www.carbonaddict.org

Carbon DependenceA public health challenge

Carbon Dependence

Definition*

“a cluster of physiological, behavioural, and cognitive phenomena in which the use of carbon-based fuels takes on a

much higher priority for a given individual than other behaviours that

once had greater value”.*In accordance with ICD-10

Carbon Dependence

Epidemiology

• Early case reports date back to the 19th century, with prevalence rising exponentially in the last 50 years

• Now reached epidemic proportions in the UK – affecting almost 100% of the population

• Fears of global pandemic

Aetiology

• No genetic influences identified

• Environmental factors important – e.g. out-of-town shopping

Carbon Dependence

Presentation

High carbon behaviours:

• T-shirt in winter

• Travel history

• Meat bingeing

• New-variant consumption

Carbon Dependence

Recognising dependence (ICD-10)

• A strong desire or sense of compulsion to take the substance. e.g. compulsive upgrading of mobile phone or other functioning electronic goods; overwhelming desire for overseas weekend-break.

• Difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use. e.g. failed attempts to cycle to work; inability to use up contents of fridge in preference to buying new food.

Early Complications

• Anxiety, stress – due to lack of psycho-protective effects of physical activity, misdirected attempts to fulfil non-material needs (e.g. companionship) by carbon-intensive material means (e.g. purchase of a new iPod), etc.

• Reduced exercise tolerance – NB intractable clinical syndrome when combined with COPD, heart disease

• Respiratory symptoms, asthma – in children may be Munchausen by proxy

• Constipation

Late Complications

• Obesity

• Diabetes, cardiovascular disease

• Colorectal cancer

• Fuel poverty

• Falls

• Social isolation

Climate toxicity

• Already responsible for many deaths worldwide: malnutrition, malaria, diarrhoeal disease (WHO)

• Severity not related to intensity of same individual’s carbon addiction

The FART TestFlatus - Air Redistribution Test (not recommended)

• Non-invasive, measures methane produced

• Disliked by patients

• Inaccurate - ?leaks

• Fire hazard

• Confusing: high methane measurements may correlate with vegetable-based diet

Medical Intervention• Carbon intensity of pharmaceuticals and medical

procedures* restrict options

• Surgical techniques (unproven) e.g.:

Division of patient-car connecting structures

Ablation of internet shopping area of brain

Stomach stapling

*See NHS Carbon Emissions Modelling 2008

PsychologicalRecommended techniques include:

• Motivational interviewing

• Cognitive behaviour therapy

• Self-help groups

Social: behaviour• Active travel – replaces gym membership + trips to

seaside. (Effective in prevention and treatment of depression, coronary heart disease, hypertension, obesity, diabetes, osteoporosis, etc)

• Diet – gradual meat reduction; exposure to local markets

• Occupational therapy – e.g. tea-making (attention to non over-filling of kettle), growing schemes,BTCV green gym

Social: environment• Natural / green spaces – proven therapeutic value in

depression, enhancing recovery after surgery, etc.

• Protective against urban heat island, and in flood management; absorb CO2

• Built environment – certain features show close correlation with uptake of active travel*

*NICE guidance available on creation of physical environments that support physical activity

Social: housing• Housing improvement programmes benefit almost

all addicts, but particularly the elderly, living alone, those with cardiovascular or respiratory disease

• Suggested home insulation “step” in treatment of asthma; “I for insulation” in NICE guidelines on hypertension

• Referral to specialist services is available*

* e.g. www.warmfront.co.uk, www.energysavingtrust.co.uk

Prognosis

• Recent advances have transformed outcome in what was previously universally disabling disease.

• With help of multidisciplinary team, addicts may even achieve full recovery.

www.carbonaddict.org

For a comprehensive, evidence-based guide to medical management of carbon dependence:

www.CarbonAddict.org

Carbon Addict is an opensource project of The Climate Connection and The Campaign for Greener Healthcare.

The illustrations are by www.worldofinferiors.co.uk and are licensed under a

Creative Commons License.