Chemical Colonialism: Environmental justice and industrial epidemics

I’ve got a new blog in the Environment & Society blog loosely connected to my 2021 paper in their journal.

It builds on my interest in environmental history, particularly having read Fabian Scheidler’s The Age of the Megamachine. “Before colonizing the world, Europe itself had been brutally colonized,” Scheidler writes.

I focus on phosphate mining on the island of Nauru, and how this unnecessary practice emerged from a break in the biological circular economy, what Marx called “the metabolic rift.”

Environment & Society do a real service to the academic and public communities, and it’s always a pleasure to work with them. Their articles and content is exactly the sort of research that needs to be done to connect history, community agency, environmental acknowledgement, and policy change.

The tobacco industry’s endlessly “new” tactics: find a loophole in the law, and f%$# it until it’s gone

One of my old colleagues, a lawyer at UCSF once said that the tobacco industry finds loopholes in the law and exploits them until someone closes them. And then moves onto the next one. Our new Open Access paper in Tobacco Control discusses some of these problems. https://tobaccocontrol.bmj.com/content/31/2/222

“Moving targets: how the rapidly changing tobacco and nicotine landscape creates advertising and promotion policy challenges,” led by UCSF Center for Tobacco Control Research and Education Director Pam Ling, discusses the rise of synthetic nicotine to evade regulations.

As cigarettes became déclassé in mature markets and volumes and revenue has dropped, the industry has swooped in just in time to rescue their profits with a potpourri of heated, electronic, and nicotine tobacco products. The strategy is hooking new recruits (kids).

“Make tobacco cool again” could be the industry’s slogan.

Think tobacco’s bad? We’ve got synthetic nicotine for ya! Think smoking will kill you? We’ve got heated tobacco products (with that familiar tobacco taste). Don’t like smoking? Try vaping, or nicotine salt pouches!

The hustle to make a deadly product blend in with the background of consumer items is not new for the tobacco industry, but their recent tactics are even beyond the pale for this morbid industry. Candy flavors and colors and add ons are meant to attract kids. Why do we allow this blatant predation? Because of the always delayed promise of helping inveterate smokers. We sacrifice reason to baby smokers who might switch to slightly less deadly products. Quixotically, the tobacco industry’s raison d’état is now to coddle addicted smokers, as their official party line, in order to cover up the fact that really they are much more interested in recruiting kids to continue their legacy of pollution of the environment and human health. The industry would be all too happy if smokers continued smoking conventional cigarettes, and children and young adults uninterested in smoking would think their new technologized gee-whiz products are cool and harmless – becoming lifelong ‘customers’ (addicts) in the process.

Building on our previous work, we write:

The use of the term ‘pharmaceutical grade’ nicotine to describe recently developed nicotine products and the acquisition of NRTs extends the tobacco industry’s embrace of pharmaceuticalisation —producing products that appear like medical therapeutics conferring perceptions of safety.”

We conclude: “Finally, as the industry continues to reinvent itself to stay in business, regulatory authorities mostly play ‘catch up’. Current strategies which give the industry ample time to market products while they are brought under regulatory frameworks are not helpful for public health.”

Designing cities for silence

As an academic, I crave silence. In fact, without silence, I can’t think. And since thinking is my job, in our current media blitz steal-your-attention economy, I’m often miserable. When I don’t wish to work from home or my office, or am on the road, there are scant places where I can simply walk in, sit down, open my computer, journal, or book, and get to work. It’s a tyranny of noise. Or in the words of Grand Master Flash in “The Message”: “It’s like a jungle sometimes It makes me wonder how I keep from going under.”

The noise, the stress of noise, the violence of noise, is one of the elements that push us close to the edge.

As I study harmony inside and outside, among humans and between humans and nature, silence – or the science of listening – plays major. If we wish to cultivate a harmonious society, where we can invest our resources in art and movement and beauty and biomimcy and regeneration, then we need to create the conditions where we no longer have to contend with broken social norms; where crime is low to nonexistent; where hunger is nonexistent. Where we’re not polluting our air and our pure water is sacred. Where we respect silence and freedom of movement enough to create large carfree swaths of our cities. Where we find better ways to deliver goods like rail and cargo bike. Where we plant trees for shade and beauty.

People always lament: how do we get from here to there?

I always answer: queerly. Asymmetrically. In fits and starts. Non-linearly. Start with where you are. Don’t wait for a new city. Transform what you’ve got.

Buckminster Fuller always said that it’s easier to create alternatives and magnetize the world to the new innovation than to battle antiquated ideas. We have to actively make the old ideas obsolete by making the new ones simply more sexy.

But how do we make silence sexy? How do we make the tao sexy? How do we make sitting around and doing nothing (meditation) sexy? How do we make things sexy without the manipulative strobe-light grab you by the eyeballs and ears approach of hype-media that has come to be the dominant carnie form in late capitalism?

We do this by fairyrings of trees, solidarity circles of silence, nested neighborhoods of stillness. Dedicated communities upon communities showing the shades and nuances and varieties of silence, stillness, quietude, tranquility. We show the 1001 ways of doing silence. The abundant variety of nuance. We help people downregulate from numb dumb shouting blaring beeping to listening to jazz, then classical, then kora and koto, then the water in the river, the wind in the leaves, their own breath. We take people down in stages. We titrate with waves of in and out, so it doesn’t have to be all or nothing, so severe. But it does become all-encompassing in a non-cloying, non-forced way. Like the unforced force of the better argument – which only works under the auspicious conditions of listening and self-reflection and openness – silence can be won. It can be wooed.

For if we don’t have places to think, what good are our cities? Without silence, how do we think? How do we enter conversation, if not from a place of knowing our own thoughts? How can we truly join a crowd or a team if we don’t already know the beautiful solitude of trusting our senses, by living in places of beauty and the song of the elements?

Hypocrisy at the International Society for Environmental Epidemiology

The ISEE, or the International Society for Environmental Epidemiology, is an organization that one would expect to walk its talk. After all, it has been around for 31 years with its annual conferences, and is one of the most sophisticated and cutting edge of the biological medical sciences. Environmental epidemiology’s ability to aggregate data across many different scientific domains in a meaningful way, to build off of findings in genetics, population biology, medicine, and public health, is truly extraordinary. Furthermore, the field has demonstrated a commitment to addressing questions of environmental racism, classicism, and gender inequality, and is actively diverse.

isee_2019_meeting_graphic

Why then, at my first ISEE conference, in Utrecht, which was a 30 minute train ride from my home in Rotterdam, am I bombarded with 1960s style catering?

I know, I know. Why pick on such a minor detail? After all, the content of the meeting is driving policies far more important than some PC peccadillo having to do with food, right?

I do not dispute the good of bringing people together here. I do not dispute the good of the research, the necessity of the work. But I do object to the weak argument that because of all the other good being done, that we can ignore our own personal emissions and harms, that we can refuse responsibility to do our part, to do better, to be the change we wish to see in the world.

The metaphor is how discredited Al Gore has been for flying all around the world on his private jet to promote sustainability. It doesn’t pass the smell test. How can we say, “Do as I say, not as I do?” It’s this sort of elitist thinking that got us into this quandary in the first place.

Example A. In a Symposium session today on “A World less dependent on fossil fuels — scientific evidence and corporate influence,” a presenter brought up the fact that the way academic conferences are organized are going to have to change. But, the presenter said the AMA (American Medical Association) has to change, but immediately addended his comment with, “But not the ISEE.” I and a few others blurted out “Why not?” Why is our precious little conference exonerated? How are we any different, except for our smaller size? People still are arriving from all over the globe via airplanes to spend 3 days presenting a 10 minute paper and then hanging around nervously at the peripheries hardly communicating with people they didn’t already know.

Thanks for the trash, ISEE!

Which leads me to the point of my post.

I have been to APHA and many other larger and smaller conferences, in Europe and the US, and I am sorry to say that this is the least environmentally sustainable conference I have ever been to. The fact that hundreds of thousands of pieces of single-use plastic are being used every day for this conference should be sobering to us all.

And the fact the majority of the food is meat and animal-based shows the height of hypocrisy on environmental issues—not leadership.

Therefore, I propose that the ISEE adopt the following two binding resolutions, effective immediately, and for all future conferences:


(1) Conference organizers and any other contracted companies and caterers shall only use reusable forks, knives, spoons, plates, bowls, cups, and other food ware items. This includes no longer relying on single-use creamers, sugars, etc. 

(If the ISEE and its conference organizers are still addicted to disposables, at least have them be PLA (compostable bioplastics), which is a far second-best to washing actual silverware and dishes, but is still better than sucking down more on the plastic-petrol pipeline.)

(2) In light of the well-documented harmful effects to personal and planetary health, ISEE conferences and gatherings shall only serve vegetarian meals, with a minimum of 50% of all meal items being vegan (and clearly labeled). This is consistent with the evidence base and ISEE’s leadership in walking our talk on health and climate change.
Please forward these resolutions to the authorizing boards, and let me know the outcome of the vote.

I see this as a beginning, not a destination. Complacency on these issues will just make the ISEE less relevant. For example, the name badges are oversized non-recyclable hard plastics. A huge amount of waste. And instead of giving steel water bottles out at every conference, just start selling them, and advertise in large font “BRING YOUR OWN REUSABLE WATER BOTTLE.” A little prevention goes a long way. But we, more than anyone, environmental epidemiologists, already knew that.

CODA

It turns out, that in the ISEE’s 2018 meeting in Ottowa, Canada, a country quickly becoming synonymous with oil power obliterating public health, that affiliated societies part of the ISES-ISEE joint conference received financial sponsorship by ExxonMobil — a huge conflict of interest! That the ISEE, and its local organizers let this one “slip past them,” is a huge cognitive-ethical bungle. How can public health researchers be credible in evaluating the science of pollution when they are lining their pockets and funding their meetings with those very same polluters’ dollars?

In the Introduction to the symposium on “A world less dependent on fossil fuels – scientific evidence and corporate influence” Prof. Dr. Manolis Kogevinas, Research Professor of the NCDs Program at the Barcelona Institute for Global Health, gave a talk on August 26th, 2019 that included the following abstract:

The Symposium organised by the Policy Committee of ISEE originated following the widespread surprise and annoyance of our members from the sponsorship of the 2018 ISES-ISEE joint conference in Ottawa by ExxonMobil. ISEE did not directly accept these funds but other societies are more willing to accept them.
We will argue that organizations representing health researchers should not accept support from the fossil fuel extraction companies.
Banning health research funded by the tobacco industry helped bring major public health gains; we will argue that we should do the same with BigOil. We further argue that ISEE should become more vocal on this issue and promote measures such as divestment from these industries.
There are three main reasons for taking this position: (i) The most important is that fossil fuel industries are major determinants of human disease and environmental deterioration; (ii) The second is that they knew! Like the tobacco industry, Big Oil knew for decades that their products could make the planet uninhabitable, and intentionally buried the evidence; (iii) The third reason is that like our stand against the tobacco industry that resulted to significant public health advances, we should take a categorical, effective and clear-cut position against the products and actions of these harmful industries. The science is more than adequate to warrant action. Unless we do this, we will not be able to effectively convince the lay public and our politicians of the urgency with which we must mobilise.
The proposed Symposium will illustrate major aspects of health consequences of fossil fuel combustion and the reactions of the industry trying to influence epidemiological research. We will discuss on the way epidemiologists should continue providing essential support to health policies avoiding corporate interests while encouraging industry and other stakeholder involvement as a part of the solution to the problem.

New Publication: Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review

My colleagues Manali Vora, Jesse Elias, and Pam Ling and I at the Center for Tobacco Control Research and Education at the University of California, San Francisco just Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review. (Also available at PubMed).

Here are some sources that have blogged about the paper:

https://www.apha.org/news-and-media/news-releases/ajph-news-releases/2019/2019-july-issue

https://tobacco.ucsf.edu/scientific-articles-supporting-tobacco-harm-reduction-more-likely-be-industry-funded-and-lack-empirical-data

Abstract

Background. Tobacco companies have actively promoted the substitution of cigarettes with purportedly safer tobacco products (e.g., smokeless tobacco, e-cigarettes) as tobacco harm reduction (THR). Given the tobacco, e-cigarette, and pharmaceutical industries’ substantial financial interests, we quantified industry influence on support for THR.

Objectives. To analyze a comprehensive set of articles published in peer-reviewed journals assessing funding sources and support for or opposition to substitution of tobacco or nicotine products as harm reduction.

Search Methods. We searched PubMed, Embase, Web of Science, and PsycINFO with a comprehensive search string including all articles, comments, and editorials published between January 1, 1992 and July 26, 2016.

Selection Criteria. We included English-language publications published in peer-reviewed journals addressing THR in humans and excluded studies on modified cigarettes, on South Asian smokeless tobacco variants, on pregnant women, on animals, not mentioning a tobacco or nicotine product, on US Food and Drug Administration–approved nicotine replacement therapies, and on nicotine vaccines.

Data Collection and Analysis. We double-coded all articles for article type; primary product type (e.g., snus, e-cigarettes); themes for and against THR; stance on THR; THR concepts; funding or affiliation with tobacco, e-cigarette, pharmaceutical industry, or multiple industries; and each author’s country. We fit exact logistic regression models with stance on THR as the outcome (pro- vs anti-THR) and source of funding or industry affiliation as the predictor taking into account sparse data. Additional models included article type as the outcome (nonempirical or empirical) and industry funding or affiliation as predictor, and stratified analyses for empirical and nonempirical studies with stance on THR as outcome and funding source as predictor.

Main Results. Searches retrieved 826 articles, including nonempirical articles (21%), letters or commentaries (34%), editorials (5%), cross-sectional studies (15%), systematic reviews and meta-analyses (3%), and randomized controlled trials (2%). Overall, 23.9% disclosed support by industry; 49% of articles endorsed THR, 42% opposed it, and 9% took neutral or mixed positions. Support from the e-cigarette industry (odds ratio [OR] = 20.9; 95% confidence interval [CI] = 5.3, 180.7), tobacco industry (OR = 59.4; 95% CI = 10.1, +infinity), or pharmaceutical industry (OR = 2.18; 95% CI = 1.3, 3.7) was significantly associated with supportive stance on THR in analyses accounting for sparse data.

Authors’ Conclusions. Non–industry-funded articles were evenly divided in stance, while industry-funded articles favored THR. Because of their quantity, letters and comments may influence perceptions of THR when empirical studies lack consensus.

Public Health Implications. Public health practitioners and researchers need to account for industry funding when interpreting the evidence in THR debates. (Am J Public Health. Published online ahead of print May 16, 2019: e1–e8. doi:10.2105/AJPH.2019.305106)