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“Liberal freedoms should not trump public safety, especially not during a pandemic.” Daniel J. Robinson
Despite the recent passing of the COVID-19 pandemic’s one year anniversary, a surprisingly large portion of the public has remained skeptical or dismissive. While this response – ranging from anti-lockdown protests to the circulation of wild conspiracy theories – has surprised many, a look at Canada’s handling of a previous public health crisis can shed some light on our current dilemma. In this week’s blog post, MQUP author Daniel J. Robinson explores the similarities between Canada’s smoking epidemic and the country’s reaction to the current COVID-19 pandemic, exposing some troubling truths.
Highlighting the prolific marketing and advertising practices that helped make smoking a staple of everyday life, Daniel J. Robinson’s new book Cigarette Nation: Business, Health, and Canadian Smokers, 1930-1975 explores socio-cultural aspects of cigarette use from the 1930s to the 1950s and recounts the views and actions of tobacco executives, government officials, and Canadian smokers as they responded to mounting evidence that cigarette use was harmful.
This piece was originally published in the Ottawa Citizen publication on 1 February 2021.
My mother-in-law is in the hospital with COVID-19. Across the street, mask-less 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. Yet, when Gallup asked Canadians in 1954 if they believed that smoking caused lung cancer, only 25 per cent said “Yes.”
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. People’s beliefs regarding health and science are prone to fundamental biases and can lead to science denialism. This “minimizing” and “denial” is in full display with the COVID-19 pandemic. And science denial is being aided by disinformation.
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.
Tobacco executives lambasted smoking reports from the U.S. Surgeon General and other reputable organizations as biased or faulty. They lobbied journalists who wrote about health topics. Industry talking points appeared often in news stories, undermining people’s capacity to evaluate risk, weigh evidence and make informed decisions.
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 Return-to-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 back-track 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. The state’s role was to “inform and educate,” making smoking a matter of personal responsibility and not public health.
Few realize that the omnibus bill that decriminalized homosexuality also contained provisions to broaden state powers involving firearms and impaired driving. Irresponsible gun owners and drunk drivers could harm others; the rationale here was for public safety.
Liberal freedoms should not trump public safety, especially not during a pandemic.
To return to my mother-in-law in the COVID-19 ward and the mask-less workers across the street: Public health experts understand that both events are linked. They are not separate political or economic problems to be solved. Rather, they are part of an intricate web of social behaviour, government action and public health care that can either help spread or curtail COVID-19 transmission. 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.
Daniel J. Robinson is a historian, an associate professor in the Faculty of Information and Media Studies at the University of Western Ontario, and the author of Cigarette Nation: Business, Health, and Canadian Smokers, 1930-1975. He lives in London, Ontario.
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