At the Global Forum on Nicotine (GFN26), leading experts examine one of the most controversial questions in public health: What are the real costs of vaping prohibition?
This panel explores the unintended consequences of restrictive nicotine policies, including black markets, reduced access to safer nicotine alternatives, impacts on smoking cessation, and the broader implications for public health. Drawing on scientific evidence and international experience, the speakers discuss whether prohibition achieves its intended goals—or creates new problems.
Transcription:
00:03 - 05:53
[David Sweanor]
the real costs of prohibition. There's been some changes, as you may have noticed. Clive Bates was going to be hosting this. Unfortunately, Clive had a family issue come up. He wasn't able to make it, so I'm filling in for Clive. I should also say that there are no refunds for people who say, I came here to hear Clive, and I got Sweenor on the stage. So I... I know all three of our panelists, and Joe Thompson, who is also going to join us, had a family issue come up and had to leave today. So we've got a slightly smaller but very solid panel. And I wanted to start by getting people to talk about what's happening on issues of... Tobacco vaping prohibitionist policies in each of their countries, so we're dealing with the UK Canada and Australia And I think that will give us some context as we move into some of the the other questions I should also say that all three of these people have been quite influential in my own thinking on this I was just telling Chris that years ago. I was told by by people that you should ignore anything that Snowden writes because he's a bad guy and he's a libertarian and he says things that are nasty to people in tobacco control, which of course, being the sort of person I am, I immediately bought his books and read everything that I could find that he'd written and thought, Yeah, that's what I expected. He makes a lot of sense. And with Rowan, last year when I was here, it coincided with a law enforcement and public health conference that was coming up in Ottawa that was co-sponsored by my Center for Health Law Policy and Ethics at the University of Ottawa. And they were going to have a session on dealing with law enforcement issues on tobacco and nicotine. I didn't know about that, so some of the people who were going to be attending the conference had written to the law school and said, where's Sweenor on this? You should have him speaking. So I got in touch with the people, or my law school got in touch, and they said, oh yeah, that'd be great. We should have him. Because it was going to be this extra session outside of the normal conference to talk about this issue. And I was here, and I'd met Rowan, and I said, yeah, and there's somebody else here who'd be really good on this topic. And while I was here, I had email exchanges with the people who were going to be hosting this seminar, and they were very much into abstinence. And so I was in my room up here getting messages saying, well, let's be clear. We have to be very certain that nobody says anything that looks like we condone the use of an alternative nicotine product. So I responded to that. And I got a lot of silly stuff back, and I responded to that because we're being collegial, same university, et cetera. And then Rowan and I were there on the agenda for speaking about what's going on on nicotine, tobacco, and policies dealing with law enforcement. And then the people who were organizing the seminar, clearly not being particularly keen on us talking, decided to change the agenda and pack it full of people who take a very prohibitionist approach. And rather than backing down, we said, OK, we can go in. We can do that. And then they put a conflict of interest requirement on anybody registering, which was so broad that it caught absolutely everybody in the entire planet. But we thought, well, we can get past this. Let's do it. And then they refused to tell us where the room was where they were going to be holding the seminar, which is sort of important if you're supposed to be showing up to talk. But figuring out that there'd be another way to find out how to get there, I still made it back in Ottawa in time to attend. only to find out that just before the seminar was supposed to be held, they canceled it because they didn't want us talking. And I think that explains a whole lot of what we've talked about here of people who have these very strong ideological views. And rather than challenging them, like I did in paying attention to stuff that Chris was writing, they decided we need to shut down any conversation. So I think that gets into some of the issues we deal with with dealing with prohibition. And with Maria, it turns out that Maria opened a vape shop in my hometown, which I go to every week to spend time with my elderly mother, and I got to experience what she was doing to the people that I knew there in getting people off cigarettes, which was phenomenal. And she was hassled nonstop by public health people. I was in her shop once when somebody came in to do it. And you can see that the whole idea of no good deed goes unpunished. We had so many vape shops that were doing great work in getting people, including many people in my hometown who I knew, off cigarettes. And they were opposed by people who say they're public health. So it gets into this whole idea of where are they coming from? What's the idea behind this? So I'm very pleased to have all three of them here. And I thought we could start from the far end. And Rowan, if you want to talk a bit about what's happening in Australia, what are you seeing? How does it tie into this? And then we'll move to Maria and Chris.
05:55 - 18:58
[Rohan Pike]
Yeah, well, there's not much happening in Australia, actually. It's all very quiet over there. But, no, we've heard quite a bit about Australia and a lot of it's been said. But so I just wanted to just outline some of the facts of the matter just to contextualise the Australian disaster. And it starts with the excise rate, which is $31 per pack. So for other countries, that's 16 and a half pounds of tax, 19 Euro and 22 US dollars per pack. So that's making our packets of cigarettes 50 to $70, $70 for a packet of Marlboro of 20. And that compares to the illicit packs of 10 to $15. So five to seven times the price. And of course, that's created an illicit tobacco market of 80% now and rising every day. Revenue, as I said before, has dropped from $16 billion to $4 billion in just six years. If you look at the graph of that, that's quite amusing that it's just fallen completely off the cliff and is clearly heading to a legal market extinction, perhaps within 18 months to two years. It would be a good thing if smoking rates had lowered in line with that, but they haven't. They've in fact risen and so has nicotine consumption. The figures came out the other day that nicotine's gone up 40% of consumption in just the last eight years. And of course this coincides with, it's been particularly accelerated in the last three years. when we've allegedly had this enforcement crackdown in Australia, which it started from a very low ebb, which we'll come to. But it's sort of interesting that the highest rate of increase of the illicit was when we've had the highest rate of enforcement as well. The illicit vape rate is over 95%, but the prohibition methodology for that is not the price, it's lack of availability. We've made it extremely difficult for people to get their hands on alternative products. But you all want to hear about the violence, which we're now famous for, and of course the violence is an inevitable consequence of encouraging and attracting various organised crime groups into this market. And they're now fighting over market share in a good old fashioned criminal turf war. And that's led to murders, over a half a dozen of those. One lady was innocently burned alive in her house with one of the fire bombings. We've had drive-by shootings on pretty much a weekly basis in Melbourne. There have been hundreds of fire bombings, not just on tobacconists, but on associated businesses like restaurants, barbershops, and other things that criminals own. And that is actually now expanding past the tobacco industry to the liquor industry using exactly the same methodology and exactly the same cause, being an unbalanced excise. So in, I think it was March or April, just a couple of months ago, we had 34 fire bombings in the month just on liquor stores. So that's the latest craze for criminals. To go with that, we've had widespread extortion through most of the tobacconists, and that is spreading as well into the liquor industry. We have robberies of legitimate stores. There'd be at least six in my hometown of Melbourne per night and these are people who are being organised by criminal gangs to go and raid convenience stores, service stations and etc and steal the legitimate packs which they then sell to the criminal gangs for $5 a packet who then unsell them. Such is the value of these products. And of course the demand. They're selling their products through illicit stores. There's probably 10,000 in Australia. There's at least 2,000 in my home state of Victoria. And this is not secret under the counter cloak and dagger sort of stuff. This is blatant selling of a product straight out the front door, straight over from the top of the counter. Advertising in the windows at some points. And just to give you an example of how prevalent it is, I live about 300 metres from one of the busiest and most famous shopping strips in Melbourne. There's 20 illicit stores within the space of one kilometre along that street. So this is not just a city thing. Every country town, every city in Australia, a small country town in New South Wales of 20,000 people has seven shops. Of course, the legitimate sellers are not selling any product and nor getting the other foot traffic that comes along with that. So there's been closure of small businesses across the country. Insurance on these businesses and shopping centres has quadrupled in the last couple of years. Shops are spending a lot of money with security measures, etc, etc. It goes on and on. One of the bizarre consequences of this crime is that gambling has increased because smokers now have more money available because they're only spending $10 on the cigarettes and they can plough the rest into poker machines. And this is just sort of what happens, and there's far more, I won't go on, but this is what happens when an unbalanced prohibitionist policy is left unchecked. So speaking of the unchecking bit, we come to enforcement, which is... my career for 26 years. And the story I think starts back in 2003 when everyone signed the FCTC and totally ignored Article 15. There's a lot of talk about 5.3 but no one really knows what Article 15 is. And it says that every country should do their utmost to protect the market from illicit tobacco. And, of course, these are health people who signed this and completely ignored that, and there has been no enforcement until very recently in Australia post the border, and perhaps in many other countries as well. We come to 2010, where Australia supercharged Article 6 of that agreement, which calls for appropriate tax rises. And Australia has interpreted that as let's raise things exponentially and irresponsibly, starting with a 25% plus interest rise back there in 2010. And that triggered the mess that we see today and has continued on. One of the two key people, just as an aside, who introduced that policy is now in fact the Health Minister of Australia and we've spoken earlier today about some of the reasons why they're holding on to this policy and perhaps it's because he was a key architect of it. The other person who was the key person at that time is now the head of the agency who is supposed to measure smoking rates in Australia and we haven't had those measured for four years. Again, that's a bit suspicious. In 2015, there was a parliamentary inquiry. I was in the border force. Everyone was jumping up and down about the obvious increase in illicit at that time. Recommendations were made and ignored. there was still no enforcement post the border. Since that time, there were numerous warnings, there were numerous government inquiries that recommended that enforcement must be increased, and nothing happened until 2023. In March of that year, coincidentally, I wrote to the commissioner of the Victoria Police, my home state, and said, do you know that illicit tobacco is a massive thing and organised crime groups are getting bigger and better and they've pretty much taken over the streets and if you wouldn't mind doing something about it, even though it's not your primary responsibility as it's a federal matter, you might want to look at it. And one month later we had the first firebombing. in Melbourne. Of course I was the primary suspect of that at the time because it was a bit of a coincidence and as I say we've had hundreds of them since that time. The Victoria Police to their credit have been dedicated a lot of resources to stopping the violence that we've seen in Victoria but of course they haven't stopped any of the actually illicit tobacco market. So those firebombings have continued on That actually caused, reluctantly caused the government to introduce an agency called the Illicit Tobacco and E-Cigarette Commissioner's Office in June of 23. That agency was designed to coordinate the enforcement response across Australia, across all of the states. The Health Minister for some reason was the one appointing the head of that agency. And no surprise, he appointed someone from the health ministry with no enforcement experience whatsoever. As a result, we still have no illicit tobacco plan for Australia. All of the states and territories are doing their own thing. There is no coordination. I would suggest that we're going through a phase in Australia where The states are just starting to experiment with the enforcement and with new legislation. And in time, they will realise that their attempts to increase resources and penalties and so on are really futile in this area because the problem has grown too big and is too entrenched. Just as an example of the lack of enforcement that we've had in Australia, plain packaging came in in 2012 or 2013 with great fanfare, and one of the things that Australia championed as one of our world-leading... policies, we do love to say world leading, that came in 13, 14 years ago, has never been prosecuted, not once. There are tens of thousands of packages sold in coloured packaging every day in every city, as I say, not once. crime has been committed allegedly. So I would say in the future there will be a realisation that enforcement's not going to work on its own and that policy must change but that's a common sense approach and we've all been waiting for that for some years so I still hold out some hope and some of the reasons why this has happened that tobacco control enforcement is still run by the health department and they of course have no idea about enforcement, the causes, the methodology and how to prevent it, yet they're still running it. And now that their policy has failed in every respect, they're blaming the enforcement agencies for the failure of their policies. Of course, they caused it. But unfortunately, they dominate the public rhetoric. They dominate the advice to government. I'm not sure why we're still listening to them. I like to say that it's like asking the arsonist how to put out the fire. But... The pedestal that they've stood on proudly for a long time I think is starting to get a bit wobbly, especially in the last couple of days when the figure of 80% illicit came out and that must generate a response and I'm sure that it will. What else can I say about that? Why it's just persisted for so long was one of the questions that came out this morning. And it's very hard to try to explain the inexplicable. As a result, conspiracy theories are easy to rise. One of those I like to talk about is that they're voters. The 20% of the population are smoking or vaping, and they're very happy. about the fact that they can do it so cheaply. And it's not really in the government's interest to stop that and upset them with a policy. But that's perhaps a bit skeptical. But of course, we have an ideology through our health department that we're gonna have zero nicotine. in the country and that is driving the policy. And, of course, as has also been said before, the people who have designed the policy are personally invested. This is their life's work that they don't want to see go up in smoke, so to speak, and other health agencies that have a financial interest in continuing to be funded.
19:01 - 19:16
[David Sweanor]
Thanks very much. They don't want their careers to go up in smoke, so as a result, a whole lot of retailers are seeing their establishments go up in smoke. Yes. Maria, what's the good news from Canada?
19:16 - 26:56
[Maria Papaioannoy-Duic]
Well, we want to be just like Australia. So tobacco control, NGOs, government-funded folks have been continuously pushing for the Australia model. Sorry. It's okay. But, however, thankfully, the gangs and the people who want to tear down other people are taking after Australia. So I have a short little video. If you watch Reg Watch, you would have seen this. This is a friend of mine who owns some vape shops. And this is the inside of a vape shop burning down and how quickly you can tell based on body it was a woman. So let's just take a look at this because, oh, can we play video fire one? There we go. And as you can see, there was no robbery. That happened in under a minute. And sadly, this isn't the only shop in this community. This is in the smaller community. You're not looking in cities like Toronto. You're looking in communities that have populations between 70,000 people. Another community, another vape shop was, I don't know, set ablaze twice in one week because they were able to move really quickly. Their competitors set the pace. firebombed their other one. So yeah, our goal is to be just like Australia and that is on record. What is happening in Canada is, you know, we always talk about this mishmash of regulations across the country. We have some provinces that are now aiming for 21 because we want to be like the UK as well. We need an identity and So we have like PEI, what's it called, PEI? Prince Edward Island, thank you. Very small island, small population, but you have to be 21 to buy nicotine products and tobacco products. But again, they have a flavor ban. You're looking at places like right along the East Coast, there's flavor bans all over there. And their tobacco taxes go up. They have a huge black market. You're looking at places like Ontario where we have a very, a flavour ban with an exemption, but we still have illicit trade ravaging through the province. Alberta as well, BC as well. And then we're looking at that in nicotine pouches because we did have a former tobacco control member, Mark Holland, who was our Minister of Health, and needed to, you know, stay friends with his friends because he was losing his job in a couple of months. You know, put a ministerial order out there and ensure that nicotine pouches are behind the counter of a pharmacy. Other problems with that is not every Canadian lives near a pharmacy. I mean, we don't all live in Toronto and Vancouver. Some people, it is over 500 kilometers away, the closest pharmacy. So having access to safer nicotine products are not available to them. However, they know best. cigarettes are available to people all across the country. So that's maybe, I don't know, positive for someone in there. We also have a government that is probably not going to touch flavours. We have tobacco control, a federal government that won't touch flavours. I feel that the NGOs know this, and this is why they're picking it apart provincially. Currently, right now, in honour of World No Tobacco Day, three bills dropped across the country in different provinces to ban flavors or to have some sort of ban on flavors. One in Ontario, one in Alberta that would ban 85% or I think 87% of the products on people's shelves, which are single-use disposables, only flavors. And then the only flavors would be banned. And then we have another one in Manitoba, which would remove access. All these bills were written by the Lung Association, the Heart and Stroke. So politicians aren't doing their job. They're just being taken advantage of. But you can't say this because, obviously, it's for the children. And I think I need to say this again, and I've said it over and over again. If you're a parent and you think the local convenience store is willing to risk it all because they need to get your kid hooked on nicotine, you're an idiot. No one needs your child's allowance to make rent. And if you start fighting to ban these products from regulated markets, let's be very clear. The black market does not give a hoot how old your kid is. Your kid's still getting it from that place. And that's what we're seeing in Canada, where the black market shows up outside a vape shop. parks their car, pops open the trunk, and next thing you know, there's some kids lining up to get their vapes. The vape shop owner has this all on camera, talks to tobacco control enforcement, and says, what can I do? Enforcement tells them, I can't do anything. My job is to enforce you breaking the law, not the people breaking the law. So we are... And I'm going to... Like, this is such a clusterfuck, for lack of a better word. It makes no sense. There is no common sense in any of this. And it is so frustrating. And it is so... It ruins your perception. It ruins your belief in public health. It ruins the ideas that you have of these people wanting to keep you healthy when... Their actions don't show that. And if you try and defend yourself, they won't talk to you. They won't allow you to have a conversation with you. They minimize you. They marginalize you. They shame you. And it has to stop. And the more that we speak up, everybody, I mean, it's not going to be nice because they're very mean. You can ask David. But we have to continue doing it. They are not more important than us because they work for public health. We are the public they're supposed to keep healthy. And with that mindset, we have to continue to speak up. And I'm not going to shut up. So I'm going to pass it back to David now. I will.
26:59 - 27:24
[David Sweanor]
I will pass it over to Chris, who's got so many years of experience dealing with markets as an economist, and has written so much on this issue, but other issues of prohibition. And it would be just like him to say, I've changed my mind. I'm now in favor of prohibition. But we'll see what Chris says about what's going on in his country in the background.
27:24 - 34:55
[Christopher Snowdon]
Yeah, well, the situation in the UK is kind of similar to Australia, but not as violent at the moment and not quite so widespread. One difference is that the Australians now are having to accept that they've got a massive problem with illicit trade, whereas in the UK, the government is just burying its head in the sand. The Australian Bureau of Statistics is now producing estimates of how big the illicit market is. 80% obviously is a breathtakingly high figure. HMRC, His Majesty's Revenue and Customs, also make an estimate of the black market, but it's just... It's clearly wrong. That's all you can say. They say the black market is 13%. Well, legal tobacco sales have fallen by half in three years. The number of smokers has not fallen by half in three years. Nowhere near, right? So there's just no way the illicit market is as small as HMRC says it is. If you look at empty pack surveys, which are, as you probably know, the kind of gold standard way of estimating how big the black market is, you just go through recycling and litter bins and pick packs off the street. In fact, even if you just walk around England and look at packs on the street, you can see that it's a very widespread problem. But the empty pack survey done by KPMG was published this week. It said, I think, 32%. That's just of cigarettes as well. That doesn't include hand-rolling tobacco. And everyone knows that hand-rolling tobacco is a much higher figure for that because it's always been smuggled a great deal. Ireland, they actually do do empty pack survey. The government does an empty pack survey, and it bears out more or less what KPMG say with their survey. Tobacco control people don't pay attention to the KPMG figures because it's funded by PMI, but actually it's a very good methodology, and as I say, it's borne out when governments actually bother to put the effort into doing empty pack surveys, which considering we're talking about billions of pounds at stake, you'd think they'd find the money to go through a few bins. But I think they really genuinely would not like, they don't want to know how big the problem is. So if you take that 32%, you then add on all the tobacco that's brought back from countries when people go on holiday. So it's not illicit as such. It is mostly legal, but it's still not being taxed in this country. And if you add on the hand rolling, I think we're looking at around at least 40%. probably is the black market share now, which obviously is not as high as Australia, but it's about where Australia was about five years ago. These things are growing very, very quickly. And everyone can kind of see it. This is the interesting thing about the black market for tobacco and vapes, but mainly tobacco, is it's kind of now being done in plain sight, very much like it is in Australia. So it's not being sold in car parks and pubs so much as just in convenience stores and all these vape shops that have suddenly appeared. And it's part of a wider kind of low-level lawlessness that people are starting to notice on every high street in Britain. You've got a lot of businesses opening up that are fairly obviously money laundering operations or are selling drugs or illicit tobacco or illicit vapes. Lots of barbers, Turkish barbers, have suddenly popped up, which don't seem to have very many customers. Lots of vape shops have popped up that don't seem to have many customers. And I could tell you in my town where to go if you want to buy a five-pound pack at Manchester. which is another similarity, by the way, with Australia. Manchester is not really a legit brand. It's kind of a funny brand. It is made legally. It's actually, the company has its headquarters in London, if you look into it. The cigarettes are made in Dubai, I think. I'm not sure they're actually legally sold anywhere. Maybe in Dubai, I don't know. But they don't have any kind of graphic warnings. They're not plain packaged or anything like that. um and i first heard of them back in 2013 or so when they started appearing in australia after plain packaging came in and they're now a big brand in the uk again walk along the pavement you'll see empty packs of it um that's been an interesting unintended consequence of plain packaging when plain packaging came in a lot of people like me were saying well this is going to help the illicit trade because the plain packs are going to be easier to counterfeit you just have to do the same pack and just change the the name on the front. In actual fact, what seems to have happened is plain packaging worked insofar as smokers don't like the plain packs. But that just means that if they find a normal, conventional, colorful pack, that makes it more appealing. And there's also an unintended consequence of the display ban, which I think all three of our countries have. And we were pioneers in it. I should have seen this coming, really. But it's really helped the illicit trade for these shops that are selling illicit tobacco because by law, you basically have to sell cigarettes from under the counter. So you don't see the cigarettes behind them. So the fact that they are dodgy Chinese or Manchester's or whatever is not obvious. It also means that if someone comes in the shop and says, do you sell cigarettes? You can say yes or no, as suits you, depending on who you think this person is. It actually makes the illicit sale of cigarettes a lot easier. So we've got, in short, a large and growing black market that the government is turning a blind eye to. We haven't had any fire bombings. There's no overt violence, although I'm sure there is behind the scenes. We've got quite a lot of illicit vapes. And all this obviously comes down to profit at the end of the day. People talk a lot about enforcement. If you look at the shadow economy in general, there are various well-known factors that lead to illicit activity and kind of tax evasion. I mean, enforcement is one of them. Corruption is another one. People are not wrong when they say that you need to have strong institutions. You need to have good tax morale. Tax morale just means that people are happy to pay tax. They think that money is being used wisely, and they think the tax rate is fair. Well, that's no longer the case with cigarettes in Britain, which, by the way, are about £16. smokers generally don't feel that that is a fair tax rate they can't really afford it it acts as a form of prohibition because they can't afford it and they probably don't feel the money is being spent by the government particularly wisely because it's not but it's not an issue enforcement we haven't had I mean there always could be more enforcement but The level of enforcement and the amount of corruption in society, when it comes to developed countries at least, does not correlate with the illicit tobacco trade at all. There isn't less enforcement in Australia than there was 10 years ago. There's a huge amount more. Australia is not a particularly corrupt country. Britain is not a corrupt country particularly. But we've got this going on in plain sight. No one can fully get to grips with how they get away with it. It's certainly true that trading standards could be doing more in the way of kind of on-the-spot checks. and closing these businesses down. But when they do that, either they never go to court or they can't really identify who the owner of the business is. A lot of this is driven by, I think, mainly illegal immigrants. You get a lot of people from Iraq, Syria. Kurds are involved, quite often Pakistanis. It does tend to be first-generation immigrants a lot of the time running the shops. And it's not always clear actually who owns each shop. And when you close one down and another one pops up under a different owner. So this is something that could only be dealt with by dealing with the underlying drivers rather than playing whack-a-mole trying to close all these businesses down. It's not going to happen. And even if you could close all the shops down, it would just move online. It would move back to car parks and pubs.
34:57 - 35:30
[David Sweanor]
Thanks very much. I'll start with you, Chris, because you say how things aren't working very well on this. What does? I mean, if we're not looking at changing behavior through measures like prohibition, if we're not shaping the market in the way people want to through prohibition, what are the things that actually do work if you're trying to shape a market, if you're trying to achieve some, if you're actually trying to achieve a health policy?
35:30 - 35:57
[Christopher Snowdon]
Well, it depends what your objective is. If your objective is to get smoking rates down to a very low level, you can just look at Sweden and Norway. You can look to some extent at Britain's success with vaping, Japan's success with heated tobacco. I'd hardly need to preach into the converted, obviously, in this room about that. If your objective is to get rid of nicotine use, then you need your head examining because it's never going to happen. So if you have an unrealistic objective, there is no means by which you're going to achieve it.
35:58 - 36:49
[David Sweanor]
And then picking up on this idea that were we to give people alternatives and give them good information, we could actually make real progress on this. And we are seeing progress in all three of the countries represented here as we are around the world. There is a huge number of people vaping in each of the countries. In Canada, I think it's 2 million. Maria, what stops... people like you who are running vape shops from just giving people truthful information about relative risk in order to help them do this. How much is the government helping you to educate consumers to empower them to make better decisions about their own health, and how do they reward you for giving such accurate information? And it's a set-up question. It's a set-up question.
36:50 - 41:12
[Maria Papaioannoy-Duic]
I would go to prison and be a prisoner with murderers. because if you share any information, relative risk, about vaping, and that leads to a sale of a product, again, I don't own vape shops anymore, but this was a law that was around, has been around for a while, and, And that leads, so I tell someone, oh, the Royal College of Physicians said this was 95% safer, and that's it. And that led to the sale, and that could be proven. I could go to prison for 18 months, and it's a federal prison, so that means that's where the bad people, and we do have bad people in Canada, hence the fire. And a $500,000 fine. Like, I mean, I can't choose one or the other probably. So I'd have to like not work for 18 months and then work for the rest of my life to pay off $500,000. And on top of that, when you're running a business in some of these provinces, you have another layer of regulation. So technically, people can't really find you in the province of Ontario because you're only allowed to put the name of your shop and your business once on the outside of Ontario. your doors your windows need to be covered I remember I had my windows covered in a creative way because I had I was in a very old building and I put a little sign saying vaping isn't smoking and with a little thing of where they can fight the government and I got fined because I was promoting vaping by encouraging someone to understand their rights as a Canadian to use their voice, I broke a law as a vape shop owner. By telling someone the truth, I'm at risk of me going to prison. And to me, that is the bigger problem in all this is that And this bothers me a lot. that our government, our public health agencies, our doctors are not all of them, because now I'm just looking at Mark, and you're a doctor. But our medical profession, our hospitals, they rather believe in misinformation. They'd rather continue that stigmatization of people who smoke. They'd rather be OK with judging us, with treating us like garbage. They'd rather see us suffer to stop our addiction than to be okay to say, hey, use this easier way. And nicotine's not that bad. But none of that matters when it comes to people who smoke. In my country, and I think in many countries, and that all stems from the fact is that we, because of the people at the World Health Organization, those people, your tobacco control, they have been trained and taught to teach everyone that we're bad people because we smoke. We deserve what we get because we smoke. It shouldn't be easy to quit when we smoke. And this is where, in my opinion, and my humble opinion based on my lived experience, which is very important, guys, everyone's lived experiences, is that they don't care because they've been trained not to care. And we've got to do better. So I can't wait till the first person goes to prison. And we get the little follow-up story of what prison was like with the murderers because you said you shared science. But things have to change, and things aren't changing well. We're continuing allowing to be bullied by tobacco control. We're continuing to allow those lies. And we're continuing to have bad regulations right across this province so we can save the children. And by the way, less than 13% of kids vape. And our numbers keep going down and down in our country.
41:15 - 45:13
[David Sweanor]
Just to pick up on that and put my law professor hat on, laws work, just the way Chris was saying about taxes, where people believe this is a good thing to do. Laws work where people have respect for the law. And when we're talking about the real costs of prohibition, The lack of respect, the loss of respect for law is huge. And Maria just talked about the fines in Canada. And we have surveys showing the vast majority of Canadians have no idea of the differential in risk between vaping and cigarette smoking. Now that's despite having two million people who are vaping. And when you ask people who are vaping about relative risk, they don't usually think that they're reducing their risk very much. If you ask people who are smoking cigarettes, they say, well, would I switch to that? It's more hazardous. Or as somebody I know in my hometown whose husband managed to get off cigarettes by switching to vaping, his doctor told him vaping is 10 times as hazardous as smoking cigarettes. He shouldn't have done that. You have that level of misinformation. And then you have a law that makes it illegal to give people truthful information. And that's happening in a country that has a charter of rights that gives a right to free speech and a right to life. And the government, the federal government, passed a law saying it is illegal to give people truthful information that could save their lives. How does that tie into how people see the government as they learn more about the facts in something like this? And that lack of respect, that lack of trust, What impact does that have? And that ties back to what we've experienced on prohibition on many other issues, that there were prohibitions on contraception in many, many countries. The Comstock laws in the United States were a classic example. People went to prison for giving information to women about contraception or making contraceptives available. How do you think that played out? at that time for people there to say, so I don't have sovereignty over my own body. I don't have a chance to make a decision here. I'm not allowed to. I'm not allowed to help somebody else. And we've gone through that with drug prohibition, as so many people here know, that the harm that that's done at a societal level, because these laws are not enforced across the board. Even when they're crazy, draconian laws, They tend to be enforced against certain already disadvantaged people. Who went to prison in the United States because of drug laws? It wasn't wealthy white investment bankers who were also using cocaine, it was young Blacks, Hispanics, disadvantaged people. Who got caught up in the laws in various places like Ireland banning contraceptives? It wasn't wealthy people. Who got caught in the laws banning divorce? Wealthy people go to another country and get divorced. It tends to be the disadvantaged people, the people who then lose trust in the government that we count on people trusting in order for a society to work. And when we come down to... well, what can you do about this? We usually have people saying, it just needs more enforcement. You know, as we're hearing now in Australia. I know, Rowan, you've talked about this, but you spent your career fighting crime and being the enforcement side of that. How do you feel about this when people say, well, the solution is that, you know, you just need to work harder. We need the police forces to work harder. You need to do more enforcement, and we're going to solve this.
45:15 - 47:41
[Rohan Pike]
Well, incredibly frustrated is a nice way of saying it, but it would be like me coming into your hospital with a scalpel and saying, I think I'll do a bit of brain surgery today on that person, with absolutely no expertise whatsoever and cause mayhem. But this is how I feel when health authorities suggest that enforcement's the key without any background in it whatsoever. It's a similar mindset. But I think just on the lack of trust, I think COVID had a bit to play in that, certainly in Australia, where, again, the health authorities were set on zero COVID and no one was allowed outside until that was achieved. And then when it was achieved, it needed to be achieved for a week or more and it kept going on and on and on. And people just completely lost it with the government. tipped over, I think, when they banned golf, which is a sport that you couldn't be any further away from your opponents, especially the way I play it. But it just absolutely made no sense to anyone and people lost faith that the government were making decisions for their benefit. Of course, there's been a couple of other things that have supercharged in the last six to eight years being a cost of living crisis and just the excise rates continuing to go up and up and up. We're a relatively law-abiding society, you would think, in Australia, but once we hit the tipping point where they lost faith in the fairness of the law, they were holding on for a while. They had some loyalty to the brand that they liked. They had some loyalty, well, just to following the law, but it got too much and now it tipped over and they have no qualms about breaking the law and Arguments have been raised here about don't they worry about funding organised crime or don't they worry about consuming a less well-regulated product. No, they don't. They don't give any thought to that whatsoever. It's all about the price and they've just moved straight over en masse. And for England, it's hard to warn people that this might happen. And the only silver lining out of Australia is that it is a good example for the rest of the world as to what can happen if you let it go unchecked. So it got to a point and then just fell off a cliff.
47:41 - 48:03
[Christopher Snowdon]
But no one is learning. This is the thing. I mean, everything I was talking about before, plus what's been going on in Australia, which has not been covered by the UK media at all. I don't think it's been covered by any media outside Australia. It's all over the Aussie newspapers. This week the 80%, but obviously all the farm owners. I don't even understand why, because even if you ignore the tobacco part of it, it seems like quite compelling drama, right?
48:03 - 48:04
[Maria Papaioannoy-Duic]
You've got- Great visuals.
48:04 - 52:39
[Christopher Snowdon]
Yeah, right, exactly. You showed a video before. I don't know why it's just being completely ignored by the rest of the world. But it is, and so therefore it's not been a warning. And this is the backdrop against which the UK government is going to bring in a vape tax in October, which is going to at least double the price of vaping. And they've introduced this ridiculous generational smoking ban, which the smoking age goes up every year by a year forever. This is just kind of pathetic more than anything else. It's something that we see a lot of in the UK is, you know, Britain is a country that is visibly falling apart. Actually, I mean, just if you look at the apostles on the roads, they're kind of third world. You've got a health service is absolutely hopeless. We've got a huge amount of debt. Everyone's unhappy. Nobody knows what to do. We're changing prime ministers again, probably for the umpteenth time in the last 10 years. And yet politicians are just obsessed with this trivia, really. You know, oh, let's have a look at restricting vape flavors or what we call vapes. Sometimes politicians are accused of not having a big vision, which generally means that they don't have the big visions of the 20th century, fascism and communism, so good riddance to that. But it's not really true. They have enormous visions. They have visions that are so big that they don't in practice actually know how they're going to do it. So we're going to have a nicotine-free world. We're going to control the temperature of the planet from Britain These enormous visions, and they focus all their time on doing basically the impossible. You know, we're gonna halve childhood obesity by 2030. Well, how are you gonna do that? You know, we're gonna have a smoke-free Britain by 2030. Well, it's only four years away. Is any of this stuff realistic? No, it's not. And so they just legislate rather than govern. There's a big difference between governing and legislating. We're not enforcing the laws we already have, but we keep making more and more laws on things that, a lot of the time, simply none of the government's business. And this stuff isn't any of the government's business. And this comes back to part of the issue of prohibition. A lot of people say and have said during the course of this conference, prohibition doesn't work. Well, what's your definition of working? In actual fact, the law often is a deterrent against all sorts of things that people would otherwise do. And in a sense, no prohibition works insofar as it completely stamps out the behavior. To use an obvious example, murders are still committed, but nobody says, well, let's get rid of the law on murder because the prohibition isn't working. The difference is with prohibition, it tends to be about, it's essentially paternalistic. you're dealing with what are basically self-regarding actions. And public health people always try and find all sorts of arguments to say, well, no, it's not because of secondhand smoke or because of the cost of the health service, all this kind of stuff, which either you can deal with in other ways other than prohibition or, in fact, the arguments don't stack in the first place. The economic argument, actually, against smoking is extremely weak. So these things are fundamentally paternalistic. And you're dealing with things that people want to do and have wanted to do for thousands, literally thousands of years. And the individual, being a grown adult, doesn't see why the government is telling them to do this. And so if there's any significant demand for something, then the prohibition is not going to work. And my definition of working there is keeping the problem somewhat under control, dampening demand. Vape bans are a good example of this. It's pretty hard to tell. If you go to a country like Thailand where vapes are banned, you wouldn't actually guess they were banned unless someone had told you they were banned. That's how bad the prohibition is. Marijuana in Britain is kind of like that. You wouldn't know unless someone told you that cannabis is illegal in Britain because you smell it all over the place. So these kind of things, they're just so popular with people. The people who engage in the activity, don't think they're doing any harm to themselves or anybody else, and it's none of the government's business. And so again, it comes down to morale. It comes down to, do you have respect for the law? And you make a very good point, David. This kind of stuff really undermines respect for the law. And once people start breaking the law in one way, they start breaking it in other ways. And that's part of why we have, like I mentioned before, this kind of low-level lawlessness now in Britain, which has always traditionally been a very law-abiding place. Because we generally had quite a small number of laws, all of which are pretty good, and people generally obeyed them. And now we've got masses of laws, some of which people don't even know exist, and quite a few of which are quite ridiculous, and people don't feel any compulsion to obey them.
52:41 - 54:51
[David Sweanor]
Yeah, and again, having spent my career being a lawyer and know that the nature of law is that if you have laws that make sense, you don't have to worry too much about enforcement because people say, yeah, you know, that, of course not. And you mentioned COVID. I mean, some of the rules that came out in COVID where you say, yeah, well, you know, that makes sense. But then you get other ones like when we had bans on going to a park. There was a ban in my hometown against going to the beach. You got to understand, it's quite a small town. There's two beaches and they never get crowded. You're pretty much alone. There was a ban against walking beside the river. And near Ottawa, there were bans on going for walks in a forest. And you get that, and then you see the results of what's happened to trust in authority, trust in government, trust in public health, trust in NGOs. And Edelman, the research group, has a wonderful global trust barometer they put out each year. And it's scary reading, because we have ever more people who simply don't trust authority. And when they don't, it makes it much harder to get things done, because so much of what we do is based on trust. If somebody says, this is what you should feed to your kids, or here's a safer way to get to where you're going, or you might want to have that checked out in your car. You want people to say, ah, good point, rather than, oh, that idiot again. And when you look at the impact this is having on the individuals themselves, and I want to move to the audience shortly, but Maria, you've had the most, I think, firsthand experience with people who are vaping. And again, millions of vapers in all three of our countries. What do you find about their trust in public health? You know, does it go beyond vaping? Are they saying, well, they're full of baloney on vaping, but I'm sure I can trust them on everything else? Or do you just have the lack of trust?
54:52 - 57:48
[Maria Papaioannoy-Duic]
I'm finding a trend that a volley happened right before COVID. And that to me is a very impactful memory and experience for a lot of people who use vaping products at that time, because we were continuously lied to when we knew the truth. And you didn't need to be like a super advocate or anything like that. You just needed to be someone who was able to be informed, understanding that your vape is not made of oil, so how the hell can oil get into your lungs? It was really basic, basic science that someone who failed grade 10 science twice over here could understand. So that disinformation, and you know what, like, why do we sugarcoat it? Them lying and misrepresenting and leading us, leading... countries and the world's in a panic, there had to be a reason behind it. So when you look at a lot of people who are people who vaped prior to 2019, prior, I think it was, probably was 2019, right? Prior to 2019, they have a large distrust for public health, for vaccines. You could see from your Twitter feed, like if you're on Twitter and you have a large amount, I'm not judging them. I wanna respect and value their lived experience to get them to that way. I may agree, I may not agree, but I'm not here to tell them what to do, but their loss, They've lost their trust in public health. Your same chief medical officer of health that told you that you're going to get popcorn lung from vaping and is now telling you that COVID's going to kill you unless you take this vaccine, you're not going to believe them because they pretty much lied to you about one thing or didn't know it. Like either way, there's no win. And then you look that even further, distrusting taxes. A lot of people would rather buy from the black market than from a legal place. Why should my money go to the government so they can, what, try and keep this product away from me even further? So their distrust goes a lot further, and it's piled up, and rightfully so. I mean, if you're dating someone and they've lied to you once, your friends and family are going to say, don't trust them again. These are the people you're giving your money to and protecting you. So yeah, they're not trusting. I mean, even we keep saying my hometown, his hometown. Like we literally, it's 10 kilometers away from each other. Our local hospital diagnosed four people in 2019 with popcorn lung. Never reported a single one to Health Canada, but I had a ton of customers with popcorn lung. Well, they all had pneumonia later. But again, they were told to stop vaping.
57:51 - 59:54
[David Sweanor]
Issues of trust. Of course, this doesn't all happen by coincidence. I mean, if we look at past efforts on different prohibitionist agendas, you know, they were pushed. There were people who played a key role, John D. Rockefeller in funding the efforts on alcohol prohibition in the U.S., the people with the Anti-Saloon League and other organizations that pushed that. the various groups that pushed bans on homosexuality, bans on contraceptives, bans on marijuana and other drugs. And in this case, I think it's really clear to finger, this isn't hugely widespread. What if Michael Bloomberg and the World Health Organization thought this through and said, the way John D. Rockefeller II did, my gosh, this prohibition stuff is a bad idea. It's not working. I no longer support it. And he changed the trajectory on alcohol prohibition. What if they changed their mind? And if so, how would they change their mind? What should we tell them? If we were able to write a note, write a memo, something short, because multi-billionaires tend not to have a lot of time to read very much, and the people I know at WHO don't have the capacity to read very much, what's a quick message? What would you say, trying to be succinct, to them to get them to rethink what they're doing and further our transition away from cigarettes. And if I ask the panel, but then I want to open it up to the floor to say, we're going to write a memo to them. What should we say? How should we say it? Roland, do you want to give this one a go? That's a pretty simple question.
59:55 - 61:16
[Rohan Pike]
So you're basically suggesting that we screw up the entire FCTC and start from scratch with a blank canvas. I totally agree with that. and I would get all of the people in this room together and help produce those policies. I mean, we have policies in Australia that people like Joe and Alex and Fiona have compiled, and they're sitting there in a dusty drawer that has not been used, unfortunately, by the government. But if their mindset did change, then... I'd be pointing to those documents, as I have recently, to come out of that drawer and be front and centre. But we're talking about changing a mindset of an enormous number of people who are currently holding sway in the public rhetoric. You talked about the prohibition 100 years ago. Bizarrely, our customs minister keeps bringing up Al Capone for some reason, as if we're going to smash the criminal syndicates and... the Al Capones of Australia, which they are. But he hasn't really thought through the entire story of prohibition where it was only fixed by repealing the whole thing and going back to the laws as they were before. So perhaps he could just think through that analogy that he makes a bit more.
61:19 - 61:35
[David Sweanor]
Maria, what would you do? Short message. Michael Bloomberg's made a huge fortune on innovative technology. We're talking about innovative technology here. He's standing in the way. He's funding most of the opposition. What would you say? You've got an elevator pitch.
61:36 - 62:27
[Maria Papaioannoy-Duic]
I would ask him why. That would be my first question. Instead of me telling him what he needs to do, my big thing would be, be honest. Tell me why you're doing this. Because if I can understand the why, at least I can tell him my why I think it's wrong. So I don't think we understand the why. There is no why that is like... solid that we can say okay this is why they're doing it this whole for the children is not true there is a why so my first thing would be asking him the question why is this important to you and i don't want to hear about the children so you're allowed to not use the word the or children in your answer all right and uh chris that
62:29 - 62:44
[David Sweanor]
I mean, you understand economics. It's hard to imagine anybody gets to be worth over 100 billion US dollars and have no grasp of economics. What's Bloomberg missing? What does he need to hear?
62:44 - 64:44
[Christopher Snowdon]
I don't know if it's... I mean, he's very old now and you can't teach an old dog new tricks. And he literally believes that he's going to get to the pearly gates and all the money he spent trying to bring in sugar taxes and banning vaping is going to fast track him straight through to heaven. He said this on TV. I'd go along with Maria. I mean, let's assume that he is sincere and genuinely wants to improve the health of the world. He's clearly got something wrong. So what is it? Does he actually believe there's a gateway effect? Because it very obviously isn't. I see Becky Freeman in Australia was recently telling the government in their, what they called, illegal tobacco crisis committee hearing in Australia. So as I say, they have it actually acknowledged as a problem in Australia. But she is anticipating that the smoking rate's going to be up when the new figures are published at the end of the year, so she's getting her excuses in early. And she says, well, yeah, this isn't surprising because we've had a lot of young people vaping, and people who vape are five times more likely to go on to smoke, so that'll be what it is, you know? Has there ever been a country where vaping's gone up and smoking's then gone up 10 years later? No, quite the opposite. You've had high vaping rates in places like America and the UK, and smoking has almost disappeared amongst young people and has continued to go down against adults. So if they manage to achieve higher smoking rates and higher vaping rates simultaneously in Australia, it will be because of their unique combination of stupid policies, namely having the biggest, you know, highest tobacco taxes in the world combined with banning vapes. Absolutely insane. So, I mean, the real-world evidence, I guess, is what I would try and confront Bloomberg with. Say, you know, the stuff you're proposing is extremely counterproductive. It's not working. If you think that nicotine causes cancer or brain disease or something... here's some evidence to show that that's not the case. If you are sincere, and it's a big if, you're mistaken, and I'm happy to sit down and try and educate you, sir.
64:46 - 67:44
[David Sweanor]
I want to take it to the audience. I tend to be optimistic on a lot of this stuff because we see the sort of changes that happen. I just think you've booked by Norbert a Swede from 15 years ago called Progress. It's 10 reasons to be optimistic about the future. He talks about countering the view that ideas don't change. It's just the people who have them eventually die. It's saying no, ideas do change. they change dramatically, they change in our lifetimes, that we have seen this on so many issues. Like, how many people now would be really upset and concerned and near suicidal if they found out one of their children was gay? 50 years ago, that was really different. 20 years ago, in many places, that was really different. Or that they'd smoked marijuana. Or that they were planning to date somebody from a different ethnic group. I mean, these were things that were huge. How many people are upset about the idea of a woman having a job outside of the home? You know, that was not allowed at one point. Or women getting education. And in many places around the world, these things have changed in our lifetimes. You know, there were laws against interracial marriages in many states of the United States in my lifetime. There were laws against providing contraception in my lifetime. And if you ask people now, including people in their 80s and 90s, how do you feel about this? No, that's not... I mean, who'd care about that? So people have changed. So let's be optimistic and say the world's already changing, and it's changing very rapidly, as we've been hearing at this conference, and we can see the data on that. We're going to speed it up. What are the other suggestions we might have about what's the message that needs to get through to the people standing in the way, whether it's Bloomberg sending the money or the people who are taking the money, the people who are saying things, for somebody to say, wait a minute. You know, I'm starting to sound like Anthony Comstock, the guy behind the Comstock laws banning contraception. I'm starting to sound like the people who were sending people to jail because they didn't sit in the part of the bus that they were designated to sit in because of the colour of their skin. We've seen all these changes. What do we do? Where are ideas? Who wants to suggest anything that went into the note to Bloomberg, WHO, whoever we're going to try to influence? What's a good argument that might get some sanity into this field and get it there sooner? And it's hard because of the lights for me to see hands going up, but I'm looking for volunteers and anybody who has any ideas they'd like to share.
67:48 - 67:53
[Maria Papaioannoy-Duic]
There are no stupid ideas. Everybody's idea holds its value.
67:53 - 68:26
[Rohan Pike]
I continue to be surprised why Sweden and New Zealand and the UK that used to be, although you're going a bit squeamish on your vape policies, started promisingly but seems to be going backwards lately. But when people say, well, who is doing it well? Why don't they look to the countries that are doing it well and say, what are they doing? and taking on some of those policies. That would seem to be a simple solution but people, certainly in Australia, don't look above the horizon and it's all a bit incestuous.
68:27 - 69:18
[Joe Kosterich]
I think all of your examples, David, were excellent. not one of those came from authority. They all came from grassroots movements and public pressure. So it is changing ideas one at a time. And in terms of what I'd say to Michael Bloomberg, find something else to do. Just leave. And to WHO, just fold and make room for some new organisation. I think These people won't change. It's actually the people who need to be changed. They need to be replaced by people who've got better ideas. And if you look at the legislatures that changed some of these rules, they ultimately weren't the ones that introduced them.
69:18 - 69:27
[David Sweanor]
Other comments, suggestions? Oh. Unlike Martin to have an opinion.
69:29 - 69:41
[Martin Cullip]
I just want to know, if you speak to the public, any of the public, and say to them, what do you think of prohibition? They'll say, it doesn't work. So why is it politicians seem to have this idea that prohibition does work?
69:43 - 70:44
[Maria Papaioannoy-Duic]
I think they don't believe they're doing prohibition. I think they're doing the greater good. I think that when mothers or parents go to a politician, they play upon that ego side. And these types of regulations, they think of them as easy wins. And oh, yeah, I'm saving kids. I'm saving the parents. I want that vote. So to them, it plays upon their ego side, the easy side. And then all of a sudden, a whole bunch of people start sending letters, start sending emails. and it gets turned upside down, but they're too far down in the road of it. I really, truly think they're not doing prohibition. They're doing God's work, for lack of a better word. Like, I truly believe some of them think they're doing God's work. Like, I mean, I'm sure tobacco control in my country believe they're doing God's work.
70:45 - 72:28
[Christopher Snowdon]
They also don't call it prohibition, you know. Nobody ever uses the P word. In tobacco control, it's the end game. In the UK, where they've got generational prohibition, it's kind of phasing out of cigarette sales. And also, to be honest, in Britain at least, judging by opinion polls, the public actually is very keen on prohibition. They don't use the word either, I guess. But they want to ban everything, according to YouGov polls. I guess if you've traditionally been a law-abiding country, it's easy to slip into belief that, well, people obey the law, so if we just introduce more laws, people obey those as well, you know? And if, you know, you've got 60%, 70% of people support a law, then that's the majority, so it'll work. Well, it doesn't, because there's still 30 or 40 people who don't even agree with the law, even in principle. So, you know, increasingly to me, governments are kind of... You've seen downfall, Hitler's moving the imaginary armies around. This thing that they've got all this power, and they have, they spend 40-odd percent of GDP in the UK now. We've got the police, we've got the customs people. In theory, you could. If you only pick one thing to ban, you could probably stamp it out with the full apparatus of the state. It's just you're trying to ban hundreds of different things, regulate hundreds, thousands of different things, and so it can't be done. To be honest, when you've got the general population so keen on banning things and becoming so intolerant of other people's behavior, which really has nothing to do with them in the first place, what do you expect from politicians other than do what the public or the majority of the public want?
72:29 - 76:17
[David Sweanor]
And I'll just interject because I'm chair, so I get to say things. I think something that can work should be able to work is the whole idea of community standards or peer group standards. So I have long had conversations with people at WHO or health departments, disease control centers, regional health units, and a very common statement they make when I talk about some of the nonsense being said about nicotine is, yes, we know, the tobacco people, they're odd. I mean, they say a lot of stupid things, but we just leave them alone, we ignore them, and we get on because we're doing our work, you know, whether it be, you know, mental health or food standards or whatever other area they're in. And I think that's like going back to the Middle Ages of having guilds, and if we're members of a guild, and we're doing silver work, and Chris here starts doing crappy work, And he's adding substances. He's debasing the silver. Do we let him get away with it and say, oh, that's just him. He's silly. He does stuff. I'm busy doing mine. No, you kick him out of the guild. You talk to him. You say, what you're doing affects all of us because it's how we're seen. It's why professions like law and medicine have standards that they impose. on members of the profession so that if you're behaving in a really scuzzy way as a lawyer, your law society is gonna tell you you gotta stop it because the other lawyers are gonna say it's gonna hurt the overall trust in the profession. Same with medicine. What if others within health organizations, others working on other public health issues themselves got upset about this to say that lack of trust isn't just on issues of nicotine and tobacco. That lack of trust, as we've been discussing, goes across the board. If we're working on helping people get vaccinated against deadly diseases, and you're undermining trust in the World Health Organization because of the stuff you're saying, that's undermining our ability to save lives. We're calling you out. You've got to stop doing that. We're going to go to the director. We're going to do things to try to prevent this from happening. You know, there's other philanthropists doing fantastic work on a whole range of issues. But philanthropy itself is in question because of the work of people like Bloomberg funding things that end up being damaging. What if others spoke out? What if the others working on disease issues said, you're making our job harder, Michael? maybe that would have some sort of impact. If people stop standing there thinking, this isn't about me, it doesn't affect what I'm doing, to say, my God, this does affect what I'm doing. They can't be doing this because look at what's happening in trust. If people within government were to say, what they're doing over there, the people working on tobacco or vaping in some of these places, is undermining trust in the overall government. And we, I mean, fill in the blank, whatever you are, tax department, we want people to pay their taxes. And if people don't trust government, there's going to be less tax revenue coming in. You know, we need to get these people to start doing things to develop more trust. So that's one potential avenue, but I'm looking for some more, and we still have a few minutes to have suggestions that will change the world. There's two of you there. Take turns.
76:19 - 78:24
[Jeannie Cameron]
Hello, I think sometimes what could be done more with politicians and speaking as one now, is to make our messages more simple. Because I've seen in the two years I've been in that position, Probably 75% of my colleagues vote things through because they haven't even read it. And specifically on the area where a neighbouring island to where I am on vape tax, it was put in front of them. A lot of them, they voted for it. And you ask them afterwards, why did you do that? And they go, oh, there's all this stuff attached, science and all this. And it's like they're not going to read it. And when you explain very simply, you know, it's really just this, this and this, what could fit on one page, they got it. But I think we tend to want to give politicians a lot of science, a lot of evidence because it's what backs up. But if we could make our messages simpler and clearer... and very you know just on one page if they want the data and that you know put some links or something but i really do think having seen that over and over again where people who are busy politicians they don't have time it's not an issue that they are invested in or know much about and they just go with the majority without even knowing what they've done and now i think that on a lot of issues but certainly i've even seen it on these issues our messaging i think And what we could do is be more effective in making our complex message, which it shouldn't be that complex, but we do tend to send politicians a lot of science and that sometimes defeats the purpose. So perhaps simpler and clearer messaging, this is just for politicians, not necessarily for regulators, but just make that more simple and maybe those things may resonate a little better.
78:25 - 78:33
[David Sweanor]
And if you just pass the microphone to your right there, Mark, who has a lot of experience seeing the world change on areas of drug policy.
78:35 - 84:34
[Mark Tyndall]
Yeah, I think I share, you know, optimism in that it's such an overwhelming problem and affects so many people that I think things have to change. But in the You know, the experience that, you know, Alex and myself and Jerry have been at meetings talking about harder drugs, and it's quite very amazing to me what's happened with other drugs in Vancouver. So in 2014, I was head of the BCCDC, and in our province, about 200 people died of opioid overdoses for, you know, for 20 years. And then in 2014, it doubled. And in 2016, doubled again. And all of a sudden, in the province, we're having six or 800 people dying. And that kept going up, even though we called a public health emergency. And now, 12 years later, there's still six people die a day in the province. And so over 100,000 deaths. you would think that would really catch people's attention. But it hasn't. We haven't really done anything different. And some of us have tried other interventions. And we have some naloxone. But people are still using deadly drugs. And I think the way it's justified is that we blame the victim. It's their fault. They're disposable people. We've given them as much information as we can. But we're still going to stick with prohibition, even though that's what's led to all these deaths. And I think we're slipping, you know, in this conversation, we're kind of slipping into the same kind of idea that they're promoting that if you're stupid enough to smoke or stupid enough to want nicotine, it's kind of your problem. And we blame nicotine. We blame the victims of this thing. Because 80% of the voting population doesn't smoke cigarettes, we've been so trained into believing that drugs are bad, people shouldn't use them, and if these bad outcomes happen, we're very sorry about it, but it's your fault. Our response is to try to prevent other people from getting into that same situation. And that's why so much emphasis has been on primary prevention and not allowing people to initiate this in the first place. And somehow, as a society and the politicians, we've got a mindset that it's not our problem. We've done everything we can to prevent people from doing it. We banned these substances. They're still persisting to do it. what happens to them is kind of their problem. And in some kind of sick way, that's kind of how we've justified it. And you would think with 1.2 billion people affected by this that it would be so overwhelming, the evidence is so terrible, and the outcomes for people are so horrible that obviously we'd change our prohibition stance on these things. But And I do think that there's so many people impacted that it will be pushed in that direction, but it's quite pathetic when you think how much damage has been done from the harder drugs and we still stick with prohibition. It's still part of how we approach this thing and it was never a good idea and it's killed a lot of people and caused so much destruction. But I think we've jumped into, and the people that are ideologically directed this, and as Maria said, they're doing God's work. A world would be better off drug-free, and this is what people should do, and the consequences of not obeying our laws is your problem and your fault. And I think that the what's happened in Australia and how it's disrupted society and all the crime and everything, maybe people will wake up because it's impacting them directly. But as far as somebody dying of a fentanyl overdose, I think somehow we've got in our minds that we've done what we could for those people and that what happens, happens. They're a kind of disposable part of our population. I think Part of that is also because of who's mainly affected by smoking, and it's poor, marginalized people for the most part. I've said a hundred times, if 13% of the richest Canadians were smokers, we would not be having these conferences. Everybody would have access to safer products, and we're dealing with a marginalized group, and we think of them as kind of disposables, and we really need to And if people, you know, the people in Canada who look at the graph of decreasing smoking rates don't really care how they get there. They just look at the smoking rates, and we're doing okay. Every year it goes down one or two percent, and if that's driven, those graphs are driven by deaths, and so our success rate is like having people die off as quickly as possible, and then hopefully that we don't repeat our mistakes. But anyways, it's... I think that's how I justify or how I understand the approach to harder drugs, and somehow some of that same attitude's been adopted to nicotine.
84:36 - 85:27
[David Sweanor]
All right, well, thank you. We're out of time, but just, you know, again, an ejection of optimism. I think eventually somebody comes along who won't move to the back of the bus. Somebody comes along who crosses the bridge when they're told you're not allowed to cross that bridge. The birth control pills changed lives. It got no government funding. That was all from one woman who had motivation to help other women. So we've seen all these changes happen. So somewhere out there, there are people who are going to accelerate this. I think some of them are in this room, and some of that acceleration is going to be dramatic. I'm sorry we're now out of time. We have to hand it over to Konstantinos to sum up the conference. Thank you very much for everybody who stuck around and participated in what I think has been another fantastic conference. Thank you.