Drug Abuse News Review

Items listed by date, starting with the most recent:

2000 - current

Cannabis-based drug on prescription (July 2003)
Cannabis - a major health hazard (July 2003)
Tobacco advertising banned (April 2003)
Cannabis 'worse' than tobacco (January 2003)
Tough new government drug policies (July 2002)
Cannabis to be decriminalised (January 2002)
Cannabis legalised in Canada (October 2001)
Cannabis ‘to be legal as pain killer in two years’ (January 2001)
Acupuncture for drug users (January 2001)

1997 - 1999

UK government plans to ban tobacco advertising by December (October 1999)
Heroin, cannabis and medicine (October 1999)
Internet drug prescriptions raise concern in US (October 1999)
Tobacco companies under fire (July 1999)
UK Government acts to curb smoking through NHS (July 1999)
Sniffer dogs hunt drugs in Manhester school (July 1999)
Tobacco Controversy continues (April 1999)
Smoking update (January 1999)
Smoking causes cancer in fetuses (January 1999)
Drug abuse and testing (January 1999)
Smoking update (October 1998)
Cannabis as Medicine? (July 1998)
More Pressure on the Tobacco Industry (July 1998)
Anti-smoking advances (April 1998)
Moves to legalise cannabis? (April 1998)
Tobacco controversy continues (January 1998)
Western Countries introduce smoking bans and restrict tobacco advertising (October 1997)

news index

drug abuse index

resource centre

July 2003

Cannabis-based drug on prescription

The first cannabis-based medicine is about to be made available to patients on the NHS. The Medicines Control Agency is expected to give the go ahead this summer to Savitex, a sublingual spray that helps to alleviate pain and muscle spasms.

Many of Britain's 85,000 multiple sclerosis sufferers could be among the first to receive the new drug as it is thought to reduce nerve pain and sleep disturbance. Studies have shown that it may help to ease the symptoms of several diseases and additional trials are currently assessing its value in treating the pain of cancer and spinal cord injury.

The cannabis-derived medicines do not contain the active psychotropic substance found in recreational cannabis, so patients taking the new drugs will not become intoxicated. The drugs will not be subject to the international treaties banning the production and sale of cannabis. (Daily Mail 2003; 14 April, Guardian 2003; 22 March)

Cannabis - a major health hazard

A leading toxicologist has warned that cannabis could be killing 30,000 people a year. John Henry, professor at Imperial College, London, reported that regular users have a fourfold increase in schizophrenia and major depressive illness.

The National Institute for Clinical Excellence (NICE) estimates that treatment of schizophrenia in England and Wales costs £1bn a year, accounting for three per cent of the total NHS bill. However, rates of schizophrenia have not risen dramatically in the past 50 years to correspond with increasing use of the drug. Professor Henry's figures are based upon regular cannabis use over a year and opponents have argued that normal use is likely to be much smaller.

The reclassification of cannabis from a category B drug to category C takes place this summer, following recommendations from the Police Federation. According to Professor Henry, the government has overlooked the burden this will place on the NHS by creating a dangerously permissive climate for its use.

The main active ingredient in cannabis - tetrahydrocannabinol (THC) - has a marked effect on the cardiovascular system. According to the British Lung Foundation, three joints may do as much damage as twenty cigarettes. Cannabis smokers inhale larger volumes and hold smoke down far longer, causing higher levels of chemicals to be retained. (Observer 2003; 6 April, Daily Mail 2003; 7 April, Daily Express 2003; 2 May, Guardian 2003; 2 May)

April 2003

Tobacco advertising banned

Legislation to ban tobacco advertising in the UK, which could save up to 3,000 lives a year, came into force on 14 February.

The new law was finally passed by Parliament in October 2002, after making slow progress since its initial introduction well over a year ago. The Tobacco Advertising and Promotion Bill bans press, billboard and internet advertising of tobacco products and will prohibit promotion through the distribution of freebies. There are also restrictions on the display and promotion of tobacco products in shops. Advertising through sponsorship of Formula One motor racing and other sporting events has been delayed until 2006.

At the international level the World Health Organisation (WHO) has agreed to the world’s first anti-smoking treaty, due to be adopted at their annual meeting in May. The treaty fell short of a complete ban after opposition from countries with big tobacco industries, most notably the US and Germany. The final wording agrees that warnings should take up a third of all adverts, countries should increase funding for anti-smoking programmes, and public health must take priority in conflicts between health measures and trade agreements. Countries may choose to enforce a complete ban, depending on their constitutional principles.

Smoking is an increasing problem in developing countries. About half of all global smoking-related deaths in 2000 were in the developing world. Officials recognise that tobacco is a drain on the poor and can contribute to malnutrition, yet these countries have been increasingly targeted by the tobacco industry in recent years. The World Bank and European Union has pledged to provide the financial aid that many of these countries will require if they are to put the WHO treaty into action.

Although poorer countries pushed hard for a stricter advertising ban, they remain pleased with the outcome. However, like all international treaties, it will only be as strong as the countries that sign it. (Reuters 2002;21 October, bbc.co.uk 2003;14 February, 1 March)

January 2003

Cannabis 'worse' than tobacco

A report from the British Lung Foundation has shown that the tar from cannabis cigarettes contains 50% more carcinogens than that from tobacco, and smoking three cannabis joints a day causes as much damage as smoking 20 cigarettes.

This may be partly due to the increase in inhalation volume when smoking cannabis - smokers inhale deeper and wait for longer before exhaling, increasing the amount of carbon monoxide and tar entering the lungs.

The report also shows that the health dangers of cannabis have increased since the sixties, due to higher amounts of delta-9 tetrahydrocannabinol (THC) in the cannabis consumed today. This means that previous clinical studies may underestimate its damaging effects. THC is the active chemical in cannabis that affects specific nerve receptors associated with pleasure, memory, thought, concentration, sensory and time perception, and co-ordinated movement.

Other evidence suggests that many people have misconceptions about cannabis smoke. A 2002 survey showed that 79% of children believed cannabis is 'safe', whilst only 2% correctly understood that there are health risks associated with smoking the drug. Similarly, many smokers choose cannabis over tobacco, thinking that it is safer for them. (bbc.co.uk 2002;11 November)

July 2002

Tough new Government drugs policies

Most illegal drugs cause no harm to users, according to a Commons committee report. Currently around four million people are involved with drugs each year. However, the report says that a hard core of around 250,000 users are dependent on cocaine or heroin and are often involved with crime.

The report also claims that the efforts of police and customs officers have had little effect on the availability of illegal drugs. It is believed that the need for addicts to buy drugs is behind one third of all property crimes.

In the first major parliamentary study of drug use in Britain, the Government rejects the legalisation of drugs. It concedes that there is some weight behind arguments for legalisation but does not support such a ‘drastic step’ at this time. It does however advocate the downregulation of both Ecstasy and Cannabis from class A to class B and from class B to class C respectively. Other key points include the introduction of safe injecting centres for heroin users and the prescribing of heroin to addicts. Teaching about drug misuse would also become a key part of doctor’s training.

On the same day the report was released, education secretary Estelle Morris recommended that every secondary school receive a copy of Rachel’s Story, a video depicting the life and graphic death of a heroin addict. The film includes pictures of the body of 21 year old Rachel Whitear, who died following a heroin overdose in a bedsit in Devon. It is aimed at warning teenagers of the dangers of drugs.

Other new measures to combat drug abuse amongst young people, include automatic expulsion for children caught dealing in drugs at school, with no chance of a reprieve, whilst drug dealers who deliberately target children and tout at school gates will face the prospect of longer jail sentences.(Guardian 2002; 21 May, Times 2002; 22 May)

January 2002

Cannabis to be decriminalised

In the biggest shake up of British drugs policy in recent years, the Home Secretary has revealed plans to reclassify Cannabis from Class B to Class C, placing it in the same category as antidepressants and steroids.
He said the reclassification was necessary if the government's drug policy was to be taken seriously by young people.

Although David Blunkett was adamant that that his proposal was not the same as decriminalising the drug, cannabis campaigners believe that, in practice, users of the drug will no longer face prosecution.

Mr Blunkett also said that subject to the outcome of clinical trials to be completed in 2003 he would recommend the legal use of cannabis-based drugs (carrabinoids) for medicinal reasons. He also announced plans to make heroin more widely available on prescription where doctors considered it to be appropriate. (Independent 2001; 24 October)

October 2001

Cannabis legalised in Canada

Canada has become the first country to legalise the growth and use of cannabis for medicinal purposes. The new regulations passed at the end of July will allow three groups of patients to benefit. The first is patients with terminal illness and a life expectancy of less than twelve months. The second is chronic illnesses such as multiple sclerosis, cancer, HIV or AIDS, severe arthritis, and epilepsy. The last group are those who have obtained two medical opinions declaring that cannabis would be beneficial. The patient applies for permission to use cannabis by completing a form that must also be signed by their doctor. If approved, the doctor must also set the dose.

The government was keen to clarify that it was not supporting the widespread use of cannabis and would not be providing it. The Canadian Medical Association, however, said it did not support the move, pointing out the 'lack of adequate scientific support.' Peter Barrett, president of the association, said that, 'most physicians were reluctant to participate in the government's programme because they worry about recommending a drug that has not been subjected to rigorous testing and whose full side effects, interactions with other drugs and correct dosages are not known.' (BMJ 2001;323:68,14 July; BMJ 2001;323:302,11 August)

January 2001

Cannabis ‘to be legal as pain killer in two years’

Cannabis will be legalised for medical use within two years because clinical trials of the drug have show that it has few side effects, the chief scientist of the Royal Pharmaceutical Society believes. Professor Tony Moffat says his view is based on a number of small trials already done, showing that cannabinoids are very potent compounds for relaxing muscles, and the anecdotal evidence from MS sufferers who smoke cannabis and say it is ‘absolutely wonderful’. It is believed that its main uses will be for relaxing muscles in the treatment of MS, and as a painkiller. However, he stated, medicinal cannabis would not give people a drug induced ‘high’, and would not take the form of a cigarette with its attendant health risks. Research shows that swallowing the drug was not effective as 90 per cent of it was broken down by the liver before having much effect. But a mouth spray or even a suppository would deliver 50 per cent of the drug into the user’s system. (Telegraph 2000; 15 October)

Acupuncture for drug users

The NHS has come under renewed pressure to abandon its perceived antagonism towards alternative medicine following two studies which suggest that both that heroin and cocaine addicts could be successfully treated with acupuncture.

Janine Scofield of Sheffield’s Rockingham Project, where the research into acupuncture and cocaine was carried out, said: ‘This works not just to help people come off drugs, but also in preventing them from relapsing. The cost is tiny in comparison with drug rehabilitation.’ The average cost of residential rehabilitation for hard drug users is £350 a week. The cost of each acupuncture session is estimated to be less than £10. Sessions last 45 minutes and end with a cup of herbal tea.

Acupuncture came to Europe 400 years ago but there have been numerous problems obtaining funding. It has been dismissed as a health intervention on the grounds that it is not conventional. However, a British Medical Association report published earlier this year said that the NHS should provide it. Vivienne Nathanson, BMA head of policy, said ‘It is mainstream complementary medicine’. (Guardian 2000; 20 August, Times 2000; 15 August)

October 1999

UK government plans to ban tobacco advertising by December

The Government has drawn up drafts of legislation to ban tobacco advertising in Britain by 10 December of this year. Most tobacco sponsorship would be ended by July 2003, although, as expected, a three or six-year exemption is to be granted to wean global events, such as Formula 1 motor racing and snooker, from their dependence on tobacco revenue. The Government is determined to prevent tobacco manufacturers getting round the ban by 'brand stretching' their products and promoting other goods such as clothing, footwear and coffee houses. ASH, the anti-smoking lobby, joined the BMA in calling for vigilance against any tobacco companies ready to use 'every possible trick' to preserve advertising by other means. The aim of the legislation is to protect children from tobacco which kills 120,000 Britons every year (Telegraph 1999; 18 June, Guardian 1999; 18 June).

Smoking amongst teenagers is showing no signs of decreasing. About eight million Californian teenagers experimented with smoking between 1988 and 1998 because of the encouragement of tobacco advertisements. Cancer prevention experts have estimated that the tobacco companies' campaigns in that period will generate about three million new smokers in the state, over 800,000 of whom will eventually die from their habit (BMJ 1999;318:1708, 19 June).

A WHO report released in June shows that the health of half the world's children is endangered by passive smoking. 700 million children breathe air polluted by tobacco smoke and experience numerous health problems as a result. 70% of children who have two smoking parents have a higher incidence of many medical problems. If one parent smokes, they are 30% more likely to have those medical conditions than are the children of non-smokers, and their cot-death rate is five times higher (Guardian 1999; 17 June).

Australia has managed to reduce its smoking rate to its lowest level since records began. 22% of the adult population now smoke, compared to 25% in the early 1990's. The decline is believed to be due to 'scare campaigns' where TV viewers see the results of smoking inside the body of a smoker. Evidence has emerged that the advertisements had a powerful effect on teenagers and similar campaigns are now being run world-wide (BMJ 1999;318:1508, 5 June).

Heroin, cannabis and medicine

The Sisters of Charity who run one of Sydney's inner city hospitals are beginning an 18-month trial of the country's first legal and medically supervised heroin injecting room. An estimated 50,000 visits a year by drug users are expected at the centre, which will be staffed by a medical supervisor, a registered nurse, and security staff. The controversial plan will include the provision of clean needles and syringes; users must supply their own drugs. They will be encouraged to seek counselling and treatment for their habit. Such an approach would also help control the spread of HIV amongst intravenous drug users (BMJ 1999;319:400, 14 August).

The UK Committee on Safety of Medicines has banned the Chinese herb Aristolochia after two people developed kidney failure after using it by mistake. The herb is used to treat eczema, urinary problems, swelling and rheumatic conditions (Telegraph 1999; 29 July).

The first clinical trial of cannabis began in July. Patients suffering from conditions such as multiple sclerosis, neuralgia and glaucoma are taking the drug through an inhaler similar to those used by asthma sufferers. Cannabis provides pain relief in small quantities when it is heated, and the dosage is being carefully controlled so no side-effects are experienced (Telegraph 1999; 13 June).

The BMA's Scottish committee for public health has renewed calls for the legalisation of cannabis for medicinal and recreational purposes, claiming that it is no more dangerous than alcohol or cigarettes (Telegraph 1999; 21 June).

Internet drug prescriptions raise concern in US

The American Medical Association has issued a report on the practice of prescribing drugs via the Internet and has declared that relying solely on a patient-completed on-line questionnaire falls well below a minimum standard of medical care. At least 400 'instant-prescription' websites exist, and the terms used in the questionnaires are often beyond the technical comprehension of a lay person. No mechanism exists to ensure that the questions have been answered correctly or to confirm the history by physical examination (BMJ 1999;319:213, 24 July).

July 1999

Tobacco companies under fire

Tobacco company Philip Morris, which makes Marlboro cigarettes, has just lost two major lawsuits by smokers, who have been awarded œ30 million and œ50 million in damages. This follows disclosures of documents which show that tobacco companies have lied for decades about the hazards and addictiveness of smoking and have deliberately targeted young people (BMJ 1999;318:1086,17 April, BMJ 1999;318:481,20 February).

Tobacco companies have also tried to disrupt the sale of nicotine replacement products in different parts of the world (BMJ 1999;318:1026,17 April).

UK Government acts to curb smoking through NHS

The UK Government has launched the first concerted attempt to make smoking cessation a core function of the NHS. Health authorities and primary care groups must now plan and develop a service to help smokers to quit, some with free nicotine patches. £60 million has been made available for this initiative over the next three years. (BMJ 1999;318:1096, 24 April)

Sniffer dogs hunt drugs in Manchester School

A high school in Manchester has carried out the first random search for drugs by sniffer dogs, with the result that two boys were suspended. The dog searches are being complemented by education classes for pupils. There is controversy about whether this infringes pupils' rights and many groups believe that this approach is not the answer to the drug problem in Britain's schoolchildren (Daily Telegraph 1999; 20 April).

April 1999

Tobacco Controversy continues

The American Medical Association has produced a report recommending that the nicotine in cigarettes should be reduced to non-addictive levels within ten years, and access to smoking cessation treatment should be improved. Seven health organisations in the UK have called for an overhaul of current testing and regulating of tar, nicotine and addictive agents in cigarettes. According to the director of ASH (Action on Smoking and Health), most tobacco companies still claim that nicotine is important for taste and is not addictive.

The BMA, ASH and the World Development Movement have urged the British Prime Minister Tony Blair to implement tough international controls on tobacco marketing on order to put an end to the companies’ aggressive tactics of targeting women and children in the developing world (BMJ 1998;317:1271, 7 November).

The Government’s White Paper, Smoking Kills, set out the new £100 million package aimed to reduce smoking in Britain. There are 20 initiatives to cut the number of smokers by 1.5 million over the next ten years.

From April, doctors in certain pilot areas will be encouraged to refer patients keen to give up smoking to new ‘cessation’ clinics, where they will receive specialist counselling. Also, a week’s supply of free nicotine patches will be given to smokers who are least able to afford them. The makers of the Nicotinell patches claim that three times as many people give up with the patches than by willpower alone. However, a course of twelve weeks is recommended and there is no evidence that patches are more successful than any other method in keeping smokers free of the habit in the long-term. The proposals have been clouded by allegations that the manufacturer of the nicotine patches spent £10,000 sponsoring the Labour Party conference in 1997.

The Government does not propose to ban smoking in public places or at work. However, a voluntary proof of age card for young people may be implemented. Shops will also be encouraged not to advertise cigarettes, and to site their vending machines in such a way as to reduce their use by children. Criminal sanctions against retailers who persistently sell cigarettes to underage children are being considered.

The Health Secretary has also announced a new £50 million advertising campaign directed at the young, warning them of the dangers of smoking. The ban on tobacco advertising on billboards and the media is being brought forwards to this summer (BMJ 1998;317:1405, 21 November).

The Australian spin-bowler, Shane Warne, has agreed to be paid £76,900 if he gives up smoking using Nicorette, a nicotine replacement treatment that has at least double the effectiveness of placebo gums and patches. This has provoked widespread media debate about the ethics of this arrangement. However, most people in the public health community are delighted that such a prominent person has agreed to be associated with giving up smoking. They believe this will have far more of an effect on young people than the extremely healthy role models used in past campaigns (BMJ 1999;318:9, 2 January).

Cigarette use has risen in universities in the US. Substantial numbers of students are both starting to smoke and trying to stop, according to a study examining changes in smoking rates among 29,000 students at 116 universities, reported in JAMA. Between 1993 and 1997, the prevalence of smoking rose by 28%, and more than a quarter of the smokers had begun smoking regularly at university (BMJ 1998;317:1405, 21 November).

January 1999

Smoking update

The British Medical Association’s Annual Festival of Science has been told that tobacco use will kill four million people in the year 2000, and ten million in the year 2030. Tobacco is still the biggest killer in Britain, and many teenage girls are taking up smoking to control their weight. Normal body changes at menarche are perceived as fatness and smoking helps them to lose the ‘extra weight’.

In the USA, it has been ruled that the Food and Drug Agency does not have the power to regulate cigarettes or smokeless tobacco. This is a big blow to those who saw the regulation as a way of reforming the industry.

A government minister in South Africa has proposed a bill introducing tough anti-smoking legislation, despite strong opposition from the tobacco companies. The bill would greatly reduce tobacco advertising, in effect ending sporting event sponsorship, and would ban smoking in public places and at work.[The Telegraph 1998;8 September, BMJ 1998;317:366, 490, 698]

Smoking causes Cancer in Fetuses

Recent research has found that one of the strongest carcinogens in tobacco smoke is passed on to the developing fetuses of pregnant women who smoke. The carcinogen (NNK) is taken up and processed by the fetus and has been found in alarming quantities postnatally. Hopefully these findings will encourage more women to give up smoking, as currently 60% do not give up during pregnancy.

Furthermore, maternal exposure to passive smoke is sufficient to induce deleterious genetic deletion mutations in the developing fetus. These mutations are potentially carcinogenic. (BMJ 1998;317:555, 903)

Drug Abuse and Testing

Four-fifths of a sample of secondary schoolchildren were found to be drinking regularly by the age of 16, according to a report in the journal Addiction.25 Alcohol is a gateway to other substance abuse, and a report from the Home Office Police Research Group shows that British teenagers are taking heroin in increasing numbers, especially in smaller towns.26 More than 100 leading schools have introduced random drug testing, as 25% of GCSE pupils have tried illegal drugs, and 10% take them regularly. A Blue Peter presenter was recently sacked for taking cocaine.

Over a quarter of junior house officers take cannabis and two thirds of the 93% who drink exceed safe limits. 21% of men and 45% of women house officers may be suffering pathological anxiety, leading to the misuses. (The Telegraph 1998;19 October,
Lancet 1998;352:785-6;5 September)

October 1998

Smoking update

The US Senate Republicans have killed a bill aiming to deter young smokers because it was too costly; they hope to produce a cheaper version.[10] The bill intended to raise the price of cigarettes, establish regulations on advertising and penalise tobacco companies for every year the rate of smoking among young people did not decline.

An American study has shown that 54% of the 10-13 year olds studied had tried smoking, with a substantial number continuing to smoke. Parental and peer smoking were the strongest influences; many children were not properly supervised by their parents and had easy access to cigarettes.

The UK pressure group ASH (Action on Smoking and Health) has shown that tobacco companies were aware of the link between smoking and cancer since the 1950s. They have also known of tobacco's addictive nature since the 1960s. Since 1975, the companies have been targeting young people, the cigarette smokers of the future. They have been taking advantage of teenagers' 'fragile developing self-image, which needs all the support and encouragement it can get'.

British doctors are fighting for a ban on smoking in all public places, saying that passive smoking increases the risk of lung cancer by 20-30%.

Three quarters of articles denying a risk due to passive smoking have been written by authors affiliated to the tobacco industry, casting doubt on the validity of their conclusions. (Lancet 1998;351:1943;27 June, BMJ 1998;316:1840,1923, Lancet 1998;352:205;18 July, BMA News Review 1998;11 July)

July 1998

Cannabis as Medicine?

British doctors have been unable to prescribe cannabis since 1971 under the Misuse of Drugs Act, but now a working party on the therapeutic uses of cannabinoids is being set up by the Royal Pharmaceutical Society of Great Britain.

This move follows last year's BMA Report Therapeutic Uses of Cannabis, which concluded that, while cannabis is unsuitable for medicinal use, cannabinoids should be considered. In a written submission to the House of Lords Science and Technology Committee inquiry into cannabis, the BMA further said that individual cannabinoids have a therapeutic potential in several medical conditions in which present drugs are not fully adequate. Submissions to the inquiry closed on 12 May.

Only a few of the 60 known cannabinoids have been so far studied. The strongest evidence relates to the effectiveness of d-9-tetrahydro-cannabinol and the synthetic cannabinoid nabilone in relieving nausea and vomiting secondary to cancer chemotherapy. Anecdotal reports and animal studies suggest that cannabis derivatives may also have application as muscle relaxants, analgesics, anti-inflammatories, anticonvulsants and bronchodilators, but the results of controlled trials in humans are still awaited. (BMJ 1998;316:1335;2 May, BMJ 1998;316:802;14 March, BMJ 1998;316:1033-4;4 April)

More Pressure on the Tobacco Industry

Almost 75% of respondents in a British Market Research Bureau survey of 2757 smokers believe that the tobacco industry should fund specialist smoking clinics, and one in three think that the industry should be made liable for smoking related illness. The tobacco industry makes £800 million profits each year but the government and health authorities spend only £22 million in helping smokers quit. 30% of the smokers believed doctors to be the greatest influence in helping them to stop and BMA Council Chairman Sandy Macara has labelled the tobacco industry 'public enemy number one'.

Last year the American tobacco industry agreed restrictions including a payment of $368.5billion in instalments over the next 25 years in return for a limit of $5billion annual compensation claims and future immunity from future class action lawsuits. However, they recently pulled out of the deal when the Senate commerce committee drafted a bill with revised figures of $600billion and $6.5billion respectively. The industry ran adverts in national newspapers claiming: 'We agreed to change the way we do business...not to go out of business'. President Clinton has vowed to push ahead with or without the co-operation of the companies.

Meanwhile, a huge number of confidential tobacco industry documents have come into the public domain after a US Supreme Court ruling. Apparently they show that the industry 'was aware of the addictive or habit forming nature of nicotine, experimented with 'dosages' of nicotine, and did not reveal to consumers the extent of their knowledge'. (BMJ 1998;316:802; 14 March, BMA News Review 1998;March:13, BMJ 1998;316:1185-6;18 April)

April 1998

Anti-smoking advances

European Union health ministers have decided that all tobacco advertising will be scaled down from 2001 and banned completely by 2006. The WHO has confirmed that smoking is the single greatest cause of preventable disease and death. In the EU alone, 91% of lung cancers in men are caused by tobacco smoke and over 500,000 deaths annually are related to tobacco.

Passive smoking kills 22,000 people in the EU, according to an authoritative study funded by the European Commission. Passive Smoking, The Health Impact suggests that each year 2,000 die from lung cancer and 20,000 from cardiovascular disease.

Fifty British lung cancer patients are to go ahead with test cases for compensation against tobacco companies after an appeal court ruling. A leaked internal memo from British American Tobacco (BAT) allegedly shows that Britain's biggest tobacco company knew 20 years ago that the sale of their products depended on their addictiveness, a fact never admitted publicly by the industry. (BMJ 1997;315:1559; 13 December, BMJ 1998;316:9; 3 January, BMJ 1998;316:571; 21 February)

Moves to legalise cannabis?

The BMA has called for a change in licensing laws to allow controlled trials on cannabinoids. The report Therapeutic Uses of Cannabis recommends research on their use as antiemetic agents and in managing spasticity. Trials could point out possible therapeutic advantages in the management of chronic pain, epilepsy, stroke, immunocompromised states and glaucoma.[6]

Meanwhile, the House of Lords' Science and Technology Committee is conducting an inquiry into the wider issue of the legalisation of cannabis. Its report is expected in the autumn. (BMJ 1997;315:1329;22 November, BMJ 1998;316:572; 21 February)

January 1998

Tobacco controversy continues

The Cancer Research Campaign has decided to cease supporting research bodies that receive funds from the tobacco industry. The announcement follows British American Tobacco's offer last year to provide £1.5m to fund a chair of international relations at Cambridge University.

Latest figures from the Office for National Statistics show that in 1996 in England 15% of girls and 11% of boys aged 11-15 smoked. In the UK 40% of smokers begin before they are 16 and virtually no-one over the age of 21 takes it up.

Already tobacco prematurely kills an estimated three million people world wide each year. This will rise to 8.4 million deaths annually by 2020. Delegates at the 10th world conference on 'tobacco or health' in Beijing in August were told that the ever rising number of deaths from tobacco will shift markedly from the developed to the developing world over the next three decades.

Japanese tobacco companies are to introduce a voluntary ban on advertising on radio, television, cinema and the internet from April 1998.

Increasing legislation on cigarette advertising in the USA and Western Europe has meant that tobacco companies have shifted their sights to sub-Saharan Africa. Its population of 850 million and limited regulatory measures make it an ideal target. In Kenya and Tanzania, rival companies are already vying for a bigger share of the market with aggressive advertising and sponsoring of events. Smoking has risen in the region, partly due to advertising and the availability of cheap brands. Farmers are tempted to become involved: tobacco fetches more than other cash crops. A WHO consultant said, 'Very soon a new global ash-tray will be in the tobacco-growing areas of Africa'.(BMJ 1996;314:186, BMJ 1997;315:439, 440, 900, 967, Student BMJ 1997;5:360, Lancet 1997;350:792)

October 1997

Western Countries introduce smoking bans and restrict tobacco advertising

The US Food and Drug Administration (FDA) has upheld its decision to control tobacco sales and advertising due to a scientific consensus on the addictive and other properties of nicotine. President Clinton has declared a smoking ban in all US federal buildings. Heavy restrictions on tobacco advertising have been introduced in Belgium and Hong Kong and are being planned also in the UK. Romania, where 45% of men smoke, plans tough anti-smoking laws whilst Israel plans to be the first country outside the US to sue tobacco companies. In the 50-year history of the state, more Israelis have died from smoking-related illness than from terrorism, road accidents and five wars combined.

However, smoking bans in the West are leading tobacco firms to target the East aggressively. In the Philippines, 75% of adults smoke. A recently-leaked memo shows that tobacco companies have heavily funded amenable scientists to carry out biased research into the effects of passive smoking. Huge fines on tobacco companies will in fact be paid over 25 years by raising the price of cigarettes. It seems that the huge revenues which governments receive from the tobacco industry make them less than enthusiastic to crack down on smoking. (Lancet 1997; 349:1305, BMJ 1997; 315:8, 209, 384, BMJ 1997; 314:169, 1502, 1506, 1569, 1711, New Scientist 1997; 2092:3)