Richard Roope, of the RCGP, has recently released a report on e-cigarettes.
Essentially, the Royal College of General Practitioners, the official channel for General Practice of Medicine in the UK, has given their informed recommendations to health professionals regarding smoking cessation and the use of e-cigarette.
1. GPs provide advice on the relative risks of smoking and e-cigarette use, and provide effective referral routes into stop smoking services.
2. GPs engage actively with smokers who want to quit with the help of e-cigarettes.
3. Where a patient wants to quit smoking, and has not succeeded with other options, GPs should recommend and support the use of ENDS.
[GENEVA – Electronic nicotine delivery systems (ENDS), of which electronic cigarettes are the most common prototype, are devices that do not burn or use tobacco leaves but instead vaporise a solution the user then inhales. The main constituents of the solution, in addition to nicotine when nicotine is present, are propylene glycol, with or without glycerol and flavouring agents. ENDS solutions and emissions contain other chemicals, some of them considered to be toxicants.The World Health Organization (WHO) submitted a report on Electronic nicotine delivery systems to the sixth session of Conference of the Parties to the WHO Framework Convention on Tobacco Control (COP 6), which occured in Moscow, Russian Federation, from 13 to 18 October 2014.]
4. GPs recognise ENDS offer a wide reaching, low-cost intervention to reduce smoking (especially deprived groups in society and those with poor mental health, both having elevated rates of smoking).
5. All GPs encourage smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of local stop smoking services.
Harm-reduction has come out on top. Vape Fear has lost this one.
I have written my fair share about e-cigarettes in Canada, the United States, and Great Britain.
* ‘Why Aren’t we Regulating E-Cigarettes?,’ Regina Leader-Post [May 16, 2016]
* ‘Let’s Get Proactive with E-cigarettes,’ Saskatoon Star Phoenix [April 24, 2015].
* ‘Lot of Smoke and Mirrors with Vape Policy,’ Saskatoon Star Phoenix [November 28, 2014]
Often, I have suggested a measured response. My sense is, a little bit of regulation can go a long way. Minor rules can make a major difference. Don’t go overboard, but the waters are rough. Vaping should play by the rules, basically.
With my last op-ed back in May, people in Canada weren’t impressed with my approach. Folks were not interested in a middle-ground perspective. Here’s a list of the harshest responses to my articles on vaping. I’m basically the Red Skull mixed with Lex Luthor for suggesting some thoughtful rules might be in order.
1. “Please take the check that you earned from writing this trash and take an ethics course. Or a journalism degree.”
(Uh, I didn’t get paid. Woulda been nice.)
2. “It’s pretty obvious you don’t quite understand how the system works here in Canada…”
(Does anybody. There are no regulations? Ha.)
3. “You help tobacco companies profit from murder.”
(Jeez, really?! C’mon it’s my birthday.)
4. “…governments are making decisions based on MONEY, NOT PUBLIC HEALTH.”
5. “What tobacco lobbyist wrote this trash?”
(I’m no tobacco lobbyist, but I sure do think they’re funny in the movies. Aaron Eckhart, anyone?)
Cheech and Chong. Tony Montana. Reefer Madness. Blow. These are some of the characters and films that normally come to mind when you bring up drugs in cinema. But let’s get real, folks. It goes so much deeper.
Drug movies are both fascinating and titillating. Whether it’s the “War on Drugs” or depictions of the counterculture or portrayals of Big Pharma and the business community, all sorts of movies have been made about the illicit drug trade, pill-popping, and even more that simply feature drug use. But what are the best drug movies of the past 50 years? High Times has got some ideas. Buzzfeed has done it. And so has IMDB.
Now it’s time to offer a fresh take on the list.
Before we begin, though, let’s establish a boundary or two. What is a drug movie, one might ask? The best way to think about it has to be through heavy drug use and a focus on the drug trade, organized crime, or medical marketplace. This means that Dazed and Confused, which only has mild drug use, doesn’t make it. Neither does The Program, with James Caan. Or Rocky IV. Or the relatively new Alice in Wonderland. These films feature some drugs use and are trippy to watch, but to make this list drugs have to be absolutely central to the plot. There are other rules, too. First off, alcohol is NOT a drug. (In fact, there’ll be another alcohol list in the future.) Second, power – money, politics, sex, the ability to get others to do what you want – is NOT a drug. Finally (thank fuck), altered perceptions or dream sequences, but which are NOT based on explicit drug use, are thrown out. So, for example, Raising Arizona, The Matrix, or Fight Club have to get bumped from consideration.
Here’s my Top Ten and watch those other more standard lists go Up in Smoke.
10. Sicario (2015)
French Canadian director Denis Villeneuve crushes it. Again. With Sicario (meaning hitman), he drops us into the grisly world of drug enforcement.
I’ve been an outgoing proponent of Denis since Incendies (2010), and he’s continued to crank out brooding and thought-provoking pictures, including Enemy (2013) and Prisoners (2013). After having worked with Jake Gyllenhaal for both films in 2013, he casts Emily Blunt, Josh Brolin, and Benicio Del Toro to headline his take on the War on Drugs’s primary theatre of war – the US/Mexico border.
Emily Blunt is once more playing Ellen Ripley. (Think Edge of Tomorrow – wait, is that what it’s called?). Really, it’s not a bad place to be. She’s steely-eyed and intrepid. And she’s posing moral questions as the focal piece of the film.
The soundtrack is hauntingly grim, the acting is understated, and the cinematography – by the incomparable Roger Deakins – is spartan. Rapid cutting is superseded by long, lingering shots. Movement gives way to stillness. A great example is one of the signature battles of the film, when a traffic jam, not a car chase, ramps up the tension. Deakins, who was burned at the Oscars once more, uses most of the arrows in his quiver to generate one of the most gorgeous films of 2015-2016. By itself, that’s enough to make this list.
9. Good Fellas (1990)
GoodFellas tells the true story of Henry Hill, played by Ray Liotta in a star-making performance and it wasn’t till Blow (2001) and Narc (2002) that he reached such heights once more. Am I fond of Liotta? Somewhat. But not a lot. I like Liotta as much as, say, Al Gore or John Kerry or, I don’t know, porridge. In this, however, Liotta’s compelling. His Henry Hill is chaotic and flawed. He’s shallow and violent, as well as understandable and all human. At times, I find myself cheering him and pitying him simultaneously. When he suggests, “as far back as I can remember I always wanted to be gangster,” I shake my head and, at the same, kind of wonder. Hmm? This is a testament to Liotta’s best and breakout performance.
In 1990, Martin Scorsese wasn’t unique in addressing organized crime. A tipping point, it seems, had been reached, and audiences that year were treated to an abundance of mafia, mob, and crime films, including: Miller’s Crossing, King of New York, The Krays, The Grifters, and, yes, The Godfather Part III. But GoodFellas stands apart and above.
As Henry is initiated into the world of guns and drugs, gambling and prostitution, he is mentored by Robert De Niro’s Jimmy Conway and Joe Pesci’s Tommy Devito. Both actors have been understandably lauded for their vibrant portrayals of tough guys. Eventually, Henry and his wife Karen (played by Lorraine Bracco) discover the sex and violence of organized crime is thoroughly intoxicating, just as much as the cocaine that they inhaling.
This movie – its soundtrack and cinematography, and so much more – is just as addictive.
8. The Constant Gardner (2005)
Big Pharma. Big Bad Pharma. This is the subject of John Le Carre’s novel and ultimately the movie, directed by Brazilian director Fernando Meirelles. The story is disjointed, relies on flashbacks, and, according to Roger Ebert, is a far distance off ‘a logical exercise beginning with mystery and ending at truth…” Instead, we are pulled into a maddeningly elusive conspiracy and a fragmented narrative in which Ralph ‘Rafe’ Fiennes (i.e., Voldemort, The Red Dragon, Hades, and M) plays a widower in search of the truth. Why is his wife dead? Who is responsible?
His answers rest in the multinational pharmaceutical corporations. In particular, a company that is using Kenya’s population for fraudulent testing of a fictitious tuberculosis drug (“dypraxa”). The drug has known harmful side effects, but this is disregarded, as is the health of the African test subjects. Of course, this sort of testing is based in reality and spots like China, Estonia, Romania, Tunisia, as well as other African countries, have served as fertile testing grounds.
Fiennes, playing Justin Quayle, confronts Big Bad Pharma and suggests that the pill we take – whether for Tuberculosis or Tachycardia – is more than just an ‘an inanimate fucking object.’
If you like underdog tales, especially ones where caricatured corporations are fucked over by the ‘little guy’ (see Erin Brockovich, The Insider, Michael Clayton, etc.), this movie is for you.
7. Easy Rider (1969)
It’s difficult to begin with Easy Rider, which nearly everyone regards as one of the greatest and most influential drug movies of all time.
Disclosure: I should not have watched Easy Rider at an early age. I found it incredibly jarring. I was in grade 9 and not at all battle-hardened or street-smart. The cruel ending forced me into a funk. It challenged me to think about human nature, the nature of the United States, and served as a bewildering counterpoint to many of the testosterone-fuelled and predictably satisfying action movies (think Arnold, Jean Claude, Sylvester) to which I was exposed in the 1980s.
Wyatt and Billy didn’t deserve that! Who were they bothering? What, there’s not going to be any payback? That’s it?! Jesus Christ. Dammit.
Plot and Characters: Peter Fonda plays Captain America with the old stars and stripes on his back, helmet and bright long-barrelled motorbike. Dennis Hopper plays the sidekick, sporting pioneer trooper buckskins, long mustache and hair. They’re touring around the beautiful USA and shit happens to them: there’s a drug deal, parades, bordellos, Mardi Gras, LSD trips, and unexpected violence.
Easy Rider is a quintessential American road movie.
And the best part of the piece is Jack. This is his breakout. Vincent Canby, writing in the NY Times in 1969, was tepid, even haughty, about the film, but he sure loved Nicholson:
‘Suddenly, however, a strange thing happens. There comes on the scene a very real character and everything that has been accepted earlier as a sort of lyrical sense impression suddenly looks flat and foolish.Wyatt and Billy are in a small Southern town—in jail for having disturbed the peace of a local parade—when they meet fellow-in-mate George Hanson (Jack Nicholson), a handsome, alcoholic young lawyer of good family and genially bad habits, a man whose only defense against life is a cheerful but not abject acceptance of it. As played by Nicholson, George Hanson is a marvelously realized character, who talks in a high, squeaky Southern accent and uses a phrase like “Lord have mercy!” the way another man might use a four-letter word.’
In Jack, we trust.
6. Apocalypse Now (1979)
Francis Ford Coppola had a mental breakdown during shooting, as he wrote the script on the fly and had to negotiate with a hard-partying, spaced-out crew, in addition to the fickle President Marcos of the Philippines. Coppola had to fire the original leading man, Harvey Keitel. Then, Martin Sheen – the replacement – had a heart attack.
Marlon Brando showed up to film his scenes as Colonel Kurtz much like Shaq often did to start the Lakers training camp – in less than ideal shape. Coppola would also have to tread carefully with the mercurial Brando, who hadn’t learned any lines and insisted on being filmed in shadow. And Dennis Hopper. Dennis Hopper being Dennis Hopper, well, he was regularly stoned on marijuana, cocaine, speed and many other drugs. He was manic. Crazed. Demented. A feature of this list a second time, he didn’t have much acting to do in portraying a whacked-out photojournalist drunk on the Colonel’s Cool-aid.
The story, based loosely on Conrad’s Heart of Darkness, follows a booze-fuelled, PTSD-suffering, lone-wolf agent as he journeys up a river to find a rogue soldier, Kurtz, who has slowly gone mad, raised his own army, and established his own territory in Vietnam. As this troubled agent/assassin, Willard (first Keitel, then Sheen), heads up the river, the visuals gets increasingly trippy. The imagery, in short, becomes more hallucinogenic. By the time Kurtz converses with Willard, the audience has gone way down deep into the proverbial rabbit hole.
The film is improvisational and chaotic. It’s intoxicating and brazen. And it’s a masterpiece.
5. Dallas Buyer’s Club (2013)
In the excellent 2013 movie, Dallas Buyers Club, we are exposed to valiant patient activism during the AIDS crisis in the United States. Based on the true story of AIDS-stricken Ron Woodroof, a cocaine-snorting cowboy and homophobic Texas tradesman, the film shows a shockingly thin Matthew McConaughey battle his sickness, inner demons, and the authorities in Texas Mercy Hospital, the drug industry, and government.
I’ve reviewed the film elsewhere and I’ve used it to try and communicate the complexities of medical marijuana dispensaries, in particular. I remain convinced that the movie provides a harrowing, insider overview of drug regulation and the politics of medicine in modern society.
Woodroof, who’s unhappy with his illegally purchased zidovudine, known as AZT, and on the edge of death, seeks out alternative and experimental drugs from a doctor in Mexico. Then, Ron, being the savvy entrepreneur/hustler that he is, quickly establishes a club (charging a $400 membership fee) to sell his smuggled wares, including vitamins, DDC, and Peptide T. In doing so, he runs afoul of the Food and Drug Administration and the Drug Enforcement Administration and is essentially forced to confront the existing power structure of drug regulation.
At one point in the film, he storms a town hall meeting of citizens, drug company leaders, and FDA regulators and, while still quite ill and attached to his IV bag, Ron starts finger-pointing. “People are dying. And y’all up there are afraid that we’re gonna find an alternative without you.” Inevitably, bums shift in chairs. Chests are puffed up. And murmurs echo in the room. “You see,” Ron continues, “the pharma companies pay the FDA to push their product. They don’t want to see my research. I don’t have enough cash in my pocket to make it worth their while.”
The film has strong performances, namely McConaughey and Jared Leto, who plays his cross-dressing compadre. Jennifer Garner, on the cover of a recent Vanity Fair and recovering from the newest Batman’s infidelity, offers up some of her best work.
With Dallas Buyer’s Club we see the problems inherent in the relationship between big business, regulators, and interest groups. And while the film didn’t get it all right, it’s still a stimulating film and a significant reminder about the power of Big Pharma, the complicated nature of drug regulation in the 20th century, and the ways in which everyday citizens like Ron Woodroof can influence the system.
SUPER SPECIAL THANKS TO MATT TODD, WHO WAS INSTRUMENTAL IN WORKING THROUGH THIS LIST WITH ME. WE DIDN’T ALWAYS AGREE, BUT SUCH IS LIFE. HE AND I WILL BE RELEASING A MODIFIED (HISTORY-LADEN) VERSION OF THIS ARTICLE IN THE NOT-TOO-DISTANT FUTURE.