Tuesday 22 September 2009

Government to encourage smoking

Not the smoking of tobacco, of course, but the smoking of heroin...

Heroin addicts could be given free aluminium foil to encourage them to smoke rather than inject the class A drug under plans being considered by government advisers.

Few would disagree that injecting heroin is more dangerous than smoking it. As a harm reduction strategy, this proposal has a certain superficial logic to it, but as a practical matter it is - surely - a pointless waste of time. Heroin users inject the drug because it is the most efficient way of taking it, not because they can't afford a bit of tin foil.

But what I find particularly interesting about this story is the contrast between harm reduction policies with heroin, which is completely illegal, and tobacco, which isn't. In the field of tobacco there are various alternatives - snuff, snus, e-cigarettes or even pipes and hookah - which are known to reduce or eliminate the health risks associated with cigarettes, and yet it is fashionable to pretend that this is not so.

The article goes on to explain that health professionals are already able to give away free syringes to heroin addicts. Government policy regarding hard drugs has an element of realism. There is an acceptance that not all users will simply give up. There is an acceptance that there will never be a drug-free world and so we should minimise the health risks associated with them. In the field of tobacco, however, the quit-or-die approach still reigns supreme. It is a smoke-free world or nothing.

It is now almost 60 years since Doll and Hill published their first study showing the link between lung cancer and smoking and yet there are more smokers in the world than ever before. It is safe to say there will be more smokers in the world next year than there are now.

Despite this, the public health community acts as if the eradication of tobacco is just around the corner. Any attempt to reduce the risks from tobacco is verbatim verboten because it might 'encourage' people to keep smoking. They don't appear to worry that handing out free foil and syringes might 'encourage' people to keep taking heroin.

We accept that the war on drugs can never be won and we spend public money helping heroin addicts to take their drug more safely. At the same time, e-cigarettes are being banned, snus is illegal throughout most of Europe, smokeless tobacco is being unfairly maligned and hookah is the subject of hysterical news stories

Does tobacco have to be illegal before we look at sensible harm reduction policies?


Frank Davis said...

It is now almost 60 years since Doll and Hill published their first study showing the link between lung cancer and smoking

It didn't show any link at all, except to the likes of the credulous Richard Doll, and the equally credulous George Godber.

True, 99% of the hospital patients with lung cancer were smokers. But, in the London Hospitals study of 1950, fully 98% of the patients in both the control and study group were smokers. So, if smoking had no effect either way on whether people got lung cancer or not, it would have been expected that 98% of lung cancer patients would have been smokers, simply because they comprised 98% of the population.

The patients in the London hospitals were probably nearly all Londoners as well as being nearly all smokers. But nobody ever much suggested that living in London caused lung cancer.

This also was the study which Sir Ronald Fisher used to show that inhaling tobacco smoke had a protective effect against lung cancer.

Mark Wadsworth said...

I've done a bit more debunking of the fake statistics put out by NHS Stop Smoking Services, if you're interested.

Also, you'll be pleased to hear that the Yanks have claimed a smoking ban reduces heart attacks by "up to 30%"!

Anonymous said...

I think you mean "verboten", German for "forbidden", not the Latin "verbatim" meaning "using exactly the same words".

Christopher Snowdon said...

Quite right, anon. I was very tired when I wrote that!