This week the FDA is hyping their phone app that allows retailers to scan a customer’s ID and determine if she is old enough to buy tobacco products. There is nothing wrong with this making this available, though it is hard to see the value for anyone who can remember where the date-of-birth appears on their state’s driver’s license, after checking dozens of them, and that 2018 minus 18 equals 2000. What is odd is the FDA making a big deal about this, advertising it almost as heavily as major guidances. This would just be weird amusement, but for the fact that this is part of a growing “technology will fix everything” mindset in tobacco control.
The mindset is oddly antiquated. For a few decades there was a deluge of hype about how computational power or internet connectivity would change whatever human activity was being discussed. It did, of course, change quite a few activities. But usually that resulted from identifying a particular problem, bottleneck, or other limitation that the technology could solve, and then creating the technology. The naive approach of just throwing a computer into the mix and assuming fundamental change (computers in arithmetic class! smart toasters!) has largely died out. Tobacco control is just starting to fall into it.
The WHO’s recent report on the policies recommended by the Framework Convention on Tobacco Control contains oddly specific passages about the value of “tech toys.” The document is mostly written at a flyover level, looking at categories of policies policies with few mentions of specific policies and almost nothing about how they were carried out. But the section on policies to provide smoking cessation tools leads off with an detailed and excited discussion about using mobile technology. The rest of the section returns to the usual lack of detail. It turns out that “mobile technology” mostly just means letting people sign up to get text messages reminding them to quit using tobacco products. If that is what people want, and if it makes some smokers who want to quit happier about doing so, then that is just fine. But it is difficult to imagine that it helps much, and there are other ways to feed someone a series of twenty-word pep talks, though perhaps not as convenient. Getting excited about it is rather odd.
As for the FDA phone app, it is far from convenient: Instead of just looking at someone’s ID, the clerk needs to fish into his pocket or wherever to get his phone, turn it on, enter the passcode, launch the app if it is not already running, and scan the ID. Or he has to leave his phone sitting out and unlocked, vulnerable to theft or falling from the countertop. Alternatively, the merchant needs to buy a dedicated smartphone or tablet and chain it to the counter. Also, any of these require the app to work right away, which may not be the case. (I was unable to get the app to read an ID.) The upshot is that technology is being created for the sake of creating technology, without considering demand.
Whether technology is completely superfluous and worse than the low-tech option or is convenient and slightly useful, getting excited about merely having it is so 2005. So why now? The answer is probably vaping. Tobacco controllers have been outflanked by technology products, e-cigarettes and heat-not-burn devices. They are dealing with the (accurate) feeling that traditional tobacco control measures are played out, and that what matters now are innovations. Tobacco control has no real new ideas in decades and they are running a bit behind on their plan for a tobacco-free world by 2010. But rather than trying to genuinely innovate (let alone productively engage with the innovative products), they are just trying to figure out what basic smartphone functions they can adopt. It is a bit sad to watch.
The FDA’s excuse for hyping the app now is that it now knows how to subtract 19 or 21 from 2018, instead of just 18, which is relevant for those jurisdictions that have stopped treating young adults as adults. But the mindset behind it is what really matters: any outcome they dislike must be a result of someone goofing up or being tricked. They refuse to understand that people use tobacco products because they want to, that the relative few minors who vape or smoke do so because they want to, and that occasionally (though not usually) they get those product from a retailer who wants to sell to them despite the law. Thus, they pursue a technical fix. In this case it is a techie fix, but in some cases it low-tech actions like trying to eliminate marketing. The common feature is a failure to recognize that, for the most part, people’s consumption choices are not goofs.