Simon Chapman (2007). Public Heath Advocacy and Tobacco Contol: Making Smoking History.
Wiley-Blackwell.
Length: 344 pp.
List price - $59.99
ISBN 9781405161633
For more information on this book: Click here
FEB/MAR 2008
Volume 14 - No. 1
Book Review: The Cigarette Century
Book Review: The Science of Real-Time Data Capture
Book Review: Public Health Advocacy and Tobacco Control: Making Smoking History
Research Activities at a Featured Program: Twin and Family Research
SRNT Newsletter
February/March 2008, Volume 14, Number 1
Book Review
As a primary care physician, I would like to think that much of the decline in the prevalence of smoking has been due to physicians in part and health care in general. Unfortunately, this would be naïve and totally incorrect. The remarkable decline in tobacco use in many countries has been a tremendous success for public health and tobacco control advocates. This excellent book chronicles these remarkable achievements and also serves as a primer for current and future advocates.
Since advocacy is seldom rewarded academically, should we not publish papers instead? Papers certainly advance scientific knowledge, but much of what is needed to get smokers to quit is already known. As Chapman illustrates, a very well-received paper might be cited by 50 other papers or heard by as many as a few thousand people, whereas a successful TV program will be seen by millions. This same view underlies the population health approach that he advocates; namely, a less effective intervention delivered to an extremely broad range of people will get more smokers to quit in the long run.
The first two thirds of the book is devoted to a history of tobacco control and some suggestions for the future. Chapters include titles such as “Death is Inevitable, So Why Bother With Tobacco Control? Ethical Issues and Tobacco Control”, “Dead Customers are Unprofitable Customers: Potential and Pitfalls in Harm Reduction and Product Regulation”, “Accelerating Smoking Cessation and Prevention in Whole Communities”, and “Making Smoking History: How Low Can We Go?” The remaining third of the book is “An A to Z of Tobacco Control Advocacy Strategy”.
Dr. Chapman has been a leading figure in tobacco control for 30 years, having won the Luther Terry and WHO medals. His style is engaging and easy to read. Australia has a tremendous record in tobacco control, as Dr. Chapman cites from two tobacco company documents: “Australia has one of the best organized, best financed, most politically savvy and well-connected anti-smoking movements in the world. They are aggressive and have been able to use the levers of power very effectively to propose and pass draconian legislation.” and “In Australasia… we have perhaps the most virulent and nasty-edged anti-tobacco lobbies to be found anywhere in the world. There is nothing less than a battle raging in Australia and New Zealand, and all the guns are out on both sides…” (page 173). Dr. Chapman has been at the forefront of these efforts since their early days. If effectiveness is measured indirectly by the level of fear you evoke in the enemy, then Dr. Chapman and his Australian colleagues are indeed formidable. This book shares stories and efforts from Australia and elsewhere, including both successful and unsuccessful approaches.
There are sections that will likely upset some tobacco control activists. For example, in discussing outdoor smoking bans, which some feel send an “important message” to communities, he says, If any message is sent to the community by an outdoor smoking ban, it may well be one that says health policymakers do not care about evidence of harm, but are more concerned to impose standards cut loose from any evidence base and indifferent to a vital ethical principle of respect for autonomy. (page 164)
At times, Dr. Chapman waxes rather rhetorical, such as Emboldened in their fetching news sheepskins, and barely finished gagging from being publicly force-fed truth serum via their embarrassing public documents, tobacco industry wolves are doing the rounds of the world’s CSR [Corporate Social Responsibility] conferences, where corporate spin doctors meet to swap war stories about clothing naked emperors and turning frogs into princes. (page 193) However, he never lets his passion distract him from the evidence and from trying to intervene in the most effective way possible.
Overall, this is an outstanding book, required reading for anyone interested in tobacco control advocacy. The A to Z primer is invaluable not just for tobacco control activists but also for anyone involved in public health advocacy.
About the Author: Scott Sherman, MD, MPH is a primary care physician and health services researcher at the VA New York Harbor Healthcare System and Interim Chief of Geriatrics at the New York University School of Medicine.