A tale of two epidemics: drugs harm reduction and tobacco harm reduction in the United Kingdom

2016 ◽  
Vol 16 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Gerry V. Stimson

Purpose The purpose of this paper is to compare the response to HIV/AIDS and drug use (drugs harm reduction) with tobacco harm reduction. Design/methodology/approach Analysis of historical and contemporary sources, combined with personal knowledge of key stakeholders in the history and development of both fields. Findings Both drugs harm reduction and tobacco harm reduction share a similar objective – to reduce health risks for people who are unwilling or unable to stop using their drug of choice. Both also share a broader public health aim of helping people to make healthier decisions. Drugs harm reduction – as a response to HIV/AIDS – included the adoption of a wide range of radical harm reduction interventions and was a public health success. It became an established part of the professional Public Health agenda. In contrast the Public Health response to e-cigarettes and tobacco harm reduction has ranged from the negative to the cautious. A recent Public Health England report is exceptional for its endorsement of e-cigarettes. Originality/value Highlights contradictions in Public Health responses to drugs and tobacco; and that public health interventions can be implemented without and despite the contribution of professional Public Health.

2021 ◽  
pp. 009145092199870
Author(s):  
Geoff Bates ◽  
Jim McVeigh ◽  
Conan Leavey

Understanding of the choices and motivations of people who use anabolic androgenic steroids (AAS) for muscular enhancement has increased greatly in the past thirty years, along with understanding of a wide range of health harms associated with this form of drug use in the community. During this period the predominant public health intervention for this population in the UK has consistently remained the provision of injecting equipment to prevent blood borne virus (BBV) transmission. The study explored the health professionals’ and other stakeholders’ perceptions on: whether the current UK public health response is sufficient to address the needs of people who use AAS, and if not, what other needs they might have. This included an exploration of whether there were gaps in harm reduction strategies or other behavioral outcomes and interventions that were needed. Interviews with 27 stakeholders who provide support to people who use AAS in a variety of roles established consensus on the need for a range of interventions to reduce harm and risk in those that choose to use AAS, to prevent initiation, to motivate and support cessation, and to prevent relapse. Study findings indicate that while providing sterile injecting equipment remains essential, it should be considered a bare minimum. The challenge is to develop and deliver a range of harm reduction interventions that look beyond BBV prevention to provide appropriate support to who choose to use AAS at all points in their cycles of use and ultimately for those choosing the temporary or permanent cessation of use.


2018 ◽  
Vol 27 (5) ◽  
pp. 523-533
Author(s):  
Adrienne Lefevre ◽  
Madison Walter-Garcia ◽  
Kimberly Hanson ◽  
Julia Smith-Easley

Purpose In the incident command system (ICS) structure, response documentation is formally found within the planning section. However, longer term emergency responses have demonstrated the need for a flexible and innovative role that encompasses a variety of activities, including response documentation, communications science, real-time evaluation of major themes, and information management. The paper aims to discuss this issue. Design/methodology/approach This need can be universally met through the functional role of “Historian,” a term specific to ICS, or in the case of public health response, incident management system (IMS). It should be noted that the Historian role discussed is not related to the academic study of history, but to archiving key successes and challenges during a response. Ideally the Historian should be activated at the start of an emergency response and remain active to capture the overall picture of the response, including internal information, such as lessons learned, response activities, and decision-making processes. Findings The Historian compiles details of response activities that inform leadership, donors and external communications products while alleviating pressures on the planning section. The primary, minimum output of an IMS Historian is a response timeline, which notes major internal and external events during a response with emphasis on major themes, lessons learned, and creating a user-friendly interface to display this information (see the list “Abbreviated Example of Hurricane Matthew Response Timeline” in the text). Originality/value In a world with competing priorities and ongoing emergencies, the Historian’s role of archiving details of response efforts can help the international public health community to share lessons learned and contribute to lower morbidity and mortality among those affected by emergencies.


2021 ◽  
Vol 26 (32) ◽  
Author(s):  
Gemma Hobson ◽  
James Adamson ◽  
Hugh Adler ◽  
Richard Firth ◽  
Susan Gould ◽  
...  

Most reported cases of human monkeypox occur in Central and West Africa, where the causing virus is endemic. We describe the identification and public health response to an imported case of West African monkeypox from Nigeria to the United Kingdom (UK) in May 2021. Secondary transmission from the index case occurred within the family to another adult and a toddler. Concurrent COVID-19-related control measures upon arrival and at the hospital, facilitated detection and limited the number of potential contacts.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marc Richard Hugh Kosciejew

PurposeIntroducing immunity or vaccine passports is one non-pharmaceutical intervention that governments are considering to exempt immune, vaccinated or otherwise risk-free individuals from lockdowns and other public health restrictions during the coronavirus pandemic. The primary objective of these documents would be to begin reopening societies, restarting economies and returning to a pre-pandemic normalcy. This article aims to present the start of a conceptual documentary analysis of (proposed and existing) COVID-19 immunity passports in order to more fully center their documentary status within research, considerations and conversations about their potential roles, impacts and implications.Design/methodology/approachInspired by Paula A. Treichler's argument for the importance of theoretical thought for untangling the socio-cultural phenomena of epidemics, and drawing upon interdisciplinary theories of documentation, identity and public health, combined with recent news coverage of the coronavirus pandemic, this article provides a contemporary overview and conceptual analysis of emerging documentary regimes of COVID-19 immunity verification involving immunity or vaccine passports.FindingsThree major interconnected objectives could be fulfilled by immunity passports. First, they would establish and materialize an official identity of COVID-19 immune for people possessing the formal document. Second, they would serve as material evidence establishing and verifying individuals' immunity, vaccination or risk-free status from the coronavirus that would, in term, determine and regulate their movements and other privileges. Third, they would create tangible links between individuals and governments' official or recognized identity category of COVID-19 immune. Immunity passports would, therefore, help enable and enforce governmental authority and power by situating individuals within documentary regimes of COVID-19 immunity verification.Research limitations/implicationsIn the expanding interdisciplinary literature on COVID-19 immunity passports, sometimes also called certificates, licenses, or passes, there appears to be only minimal reference to their documentary instantiations, whether physical, digital, and/or hybrid documents. As yet, there is not any specific documentary approach to or analysis of immunity passports as kinds of documentation. A documentary approach helps to illuminate and emphasize the materiality of and ontological considerations concerning the coronavirus pandemic and its associated kinds of immunity or vaccination.Social implicationsBy beginning an exploration of what makes immunity passports thinkable as a public health response to the coronavirus pandemic, this article illuminates these health and identity documents' material implications for, and effects on, individuals and societies. This article, therefore, helps shed light on what immunity passports reveal about the complicated and contested intersections of identity, documentation, public health and socio-political control and discipline.Originality/valueThis article contributes the start of a documentary analysis of (proposed and existing) COVID-19 immunity passports in order to more fully center their documentary status within research and conversations about them.


2020 ◽  
Vol 20 (3) ◽  
pp. 191-206
Author(s):  
Sarah Rajkumar ◽  
Nada Adibah ◽  
Michael Jonathan Paskow ◽  
Brian Eric Erkkila

Purpose Nicotine is widely known as a tobacco constituent and for its use as a tobacco cessation aid. The development of new devices for nicotine delivery in recent years has led to uncertainty among consumers regarding the health risks of nicotine relative to tobacco. The purpose of this study was to discover if current and former consumers of tobacco and tobacco harm reduction (THR) products could distinguish between “nicotine” and “cigarettes” and examined the preceding media dialogue to determine if conflicting messages by the media influence public perceptions. Design/methodology/approach A quantitative survey was administered online in Norway (NO), Japan (JP), the United Kingdom (UK) and the United States (US), while face-to-face computer-aided interviews were conducted with randomly selected samples in India (IN), Greece (GR) and South Africa (SA). Participants were between 18 and 69 years of age and either current users of tobacco and THR products or previous users who quit within the past five years. Questions assessed beliefs about harmfulness of nicotine. Nicotine and other products and substances were also independently rated for harmfulness on a scale of 1–10 and subsequently compared. In addition, the authors examined the media dialogue of top media outlets in four countries to assess the potential influence on people’s beliefs. Findings A total of 54,267 participants (NO: 1,700, JP: 2,227, UK: 2,250, USA: 2,309, IN: 41,633, GR: 1,801, SA: 2,359) were sampled with the percentage of women participants ranging from 14.8% (IN) to 53.8% (UK). Between 68.3% (men, IN) and 88.7% (men, USA) of current consumers believed nicotine is harmful. Current consumers who agreed with the statement that nicotine is the primary cause of tobacco-related cancer ranged from 43.7% (men, UK) to 78.0% (men, SA). In six countries nicotine was rated nearly as harmful as cigarettes and alcohol, while other substances such as sugar, salt or caffeine, were usually rated as less harmful. Research limitations/implications A large proportion of consumers across all surveyed countries view nicotine and cigarettes similarly. Clearer communication on the harmful properties of both by the media is needed to help consumers make informed decisions about products across the continuum of risk. Messaging to consumers, especially via the media, propagates misinformation about the relative harms of tobacco and nicotine through reporting that is often incomplete and biased toward more negative aspects. Originality/value This study specifically assessed public perceptions of nicotine as opposed to products containing nicotine, which is the focus of previous studies. Apart from showing that consumers often incorrectly perceive nicotine and cigarettes as similar in terms of harmfulness, the authors highlight the need for more accurate and complete reporting by the media to clarify widespread misunderstandings and mitigate public uncertainty.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  

Abstract   The COVID-19 pandemic has revealed many gaps and vulnerabilities in health systems and pandemic preparedness in European countries. It has also led to innovation and rapid improvements in certain elements of public health practice. One defining characteristic of the COVID-19 pandemic has been the rapid advance of scientific knowledge, accompanied by high degrees of scientific uncertainty. Each phase (or “wave”) of the pandemic has presented unique challenges. This workshop involves public health practitioners from multiple European countries. They will reflect upon some over-arching lessons learned through their experiences in the field, while also alluding to important innovations in public health that should be safeguarded for the future. The panellists will also discuss how lessons learned can be systematically identified and acted upon, through approaches such as after-action reviews (AARs), in order to optimise the public health response to the ongoing COVID-19 pandemic as well as to future ones. The panel discussion format of this workshop adds value to EUPHA 2021 participant through hearing, in a relatively informal format, the experiences from senior staff at national public health agencies from a variety of European countries and contexts. This approach keeps a coherence between speakers will also highlighting the unique challenges posed by specific national contexts. This workshop will also consider how processes such as AARs can be formalised to become routine aspects of public health practice. Particular attention will be paid to challenges and solutions that are similar across national boundaries. During the workshop, the moderator will ensure that the panelists responses are short and succinct. The final 15 minutes will be dedicated to questions from the audience. Speakers/Panelists Flavia Riccardo ISS, Rome, Italy Ute Rexroth RKI, Berlin, Germany Tanya Melillo Directorate of Health Promotion and Disease Prevention, MSIDA, Malta Mario Fafangel National Institute of Public Health, Ljubljana, Slovenia Key messages In order to guide the public health response to the COVID-19 pandemic as well as to future pandemics, it is essential to systematically identify lessons learned as well as innovative good practices. Identifying lessons learned, however, is only a first step as it is essential to develop action plans that are supported and endorsed across a wide range of stakeholders.


2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zhaochen He ◽  
Yixiao Jiang ◽  
Rik Chakraborti ◽  
Thomas D. Berry

PurposeThis study aims to uncover the extent to which cultural traits may explain the puzzling international divergence in COVID-19 outcomes, and how those traits interact with state action to produce compliance with pandemic health policy.Design/methodology/approachA theoretical framework illustrates the surprising possibility that culture and state action may not reinforce each other but rather act as substitutes in eliciting anti-pandemic behavior. This possibility is tested empirically in two specifications: a cross-sectional regression that includes several novel COVID-related measures, and a panel model that controls for contemporaneous disease burden. Across these models, we use the measures of national culture developed by Hofstede (1984) and a newer metric developed by Schwartz (1990).FindingsIndividualism and egalitarianism have a positive effect on disease prevalence, while cultural heterogeneity was associated with a more robust public health response. Consistent with our model, we find that culture and state action served as substitutes in motivating compliance with COVID-19 policy.Practical implicationsThe results of this study imply that culture and state interact in determining the effectiveness of public health measures aimed at combating COVID-19; these results recommend culturally aware state intervention when combating pandemics.Originality/valueThis study offers several new contributions. First, it proposes a model to help contextualize the empirical analysis. Second, it examines a wider range of traits than previous studies, including cultural homogeneity and the Schwartz variables. Third, it employs a richer econometric specification that explores the interaction between state and culture in a panel context.


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