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The spat over the merits of ecigarettes intensified this week as UK MPs urged the government to promote their use while academics urged caution and US authorities prepared for a clampdown. 

At the heart of the debate is whether the benefit of vaping in weaning adults away from smoking outweighs the risk to young people who might otherwise not use a nicotine product.

Westminster’s Science and Technology Committee said the devices were a “useful tool in the NHS anti-smoking arsenal”. “Concerns that ecigarettes could be a gateway to conventional smoking, including for young non-smokers, have not materialised,” it added.

Some maintain, however, that the UK — and England in particular — is out of step with international opinion. A study in Thorax journal warned against “the widely-held opinion that ecigarettes are safe” and said they could make lungs vulnerable to infection.

In the US, the rapid rise of Juul, the San Francisco-based vaping start-up that has just launched in the UK, has spooked regulators who are launching a prevention campaign targeting 10m youths who vape or are open to trying it.

"We are very concerned that we could be addicting a whole generation of young people," said FDA chief Scott Gottlieb. "We only have a narrow window of opportunity to address it."

Listen to our podcast on Juul and the health effects of ecigarettes.

Three questions

Paolo Bonanni, professor of public health at the University of Florence, and a critic of the Italian government’s efforts to overturn legislation making vaccination mandatory.

Why was a law introduced in 2017 making vaccination compulsory?

Vaccination was mandatory in Italy for much of the 20th century, with a fine and even temporary removal of parental authority until the 1980s for those who did not comply. At the start of the new millennium, public health experts thought recommendations would be sufficient. But by 2016, it was clear the role of new media had changed the landscape with a five per cent decrease of MMR coverage nationally to 85 per cent in just two years, presenting a danger to the protection of the population.

What drove the rise in ‘vaccine hesitancy’?

A small minority of parents and “alternative” doctors started to instil doubts on the benefit/risk profile of vaccination through a well-organised communication strategy with moving stories of children with real health problems but with unproven or, more often, clearly false causal association with vaccination. It was fuelled by mainstream media misinterpreting the idea of “balanced information” by giving equal time to the solid evidence in favour of vaccination by scientists and opponents with unproven allegations of serious side effects.

What needs to be done now?

Scientific and medical organisations are fighting back with evidence and creating websites like The mood of the population has changed in the last three years with the formerly ‘”silent majority” of vaccination advocates very vocal. A public petition of mothers of immuno-suppressed children has gained 200,000 signatures. We must pursue these initiatives, and stress that the government’s idea of “flexible compulsion” puts the health of the most fragile children in danger. Compulsory vaccination, like fastening seat belts or prohibiting smoking in public spaces, can easily become a “social norm” if we ask parents to behave fairly for the community.


Drug deaths US overdose deaths jumped 10 per cent in 2016 to hit a record 72,000 — higher than yearly peak figures for HIV, car crashes or gun deaths, according to provisional figures. Analysts say more Americans are using opioids and the drugs are becoming more deadly. (NYT)

News round-up

Monsanto found guilty A jury ruled that weedkillers made by Monsanto caused terminal cancer, in the first case concerning the chemical glyphosate to go to trial. The seeds and chemicals group was recently bought by Bayer, the German life sciences company. PR experts were already concerned about the acquisition. A legal battle over cancer means the reality may be worse than they feared. (FT)

China vaccine scandal The drug safety scandal in China deepened with top officials sacked and healthcare stocks plummeting. The government ordered the seizure of “illegal gains” by Changchun Changsheng Bio-technology, accused in July of making substandard vaccines for children. (South China Morning Post)

Nanomedicine and TB Advances in nanotechnology — the creation of structures thousands of times smaller than the diameter of a human hair — are enabling scientists to deliver TB drugs to infected sites in the human body. (The Conversation) 

BMA Brexit blast A “no-deal” Brexit would be “catastrophic” for patients and the NHS, disrupt the supply of medical isotopes and weaken the response to pandemics, the British Medical Association warned. Campaigners said the European Medicines Agency would also be seriously affected. (FT, BMA)

Medical data Tech giants including Google and Microsoft pledged to make health data more accessible in the US. Much of this information is spread across several databases and can be hard to access for patients and healthcare providers alike. A former UK minister said the NHS “owes it to society to make money from patients' information”. (The Hill, Times)

Bulging Buddhist monks Well-meaning religious offerings of sugary drinks and fatty foods are helping create an obesity epidemic among monks in Thailand. Nearly half are obese, more than 40 per cent have high cholesterol, nearly 25 per cent have high blood pressure and one in 10 are diabetic. (NYT)

Digital contraception US regulators cleared the first fertility app to prevent pregnancy. The FDA said the failure rate of the app — which works by logging temperatures to check when women ovulate — was 6.5 per cent — much lower than the 24 per cent of the traditional fertility awareness or “rhythm” method. (Stat)

The Human Cell Atlas An international project is documenting every type of cell in the human body and how they interact. The atlas may take 10 years to complete but could offer valuable help in treating diseases from asthma to cancer. (NPR)

Wearable scanners Conventional magnetoencephalography (MEG) scanners are bulky because they require cryogenic cooling, but new lightweight ”quantum sensors” work at room temperature and can be mounted on headgear. The devices will allow researchers to investigate how the brain functions — including how individuals interact and make decisions. (FT)

'Snapchat dysmorphia' A new wave of plastic surgery is being driven by people altering their faces to look more like their heavily-edited social media photos. (Vox)

Grounds for concern? Californian officials are attempting to overturn a requirement for mandatory cancer warnings on cups of coffee. A court had ruled that the presence of acrylamide, a chemical linked to cancer risk, must be made clear to drinkers. (NYT) 

Health and hoppiness Looking forward to that weekend pint? Beer — like coffee — has been the subject of many good-for-you/bad-for-you newspaper stories but what does the evidence actually say? And is drink really “the secret to humanity’s success?” (The Conversation, FT)

Best from the journals

Adolescent health Adolescent health accounted for just 1.6 per cent of total global development assistance from 2003-2015. HIV and Aids took the biggest share while common adolescent problems such as anaemia, mental disorders and road traffic injuries were largely ignored. (Jama)

Life expectancy Another life expectancy study, this time for 19 OECD countries, underlined the damaging effect of the US opioid epidemic. Women whose mothers live to at least 90 are more likely to also live to 90, free of serious diseases and disabilities, according to another report. (BMJ, Age and Ageing)

Malaria nets Trials in Burkina Faso of a new type of malaria net have produced promising results. The nets combine a traditional pyrethroid insecticide with a chemical that shortens mosquitoes' lives and affects their ability to reproduce. Read more on malaria nets in our special report here. (The Lancet, FT)

Google eyes AI trials DeepMind, Google's artificial intelligence business, is planning clinical trials of technology to help diagnose eye diseases after promising results from tests at London's Moorfield's hospital. (Nature Medicine)

Genetic screening A new genetic test could identify individuals at high risk of developing heart disease, breast cancer and other common conditions well before any symptoms are evident. Scientists hope to eventually give people a risk score from birth. (Nature)

How gene hunting changed science A study shows how work on the Human Genome Project acted as a catalyst in bringing together different scientific disciplines in pursuit of a common goal. The graphic shows collaboration (black dots) between biology (green) and computing (magenta) and how small groups working in isolation became a massive, interconnected network. (Science Advances)

Podcast of the week

Ebola and beyond Dr Vanessa Kerry of Seed Global Health discusses the Ebola outbreak in the Democratic Republic of Congo and the challenge of strengthening health systems in poorer countries. (Global Dispatches, 30m

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Final thought

Healthcare ‘gaslighting’ Women have long suffered from doctors downplaying their medical problems — including receiving less pain relief than men. Is media attention finally helping them get the attention they deserve? (The Atlantic)

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