So much of tobacco control public health communication centres on a few common precepts, such as creating a false consensus through headline trickery, pretending to misunderstand concepts and data, and making false or tenuous claims without support. A recent article about nicotine pouches in Health eNews, which is funded and operated by the U.S. nonprofit health system Advocate Health, fits the bill for all three.

Let’s take a look.

People only read the headline

Studies suggest that as much as 60% to 75% of people only read or act on a headline. Pew Research puts the numbers at 63% for US adults consuming news via social media. 

This is not arcane knowledge. The organisations that fund tobacco control and the editors who run these publications know this very well. As a result, you will often see headlines or subheads that state positions that go far beyond the arguments laid out in an article. As a result, the author has some plausible deniability. 

However, the real result, if we believe the number above, is that despite the mechanism that shields the author, their reputation is being used to push through a statement that two-thirds of people will believe is true. Observant readers will know that this is essentially how propaganda works.

Now, you might say that this is about clickbait and stiff competition for attention. And yet, these exaggerations always go one way. We never see an editor overplay the safety of nicotine pouches to create interest.

The fact is, these headlines are part of a broader ambience that influences how people think and feel about a product. We’ve seen how this affected vaping, to the point that half of UK smokers think vapes and cigarettes are on par in harm. They are not, and it’s totally unacceptable to fill smokers' heads with lies that could and do stop them from transitioning to safer products. In fact, it's evil.

Pretending to misunderstand how language works

One of the cheapest and most pervasive pieces of tobacco control sophistry is the persistent pretence that the words “safe” and “safer” are interchangeable. The headline of this article, “Nicotine pouches: why they aren’t a safer alternative,” is built on these shaky foundations. 

With such a headline, you’d think that the article would:

  • Try to back up the claim in any way that pouches are not safer than cigarettes.
  • Cite toxicology reports.
  • Compare the relative risks of cigarettes and pouches.

It does none of this. 

Instead, it says nicotine is “dangerous due to its addictive nature,” and pouches need more research. Most of the analysis is built around the claims of an Aurora Health Care physician, called Dr. Milind Mehta, which includes deranged scaremongering claims like, “we’ve seen the devastating damage vaping can have on your lungs.” 

Links that lead nowhere

Too often, an article will make a truth claim, and I’ll read the sentence and think, “oh, I need to know about that.” Well, the esteemed Dr. Milind Mehta provides us with this classic: “There aren’t many research studies that focus on whether pouches directly cause oral cancer, but it wouldn’t be surprising if that’s the outcome we soon learn.”

This is the level of analysis we are getting from Dr. Mehta. There is no evidence. It’s embarrassing. He follows up by saying, “We have seen how the frequent use of other smokeless tobacco products, like chewing tobacco, can lead to head and neck cancers. So, it’s best to avoid nicotine and tobacco entirely.”

The research Dr. Mehta is likely citing is Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium. It was mostly about snuff and covers data from 1981 to 2006. The paper also notes that chewing tobacco showed weaker and imprecise associations.

Dr. Metha seems entirely unaware that these products are very different from nicotine pouches, which have more in common with the NRT products that he calls a “safe and temporary alternative”. We shouldn’t have to put up with this nonsense.