The Irreconcilable Conflict Principle (redux)

The governing idea of tobacco control is an irreconcilable conflict between the interests of the tobacco industry and public health. The idea is wrong and dangerous.

The Irreconciliable Conflict Principle is an elaborate rendering of the “scream test”. If tobacco companies hate it (scream), then it must be good for public health.

[This is a substantially updated and expanded version of an article previously published in Tobacco Reporter that is no longer available]

Defining an iron rule

Sometimes, defining an iron rule or governing idea and reorganising our understanding of the world around it can be immensely revealing. Einstein developed the special theory of relativity from the assumption that the speed of light in a vacuum is unwaveringly constant for all observers. The most surprising results follow from that. Darwin showed that the simple mechanisms that underpin evolutionary biology (mutation, fitness, and selection for survival and reproduction) could explain much of the astonishing complexity of the natural world. Governing ideas are found everywhere: supply, demand and prices in economics; innocent-until-proven-guilty in criminal justice; and mutually assured destruction in arms control are further examples.

The governing idea of tobacco control - Article 5.3

So, is there a governing idea in tobacco policy? Something that shapes everything and means that the world is understood through rigorous application of that rule? I think there is, and it is playing an increasingly larger, more polarising, and more counterproductive role.

The starting point is Article 5.3 of the WHO Framework Convention on Tobacco Control. Though often overstated, Article 5.3 is fairly innocuous:

In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.

When read as originally intended by the FCTC framers in 2003, this clause aims, quite reasonably, to guard against the improper commercial influence of Big Tobacco on public health policy. There is nothing wrong with that. Many governments would quite happily apply the same principle to Big Oil in climate change policy or Big Pharma in health care policy. It is essentially an expression of good policymaking practice: don’t be captured by commercial interests.

Note that it does not present public and commercial interests as a zero-sum game; it simply holds that public interest should come first. The zero-sum game came later: the maximalist enthusiasts for Article 5.3 didn’t stop with the FCTC.

The Irreconcilable Conflict Principle

In 2008, the concept was further elaborated in the Guidelines for the Implementation of Article 5.3. Note the title – it does not suggest new treaty provisions are introduced, but that the guidelines will implement the treaty as it is. However, the guidelines go far beyond the treaty. They set out four guiding principles for Article 5.3, and the first of these is the most problematic:

Principle 1: There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests.

Wow: that’s quite a statement. Let us refer to this as the ‘Irreconcilable Conflict Principle”. First, it is qualitatively different to Article 5.3 itself: it is a finding of fact rather than a principle that governs the process of policymaking. That finding is also permanent and inescapable – under this principle, no matter what the tobacco industry does or becomes, its actions will always and everywhere be in conflict with public health. That’s a big claim. This is not merely expressed as a cautionary recitation from history, a lesson for which there is at least some supporting evidence. It is binding on the future and expressed as a permanent truth.

Historical origin: the scream test

I believe the Irreconcilable Conflict Principle is the governing idea, the iron rule of tobacco control. I do not wish to imply that this emerged in 2008 or that it exists because of these guidelines. The direction of causation is the other way. This principle was included in the guidelines because it is the guiding principle of tobacco control.

It is, in fact, little more than a legalistic rendering of the “scream test”, which emerged as a big idea in tobacco control in the early 1990s. The scream test is a tobacco control operating assumption in which the effectiveness of a tobacco control policy is measured by the intensity of the tobacco industry’s opposition (i.e., how loudly it screams). It was always an infantile idea, but it is especially ridiculous today, when it is clear that it is possible to radically lower the total risks of nicotine use through the use of different nicotine products.

Negative impacts of the Irreconcilable Conflict Principle

By endorsing this principle at the urging of tobacco control activists, complacent or complicit bureaucrats greatly extended the reach of the FCTC. They did this apparently without appreciating or caring about the potential negative consequences.

To be clear: this principle means that anything that is in the interests of tobacco companies must, by definition, be deemed bad for public health. It means nothing can be in the interests of both public health and the tobacco industry. In the same way that Einstein assumed the speed of light was constant, and his understanding of the world was reshaped around that assumption, so we see tobacco control reshaping its worldview around the Irreconcilable Conflict Principle in the eight examples given below.

The important difference is that Einstein was basically right and his radical insight advanced human understanding.

For tobacco control, this governing idea is wrong and damaging. Consider the following implications (1-8).

1. Makes harm reduction impossible

The Irreconcilable Conflict Principle does not allow for the migration of the nicotine market from high-risk to low-risk nicotine use, because this is something that several companies want to do, in both their own interests and in the public interest.

Imagine having to give up on a life-saving public health strategy because someone else (tobacco industry shareholders) also benefits from it. It’s hard to imagine anything more unethical: people who smoke should lose their lives because a tobacco company might profit from selling a low-risk alternative. Yet, here we are.

But tobacco control activists cannot just admit that they dislike tobacco industry profits more than they like saving smokers’ lives. So, we see contorted reasoning claiming that tobacco harm reduction isn’t real and its public health benefits don’t exist; it is just an industry marketing scam [see the WHO position on Tobacco Harm Reduction]. That argument does not stand up to scrutiny. The migration to low-risk nicotine products is driven by consumers and works through consent rather than coercion. It is a way for people to be as safe as they wish to be. It also means reducing policy-induced harms - such as regressive taxation or stigma. Tobacco harm reduction, as it plays out in today’s nicotine market, aligns well with the Harm Reduction International definition:

Harm reduction refers to policies, programmes and practices that aim to minimise the negative health, social and legal impacts associated with drug use, drug policies and drug laws.

Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.

2. Demands weird explanations for the obvious

The Irreconcilable Conflict Principle drives implausible explanatory theories to avoid giving tobacco companies any credit for anything. The experience of snus in Sweden clearly challenges the guiding principle. This was already clear in 2003 (Foulds et al. 2003):

Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a notably less harmful form of nicotine dependence.

This study and others provided an instant refutation of the Irreconcilable Conflict Principle well before 2008. It should never have been agreed. Widespread use of a tobacco product made by tobacco companies is responsible for Sweden’s unusually low smoking prevalence (though about the average EU nicotine use) and, with that, an unusually low level of cancer and heart disease in the male population. This alone should be enough to justify abandoning the principle. There is no serious doubt about this, except among tobacco control’s adherents to the Irreconcilable Conflict Principle. They cannot allow snus use to be the explanation for the low level of smoking in Sweden, Norway, Finland, and Iceland.

So, the tobacco control establishment has been driven to find ever more desperately implausible reasons to explain the observed reality. Some recent examples:

• February 2026: Sweden: Setting it Straight (Teams event). Explore how the tobacco industry is distorting Sweden’s smoking reduction success by promoting snus and nicotine pouches.

• November 2025: COP-11 Side Event: “Sweden: Setting it Straight” see press release. Sweden’s decline in smoking is largely the result of strong tobacco control measures, not a shift to alternative nicotine products.

• January 2026: Swedish Cancer Foundation: Swedish Tobacco Policy - claims the anomalously low rates of smoking are down to the triumph of Swedish tobacco policy (even though Sweden was ranked 21st of 37 European countries in the most recent Tobacco Control Scale)

Tobacco control advocates have consistently and unethically opposed any lifting of the European Union ban on snus because doing so would admit a harm-reduction case for snus violates their guiding principle, the Irreconcilable Conflict Principle.

I once suggested a sincerity test for tobacco control advocates:

It’s a good question to ask anyone in ‘tobacco control’ – how do you explain the very low smoking rates in Sweden? If they come up with another explanation than snus, the conversation should end there.

3. Shifts the goals of tobacco control

The Irreconcilable Conflict Principle has shifted the goals of tobacco control. With the rise of vaping, pouches, and other far safer forms of nicotine use, tobacco control objectives have steadily shifted away from tackling the health consequences of smoking. Why? Tackling the harms of smoking can be achieved by migrating nicotine use from high-risk to low-risk nicotine products, made by “industry”, including the tobacco industry. That would violate the Irreconcilable Conflict Principle.

So activists increasingly stress opposition to nicotine use itself and set the goal of a “tobacco and nicotine-free society”. Nicotine is intrinsic to both the industry and the consumer preferences, so they have moved into a war-on-drugs mindset and away from a health objective. Ending smoking is no longer enough, because it could give a positive role to tobacco companies as they transition their business from sales of high-risk to low-risk nicotine products.

4. Distorts science

Imagine trying to be an open-minded, curious scientist while also producing work that complies with the Irreconcilable Conflict Principle. If your iron rule is that nothing good ever comes from tobacco companies, then you are motivated to develop science that always demonstrates conflicts with public health, and ignores or dismisses findings suggesting alignment. So, for example, we see more scientists claiming that there is no difference in risk between smoking and vaping, that the data are so uncertain that nothing is or can be known about relative risk, that new products do not displace smoking, or that the problem is youth uptake. All are wrong.

The gateway effect provides a useful example. Presented with a positive correlation between vaping and subsequent smoking, we can explain it in two ways: (i) a gateway effect (assuming that vaping causes smoking); (ii) common liability (the psychosocial factors that cause people to vape also cause them to smoke, and vice versa, likely reducing smoking overall and over time). Guess which explanation is compliant with the Irreconcilable Conflict Principle and which one is right? Guess which is constantly touted in tobacco control?

5. Creates enemies of innovation

The Irreconcilable Conflict Principle has made mainstream tobacco control into enemies of innovation. The US Food and Drug Administration granted a tobacco company the right to claim that its heated tobacco product was a reduced-risk product after concluding that it was “appropriate for the protection of public health” - literally the opposite of the Irreconcilable Conflict Principle. Predictably, it triggered a backlash of denial and desperate arguments claiming that the FDA was somehow mistaken and that there was no benefit to public health, even though the FDA was merely stating the obvious.

Nicotine pouches, such as Zyn, ON! and Velo, offer recreational nicotine use with risks similar to pharmaceutical NRT. Has this been greeted as a breakthrough for public health, allowing nicotine use with minimal risks? Of course not. That would be evidence of tobacco companies dealing with the public health problem of smoking. Instead, there has been a frantic problem-seeking rear-guard action against pouches to uphold the Irreconcilable Conflict Principle.

6. Builds bubbles and nurtures groupthink

The Irreconcilable Conflict Principle has created a self-amplifying echo chamber in tobacco control. Suppose there are people in public health (like me) who do think that some of the things done by tobacco companies are positive. Under the guiding principle, that just cannot be true. It follows that such people must have a conflict of interest or are in some way working to further the interests of Big Tobacco. They must be delegitimised and excommunicated - and certainly never permitted to debate their heretical ideas with true believers. The problem is that I don’t decide what I think is good for public health based on whether the industry opposes it. Nor do I change my mind just because the industry agrees with it.

We can see this in some of the McCarthyite efforts by tobacco control meeting organisers to exclude these dissonant voices. That includes the hurdles to achieving observer status at the FCTC and to attending major events like the World Conference on Tobacco or Health. What if you think (like me, for example) that it would be good for public health if smokers were encouraged to switch to snus or heated tobacco products, that responsible marketing of these products as alternatives to smoking is health-positive, and that regulation and taxation should be proportionate to risk? Do those ideas become wrong just because a tobacco company decides they agree?

A fringe Australian tobacco control activist has even proposed an “Article 5.3 for civil society”, to “maintain an evil industry’s pariah status” with new purity tests that would exclude heretics like me.

7. The assumption of infallibility

Under the Irreconcilable Conflict Principle, tobacco companies can never do anything good for public health. It follows that their presence in any forum can never be beneficial, and their role can only be “tobacco industry interference”. If so, then a case can be (and is) made to exclude them and their fellow travellers from all public health fora: conferences, journals, research collaborations, sponsorship, and even routine meetings. The problem with that is what John Stuart Mill (On Liberty, 1853) called “the assumption of infallibility”.

First: the opinion which it is attempted to suppress by authority may possibly be true. Those who desire to suppress it, of course deny its truth; but they are not infallible. They have no authority to decide the question for all mankind, and exclude every other person from the means of judging. To refuse a hearing to an opinion, because they are sure that it is false, is to assume that their certainty is the same thing as absolute certainty. All silencing of discussion is an assumption of infallibility.

It raises questions for tobacco control: what if you are wrong? What if you were right in 2008, but wrong now? What if the facts have changed? What if they are right about some things, and wrong about others? What if societal norms have changed? It means that people who claim to be experts on the industry know little about it and have evolved a cartoonish caricature of the industry, far removed from what it actually is in 2026.

Or what if the tobacco industry is wrong, dumb, or self-serving? How can you be sure unless and until you hear what they say? Shouldn’t they be wrong and be seen to be wrong? If your arguments are so good, why don’t you go ahead and confront them? JS Mill was strong on this, too:

There is no greater assumption of infallibility in forbidding the propagation of error, than in any other thing which is done by public authority on its own judgment and responsibility. Judgment is given to men that they may use it

8. Distorted policymaking and ignoring unintended consequences

The Irreconcilable Conflict Principle distorts rather than protects policymaking. Those who adhere to the principle cannot recommend policies that would encourage low-risk nicotine products at the expense of cigarettes, as that would be to accept that these products - and the companies that make them - have a role in public health. So, we see that tobacco control activists and many academics have adopted hostile regulatory paradigms for reduced-risk products: prohibition, pharmaceutical or equivalence to cigarettes. But that triggers further distortions. These restrictive policies have unintended consequences: more smoking, more illicit trade, more risky workarounds. So adherents double down, dismissing these effects as tobacco industry talking points and calling for stronger enforcement and stiffer penalties. Before you know it, they have gone full war-on-drugs.

Mr Bloomberg is on record as favouring vaping prohibition, and he sees no role for reduced-risk products. Perhaps public health policies now need to be protected from these vested interests?

Coming soon: Aligning the interests of the tobacco industry and public health