The hardening in attitude among the anti-smoking lobby away from harm reduction and towards abstinence had been seen as early as the 1970s. Dr Gio Gori was Deputy Director, Division of Cancer Cause and Prevention and Director, Smoking and Health Program at the National Cancer Institute. He published a paper in The Journal of the American Medical Association in 1976 discussing the need to protect individuals who continue to smoke despite all warnings. He compared the strength in tar and nicotine yields of cigarettes on the market in the 1970s with their counterparts in the 1960s, and discussed the idea of a “tolerable level” of risk. He went out of his way to say “We don’t want to call them safe. We don’t think there is such a thing”. Despite the very clear warning he made that in his opinion the only safe cigarette was an unlit one, there were immediate calls that Gori should be sacked. He left the NCI in 1980 and subsequently worked for the tobacco industry, mainly it seems because he could not find work in “public health”. All of his prior work in harm reduction, of which there was much, has been overshadowed by his subsequent work with the tobacco industry although as his 1976 paper makes clear “Antismoking education campaigns in our society have met with only partial success”.

It is around this time, in our view, that the lines of what constitutes “the truth” about tobacco become most blurred and as much as the companies continued to withstand admitting the potential risks of smoking, so those risks – to smokers directly and to non-smokers via the stance taken on the risks of second hand smoke – were amplified by the anti-tobacco movement.

We have discussed above the hardening of stance taken at the 1975 World Conference on Smoking and Health and the clear intent to “denormalise” smoking but there was also a more aggressive stance being taken towards those that did not subscribe to the official mantra. As well as the treatment of Gio Gori other examples exist, perhaps most tellingly in the case of Dr Michael Siegel, Professor in the Department of Community Health Sciences, Boston University School of Public Health, who describes his history thus:

“If you take part in secondhand smoke policy training in the tobacco control movement, chances are that you will be taught that all opposition to smoking bans is orchestrated by the tobacco industry, that anyone who challenges the science connecting secondhand smoke exposure and severe health effects is a paid lackey of Big Tobacco, and that any group which disseminates information challenging these health effects is a tobacco industry front group. Consequently, the chief strategy of tobacco control is to smear the opposition by accusing them of being tobacco industry moles. And in no situation should one say anything positive about an opponent, even if true.

How do I know this?

Because for many years, I was one of the main trainers of tobacco control advocates in the United States. And this is what I taught, because this was what I was led to believe. I attended many conferences and trainings and this is precisely what I was taught. I accepted it for the truth, and passed it along to others.”