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s2smodern

Insightful read of the week award goes to a review of a new book on the AIDS pandemic in which the authors reveal how the leadership of the WHO failed miserably to save thousands of lives until redeemed by an administrator, Dr Jonathan Mann who did everything right from inaugurating World AIDS day to involving NGOs and fighting stigma and discrimination. Yet he felt he had to resign from WHO, frustrated that his boss was just putting every obstacle in his path. Mann tragically died in an air crash in 1998.

This is an extract from his Wikipedia entry

Mann was a pioneer in advocating combining public health, ethics and human rights. He theorized and actively promoted the idea that human health and human rights are integrally and inextricably connected, arguing that these fields overlap in their respective philosophies and objectives to improve health, well-being, and to prevent premature death.

Mann proposed a three-pronged approach to the fundamental issue of the relationship between health and human rights. First, health is a human rights issue. Secondly (and conversely), human rights are a health issue. Human rights violations result in adverse health effects. Thirdly, linkages exist between health and human rights (a hypothesis to be rigorously tested). Literature substantiates the effects of the first two points, but Mann and colleagues proceeded to call for the validation of the third point and challenged the world to practice it. His work led to the development of the Four-Step Impact Assessment, a multi-disciplinary approach of evaluating interdependent and overlapping elements of both disciplines of human rights and Public Health.

At the risk of stating the bloody obvious, the leadership of the WHO is still failing miserably to save thousands, even millions of lives by putting every possible obstacle in the way of encouraging smokers away from cigarettes towards options which can both be a gateway to quitting or at least save them from a tobacco-related death. According to the book, the in-fighting over AIDS within the WHO became so toxic, that UNAIDS was created which further isolated the WHO.

There is an urgent need for a Jonathan Mann to help drive global public health towards a human rights approach to tobacco harm reduction. UNVAPE anybody?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32705-8/fulltext?dgcid=TheLancetTwitter_social_lancet&sf124215628=1

https://en.wikipedia.org/wiki/Jonathan_Mann

Our friend Dick Puddlecote wrote to the Australian Foreign and Commonwealth Office (FCO) to point out that while Australians were being warned about the risks of vaping in Thailand, precisely the same thing could happen to Australians at home while they relaxed at a barbie with a six pack of tinnies. DP’s intervention resulted in this updating on the FCO site,

“The legality of using e-cigarettes in Australia differs between states. Liquid nicotine is classed as a poison and banned from sale nationwide, however some states allow importation for personal use and the use of e-cigarettes without nicotine. You should seek local advice on what restrictions are in place at your destination”.

As he says, you won’t find mention of this in the glossy holiday brochures. Fancy a trip down under while you are quitting the fags? Best go to New Zealand in case you get bounced into a kangaroo court.

https://dickpuddlecote.blogspot.co.uk/2017/10/travel-advice-for-australia-updated-for.html?m=1


On a very different discriminatory note, according to Sunday Times, English NHS commissioners in the county of Hertfordshire, just north of London. ‘declared they would ban smokers from referrals for non-urgent surgery. The smokers would be allowed back on the surgery lists only if they quit their habit for at least eight weeks and submitted to a breath test to prove they had done so’. The author’s free market belief was that this was wrong: however much smokers might cost the NHS, this was far outweighed by the cash they brought the NHS in tax. But for me, the more worrying notion is that the propaganda which continues to dub the new products as tobacco-based could affect vapers who might also be medically discriminated against even if they are costing the NHS nothing.


If you thought that vapers were inevitably in the higher socio-economic groups because of the cost, then this UK research indicates otherwise.

http://www.smokinginbritain.co.uk/read-paper/draft/8/Quit%20success%20rates%20in%20England%202007-2017

But overall, it is still likely on a global scale that various factors will continue to favour more privileged groups. Having internet access at all or at least via computer rather than phones is important in being able to engage with the vaping community, whereas using just a phone, you could rack up huge bills being involved in vaping networks and watching online media. Internet access and the ability to pay by credit card is also still important as online vending is a significant part of the market especially for better quality and choice of products.


The Science and Technology Committee of the UK Parliament has announced an inquiry into electronic cigarettes. The inquiry will examine the impact of electronic cigarettes on human health (including their effectiveness as a stop-smoking tool), the suitability of regulations guiding their use, and the financial implications of a growing market on both business and the NHS. The committee chair, Norman Lamb MP, Chair, said:

“Almost 3 million people in the UK now use e-cigarettes, but there are still significant gaps in the research guiding their regulation and sale. They are seen by some as valuable tools that will reduce the number of people smoking ‘conventional’ cigarettes, and seen by others as ‘re-normalising’ smoking for the younger generation.

“We want to understand where the gaps are in the evidence base, the impact of the regulations, and the implications of this growing industry on NHS costs and the UK's public finances."

Here is how to submit evidence http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/news-parliament-2017/e-cigarettes-inquiry-launch-17-19/

Clive Bates has been hostile to the idea of reduced nicotine cigarettes as essentially a bad idea that will never work. However, a recent FDA announcement that it is taking soundings on this has prompted something of a rethink

https://www.clivebates.com/fda-wants-to-reduce-nicotine-in-cigarettes-what-could-possibly-go-wrong-and-right/

With all the excitement around new product gadgetry, it is easy to forget the role of humble, low-tech snus in tobacco harm reduction. But here is a new market report indicating its growing appeal

https://www.whatech.com/market-research/industrial/394480-research-report-explores-the-snus-market

And leading us back to the start of this blog is an article by David Sweanor in the Irish press about those rare opportunities to do ‘something amazingly good for humanity’ like tackling smallpox and polio. But it will take visionaries like Jonathan Mann and global political will to dramatically reduce the death toll from tobacco. And it won’t happen just by bans.

http://www.thejournal.ie/readme/abstinence-only-approach-to-nicotine-has-created-undue-fears-about-alternatives-3652593-Oct2017/