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Thursday 23 April 2009 – DAY FOUR –
Daily Update
– 5
The ‘war on tobacco’ was impeding any effective tobacco harm
reduction policies
, Paul Bergen of The University of Alberta told delegates at
the
Tobacco use and harm reduction
session. ‘The single best way of reducing
risk is communication,’ he said. ‘But the only message that seems to be
getting through is “quit or die”.’
This ‘politically motivated war’ had meant that tobacco had come to be
defined as outsider behaviour he said. ‘The wars on drugs, tobacco and
obesity envisage worlds without these things – those worlds have never
existed.’ Groups arguing that all tobacco products should be banned meant it
was likely people could remain smokers instead of switching to safer products,
he said. ‘There is a righteous sense of quest in this “war” that classes any
opposition as heretical. It’s a campaign of demonisation that cuts off access to
healthier products.’
Among these products was snus – a tobacco product placed under the lip
– said Lisa Cockburn of the same organisation. There had been a long tradition
of snus use in Sweden, she said – many people had switched to it, and
smoking prevalence was now lower among men than among women as a
result. ‘This creates a natural experiment, with the women serving as a control’
she said.
Overall cancer rates – and death rates for most smoking related diseases –
were now lower in Sweden than in the rest of the EU for males, while for
females they remained the same. ‘If other countries had Sweden’s tobacco use
patterns we could expect similar reductions in risk.’
‘War on tobacco’
damages harmreduction
Is drug use a cause or effect of sexual behaviour?
asked researcher
Garrett Paul Prestage in the
Illicit drug use, intensive sex partying and risk
session. Levels of drug use among gay men in Australia were much higher
than in the general population, he said – research showed that men who
engaged in unprotected anal sex and group sex were more likely to use
drugs in general, not just to enhance sexual pleasure.
Drug use patterns in this community were in a continual state of flux, said
Angela Matheson of ACON in Sydney. ‘GHB, crystal meth and Viagra have
all gained popularity in recent years, and there’s a lack of relevant
information.’
The association between drug use and whether men chose to use a
condom was not necessarily causal, however, said Prestage. Nevertheless,
for some gay men drug use was problematic and likely to be a risk factor,
while the normative nature of drug use in gay communities meant that young
gay men were more likely to start using drugs in the first place.
Defining populations was problematic, said ACON’s Ben Bavinton. ‘Men
move in and out of different subcultures at different times, and many overlap.’
There were also difficulties in engagement with HIV awareness messages
and condom-focused HIV prevention, because of a wariness of the ‘fun
police’, while another challenge was the lack of clear goals and objectives in
much health promotion. There was a need to look outside traditional
methods of posters and forums, he said. ‘Some of it won’t even look like
traditional health promotion.’
Sex partying and the ‘fun police’
‘The Commission on Narcotic Drugs operates in a parallel
universe to the rest of the UNwhen it comes to harm reduc-
tion. There has been a decade or more of neglect of health
issues from the CND and we are set for a further decade.’
Gerry Stimson
‘Our movement truly has some heroes throughout the
world.’
Michel Kazatchkine
‘Advocacy for harm reduction has developed along a tunnel
vision of Aids control – there is minimal involvement of
people who use drugs. Harm reduction is now on a sticky
wicket.’
Tripti Tandon
‘Young people are being denied services. They’re being told
to wait until they’re older, sicker, more worse off.’
Caitlin Padgett
‘Punitive policies have led some criminal justice systems to
the point of collapse.’
Manfred Nowak
‘Traditionally public health and the drinks industry don’t
talk to each other. But the drinks industry has children and
the drinks industry drives on the road.’
Ian Newman
‘Simple and low cost interventions work.’
Andrea Fischer
‘There is a lost generation in Indonesia because of drugs.’
Dr Laode Ida
‘There is no port of exit in Afghanistan so a lot of heroin
comes through Pakistan. Because of that there are around
500,000 drug dependent people in my country.’
Dr Donya Aziz
'We get called smackocrats'
Jenny Kelsall
(on people's reaction to their service user group
being office based).
'Drug users need to be supported and mentored to fight for
their lives.'
Delegate
'We need to recognise the important role of activism.'
Dr Anindya Chatterjee
'We are not going to be able to tackle human rights unless
we tackle criminalisation.'
Anand Grover
'The epidemic goes wider than HIV – it's about abusing
human rights, of using the criminal justice system and
calling it treatment.'
Dr Chris Ford
'We should agree on a language to call these [compulsory
rehab] centres concentration camps.'
Delegate
'Broader engagement can't be left to technical experts
because that doesn't work.'
Delegate
Conference quotes