Tobacco: The ongoing pandemic

May 29th, 2020 | Viewpoint


It used to be straightforward. Smoking was the pandemic, with 8 million people dying each year and multi-organ damage for many millions more. The tobacco industry was the vector, and public health measures, lawsuits, and regulations were the cure, with new social norms set as the hopes for a behavioral vaccine. A World Health Organization-sponsored international treaty, signed by more than 170 countries, coordinated responses to the pandemic. Thus, in many parts of the world smoking prevalence and death rates fell to such a degree that we imagined a  world in which  the resulting diseases would be mitigated, the tobacco industry hobbled, and everything would be beautiful.

And then came the shock: a non-combustible electronic nicotine delivery device that within a few years spread across the worldmorphing into many forms and soon promoted by big tobacco manufacturers as a way for smokers to quit ordinary smoking, as if that wasn’t happening already. 

Big Tobacco’s cunning, however, was advertising the cool-looking, easily disguised, inexpensive, and disposable devices on all social media platforms.  All these strategies, including the availability of fruit and other sweet flavors, made e-cigarettes appealing, especially to children and adolescents, most of whom had never smoked. There is little evidence that the use of electronic and vaping devices as cessation tools helps people quit smoking. Instead, these devices have created a new and dangerous nicotine addiction across adults and particularly teens. A win-win for the industry, and a lose-lose for tobacco control. 

World No Tobacco Day reminds us to get back to the basics of tobacco control: taxes, laws against smoking in public spaces, counter-advertising, safe quitting, and citizen action. 

The COVID-19 pandemic reminds how critical it is to keep our lungs healthy (smokers are more endangered by the coronavirus), and to prevent young people from taking up any kind of nicotine use. 

We must call out Big Tobacco’s insidious exploitation of the pandemic to promote and market their even deadlier products, given the growing relationship in the areas of the U.S. where e‐cigarette, or vaping, product use‐associated lung injury hospitalized cases are connected to the distribution of COVID-19 hot spots.

Number of hospitalized EVALI cases or deaths reported to CDC as of 18 Feb, 2020
Source: CDC


Just as we must be prepared to fight global plagues that are certain to arise, we must continue the battle against the tobacco industry. It’s a fight that we can and must win.

Written by: Norbert Hirschhorn

Norbert Hirschhorn is a physician specializing in the public health of women, children, and communities around the globe. In 1993, he was commended by President Bill Clinton as an “American Health Hero.” His work has been recognized by awards from the Dana Foundation and the Linda and Kenneth Pollin Foundation. Norbert was a founding member of JSI and is a current member of JSI’s Tobacco Resource Group.

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