It’s time to rethink public health interventions.
As Judith Green has argued in a different context, it’s time to “move away from tightly monitored outcomes” — like smoking, for our purposes — “and towards processes that will enable rethinking the sites of interventions. If we accept that inequalities in health are caused by inequalities in societies, it is perverse to continue to focus interventions and research at the very groups that have the least power: the poor, the marginal and the vulnerable.”
This might mean focusing on access to health care to equitably provide resources for mental and physical health to reduce the saliency of smoking-for-survival for some people. Or this might mean making less risky nicotine products more accessible to facilitate their use over combustible tobacco products that are far more risky, rather than treating all nicotine and tobacco products similarly. But regardless of the solution, let’s not forget that public health professionals hold power in setting the agenda and that it’s in part the perspectives of the publics that we will ultimately learn from, because those perspectives will help us to challenge the status quo in public health and think critically about what form our agendas should take.