tag:blogger.com,1999:blog-2609374916452770922024-02-07T03:26:13.967+01:00Freedom-2-Choose (Scotland)Blog describing the work of Freedom to Choose (Scotland). Educating the general public, and particularly the general public in Scotland,
on matters where freedom of choice is under threat....
"When health is equated with freedom, liberty as a political concept vanishes." (Dr. Thomas Szasz, The Therapeutic State)....
INTOLERANCE IS THE MOST PREVENTABLE CAUSE OF INEQUALITIES!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.comBlogger793125tag:blogger.com,1999:blog-260937491645277092.post-59979523443074133442014-04-25T18:38:00.000+01:002014-04-25T18:40:10.869+01:00How to resolve a smoking problem: ban e-cigarettes in pubs?Just a quickie: a <a href="http://www.edinburghnews.scotsman.com/news/health/nhs-blows-600k-cleaning-up-after-eri-smokers-1-3388423">headline article in the <i>Evening News</i></a> claims that Edinburgh Royal Infirmary has 'blown' £600,000 on clearing smoking-related litter<i> </i>since the smoking ban. Clearly this is another attempt to attempt to outlaw smoking on hospital grounds, but to my mind the real question is why anyone has tried to extrapolate smoking-related cleaning costs from total cleaning costs at the hospital. More observations that smoke has been seen curling its way into hospital windows. The way to prevent generalised hostility against smokers on hospital sites is to provide appropriate spaces for people to smoke where they can be comfortable, reasonably safe and won't get in the way of others, but such common sense would be interpreted as an attempt to 'normalise' smoking and cried off the agenda.<br />
<br />
Anyone would think that an electronic gadget that produces no obvious waste problems and emits no tar would be a welcome addition to the anti-smoker's apparatus. But the e-cigarette has been widely attacked for not having been proven to be safe: not only concerning their direct use, but there have been stories abound about e-cigs exploding while being charged, children swallowing cartridges, and doubtless others. Now, incredibly, Borders Council Licensing Board has <a href="http://www.itv.com/news/border/update/2014-04-25/borders-council-discuss-banning-e-cigs/">tabled a motion to ban e-cigarette use in licensed premises</a>. (Stop press: <a href="http://www.itv.com/news/border/update/2014-04-25/licensing-board-rejects-e-cig-ban/">the licensing board has requested more information before agreeing to ban e-cigarettes</a>. I hope they find it's more trouble than it's worth.)<br />
<br />
These days there is not even the excuse that most e-cigs resemble real cigarettes and their use presents staff with potential difficulties in enforcing the smoking ban. It's a case of 'they may not be safe', and for some reason this is a reason to ban them. Is it really about <i>normalising smoking</i>? or the idea that people cannot assess safety, even with the help of widely available data?<br />
<br />
Official objections to e-cigs versus Forest in debate two months ago <a href="http://www.rpharms.com/what-s-happening-/news_show.asp?id=1090">here</a>. <br />
<br />Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com7tag:blogger.com,1999:blog-260937491645277092.post-87375171118480148412014-03-24T21:50:00.000+01:002014-03-24T21:51:43.304+01:00'Further indoor smoking restrictions', aka ban on smoking at homeI had a call from the BBC this morning inviting me on to the Radio Scotland Morning Call phone-in with Louise White. The subject was the study blogged by Forest <a href="http://taking-liberties.squarespace.com/blog/2014/3/23/expert-calls-for-ban-on-smoking-in-the-home.html#comments">here</a>, by someone at Heriot Watt University here in Edinburgh. It claimed that passive smoke exposure 'in particular in more than two places of exposure was significantly associated with risks of stroke, angina, heart attack, abnormal heart rhythms ... impacted on sleep problems, self-recognition, making decisions, self-confidence, under strain constantly, depressed and happiness in never smokers' (this from the abstract).<br />
<br />
Ouch. And to wind up, 'elimination of indoor passive smoking from different sources should still be a focus in future health programs'.<br />
<br />
This is surely a case of torturing the figures till their pips squeak. None of the issues in question, including depression and lack of self-esteem, can be attributed to causes as vague as secondary smoke exposure (especially if you experience it in two friends homes in the space of what, a day? a week?)<br />
<br />
I wasn't called on to the show until very nearly the end of the discussion, just before 9.30 a.m.. Professor Linda Bauld was on and a medic arguing for further restrictions, and Dr Stuart Waiton from Taking Liberties against it. Stuart pointed out that the new research that comes out all the time always tends to suggest that people's liberties should be further restricted for their own good. Professor Bauld didn't think that legislation would be the answer, but she did want to use what I can only describe as pester power. (It's not enough to open the window or even to go out of the door, you have to go <i>right </i>outside, close the door, etc. I am only surprised that third-hand smoke wasn't mentioned). The medic acknowledged that he would not want to use extra powers to interfere if he thought people were smoking at home in front of kids, but somehow did want something to be done. Callers had varying viewpoints, I think most felt that further powers would not be enforceable (by which I think was meant teachers, health visitors and social workers being able to take action of sorts if they suspect kids are exposed to passive smoke).<br />
<br />
My objections to all these restrictions are that the other factors in these conditions they talk of are all vague, nothing is being measured, everything is approximate, nothing is ruled out, and we are expected to accept more or less as a matter of faith that tobacco smoke has the same effect as bad air and damp housing.When I did finally get on air I responded to the point made about this 'new research' recommending more restrictions, by commenting on the neverending flow of anti-smoking studies and by pointing to <a href="http://www.cancerresearchuk.org/science/funding/find-grant/all-funding-schemes/tobacco-advisory-group-project-grants/">my favourite page on the Cancer Research UK website</a>. It's the one that says that they fund studies that support existing tobacco policy. (Or to be blunt, they are unlikely to fund studies that don't find a significant risk to health from secondary smoke, or any other excuse to tighten restrictions further.) <br />
<br />
Then I had the producer on the line thanking me for my time. By the time I remembered to put up the volume again a minute or so later, they had moved on to a discussion about doggie-bags. Seriously I hope that the national broadcasting station in an independent Scotland will offer something a little more heavyweight!<br />
<br />
My views were offered as a non-smoker. I did dabble in smoking a little bit in the early days following the smoking ban. But I didn't miss it when I wasn't smoking.<br />
<br />
I was also invited on to the show as a campaigner. Campaigning is not one of my strengths, I am more of a desktop warrior, and it's superficial and non-engaging. Other priorities have taken over (work, mostly) and the group on which this blog bases its name has not really functioned effectively for over two years. I now see the whole issue as one caused by too much centralisation of power generally, and certainly not one that can be resolved by people like me taking on tobacco control directly. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com6tag:blogger.com,1999:blog-260937491645277092.post-15661112806221596752014-02-12T14:11:00.001+01:002014-02-12T14:11:46.046+01:00Double standards on child health and smoking in cars banFollowing the decision that smoking in cars could now be outlawed south of the border it was refreshing to <a href="http://www.theguardian.com/commentisfree/2014/feb/11/in-car-smoking-ban-mps-children-poor-parents?commentpage=1">see from Zoe Williams in the <i>Guardian</i></a> some criticism of double standards on smoking. This is the highlight:<br />
<br />
<blockquote class="tr_bq">
Almost all the Tories so fervently against smoking in cars are
simultaneously pretty sanguine about foodbanks. Six weeks ago nearly 300
MPs voted <a href="http://www.independent.co.uk/news/uk/politics/iain-duncan-smith-leaves-commons-debate-on-food-banks-early-9013917.html" title="">against a motion calling on the government to reduce dependency on emergency food aid</a>.
It is difficult to observe, without the option of yelling and swearing,
how disingenuous this is, how slimy and mawkish for a government happy
to live with the idea of people living in squalor, in fuel poverty,
going hungry, suddenly to find itself unable to bear the idea of a child
in a smoky car.</blockquote>
Williams gets flak from readers about this. It's clearly aimed at all benefiting all kids, not just poor ones and the poor shouldn't be spending their money on cars anyway (or tobacco). But here and elsewhere she points out that Westminster MPs are highly selective in their view of what damages children's prospects and interests.<br />
<blockquote class="tr_bq">
In perspective: <a href="http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCwQFjAA&url=http%3A%2F%2Fash.org.uk%2Ffiles%2Fdocuments%2FASH_130.pdf&ei=EEH6UvPEKMmP7AbAnYDAAg&usg=AFQjCNHQ6f_hqSs1KeBmIAiF_Y-vGA_scg&sig2=7OciLTVK1DJTlYJH842MgA&bvm=bv.61190604,d.ZGU&cad=rja" title="">secondhand smoke is implicated in one in five cases of sudden infant death</a>.
Since smoke is more intense in a small, enclosed space, it is logical
to assume that babies are more endangered by smoking in cars than by
smoking elsewhere. </blockquote>
<blockquote class="tr_bq">
However, the smoking figures are almost always
in constellation with other factors – factors surrounding or inherent to
the child, from poor housing to low birth weight. Birth weight is of
course related to smoking in pregnancy, but again other factors, such as
maternal education, age and class, have an impact. A study in Ohio
found <a href="http://www.livestrong.com/article/213978-black-mold-the-effects-on-infants/" title="">mould spores in the lungs of sudden infant death victims</a>;
and midwives regularly say that mould is dangerous. Kia Stone, a young
mother profiled in the Guardian's Breadline Britain series 18 months
ago, <a href="http://www.theguardian.com/society/2012/nov/19/housing-crisis-damp-cot-death" title="">lost her daughter shortly afterwards</a>. A large mushroom was still growing out of the damp plaster in the bedroom when she got home from the autopsy. </blockquote>
<blockquote class="tr_bq">
<a href="http://www.aims.org.uk/Journal/Vol15No4/PoliticsCotDeath.htm#REF10" title="">Nobody even collects figures for mould as a risk factor</a>
– separate from damp and leaks. Bedrooms that are too hot are also a
factor, as is frequent house moving, and living in overcrowded
conditions, B&Bs or hostel accommodation. The connection isn't made –
presumably through sheer lack of interest – that buildings in which
people can't control the heating are often too hot or too cold.</blockquote>
Never take your ability to adjust the central heating for granted! This points to an area of public health (cot death) in which there is no interest in pursuing certain lines of research. When I grew up in the 1970s we were taught that bad housing contributed to poor health, but now the agenda is all about blaming the impoverished for bad choices.<br />
<br />
More crudely, is it sensible to assume that what Westminster votes for is aimed to benefit anyone's health? (this question refers not to the general UK population but to its rulers). Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com2tag:blogger.com,1999:blog-260937491645277092.post-21306292241137889582014-02-06T02:35:00.000+01:002014-02-06T19:10:04.119+01:00Health, safety, toxicology and hypotheses<a href="https://theconversation.com/explainer-what-do-we-know-about-e-cigarettes-22616">Hat tip Junican, see comments</a>. In reply to Linda Bauld.<br />
<blockquote class="tr_bq">
You can't go far wrong if, whenever you see the word 'may' in science,
you dismiss the supposition. Science does not do supposition or
superstition. It does hypothesis. Scientific investigations MUST depend
upon an initial hypothesis. It would be extremely silly to assume that
the hypothesis is true, and act upon it, without confirmation of its
truth.
<br />
<br />
The propositions of Public Health are, at the moment, concerning
ecigs, ambivalent, and this is a serious matter. There ought to be no
such ambivalence.
<br />
<br />
<b>The mechanical safety of the machine is not a 'health' matter. It is
a 'safety' matter, just as electric kettles are a 'safety' matter. The
liquids are also not a 'health' matter. They are a 'toxicology' matter.
That is, the danger of trace elements in ecig liquid is a matter for
scientists in toxicology to decide, and not the Public Health advocates.
</b></blockquote>
Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com2tag:blogger.com,1999:blog-260937491645277092.post-16962770478395218252014-02-03T01:29:00.000+01:002014-02-03T01:30:12.392+01:00Welsh Health Minister wants to restrict e-cigarettes because they resemble a legal product<a href="http://www.bbc.co.uk/news/uk-wales-26008450">Because they 'renormalise' and 'reglamorise' smoking</a>, says Mark Drakeford, more restrictions should be imposed on e-cigarettes. In almost the same breath, he mentions New Zealand where these things 'are viewed as health products'. Muddle, muddle, muddle.<br />
<br />
Mr Drakeford mentions the addictive nature of nicotine, which the Welsh health authorities don't seem to object to prescribing for pregnant women, only recommending caution. <a href="http://www.decipher.uk.net/en/content/cms/news-and-events/hcw/health-challenge-wal/">See 'Using nicotine replacement therapy for smoking cessation in pregnancy'.</a> It's not quite clear what their objection to nicotine is, but in any case e-cigarettes are not the first products to offer alternative delivery systems for nicotine.<br />
<br />
As it happens I don't object to e-cigarettes being restricted to young people, but the health authorities would be far better advised to let people use them from age 16. That way, they will be able to obtain e-cigarettes legally at an earlier age than they can obtain cigarettes. Given the dastardly character in which tobacco has been painted in the last few years, it's hard to understand what the fuss is about when a product that is thought to be significantly less harmful becomes available.<br />
<br />
Do we know that it's significantly less harmful? No? <a href="http://antithrlies.com/2014/01/24/we-just-dont-know-is-a-bit-old-isnt-it/">If not, why not?</a>Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com4tag:blogger.com,1999:blog-260937491645277092.post-20301098807574815142014-01-31T21:07:00.002+01:002014-01-31T21:12:09.717+01:00Economic sovereignty and the freedom to chooseMax Keiser in this video, produced last summer, explains how Gordon Brown MP sold off the UK's sovereignty by putting 60 per cent of its gold bullion on the market below the market price. It's an illuminating talk, and the discussion of UK gold reserves starts about 19 minutes in.<br />
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<iframe allowfullscreen="" frameborder="0" height="350" src="//www.youtube.com/embed/Wn_x_SNH5UE?feature=player_detailpage" width="400"></iframe><br />
<br />
This lecture is a resounding condemnation of current economic policy going back to the Thatcher era, but not letting anyone off since that financial meltdown of an era. It describes generally how interest rates are being kept low because that makes it cheaper for bankers to borrow in order to speculate. This is what enables the financial class to get rich while everyone else lives in fear of a rise in interest rates, because they are experiencing a squeeze on all fronts including housing costs and some people have been also borrowing too. Kaiser predicts that an expected international currency collapse will be particularly hard felt in the UK because of this disastrous sale of gold, leaving the UK without a tangible asset that the rest of the world is buying up.<br />
<br />
This affects 'freedom to choose' significantly, showing how little it figures in the calculations of modern-day managers of the UK economy. From a Scottish perspective it heightens my interest in the independence proposition, because the Scottish Government's financial performance has been creditable by comparision. And it makes me wonder how George Galloway can sit through such a lecture and still declare that it is still in Scotland's best interests to stay in the union. He has argued that it is not 'real' independence if Scotland proposes to keep sterling, and this is a criticism that many on the independence side are making, but the sheer savagery of the UK's economic management makes one wonder why anyone would seriously want the Scottish people to stay on board. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com6tag:blogger.com,1999:blog-260937491645277092.post-67694100645649354862014-01-29T14:04:00.000+01:002014-01-29T15:12:09.768+01:00'Zealotry plain and simple': e-cigarettes to be banned from Glasgow's Commonwealth GamesSo says the <a href="http://www.scotsman.com/news/health/glasgow-2014-e-cigarettes-banned-from-all-venues-1-3285053"><i>Scotsman </i>leader today</a>. The games organisers, after taking advice from the public health community, announced their intention to ban e-cigarettes at the games, having last year announced their intention to ban tobacco.<br />
<br />
Public health illuminary Sheila Duffy said:<br />
<blockquote class="tr_bq">
“The Commonwealth Games will showcase excellence and aim to build a healthy legacy for the next generation. Providing smoke-free environments during events will help deliver on
that commitment, and the decision to exclude e-cigarette use should
make enforcement more straightforward and also help put the appearance
of smoking cigarettes out of fashion.”</blockquote>
And from Health Minister Michael Matheson: <br />
<blockquote class="tr_bq">
“I welcome this, as e-cigarettes are not
regulated, nor have they been proven to be safe and effective.”</blockquote>
This is nonsensical: Matheson's doubts about the 'effectiveness' of smoking are based on the assumption that they are designed as a smoking cessation tool. As an alternative to smoking there is no doubt of their effectiveness. You just put down a roll-up and pick up an e-cig: job done. As to the appearance of smoking cigarettes, these devices appear more like inhalers than cigarettes these days. <br />
<br />
These people, especially Duffy, have made a career choice out of the desire to stop people smoking. You would have thought that an anti-smoking sports event would be a lifetime's opportunity to encourage people to quit smoking because 'the single best thing you can do for your health is to stop smoking'. But that's not good enough, because it's not actually enough to stop smoking – you must do so in the <i>approved </i>way.<br />
<br />
A <i>Scotsman </i>reader also remarks:<br />
<blockquote class="tr_bq">
Clever of them to wait until all the tickets have been sold before
imposing this ban - and whatever others will be announced before the
summer.</blockquote>
For the avoidance of doubt, I don't approve of a smoking ban at the Commonwealth Games either. The public health community only seems to count as public health hazards things that they can blame on the general public: habits, including eating, drinking and smoking. The biggest offender in public health terms is multiple deprivation, and the Commonwealth Games <a href="http://gamesmonitor2014.org/">stirred up controversy</a> by accepting sponsorship from ATOS, the company notorious for declaring people of all shades of invalidity fit to work. Clearly there is more to this event than a friendly opportunity to compete internationally in sports, and even the public health community is set on laying unhelpful conditions to participation.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com7tag:blogger.com,1999:blog-260937491645277092.post-82809088404746051492014-01-25T00:08:00.002+01:002014-01-25T00:26:18.567+01:00Irish showdown over e-cigarettes shows lack of logicWatch Clive Bates calmly demolish the logic of tobacco control in the Republic of Ireland:<br />
<br />
<iframe allowfullscreen="" frameborder="0" height="350" src="//www.youtube.com/embed/8tjlY98NUc0?feature=player_embedded" width="400"></iframe><br />
<br />
<br />
The anti-smokers describe the need to classify e-cigarettes as medicines
and then scratch their heads as to whether these 'medicines' <i>work</i>, when e-cigarettes have never been described smoking cessation medication by their manufacturers (and yet they clearly do <i>work</i> miles better than pharmaceutical alternatives). Kathleen O'Meara manages to suggest that <i>unless </i>smokers use e-cigarettes to give up smoking they are using them simply to 'get round the smoking ban' by using them in places where tobacco smoking is banned – even though no smoke is involved. Far from getting round the smoking ban the smokers concerned are in full compliance with the smoking ban – if the likes of Kathleen O'Meara can't tell the difference between smoke and water vapour that's not the fault of users.<br />
<br />
For further remarks see <a href="https://www.facebook.com/jude.cunnison/posts/10151913081580924?comment_id=28925611&notif_t=like">Dick Puddlecote's review</a>.<br />
<br />
And more again: <a href="http://antithrlies.com/2014/01/24/we-just-dont-know-is-a-bit-old-isnt-it/">Carl V. Phillips explains</a> why the tobacco control community should no longer be able to say 'we just don't know' the effects of e-cigarettes. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com1tag:blogger.com,1999:blog-260937491645277092.post-40382546170132578352014-01-20T10:32:00.000+01:002014-01-20T11:53:06.415+01:00Morning Call, BBC Radio Scotland covers e-cigarette banning, Monday 20 JanuaryIt's Monday morning, 9.30 GMT. Gerard Hastings just now saying that e-cigarettes is encouraging people to 'self-medicate on nicotine'. (What is use of nicotine patches if not self-medication on nicotine?) <a href="http://www.bbc.co.uk/radioscotland">Go here</a> for a discussion for the next hour.<br />
<br />
Post-discussion<br />
The official contributors to the programme, Sheila Duffy of ASH Scotland and former Health Minister Andy Kerr, attempted to give e-cigarettes a qualified thumbs-up but seemed hung-up on the idea of renormalising smoking, and, bewilderingly, encouraging nicotine addiction. The bright part was the callers. Caller after caller pointed out that banning e-cigarette use was counter-intuitive to efforts to discourage smoking, and many had been able to give up smoking since they started using e-cigarettes. Some of them were conversant with recent research, and able to compare favourably the numbers of children allegedly using e-cigarettes with those experimenting with smoking.<br />
<br />
Two callers at the end who opposed e-cigarette use were particularly unconvincing: one of them pointed out that nicotine was a stimulant and nicotine in e-cigarettes keeps smokers addicted, and the other reported that having given up smoking forty years ago she tried e-cigarettes and enjoyed them. Hence they really should be banned as they are clearly a gateway back into smoking!<br />
<br />
The confused kind of consensus to emerge out of all this was that e-cigarettes should be regulated rather than banned. Even I agree with regulation to the extent that (for example) there could be limits on nicotine concentrations for the general user. But there was also talk (by Andy Kerr) of regulating the appearance so that there is a less clear resemblance between the e-cigarette and smoking. Age restrictions might also be beneficial – one could have a minimum age of 16 for purchasing e-cigarettes, which would give e-cig users two years' advantage in terms of legal purchase. By the time they reached 18 they might find the cost advantages outweighed the attractions of experimenting with smoking (unless they were already smoking black market cigarettes of course).<br />
<br />
Well done everybody who called the programme. Most of you put the case clearly and rejected the proposition of banning e-cigarettes decisively on the basis that they are an effective and safer alternative to smoking.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com5tag:blogger.com,1999:blog-260937491645277092.post-14866720275882641692014-01-20T01:37:00.000+01:002014-01-20T01:37:45.934+01:00Public authorities in Scotland ban e-cigarettes in public buildingsThis escalation of <a href="http://www.dailyrecord.co.uk/news/scottish-news/electronic-cigarettes-banned-majority-scotlands-3037859">banning e-cigarettes</a> does look odd, doesn't it? They are even banned in some outdoor areas around public buildings.<br />
<br />
The fear seems to be as expressed by a Glasgow health board spokesperson: <br />
<blockquote class="tr_bq">
NHS Greater Glasgow and Clyde said: “The use of e-cigarettes in NHS
grounds perpetuates the idea smoking is acceptable in public areas.”</blockquote>
But this approach seems very unscientific. E-cigarette use is not smoking. People are using e-cigarettes instead of smoking, either on a selective basis or completely. After being told more times than most of us have had hot dinners that there is <a href="http://www.john-uebersax.com/diet/nosmoke.htm">nothing better for your health than stopping smoking</a>, the device people are turning to in their thousands is now facing significant restrictions, and EU legislation still hovers over them.<br />
<br />
The <i>only </i>thing that needs to be done is regulation. Tobacco is regulated, and all consumer products require some regulatory oversight to protect consumers. There is no call whatever for a ban.<br />
<br />
Health authorities who ban e-cigarettes because they make users look like smokers should take a good hard look at themselves. Having derided tobacco companies for the alleged health records of smoking for over 30 years, it seems perverse to ban the use of a product that can eliminate the most hazardous elements of smoking, namely the absorption of tar and smoke. If smokers can use this product at less than the cost of smoking, they may not return to smoking.<br />
<br />
Anti-smokers have little to be complacent about. Illicit tobacco is becoming <a href="http://networkedblogs.com/SYrph">more plentiful on our streets</a>, and can remove any price advantage that the less harmful product has.<br />
<br />
Scottish public authorities need to get a grip on themselves. They provide a valuable service but they are not (or should not be) empowered to pronounce what recreational products the public should find 'acceptable'; or to assert ownership of 'public areas'. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com2tag:blogger.com,1999:blog-260937491645277092.post-68319137127737437262014-01-13T21:32:00.000+01:002014-01-13T21:33:26.029+01:00Bafflement on devolution from Scottish tobacco controlThe bit of <a href="http://www.scotsman.com/news/opinion/letters/tobacco-only-benefits-makers-1-3264958">Sheila Duffy's letter</a> that I don't understand comes right at the top.<br />
<blockquote class="tr_bq">
JORGE da Motta of JTI claims that devolving powers on tobacco duty to
Scotland could harm our economy (“Tobacco chief fires up debate over
duty”, News, 5 January). But World Bank reports show clearly that
tobacco is poor value to any economy, on economic as well as on health
grounds, as the diseases smoking causes cut down many in the prime of
their working lives.</blockquote>
She's writing a response to the <a href="http://www.scotsman.com/news/health/tobacco-chief-fires-up-debate-over-duty-1-3256130">article here</a>. But the article doesn't say that JTI says that devolving powers might harm our economy. He warns that the wrong policy choices will bring about more bootlegging – not the tobacco duty, but failures in policy-making, which will lose the Scottish government money. So apparently Sheila claims that JTI fears that tobacco duties will somehow ruin the economy, and contrasts this with the World Bank view that tobacco is poor value to any economy.<br />
<br />
Not a lot of contrast there. Perhaps Sheila has been the victim of a bad sub-editor.<br />
<br />
I was hoping for some enlightenment on the finances of post-devolutionary Scotland, but I'll have to go elsewhere!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com2tag:blogger.com,1999:blog-260937491645277092.post-33168308862044575322014-01-11T19:08:00.000+01:002014-01-11T19:08:32.536+01:00Professor John Britton's UKNSCC conference address supporting e-cigs, summer 2013Having predicted that e-cigarettes will destroy tobacco control I decided look further for signs of hostility on the part of major tobacco control players towards e-cigs. I started with Professor John Britton, a leading light in the UK Centre for Tobacco Control Studies. Professor Britton spoke in favour of the motion 'The field should be positive about the development of e-cigarettes' (the only part of the debate that seems to have been recorded). His opposer was Jean King of Cancer Research UK. The debate is accessible from <a href="http://www.uknscc.org/uknscc2013_presentation_188.php">this link</a> and includes a slide presentation.<span id="goog_758816760"></span><span id="goog_758816761"></span><br />
<br />
The debate addresses tobacco control's fears that tobacco companies use the e-cigarette market in e-cigarettes to buy respectability and even a place at the public health table, from which the tobacco industry is excluded.<br />
<br />
I have to admit that Britton surprises me in some ways in this address: first by describing the non-medical nature of e-cigarettes as a 'strength'. He sees it definitely as an asset that smokers are using e-cigarettes heavily. His evidence tells him that smokers use them overwhelmingly as a tool to stop smoking, and in general he is in favour of them. <br />
<br />
He also points out the involvement of pharmaceutical investment in the smoking cessation conference itself, and notes that pharmaceutical investment is an accepted part of life. Not only does he ask whether it is acceptable to take money from pharmaceutical companies and decline it from others, he goes so far as to point out that pharmaceutical companies have in some respects a murderous safety record. (I'm now trying to work out exactly what he means by this: surely not that tobacco money is acceptable?)<br />
<br />
As to whether the tobacco industry's involvement should be a cause for
alarm, he illustrates deftly how hard it would be to advise smokers
against specific electronic products, because ownership and investment
in these by tobacco and other companies shifts all the time. The key, he concludes, is to regulate the product, not the manufacturer. I'd love to hear Jean King's case against this, indeed the rest of the debate.<br />
<br />
Britton's closing slide shows a technician at his university who has stopped smoking 'on his own' with the help of an e-cigarette. The technician doesn't want him (as a tobacco control policy leader) to interfere with the flavourings. It seems clear that at least some professional tobacco control practitioners feel <i>ownership </i>of this new tool in the box that <i>they </i>can use to help people stop smoking. But the technician, using the e-cigarette, has not needed Britton's professional help.<br />
<br />
If anyone knows whether the rest of the debate was recorded I'd love to hear it!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com2tag:blogger.com,1999:blog-260937491645277092.post-88543735099320398152014-01-11T02:31:00.000+01:002014-01-11T11:36:48.196+01:00Use e-cigs in the fight against tobacco, says former ASH directorMy attitude to the smoking ban is unchanged: I still believe it is step too far, especially when since it was based on a phenomenon (secondary smoke) that I regard as highly speculative.<br />
<br />
But I am now interested in the e-cigarette issue. There can be little doubt that e-cigs are the bastard child of the two warring parents: tobacco and tobacco control. The child has now taken on its own identity and has many of its own friends. Had tobacco control not come along, e-cigs would not, so to speak, have been conceived at the time that they were. Not only have they satisfied the demand of an alternative to smokers that is acceptable on health grounds – no tar is inhaled into the lungs, but they have done so by avoiding the much feared smoke that is a product of smoking tobacco.<br />
<br />
Tobacco control can huff and puff but a paternity test would probably prove my suggestion that the e-cig is its own doing. Legitimate health concerns followed by a virulent campaign against smoking (that continues even now) have provided the incentive to produce a product that smokers can enjoy without bothering anyone else.<br />
<br />
Committed smokers fear that the e-cigarette will be 'forced' on them and I hope that they are mistaken. I would still like to see the smoking ban rescinded. But the reason e-cigs are interesting to me is that they are an effective alternative to smoking, meaning that we don't really need tobacco control any more. Action on Smoking and Health has a mission to fight 'the harm caused by tobacco', and, with e-cigs, much of the problem is resolved. <br />
<br />
Among the good things that former director of Action on Smoking and Health Clive Bates says in <a href="http://www.bmj.com/content/348/bmj.f7686/rr/681015">this piece</a> (a Rapid Response to the piece <a href="http://f2cscotland.blogspot.co.uk/2014/01/the-bmj-e-cigarettes-and-scotland.html">discussed here</a>) is that he scolds tobacco control for its inveterate hostility to tobacco companies: <br />
<blockquote class="tr_bq">
Negativity about the tobacco industry is inevitable and appropriate, but
there has long been scope for a different business model to emerge [8].
Many in the public health community regard the industry as, a priori,
capable only of causing harm as they strive to make money [9]. But this
idea is not universally accepted, and there are different ways of
looking at the role of tobacco companies when it comes to ‘harm
reduction’ [10]. ... Big Tobacco is moving into e-cigarettes because it has to, not least
because its customers may want nicotine, but increasingly they don’t
want the smoke that goes with it. Meeting that changing demand happens
to be a very positive one for public health, and it <i>could ultimately
change the tobacco industry itself for the better</i>.[emphasis added]</blockquote>
I am not sure whether Big Tobacco is actually capable of becoming a significant player in the e-cig market, but the point is that Clive Bates (and many others) can see beyond the caricature of Big Tobacco as irrevocably and completely evil. Another dynamic is possible.<br />
<br />
Tobacco control has allowed its hatred of tobacco companies to present a conflict of interest with its own health goals. Every time it declares a wish to <a href="http://www.smh.com.au/news/opinion/kill-the-tobacco-industry/2008/10/01/1222651169026.html">destroy tobacco companies</a> it takes its eye off the ball of public health improvement, preferring to focus its attention on winning a war, on destroying an industry. Is this a bid to improve public health, or more to gain market share for nicotine-based cessation medications?<br />
<br />
I haven't seen smokers' groups forming themselves to discuss the merits of nicotine patches. This phenomenon has occurred with e-cigs: there is a market of people who are actively interested in the product, which has evolved to become affordable.<br />
<br />
OK, perhaps I am daydreaming a little with the fantasy that e-cigs will finish off tobacco control. But if all it can now do is to try and frighten users away from e-cigarettes, what will it then achieve? 'The best thing you can do for your health is to stop smoking': this logic has to remain the purpose of tobacco control. It cannot now shift the goalposts and insist on the right to dictate to users <i>how </i>to stop smoking. That horse has left the stable and e-cig shops are everywhere. <br />
<br />
It may be that tobacco control <i>can </i>survive by taking on the cause of e-cigs, but I am not sure how that would stack up financially. I am sure that some of their revenue stream must come through pharmaceuticals but I haven't figured out exactly how it works. I expect to see tobacco control continue to insist that patches 'n' Champix R best, digging itself deep into its own grave as it does so. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com3tag:blogger.com,1999:blog-260937491645277092.post-60037929058559111182014-01-07T11:05:00.001+01:002014-01-11T02:32:01.573+01:00Scottish Government welcomes JTI intervention on tobacco dutyHas to be true because I read it in the <a href="http://www.scotsman.com/news/health/tobacco-chief-fires-up-debate-over-duty-1-3256130"><i>Scotsman</i></a>! Japan Tobacco has pointed out that post-Independence the Scottish Government will receive tobacco revenues directly, and speculates that it might think twice about bringing in policies that might jeopardise revenue receipts.<br />
<br />
I have to put this in context a little. The suggestion is that the Scottish Government will get revenue-raising powers even if Scotland doesn't go independent. I am still not sure why Westminster would want to encourage devolution of tax-raising powers if the vote is no, because it would allow more divergent economic policies to develop than we have at present – surely the kind of scenario that Westminster rejects when saying that sharing a currency with an <i>independent </i>Scotland wouldn't work.<br />
<br />
The Scottish Government clearly want a situation with more tax powers, and in fact I agree with them – it is right that Holyrood should have the responsibility for raising revenues as well as spending them. (I also agree with them that they are unlikely to be able to exercise responsibility fully in a devolved Scotland, but that's not really the point of this article.)<br />
<br />
The purpose of the JTI intervention is to sound a warning shot about the Scottish Government's plans for plain packaging of tobacco. I am not aware of any certain evidence about plain packaging deterring youth from smoking. There has been a lot of speculation, but no hard evidence.<br />
<br />
I can speculate too, and my speculation is that criminalising the branding of tobacco removes a tool for consumer protection that is designed to reduce counterfeiting, and is likely to result in a race to the bottom in tobacco prices. If such a move is backed by further increases in duty, the illegal market will grow even faster than it is growing currently. <br />
<br />
Both these moves will be bad for government smoking cessation plans – for its heralded ambition to make smoking history by 2034 – and for its treasury coffers. Treating e-cigarettes in the same prohibitive way as tobacco, rather than as a probably harmless alternative, will aggravate this effect.<br />
<br />
The Scottish Government's comment? <br />
<blockquote class="tr_bq">
The intervention on devolving duties has been welcomed by the Scottish Government.</blockquote>
<blockquote class="tr_bq">
A
spokesman for First Minister Alex Salmond said: “We welcome all backing
for transferring responsibility for duties and revenue to Scotland. </blockquote>
<blockquote class="tr_bq">
“Only by having control of these key levies can we take forward
policies designed to protect public health and boost the Scottish
economy.”</blockquote>
They'll have to mull that one over before it's time to produce the first post-Referendum election manifesto. <br />
<br />Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com1tag:blogger.com,1999:blog-260937491645277092.post-26607528763770956962014-01-06T00:01:00.000+01:002014-01-06T00:05:25.717+01:00The BMJ, e-cigarettes and Scotland<a href="http://www.bmj.com/content/348/bmj.f7686">The <i>British Medical Journal </i>clearly expects Scotland</a> to lead on its crusade against e-cigs, as it did with the smoking ban and in the way it has not blinked in its pursuit of plain packaging of tobacco. Fiona Godlee, <i>BMJ </i>editor, declares that the Scottish Government's ambition to end smoking by 2034 will go pear-shaped if it does not take a firm line with tobacco. The Scottish Government along with ex-Mayor Bloomberg of New York earn brownie points with Godlee for taking stern measures against food, drink and tobacco and the paper turns on Bloomberg's action in banning indoor use of e-cigarettes before leaving his post recently. (Godlee uses the word 'smoking', although you would be no more likely to get smoke out of an e-cigarette than you would out of your kettle.)<br />
<br />
There is some unhelpful argument here along the lines of tobacco being normalised by the popularity of e-cigarettes, and it seems based on the assumption that tobacco companies are a significant player in the e-cigarette economy. She says, 'E-cigarettes also legitimise the industry, buying tobacco companies a seat as “partners” at the health policy table'. Not only is this untrue (at least in the view of Rose, quoted <a href="http://f2cscotland.blogspot.co.uk/2014/01/vaper-challenges-australian-charity-on.html">here</a>), it is also quite irrelevant to health policy.<br />
<br />
Another plank of her paper is asserting that the <i>BMJ </i>will not reverse its decision to decline publication of papers that have been funded by the tobacco industry. This is a related error. The veracity of papers is determined by its content: funding is a consideration, which it is why it is declared, but funding does not determine accuracy or otherwise. Tobacco companies are legal entities and players in the market place and there is no reason to dismiss them from public debate, which exists to allow the weighing of different perspectives against each other. Health policy is another arena in which tobacco companies have a contribution to make (balanced by other interests, obviously); Godlee allows her position that tobacco companies have no place in health policy to influence her view on whether e-cigarettes are a beneficial alternative to smoking. This seems to me to be a conflict of interest, since her desire for tobacco control interests to dominate the health policy arena over-rides the health concern. If this results in the banning of a safe alternative to smoking when medicinal alternatives fail to work, there is at least potential for severe adverse health reactions.<br />
<br />
As far as Scotland goes, so far they have backed the UK as shown in this Parliamentary motion published last June: <br />
<blockquote class="tr_bq">
<div id="MAQA_Search_gvResults_ctl00_ctl04__pnlMotionHeader">
<b>
<a href="http://www.blogger.com/null" id="MAQA_Search_gvResults_ctl00_ctl04_lnkIndividualMotion"><span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionHeader">Motion S4M-06979: Stewart Maxwell, West Scotland, Scottish National Party, Date Lodged: 12/06/2013</span></a></b>
</div>
</blockquote>
<blockquote class="tr_bq">
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionTitle" style="font-weight: bold;">New Restrictions on Electronic Cigarettes</span>
<br />
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionText">
</span></blockquote>
<blockquote class="tr_bq">
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionText"></span><br />
<div style="margin-bottom: 0pt; margin-top: 0pt;">
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionText">That the Parliament
welcomes the decision by the Medicines and Healthcare Products
Regulatory Agency that electronic cigarettes (e-cigarettes) will be
licensed as a medicine in the UK from 2016; understands that the new
classification will assist in ensuring that the promotion of these
products to children and non-smokers is prohibited; regrets however that
this decision will not be implemented for a further three years;
believes that any change in the classification of e-cigarettes should
ensure that they are sold only by appropriately licensed premises;
highlights that e-cigarettes are currently unregulated and the
associated potential health risks are unknown, and encourages smokers to
take the advice of the British Medical Association, which directs
patients to regulated products and licensed nicotine replacement
products to help quit smoking.</span></div>
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionText">
</span></blockquote>
<span id="MAQA_Search_gvResults_ctl00_ctl04__lblMotionText">
</span><br />
<blockquote class="tr_bq">
<b>*S4M-06910 Stewart Maxwell: The Scottish Directors of Public Health and E-cigarettes</b>—That
the Parliament welcomes the position of the Scottish Directors of
Public Health (SDPH), which, it believes, has strongly advocated that
NHS policies on tobacco should treat electronic cigarettes
(e-cigarettes) the same way as normal cigarettes; understands that SDPH
has claimed that the use of e-cigarettes in NHS grounds perpetuates the
idea that smoking is normal behaviour and acceptable in public areas;
believes that the potential of e-cigarettes as a tool in harm reduction
and the risk that they pose to health and safety is still to be
determined; notes that smokers who wish to quit can use evidence-based
nicotine replacement therapy products and contact NHS Smokeline to find
out further information, and urges them to use one or both of these
approaches instead.</blockquote>
This shows that the party leading Scotland to independence in the referendum this coming September has a steep learning curve on the subject of e-cigarettes. Vapers in Scotland should renew their efforts to brief parties that support the independence project with their concerns about regulating e-cigarettes, especially in the event of a yes vote. (In the event of a no vote I predict that not much will change, because Westminster is top-down rule.) Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com1tag:blogger.com,1999:blog-260937491645277092.post-7876316044082977422014-01-01T14:22:00.000+01:002014-01-02T13:27:02.253+01:00Vaper challenges Australian charity on its opposition to e-cigsI make no apology for including this in the blog although I know that some readers may wince at the bad press that e-cig enthusiasts might give smoking. The point here is not about whether smoking or e-cigs are bad for you, however, it is to show what is obvious to vapers – namely that proposals to ban e-cigs illustrates more effectively than any other measure that tobacco control is about anything but health.<br />
<br />
Vapers might give tobacco and smoking a bad press, but in general I have found little sign that they agree with the banning of tobacco or institutionalised stigmatisation of smokers – of course there are many bad apples in the barrel who like to mouth off in online comments, but let's look at this rationally. They have found an alternative to smoking that works for them, and then find that the health authorities wish to ban their preferred solution to the smoking issue. They find that the health authorities don't want them to help themselves but to accept help from official channels that is worse than useless and guaranteed to keep many would-be quitters smoking.<br />
<br />
This makes a grim picture: not of health authorities that work for the good of health, but of health authorities that work to an agenda that is not altogether clear, but one suspects is contaminated by authoritarianism and perhaps commercial considerations. Who knows, but anyway it's contaminated by irrelevant factors. <a href="http://forums.aussievapers.com/e-cigarette-vaporization-political-media-discussion/17354-cancer-council-wants-tobacco-laws-changed-specifically-ban-ecigs-24.html#post368127">There is a discussion here about it</a> between Rose (a vaper) and Terry of the Cancer Council of Western Australia. Rose has written an angry letter to the CCWA and now writes, more calmly, to counter Terry's response.<br />
<br />
The main points: (1) Terry, writing on behalf of a cancer charity, does not mention cancer in relation to e-cigs, yet his organisation calls for an e-cig ban. Why does he want to ban a product that has not been linked to cancer? This goes beyond the remit of his charity. (2) In common with other authorities wishing to restrict e-cigs, Terry refers to e-cigs as smoking cessation tools, whereas they are in fact an alternative to smoking – recreational products, not medicinal or therapeutic ones. The law that Terry wants to use to ban e-cigs is called the Therapeutic Goods Act, and it does not cover recreational products. (3) Contrary to Terry's assertions about the ineffectiveness of e-cigs 'as smoking cessations tools', Rose points out the enormous popularity of e-cigs and internet presence in the form of user discussion groups. They are truly an alternative to smoking popularised by users rather than by those claiming to act in their interests. (4) Terry recommends conventional smoking cessation medications, as further proof that he is not paying attention to people's preference and experience about what works for them. (5) To Terry's concern about the long-term effects of e-cigs, Rose offers herself as a medical guinea pig, in the meantime pointing out the documented differences between conventional tobacco and e-cigs in terms of carcinogens and other toxins.<br />
<br />
Rose compares the CCWA's head-in-the-sand approach to e-cigs as follows:<br />
<blockquote class="tr_bq">
<span style="color: mediumblue;">an organisation such as a Cancer Council failing to
notice the current storming of the tobacco market by e-cigarettes, is
like the Australian Bureau of Meteorology failing to notice the
formation of a Category 5 cyclone just off the coast of Queensland.</span></blockquote>
I think the observation is apt. (I hope that e-cigs will also help to destroy what remains of tobacco control – at least its worst excesses, and there are very many of these.) She also says:<br />
<blockquote class="tr_bq">
<span style="color: mediumblue;">Those of us who use these products generally
experience a profound gnosis that the era of smoking tobacco is coming
to an end. Ecigs are to smoking what the motor car was to the horse and
buggy.</span></blockquote>
You may or may not agree with this. But it is a prediction of a trend, not an avowed intent to destroy the tobacco industry. Elsewhere Rose states:<br />
<blockquote class="tr_bq">
<span style="color: mediumblue;">Tobacco control is one thing. Placing prohibitive
taxes on smokers, defacing their packaging with theatrical disease
pictures, and concurrently preventing them from accessing a safer
alternative does nothing but serve the lust for vengeance of
anti-smoking zealots, and drive more and more smokers to the black
market. The recent KPMG report shows that illegal tobacco sales have
risen from 1.4% share of the overall market to 10.4% in a single year. </span></blockquote>
The argument has moved away from the tedious issue of whether passive smoking causes cancer or not to what the hell is tobacco control up to, actively trying to prevent people from looking for their own preferred alternatives to smoking. They say 'the best thing you can do for your health is to stop smoking', but when people take this advice they are hampered and told they're doing it wrong. This is a sound and well researched argument – well done, Rose!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com4tag:blogger.com,1999:blog-260937491645277092.post-22923495614446908922013-11-19T01:44:00.000+01:002013-11-19T01:51:41.364+01:00Tobacco control in the Gulf statesI picked up this story this morning from the Framework Convention Alliance news feed: <a href="http://www.aawsat.net/2013/11/article55322345">Saudi Arabia enforces crackdown in shisha caf<span style="font-family: "Times New Roman"; font-size: 12.0pt; mso-ansi-language: EN-GB; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">é</span>s in Eastern Province</a><!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:DoNotOptimizeForBrowser/>
</w:WordDocument>
</xml><![endif]-->.<br />
<br />
I can't help wondering how much good it does the tobacco control cause to associate itself with an authoritarian regime that <a href="http://www.amnesty.org/en/library/asset/MDE23/026/2013/en/424c1f63-887b-4b6c-a07e-0b3dd9717be6/mde230262013en.html">makes use of the death penalty and flogs people</a>, doesn't allow women to drive, doesn't allow public worship of any religion but Islam, and so on. <a href="http://article.wn.com/view/2013/08/07/USbacked_Saudi_Arabia_tries_to_bribe_President_Putin_into_st/#/related_news">The Saudis wanted to stop Russia from supporting Syria too</a>, incredibly falling into line with Israel in the Middle East battle lines. Isolating Syria from its alliance with Russia could have led to war, giving rise to some wonderful health outcomes.<br />
<br />
My last blog post touched on this: the <a href="http://f2cscotland.blogspot.co.uk/2013/11/local-choice-and-democracy-normal-life.html">importance of central control in the tobacco control model</a>. I think it's partly why I am drifting away from the tobacco control debate (which can get a little repetitive after eight years) and taking more interest in how we are governed. It certainly feels odd that in both Saudi Arabia and Scotland concern for people's health takes the form of fighting tobacco, and the same applies south of the border, when we have so little else in common.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com0tag:blogger.com,1999:blog-260937491645277092.post-40349573060801632422013-11-14T23:52:00.000+01:002013-11-14T23:52:41.985+01:00Local choice and democracy: normal life versus tobacco controlHow local is democracy? This question arises in relation to the news that elections to local health boards will not now occur, as <a href="http://www.scotsman.com/news/lesley-riddoch-unhealthy-to-think-big-is-beautiful-1-3183129">reported by columnist Lesley Riddoch here</a>. (Her recently published book <i><a href="http://www.lesleyriddoch.com/blossom-the-book.html">Blossom</a><b><span id="goog_627691909"></span><span id="goog_627691910"></span></b></i> covers similar arguments.)<br />
<br />
She talks about how to make Scotland blossom: how to arrange matters so that far more of its population can access its natural resources. One major point of comparison is that 'local' in Scotland is fairly meaningless, considered in the example of, say, Strathclyde or the Highland Region, where populations under regional administration are vast, as is the area covered. <br />
<blockquote class="tr_bq">
Every way you measure it, Scotland is doing badly. In Norway, with
genuinely community-sized, tax-raising municipalities of around 14,000
people, election turnouts range from 70-82 per cent and one in 80
Norwegians stands for election. In Scotland, community councils have a
tiny average annual budget of £400 and no statutory clout and services
are provided instead by large council bureaucracies for an average
162,000 people. These “local” councils receive most of their cash from
central government. Turnout in the 2012 elections was 38 per cent and
one in 2,071 Scots stood for election.</blockquote>
I am just reading another book about how multiparty democracy and proportional government make for a greater diversity of political parties, and the paragraph above goes some way to explaining why this doesn't seem to happen in Scotland. More centralised administration yields fewer parties, lower political participation, and lower living standards generally. Scotland is far from being the worst governed country in the world, but it seems to have much to learn about increasing democratic participation.<br />
<br />
If Scottish democracy is characterised by a shortage of public representatives below regional council level, ASH Scotland represents a stark contrast in its <a href="http://www.ashscotland.org.uk/media/4658/STCA%20Structure%20Diagram.pdf">flow chart illustrating the Scottish Tobacco Control Alliance</a>. This is top-down stuff, but they are organising the whole country into tobacco control groups at all levels. (All right, not quite the whole country.) Topic groups, smoking cessation groups, working groups, member organisations, overseen by the SCTA, ASH Scotland, and further up the tree the European Union, the UK government, the Framework Convention on Tobacco Control (FCTC), and overall the Scottish government 'involving the tobacco control community in developing and implementing policy'.<br />
<br />
It's an impressive level of networking, but it should not be top-down, and is crushingly narrow in its outlook. We have huge problems in our country of chronic ill health, poverty and under-representation, but the answer seems to be – just don't smoke. <br />
<br />
Even people who do support certain tobacco control initiatives should worry about the centralised nature of this drive for greater tobacco control which is entirely centre funded, has tentacles throughout and beyond all health boards and is mirrored by the absence of any <i>real</i> local democracy.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com1tag:blogger.com,1999:blog-260937491645277092.post-83527009246621331902013-11-05T16:30:00.000+01:002013-11-05T16:30:15.101+01:00More enormous settlements from drug companiesI heard this story on BBC Radio 5 last night and thought it would be everywhere today but I've had to look for it.<br />
<br />
In the face of this kind of story I really don't understand why such a fuss is made about tobacco companies covering up evidence that their product is harmful. Since people inhale tobacco smoke into their <em>lungs</em> and quite often feel ill the first time they smoke, tobacco itself is not generally expected to help improve people's health. Even before the days before tobacco control could afford to studies week after week telling us (again) how dangerous smoking is, there can be few people who seriously believed that their health was not at some risk in the medium to long term as a result of smoking.<br />
<br />
Only last year <a href="http://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html?pagewanted=all&_r=0">GlaxoSmithKlein</a> and now <a href="http://www.hispanicbusiness.com/2013/11/4/johnson_johnson_to_pay_billions_to.htm">Johnson & Johnson</a> and subsidiaries have now settled multi-billion dollar lawsuits on the grounds of fraud. For companies of such stupendous size and with such stupendous drugs to market drugs for uses other than those that they were designed for should be a matter for criminal liability: <br />
<blockquote class="tr_bq">
In its plea agreement, J&J subsidiary Janssen Pharmaceuticals admitted that it promoted Risperdal to nursing home doctors and nurses to control erratic behavior in seniors with dementia between 2002 and 2003. ... </blockquote>
<blockquote class="tr_bq">
In a separate civil complaint, the government alleged that J&J and Janssen also promoted Risperdal and a similar drug Invega, to control numerous behavior problems in seniors, children and the mentally disabled between 1999 and 2005.</blockquote>
Not only did the charges relate to unlawful marketing, but also the targets were patients whose capacity to understand what they were being prescribed was limited. The report says that the purpose was 'controlling behavior problems', but this involves messing about with brain chemistry and should not be done using the wrong drug (even using the 'right' drug is probably questionable in many cases).<br />
<br />
This seems an unforgiveable breach of professional practice. People are entitled to expect better health from prescription drugs in a way that is simply not true of tobacco. <br />
<br />
This settlement goes back to cases that took place nearly fifteen years ago. Clearly the profit imperative is very strong in the pharmaceutical market. Somebody will no doubt say that this is a 'few isolated cases', whereas the whole of tobacco is suspect. But it should not happen with pharmaceutical drugs at all, and more importantly tobacco does not set out to be medicinal.<br />
<br />Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com0tag:blogger.com,1999:blog-260937491645277092.post-51608545210405691992013-10-20T12:03:00.000+01:002013-10-20T12:03:05.787+01:00Do as we say, not as we do on addictionThe British Medical Association<a href="http://www.scotsman.com/news/health/celtic-rangers-urged-to-cut-ties-with-e-cigarettes-1-3148988"> has advised Celtic and Rangers to cut its ties with e-cigarettes</a>. The clubs now both have links with E-Lites, enabling the e-cigarettes to be sold and used at matches.<br />
<br />
Clubs have been persuaded to enforce the smoking ban at matches, even though a substantial number of fans are not standing or sitting under cover during matches. They have bought into the idea that smoking should be avoided at any cost, an ambition that e-cigarettes have attempted to capitalise on. <br />
<br />
The clubs and companies have together formed a partnership to allow people access to a product that allows an experience mimicking smoking to be carried out at matches. It might even make the difference between some fans attending or not attending matches, But their anti-tobacco stance does not satisfy the BMA, which is interested only in complete cessation or pharmaceutical alternatives to smoking, because anything else 'encourages addiction' (why e-cigs do this more than nicotine patches is anybody's guess. <br />
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Two readers' comments seem quite apposite: <br />
<blockquote class="tr_bq">
Is this the same BMA that is quite happy to give methadone to opiate misusers as
it "lowers the death rate"?</blockquote>
The other appears in an <a href="http://www.heraldscotland.com/news/home-news/e-cigs-firm-complete-old-firm-double-by-sealing-deal-with-rangers.1378988025">earlier version of the story</a>, announcing the double deal between E-Lites and both Rangers and Celtic (<em>Herald</em>,<em> </em>free registration required): <br />
<blockquote class="tr_bq">
The MHRA says ecigs will be regulated as medicines in 2016 with all flavouring to be banned and strengths to be limited. It's spokesman Jeremy Mean says that no current devices would would gain medical approval (even if the importers could afford the million pound cost of licensing their device). Now ecigs have the backing of huge businesses such as Celtic and Rangers, <em>it will be interesting to see whether the MHRA persists with its policy</em> – a policy likely to result in tens of thousands of extra future lung cancer deaths when people find the approved devices, ironically likely to be owned by tobacco companies, unsatisfactory and switch back to tobacco [emphasis added]</blockquote>
The idea that medics are anxious that the economic power of Rangers and Celtic might ultimately dilute the MHRA decision on e-cigarettes is sadly believable. It makes one wonder if giving up smoking is as high up their list of priorities as they would have us believe.<br />
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Far from not wanting people addicted, it looks as if all parties are anxious to make money out of addictions, even if only to prevent their evil competitors from making money out of addictions instead!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com0tag:blogger.com,1999:blog-260937491645277092.post-31219463978249951752013-10-18T10:34:00.000+01:002013-10-18T10:42:48.037+01:00Please have a sense of proportion!Why is a BBC reporter saying that smoking is deeply unpleasant for people when he is clearly speaking only of part of the population, and when the subject at issue is harming people?<br />
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<iframe allowfullscreen="" frameborder="0" height="350" src="//www.youtube.com/embed/aSdGI2-vUAE?feature=player_detailpage" width="450"></iframe><br />
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Irons is correct that smoking is in the only category of health hazards that is acknowledged by the establishment: nothing effective <em>is</em> being done about the vast majority of pollution that pervades everyday life, especially in these days of cutting back regulation in the UK. Focusing on smoking as a health hazard is fiddling while Rome burns.<br />
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<br />Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com0tag:blogger.com,1999:blog-260937491645277092.post-81009211336012559832013-10-17T01:42:00.001+01:002013-10-17T01:42:17.440+01:00The debate is over on vaccination and smoking both!Two articles in one day declare as much. A <span id="goog_30143889"></span><a href="http://www.theguardian.com/commentisfree/2013/oct/16/anti-vaccination-activists-should-not-be-given-a-say-in-the-media?commentpage=1"><em>Guardian</em> writer bemoans the need for editorial coverage of the vaccination issue to cover the anti-vaccine position<span id="goog_30143890"></span></a>. And the <a href="http://www.bmj.com/content/347/bmj.f5193"><em>BMJ </em>decides it won't cover any research funded by the tobacco industry</a> – a decision I thought it had taken years ago.<br />
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I actually understand the <em>Guardian </em>writer's position about false balance. Something of the kind occurs regularly on news broadcasts when two spokespersons from major parties face each other in discussion. Deciding the parameters of the discussion is something editors have to do on all subjects and I suspect many are quite lazy some of the time – such are the pressures of broadcasting – and break down the debate into something like a false dichotomy.<br />
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However I disagree with her, as I do with the <em>BMJ</em> on tobacco, that the best course is to take the view that the 'other side' is incapable of making a valid contribution to the debate. The mere fact that a researcher is funded by big tobacco, for example, does not invalidate the conclusions of the study. All major corporations engage in activities with adverse health effects, but I cannot think of any other whose intentions are so reviled. The justification is that tobacco companies set out specifically to injure their customers (surely their purpose is to satisfy a market desire for a popular product), and everything they do must contribute to this murderous intent. <br />
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In my view, tobacco companies make a consumer product with known health risks. Some of these they have sought to cover up. Pharmaceutical companies make products that carry significant health risks (there are plenty of cover-ups here too), and are arguably more dangerous, because they don't declare this on the tin. You expect to be cured by pharmaceutical companies, yet there is an alarming list of medical injuries running into hundreds of thousands. For every tobacco CEO scheming how to recruit teenage smokers, there is a pharmaceutical salesman wondering how to dump unapproved drugs in some far flung corner of the world to reduce losses. <br />
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I have no direct experience of the debate on vaccinations – I don't have children so have never had to take the decision whether to vaccinate them. But I have taken an interest in the debate on autism because it seems to me that there does have to be some explanation for the stupendous jump in autism rates that we have seen in the last 30 years, beyond an improvement in diagnosis methods. <br />
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But there is more to this debate than whether autism is caused or triggered by the MMR vaccine. There is the issue of the way autistic children are treated. Dr Andrew Wakefield, known primarily for his position on vaccines,* treated children with gut problems that had been associated with an MMR vaccine, putting them special diets to improve gut flora and achieving significant health improvements. As I understand the story, his assertion of a link between autism and gut problems has also been challenged by journalist Brian Deer. <br />
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It seems to me that Dr Wakefield and those who follow him have sought to understand the problem of children in chronic pain who have lost their communication skills following autism jabs. Whatever the cause of their autism, the duty of doctors is to treat their symptoms. In the short video below, this duty is completely by-passed, as doctors treating Alex concluded that there was no physical condition to treat, even following the results from an endoscopy. Autism, to them, is a psychiatric condition, and they did not cooperate with any attempt to show them otherwise; the story starts when a doctor advises his mother to stop the special diet designed to help the gut flora.<br />
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<iframe allowfullscreen="" height="350" mozallowfullscreen="" src="//player.vimeo.com/video/76970712" webkitallowfullscreen="" width="400"></iframe><br />
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Whatever the cause of autism in this case, it demonstrates a failure at every level to pursue reasonable treatment options for the young man concerned, with the exception of specialists who could not influence events, in spite of their best efforts. <br />
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This is just one example of why I oppose censorship on the lines suggested by the <em>BMJ</em> and in the <em>Guardian</em>. Polarizing the debate helps no one except those who, for their own reasons, want to suppress information. <br />
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The video is also a fundraiser for the purpose of producing a full documentary on this case. Please share and donate if you can.<br />
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*Dr Wakefield, contrary to popular belief, is not anti-vaccine as such. A gastroenterologist, he supported parents who were convinced of a link between MMR and autism and whose children also suffered from gut problems. His paper in the <em>Lancet</em>, withdrawn by the paper some time after publication, did not claim an explicit link, but described the case studies of a small number of children whose autism had followed MMR jabs. In the course of his work he discovered that proper safety trials for combined vaccines had not been carried out. At the outset his fear was that improper use of vaccines would imperil legitimate vaccine use by losing the confidence of the public. He has explained his case many times publicly and is easily found on Youtube. Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com0tag:blogger.com,1999:blog-260937491645277092.post-70295937296637390842013-10-09T01:05:00.001+01:002013-10-09T01:05:24.659+01:00Archie McPherson wants smokers to be terrorisedHe says so here: [<a href="http://player.stv.tv/programmes/news-at-six-glasgow-west-full/2013-10-08-1800/">you can only watch this until 6pm BST today, 9 October</a>]. We are told that sports broadcaster Archie McPherson tells us <em>why</em> he believes that passive smoking is to blame for his kidney cancer. This reason amounts simply to the fact that he is not a smoker himself. He tells the interviewer that he feels a 'venomous hatred of the smoker' (extended to one that he encounters smoking in her night-gown attached to a drip outside a hospital). His memories of smoky environments apparently entitles him to 'decide' that his tumour was caused by passive smoking. The smoking ban is the 'greatest piece of legislation that has been passed anywhere in the world'; and 'we must find some other way, even in this era of human rights legislation and whatever, of <em>terrorising </em>smokers'.<br />
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I can't help Mr McPherson much. My favourite source of anti-smoking propaganda, Cancer Research UK, gives the <a href="http://www.cancerresearchuk.org/cancer-info/cancerstats/types/kidney/mortality/uk-kidney-cancer-mortality-statistics">following information</a>: Figure 2.2 shows that mortality from cancer of the kidney has been rising steadily since the 1970s (although the graph goes up only to 2008) (the smoking rate does not appear on this graph but it is commonly agreed to have been falling rapidly in the 1970s to 1990s). The mortality rate per 100,000 for males in Scotland (2008) was 10, females 6.3 and overall 8.1. CRUK says that smoking is a primary risk factor (even though the mortality rate was rising at the same time as the smoking rate was dropping), but even so I don't consider the figures particularly alarming, and if Mr McPherson did indeed succumb to kidney cancer as a result of passive smoking he may be the only one ever to have done so.<br />
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That aside calling on national TV for a distinctly identifiable group in society to be 'terrorised' and professing 'venomous hatred' for a group of people on the suspicion based on <em>very dubious </em>grounds that their collective behaviour contributed to his illness is deplorable behaviour; both he and STV should be ashamed.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com4tag:blogger.com,1999:blog-260937491645277092.post-24088618737434004472013-09-07T15:45:00.000+01:002013-09-07T15:45:06.101+01:00Did rebels have advance notification of escalation in Syria?<a href="http://www.usatoday.com/story/news/world/2013/09/07/eu-all-info-on-syria-gas-attack-points-to-assad/2779295/">A news report</a> shows that Senator John Kerry's attempts to woo the European Union to his viewpoint seem to have borne some fruit. The heading of the article, 'All info on Syrian gas attack points to Assad' quotes the chief of foreign affairs, Baroness Catherine Ashton, saying just this, before suggesting that the crisis must be tacked 'through the U.N. process'. <br />
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Direct evidence linking President Assad of Syria to the attacks of 21 August is scarce, and Baroness Ashton appears to be speaking to deaf ears if she wants to resolve the situation using the UN. The latest news appears to be that Obama is still considering going in without the approval of either the UN or Congress.<br />
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<a href="http://oilprice.com/Geopolitics/International/Did-the-White-House-Help-Plan-the-Syrian-Chemical-Attack.html">Did rebels have advance notification of escalation in Syria?</a> In other words, did they know that something would happen that would draw the ire of the US?<br />
<blockquote class="tr_bq">
On August 13-14, 2013, Western-sponsored opposition forces in Turkey started advance preparations for a major and irregular military surge. Initial meetings between senior opposition military commanders and representatives of Qatari, Turkish, and US Intelligence [“Mukhabarat Amriki”] took place at the converted Turkish military garrison in Antakya, Hatay Province, used as the command center and headquarters of the Free Syrian Army (FSA) and their foreign sponsors. <em>Very senior opposition commanders who had arrived from Istanbul briefed the regional commanders of an imminent escalation in the fighting due to “a war-changing development” which would, in turn, lead to a US-led bombing of Syria.</em> [Emphasis added]</blockquote>
Not only does this report suggest strongly that the rebels had advance warning that trouble was brewing – there is also (h/tip 21st-century Wire) strong evidence to suggest that a Conservative MP, who has written passionately in favour of intervention in Syria, was at the Turkish garrison with the rebels at or near the time in question and may have been aware of such intelligence. The MP, Brooks Newmark, <a href="http://www.mailonsunday.ie/debate/article-2408038/US-pays-Cameron-highest-compliment-all.html">writes in the <em>Sunday Mail</em></a>, 'I told the rebels David Cameron was about to come to their rescue with Mr Obama': this was a very irresponsible commitment to make, however confident his prediction of the result of the vote. <br />
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Another significant development is the enthusiasm of Senator John McCain for the project of launching (<a href="http://rt.com/news/pentagon-syria-targets-expand-507/">limited?</a>) air strikes on Syria , who has told his colleagues that Saudi Arabia and Qatar will <a href="http://rt.com/op-edge/mccain-us-syria-war-eland-460/">pay the cost of launching air strikes</a>. The idea of the US undertaking military adventures against a country paid for by a third party is completely staggering – almost as much as the idea that Senator McCain should consider such a crass arrangement as remotely alluring to voters. The presence of al-Qaida and other terrorist groups firmly in the opposition camp must belie the hawks' declaration that action would be in America's 'national security interest'.<br />
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Calls for impeachment of the President are growing. From this side of the Atlantic it is hard to assess their scale, but the case is strongly made. If you are in the US and feel that this strike should be stopped, <a href="https://www.youtube.com/watch?v=eS-nlv2YyrQ&feature=player_embedded">view this video</a> and call your Congress representative now!Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com1tag:blogger.com,1999:blog-260937491645277092.post-40028209157436067342013-08-28T00:06:00.002+01:002013-08-28T00:06:46.814+01:00Patient wins smoking challenge at State Hospital Carstairs<a href="http://www.bbc.co.uk/news/uk-scotland-glasgow-west-23849198">This is today's good news</a>. A patient at The State Hospital has won a ruling that his human rights were breached when he was prevented from smoking while an inmate there. <br />
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I think the result would have been better. For example, the judge, Lord Stewart, said that the plaintiff had saved a lot of money by not smoking, and therefore did not award him damages. He also did not criticise the principle behind the ban, although it is hard not to see that many others would have been detrimentally affected in the same way as the plaintiff. And he said: <br />
<br />
<em>"I also want to make clear that I am not endorsing the idea of a human right
to smoke. There is no right to smoke in a legal sense."</em><br />
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No, if you think there should be an act detailing everything you are legally entitled to do. The presumption is usually that you can do things, not that you have to be awarded the right to do things. <br />
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But on the plus side:<br />
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<em>Lord Stewart noted that if Mr McCann was a prisoner, he would be allowed to
smoke in jail.</em><br />
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</em><br />
<em>The judge said: "It may not be attractive to contemplate but I infer that the
smoke-free policy has been imposed on mental health detainees and not on penal
detainees simply because the latter are in a better position to defend their
smoking habit whereas the former are not. </em><br />
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</em><br />
<em>The judge added: "On the information available, I have come to the view,
though with reluctance, that the decision to compel the petitioner to stop
smoking was flawed in every possible way." </em><br />
<em></em><br />
<em>Lord Stewart said the decision should have been made with reference to
principles set out in mental health legislation but was not.</em><br />
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He points out, in other words, that mental health detainees are 'picked on' in terms of legislation preventing them from smoking, because they are soft targets, and that those making decisions about the plaintiff's smoking had gone beyond the law. <br />
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In case anyone out there is still under the illusion that smoking restrictions are motivated by health concerns, <a href="http://connecticut.cbslocal.com/2013/08/23/elderly-newington-couple-facing-eviction-for-smoking/">this story should disabuse you</a>.Belindahttp://www.blogger.com/profile/16284836559314332001noreply@blogger.com4