This week I am at the International Harm Reduction Association Conference in Beirut, and there is so much interesting stuff going on that I have to admit I am hardly paying attention to the health news. So rather than force it too much, I thought I would write about this for a few days. I expect I will be more focused on specific points on later days. For today, random thoughts:
1. There are still a lot of bullet and shrapnel scars in walls here. I met someone today who works to help sex workers and sexual minorities in Zimbabwe. Kind of puts all my personal complaints in perspective.
2. Many of the more influential people at the conference (government/quasi-governmental officials, leaders of the host organization) are, at best, ambivalent about tobacco harm reduction. Tobacco (also alcohol) was not even mentioned in the opening addresses even though we have a large presence at this meeting. They seem to be worried about politics/image/etc. in a political world where it is fashionable to worry about some minorities, even though their behaviors are controversial, but a litmus test of Seriousness that you condemn certain others. But I hardly meet anyone else here who does not immediately embrace the idea of THR, either as a good idea for themselves and their friends, or as something to encourage as a public health intervention. The latter is not surprising, given the population, but is still quite gratifying. I have already discussed ideas for a couple of possible projects.
But the continuing limited institutional support for a billion smokers and the way to reduce their risks by 99% is still disappointing.
3. An official from the WHO spoke in the opening plenary session. He spoke in Arabic and so I am basing this only on what the translator said that he said, and then what my colleagues told me the translator said (I was being lazy and did not listen to the translation headphones – turns out to have been a big mistake). So this is a "third hand" statement about smoking, and thus I suggest you consider it only an unconfirmed paraphrase, and I will see if I can come up with a better confirmation: He declared that smoking is the cause of drug use, and that drug users are victims while smokers should be punished as criminals. (Background: This is a conference that focuses on hard drug users, so this was partially a way of sucking up to the majority of delegates who are advocates for that population.)
Whatever the exact statements really were in the original, this seems kind of similar to WHO policy: Try to improve people's health, unless they are doing something they do not approve of (especially using nicotine in any form), in which case let them die. It took quite a bit of campaigning to change this for other behaviors. Hallways-of-power master-of-the-universe-type politicians like WHO officials do not say things because they believe they are true, but because they are institutional policy. Thus, whatever he said was undoubtedly a message from WHO about their policy not one man's opinion.
4. There is something very strange about the fact that almost everything written on a tin of Camel Snus, by either the manufacturer or the regulators, is an imperative or a threat. "Break free with premium Camel Snus." (free of what? - I know what they mean, but do most people?) "This product can cause gum disease and tooth loss." (maybe, but there is no evidence to support the claim) "Simply place a pouch under your lip and savor the rich and complex flavor…." (Bill Godshall tells me that he urged them to say "upper lip" which makes it cleaner to use, but for some reason they did not.) "This product can cause mouth cancer." (clearly contrary to the evidence) "Grin with confidence when you feel the tingle." (weird, and a bit creepy, especially if the previous claim was right and you have no teeth left) "Do not litter." (always good advice) "Underage sale prohibited." (if you are underage and you can read this, then you better have stolen it)
The only other words, beyond the contents and other fine print on the side are the product name and "Refrigeration not required after opening" and "Best before date…." At least these are merely suggestions and not demands. I think this is a very good product, but I really don't like inanimate objects being quite so bossy.
5. As a complete aside, off of my usual topics (thought it is news and has a lot of effect on some people's health): I noticed with horror that there have been deadly riots as well as focused killings in Afghanistan due to rage about some nutcase "christian" cleric in Florida, USA publicly burning a Koran. A lot has been said about this, but I have one thing to add: If you are going to try to function in a global communications network, you have to learn to deal with stupid trolls. If you let people figure out that if they type something or commit some other easy act, like burning a book, that this will cause you to off the rails, then you can assume that someone will write/do it. It is not a good idea to give everyone in the world that much power over you; one of them will exercise that power just because his mother did not show him enough affection or his girlfriend just dumped him.
1. There are still a lot of bullet and shrapnel scars in walls here. I met someone today who works to help sex workers and sexual minorities in Zimbabwe. Kind of puts all my personal complaints in perspective.
2. Many of the more influential people at the conference (government/quasi-governmental officials, leaders of the host organization) are, at best, ambivalent about tobacco harm reduction. Tobacco (also alcohol) was not even mentioned in the opening addresses even though we have a large presence at this meeting. They seem to be worried about politics/image/etc. in a political world where it is fashionable to worry about some minorities, even though their behaviors are controversial, but a litmus test of Seriousness that you condemn certain others. But I hardly meet anyone else here who does not immediately embrace the idea of THR, either as a good idea for themselves and their friends, or as something to encourage as a public health intervention. The latter is not surprising, given the population, but is still quite gratifying. I have already discussed ideas for a couple of possible projects.
But the continuing limited institutional support for a billion smokers and the way to reduce their risks by 99% is still disappointing.
3. An official from the WHO spoke in the opening plenary session. He spoke in Arabic and so I am basing this only on what the translator said that he said, and then what my colleagues told me the translator said (I was being lazy and did not listen to the translation headphones – turns out to have been a big mistake). So this is a "third hand" statement about smoking, and thus I suggest you consider it only an unconfirmed paraphrase, and I will see if I can come up with a better confirmation: He declared that smoking is the cause of drug use, and that drug users are victims while smokers should be punished as criminals. (Background: This is a conference that focuses on hard drug users, so this was partially a way of sucking up to the majority of delegates who are advocates for that population.)
Whatever the exact statements really were in the original, this seems kind of similar to WHO policy: Try to improve people's health, unless they are doing something they do not approve of (especially using nicotine in any form), in which case let them die. It took quite a bit of campaigning to change this for other behaviors. Hallways-of-power master-of-the-universe-type politicians like WHO officials do not say things because they believe they are true, but because they are institutional policy. Thus, whatever he said was undoubtedly a message from WHO about their policy not one man's opinion.
4. There is something very strange about the fact that almost everything written on a tin of Camel Snus, by either the manufacturer or the regulators, is an imperative or a threat. "Break free with premium Camel Snus." (free of what? - I know what they mean, but do most people?) "This product can cause gum disease and tooth loss." (maybe, but there is no evidence to support the claim) "Simply place a pouch under your lip and savor the rich and complex flavor…." (Bill Godshall tells me that he urged them to say "upper lip" which makes it cleaner to use, but for some reason they did not.) "This product can cause mouth cancer." (clearly contrary to the evidence) "Grin with confidence when you feel the tingle." (weird, and a bit creepy, especially if the previous claim was right and you have no teeth left) "Do not litter." (always good advice) "Underage sale prohibited." (if you are underage and you can read this, then you better have stolen it)
The only other words, beyond the contents and other fine print on the side are the product name and "Refrigeration not required after opening" and "Best before date…." At least these are merely suggestions and not demands. I think this is a very good product, but I really don't like inanimate objects being quite so bossy.
5. As a complete aside, off of my usual topics (thought it is news and has a lot of effect on some people's health): I noticed with horror that there have been deadly riots as well as focused killings in Afghanistan due to rage about some nutcase "christian" cleric in Florida, USA publicly burning a Koran. A lot has been said about this, but I have one thing to add: If you are going to try to function in a global communications network, you have to learn to deal with stupid trolls. If you let people figure out that if they type something or commit some other easy act, like burning a book, that this will cause you to off the rails, then you can assume that someone will write/do it. It is not a good idea to give everyone in the world that much power over you; one of them will exercise that power just because his mother did not show him enough affection or his girlfriend just dumped him.
are you sure? Because right now we have Von Behrens in Ottawa telling kids a very different story.
ReplyDeletehttp://www.yourottawaregion.com/news/article/974131--tobacco-can-ruin-your-life-cancer-survivor-tells-students
At age 13, Von Behrens tried chewing tobacco for the first time and quickly got addicted. By the time he was 17, he was diagnosed with oral cancer. He has lost half of his tongue, all of his teeth and his entire jawbone.
“I have lost my entire face because of tobacco,” Van Behrens told the packed gymnasium. “Every time I look out in the mirror, I ask God, ‘Why did you do this to me, I wasn’t a bad kid.’ ”
Anybody who believes that Swedish snus (a different product to chewing tobaccos in other countries) causes cancers should look at the European cancer incidences on the CRUK website (stats section). Sweden doesn't feature highly for either oral or pancreatic cancer- those frequently attributed to snus. The incidence of male lung cancer is strikingly low, as is the male smoking prevalence. In fact, those who support bans on snus are responsible for thousands of future lung cancer deaths. Good job that's true, or I'd be sued for defamation.
ReplyDeleteIt is really quite something that someone can make a career out of having gotten probably sexually-transmitted and almost certainly not substance-cased oral cancer. It is not so surprising that there is a living to be made lying to children.
ReplyDeleteAs for the Swedish evidence: First, there is no observed difference in risk across Western smokeless tobaccos, Swedish or American, chewed or not. Second, the ecological evidence about lung cancer is pretty clear, but for pancreatic cancer it is a bit trickier than that. Third, there is little doubt that prohibitions against smokefree alternatives to cigarettes (or even simply discouraging -- as with the oral cancer road show) kill people, from lung cancer as well as other lung diseases, other cancers, and most of all, cardiovascular disease. Also, I don't think that making a scientific claim about the consequences of someone's action would be considered actionable even in England, the black hole of Western free speech (though, in fairness, they are trying to change that).
I should have started my comment with: "Johathan, good point about the Swedish evidence. I am glad to see that some people understand the value of the ecological data that many others seek to ignore." I was tired (still jet-lagged! as was being too terse).
ReplyDelete