I mentioned the “tobacco epidemic” yesterday. It’s not something I made up. It appears in the first few lines of the Foreword of the Framework Convention on Tobacco Control:
The WHO Framework Convention on Tobacco Control (WHO FCTC) is the first treaty negotiated under the auspices of the World Health Organization. The WHO FCTC is an evidence-based treaty that reaffirms the right of all people to the highest standard of health.
The WHO FCTC represents a paradigm shift in developing a regulatory strategy to address addictive substances; in contrast to previous drug control treaties, the WHO FCTC asserts the importance of demand reduction strategies as well as supply issues. The WHO FCTC was developed in response to the globalization of the tobacco epidemic. The spread of the tobacco epidemic is facilitated through a variety of complex factors with cross-border effects, including trade liberalization and direct foreign investment. Other factors such as global marketing, transnational tobacco advertising, promotion and sponsorship, and the international movement of contraband and counterfeit cigarettes have also contributed to the explosive increase in tobacco use.
What the hell is a “tobacco epidemic”? Shouldn’t they define what they mean by a “tobacco epidemic”?
Firstly, an epidemic is something that affects people – demos:
A disease that quickly and severely affects a large number of people and then subsides is an epidemic: throughout the Middle Ages, successive epidemics of the plague killed millions. Epidemic is also used as an adjective: she studied the causes of epidemic cholera. A disease that is continually present in an area and affects a relatively small number of people is endemic: malaria is endemic in (or to) hot, moist climates. A pandemic is a widespread epidemic that may affect entire continents or even the world: the pandemic of 1918 ushered in a period of frequent epidemics of gradually diminishing severity. Thus, from an epidemiologist’s point of view, the Black Death in Europe and AIDS in sub-Saharan Africa are pandemics rather than epidemics
Early 17th century (as an adjective): from French épidémique, from épidémie, via late Latin from Greek epidēmia ‘prevalence of disease’, from epidēmios ‘prevalent’, from epi ‘upon’ + dēmos ‘the people’.
Tobacco is a plant. There is no such thing as an epidemic of plants. The authors of the FCTC seem to believe that in forests and farms and gardens they are witnessing plant epidemics.
If they believe that there is a tobacco epidemic, with tobacco plants becoming superabundant, do they want to wipe out the tobacco plant? Are tobacco plants harmful to humans, in the way that stinging nettles and thorn bushes can be? To the best of my knowledge, there’s no danger from tobacco plants, because they don’t have thorns or barbs.
Most likely what they really mean by a “tobacco epidemic” is that there is an epidemic of people smoking tobacco. But is that an epidemic disease either? If a lot of people choose to do something, does that make it an epidemic? If lots of people buy and read books, does that mean that there is a “book epidemic”? Is there a Framework Convention on Book Control to accompany the Framework Convention on Tobacco Control? If not, why not?
The answer to this would seem to be that the authors of the FCTC believe that smoking tobacco is in itself a disease. It’s not so much that they think that there are diseases that are the consequences of smoking tobacco (e.g. lung cancer). It is instead that they regard the act of smoking tobacco as itself being a malady, and they regard smokers as sick people, and as much in need of treatment as people who are suffering from leprosy or cholera or any other disease. They would list “tobacco smoking” as a disease just like pneumonia or epilepsy.
They also see tobacco smoking as an involuntary affliction, like catching ‘flu. In their view, smokers no more wish to catch the tobacco smoking disease than lepers want to get leprosy. They regard tobacco smokers as helpless addicts, as wedded to their addiction as lepers are wedded to leprosy.
But why not say the same of reading books? Aren’t avid book readers as much addicts of the written word as smokers are addicts of tobacco? Aren’t authors like J K Rowling peddlers of a kind of addictive drug, which has the effect of making people sit for hours with their eyes fixed on pages that they slowly turn? Aren’t television sets as addictive as books as well? And aren’t the addictions of reading books and watching television far more dangerous than tobacco, because – unlike tobacco – these books and TV sets transmit ideas which are very often ‘go viral’ (e.g. the Communist Manifesto)?
Anyway, the fact that the authors of the FCTC chose to call it a “tobacco epidemic” rather than a “lung cancer epidemic” strongly suggests that they see the real disease as being that of smoking tobacco rather than getting lung cancer as a consequence of smoking tobacco. They would seem to believe that simply being a tobacco smoker is in itself an affliction, quite regardless of any consequences that might result from smoking. For them, smoking is the disease from which smokers suffer. And even if all smokers enjoyed the best of health in other respects, they would still wish to “cure” smokers of the disease of smoking.
I don’t think smoking is itself a disease. I don’t think that reading books or watching television is a disease either. I think epidemic diseases are transmissible diseases that pass from person to person, and neither tobacco nor books nor TV is this.
And I think that the “tobacco epidemic” in the FCTC is going to come back to haunt the WHO one day. For it is evidence that the medical profession has lost its way, when it starts to classify behaviours like smoking as epidemic diseases, when they are not.