Jan Pezarro is a Vancouver-based writer and award-winning marketer who is writing a memoir about Mad Men and lung cancer.
It was one of the most successful public health campaigns in history: starting in the 1960s, Canadian governments began educating the public about the link between cancer and smoking, and then creating regulations on the marketing and branding of cigarettes. This effort shifted society, and smoking prevalence in Canada fell from 50 per cent in 1965 to under 11 per cent in 2021. Offices, restaurants, bars and even many parks are now smoke-free – all of which would have been unthinkable a few decades ago. The prevention campaigns that exist are working, and most people aren’t smokers.
So it feels as if we’ve finally overcome the influence of tobacco advertising and marked victory in the war on smoking. Isn’t it now old news?
Well, lung cancer isn’t old news. It is the leading form of cancer death, having claimed 21,000 Canadians in 2021 – a death toll greater than the combined total for colon, prostate and breast cancer combined. As many as one in ten smokers will develop lung cancer because of mutations triggered by the carcinogens in tobacco smoke. Despite some good news – low-dose CT scan programs, which can detect lung cancer early when it is still treatable, are now available in many provinces, including Ontario and B.C. – the disease is still a scourge.
But smoking isn’t old news either – not if we consider that the story of smoking is a story of nicotine. Millions of Canadians may have started smoking to be one of the cool kids, to demonstrate our liberation, for appetite suppression, or to mimic a hero – I know these reasons are why I started smoking – but we stayed for the nicotine: a drug so powerful it rewires the brain and may be more difficult to quit than heroin. Yet companies continue to market it, no longer in pristine white tubes of chemically saturated tobacco, but in colourful vapes and pouches.
We cannot say we have won the war on smoking when, after the 2015 launch of Juul – a sleek vaping product with flavouring of candy and fruit – the rate of vaping amongst high school students shot up from 1.5 per cent to 27 per cent. This wave was not about nicotine replacement, as the vape manufacturers tried to claim, nor is the success of the latest Trojan horse, Zyn, a nicotine pouch developed in Sweden which also employs flavouring and hip names to attract young users, and which can be purchased online and shipped to Canada. What’s more, last July, Health Canada approved the sale of Zonnic, a nicotine pouch marketed by Imperial Tobacco Canada; while Ottawa is working to close this loophole, and the B.C. government has restricted where it can be sold, Zonnic remains easily purchasable in local stores. Officially intended to support smokers in quitting, these products have become new gateways for nicotine addiction – and the tactics of the advertising industry are proving as irresistible today as they were in the 1920s, when ads for cigarettes took off.
When I was in marketing, we had a saying: it is easier to market medicine than vitamins. After all, everyone knew medicine was important. Long strategy sessions focused on how to make our products – horticultural goods, ski resorts, transit systems – feel as important as medicine. We worked hard to convince consumers that this potting mix would flood them with warm and fuzzy oxytocin from growing better plants; that that ski resort guaranteed endorphin rushes; that switching from a car to public transit would release a wave of serotonin at the pride of being a climate hero.
How much easier would it have been if the product was a drug that hooked consumers by physically altering their brain chemistry?
After society’s long history with smoking, how could nicotine replacement products seem like a reasonable candidate for commercialization? No one is marketing methadone, for instance, unless you count a person trying to overcome heroin addiction who sells a portion of their prescription on the street corner. I am confident that neither Altria (previously known as Phillip Morris Companies), which acquired 35 per cent of Juul in 2018, nor Phillip Morris International, which acquired 90 per cent of Swedish Match, the maker of Zyn, in 2022, ever contemplated buying shares in a methadone manufacturer. The reason seems clear: methadone is a controlled substance, requiring a prescription. It may be time to reclassify nicotine as such.
Cigarette smoking may be old news, but nicotine is making a big comeback. Like a wolf in sheep’s clothing, we are creating a new generation of addicts – and worse, we’re doing so when we think the war has been won.