Tuesday, July 28, 2009

Harm redux/ FDA's limited authority

It is unfortunate to see ostensible tobacco prevention advocates carrying water for the tobacco companies under the banner of harm reduction. The term harm reduction was coined as a means of dealing in a compassionate manner with drug use and sexual behaviors that put one at risk of harm or disease. Needle exchanges and free condoms are tactics to protect individuals, and therefore the community, from the worst results of risk taking behaviors. Using the term in this manner there is no tacit approval, or disapproval, of the addiction but a means that an individual's behavior can reduce harm. The perversion of the concept toward tobacco is not behavior modification but product modification and hence implicit approval of nicotine addiction. Simply calling oneself smoke free does not address the real need to challenge the rogue capitalism behind the tobacco pandemic.

The linked article from Glantz, Barnes, and Eubanks is just about a must read for sincere tobacco free advocates. The question remains why so many public health advocates could support such poor, even detrimental, legislation. My first assumption is that while public health groups out of necessity must deal with tobacco related disease they are not primarily focused on what it takes to challenge tobacco.

My experience in tobacco prevention is minimal but an overwhelming awareness has been that not everyone who claims to be a tobacco free advocate is. This unfortunately includes everyone from ADH grantees, employees, and even major public health group lobbyists.

This sounds like an old saw to me now but I once heard Dr. Tom Houston remark that 100 years ago, when infectious disease was the leading cause of death, there were no transnational corporations challenging the public health. In 2006 Dr. Houston's words curiously came to fruition with a federal conviction for fraud and racketeering in U.S. versus Philip Morris. Philip Morris was the lone supporter among tobacco companies of the FDA's limited authority over tobacco. Be sure that it will not be alone in the inevitable litigation the tobacco industry will throw into the gears of curiously suspect legislation. Enjoy the article!

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000118


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