Medicine and Science from The BMJ

The BMJ published a negative result this week. A new trial focuses on a peer support intervention for improving breastfeeding rates in the UK, but finds no major improvement. We hear from the lead author who tells us what went wrong, and the insights that can still be drawn from apparent ‘failures’. Next we turn our eyes to shisha smoking in the UK. With shisha or “hookah” cafes on the rise, we explore the smoking habit in more detail. What are the effects on health? And why are UK laws poor at regulating the practice? Kate Jolly is professor of public health and primary care at the University of Birmingham. Zainab Hussain is a UK-based freelance journalist writing on behalf of The BMJ. Links: Peer support intervention (ABA-feed) to improve breastfeeding: UK based, multicentre, parallel group, randomised controlled trial Shisha tobacco’s availability is rising. Why does UK smoking policy fail to tackle it?

The UK Covid Inquiry released Module Three of its findings this month. It lays out in startling detail the lived experiences of NHS staff and patients who bore through the pandemic. In the report’s words: ‘healthcare systems coped with the pandemic, but only just’. The BMJ speaks to Kevin Fong, anaesthetist lead for major incidence planning at UCL hospitals, to break down Module Three’s most important takeaways. And, invasive surgical cosmetic procedures are on the rise in the UK, with regulation patchy at best. From botox and fillers, to tummy tucks and breast surgeries, we hear about the gaps in patient protections that leave space for harm. Kevin Fong is a consultant anaesthetist, broadcaster, and anaesthetist lead for major incidence planning at UCL hospitals. Danielle Griffiths is an author and lecturer at the University of Liverpool’s School of Law. Alexandra Mullock is an author and senior lecturer in medical law at the University of Manchester. UK Covid Inquiry Module Three Report Regulating invasive cosmetic procedures to reduce harm | The BMJ

The Gulf states are not large producers of pharmaceuticals or healthcare products - but the oil they supply, and the transport infrastructure they have built, are key components in a worldwide logistical network that underpin all of the pharmaceutical and other medical consumables we use. From critical NHS shortages like Bone Cement for orthopedic surgery, to persistent IV fluid supply crises plaguing Australian hospitals, we discuss how the conflict in Iran will affect fragile healthcare logistics. Joining us today are Mark Dayan, Brexit programme lead at the Nuffield Trust) on NHS procurement problems Anny Huang, doctor and journalist in Brisbane,on the three-year IV fluid shortages in Australia. Prashant Yadav a senior fellow for global health at the Council on Foreign Relations, on the potential global effects of the Iranian conflict on international supply chains. Reading list Global bone cement shortage: NHS could cancel or delay knee and hip operations How Australia survived a sudden shortage of IV fluids Where the Iran War Could Disrupt Pharmaceutical Supply Chains

The lure of health influencers and AI chat bots is strong. More and more people are placing trust in them to answer their health problems, misplaced trust - as we know these AIs can misinform. At the same time, people are struggling to access the NHS, and when they do doctors have little time or the right tools to unpick complicated science, and challenge misunderstandings. So in this roundtable, we’re asking, are we in danger of the NHS making the problem of misinformation worse, and what can we do to combat that. Joining Kamran Abbasi, the BMJ’s editor in chief are: Deborah Cohen: Freelance Journalist; Senior Visiting Fellow at LSE Health Kamila Hawthorne: Chair of the National Academy for Social Prescribing Nnena Osuji: Consultant haematologist and CEO of North Middlesex University Hospital NHS Trust Chapters [00:00] The rise of health influencers [03:55] Patient satisfaction and the NHS [05:58] The "Infodemic" and clinical impact [11:04] Digital literacy and health inequalities [16:40] Questions from the audience Reading list: Cohen D. Bad Influence: How the Internet Hijacked Our Health. Oneworld Publications; 2026. Satisfaction with NHS hits record low, but public still back founding principles - The BMJ

In this episode, Dr Katie Bramall, Chair of the BMA’s General Practitioners Committee, joins the podcast to discuss her concerns surrounding the new GP contract imposed by the UK government. GP contract overhaul: What's included and how has it been received? Helen Salisbury: Another imposed GP contract

As public health officials warn about rising emissions from urban wood burning, a BMJ investigation finds that just under a third of UK councils in high use areas have faced pressure from the stove industry to tone down or withdraw campaigns. Almost a third of UK children live in poverty. Leading expert Michael Marmot weighs in on the UK’s "steepest rise" in child poverty among OECD countries and why local government "Marmot Cities" like Coventry and Manchester are taking the lead where national policy falls short. And, a new BMJ collection has just been published on child mental health in conflict zones. 1 in 5 children globally live in conflict zones, creating a staggering mental health toll. We hear about community-led interventions. Reading list: The growing threat of domestic wood burning stoves—and industry’s legal attempts to shut down clean air campaigns Michael Marmot: Labour has reneged on its child poverty promises Child mental health in conflict settings

In this episode, we investigate the alarming resurgence of measles across North America and the UK. While cases are falling across much of Europe and Asia, North America is seeing explosive outbreaks fueled by vaccine hesitancy and political shifts. We break down the 2026 crisis: Why London is the epicenter and how the UK lost its "Measles Elimination Status". An in-depth look at outbreaks in Ontario, Alberta, Texas, and Mexico. How returning travelers—not migrants—are actually driving the spread. The impact of "shared clinical decision-making" and current US health leadership on vaccine access. Kamran Abbasi is joined by: Angela Rasmussen - Virologist, University of Saskatchewan. Azeem Majeed - Professor of Primary Care and Public Health, Imperial College London.

In this week’s episode, we challenge long-held medical narratives, starting with how the healthcare system manages life after a cancer diagnosis. While medical advancements mean more people are surviving cancer than ever before, many patients report a "cliff-edge" experience where coordinated care effectively vanishes once primary treatment ends. We are joined by Dr. Rosalind Adam, an Academic GP at the University of Aberdeen, who argues that it is time to stop viewing cancer as a discrete, one-off episode and instead integrate it into routine chronic disease management. Next, we dive into a landmark study from Sweden that is overturning the conventional notion of autism as a predominantly male condition. Historically, autism has been cited as having a 4:1 male-to-female ratio, but new data suggests this gap may be a byproduct of timing rather than biology. We speak with Dr. Caroline Fyfe, a medical epidemiologist at the University of Edinburgh, and Dr. Natasha Marrus, a child psychiatrist at Washington University in St. Louis. They discuss their analysis of 2.7 million individuals, which revealed a significant female catch-up during adolescence, showing that by age 20, the diagnosis ratio approaches 1:1. The team explores why girls are so often missed in childhood and what this shift means for the future of sex-sensitive diagnostic practices. Reading List For more details on the research discussed in this episode, you can access the full papers on bmj.com: Cancer is a chronic disease: why don’t we treat it as one? Adam R, Hogg DR, Ritchie LD, Nekhlyudov L. BMJ 2026;392:e086624. Time trends in the male to female ratio for autism incidence: population based, prospectively collected, birth cohort study. Fyfe C, et al. BMJ 2026;392:e084164. Please subscribe to the Medicine & Science podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts, Spotify, or YouTube.

The House of Lord's amendments to England and Wales assisted dying bill might be causing a constitutional crisis. Lords have tabled 1,277 amendments—which is a record for any equivalent bill in history - and over half of those came from just seven peers. This has led to accusations of "delaying tactics" or "filibustering" to run down the clock deliberately and run this bill off the road. Although some of these amendments have been described as unworkable, repetitious and unnecessary; others reflect serious, legitimate concerns, around the prevention of coercion, how to identify victims of domestic abuse and the broader impact on the disabled community, and whether it’s wise to introduce assisted dying while palliative and social care services are so stretched. 300 territories around the world, allow physician assisted death - so we asked experts from Canada and California to reflect on those objections, and if there is any evidence of this issues arising where they live. James Downer is Professor and Head of the Division of Palliative Care at the University of Ottawa, and Catherine Forest is clinical associate professor of family medicine at the University of California San Francisco. Reading list: Scrutiny of the assisted dying bill is vital but obstruction in the House of Lords could mean it never becomes law

Deborah Cohen's new book "How the internet hijacked our health" explores the profound impact of the internet on our wellbeing. In this conversation with BMJ Editor, Kamran Abbasi, they discuss the ways in which online information can both empower and mislead, the role of big tech in shaping our wellbeing and the complex and disturbing ways wellness influencers are becoming more trusted than the NHS. With insights drawn from extensive research and a deep understanding of the digital landscape, Deborah Cohen sheds light on the critical issues at the intersection of technology and healthcare, and challenges anyone who consumes health information online to think differently about what they're doing.

We’re 18 months into the Labour government, and their changes to the NHS are beginning to be felt. In the 10 year plan that they launched last year, they announced three planned shifts for the health service. Firstly, they pledge to move care from hospitals to the community, an increased focus on prevention rather than sickness, and shift from analogue to digital with an improved NHS app where patients can access records, seek advice and control some aspects of their care. However, accessing primary care and getting a GP appointment is still a key area of concern for patients and healthcare staff. In a new research paper on bmj.com, a group of researchers have performed a qualitative study asking 70 patients about their experiences of accessing primary care in England. We're joined by Hugh Alderwick and Luisa Petigrew from the Health Foundation to discuss what the findings mean for the 10 year plan. Also this week, online gambling is a growing problem. The immediacy of access, combined with advertising and push notifications, and a proliferation of new gambling companies, undermines traditional ways of managing a gambling addiction. A new analysis argues that these new forms of online gambling requires new forms of regulation. Spencer Murch from the University of Calgery offers some ideas on how that could work. Reading list Experience of access to general practice in England Policies to increase access to general practice may have unintended consequences Online gambling requires greater government regulation

This interview is available in video form: https://www.youtube.com/watch?v=-yNO47EfuEM ​‪ @RichardJMurphy‬, political economist and tax campaigner, joins Kamran Abbasi, Editor in Chief of The BMJ. In the UK an ongoing dispute between resident doctors and the Labour Government saw doctors go on strike in mid-December. With Winter pressure piling on and cost-of-living on the rise, do doctors have a credible case of pay rises? And more broadly, how can the economic situation of the NHS be improved? 00:00 Introduction 01:30 Doctor Pay Claims 04:33 Inflation Measures 07:29 Affordability Crisis 09:48 Market Forces Arguments 12:52 NHS Affordability 15:00 Youth Unemployment 19:14 Political Priorities 23:10 Neoliberal Capitalism 27:35 Mixed Economy Alternative 32:32 Prescription for NHS

The class of GLP-1 agonist drugs including Ozempic gained a wide reputation for weight loss in 2025. However, it's well established that weight regain is a common result after people stop their doses. We report on new research which aims to quantify what is happening in the here-and-now for patients who stop using these and similar drugs. Weight regain after cessation of medication for weight management: systematic review and meta-analysis Also, The BMJ reports on news from Gaza. The Israeli government has issued new directives to strip 37 NGOs of their licences to provide essential aid to the population. This includes Médecins Sans Frontières, the charity directly supporting many of the critically important hospitals in the territory. Gaza is experiencing an especially harsh Winter and MSF warn that this measure could leave Palestinians without lifesaving medical care. Gaza: Israel moves to ban dozens of aid groups in "cynical and calculated" move Gaza in winter: 29 day old baby dies of hypothermia amid dire conditions The BMJ’s annual appeal is supporting the work of Médecins Sans Frontières (MSF). Around the world, MSF teams are providing maternity care, containing outbreaks, and performing vital surgeries. In areas overwhelmed by conflicts and natural disasters, more lives can be saved when we are in the right place at the right time. Donate today at https://msf.org.uk/bmj-annual-appeal-2025

This episode is available in video form on YouTube: https://youtu.be/1cGrD47eZSk American science fiction author Kim Stanley Robinson joins Kamran Abbasi to discuss climate disaster, the need for political imagination, and science fiction's vision for health. Kim Stanley Robinson is the acclaimed author of a trilogy of novels, exploring the terraforming and settlement of Mars. His most recent novel, 'Ministry for the Future', was published in 2020. 'Ministry for the Future' sets out a vision for real solutions to our climate crisis, covering global finance, the animal kingdom, rising sea levels, energy production and much more. The book imagines a Ministry that begins its work in 2025. Five years after publication, with 2025 past and gone, The BMJ spoke to Robinson to explore how closely the novel's vision for the future has reflected reality. 01:00 BMJ's New Climate Change Initiative 01:21 Kim Stanley Robinson's Ministry for the Future 04:02 The Role of Political Violence in Climate Action 10:50 The Concept of the Carbon Coin 12:51 The Importance of Global Collaboration 27:32 The Role of Medicine in Climate Change 32:33 Youth and Climate Activism 37:53 Hope and Despair in Climate Action 41:29 Conclusion and Future Works Read more about The BMJ's climate coverage in the latest issue: https://www.bmj.com/content/392/8479

It’s time for 2025’s festive fun! Practicing medicine can be a very visceral experience - and the English language can’t always adequately capture the sights, sounds, smells. So Matt Morgan, intensivist and BMJ columnist, is creating medical neologisms, and joins us to share a few. Madhvi Joshi, a GP in London, has written about longevity science, and we hear how the “biohacking” of internet influencers like Bryan Johnson is making its way into the consultation. Navjoyt Ladher and Tim Feeny take us though this year’s festive research, and are joined by Anupam Bapu Jena from Harvard, who has been looking at self censorship in the time of Trump, and Melanie de Lange, from the university of Bristol, who has been investigating the impact of daylight savings time. Reading list: A dictionary for medicine’s unnamed moments https://www.bmj.com/content/391/bmj.r2476 Science of longevity medicine https://www.bmj.com/content/391/bmj.r2536 Changes in diversity language in National Institutes of Health grant awards https://www.bmj.com/content/391/bmj-2025-087222 Acute effects of daylight saving time clock changes on mental and physical health in England https://www.bmj.com/content/391/bmj-2025-085962