The first statement of the Hippocratic Oath to which all doctors are supposed to adhere to is ‘do no harm’. But to the best of my knowledge, no such undertaking is required of scientists whose findings are often translated into public policy and legislation which in turn affects millions of lives. This is wrong; scientists should be held to account more than just by having peer-reviewed papers argued over which, as the name suggests, only peers are likely to see.
I am just winding down from the whirlwind of activity that is the Global Forum on Nicotine (GFN) conference held in Warsaw earlier this month. It is a gathering of people from all occupations and disciplines; lawyers, doctors, scientists, economists, consumers, public health officials, nurses and industry to name but a few. Over 600 people from 70 countries, but with one thought in mind: to try and mitigate the worst effects of the global smoking epidemic, through the mechanism of tobacco harm reduction (THR) and within that, an emphasis on the use of safer nicotine products for those who for whatever reason cannot or don’t want to give up nicotine.
Author, journalist and outspoken socialist Upton Sinclair, noted for his exposure of corruption in government and business, wrote that "It is difficult to get a man to understand something when his salary depends upon him not understanding it". He used this line in speeches and the book I, Candidate for Governor: And How I Got Licked about his campaign for governor of California as a way to explain why the editors and publishers of the major newspapers in California would not treat seriously his proposals for old age pensions and other progressive reforms.
Last week, I was invited to speak at an informal seminar in Portugal under the banner ‘Portugal without smoke’ with a seminar title: Tobacco control and risk reduction: what are the options? The venue and attendees signalled, I thought, a very important step forward in acknowledging the link between tobacco and drug harm reduction.
When I’m not unhealthily hunched over my laptop consuming my nth cup of nuclear coffee, I quite like to relax in front of Star Trek Discovery on Netflix. Gibberish science, cod philosophies and mawkish sentiments notwithstanding, I still find it eminently watchable. Wormholes into parallel future universes often feature, so does dark matter, supremely enigmatic but nevertheless thought to comprise 85% of all the matter in the universe and of course, the world got its first view of a black hole into which all things get sucked but no light appears.
When I was in Australia, my very good friend Dr Alex Wodak took me to one side and, in his typically low key, gentle manner, berated me for my attack on public health prompted by Ron Dworkin’s article on how public health messaging has taken on the mantle of moral crusading (see Blog 83). Alex pointed out all the good that public health has done in improving health in many different areas, not least in tobacco control.
I, along with other colleagues from Knowledge-Action-Change, have just returned from Australia on a trip to showcase the Global State of Tobacco Harm Reduction report and to support our friends in that country battling against monolithic political intransigence fuelled by smears and whispers from ‘public health’ flat earth activists over tobacco harm reduction. I was honoured to speak at two sessions in both the parliaments of Victoria and New South Wales and engaged anybody and everybody prepared to listen, enjoying very welcome support from Melbourne MP Fiona Patten who chaired that session.
This blog unashamedly takes its title from a very interesting article by Ronald Dworkin who is an American anaesthesiologist, teaches political philosophy at George Washington University and is a Senior Fellow at the Hudson Institute, where he heads up its Medicine, Society, and Culture project.
I am a big fan of The Guardian; its editorial positioning lines up with my left-liberal views and I have been a regular reader of its articles for many years. Recently it has taken up the cudgels against Big Tobacco, which at one level is strange because in most of the countries where the paper is read, smoking has been in steep decline with the companies on the legal backfoot time and again, for instance, regarding new legislation about plain packaging. More generally, the long and tawdry history of tobacco company deceit is hardly news.
The celebrity chef and healthy food activist Hugh Fearnley-Whittingstall interviewed a director who was making a TV campaign to encourage kids to eat more vegetables. The director said that when he told people he was doing this their first response was ‘OK. What’s the twist? What evil company is behind this?’. And that is a perfectly understandable response when major food and drinks companies promote breakfast cereals, fizzy drinks and snacks loaded with sugar directly to children, and every type of store from supermarkets to garden centres have sweets and chocolates deliberately sited near the check-out to put pressure on parents.