Critique – Fags ‘n’ hash – a wasted opportunity.

Professor Neil McKeganey who was the subject of last weeks blog has been having another prohibitionist rant, this time about a leaflet published by NHS Health Scotland called “Fags ‘n’ hash”, about cannabis and tobacco. – see it here (pdf)

Prof Neil McKeganey

Prof Neil McKeganey (picture: Scottish Sun)

Neil was quoted in the  Scottish Sun “news” paper today in an item headed “Fury over guide to cannabis” – it is funny how prohibition supporters are always “furious” or “outraged” by such things, but that’s just the way they are.

Prof Neil McKeganey, of Glasgow’s University’s Centre for Drug Misuse, said: “The leaflet conveys a far too positive image of cannabis.”

And he was backed up by  Tory justice spokesman John Lamont who said:
“A lot of drug addicts who use heroin start off on cannabis.”
Lamont’s contribution will get the contempt it deserves here by simply being ignored, but as we’ve noted before McKeganey is a respected scientist who, with his unshakable faith in prohibition as a workable regime, does much to give it the sort of respectability such a failed regime would not otherwise have.Whereas John Lamont is just some idiot politician, Neil McKeganey is a genuine drugs expert – or he should be.
The leaflet that’s caused so much fury is actually a minor update of a leaflet that’s been around since 2005 (original here pdf), so why Neil has only just noticed it isn’t clear. The only change that’s obvious is in the information about the legal status of cannabis, having been moved from C to B since the old leaflet.
Fags ‘n’ hash looks at first sight like just the sort of thing UKCIA has wanted to see for a long time; a leaflet describing the added dangers of tobacco and how to use cannabis in ways which avoid these dangers; at the risk of over repetition, Tokepure is the sort of thing. Sadly, this leaflet is no Tokepure, although it gets so close.
This is what the leaflet says:
Cannabis and tobacco are both smoked, often together. This booklet tells you how using them can affect you, what the law says and how to reduce the risks.
The big problem this leaflet suffers from right from the start is that it isn’t just a health advice leaflet, it’s also a part of law enforcement. This mixing of stating the law and trying to give health advice really doesn’t work, why should anyone trust information in such a leaflet to be fair and balanced? This is something prohibitionists simply don’t understand yet is at the heart of why their approach fails so badly.
How is tobacco used?
Tobacco is usually smoked in:
• cigarettes
• roll-ups using cigarette papers
• pipes or cigars.
There are over 4,000 chemicals and gases in tobacco (such as ammonia, carbon monoxide and hydrogen cyanide). Many of them are killers, causing cancer and heart disease. Nicotine is the drug in tobacco that makes it addictive. Cigarettes are designed to send a nicotine rush to your brain within a few seconds of inhaling.
No problem with that
How is cannabis used?
Cannabis is usually found in two main forms:
• dried leaves and/or flowering tops of the plant (known as grass or weed)
• blocks of resin (hash, pot or blow).
Both forms are often mixed with tobacco and smoked together (known as joints) or in pipes (bongs). Cannabis can also be mixed with food, taken as a tea or eaten on its own.
Oh dear. This leaflet is aimed at cannabis users, so why describe the two forms cannabis comes in or what it’s called? Yes, both forms are often mixed with tobacco in joints, but not in pipes or bongs (although bongs can sometimes be mixes, but that’s less common).
Then we get the bit that so annoyed Neil:
Why are they used?
People use cannabis and tobacco for their effects. With any drug, the effects depend partly on your mood, personality and surroundings. One of the most common reasons why people begin to use tobacco and cannabis is that their friends encourage them.
Probably reasonably true – but then how do we discover anything interesting?
People who smoke describe it as relaxing, making them feel more at ease. They often smoke to be sociable.
People do smoke to be sociable, but often – if not mostly – they smoke to relieve a tobacco craving caused by the addiction to nicotine. The drug effect of tobacco is to make them feel good about having smoked.  They could have added that tobacco smoking often leaves the user short of breath and tight chested, but they chose not to mention any bad aspects of tobacco use. It then goes on to describe cannabis:
Cannabis is a mild hallucinogen, which means it can alter the way you see colours and shapes. Most people who smoke say the most common
effects are:
• relaxation and tiredness
• the ‘munchies’
• being talkative
• things sounding, looking and tasting different.
Other people feel it makes them tense and anxious.
We could quibble about that but it’s not too far off the mark and manages to get a bad effect in as well although it didn’t do that for tobacco.
Accepting that people use drugs for fun and pleasure is important. Prohibition campaigners would seem to like us to be told that drugs are bad and never any more than that.
Then we have two pages of the leaflet devoted to the legal state of the two drugs – which amounts to one paragraph about age limits for tobacco sales and the rest about the prohibition and legal risks attached to cannabis use. As mentioned above this sort of information has no place in a health leaflet which is supposed to be giving plain, trustworthy and honest information so we’ll ignore it.
What’s the harm?
The smoke from burning cannabis or tobacco or both contains poisonous gases that reduce your blood’s ability to carry oxygen, and tars that can cause cancer.
When you smoke, these poisons go straight to your lungs. Smoking cannabis can give you even higher levels of cancer-causing tars, gases and chemicals than cigarettes.
Again, this is something this blog has covered at length before, but whereas lab experiments have indicated cannabis smoke should be carcinogenic because it does, indeed, contain chemical nasties, when populations of cannabis users (of pure cannabis) are studied cancer and lung damage  isn’t found (Tashkin). This could be because THC actually kills cancer (anti-tumour). Despite all the research which has been done into this in recent years – and there’s been quite a lot now, they still try to claim cannabis smoke is worse than tobacco – it isn’t, they’re wrong.
It’s worth noting this use of the word “poison” as well. Whereas tobacco is actually a poison – it will kill you if you eat enough – cannabis isn’t. Cannabis smoke contains some nasties, but it also relaxes blood vessels making breathing easier.
Smoking cannabis and tobacco multiplies the dangers.
Rather more importantly, smoking tobacco with cannabis makes the risk much worse than smoking pure cannabis. Smoking cannabis alone – which they don’t even mention as a possibility – does not appear to lead to lung problems in real life studies of users, smoking tobacco or cannabis/tobacco does.
Joints don’t usually have filters. What’s more, the smoke is often drawn in deeper and held in the lungs for longer. These two factors mean that smoking cannabis and tobacco together is probably the most damaging way to use them.
It’s probably the most damaging way to use cannabis for sure, as they are about to tell us, there is no safe way to use tobacco.
Tobacco and your body
There is no safe level of smoking. Half the people who smoke will die from it.
• Tobacco can quickly become very physically addictive because of the nicotine it contains.
• You are more likely to catch colds and chest infections as a smoker.
• Smoking gives you wrinkles.
• Smoking causes cancers, strokes, lung and heart diseases.
• Tobacco is the single biggest preventable killer in Scotland, killing over 13,000 people every year.
Smoking is hard to stop, hard on your health and hard on your pocket.
All true. And about cannabis they say
Cannabis and your body
• Using cannabis makes some people feel tense and anxious.
• A common bad effect is the ‘whitey’ – light headedness, fainting and sometimes feeling sick. This is particularly associated with taking cannabis and alcohol together.
• Cannabis may make you less alert and can affect your decision-making and judgement. It is dangerous and illegal for you to drive or operate machinery when you are under its influence.
• Cannabis can contribute to mental health problems.
Despite what Neil McKeganey claims, they really have tried quite hard to make cannabis sound dangerous here, but compared to tobacco it does look pretty mionr stuff – which of course it is.
Can I become addicted?
if you smoke cannabis or tobacco or both regularly you may become dependent on using them and have withdrawal symptoms if you stop.
Tobacco
It can be hard to stop using tobacco. While your body gets rid of the chemicals in tobacco you might have:
• cravings for nicotine
• mood swings
• panic attacks
• headaches.
You may also feel cut off from friends who continue to smoke.
And for cannabis
Cannabis
Regular cannabis users who stop may experience:
• restlessness
• anxiety
• sleeplessness.
You may also feel cut off from friends who continue to use cannabis.

They don’t say that the withdrawal form tobacco is often severe, from cannabis rarely so. Indeed, the worst problem people who quit face is common to both – you’ll lose your old friends and ways of socialising. They also don’t make the point that quitting both is much harder than quitting one and that if you usually smoke both together, quitting either makes the other less satisfying.

There is then a page dedicated to drug testing as a part of cannabis law enforcement – again, nothing to do with the health advice this leaflet is supposed to be giving so again we’ll ignore it.

How can you reduce the harm?
Tobacco
• There is no safe level of smoking – stopping is the only way to reduce harm to zero.
• Be aware of fire risks if you drink and smoke.
• Keep smoking materials away from children. Every year, young children are admitted to hospital, having poisoned themselves by eating cigarette ends. If you decide that you want to stop smoking, you can talk to your GP, teacher or pharmacist. They can talk to you about the best ways to stop.

Yep – simple advice, there is no safe way to use tobacco – and it’s true.

Cannabis
Limiting when you smoke cannabis may reduce the risk of becoming a heavy user. Smoking cannabis with tobacco increases the damage to your mouth, throat and lungs –
reduce the harm by smoking less.

Surely the advice that should have come there is to toke pure – don’t mix cannabis with tobacco. Why didn’t they say so?

If you eat or drink cannabis, it can be difficult to judge how much you’ve taken. It also takes longer to kick in and the effects can hit you suddenly and harder than you expect. Hash is not produced in the most hygienic of conditions; it may come already mixed with other substances, which may be harmful, and with germs that are only destroyed by heating. Don’t mix drugs – that includes alcohol. You don’t know what will happen.

Not bad advice apart from the obvious missing safer smoking pure bit. The risks from cannabis do pale into insignificance when compared to the risks attached to tobacco use and this is a hard fact for prohibitionists to swallow. Cannabis is not without downsides and risks, but when compared to drugs like tobacco it’s  a real pussycat. It makes the government’s decision not to include tobacco in the Misuse of Drugs Act on the basis of tobacco wide social acceptance, yet to take the opposite approach to cannabis so clearly illogical and the prohibition policy so hard to understand and rationalise. This is what makes the hypocrisy of cannabis prohibition so apparent and it’s what Neil McKeganey and people like him are so worried about.

As regards this leaflet, it’s worth 2/10 and half a cheer at best. It falls down because it mixes up the legal and the health messages, which compromises its integrity. The sections on the law and drug testing simply do not belong in a leaflet like this. Most of all it fails to give the most important message which would be an enormous benefit to cannabis users – don’t mix cannabis with the killer drug tobacco. All in all, a wasted opportunity and not worth getting all furious about.

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11 comments on “Critique – Fags ‘n’ hash – a wasted opportunity.

  1. Sam

    A fair article, Derek. Good stuff, and very calm analysis in the face of a near constant stream of bullshit.

  2. Peter Reynolds

    Join me in A PCC Complaint Derek?

    It’ll be knocked back because the paper will claim it was just reporting what was said but that’s not the point, it will call McKeganey and Lamont to account.

    I’ll copy you in on my email to the PCC but it’ll be most effective if we do it independently anyway.

  3. UKCIA Post author

    Oh why not?

    Sent to complaints@pcc.org.uk

    The Scottish Sun: Fury over guide to cannabis
    By TIM BUGLER
    Published: 30 May 2011

    I wish to make a complaint concerning the article which is available online at: http://www.thescottishsun.co.uk/scotsol/homepage/news/3607882/Fury-over-guide-to-cannabis.html
    I am making the complaint on my own account but also in my capacity as the webmaster of https://www.ukcia.org, a cannabis law reform website.

    1. This article breaches the Editors’ Code Of Practice clause 1.i) in that it publishes inaccurate, misleading and distorted information.
    2. It also breaches clause 1.iii) in that it fails to distinguish clearly between comment, conjecture and fact.
    3. The article is presented as a news story, not an opinion piece. It should therefore be concerned only with facts – unless comment or conjecture is clearly distinguished.

    The article refers to the leaflet issued by NHS Scotland entitled “Fags ‘n’ hash” (http://www.healthscotland.com/uploads/documents/15715-FagsNHash.pdf) – a leaflet designed to communicate a health message to cannabis users concerning the risk of smoking cannabis mixed with tobacco. In fact this is leaflet is some 7 years old (issued in 2005) and has simply been updated to reflect the reclassification of cannabis to class B, the actual information it contains about cannabis and tobacco is unchanged.

    The paper stated that “experts and politicians have branded the brochure “perverse””, giving the false impression that a number of experts and politicians have made that judgement. In fact, only one expert – Prof Neil McKeganey and one politician – John Lamont – have made critical comments to that effect.

    Neil McKeganey is a prohibition campaigner well known for his extreme views, which have on occasion flown in the face of his academic studies. An example of that would be his enthusiastic support for drug law enforcement despite producing a report which demonstrated that only 1% of heroin imported into Scotland is actually seized (http://files.stv.tv/pdf/heroin-seizure.pdf). His personal views are therefore difficult to rationalise and cannot be taken to reflect the majority of opinion of experts in the field.

    Neil McKeganey claimed “The leaflet conveys a far too positive image of cannabis.”, whereas in fact the opposite is true; the leaflet making several exaggerated claims of harm from cannabis use such as an increased risk of lung diseases. The leaflet also gave great prominence to the legal position of cannabis.

    What was reported in the Scottish Sun was no more than Neil McKeganey’s opinion, it was not fact.

    Secondly the comment from MP John Lamont to the effect that “A lot of drug addicts who use heroin start off on cannabis” has no basis in fact. Indeed very few if any heroin addicts used cannabis as their first drug, the vast majority used tobacco or alcohol before any prohibited drug. This contribution was therefore also no more than opinion and was totally irrelevant to the story.
    No counter opinion was published in order to balance these claims, the article is therefore biased.

    This story was a classic example of opinion presented as fact and thus is the basis of my complaint. This is a serious social issue which should not be misrepresented in this way.
    I look forward to your response.

    Derek Williams
    ————————

    I’m not holding my breath…

  4. tokedesigner

    I have followed the link and reviewed the Scottish Sun story by TIM BUGLER (sic)– yep folks, it’s a $IGARETTE AD.

    In each of two opportunities to show a picture of cannabis or any use modality associated with it, they show, guess what– a big fat (at least 500 mg) joint. (Only one brief text mention of “pipe”, seeming to equate it with “bong”.)

    Seeing the name “BUGLER” reminded me of what the Wikipedia “Cannabis smoking” article looked like till about 2007 (which you can view by pressing the “History” button and scrolling down far enough). The only picture in the article was of (a) a $igarette rolling machine, (b) a pile of unsifted herb, (c) a rolled joint, and (d) a pack of $igarette papers with the tradename “BUGLER” on it, staring out of the picture at you in larger letters than anything else in the article– quite in defiance of WP rules, but that’s the kind of thing the $igarette industry has gotten away with for years in their effort to control the dosage administration decisions of cannabis users worldwide.

    (The struggle to remove $IGARETTE SPAM from Wikipedia articles about cannabis is under way but far from finished– please go there, adopt a user name, sign in and edit, adding diagrams and photos of Herbal Inhalant Dosage Restriction Utensils (HIDRU) (one-hitters) and anything else that contributes to breaking the Hot Burning Overdo$e Format (HBOF) media stranglehold of Big 2WackGo in whose interest to this day the Drug Warriers pursue their paid vendetta against cannabis.)

  5. tokedesigner

    ERRATUM(-A):

    Not Mr BUGLER’s story but the NHS leaflet, with its image of a huge Joint pointing at some guy’s head and two more pictures of Joints but none of a one-hitter or a vapouriser, is the $igarette advert.

    Hey, just in passing, do you think MiracleWonder (that’s Elizabethan for marijuana) can make hair grow on Prof McKeganey?

  6. Sam

    I’m not sure Wikipedia can be construed as part of the media given that it’s entirely user generated.

    P.S. You’re still a conspiracy loon x

  7. phrtao

    Don’t get bogged down in arguing the toss with this guy – Give him the benefit of the doubt on the harms but argue that prohibition does nothing to lessen the damage or control who has access to the substance. They want you to get into an argument about how bad it is for you since it misses the point that prohibition is not the right approach. Concentrate on why cannabis is banned but tobacco is not

    More news on the appropriateness of prohibition today

  8. JOHN

    Why would the body keep a substance that is bad for it for up to 60days (weight dependent).

    Is it because cannabis gets used by the body because its more robust than endo cannabinoids.

    Our body needs cannabinoids to neuromodulate our bodys imbalances.

    Fags vs cannabis well our body doesn`t make nicotene naturally or cyanide does it wheras we need essential fatty acids. Gama radiation is bad for the tobacco plant.

    If a joint is more dangerous than a fag the i should be dead years ago.

    Why would someone need external morphine if the body produces its own version well the body does need help and the same goes for cannabinoids

    Shout about how good cannabinoids are and how our body needs them scietific proof everywhere on the subject

  9. UKCIA Post author

    Reply from PCC

    Dear Mr Williams

    Further to our previous correspondence, the Commission has now made its assessment of your complaint under the Editors’ Code of Practice.

    The Commission members have asked me to thank you for giving them the opportunity to consider the points you raise. However, their decision is that there has been no breach of the Code in this case. A full explanation of the Commission’s decision is attached.

    Although the Commissioners have come to this view, they have asked me to send a copy of your letter to the editor so that they are aware of your concerns.

    If you are dissatisfied with the way in which your complaint has been handled – as opposed to the Commission’s decision itself – you should write within one month to the Independent Reviewer, whose details can be found in our How to Complain leaflet or on the PCC website at the following link:

    http://www.pcc.org.uk/about/whoswho/independentreview.html

    Thank you for taking this matter up with us.

    Yours sincerely
    Elizabeth Cobbe
    elizabeth.cobbe@pcc.org.uk

    Commission’s decision in the case of Williams v Scottish Sun

    The complainant was concerned that the newspaper failed to distinguish the opinions of Professor Neil McKeganey and John Lamont MP from fact. He was further concerned that the article incorrectly implied that further experts and politicians had criticised the leaflet.

    Under the terms of Clause 1 (Accuracy) of the Code, newspapers must take care not to publish inaccurate, misleading or distorted information. The Commission noted that the article did not claim that the leaflet “Fags ‘n’ Hash” was a new publication and, as such, it could not establish a breach of Clause 1 on this point.

    The Commission acknowledged the complainant’s concern that the reference to experts and politicians hostile to the leaflet was plural, yet the newspaper only reported the comments of one expert and one politician. There appeared to be an element of imprecision in this aspect of the reporting, which caused the Commission some concern. However, given that the newspaper did quote a politician and expert who were indeed criticising the leaflet, the Commission did not consider that readers would be significantly misled by the reference in such a way as to warrant correction under Clause 1 (Accuracy) of the Editors’ Code.

    The complainant was concerned that the opinions of the two individuals quoted in the article had been presented as fact. The Commission noted that the comments made by Professor Neil McKeganey and John Lamont were clearly presented as direct quotes and, as such, the Commission was satisfied that readers would be aware that the comments reflected their views rather than necessarily amounting to statements of fact. As such, the Commission was satisfied that comment had been clearly distinguished from fact and, as such, there was no breach of Clause 1 (Accuracy) of the Code.

    Reference No. 112471

    Elizabeth Cobbe

    Complaints Officer
    Press Complaints Commission
    Halton House
    20/23 Holborn
    London EC1N 2JD

    Tel: 020 7831 0022

    Website: http://www.pcc.org.uk

  10. user / or not / is my buisness

    What medical training does Mr Mckeganey actually have. I know he is a sociologist but what back ground does he have in mental health ? He also fails to acknowledge the many complex reasons for marijuana becoming a gateway drug.

Comments are closed.