A tale of two epidemics: drugs harm reduction and tobacco harm reduction in the United Kingdom
Abstract
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.
Keywords
Acknowledgements
Declaration of interest: the author has strong personal views in favour of drugs and tobacco harm reduction. The author helped invent, disseminate, develop and evaluate drugs harm reduction from 1986 and has advised UK government departments, WHO, UNODC, World Bank and GFATM on harm reduction. As head of the International Harm Reduction Association the author’s task was to convince multi-lateral agencies of the public health and human rights case for harm reduction. In the author’s retirement he advocates for tobacco harm reduction. The author was a member of the NICE guidelines group on tobacco harm reduction, and is a member of the BSI and BSI/CEN standards group on e-cigarettes. The author helps run a website, a news service and an annual conference on nicotine. The author helped found and is the chair of the charity New Nicotine Alliance which represents the views of e-cigarette users. In 2012 a company of which the author is the director sought and received a small development grant from Nicoventures for testing the feasibility of the use of a licensed nicotine product in a disadvantaged population. A version of this paper was delivered at Guildhall, London 14 April 2014 at a meeting hosted by the London Drug and Alcohol Policy Forum www.youtube.com/watch?v=sCKXhOnO8aE
Citation
Stimson, G.V. (2016), "A tale of two epidemics: drugs harm reduction and tobacco harm reduction in the United Kingdom", Drugs and Alcohol Today, Vol. 16 No. 3, pp. 203-211. https://doi.org/10.1108/DAT-03-2016-0007
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited