The Four Ongoing Pandemics: Covid-19, Obesity, Tobacco use and Science Misinformation

“Don’t let the urgent crowd out what’s important” Dwight Eisenhower 1954

 I was delighted to chat to Dr Derek Yach, President of Smoke Free World, formerly at WHO, Rockerfeller, World Economic Forum and Yale.

We discussed a wide range of topics including the urgent current Covid-19 pandemic, along with important longer term pandemics of obesity, tobacco use and science misinformation.

“Follow the science” is a mantra that has often been used during the pandemic but what does this actually mean? Derek and I discuss some of the problems with conducting ‘Real World Science’. 

Countries that have fared better than expected against Covid-19 had two things in common: lower chronic disease burden and good public health infrastructure.

Whilst the UK ranks highly for rapid vaccination of its high risk population, chronic underfunding and outsourcing of key public health functions such as test and trace has been instrumental in leading to poor outcomes from Covid-19 according to a key report (Build Back Fairer) by the Institute for Health Equity. The US finds itself in a similar position with respect to public health infrastructure.

The pandemic of obesity has now overtaken smoking in terms of contribution to deaths. According to a recent study in the UK, deaths attributable to current/former smoking declined from 23% in 2003 to 19% in 2017, whilst those attributable to overweight or obesity increased from 18% in 2003 to 23% in 2017.

We are seeing for the first time on this scale how sub-optimal health that builds up over a lifetime of poor health behaviours such as diet, physical activity, excess alcohol and smoking, can manifest later in life with heart disease and stroke, but also much earlier in terms of impaired immunity against covid-19. The Covid-19 pandemic should serve as a wake-up call for governments to put more, not less as we are currently seeing, resources into enabling healthier choices and tackling the risk factors for chronic disease.

The environments that we live in should facilitate a shift to reduce chronic disease, individuals should not be faced with doing so against the tide. A prime example of this is the availability of reduced risk products to facilitate smokers wishing to quit. Derek and I discuss the findings of two systematic reviews that I have just published summarising the health impact from the use of Electronic Nicotine Delivery Systems such as e-cigarettes, and smokeless tobacco. The findings of these reviews have important implications for tobacco policies such as the Tobacco Products Directive and EU Commission's SCHEER public consultation on e-cigarettes, neither of which reflect the current understanding of health harms from reduced risk products.

Derek and I discuss how we must take action now to reduce risk factors for chronic disease as part of our longer term pandemic planning.

Dr Cother Hajat

Professor of Public Health