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.
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.
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.
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.
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.
So here is my half century blog post. Thanks for all the positive feedback. The cheques are in the post. Sorry I don’t do online banking.
Snus is banned across the EU, except in Sweden. Swedish Match, the leading snus manufacturer, initiated a challenge against the ban. In January 2017 the High Court in London ruled that the challenge should be heard at the European Court of Justice in Luxembourg. The hearing took place on 25 January 2018.
You would think that any government looking at these figures for the steep decline in smoking among those under 25 would be a cause for celebration, Yes, over the same period, snus use has gone up, but that blows a hole in the gateway theory while all the independent evidence makes it clear that snus is so much safer than tobacco. The government gets what it wants – dramatically reduced smoking rates among young people (and among the population overall) while the population at large including young people make the consumer choice to use a safer product. Win-win? No, not at all.
Over January 24th/25th, the US Tobacco Products Scientific Advisory Committee (TPSAC) sat in session to consider PMI’s Modified Risk Tobacco Product Application (MRTPA) for the heated tobacco product IQOS. In preparation for the meeting, the FDA produced its own briefing document in which the top banana regulatory body acknowledged that:
If you attach the word Big to any multi-national industry, it immediately takes on a threatening and evil connotation: Big Pharma, Big Food, Big Alcohol, Big Energy and of course, Big Tobacco. And often this is for very good reasons: their prime directive is to make profits for shareholders, often at the expense of customers’ health and wellbeing (eg fast food, cheap alcohol and cigarettes) and have used their extreme wealth at best to try and thwart legislative controls on their business and at worst, engaged in rampant bribery and corruption.
Language matters. In my last blog, I highlighted the campaign by Cancer Research UK to counteract the idea that e-cigarettes are just as dangerous as smoking. And part of the problem resides in conflation of ‘smoking’ and ‘tobacco’ when communicating about smoking-related death and disease and more generally the denial of accurate public health information to smokers.
First off, if it’s not too late, a happy new year to all and for those who have seen the new Star Wars movie, let the Resistance to public misinformation about tobacco harm reduction intensify with the growing Force of evidence. (OK that’s enough). And to see in the new year with a bang, is a very welcome development.