Three architects of tobacco harm reduction disinformation land in London.
On 15th March, Bloomberg Philanthropies (BP), the World Health Organization (WHO), and Vital Strategies (VP) will co-host the inaugural Partnership for Healthy Cities Summit with London Mayor Sadiq Khan. The Summit will bring together mayors and other city leaders from the Partnership global network to discuss strategies to combat the global burden of noncommunicable diseases (NCDs) and injuries.
Nicotine consumer advocates the world over are fighting for the right to health. Nobody is listening.
There are over 100 million users worldwide of safer nicotine products (SNP). Many will have struggled to find the right option for themselves, friends or family, or any option at all. Many will have obtained nicotine products illegally, smuggled into the country or bought under the counter. Few will know that there are activist groups all over the world campaigning for the right of these same people to have ready access to nicotine products which are affordable, appropriate and acceptable. The first study looking at the nature of these groups has just been published by Knowledge Action Change (KAC).
The WHO has just published Invisible numbers: The true extent of noncommunicable diseases and what to do about them.
I’m not sure where the WHO gets the idea that the statistics on death and disease from cardiovascular and respiratory diseases and cancer are ‘invisible’. There is a wealth of data out there from national and international public health, medical and academic sources, including the Global Burden of Disease annual reports and the WHO’s own International Agency for Research on Cancer.
Huge disruption has been caused by the evidence that non-combustible vaping and heated tobacco products and Swedish-style snus can have a game-changing impact on reducing death and disease from smoking. The advent of these products has disrupted industry thinking while governments have been trying to play catch-up with often knee-jerk and harmful revisions to tobacco control policies. But the disruption has been most keenly felt within the global public health community.
As part of my preparation work for the next Global State of Tobacco Harm Reduction report, which is due out in November, I was reading Professor Virginia Berridge’s book Demons: Our Changing Attitudes to Alcohol, Tobacco and Drugs, published in 2013. I was surprised to read that back in the 1970s, the anti-smoking warriors objected to medical help for people who wanted to stop smoking.
In a previous blog, I described a particularly absurd situation regarding tobacco control paranoia about the industry. An anti-smoking NGO operating in Southeast Asia announced an anti-smoking poster competition for young people. Buried in the terms and conditions of entry was the stipulation that entrants could not have any connection with the industry to the ‘fourth level of consanguinity’. In other words, teenagers were barred if their great-great grandfathers had any industry connections.
Globally most smokers know or at least have a strong inkling their habit is bad idea. They may have lost family and friends to cancer or some form of lung disease. They themselves may now be easily out of breath where once they were active sportspeople. They tell researchers they want to quit. But millions don’t. Why?
Traditionally, tobacco regulation has majored on controlling access to cigarettes through taxation, advertising bans and packet warnings, bans on public smoking and youth access and all the panoply of regulation to reduce the death and disease toll from the most dangerous way of consuming nicotine.
We are now used to hearing experts of all disciplines, from virologists to behavioural psychologists, interviewed in the media about COVID-19. There is general agreement on personal safety measures like social distancing and hand-washing. But even at this basic level, questions arise. As it becomes clear that the virus can be carried in airborne droplets, should the recommended distance in the UK remain at 2 metres rather than I metre plus or even 3 metres?
This blog is inspired listening to Mark Carney, former Director of the Bank of England give the BBC 2020 Reith Lecture named after John Reith, the first Director-General of the BBC.
Carney’s theme was how moral values have morphed into market values, a way of economic and financial thinking which ultimately led to the financial crash of 2008. Years of uninterrupted economic growth led bankers to believe they were masters of the universe, that markets were always right. Unlike say teachers and farmers who can directly see the impact of their work through the development of children and the growth of crops respectively, those in the financial world became entirely disconnected from the communities, small businesses, and families they ultimately served. They became fixated on the numbers appearing on their screens, it was all about ‘we win, you lose’ in the financial game. Such tunnel vision corroded any notion of trading ethics.
COVID has accelerated the speed of fake news around the world much to the delight of the dangerous and delusional. In such times, the lay person could be forgiven for thinking that when the media cite ‘peer-reviewed’ papers, the publishing journals in which they appear would be an oasis of unbiased evidence and probity. The expectation is that the editors would have sufficient gravitas to weed out those papers which should never see the light of day. If only.
Richard Smith is the former editor of the British Medical Journal. On leaving his post, he wrote a refreshingly honest book entitled, The trouble with medical journals. Commenting on the quality of much research that manages to get into print, often after multiple rejections. he quoted Drummond Rennie, deputy editor of the Journal of the American Medical Association who observed,