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Ethics case study: The use and potential of science education centres for tobacco control

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The use and potential of science education centres for tobacco control – work with young activists (W-West)

Description of the project

'Don’t Get Me Started' is a Durham University/W-West Glasgow/ASH-Scotland/Espacio Ciencia (Montevideo) and CIET (Centro de Investigación para la epidemia del tabaquismo) Uruguay collaborative research project on the use and potential of science education centres for tobacco control. This project involved six core members (age 9-19) of W-West, the Glasgow-based young person's advocacy group for tobacco control, travelling with co-researchers from Durham University, the Greater Glasgow and Clyde Health Board and ASH-Scotland on a visit to 'Respira Uruguay' at the 'Espacio Ciencia' science education centre, Montevideo, in February 2012. The purpose of the visit was to learn more about this unique interactive exhibition, which is designed to discourage young people from smoking, and to consider how it could be adapted for use in a UK context.

Ethical issues anticipated in the project

The visit was essentially an appraisal of Respira Uruguay designed to assess its feasibility as a template for a UK equivalent. In terms of 'everyday ethics', one of the appealing features of undertaking this work was the way it turned the tables on the normal movement of knowledge and expertise from the so-called ‘developed’ world to low and middle income countries such as Uruguay. Uruguay has a long-standing reputation for excellence in public health. There were other parallels that could be drawn between it and Scotland in terms of their post-colonial, small nation experiences.

We see smoking as a social justice issue as much as a health issue. The tobacco industry, despite the ban on overt advertising in the UK and other countries, remains tireless in its efforts to encourage young people to start smoking in order to replace those older people who either quit smoking or die. Over the past fifty years in the UK, although smoking rates have declined overall, they have fallen faster amongst people in the professional and managerial classes and more slowly amongst those in routine and manual occupations.  As an increasingly ‘class-based’ activity, smoking has become an important health inequalities issue. This is the case globally as well as nationally. As smoking prevalence declines in countries such as the UK and the USA, so the industry redoubles its efforts to increase its markets in parts of the world with less well developed legislative and public health controls. Young people tend not to be influenced by messages concerning the long-term health consequences of smoking (an addiction which kills half its long-term users). They are more likely to be moved by hearing of the way the industry exploits child labour in Malawi (say) or the environmental consequences of long-term tobacco production, not to mention the nefarious marketing tactics of the tobacco industry in many parts of the world. 

Were an equivalent to ‘Respira Uruguay’ to be built in the UK, an obvious ethical issue would be what sources of funding would be acceptable for it. The visit was funded by an HEA National Teaching Fellowship award, the Santander mobility grant scheme and the Centre for Medical Humanities at Durham University, and a Crofton Award given to W-West. These are all reasonably ‘clean’ sources of funding. We would not, however, be willing to accept money from the tobacco industry even though such funding would undoubtedly be easy to obtain, since the industry is always keen to foster an image of ‘corporate social responsibility’ in order to divert attention from the fundamental injustices it perpetuates worldwide.

Ethical issues emerging and developing

‘Regulatory ethics’ reared its head in terms of the fulsome risk assessment work that was required by Greater Glasgow and Clyde Health Board before it would countenance the young people’s participation in the project – there were particular concerns about permitting people below the age of 16 from participating. Apart from flying in the face of the inclusive approach we wanted to foster, we also felt it was important to obtain the views of a range of young people of different ages about the exhibition. The kinds of questions we were asked to answer, however, appeared to reflect the fears and anxieties of senior managers about taking young people to South America (even though Montevideo is in reality a much safer place for young people than downtown Glasgow!), and some unfounded assumptions of what the young people might try to do whilst they were there!

We are currently in discussion with potential venues about hosting an exhibition in the UK. Ensuring the 'intellectual property rights' of those who had the imagination to develop such an inspiring exhibition in Uruguay, and that those people and their institutions benefit appropriately from the development of any counterpart here in the UK, is an important ethical issue for us.

Learning from the experience of working with these ethical issues

An unanticipated result of the visit could be termed a benefactor syndrome. While W-West has had other experiences of travelling abroad in the course of their activist work, there is a sense of what can cap Uruguay? Maintaining the post-visit momentum, both of W-West as a tobacco control activist group and the plan to develop an exhibition is important, particularly when funding is tight.

We were extremely impressed with the ability of the young people to work together, frequently unsupervised, in undertaking their evaluation of the exhibition – they exhibited a keen awareness of tobacco as a social justice as much as a health issue, and emphasised the importance of developing these aspects in any resulting exhibition. We also learnt a lot about Uruguay, a country which in many respects is light years ahead of the UK and Europe in tobacco control, while identifying some areas in which the UK is arguably further ahead on than Uruguay (e.g. youth work, cessation services, mental health and prisons). We feel a UK exhibition, if brought to fruition, would thus offer a genuine example of knowledge exchange in the pursuit of social justice and health.

Further details

An English language video of the Espacio Ciencia exhibit can be seen on:

http://latu21.latu.org.uy/espacio_ciencia/en/index.php?option=com_content&view=article&id=127%3Avideos&catid=42%3Aexhibiciones&Itemid=101 

Blogs from the Uruguay visit:

http://medicalhumanities.wordpress.com/2012/02/13/dont-get-me-started-an-international-collaboration-on-young-people-and-smoking-participatory-action-research-visit-uruguay-february-2012/;

http://medicalhumanities.wordpress.com/2012/02/15/the-smoking-interest-group-in-uruguay/;

http://medicalhumanities.wordpress.com/2012/02/19/sig-in-uruguay/

Contacts

Dr Andrew Russell (a.j.russell@durham.ac.uk) Department of Anthropology and Co-Director Centre for Social Justice and Community Action; Brian Pringle (BPringle@ashscotland.org.uk) ASH – Scotland.