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Harry’s blog 61: The shiny blue moon of Kentucky
Because of the dominance of the tobacco economy in the state, Kentucky has not exactly covered itself in glory regarding tobacco control. You can smoke where you like (apart from in government buildings and schools); it has higher-than-national average adult smoking prevalence; it positions tobacco at the lower end of the tax bracket compared with other states; and until 1990 it set no minimum age for tobacco sales.
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Galileo said, “By denying scientific principles, one may maintain any paradox”. That certainly seems to pertain to official responses to harm reduction. And there are a few paradoxes to highlight this week.
The first is prompted by an article in the Washington Examiner about how American health authorities are facing up to the epidemic of opiate deaths :
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From reading the esteemed work of Professors Wayne Hall and Lynn Kozlowski, I have been led into the world of moral psychology as it applies to harm reduction and the attempt to explain the root of passionately held views. The modern day moral psychology guru Jonathan Haidt argues that trying to reconcile opposing moral positions will never work if neither side is prepared to acknowledge where the other side is ‘coming from’.
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I recall hearing Martin Dockrell from Public Health England remark that he put ‘popcorn’ into Google and ‘popcorn lung’ came up before err…popcorn in the search bar. ‘Popcorn lung’ is so nice and catchy, like ‘hippy crack’ (nitrous oxide, honestly) and ‘zombie spice addicts’.
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We start this week with the European Court of Injustice interim ruling playing fast and snus with smokers’ health as part of a rather long blog (sorry) on what the Rand Corporation call Truth Decay. More on that below.
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Brisbane’s Gold Coast is not the only venue for fun and games in a land down under. In March, the Australian Parliament published its enquiry into e-cigarettes. Clearly the ‘status quo’ outcome was a major disappointment, but there were some positive takeaways and hopefully Australian tobacco harm reduction activists might feel that the argument has moved on.
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Public health is essentially concerned with prevention and when it comes to tackling global communicable diseases like smallpox, TB and other diseases, there are many public health success stories. However, preventing the development of non-communicable diseases like the fall-out from drinking, smoking and drug use is a much more challenging prospect. The early efforts at substance use prevention in the West were spearheaded by faith groups and moral reformers whose goal was total abstinence. But as we know, the subsequent legislative history in pursuit of those ambitions has been dogged by failure - Prohibition in the USA floundered, in recent years drug control policies have tended to balkanise across the world and as for a total ban on tobacco….dream on.
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A disturbing proportion of the US population believe it’s the nicotine in cigarettes that causes cancer. This was the result of an analysis of FDA 2017 Health Information Trend Survey data conducted by Pinney Associates and presented at the Society for Research on Nicotine and Tobacco’s 24th annual meeting in February.
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I know there are some readers of this blog who are unfamiliar with the happy-go-lucky world of international tobacco control. Here is a snippet of back story. Derek Yach was formerly an important figure in WHO tobacco control circles until he recently became head of the Foundation for a Smoke Free World (FSFW) funded in a very transparent way by Philip Morris International.
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A quick check on Google Images will throw up (no pun intended) posters like these while YouTube will oblige with doom-laden videos about the iniquities of vaping. Which naturally started me thinking about this sort of campaigning in general aimed at preventing young people using drugs, alcohol, tobacco and all the other stuff we don’t want them to do - and its largely inglorious and pointless history.
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This week’s must-read cones from the ever-insightful Carl Phillips who has written a superb demolition of the latest piece of suspect science from the parallel universe of Planet Glantz. The Prof attempted to show that vaping isn’t all its cracked up to be as an aid to quitting and in the process, made some basic methodological howlers. It is hard to believe that he isn’t aware of these, so the conclusion must be an attempt to muddy the waters of tobacco harm reduction, to cause confusion and doubt among regulators and the wider public - an accusation, traditionally lobbed at the tobacco industry.