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s2smodern

Harry Shapiro Director DrugWise

This week some further reflections on the links between drug and tobacco harm reduction.

There are many interventions from a public health or health and safety perspective that could be called harm reduction – seat belts, crash helmets, speed limits, safer drinking levels, smoking bans. But as Ethan Nadelmann was at pains to point out at the GFN conference, harm reduction is not just another name for public health or health and safety. It sits at the intersection between public health on the one hand – and human rights and civil liberties on the other.

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s2smodern

Harry Shapiro Director DrugWise

GFN 2017 – report of the rapporteur Harry Shapiro

Being a conference rapporteur is not like taking minutes; it is more impressionistic, trying to pick up threads and themes, getting a feel for the event - and of course, listening in to private conversations. 

It would be hard not to start with Ethan Nadelmann’s impassioned Michael Russell Oration. I’m not going to try and summarise what he said, because you can visit the GFN site to view all the marvellous videos shot and edited by one of the unsung heroes of GFN conferences, Jon Derricott.

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s2smodern

Harry Shapiro Director DrugWise

A meta-analysis published in the Journal of the American Medical Association received widespread publicity as it purported to demonstrate an ‘association’ between teen vaping and later smoking. http://jamanetwork.com/journals/jamapediatrics/fullarticle/2634377

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s2smodern

Harry Shapiro Director DrugWise

For those of you fortunate enough to be there, I hope you enjoyed the Warsaw GFN conference as much as I did. There was a very rich and diverse mix of science, technology, law, public policy, health and advocacy. Something for everyone in an excellent venue where all the logistics ran with quiet efficiency.

My contribution as conference rapporteur will be published later, but here are just a few headline thoughts.

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s2smodern

Harry Shapiro Director DrugWise

Well, not quite ‘in the News’ more my news – or rather vignettes from an ordinary life that have wider implications.
I was sitting outside a café with my wife and the guy on the next table was ‘enthusiastically’ vaping. ‘I hope that’s not toxic’ said my wife as the vapour wafted our way.’ So I put her right on that one and then she said ‘Mind you, it smells quite nice’.

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s2smodern

Harry Shapiro Director DrugWise

As I’m writing this, more news is emerging about the terrorist attack in London Bridge, an area I know well having worked round there for many years, often shopped in Borough Market and frequented the cafes and restaurants in the area. So my mood is not what you would call bright, but even so I thought I’d start this week’s missive with an amusing slot about the vagaries (or should that be vaparies?) of Australia’s e-cig laws.

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s2smodern

Harry Shapiro Director DrugWise

My attention was caught this week by a series of exchanges focussing on whether nicotine was less addictive when delivered via an e-cigarette than a cigarette or whether you were simply swapping one equally harmful addiction for another. The conversation was sparked by Professor Linda Baud seeking materials to use in addressing barriers among smokers to switching away from cigarettes.

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s2smodern

Harry Shapiro Director DrugWise

Now that he has been confirmed as the new FDA Commissioner, the heat is on Scott Gottlieb to torch the FDA deeming regulations that themselves threaten to set a match to America's vaping industry. (OK enough of the inflammatory metaphors). As a consequence of the new appointment, the industry has won a significant reprieve in the administration's decision to delay implementing the new FDA regime.

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s2smodern

Harry Shapiro Director DrugWise

Some weighty issues to consider this week. Top of the list. ' Is it ethical to invest in Big Tobacco?'

Writing for Vice magazine, Martin Robbins told the tale of how he entrusted some inheritance money to a company whose business it is to invest in stocks and shares on your behalf. Having got tired of sitting around waiting to get rich, he decided to check out exactly where his money had gone. “The results were a bit of a shock. In my top ten were BP, Shell Oil, British American Tobacco, Imperial Tobacco, GlaxoSmithKline and AstraZeneca. That's Big Oil, Big Tobacco and Big Pharma. All I needed to round out my evil capitalist portfolio were a couple of arms companies and a stake in News International”. His biggest surprise was Big Tobacco, “Tobacco is more of a surprise: it's not just a good investment, it's one of the best. Ten years after Britain's public smoking ban, The Motley Fool recently declared 2017 "the year to invest in Tobacco stocks".

https://www.fool.com/investing/2017/01/04/why-2017-is-the-year-to-invest-in-tobacco-stocks.aspx

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Harry Shapiro Director DrugWise

This cry from the heart from Dr Joel Nitzkin:

“After all this time, we are still dealing with the same mentality within the tobacco control community. To them "tobacco" is the problem, not smoking. To them, the industry is evil and anyone or any paper disagreeing with that perception is dismissed as a tobacco industry spokesperson or someone who has been snookered (taken for a fool and now plays the role of a useful idiot for the industry). To them, the only reason anyone in any tobacco-related industry would ever produce or promote any relatively low risk product would be to addict another generation of teens, who would then, predictably, transition to cigarettes for a bigger and better nicotine hit.

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s2smodern

Harry Shapiro Director DrugWise

Clive Bates received an invitation from China to buy 99% strength USP nicotine. This is what was bound to happen when as Clive points out “the super-caution of regulators over hypothetical and negligible risks can turn out to be reckless abandon in real life”. Excessive regulation of the law-abiding market [will most likely] prompt people to buy their e-liquid over the internet in illegally high-strength concentrations and at very low cost and then to mix their own - or to establish a cottage industry and do it for others”.