1. www.carbonaddict.org Carbon Dependence A public health challenge

2. 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

3. 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

4. A carbon-dependent society?… …What’s wrong with that?

5. Early Complications Reduced exercise tolerance – fossil fuel use is replacing physical activity in daily living  negative impacts on cardiovascular and psychological health Anxiety, stress – physical activity has psycho-protective effects, so doing less of it has negative impacts on mental health - dissatisfaction Respiratory symptoms - asthma and allergies. More time spent in natural environments could reduce the risk of these complications.

6. Late Complications Obesity and diabetes – due to high fat diet and inactivity Cardiovascular disease – high salt and fat diet, and inactivity Colorectal cancer – correlates with high meat intake Falls – inactivity  low muscle mass, falls due to SE of medication Fuel poverty – using more fuel costs money (human power is free) Social isolation – interaction via facebook? TV entertainment?

7. Climate toxicity Already responsible for many deaths worldwide: malnutrition, malaria, diarrhoeal disease (WHO) Severity not related to intensity of same individual’s carbon addiction

8. Treatment?

9. Medical Intervention Medical interventions for symptoms are carbon intensive* – risk of increasing carbon dependence Psychosocial techniques? Alternative therapies..? *See NHS Carbon Emissions Modelling 2008

10. Prevention – better than cure?

11. Alternative prescriptions: Behaviour Active travel and BTCV green gyms Diet – gradual meat and processed food reduction; exposure to local markets Occupational therapy – e.g. growing schemes, tea-making (attention to non over-filling of kettle),

12. Public health: an environment for healthy living Natural / green spaces – proven therapeutic value in depression, enhancing recovery after surgery, etc. - Protective against urban heat island, & in flood management; Absorb CO 2 Built environment – to promote active travel* & social cohesion *NICE guidance available on creation of physical environments that support physical activity

13. Addressing root causes: climate change “Housing improvement programmes benefit almost all carbon addicts, but particularly the elderly, living alone, those with cardiovascular or respiratory disease” HOME INSULATION ENERGY & MONEY SAVING Equipment on standby Inefficient devices Overfilling the kettle

14. Prognosis Recent advances have transformed outcome in what was previously universally disabling disease. With help of multidisciplinary team, addicts may even achieve full recovery.

15. Discussion

16. 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.