Thursday 23 February 2017

A Night At The Pleasure Zone (part 1)

Last week I advised anyone able to do so that they should consider attending the IEA yesterday for Forest's Pleasure Zone event. I knew it was going to be an enjoyable evening - these things invariably are - but this one exceeded even my optimistic expectations.

I met up for drinks beforehand with good friends including the affable and always entertaining multi-culti mish-mash Afghan Dave, but there were so many excellent people there when we arrived that it would take a few hundred words to name check them all.

The evening was scheduled to feature a presentation by Neil McKegany on his Pleasure of Smoking report that was published around Christmas time (see my thoughts here) followed by a balloon debate on the best nicotine delivery device. I'm a big fan of balloon debates, which if you've never encountered one start with the premise that all contenders are in a rapidly-deflating hot air balloon, with passengers necessarily having to be ejected to leave just the one who has articulated the merits for remaining in the basket most eloquently.

I had been looking forward to the debate but thought - since I'd read the research and written about it - that Professor McKegany's presentation might be a trifle dry. I couldn't have been more wrong.

I actually bumped into him at the table where the wine was being served at the start of the evening and had a quick chat seeing as I'd seen him speaking at a City Health event in September last year. Apparently, that was about the time the research he was commissioned to conduct for Forest had been announced and I learned that he had received condemnation about embarking on it from academics - which you'd expect, of course - but also from some vapers, which was disappointing. He was refreshingly unfazed, though, saying that the people criticising were "unimportant" and that if he was receiving criticism he felt that he was doing a good job.

McKegany expanded on this during his presentation which, in my opinion anyway, was quite excellent.

Neil McKegany commenting on his survey research
I understand that the whole thing was filmed so if you get to see what he said, I'd highly recommend you do so. It was a very illuminating address in which he pointed out some of the interesting conclusions in his survey results, but also reflected philosophically on the tobacco control movement as a whole.

To give you a few examples, he began by explaining that he came from a background of talking about illegal drugs and how policies to reduce harm can be good for public health, but that he was very surprised once transferring that approach to legal drugs that there seemed to be an almost religious hegemony dictating matters. He noted that he was taken aback by the "stranglehold" 'public health' exerts over research in these areas and - harking back to what he'd told me at the drinks reception - said that he had been told by colleagues that studying why smokers smoke was "unacceptable".

Having come up against a mindset which had set itself to believe that smoking can never, ever, be pleasurable, he spoke of an "intellectual refusal" to ever consider such a concept. In his view, this was a two-way thing designed to come to only one conclusion amongst tobacco controllers. If you express a wish to quit, you are acting rationally and it's addiction which is stopping you; if, however, you like smoking and have no wish to quit, you are then acting irrationally and are not experiencing pleasure, merely addiction.

This pervasive way of looking at the subject matter had, in McKegany's view, perverted scientific and political discourse on the subject of tobacco and nicotine. To highlight this, he gave the example of how a British court (as reported by the FT here) has been hoodwinked into believing that there is a "causal" relationship between plain packaging and smoking, which is absolute nonsense.
The argument that plain packaging was ineffectual was largely dismissed by the UK appeal court judge, who noted that “research found that the designs and branding upon cigarette packaging and upon the tobacco products themselves exerted a causal effect upon consumer behaviour and encouraged smoking.”
There may be reason to believe there is an association (and that's heroic in itself based on the shit science - DP) but there is, McKegany rightly maintains, absolutely no way anyone can ever say it is even remotely causal. Yet a court, which is supposed to deal in cold hard evidence, has actually bought into anti-scientific tobacco control fantasy.

He also touched on the interesting revelation that, even amongst dedicated smokers, there was still a willingness to try harm reduced products like e-cigs. He said that the technology might not be there just yet to satisfy them, but expressed optimism that in time products might be available which replicate the smoking experience closely enough to tempt even the most ardent smoker away from combustion.

McKegany appears to me to be a rare thing in the academic community; someone who actually understands smokers and their motivation, as well as understanding vapers. The tobacco control industry doesn't understand either, which is a real problem. If you wish to solve what you see as a public health failure, it is first necessary to understand the people you are seeking to help. McKegany has proved that he really gets us, whereas ASH and their trouser-stuffing, policy-driven, evidence-manufacturing mates at the Department of Health, WHO and beyond simply don't (or don't want to). If it's about health, that should be their priority, but it's quite clearly not.

There was a lot to carry one's interest at this event and if I wrote about the extremely entertaining balloon debate now too it would send this article into essay territory, so I'll come back to that in part 2. Watch this space.


The presentation by Neil McKegany has now been posted on YouTube, do get yourself a brew or a scoop to last half an hour or so and have a watch.

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