Shameless opportunism

Apologies for the lack of posts these past ten days.

I'm trying hard not to comment on the coronavirus situation, here or on social media. The last thing anyone needs is yet another blowhard mouthing off from the comfort of his armchair.

Impossible, I know, but if we could agree on just one thing it should be this. Whatever actions are taken (or not taken) in the course of this difficult period, decision-makers are doing their best in unusual circumstances.

Give them credit for that, at least, even if you disagree with some of their decisions, or the timing. Anyone who tries to take advantage of the present situation to pursue their own agenda deserves our contempt, which brings me to something I do wish to comment on.

I'm sure I'm not alone in thinking how distasteful it is that tobacco control campaigners, led by ASH, have decided that the current pandemic is a good time to double down on smoking cessation.

Quoting the Secretary of State for Health Matt Hancock (“It is abundantly clear from the research into previous coronaviruses that smoking makes the impact of a coronavirus worse”) ASH last week issued a press release that began:

As the Government again highlights the risks to smokers from COVID-19, Action on Smoking and Health (ASH) is joining health professionals in calling on smokers to #QuitforCovid.

Like my fellow lobbyists at ASH I'm no expert but I do know there is currently no evidence to suggest that a disproportionate number of smokers have died from coronavirus.

It will be months before there is more data but in the meantime it's worth reading this initial study, Smoking, vaping and hospitalization for COVID-19.

Co-authored by Greek cardiologist Dr Konstantinos Farsalinos who has become synonymous with research on the use of e-cigarettes, the study 'presents an analysis of the current smoking prevalence among hospitalized patients with COVID-19 in China, compared to the population smoking prevalence in China.'

According to the authors:

The current study examined for the first time the prevalence of current smoking among hospitalized patients with COVI-19 in China and compared it with the expected prevalence based on the population smoking prevalence. Care was taken to consider the large difference between genders, with current smoking being substantially more prevalent among Chinese males than females. An unusually low prevalence of current smoking among hospitalized COVID-19 cases in China was observed when considering the population smoking prevalence. The true prevalence of current smoking among hospitalized COVID-19 cases presented in 5 studies was approximately one-third the expected prevalence. This preliminary analysis, assuming that the reported data are accurate, does not support the argument that current smoking is a risk factor for hospitalization for COVID-19, and might even suggest a protective role.

No-one, least of all Dr Farsalinos, would suggest this is a definitive study (it's far too early for that) but it does make interesting reading.

Dr Farsalinos, it should be noted, is a regular speaker at e-cigarette and tobacco-related conferences. He strikes me as being reasonable and non-judgemental about smoking and smokers. Sadly, within the public health/tobacco control community, he represents a tiny minority.

Meanwhile, according to ASH:

Exposure to secondhand smoke is also likely to exacerbate the risks from coronavirus, alongside the other harms it causes. Therefore, smokers who are self-isolating and are not able to go outside to smoke should seek alternatives such as Nicotine Replacement Therapy (NRT) or e-cigarettes to protect the people around them from harm.

CEO Deborah Arnott said:

“This is a worrying time for all of us and people are looking for what they can do to protect themselves and protect others. For smokers, quitting or temporarily stopping during this outbreak is one of the best things they could do right now. Many stop smoking services are looking at how they can support people remotely and I urge people to also use other sources of nicotine such as NRT to help them with the cravings.”

The problem with this approach is that it ignores the fact that many smokers – even those who admit to being 'addicted' – enjoy smoking or take comfort from it.

Many people's lives have been turned upside down by the Government's current strategy. Millions of jobs have been lost, or put on hold. The future, for many people, is uncertain, despite the Government's best efforts.

The threat of contracting coronavirus would seem to be a real one, even if the numbers are still relatively small, with the result that many people, including whole families, are being confined to their homes 23 hours a day.

In that situation a habit such as smoking may be one of the few comforts or pleasures some adults still have and anyone who sees the coronavirus as a "huge opportunity" to promote smoking cessation needs to take a long hard look at themselves.

As readers know I don't smoke but I am overweight. Not just overweight. Obese. The last time I checked I had a BMI of 31. (It's probably worse now because I've put on another stone since then.)

The reason I am overweight is because I eat too much of the 'wrong' type of food and apart from walking the dog round the village I don't get much exercise.

I eat too much of the 'wrong' type of food because I enjoy it and I lack self-discipline. Stuck at home all day, as I am at present, there is an even greater temptation to snack at regular intervals on comfort food.

I could of course use the current threat (Obese or overweight coronavirus patients most in need of critical care) as a motivation to diet, and I may do that, but do you know what would actively discourage me? Public health campaigners using the coronavirus crisis to shame me to shape up.

If I am to lose weight by eating less of what I enjoy it will be my decision, and mine alone. I won't be nagged or coerced by 'public health' messages.

In short, if politicians or public health campaigners believe that today is the day to quit smoking (or, in my case, lose weight) they know very little about human nature.

So my advice? Back off. There's a time and a place for smoking cessation 'advice' and this isn't one of them.

Update: Journalist Mary Kenny tweets:

Another boffin on BBC R4 explains why Italy so badly hit. 1. High number of smokers. 2. High number of oldies. 3. High level of resistance to antibiotics (possibly from prophylactic use?). Interesting. But is this "blaming the victim"?

It's true that Italy has a higher smoking rate than the UK but according to WHO figures there are many countries with a higher rate than Italy – among them the Netherlands, Turkey, France, Poland, Hungary, Germany and Austria – and to the best of my knowledge none of those countries is currently suffering as much as Italy.

Personally I would take such claims with a pinch of salt, at least until incontrovertible evidence is available.

Sadly however it's typical of the type of weak, observational analysis we have come to expect from both the BBC and the media in general.