The American Centre for Disease Control (CDC) defines harm reduction as any behaviour or strategy that helps reduce risk or harm to yourself or others. For almost every societal problem, there are available harm reduction options. For example, to reduce the risk of contracting or transmitting HIV, one needs to practice safer sex or safer drug use.
Since the year 2006, there has been exponential expansion of interest in Tobacco Harm Reduction (THR) after the American Council on Science and Health (ACSH) became the first American scientific organization to formally endorse tobacco harm reduction, which involves the substitution of far safer sources of nicotine by smokers who are unable or unwilling to achieve nicotine/tobacco abstinence.
Despite the growing interest in Tobacco Harm Reduction by players in the Tobacco Industry, there has however been growing opposition around the innovation, leading to promulgation of punitive measures and enforcement of antagonistic policies as a way of discouraging the use of nicotine in its totality. As such, there have been coordinated attacks on Tobacco Harm Reduction largely through disinformation and misinformation. Disinformation refers to the action of deliberately sharing biased or misleading information or propaganda with the intention of manipulating or skewing the narrative of certain events and phenomena. Misinformation on the other hand is untrue information without specific intent.
According to the Edelman Trust Barometer, survey respondents indicated that scientists were the most trusted leaders in the community and ranked higher than government leaders, religious leaders, journalists, businesses and people in the community. Science can be the strongest opponent to misinformation and mistrust. Industries such as oil and tobacco face ideologically-driven resistance, including from national and international authorities, e.g., the UN and the World Health Organization.
There have also been attacks on Harm Reduction from new media sources. For example, a study that was conducted by Jaime E Sidani et.al to analyse the ‘Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19’. Qualitative Analysis of Twitter Content indicated that misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) was increasing THR misinformation and disinformation at the height of the pandemic. Additionally, a common conspiracy was that the e-cigarette or vaping product use–associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This was feared to have important public health ramifications for both COVID-19 control and ENDS use.
Renowned academic and corporate strategist, Dr Tendai Mhizha told Journalists during a virtual meeting on misinformation/disinformation and tobacco harm reduction, that disinformation was an obstacle that must be addressed in order to encourage more tobacco smokers to take up alternative non-combustible smoke free nicotine products.
“Disinformation is not limited to elections but also spread on many topics from personal defamation, sales information and Catfishing to issues such as the Russian-Ukranian war, Covid 19 and its vaccines and substances such as sugar and tobacco as well. There has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on the body. This has led to policies that disfavour harm reduction products and discussion that completely denies their benefits,” said Dr Mhizha.
She added that many governments across the world were now regulating nicotine harm reduction products in a fashion that is disproportionate to the risks associated with them. For example, in countries like India and Australia, government policies are more antagonistic to life-saving harm reduction products such as e-cigarettes and vapes than to deadly combustibles.
In terms of the global trends that fuel misinformation and disinformation, Dr Tendai Mhizha said rapidly evolving technologies drive rapidly evolving definitions of misinformation and disinformation which in turn has led to declining trust in experts and institutions.
“Digital technologies have made information more accessible and shareable, increasing the speed at which lies can spread. The digital world erases standards we are used to in the physical world. Tech-enabled scale and speed make regulating the flow of information increasingly challenging and there is a continuing inability to address human psychology in the tech platforms and regulatory frameworks.”
Countering Mis/Disinformation
According to Dr Tendai Mhizha, one way that harm reduction initiatives can combat issues of disinformation is by investing in longitudinal studies on policy effectiveness. The European Union is already exploring different ways in which it can set up legal and regulatory frameworks to eliminate or prevent disinformation on the subject matter from spreading to the level of influencing government policy.
“Local journalism and civil society organizations (CSOs) can also play a key role in supporting fact-checking, media literacy, and the spreading of accurate information at a more local level. We have seen that efforts to thwart the spread of misinformation at the local level can be useful in communities where these organizations have credibility and are rooted in the fabric of the local ecosystem. It’s at this level where local journalists and CSOs can become the conveyors of truth and drivers of the correction of misinformation.”
Unlike COVID-19 where misinformation and disinformation was largely peddled by unverified ghost social media accounts and clout chasing individuals, mis/disinformation around Tobacco Harm Reductions is many a times driven by reputable individuals and reputable mainstream media. New media has also joined the bandwagon. There is this need to formulate strategies for mitigating against disinformation. According to Dr Mhizha, some of the strategies to consider include building autonomic response through awareness and nudging. Also the “good guys” need tools of equal or greater speed and scale to counter disinformation and misinformation.
“There is also need to have Consultative Roundtables and update the limits of free speech while ensuring an “open” marketplace of ideas. Invest in longitudinal studies on policy effectiveness and invest in an objective, credible fact-checking ecosystem. We have also seen that misinformation is spread through closed networks, such as WhatsApp. Some efforts have been made at the local level to provide fact-checking channels for WhatsApp. This type of on-demand service not only allows journalists to create a personal relationship and build trust with people, but it empowers them.
Moreover, the fact checkers provide transparent information about the process and guidelines for fact checking so that users of this service are involved in the process and are empowered to do their own work. To make information more useful, it needs to be interoperable: usable by multiple institutions regardless of origin. In addition, information needs to be verifiable by independent sources so that more people can rely upon it. Governments can play a role ensuring that information is gathered according to commonly agreed upon standards and can establish processes for verification and oversight to reduce misinformation.
“In addition to efforts by government and civil society organizations, the scientific community has a role in setting a standard for producing reputable, evidence based information that is then communicated through these channels to the public. For example, members of the scientific community have an opportunity to increase communication around the process through which scientific findings go through extensive peer reviews before public dissemination. Upholding processes like this sets a higher standard for accountability.”
The public has the right to informed decision-making, which must be based on clear science. Legislators, interest groups, and organizations often drive discussions on misinformation while using skewed narratives for their own interests, which must be addressed by news media, private companies, national governments, and international institutions. It is also important to depoliticize facts and science and move away from “data vs. dogma.”
“When people only believe the science that supports their own opinion, innovation suffers tremendously. For example, nuclear energy is rarely considered in EU discussions of alternative energy, which is based more in public opinion than scientific research. Science must be objectively tested and reviewed in an open forum and should not provide an avenue to a narrow-minded view,” said Dr Mhizha.
