GFN 2016: Evidence, Accountability and Transparency (Part One)

Well, I’m finally back after a hectic few days in Warsaw for the Global Forum on Nicotine 2016. I really wish I had decided to fly out earlier and stay a bit longer as everything felt a little squeezed on my trip. But the bottom line is it was really worthwhile. This will likely be a multi-part blog as there is a lot to cover.

The start of the event just happened to be a screening of Aaron Biebert’s (watch this space for something special in the near future!) documentary film A Billion Lives at the Kinoteka in the Palace of Culture (or as Sarah described it, the big spiky thing). Setting aside the film for just a moment, the architecture of the Palace of Culture is truly fascinating, and I wish I had more time to explore - maybe that is something for GFN 2017 (if they’ll let me go).

I’ll be honest, I had no real expectations of the film - though I did want it to be truly exceptional, after all it is a big topic and something that has (until now) never been done - so I tried to keep an open mind and view the film as someone who isn’t directly affected by it (which wasn’t easy). Remember, the majority of the audience at this showing were either vapers, or supporters of vaping as an alternative to smoking (along with those who view vaping as a cessation method).

The opening of the film concentrated on the tobacco industry and a lot of historical footage - on the one hand (as a vaper) this aspect could have been condensed slightly, but having considered it from a more neutral point of view, I can understand why it had been laid out this way. Surprisingly some of the footage and coverage I either wasn’t aware of, or only vaguely aware of. It did highlight just how much the tobacco industry mucked up in the past, and it did provide a lot of context to frame the next part of the film.

The Bootleggers and Baptists section, at first I thought this segue wasn’t necessary - I couldn’t really incorporate the parallel in my mind, at least to begin with, but as Aaron narrated the past and drew the parallels to the current situation, it made perfect sense with the Tobacco Industry and the vapour industry being on the side of the Bootleggers.

Then came the part I was afraid of - the potential of the film turning into a conspiracy theory. It didn’t. It laid down what is known in a straightforward, no-nonsense manner which was surprisingly refreshing. Overall, from an outsider perspective (which was incredibly difficult to maintain), the film certainly laid out the historical path which set all the precedents for the current debate, with plenty of hole filling for those that aren’t as involved as the likes of me.

Plenty of good imagery, clever use of music and good quality direction. Is it the groundbreaker that is needed? I want to say yes, I really do. It will certainly open a few eyes, and possibly guide people to ask some very pointed questions. But will it shake the tobacco control industry to its core? Honestly, I’m not sure. It’s a good solid film, and I only have one gripe and that was the (what I feel) overuse of public health / tobacco control soundbites. If you haven’t seen it yet, I do recommend you do see it as soon as you can. If you’ve already seen it, maybe watch it again as there was a lot of information imparted throughout the film and Aaron’s narrative.

Following on from the film, an evening of meet and greet at a local restaurant bar - Lakonta. There were so many faces to say hello to, along with plenty of discussion about the film and the upcoming conference among a variety of other topics. Being the reserved type, I did tend to stick with who I knew, but did manage to say a proper hello to Linda Bauld and Stefan Didak (who is actually shorter than I thought he would be!)

The conference itself was sure to be packed to the rafters with information and debate, and I wasn’t at all disappointed. Day one left me with an overloaded brain trying to take it all in. Prior to the Michael Russell Oration (presented by Marewa Glover, who I did have the pleasure to finally meet) were three satellite sessions: Science & Policy Update, Regulatory Developments and Consumer Advocates Meeting. It was a tough choice to decide which session to go to, and although the Science & Policy Update, and Regulatory Developments sessions both had good line ups, I ended up in the Consumer Advocates Meeting.

Consumer Advocates Meeting Agenda

Consumer Advocates Meeting Agenda

Chaired by Kevin Molloy and featuring Clive Bates, Dr Jeannie Cameron (JCIC International Consulting) and Dr Chris Ford (International Doctors for Healthy Drugs Policies), the aim of this session was to establish a) the feasibility, b) the proprietary for an “International Organisation for Nicotine Consumers” - given that the regulatory landscape varies wildly from country to country, and even further in the different countries (such as the US for example), it would seem on the surface that such an International level organisation could be destined for failure, but the discussions in the meeting suggested otherwise.

Kicking off proceedings (after the introductions, which for me were I’m just an average consumer, unlike Dave who was a “vaping dinosaur” (yeah, OK Dave keep telling yourself that!)), Clive outlined three main reasons to act “collectively”:

  1. Organised at an International level that can affect what is achievable (cited the WHO FCTC as “an example”)
  2. Commonality - a number of regulatory and policy themes globally are similar in nature, and can be addressed in the same manner
  3. Solidarity reasons

Globally, the media has incredible pull, regardless of the headline - in the UK especially, whether we like it or not, the Daily Mail is read and taken as fact by many. There is a case for a more organised presence internationally, if only to have a “way in” to the various media outlets to release counter statements, or announcements. The press, for better or worse, do have a lot of power in the debate surrounding vaping, and nicotine products in general.

Thing is, having an “international organisation” doesn’t necessarily mean that the structure and guiding rules for that organisation are imposed on the national level. It can be beneficial to have an international body, as it can make it easier to organise conferences, attendances and so forth, but there is also benefit to “organised disorder” - it has been a strength of the community as much happens spontaneously without much in the way of planning.

Governments don’t want to talk to individuals, they prefer to talk to a single body

When put like that, dealing with Governments as an international organisation does make sense, but that also doesn’t rule out the power of the individual (the LordsVapeVote is a prime example of the pressure that can be applied by individuals). No, organisations are effective because they know what they want, and how to express it.

The question then turned to how to effectively communicate - social media, blogs (such as this humble tome), something more formal such as newsletters, conference calls, or a federation (I did kind of like this idea, but for totally the wrong reasons.). Let me expand on the Federation idea slightly - organisation is not strictly at International level but there would have formal relations with other national organisations - think of the FCA (Framework Convention Alliance) as an umbrella organisation at an International level which represents the interests of multiple organisations:

FCA was created in 1999 and formally established in 2003. It is made up of nearly 500 organisations from over 100 countries.

Let’s reiterate - FCA is more of a federation than an actual organisation. It represents organisations but doesn’t impose any rules or guidelines on how those organisations actually operate. But what the FCA does have is a simple message, with simple targets - which means it garners far more support. Interestingly, the very definition of “tobacco control” as defined by the Framework Convention on Tobacco Control (FCTC) is:

FCTC Tobacco Control Definition

That’s right. The very definition of tobacco control by the FCTC includes harm reduction strategies - all variations of harm reduction, which includes Snus, vaping, Heat not Burn and other low (or lower) risk nicotine/tobacco products. Yet, not one policy implemented by the agreeing parties includes harm reduction strategies, despite there being a legal obligation for implementing such strategies. But don’t be fooled into thinking that the next COP (Conference Of the Parties - COP7) will provide any insight, most of what is discussed and/or “debated” has already been agreed/decided in advance.

Dr Chris Ford did have some striking comments:

You have passion and compassion - make the debate lively!

Practice versus Policy - policy doesn’t necessarily reflect practice

Speaking as someone who has “done drugs for 30 years”, Dr Ford is eminently aware of the role that harm reduction has with regards to the health of the public - not necessarily public health. Dr Ford did make, what I felt was an interesting comparison with her work in drugs - Support, not punish. Which led me to this note:

There is more harm in the war on drugs then in their use

The very same could be said for the “war” on tobacco. Dr Ford has spent her time working with the people who use drugs and she has learned a lot from the people who use them.

There had been plenty of talk, up to that point - some useful, some not so useful, then Dave Dorn (of all people) suggested that actual action was needed (unfortunately I won’t go into too much detail here, for now at least) and proposed an action as we broke for coffee/tea/drinks/vape which prompted lively discussion in the halls and corridors of the 3rd floor.

There will be more detailed notes of this session made available as I’ve likely missed some thanks to the discussion (no bad thing), but one thought to leave this post on, I thought I had which Dave agreed with:

One of the key resources is the community. The community is made up of people with a wide array of skills.

If you, dear reader, have a skill - doesn’t matter what it is, you can help.

Whew. I haven’t even gotten to the end of day one yet. The coverage (from my perspective) of GFN 2016 will carry over to a few more posts yet. Stay tuned for the next installment!