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Tobacco control has no sympathy for the smoker, says Samrat Chowdhery tobacco harm reduction expert and consumer activist. He says there has to be a more humane way to tackle the tobacco problem and tobacco control needs to start thinking more like drugs control.

Samrat Chowdhery
Journalist, THR Consumer Activist


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Brent Stafford: Hi everybody, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.TV. We're here in Warsaw, Poland for the Global Forum on Nicotine, the annual conference on safer nicotine products and tobacco harm reduction celebrating its 10th anniversary this year. Joining us today is Samrat Chowdhery.

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Samrat Chowdhery: Hi, Brent.

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Brent Stafford: Hi, it's good to see you again, finally in person, actually.

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Samrat Chowdhery: Yeah.

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Brent Stafford: Thanks for coming back on the show. You are a consumer activist. What does that mean?

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Samrat Chowdhery: Well, what it means is that I am one of those long term smokers who tried everything to quit to a point of really being frustrated and not even believing that you can quit. And then came along e-cigarettes. Within a week, without realizing, with all that effort that went into other ways of quitting, I was off cigarettes. And that was like a eureka moment for me. And from then on, my health improved. My taste buds were back. My mom, because my dad was a long-term smoker, and then I was, she was like, in 40 years, the house, for the first time, doesn't stink anymore. So it was not just me who saw the immediate health benefit, but also people around me who were happier.

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Brent Stafford: So did you, was there any health problems in your family?

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Samrat Chowdhery: No, not, no, yes, my father was a long term smoker. And then he quit. And after eight years is when he was diagnosed with lung cancer. And every time we would take him to the doctor, and the first thing they would say, Oh, but he's a smoker, right? And I was like, No, he quit eight years ago. Well, then the doctors would say, but if I look at his vitals and his scans, I see a smoke up because, you know, that's the damage that's been caused. So, that was quite disastrous. I just didn't want to repeat the mistakes, you know, and learn from that and at least not that mistake. So, I did really very seriously try to quit. But it's just not easy. You know, I went to a medical specialist and I got some 17 medicines which would make me feel woozy and not being able to operate. You know, it's not easy to quit. Weeping really worked for me. And then I thought, OK, why shouldn't others also have that opportunity, or at least the option? It may or may not work for everyone, right? But people should have the option to try it and see if it does. And of all the studies that were being published and the scare stories, I have my own health, right? I mean, that's the relationship which I would really trust. If I can climb stairs suddenly, which I couldn't earlier, if I can go for 40-kilometer cycle rides, which I couldn't go earlier, That's meaningful difference. I know that it's working for me.

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Brent Stafford: Now, you're from India? And was it easy to find product in India at the time?

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Samrat Chowdhery: Well, see, so we were small communities, like Facebook groups or WhatsApp groups, and these were like counseling centers. You know, these were like consumers helping other consumers. Okay, so what do you smoke? How much do you smoke? What kind of a device you'd like? They were, you know, these were like cessation experts. These were helping people quit, and it was just like a community. So we would order from outside, from China, you know, fast tech, which I think closed shop last year, which is quite, you know, iconic for us. I mean, and that's how trial and error, there was a steep learning curve. Now, of course, we have devices which are just, you know, we can use, but earlier you had to invest some effort. But it was still worth it because, you know, the health benefits were tremendous.

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Brent Stafford: So when was this that you found vaping and you quit?

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Samrat Chowdhery: Well, see, I first tried vaping, I think, around 2011 or 2012. Personal devices were really very fragile and very expensive. So I would pick one up, and then in three months, it would conk off. And I was like, OK, now I need to save some money and get another one. So it wasn't that easy. So I was on and off. And I think it took me almost two years to completely stay off, get off cigarettes. Because I found a good device, 31, which could be long term solution. So to that argument that most vapors are also dual users, but that dual use also exists with gums and patches, right? Like not, you know, so that it's a phase. And if you try to project that as a main characteristic. That's not true. Most people I know, or I work with and our association works with, have had their own trials. Some people just gave up on the first day that they tried vaping. And some like me took a long time, but did finally. So what we tell, you know, smokers when they say, okay, I do feel like smoking, yes, but just continue vaping because you will see the benefit over time and you will be replacing it more and more till the time that you don't need it anymore.

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Brent Stafford: So you were dual user bad. You're so bad. Tobacco Control says that's the worst thing possible.

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Samrat Chowdhery: But there is a transition phase. You know, you cannot expect to have some sort of, you can't decide how people quit. They will do it. As long as they're making that effort to wean away, however slowly, it should be encouraged, rather than tell them that this dual use is more harmful, so you either quit vaping, and then there is that other crazy school of thought, but at least we know what's in cigarettes, we don't know what's in vaping. So all crazy kind of arguments are being presented to dissuade smokers from making the switch.

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Brent Stafford: Do you find the dual use argument that comes out of public health and tobacco control to be maybe a smidgen disingenuous?

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Samrat Chowdhery: They are trying to pick on points. I think what I generally see is the lack of desire or willingness to understand what vaping is, how it actually helps people. Because a lot of these arguments are from people who obviously have not experienced someone trying to quit and with vaping. Had they, they would be happy that people are still on the journey to quit. rather than scaring them off that journey, saying, okay, you should, you know, quit one or the other. It's not always easy for someone to quit smoking, because it's not just about the nicotine. It's also a lot of other things involved, the social circle you are in. For example, I was a journalist, everyone smoked. You know, I mean, we would, our best work would be in the smoking area. So that's the culture I'm in. And then when I started vaping, I couldn't be in that smoking room. So I would go out somewhere and vape. But those changes are incremental. You cannot expect me one day, and you cannot expect anyone to do that. And you should just be happy that they're trying.

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Brent Stafford: What makes a tobacco control person happy?

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Samrat Chowdhery: I'm increasingly beginning to think it is the right decision-making power they have over other people. Because it doesn't look like public health to me. Because if you're really looking at solutions, which is how we started in India, when we formed the association, we said, OK, India has a huge number of tobacco users. We have a huge tobacco health burden. Even if you calculate the health cost, it's five times the revenue. We are a country we don't have public health care, widely accessible one. So, in a situation like that, harm prevention would be really welcome. But then there are wheels within wheels, and the government is itself involved in the tobacco trade, and then you have the Bloombergs and the WHOs saying, okay, go for it, ban it, and you know. So, it was quite shocking when the ban came, when India did ban it. And that was in 2019? In 2019. So, a quick chronology of events. In the beginning of the year, Juul announced that it would officially launch in India. That sudden motion, you know, a lot of things. A new health minister came in, who actually has been a long-term WHO advisor, who happened to get into politics. So, he's actually a WHO man. He's quite indoctrinated in the whole prohibitionist, you know, kind of I mean, if we can ban it, let's ban it, and then the problem will go away. It'll obviously not go away. And now we have a bigger problem than when we started out, and we'll come to that. And then in 2019, they banned it first through an ordinance, which didn't have to pass through Parliament. And then three months later, it was brought to Parliament, where the Health Minister began by saying that, okay, you have 500 people here. I invited you to look at e-cigarettes, and none of you have even seen these products. So they don't know and you have to see some of the arguments being made. One politician, a well-known one, this has meth, this has crystals in it, you know, weird kind of stuff. One came up with an argument that since it is good, it must be bad. You know, so that kind of really ill-informed, you know, people were then asked to, well the way they were sold was WHO is saying it. And in country, developing nations, WHO carries a lot of weight.

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Brent Stafford: I think people don't give enough credit to the word control in tobacco control. I think that says it all.

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Samrat Chowdhery: Yeah, I mean, that's what I was saying right on. But how did we get here? You know, sometimes I wonder. how I think because you know the smokers rights were eroded and then everyone I mean the whole thing was sold as okay it's the secondary harm so therefore you cannot and then those rights kept becoming more draconian to a point where smokeless tobacco gets banned in non-smoking areas. I mean what's the logic in that? And then lack of respect for that individual who is using tobacco. You know, now we are in a strange situation that we have more respect for people, for drug users, but not for tobacco users, when more people die from tobacco use. And you know, on one hand, we say, you know, the US Surgeon General, I think, said it's more addictive than heroin or cocaine. Would you tell a cocaine or heroin addict, just quit on your own? or not like give them proper, you won't do that to that. But you know, the tobacco users you suddenly expect, or the policies are being framed in a way, which assume that if you tax them more than they will stop doing it. It is addiction, it's dependence, you cannot come at it with, you know, things which will only make the problem worse, because that person is going to buy something cheaper from from the illegal market will cause more harm. So I don't see how you're helping.

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Brent Stafford: In your experience, do you think there could be maybe underlying this lack of respect, lack of dignity, and so forth that tobacco control exudes towards smokers? Could that be because they somehow can't separate the smoker from big tobacco?

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Samrat Chowdhery: I think when FCTC was formed in 2003, they did have big hopes that they would be able to tackle this issue. I think over the years, as the number of smokers never went down, it's still over a billion, they tried to reason to themselves why they should exist when the problem that they are trying to deal for 20 years is just where it was. or worse, you know, perhaps. So then come these ancillary arguments of trying to justify why they're doing what they're doing, you know, and nowhere. So we have like the one of the most famous or well known tobacco control experts in India is on record saying things like, but smokers anyway, only 5% of them quit. So let's just leave them aside. Let's just, you know, forget about them. Let's just focus on kids. That's 270 million people. he wants us to just forget about. And these are tax-paying people. They pay tax, the most tax on a product. And they are your people.

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Brent Stafford: So is that then the concept that, let's just breed the smokers out?

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Samrat Chowdhery: Yeah, let's, why should let, they are a lost generation, they are lost people. The moment you touch a cigarette, you are a tobacco industry shill or you are not someone that should be considered. So, now you are a population which we want to, you know, just throw into the sea if we could. And let's just focus on kids not coming in. But one of the reasons I started smoking was because my dad was smoking. You know, I would pick up those tubs. So, just, you know, just ignoring a billion people is also not, I don't see how that is good strategy. But not once have I seen sympathy or at least empathy for smokers. These are the people you've been mandated to protect the lives of by restricting options. You're taxing them, you're pushing them into no-smoking zones. I mean, I'm not against any of these measures. What I'm saying is that there has to be a more humane way to tackle the problem. It's not that we have not done it in drugs control. We have, and there has been great success. So, we know it works. Tobacco control needs to start thinking like drugs control. And I'm not sure why people from there are not advising the UNDP program, you know, has the autonomy of the user at the center of its policymaking. Drug users are regularly part of their cops or, you know, the meetings, but not in tobacco.

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Brent Stafford: When we last had you on the show in 2021, it was to talk about some of the activities of Mr. Bloomberg. Yes. And has that influence grown? And what's been the impact?

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Samrat Chowdhery: So the THR side, the Tobacco Harm Reduction side, the way the game is designed, We, as consumers, are delegitimized. Article 5.3 is thrown at us. We cannot even go meet our officials, like our representatives. We, as consumers, cannot meet because I took, you know, I was a KAC scholar and, you know, I did a scholarship where I was trying to figure out if risk-reduced solutions can work for the BD and the Kenny users, which are actually, you know, the largest, I mean, cigarette use is just 10-11% of the overall tobacco use. So, if you're going to solve or look at the problem, we have to look at those people. So, my project was on that, but that makes me a tobacco shill because that money, five organizations back somehow is linked to tobacco and so you know they would use an argument like that to discredit us.

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Brent Stafford: Which forces, correct me if I'm wrong, really a lot of consumers who experience the issue that they're never at the table, because consumers are never at the table.

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Samrat Chowdhery: Yeah, and you know, they say that the tobacco industry has been creating these astroturf organizations, which is, I'm not denying that's not true. And for long, they have tried to, you know, sort of help a consumer movement grow. But who would really defend trying to smoke and die from it? You know, I mean, there are consumer smoker groups, and I have nothing against them. People have all the right to demand the rights they think are fair to them. But it still didn't have wider appeal. But now, there are people like me who know for sure that they have averted a certain part to death and want others to have that opportunity. So we are genuinely fighting for human rights, right to better health, right to autonomy, right to make choices, safer choices. But they have not adapted to that. So the tobacco control does not understand a person like me, why would they do that? You know, I mean, that rationale. So there was a paper published in Tobacco Control and it somehow painted Inco like the organization which is an umbrella organization representing about 30 national consumer groups as the fulcrum of evil as taking money from PMI and we are all you know people from different walks of life we we have nothing no connections with the tobacco company, having said that though, there is, we cannot get funding. You know, if we come up with a project, let's say, okay, let's try, you know, a pilot THR program, let's say in a village, we adopt one, we would not be allowed to do that. So, we don't have access to funding. The government has also issued sort of a directive that you cannot work with anyone from the foundation or accept that money. Then they have issued a diktat on banning research into e-cigarettes. And, you know, if that wasn't all, they just last month issued a gag order on the media from publishing anything pro vaping. So that is just, it would not be okay in any other field.

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Brent Stafford: So, excuse me, in India, the mainstream media has been, it's banned. Yeah. They cannot.

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Samrat Chowdhery: Yeah. So the way the argument has been framed is that speaking in favor of e-cigarettes would be termed e-cigarette promotion, which in the bill, is a offense punishable by a few years in prison. So, we have spoken to lawyers about it. How can a law, a bill, in itself contain a provision that you cannot criticize it? This is a democracy. You know, people have the right to criticize any bill or any piece of legislation which they do not agree with. Here you are threatening media houses, you are muscling scientists, And now, of course, consumers, you know, you think that anyway are, you know, in bed with the industry. Of course, you can also access funding. You know, we cannot make representation. So just everything is stacked against us. And I don't see how...

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Brent Stafford: Isn't it strange, though, because India is a large, one of the world's largest suppliers of nicotine. Is that not correct?

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Samrat Chowdhery: That is true. So, while the WHO has somehow shifted focus from trying to save the lives of smokers to fighting the tobacco industry, when they say tobacco industry, they just mean the big four, the BATs and the GTIs and PMIs and you know those major multinationals. They do not talk about the China monopoly. They do not talk about the India monopoly which actually are selling I mean China, it sells the most cigarettes than any other company does. Those companies are somehow shielded under this excuse of sovereignty of the nation. So, the Indian tobacco monopoly in which the government owns almost like a quarter or to that extent. It also controls tobacco cultivation. It is the one which distributes seeds. It controls which area is cultivated. So, it is milking the crop from the time that it is sown to the time that it is sold. So, it is a direct stakeholder. Article 5.3 is being applied to a consumer who is just trying not to die from smoking. But these companies are shielded. And WHO and FCTC would never say a word about it. I mean, in fact, the Indian Health Minister was given an award.

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Brent Stafford: Well, yeah, like, I mean, India is allowed to attend COP10, right?

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Samrat Chowdhery: It was sharing that COP, you know. It was sharing that COP. So, how, it doesn't make sense to us that, you know, if it is, if a tobacco company has state backing, it somehow is not a problem. What we've also done is then, because of that shielding that we're providing these companies, you have taken away the incentive to innovate, because then they have a closed market and they would like to keep making it without having to put in more effort into developing products. Because, you know, when you're going into a vaping or, you know, heated tobacco category, then you become a technology company, you have to invest, you have to behave like one, the ethos has to change. And they don't want to do that. And this is easy for them. So on one hand, you have the tobacco company interest. And on the other hand, you have the Bloomberg people just making it easier and giving you all the reasons to do it.

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Brent Stafford: Considering that COP10 is coming up later this year in Panama, the Conference of the Parties for Framework Convention on Tobacco Control, if you had an opportunity to send a message to delegates there, what would that message be?

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Samrat Chowdhery: To just keep one thing in mind that they are there to save a billion lives, right? They're there to represent us. Do they really think they have a genuine interest in our interest in their heart? Are they trying to solve our problems or are they trying to solve something that they think is a problem? Even the, you know, so I was telling you about the astroturf, you know, accusation against tobacco companies, even the tobacco control Consumer groups are astroturfs. I didn't see any consumer in the Indian supposed cancer, you know, cigarette smoking survivors. It's just run by doctors. That's an astroturf. That's not true representation of what a smoker would want. No smoker, even ones who have quit, would say ban vaping, you know, because they would like to have an option to at least try it. It may not work for them. But they should have that option to reduce risk.

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Brent Stafford: The only thing, Samrat, that I think that could be at the heart of this deep, deep, it's not even hypocrisy, there's something malevolent, I believe, in the position. The only thing that I can believe is that it's rooted somehow in an anti-West, anti-capitalist kind of position. If PMI sold themselves tomorrow to China Tobacco, would there still be the same issue?

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Samrat Chowdhery: You're right. I think tobacco has been a cash crop. It is something that has really helped nations, especially the developing ones, survive and grow. So it is a crop of national importance. But large countries like India, you know, even if 1.3 point million people die in a country of 1.3 billion, you know, it's a good trade-off because they're making some 50,000, about 5 billion, you know, which is, again, for India, it's quite a lot of money. So it's always been viewed from a financial, from economics viewpoint, right? So even the Indian ban on vaping was announced by the finance minister, not the health minister. And then just as she announced, the stock of all these tobacco companies went up because everyone understands the competition is gone. So there is need to look at the lives of smokers, have more appreciation for these premature deaths, how they kind of impact. Because when I lost my father, I was 17, right? So that's not an age that you should lose your father. And it does impact the course of four lives. So, you know, and if there was appreciation of that, perhaps it's also, you know, that these kind of changes take time to show results, and governments have voted in for five years. So, you know, they're perhaps, you know, thinking short term, and in that, these kind of decisions seem to make sense. But over the long term, you're going to help people, if you're going to bring down over mortality and morbidity, it helps everyone. You know, there's more productivity, people live longer, you know, pay you more taxes, you know, less health care bills. So there is, I think, resignation that we could not do much about it. So let's just forget. Let's just try to focus on other things. I think the WHO focus is not on smokers. It's an unfortunate thing, according to them, but they are intent on preventing. So that is why I think the whole team, everything gets framed In terms of a teen issue, you know, but these are not kids are not dying It's adults who are you know, eight million of them are dying every year.