BMJ article on conflicts of interest in the tanning industry just published

Working at the CTCRE at UCSF allowed me to meet all sorts of medical practitioners aware of the influence of industry on the health of their patients.

One of those people I happened to meet, was Eleni Linos (now at Stanford), a dermatologist who had noticed throughout the years the influence of the tanning industry on spreading disinformation to the public on the health harms of tanning.

Lola Adekunle, Rebecca Chen, Lily Morrison, Meghan Halley, Victor Eng, Yogi Hendlin, Mackenzie R Wehner, Mary-Margaret Chren, and Eleni Linos’ paper “Association between financial links to indoor tanning industry and conclusions of published studies on indoor tanning: systematic review,” challenges the invisibility of industry as it attempts to blend in its research into the scientific public record. Our paper shows the impressive discrepancy between the scientific conclusions on the health harms of tanning studies with financial links to the indoor tanning industry found, versus those of independent, non-financially-interested researchers.

Figure 3 from our paper, available here: https://www.bmj.com/content/368/bmj.m7

Jerod Stapleton also published for the British Journal of Medicine an editorial on our article, concluding that “We must challenge industry attempts to change the conversation about tanning.” Stapleton is no stranger to the harms of tanning, having conducted significant research on the health outcomes, as well as leading a paper in JAMA Pediatrics titled “The American Suntanning Association: a “science-first organization” with a biased scientific agenda.” Indeed, according to the tanning industry’s January 2015 issue of Smart Tan, the ASA succeeded in convincing (bullying?) the CDC to remove claims of a 75% increase in melanoma risk from sunbed use that had previously been displayed on the CDC website.

National Geographic and Guardian Articles about Ecigarette Waste and EPR

In the flurry of the semester starting, I’ve been remiss in updating this blog with a couple important articles that have come out in the press discussing the environmental harms of electronic cigarette (ecig) electronic waste (ewaste).

Both The Guardian and National Geographic did excellent jobs surveying the topic and getting across the complexities as well as most important points. And I’m grateful to through interviews have been able to contribute to these articles.

I think the most important point I made in The Guardian article is the need for Extended Producer Responsibility, and how it practically works:

Hendlin said he and other environmental advocates have endorsed an Extended Producer Responsibility (EPR) model for e-cigarettes – one JUUL is considering. This would include charging users an extra deposit (ie $1.00 per pod, $5.00 per vape unit) that consumers get back when they return them, practices like returning old packaging to JUUL after receiving new pods each month, and refunding or giving credits for returned pods/vapes.

https://www.theguardian.com/society/2019/aug/26/vapings-other-problem-are-e-cigarettes-creating-a-recycling-disaster

ADDED BONUS:

What made me want to puke however, is just before I was settling down with my popcorn to watch the (excellent!) National Geographic video they made on the effects of e-cig waste, I was subject to a 15-second propaganda piece by the grandmasters of waste and treachery themselves, Nestle. Especially as in my piece in The Conversation, I write

The two largest global brands of capsule coffee, Nespresso and Keurig, are regarded by many as environmental nightmares. Billions of the throwaway nonrecyclable plastic products currently clutter waste dumps, waterways and city streets. Both inventor of the “K-cups” John Sylvan and former Nespresso CEO Jean-Paul Gaillard have publicly bemoaned the environmental consequences of the products they once championed. Sylvan has stated that the disposable (but not biodegradable) coffee capsule is “like a cigarette for coffee, a single-serve delivery mechanism for an addictive substance.”

https://theconversation.com/e-cigarettes-and-a-new-threat-how-to-dispose-of-them-105096

The comparison between cigarette butts and capsule coffee is surprisingly fitting. Both butts and capsules are intentionally designed to be convenient, single-use products. Both are also nonbiodegradable and unrecyclable. As pervasive and polluting as cigarette butts are, however, the e-waste from e-cigarettes presents an even more apt comparison.

https://theconversation.com/e-cigarettes-and-a-new-threat-how-to-dispose-of-them-105096

You can imagine how I felt then, when Nestle pimps this feel-good (Spanish language!) advertisement at me, never mentioning the billions and billions and billions of plastic-metal-paper non-recyclable single-use bad-tasting coffee hits it blights the planet with each year.

The Nespresso ad video before the cool National Geographic video. So nice (not!) that National Geographic is producing videos for Nespresso, to preempt people realizing that environmental health problems (having to do with the environmental determinants of health) are intersectional, too.

San Francisco BART’s Unpleasant Design

Introducing: The inverted guillotine

Having lived for the better part of my life in the San Francisco Bay Area, I have put in my time on the Bay Area Rapid Transit (BART) system. From it’s loud, overcrowded, clunky, and infrequent trains, to the spate of BART police shootings of young men of color, this privatized (militarized?) operation has a monopoly on public transport, and unashamedly has its will with the region with little grace.

The latest offense is the instillation of “skull crusher” “inverted guillotine” pop-up spring-loaded barriers, that could hurt or maim (it’s just a lawsuit waiting to happen).

Instead of pouring money into education, or helping the homeless, the Bay Area has now apparently prioritized metal spikes shooting up from their BART turnstiles. Way to go, gentrification!

The fact that “fare jumping” is solved by violence is telling. Instead of maybe just making the BART – a public service – into a public company, free for all riders, payed by a corporate property tax (or some other public funding in the insanely overpriced Bay), as many other localities such as Tallinn in Estonia have done, doubling down on menacing design elements further marginalizes the marginalized. BART really doesn’t lose much money at all on fare jumpers. Their financial mismanagement is sui generis. Yet, like all administrative classes, the propensity to pay themselves more to harm the poor is too tempting; it exculpates their responsibility for mismanagement (and points to the need for the region to re-buy the service to run it correctly), and instead finger-wags at “scofflaws” for being bad people, when all they really are doing is what is necessary to get around their own town when they haven’t benefited from the Silicon Valley boom.

The book Unpleasant Design discusses the epidemic of public infrastructure that makes being in public an injurious experience for those worst off. From bus benches in shelters that slope so you can’t sleep on them (you’d fall off), to “anti-homeless spikes,” sonic warfare (projecting odious or repetitive noises, like that corporately-engineered “hit” “Baby Shark“), ordinances against “sitting” or lying in public spaces for too long — rich countries, especially English-speaking ones, have declared war on public space.

London, UK. 10th June 2014. Anti-Homeless Spikes Protest outside Stock Photo: 70030582 - Alamy
Anti-homeless spikes

Unpleasant design takes what little of the commons are left – the nooks and the crannies – and puts money into destroying them to keep out “undesirables.” This racist and classiest action is often the result of gentrification; justified to keep the zoos of the rich free of those who can’t pay their entry fee.

These artists are tackling London's anti-homeless spikes head on
Activists in London combat the painful anti-homeless spikes

The psychological warfare of guillotine turnstiles makes the entire experience of public transportation less comfortable for everyone. Instead of dealing with the 80-20 principle that 80% or 90% of riders will pay no problem, and that there will always be a remainder of the population that for what ever (often very legitimate) reason cannot or will not pay, BART has chosen to harm the public, pushing more people into their polluting cars.

I’m sure before long, people will be defacing these violent turnstiles. And it is likely that the accumulated rage against BART will reduce paying ridership (despite their monopoly), actually bringing them less money than they had before–the exact opposite result than they profess to so-desperately and so-forcefully want.

The public outrage on Twitter is already loud and clear against BART’s weaponization of its service. Such aggrandizement activities miss the point of their charge: they are in the business in providing a public service, and some people can pay more, some less, and not at all. Perhaps peg BART tickets to income. Then the rich might pay $100 per ride, the poor the normal $3.40 trip, and the very poor nothing. That would be a fair approach. Our society is far from that enlightened thinking, sadly, even in that hotbed of *potential* San Francisco, Oakland, Berkeley, and environs.

But let’s not deceive ourselves. There’s a reason why you can’t take the BART to Marin County: racism. Back in the 1950’s there was a plan in place to extend the San Francisco BART to Marin (North Bay), but because of vocal refusal by residents, it failed. And now, no easy public transportation (besides the ferries) go to Marin. The Bay Area is disconnected by design, an open gated community in a natural and cultural paradise predicated on class, race, and exclusion.

Have we not evolved as a city in 70 years? Are we still just as violent towards those less fortunate than us. San Francisco is a mess because of its wealth. But at least on this case of BART structural violence, the people are having their day of reckoning.

Science and Politics of Glyphosate Workshop June 6, 2019

My Erasmus University Rotterdam colleague Alessandra Arcuri and I are organizing a day-long workshop on the most used pesticide in the world: glyphosate. Glyphosate, the active ingredient in RoundUp, Monsanto’s flagship herbicide, has been linked with cancer by the International Agency for Research on Cancer (IARC) in 2015.

For more information, registration, and to submit a paper to present at the conference, please visit our website, at the Dynamics of Inclusive Prosperity Initiative.

IARC and EFSA’s differing views on glyphosate

Disposable is NOT Environmental

I was perusing Kickstarter when I happened upon a solution to a problem that I didn’t know was that big of a deal: spices going bad. As it turns out, it’s not that big of a deal, it’s what could easily be classified as a “first world problem.”

Spices, because we live in a commodified society with more supply than demand, often sell us large quantities of pre-picked, pre-ground spices. Moreover, these spices are picked from around the world, very far from where we live, and so by the time we use much of them, they lose some of their pungency.

For the same reason that many people grind their own coffee beans, and in many parts of the world including Europe, their own grains, many people still grind their own spices. (Full disclosure, wherever possible, I grind my own spices too – they taste way better fresh that way; no pre-ground spice, no matter how well packed, will taste as good). There is no secret to this. A couple of good kitchen tools, and you’re good to go with most spices. It keeps the nutrients fresh and less degraded (though of course, from picking a spice, it’s shelf-life starts ticking away), and much more pungent and enticing.

Yet, this Kickstarter doesn’t say, “hey, I’d like to make some money by selling you high quality spices, but you’ll still have to grind them yourselves and take an extra minute of delight every time you cook!” No, instead, it fails to see that good cooking, by its nature is a meditation, not something to create a lot of trash with for convenience’s sake. It is a fail because it does not understand that gourmands who like fresh spices are happy to take the extra 30 seconds and grind their own pepper, ginger, or nutmeg. Instead, it grinds the spices already, prematurely, and puts all of its heft on the claim that it has found a better “preserving” mechanism, better than glass containers, but somehow stopping short of formaldehyde.

By appealing to “design” this company is yet another hipster gourmand appropriation of disposable trashy production in order to pull the wool over consumers’ eyes. They have the gall not to merely discuss how their throw away, potion enough for a bachelor(ette) only spice capsules, but to call their product “revolutionary” for its ability to “keep spice fresher at the molecular level.” At the molecular level! I love it–they don’t explain what they mean (except through appealing to the boogieman of “oxidation”) by saying “molecular,” other than that it has become the new buzzword after “neuro” and “nano.” But hey, if you’re already in the business of commodifying trends, why not throw in meaningless buzzwords to prey on consumer gullibility?

Beyond their appeals to their product perhaps rightly being “more flavorful,” than old forgotten spices, they also make the much more suspect claim of it being more “affordable” as well. But worst – and here it’s just a blatant lie – they also claim that their throwaway aluminum pod peel trash wrapper is also more “sustainable.” And that’s why I’m calling bullshit on Occo, and all products like them that attempt to solve a non-problem for people who have more money than they know what to do with, by creating more trash for future generations.

For fun, let’s take a look at some of their misleading and fallacious sustainability claims:

(1) That aluminum is “the most recyclable material in the world”

(1) A: The price for aluminum is higher today than it has been in many years. That’s why there have been, for the first time a rash of thefts of aluminum bleacher seats at parks. So I ask the very Instagrammable Connie and Lisa: do you know what bauxite is? (The raw material from where aluminum comes from). Have you ever been to a bauxite mine? How about a bauxite processing plant? Ever breathed in those fumes? No, because otherwise, you would avoid aluminum like the plague that it is.

Sorry to burst your bubble, but disposable aluminum (where do you even discuss recycling, and the fact that in many jurisdictions your customers may not even have adequate access to recycling facilities?) is a loser. It’s an environmental nightmare, not the paragon of recyclability you paint it as.

Anything that can be used more than once, or say, used many, many times, for years, is more sustainable than something that is only used once. Period. You don’t have to be an industrial ecologist to do the math and realize that even in the best case scenario, if you melt something down, you’re using a tremendous amount of energy to do so, (coming from where?), and then refashioning that raw material into another thing–losing material and energy along the way.

(2) “Saving food waste” claim.

(2) A: Another fallacy is that Occo is helping reduce food waste and saving the planet by selling expensive spices in high quantities in disposable aluminum. The company even does a masterful deflection of using a loaded label against the waste in bulk food items (they call it the “Movie Soda Mark-Up”), that strikes a chord with their Millennial audience of single, big income, no children. They say that food waste is created because people buy more than what they need, and when people are more minimalistic (I love the movement of minimalism, but detest the way it has become commodified to sell more crap that people don’t need to them in the name of minimalism!). But I truly have to question how true this is around spices: what percentage of the 40% of food waste boils down to spices? 1%? 0.5%? If so, that would boil down to 0.4-0.2% of food waste blamable on too many spices. And this is a generous estimate. Nice try, but this is a clear case of the misuse and abuse of pulling on legitimate environmentalist heartstrings.

 

To sum up: the problem with this scheme and so many like it is that there’s no money in simply telling people to go quality over quantity; and to buy less instead of buying more. The “super premium” segment of the nouveau riche, always eager to virtue signal their “style” and “taste” is one of the leading contributors to ecological disaster and climate chaos.

To falsely claim some sort of ecological currency in doing so, should be met with a healthy dose of reality and opprobrium. There are enough charlatans around; the last thing we need is more cannibalism of truth by poseur minimalists willing to say any ecological lie to make a quick buck.

P.S. After writing this, I just found some more spurious reasoning from these poster-children for the Dunning-Kruger effect (a little bit of knowledge is dangerous–you might actually think you know something when that’s not the case). I’m not going to comment on it, I’ll just put it here:

E-cigarette e-waste litter is an environmental health harm that can be stopped before it metastasizes

My op-ed in the American Journal of Public Health that appeared this week discusses the new tobacco waste stream of electronic cigarette waste. Electronic waste is already the fastest growing waste stream globally. Creating a new product that has no current responsible recycling infrastructure, and that may be littered widely, contributing to plastic sinks such as the Great Pacific Gyre (garbage patch) in the Pacific Ocean, is a mistake. This op-ed discusses the problem and some of the solutions that can be taken to avoid a possible environmental health and ecological disaster.

signal-2018-03-20-083324

Photo of a dropped Juul vape on SF MUNI by Julia McQuoid, used with permission

Regarding this article and other research I am conducting, I also wrote a piece in the online academic blog/forum The Conversation on e-cigarettes as the Nespresso of tobacco products, environmentally speaking.

This article was republished by the University of California, Salon, Phys.org, The Houston Chron, the Connecticut Post, The Fresh Toast, Business Insider, EcoWatch, The Chicago Tribune, and many other news sources.

Reuters also interviewed me for a piece titled “E-cigarette policy should consider environmental effects, expert says.”

For my other writing on e-waste, please see my interview with Eric Lundgren in Nautilus.

 

The Elon Musk of E-waste

My new article, “Is This Man the Elon Musk of E-Waste?” in my favorite popular science online magazine Nautilus, describes the Right to Repair movement, and the necessity to move from a linear manufacturing process built on planned and perceived obsolescence to a circular economy.

If we are to combat the 99 billion pounds of e-waste produced per year, ending up incinerated, in lakes and rivers, and trashing our communities and the lives of future generations, we’re going to need to mandate manufactures of electronics such as Apple, Samsung, Microsoft, IBM, Dell, and all the other major players, to engineer products that can DIY be taken apart, repaired, and built to last.

My interview with Eric Lundgren, his last before he was sent to prison for creating 28,000 Microsoft Windows restore CDs meant for refurbishing computers that otherwise would end up as e-waste, describes the necessity for financial mechanisms to incentivize companies and consumers to place e-waste back into an (dis)assembly line of reuse, reduce, recycle.

Screen Shot 2018-07-10 at 14.52.48.jpeg

Lundgren has championed the right for electronics to be repaired rather than tossed by staging high-profile recycling demonstrations including his Guinness Book of World Records farthest driving on a single charge electric car (999 miles with 90% recycled materials including recycled hybrid batteries) and his flagship solar-powered e-waste recycling factory.

I appreciate the comment on the article made by Ryan Shaw, who wrote:

Mr. Lundgren has done more with far less than what Musk started with so I don’t think the comparison does Lundgren justice (although I am a huge Musk fan). Maybe someday if Tesla starts a car rebuild program to re-use scrapped cars the title would be, “Elon Musk is the Eric Lundgren of car manufacturing.”

Airplanes and Death: A Study in Sound Pollution

 

I recently published an article in Berkeley’s newspaper, Berkeleyside, about the incessant overhead air traffic, and how this likely is causing significant public health effects.

Here’s the evidence  base:
https://www.ncbi.nlm.nih.gov/pubmed/25332277
https://www.ncbi.nlm.nih.gov/pubmed/22491084
https://www.ncbi.nlm.nih.gov/pubmed/26356375 “These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded.”
https://www.ncbi.nlm.nih.gov/pubmed/20881600 “Aircraft noise was associated with mortality from myocardial infarction, with a dose-response relationship for level and duration of exposure. The association does not appear to be explained by exposure to particulate matter air pollution, education, or socioeconomic status of the municipality.”

Upcoming UCSF Cancer Center talk

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CANCER CENTER TOBACCO CONTROL PROGRAM SEMINAR

 

Does the Tobacco Industry have its own Endgame?

The pharmaceuticalization of the tobacco industry and implications for public health

 

Yogi Hale Hendlin, PhD

Tuesday, September 26, 2017, 3:00 – 4:30 pm

CTCRE, Kalmanovitz Library, Room 366

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Yogi Hale Hendlin, PhD, is a Postdoctoral Research Fellow at the Center for Tobacco Control Research and Education working on inter-industry epidemics and industry subversion of science. His recent first-authored publication in the Annals of Internal Medicine titled “The Pharmaceuticalization of the Tobacco Industry” (reviewed by Reuters) demonstrates that in the face of declining cigarette volumes, the tobacco industry has been actively pursuing alternative forms of “medicinal” nicotine delivery to maintain profits. Hendlin is also currently working on a systematic review of tobacco harm reduction, analyzing the role of industry-funded scientists on the prominence of product substitution rather than cessation and public health measures in the tobacco harm reduction debate. At the intersection of environmental politics, the social determinants of health, and critical public health, Hendlin’s research addresses corporate harms to the health of society and the environment.

 

UCSF Kalmanovitz Library

530 Parnassus Ave., #366

San Francisco, CA 94143-1390

             

 

 

Owning Life versus Thwarting the Hygiene Hypothesis

 

With such a provocative title as “Pet Ownership Protects Us Against Allergies,” UCSF’s Dr. Homer Boushey makes the claim that children brought up with pets inherit some of their protective microbes that mitigate against developing allergies.

 

 

 

 

While certainly the science on exposing human children and adult humans to other forms of life soundly concludes that microorganism transfer is on the whole necessary for healthy (mind and body) development, owning life for the instrumental good of health is quite a quixotic mission. Destroying the planet and then importing charismatic genetically-altered (through breeding now, later through genetic engineering) cute critters that bypass our evolutionary instincts for fear by mirroring the oversized eyes of babies and other exaggerated features, is like getting silicon peck implants instead of actually doing manual labor to help society. It puts a natural symbiotic process into the realm of money–the financialization of nature. This devalues nature as such, and sees pets in terms of their use value for boosting infant immune systems. Such a logic is hopelessly backwards. Instead, we should be concentrating our energies on rewilding our cities, returning our suburbs to parks where humans can go, and letting our wild areas get a breather from human interference for at least a few generations. Then, living everyday with healthy dirt, animals and plants, we will receive the bounty of beneficial microbes we need to stay healthy and avoid sickness. Proper farming and permaculture principles, and creating new definitions of hygiene which are integrated with healthy ecosystems, achieves to a much greater degree the goods Dr. Boushey might wish to confer on our ailing feeble-minded culture, while also solving most of our other problems along with it.

Furthermore, it’s high time humans question ownership. Ownership of other bodies for our own benefit–bringing these bodies out to use and cuddle or parade, is just another misbegotten form of biopower. Where are those Foucaultians who apply biopower to pets? How do we think humans got the beneficial microbes we needed before there was even possible ownership of pets? Perhaps we need to rethink our antiseptic western civilization, our throwaway economy, and slavery of life to realize that continuous contact with the more-than-human word is the only way we will regenerate ourselves and nature.

ExxonMobile Responds to Hurricane Harvey

oil tank hurricane harvey.jpg

Cognitive dissonance is a phenomena common amongst human beings who want to have their cake and eat it too. It comes from a willing ignorance to repress and suppress the world’s inconvenient truths and hold onto the frame (or fairytale) one inhabits (or chooses) with tenacious vigor.

In their weekly missives, ExxonMobile’s “Energy Perspectives” newsletter this week features a typically tone-deaf and gumption-filled story on how destroying the world through oil and gas exploitation is actually saving the world. It’s a classic psy-ops strategy (formerly known as propaganda), only with a slicker sheen, more convoluted rhetoric, and patriotic pictures.  According to the Department of Defense, psy-ops are:

Planned operations to convey selected information and indicators to… audiences to influence their emotions, motives, objective reasoning, and ultimately the behavior of… governments, organizations, groups, and individuals. The purpose of psychological operations is to induce or reinforce foreign attitudes and behavior favorable to the originator’s objectives.

So Jerry Wascom, president of ExxonMobil Refining & Supply Company writes in the ExxonMobile Perspectives blog

I’ve been in this business for more than 30 years, and I’ve never seen anything like it.  The impact of this hurricane has been unprecedented.

There’s no reconciliatory tone. No regret. No mention of climate change. No, instead we are invited to see nature’s disrupted patterns and 500-year weather events (happening within years of each other) as mere temporary roadblocks to the further entrenchment of global capitalism. Wascom writes:

At ExxonMobil, we’ve had to temporarily shut down some operations, but we haven’t stopped working.  Just the opposite.   My team is working around the clock to bring everything back on line as quickly as we can and get fuel to drivers that need it.

But, in light of the horrors of anthropogenically destabilized climates, wouldn’t the only moral thing to do seem to be stopping working? Wouldn’t conceding at the card game before you go broke actually seem like a better strategy than doubling down with your last chips?

No, instead this is reframed as merely a logistics problem. Indeed, “the current challenge we face is mainly a logistical one,” Wascom writes.

Not all the fuel is where it needs to be.  We have to quickly reroute trucks and tankers to get supplies from more distant locations to places that previously relied on the Gulf Coast refineries.

Instead of acknowledging that in catastrophes we might have to use less, ExxonMobil is pulling a GW Bush: Buy, baby, buy. The paraphrase Ingolfür Bluhdorn, ExxonMobil is looking for creating sustainability and resiliency just in those same unsustainable practices that got us in this climate disruption in the first place. Don’t pause to reflect. Don’t use less fuel. Don’t travel less. Because such actions might cause a reevaluation of the insane oil subsidies, and our fossil-fueled toxic culture.

Of course, such psy-ops are bolstered by the other Breitbarts of news, such as Business Insider, Money, and other unidimensional news outlets who care only how any event will impact their stock prices. Thus the intentional ignorance of ExxonMobile is perpetuated throughout our culture system by the help of greed, instantiated in a news media and financially-myopic media willing to poison the world for a few more points on their stock.

ExxonMobile reassures us that they will go to the ends of the earth to ensure that our illusion of cheap fossil fuels isn’t broken.

And that’s exactly what we’re doing.  We’re going the extra mile to reconnect the dots and move fuel quickly and safely.

Amidst dire environmental justice murmurings of the toxic exposures due to hazardous waste seeping out of its quarantine in Houston, harming entire communities (especially poor and migrant communities), we are supposed to trust the self-serving interests of the world’s largest oil machine, and one of the largest funders of climate change denial.

The last stake in the heart of Corporate Social Irresponsibility is ExxonMobile’s responsibilizing consumers for the problem. They urge

drivers can help by not “panic-buying.”  Topping off your tank is one thing; stockpiling fuel is another, and puts unnecessary stress on the system.  We can all help each other if we don’t go overboard.

Who’s this “we” you’re talking about, paleface? ExxonMobile has proven time and again that they don’t care for anything but profit, yet they are doing the British gag of “let’s all play together” for their own benefit–not ours. This rallying cry to keep normalcy in the face of an insane, corrupt, oligopolistic system, is itself sick. In the words of Jiddu Krishnamurti, “It is no measure of health to be well adjusted to a profoundly sick society.” Screen Shot 2017-09-02 at 07.54.50

 

New paper published in Annals of Internal Medicine picked up by Reuters

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Today, with co-authors Pamela M. Ling and Jesse Elias, our paper “The Pharmaceuticalization of the Tobacco Industry” appears in the Annals of Internal Medicine.

Our interview with Reuters is available here.

This work contributes to the study of industrial epidemics, and how corporations, instead of dying a quiet death as the world wakes up to the inutility of their products for life, metastasize into other structures to clean up the messes they continue to create–and to charge taxpayers for it (in this case, by getting government health care like the NHS in the UK, to pay for their so-called reduced-harm nicotine products).

Learning from Science in an Age of Marketing

“It was widely believed thalidomide would be useful to control morning sickness. It did – but it did other things, too.  We need evidence, but unregulated marketing does not help us get needed data.” –A colleague at UCSF

The epidemic of reductionism that has swept throughout science leads us to rely on ersatz measure for the real thing. For example, in public health, instead of looking at holistic outcomes, how well someone is doing both short- and long-term after the intervention, we increasingly rely on biomarkers of harm or health as predictive models. These molecules act as snapshots of the larger phenomena researchers wish to investigate. Biomarkers, however complex the portfolio of them, are by definition only valid insofar as they can be abstracted in a vacuum, not taking into account the other interactions of hormones, environmental stimuli, genetic specificity, and latent versus blatant (or known versus unknown) effects and interactions of a given encounter.

The very existence of individualized medicine may warn us against biomarker essentialism. In the distribution of effects of a given pharmaceutical, for example, which end of the spectrum will we end up on? We know that while most people (whatever that meant for the pharmaceutical trials involving a geographically limited and probably age limited population), most products that make to the market (in an ideal world) are tested to be benign at worst, and helpful at best. But what about for those other people who have chemical sensitivities, are near the tipping point for severe reactions to additional stimuli, or simply have extreme adverse reactions to whatever happens to be in the drug?

We may aim at treating X (e.g., morning sickness), and be successful at it, while causing a much more severe Y (e.g., retardation in babies). While there is no failsafe method to avoid any sort of side-effects, prohibiting marketing of pharmaceuticals to doctors or directly to consumers may be one way to avoid hasty clinical trials, falsified information, and widespread corruption (deliberate and unintentional) in science. Another possibility would be setting up medical companies as B-Corporations so that they have no incentive to cut corners. Otherwise, the side-effects game, where people start piling up medications to deal with the side-effects of the previous one ad infinitum, makes them poor and the corporations rich. Certainly, this is not a happy ending for the majority, and is an unsustainable, parasitic business model.