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Prevention Action Alliance
Lessons from Smoking Prevention to Apply to Mask Wearing
The progress of the tobacco control movement is often considered one of
the public health field’s greatest success stories. After all, the drop
in adult smoking rates from 42% in 1965 to 14% in 2017 didn’t happen by
itself. Rather, it was the result of hard-learned lessons with broad
applicability to public health problems today, including COVID-19.
Lesson 1: Listen to the research.
In 1964, the Surgeon General’s Report on Smoking and Health used data
from over 7,000 articles to disprove the tobacco industry’s claims that
smoking didn’t cause cancer. Studies released in the years since then
has continued to shape the public’s understanding of tobacco as a
dangerous and addictive drug. Despite this, it’s taken decades to
change norms around smoking, not only because of the addictive nature
of nicotine, but also due to friction between “smokers’ rights” and
“non-smokers’ rights” which contributed to the politicization of
research and intervention.
On July 20, 2020, the Centers for Disease Control & Prevention
(CDC) reported that 140,147 people had died from COVID-19 in the United
States. This data, compiled from state health departments and
hospitals, helps the public understand this pandemic and the need for
intervention. Despite data from trusted health authorities, conspiracy
theories abound regarding the origins, impact, and spread of the novel
coronavirus, necessitating caution when investigating inaccurate claims.
Lesson 2: Develop direct, concise, and consistent public health messaging.
In the 1950s, tobacco companies marketed cigarettes as harmless
products; some even advertised their brand as the favorite among
physicians. Public health messaging, in contrast, lacked consistency.
Some experts touted moderation; others recommended filtered cigarettes
or other approaches to make cigarettes “healthier.” Soon after the
Surgeon General’s report, however, the public health field united with
one message: don’t ever smoke; if you do smoke, quit.
When the CDC updated its COVID-19 recommendations on April 3, public
health messaging around COVID-19 found its third pillar. In addition to
frequent hand washing and maintaining social distancing, the new
message included “wear masks in public.” Unfortunately, confusion
around what “social distancing” means, resistance to staying home, and
doubt regarding the efficacy of facial coverings have challenged public
health messaging. Public health officials must converge around a single
set of simple health directives and do what they can to persuade the
public to adopt those behaviors.
Lesson 3: Use policy to motivate behavior change.
The decrease in smoking rates since 1964 is due in large part to
policies adopted across the nation that make tobacco products expensive
and inaccessible to young people, restrict advertising, and protect
non-smokers from second-hand exposure. Research demonstrates over and
over again that these policies reduce smoking rates by changing human
behavior.
Similarly, while hand washing is generally accepted without complaint,
mask mandates have been far more controversial. And effective. Surveys
on mask-wearing demonstrate an increase in mask-wearing when mandates
are put into place. What’s more, they reduce the need for more
restrictive shutdowns.
The COVID-19 pandemic has claimed more than 600,000 lives worldwide,
the largest share of them in the U.S. We all have to work together to
beat this pandemic, and we each have to do our part. By listening to
the data, utilizing effective public health messaging, and advocating
for policies known to protect public health, we can change behavior,
whether that’s convincing people to stop using a dangerous, addictive
drug, or to do what they can to stop the spread of COVID-19.
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