Moving the Goalposts on Harm Reduction
Analyzing the Filtered Declaration on Reducing Harm from Tobacco, Nicotine, Alcohol and Unhealthy Food
Activists are never wrong. When their policies miss, they just move the goalposts. When their jobs (and income) are based on winning campaigns, activists have no problem adapting their ideologies when their dogma becomes unpopular or unworkable. It is not uncommon to see something NGOs were once campaigning against becoming a core strategic policy.
We seem to be at a moment where many in the NGO community are beginning to acknowledge the failures in their campaign against tobacco harm reduction via safer nicotine alternative products.
It has become obvious that tobacco harm reduction strategies (via products like e-cigarettes, nicotine pouches and snus) as a means for public health authorities to encourage a reduction in tobacco smoking has been extremely effective in promoting better health and saving lives. NGOs with their fingers on the campaign funding pulse (excluding the Bloomberg NGOs who are financially beholden to Mike’s narrow agenda) are beginning to see their opposition to harm reduction as a flawed position that needs to quietly be abandoned.
This would not be the first time that activists abandoned their ideology to back a winning strategy. Some examples of past NGO U-turns:
On agricultural issues, activists have adopted many conventional agriculture best practices in establishing their agroecology ideology (no-till, cover cropping, crop rotations...) and then used them to describe how their “traditional” farming practices are so much better.
On energy issues, NGOs were promoting biofuels as they were natural, lower CO2 emission alternatives to fossil fuels ... until industries started expanding the market and their environmental impact became clear. The NGOs shifted to campaigning that biofuels were anything but a green alternative, scrubbing their old campaigns from the web.
On tobacco control strategies, the recent Framework Convention on Tobacco Control (FCTC) COP 11 showed similar cracks in the fundamentalist dogma. While the WHO managed to sterilize the room of any stakeholder dissent to the anti-nicotine ideology, many governments, like New Zealand, started speaking out in favor of tobacco harm reduction and the need to respect scientific studies showing how safer nicotine alternatives were successful in reducing smoking rates and improving public health. Harm reduction, a basic risk management concept, won’t go away and this has not gone unnoticed among the chattering classes.
The debate on safer nicotine alternatives is being suppressed by the Bloomberg factions that are using their flotilla of NGOs, academics and WHO direct funding to keep the anti-vaping campaign alive. During COP11, Bloomberg’s NGOs, like the GATC, were trying to bully any FCTC countries from going off script and promoting safer nicotine alternative strategies like vaping. As the FCTC is dependent on philanthropist funding, even the WHO Director-General, Tedros Ghebreyesus had to sing from the song-sheet and condemn nicotine alternative products not as “harm reduction” but as “harm production”.
But the moral repugnance from these continued smoking-related deaths is starting to leave a stench in Geneva. Other NGOs and authorities not dependent on a Bloomberg check, are beginning to chip away at this narrow ideological funding faction.
Moving the Goalposts
The FCTC COP11 showed cracks in the activist strategy against harm reduction. Last month, a group of health NGOs in a consortium funded by the European Commission EU4Health Programme (under the project name: Filtered), held a conference where they tried to redefine (and reclaim) the concept of harm reduction.
Members of the Filtered consortium include Eurocare, the European Heart Network, the Smoke-Free Partnership, the Youth Health Organisation and several Ukrainian NGOs. The two-year project started in January, 2024 (with €1.155 million in EU public funding) but Eurocare has yet to create a project website (see a member page). Eurocare (a temperance NGO) argued that web pages are not sustainable, so they did not bother … nor did they produce anything more than a four-page bullet-point report from a (closing?) event that was not promoted to the public (once again, not sustainable … but thanks for all the cash). This is a textbook case of how Brussels-based umbrella NGOs feel entitled to free money from the European Commission with no deliverables and no scrutiny.
In any case, the four pages of bullet points after two years of thinking about harm reduction show where the non-Bloomberg funded NGOs are moving.
The Filtered consortium realized that they were losing the battle by putting dogma above common sense on harm reduction and that the loud ex-smoking community was not going away but rather getting louder in highlighting how the activist anti-nicotine, anti-harm reduction campaign was promoting more smoking, poor health and loss of life. It was time for the NGOs to reclaim the concept of harm reduction on their own terms.
First a reminder of the definition of harm reduction (see my earlier Firebreak article). Harm reduction is a simple risk management concept. In accepting that we cannot stop certain risky behavior, we should strive to reduce the harm from any consequences (as low as reasonably achievable). Harm reduction practices can be seen in common sense decisions like wearing a seatbelt in a car or a helmet on a bicycle. Some examples of harm reduction health policies include distributing free needles for drug users or condoms at music festivals. Promoting tobacco harm reduction alternatives like vaping or nicotine pouches have been very successful in reducing the number of smokers and improving public health. Activist campaign opposition to tobacco harm reduction products has been hurting the reputation of NGOs as promoters of better health so the more pragmatic groups appear to be looking for a way out.
But, as a first step in a U-turn, these NGOs have chosen to redefine harm reduction – to claim it as their own (and pretend that the tobacco harm reduction debacle had never existed). They also added an interesting activist tactic: broaden and dilute the concept by including other issues (to involve more NGOs, more foundations, more funding). What then is this new activist concept of harm reduction?
The Filtered European Declaration on Reducing Harm from Tobacco, Nicotine, Alcohol and Unhealthy Food called for the following “harm reduction” measures:
Reducing harm via policy measures (taxation, restricted access, clear labelling and warnings, and restrictions on advertising and marketing).
Protecting populations from health-harming industry interference (transparency, exclusion of industries from policy processes, and more funding for independent research).
Reform the Common Agricultural Policy to stop the production of health-harming foods.
Build up health equity, prevention and resilience.
Provide more funding and legal protection for civil society groups (ie, reducing harm to NGOs).
Harm reduction for this consortium of NGOs means stopping industries that harm public health, blocking their products, stopping conventional farming and giving more funding and protection for NGOs. While it is a far cry from the risk management approach to harm reduction, these groups are starting to realize that they cannot ignore the concept in the health policy domain.
While it is a first step in a U-turn, I imagine the NGO adoption of the term “harm reduction” will likely slowly shift to include traditional harm reduction measures, including safer nicotine alternatives as an acceptable option to reducing smoking deaths (provided that the Big Tobacco companies are not involved). Let’s be magnanimous in this small victory.
Leaving their Dogma for the “Pragma”
We can imagine (hope) that some activist groups see reason and common sense and start to adopt more sustainable health and environmental strategies, leaving their dogma for the pragma. Activists have seen reason in the past and have adapted their strategies when their ideologies have failed, and it seems their irrational campaign against tobacco harm reduction options is starting to get some reflection.
As most NGO campaigns are built more on dogma and emotion than reason and evidence, there are many more cases where activist U-turns need to take place.
My wish-list for 2026 includes:
That NGOs realize that nuclear energy is safe, sustainable and efficient for consumers who need reliable baseload, low-emission energy solutions.
That building solar panel farms on valuable farmland is a threat to food security, sustainability and respect for the environment.
That NGOs would switch to proactive plastics campaigns given that in almost all cases they reduce CO2 emissions compared to the alternatives they had replaced.
That the anti-GMO crowd will realize that seed gene editing technologies create sustainable solutions, pesticide reductions, and could even be accepted as organic-farming compliant.
That climate change is less of an issue than development and that our focus should be on promoting growth in developing countries. Bill Gates has set the roadmap for that activist U-turn.
If Michael Bloomberg were ever able to break free from the dogmatic firewall his influencers have built around him (and if he had enough courage to recognize the deaths caused by his anti-nicotine funding) to write a Gates-style note, change could happen very fast. In this season of hope and joy, I can dream now, can’t I?