There was a book that came out a few years ago – the Bully State – that I had on my list of books-to-read, but never got round to reading, perhaps because I was already fully persuaded. Today it came back to mind, and I surfed the web a bit in search of it, coming up with quite a lot of stuff. Like this:
Several additional assumptions drive both the Nuffield report’s recommendations and, subsequently, Western governments’ public health thinking. These assumptions are:
- Most of the health care burden is driven by disease that results from lifestyle decisions.
- Most of the health care burden is therefore, in theory, preventable.
- The cost of most lifestyle-related disease is not recovered from the individuals with such diseases or from the industries whose products contribute to these diseases.
- Individual autonomy cannot be the paramount value in health care.
- Individual choice as a basis for health is ‘too simplistic’.
- Individual freedoms may have to give way to the coercive power of the State.
- Interventions, including coercive actions, to change behaviour may proceed in the absence of evidence of their effectiveness.
- Individuals have a clear responsibility to refrain from lifestyle decisions that lead to disease and, consequently, treatment can be denied to those who refuse to change their behaviour.
The authors of the Nuffield Report term their approach an ‘ethic of stewardship’, which they (with straight faces) describe as a new liberal approach to health, individual responsibility, and the state. In truth, it is an extreme, and an extremely dangerous, form of nannying dressed up in stewardship clothing. It is really bullying rather than nannying, threatening people rather than merely nudging them in the appropriate direction.
As the noughties drew to a close, it was clear that state-sponsored lifestyle hectoring was out; state-sponsored coercion was in. The Nanny State had become the Bully State.
What triggered my renewed interest was the thought today that what was happening with anti-smoking zealotry wasn’t nannying or nudging. It was instead plain, simple bullying. Large scale bullying. And that it was exactly the same as school bullying, but on a very large scale. And instead of being conducted by noxious little boys in short trousers, it was being conducted by noxious full-grown adults in long trousers, many of them in positions of authority, and some with ‘Sir’ in front of their name.
It took me back to my school days, and my experience of bullying. In retrospect, it hardly seems like bullying now, because it entailed no physical violence at all. Instead, I was subjected to a fairly long campaign that was intended to reduce me to something almost entirely worthless. It was a campaign which was very successful until I decided to do something I’d never done before (and had never needed to do): fight back. After that, the bullying stopped almost as rapidly as it started, as I picked off my persecutors one by one.
Today, perhaps for the first time, I saw how antismoking zealotry was exactly the same as school bullying. It’s something that sets out to reduce, diminish, demonise, and exclude smokers. It sets out to make them feel worthless. And in this, it is just as successful with many smokers as my school persecutors were successful with me. A great deal of smokers do actually think that they’re just wretched addicts. And of course they don’t fight back.
The upside for the bullies is that, the more they reduce the self-esteem of those they bully, the higher the esteem in which they hold themselves, and in which they are held. Because nobody wants to be on the receiving end of bullying, and so almost everyone sides with the bullies, and perhaps even joins in the bullying. Nobody ever calls them out. And of course that encourages them to bully even more people.
And this applies also with antismoking bullies. They pick on smokers, and everyone else takes their side, and even joins in the bullying, and nobody calls them out. Just like it used to be, back at school. And so politicians avert their eyes, and so do the media, and so does every and every ‘pundit’. Millions of people (hundreds of millions of people, actually) are now routinely defamed, demonised, and denormalised – and nobody says a word about it! Nobody calls it out for the crime that it is.
And thus encouraged, the army of bullies (and it is an army) move on to bully millions of other people. Drinkers. Fat people. More or less anyone can be set up as a target; their all-purpose statistical weapon can be readily re-calibrated to find danger in absolutely anything, or anyone. Custard? Set the No-Safe-Level dial to 0.2. Water? Reduce the confidence level to 50%. It’s easy when you know how.
It’s got nothing to do with ‘health’. Nada. Nil. It’s all about the bullies gaining status and power and wealth at the expense of the bullied. For not only does it entail the diminution of the targets of bullying, but it also entails the confiscation of their assets – mostly through taxation -.
Why do most people not fight back against this bullying? Well, in part it’s because many of them have come to believe that they actually are as worthless as antismokers tell them they are. But also they won’t fight back for the exact same reason that initially I didn’t fight back against my bullies: they’re too nice – just like I was too nice, and too friendly (until I’d had enough, that is). Because if you’re going to fight back, you’re going to have to find something nasty in yourself, something that is prepared to smash an axe into someone’s head, and follow up with a dagger. It took me a long time to get to be not only as nasty as my persecutors, but actually far nastier. And most people don’t want to be like that. But until they do summon up the determination, the bullying is only going to get worse and worse.
Which is why, eventually, people will fight back. Because, encouraged by acquiescence, bullies will only bully more and more people, worse and worse, until it becomes intolerable, and more and more people realise: it’s either them or us, and decide that it must be them that must go.
And once the bullies meet real resistance, they will dissolve away rapidly. Because their power is entirely illusory. It’s a confidence trick. Tobacco Control has no real power at all. It commands no armies, and has little wealth of its own. Everything that it has is what has been granted to it by frightened governments and corporations and media, anxious to avoid being on the receiving end of its hectoring and bullying.
But once anyone stands up to them, and calls them out for the crimes they are committing in broad daylight, their power is negated. Because as soon as anyone successfully stands up to them, other people will see that it can be done, and start doing it themselves. And so the collapse of Tobacco Control will probably be very sudden. One day Deborah Arnott and Stanton Glantz will be welcomed in television studios, and their pronouncements dutifully heard and repeated. And the next day they’ll be persona non grata, and will have a hard time getting a hearing anywhere.
And when that happens, all the politicians and pundits and CEOs who never said a word while smokers were being excluded and demonised will all start saying how they’d always been quietly appalled by what was happening, but couldn’t speak out at the time because it was against the party manifesto line, or against editorial policy, or contrary to shareholders’ interests, or something. All concerned will have a good excuse for why they stood back and let this awful obscenity unfold, while they pretended not to notice that it was happening.
We may be not far of this final denouement. Antismoking bullying is enormously socially and economically damaging, and eventually becomes intolerable. Particularly when it is accompanied by political bullying of the sort we have just witnessed, of the EU against Cyprus. Or environmental bullying that has undermined our ability to provide sufficient gas or electricity. We are at breaking point.
I’m beginning to feel more and more confident that in a few years (and perhaps even a few months), we will have seen the back of the likes of Deborah Arnott and Stanton Glantz and ASH and Tobacco-Free Kids and smoke-free this and fat-free that. And it will be the end of Tobacco Control, and most likely the WHO, and the BMA, and the RCP. It will be like the end of a long, bad dream. It will be the end of a nightmare.