases]. I act as an expert witness. That's what we're doing in Canada, that's what we did in the United States, there was a case in Japan too. The most success so far has been in the US and now in Canada.
Q: How strongly are lawyers involved with the tobacco industry compared to the other industries you've worked in?
A: Lawyers are part of the tobacco industry both internally and externally and they are intimately involved at all phases of operations. I don't think that's true of the pharmaceutical industry.
Q: Are there any measures that governments have taken that you feel don't work?
A: I'm not that comfortable with the Family Smoking Prevention and Tobacco Control Act, which was passed in 2009, which basically gave the US Food and Drug Administration regulatory power over the cigarette industry. My problem was that the industry directly participated in crafting the law. So they exempted menthol, and two weeks after the law was passed Philip Morris introduced menthol cigarettes. It had no teeth. They should have eliminated menthol as an additive, not as a cigarette.
The tobacco industry was sued in the Netherlands in 2005, it had to disclose all the additives, then the political environment changed and the result of that was that none of the additives has been disclosed.