Friday, December 05, 2003

Ban smoking?

An editorial in today's Lancet suggests that smoking should be made illegal. There certainly is no doubt that smoking will make you unhealthy and in perhaps as many as 50 percent of cases, people will die prematurely because of smoking.

However, there is no case for banning it. It is not the business of the state to tell us what to do, even if it is not good for us. It is not as if smokers don't know that there are health risks attached to the habit. As one friend described it, it is the Englishman's inalienable right to be an arsehole if he so chooses. Perhaps it might be argued that the NHS has to spend more because of smokers... but tobacco taxes bring in about 8bn per year, compared to about 1.5bn expenditure required to treat smokers. Smokers currently fund about 13 percent of total NHS expenditure and receive about 2.5 percent in return. And surely the point of doctors is to let us live the way we choose as long as we can with the minimum of discomfort.

When I was 13 years old, I dabbled with smoking. My mother found out, but rather than try to stop me from doing it, she simply told me I was an intelligent person, that she couldn't stop me and that the choice would be mine. But I'd be stupid to take up the habit. Her expression of faith in my capabilities was a far better approach than trying to lecture me or forbid me. I wish public health leaders would try the same approach.

BBC NEWS | Health | UK ministers urged to ban tobacco

The depressing rise of the drama-doc

A new drama based on the link between autism and the MMR virus is to be broadcast soon by Channel Five.

However, the station is under pressure from doctors in the field not to broadcast the film, called 'Hear the Silence'. They say that the story gives too much credence to the views of Dr Andrew Wakefield, the researcher who first made the link between the vaccine and autism. One of Wakefield's former colleagues told producers that the film, '...inappropriately indicates Dr Wakefield to be more reasonable and thoughtful than the history would suggest...You may seek to justify the inaccuracies by invoking the notion of artistic licence. However, there is no room for artistic licence when the lives of children are at risk.' It is hard to disagree with this assessment. The scare has led to falling vaccination rates yet the scientific consensus is overwhelmingly against Wakefield's theory.

But should the show be pulled? While the UK is not yet at the same stage as the USA where ever news-worthy event is immediately turned into a TV movie, there is an emerging fashion for 'factual dramas' based on one-sided views of hot topics. Who can forget 'Smallpox 2002', based on the scenario of an infected terrorist walking the streets of London, spreading disease. Or how about 'The day Britain stopped', a kind of chaos theory illustration of how our fragile transport network could be crippled by a sequence of relatively minor incidents? Appalling though these films are, it is better that they get shown rather than have broadcasting effectively anaethetised by a group of well-meaning scientific advisers. But it would be even better if these films were never made at all.

Calls to axe TV drama on MMR, Guardian, 3 December 2003

Tuesday, December 02, 2003

Russia decides not to ratify Kyoto

It looks like the Kyoto protocol on climate change will not now come into legal force because of the failure of enough countries with enough emissions to ratify it. With the USA having refused to ratify it, the accord needed to be approved by just about all the other main emissions producers. Russia's decision makes that impossible.

A messy way for the treaty to fall, but not one that will be missed, I believe, in the long-term. There are far better ways to deal with climate change, especially when the science around greenhouse gases is still up-in-the-air, no pun intended.

BBC NEWS | Science/Nature | Russia pulls away from Kyoto pact

Social smokers and passive smoking

To what extent do social smokers play a role in passive smoking research? Could those who smoke only in the pub have any influence on the disease statistics? Many social smokers regard themselves as non-smokers (including me). If they were counted as non-smokers, they might appear in the stats as victims of passive smoking when that would not be a realistic assessment.

BBC NEWS | Magazine | 'Tis the season to smoke at parties

The war on obesity cranks up

'To help stem the epidemic of obesity in the United States, a government advisory group today urged for the first time that doctors weigh and measure all adults and recommend intensive counseling and behavior treatment for those found to be obese.

The U.S. Preventive Services Task Force said that standard obesity treatment should go far beyond casual advice to shed a few pounds. Instead, the group recommended that doctors prescribe intensive behavior therapy at least twice a month in either individual or group sessions led by a team of health professionals such as psychologists, registered dietitians and exercise instructors. Treatment should continue for at least three months, the task force advised. '

Doctors Urged to Treat Obesity More Aggressively (washingtonpost.com)

Is smoking more dangerous for women?

'A study involving nearly 3,000 U.S. women and men found that just being female doubles the risk of lung cancer in smokers.

The study is the latest to suggest smoking takes an especially devastating toll on women. Other studies have found that women who smoke are twice as likely as men to suffer a heart attack. Smoking has also been implicated in a higher risk of breast cancer. And, once they start smoking, women have a harder time quitting than men.'

But... 'Lead researcher Dr. Claudia Henschke, a professor of radiology and chief of chest imaging at New York Hospital/Cornell Medical Center in New York City, cautioned that more research is needed to prove women have a higher risk of the deadly disease.

"We have to make sure it's not because they are smoking more or started younger" or, cigarette for cigarette, inhale more, Dr. Henschke said. But "if we find women are more susceptible, we really have to target those young women who are starting to smoke and make a special effort to reach out to them."'

Smoking deadlier among women, Ottawa Citizen - canada.com network, 2 December 2003

Might do, maybe, let's panic anyway

Research undertaken for the World Wide Fund for Nature suggests that many chemicals in the environment persist in our blood for a considerable period of time - like PCBs, DDT etc.

But the quantities are absolutely tiny. So WWF resort to the line, "we don't know what they might do to us, so let's ban them". Well, while it is true that for every risk we've ever encountered, there will have been a period when we didn't know it was a risk, it is reasonable not to tailor our every action to the mere possibility of harm. How could anything useful ever get done?

New Scientist

Monday, December 01, 2003

Call barring

Legislation banning the use of mobile phones while driving comes into force in the UK today.

It is certainly annoying to come face-to-face with a driver who is not paying attention because they are talking on their phone, or who is incapable of turning the wheel properly because they are doing it one-handed. But in order to legislate against something, surely it should be more than merely irritating? Surely it should actually be a risk to others? Here's where there is a gap between perception and reality. While using a phone is a distraction, the evidence used to promote the new law indicates that the chance of an accident while talking on the phone is still very low - and that many other factors are much more likely to cause an accident: such as being distracted by a passenger or fiddling with the radio. Perhaps in-car stereos and in-car conversations should be banned. In fact, why don't we go further and ban people from walking along the street while looking attractive, interesting billboard advertising, and sneezing. Or we could accept that bans like these are as stupid as the behaviour they endeavour to prevent. There are already sufficient laws to cover situations where someone is driving without due care and attention. What we do not need is more legislation into our every minor, thoughtless action.

BBC NEWS | Politics | Drivers face mobile phone fines

BBC Science: how to fill space

Exercise is addictive we are told in the headline. But we have to wait till the bottom of the article to read 'The researchers admitted that it was not yet clear whether the same phenomenon would hold true for humans.' Still, at least the writer of this article asked the question instead of just rehashing the press release.

Addiction is an extremely dubious concept because it implies that we are basically helpless to control our urges. While certain substances do seem to make chemical changes that make cessation more painful, e.g. nicotine, heroin, it is still the case that many people give them up every day. To suggest that exercising regularly can become a matter of habit or even obsession is one thing. To suggest that it is addictive is quite another.

BBC NEWS | Health | Brain reveals exercise addiction