The Herald reported this week that a number of prisoners in Scotland exposed to secondary smoke have lodged cases claiming damages. The first is expected in court in the next few months.
The likelihood that a successful case would result in a series of copycat claims must be food for thought for the Scottish Government. But what would it achieve by defending each claim successfully?: of course it would undermine its own case that 'there is no safe level of secondary smoke' ...
What would you do in the Scottish Government's case?
Sunday, 30 January 2011
Saturday, 29 January 2011
WHO warns Spain to enforce smoking ban
Coordinator for the World Health Organisation's Tobacco-free Initiative Armanda Peruga (which produced the study behind this blog late last year) has addressed a conference in Spain. His message was that the authorities in Spain must be seen to enforce the smoking ban, and that ‘It is just as important that people believe the law is being complied with, as is actual compliance’.
This man understands why the media is so important to the government. Whether people observe an unpopular law depends in part on whether people think it is generally observed: whether it is in fact enforceable. This is certainly true of the smoking ban. The UK press told of the success stories and high compliance levels. Almost certainly the same degree of observance is not evident in Spain.
How symptomatic of our times that a World Health Organisation representative, an official of global governance, should address a national conference in Spain in such terms: that the law must be seen to be enforced. Only a law that is likely to be resented by large numbers of people would be discussed in such a manner.
We need to ask, what the need for a law that will clearly cause economic damage, and what the need for a WHO delegate (at whatever level in the hierarchy) to insist on the importance of enforcing such a law? The government of Spain is elected and can be blamed for the economic fallout of its policies. No one can touch anyone in the World Health Organisation.
And what is actually happening in Spain?
He had some critical words for some of the media in Spain. ‘Reading the headlines,’ he said, ‘could make you think that the country is up in arms’. In Peruga’s view, compliance with the law is very good, with a marked contrast between what is reflected in the media and the reality of the situation.
This man understands why the media is so important to the government. Whether people observe an unpopular law depends in part on whether people think it is generally observed: whether it is in fact enforceable. This is certainly true of the smoking ban. The UK press told of the success stories and high compliance levels. Almost certainly the same degree of observance is not evident in Spain.
How symptomatic of our times that a World Health Organisation representative, an official of global governance, should address a national conference in Spain in such terms: that the law must be seen to be enforced. Only a law that is likely to be resented by large numbers of people would be discussed in such a manner.
We need to ask, what the need for a law that will clearly cause economic damage, and what the need for a WHO delegate (at whatever level in the hierarchy) to insist on the importance of enforcing such a law? The government of Spain is elected and can be blamed for the economic fallout of its policies. No one can touch anyone in the World Health Organisation.
And what is actually happening in Spain?
Thursday, 27 January 2011
Come to the Carnival!
Tenerife bar owners will close their pubs and take to the streets on 9 March, the day of a local carnival, in protest at smoking ban legislation.
Court challenge delays Scottish display ban
The display ban was passed into Scottish law on 27 January 2010. A year later, the Scottish Government has had to put it on hold owing to a legal challenge from Imperial Tobacco, which has argued that the Scottish Government is not competent to pass the legislation.
Caledonian Mercury takes up the story (along with Scottish MSM and one or two local papers). There is little on the legal argument, most of it takes the form statements from Health Minister Shona Robison and Sheila Duffy. "The ban on displaying tobacco products in shops is being introduced to make cigarettes less attractive to children and young people," says the Health Minister. "It is disappointing that a tobacco display ban for large retailers will not be able to be introduced this year due to continuing tobacco industry legal challenges, but sadly not in any way surprising," says Sheila Duffy. I could have read their press releases myself: Scottish media coverage is typically disappointing.
By Stage 1 of the Bill in its report, September 2009 it was clear that there was no conclusive evidence that the tobacco display ban would have its intended effect of deterring the young from smoking. Richard Simpson wasn't put off: September 2009:
Frank Davis's recent piece The Scaremongers rings true here. Frank describes how the health lobby (right up to the World Health Organisation) fills the place once occupied by religion, where faith and conviction can legitimately over-ride physical evidence. It's fairly inevitable that any industry whose business was threatened by legislation (especially on the basis of evidence that the industry considered unsound) would attempt to defend itself – yet Simpson presents this scenario as if to suggest that the Devil guides tobacco industries in their sneaky attempts to get around what now passes for Divine law inspired by a Health-driven Deity.
The health debate shows an ugly side to quasi-religious fervour. They hate the sin, but profess to love the sinner. Possession by demons makes a grand excuse to marginalise and disenfranchise sinners, all for their own good. Impoverishment is immaterial, if it improves spiritual (and physical) health. All this goes for smokers and likewise for the sellers of tobacco.
We can hope that this "healthist" religion has not afflicted the courts and that they are still able to occupy their rightful place in the body politic, as independent decision makers in justice. Shopkeepers like to offer a service to the customers (offering goods for display) just like publicans used to be able to do (offering an ashtray). Stopping them trading autonomously without good cause on the pretence that customers' children might be tempted into bad ways (without any evidence that prohibition actually works) will damage them. Putting them under constant fear of surveillance in case they are caught infringing the rules during restocking is actually vicious, and moreover really fiddling while Rome burns, and won't stop cheap imitations flooding the streets. Even without the devolution issue on which Imperial Tobacco is relying, there is enough to send this legislation back under a rock
Caledonian Mercury takes up the story (along with Scottish MSM and one or two local papers). There is little on the legal argument, most of it takes the form statements from Health Minister Shona Robison and Sheila Duffy. "The ban on displaying tobacco products in shops is being introduced to make cigarettes less attractive to children and young people," says the Health Minister. "It is disappointing that a tobacco display ban for large retailers will not be able to be introduced this year due to continuing tobacco industry legal challenges, but sadly not in any way surprising," says Sheila Duffy. I could have read their press releases myself: Scottish media coverage is typically disappointing.
By Stage 1 of the Bill in its report, September 2009 it was clear that there was no conclusive evidence that the tobacco display ban would have its intended effect of deterring the young from smoking. Richard Simpson wasn't put off: September 2009:
The fact that we do not have all the evidence is not a reason not to have such a ban. I promise members that if we always wait for the evidence, the tobacco industry—this is particularly the case with that industry—will use every means in its power to get around every piece of legislation that every country passes.I hope the newsagents and tobacconists have all made a note of that statement. For Richard Simpson MSP, the balance of probabilities (even if, as in this case, it goes against him!) will suffice as the basis of legislation that is likely to damage low-margin businesses in the pursuit of an ideological goal (elevating health concerns above all others is ideological).
Frank Davis's recent piece The Scaremongers rings true here. Frank describes how the health lobby (right up to the World Health Organisation) fills the place once occupied by religion, where faith and conviction can legitimately over-ride physical evidence. It's fairly inevitable that any industry whose business was threatened by legislation (especially on the basis of evidence that the industry considered unsound) would attempt to defend itself – yet Simpson presents this scenario as if to suggest that the Devil guides tobacco industries in their sneaky attempts to get around what now passes for Divine law inspired by a Health-driven Deity.
The health debate shows an ugly side to quasi-religious fervour. They hate the sin, but profess to love the sinner. Possession by demons makes a grand excuse to marginalise and disenfranchise sinners, all for their own good. Impoverishment is immaterial, if it improves spiritual (and physical) health. All this goes for smokers and likewise for the sellers of tobacco.
We can hope that this "healthist" religion has not afflicted the courts and that they are still able to occupy their rightful place in the body politic, as independent decision makers in justice. Shopkeepers like to offer a service to the customers (offering goods for display) just like publicans used to be able to do (offering an ashtray). Stopping them trading autonomously without good cause on the pretence that customers' children might be tempted into bad ways (without any evidence that prohibition actually works) will damage them. Putting them under constant fear of surveillance in case they are caught infringing the rules during restocking is actually vicious, and moreover really fiddling while Rome burns, and won't stop cheap imitations flooding the streets. Even without the devolution issue on which Imperial Tobacco is relying, there is enough to send this legislation back under a rock
Wednesday, 26 January 2011
Tobacco harm reduction partially explained
Harm reduction means different things to different people. In the context of nicotine, it means using smokeless alternatives to tobacco without resorting to nicotine-based cessation therapies. It's a fairly new area to me, but it's been interesting how e-cigarettes are almost as political an issue as smoking itself.
E-cigarettes are, of course, an obvious example of harm reduction. Whether or not you believe that smoked tobacco is as serious a problem as the authorities wish us to believe, it is unarguable that using an e-cigarette doesn't involve inhaling in the way that smoking involves inhaling, and that it creates water vapour and not smoke.
Many e-cigarette users are far more politicised than smokers, and it is small wonder. Having given up the trouble to give up smoking, perhaps having swallowed anti-smoking propaganda in the process, they that find the product (e-cigarette) that has enabled them to stop smoking is about to be banned in New York, on suspicion that it might present some kind of health risk to the user.
At least that's the official version. In fact they are banning e-cigarettes but not real cigarettes (from which they derive huge levels of tax, but which (officially) carries enormous health risks), or drugs such as Champix, which is the subject of hundreds of lawsuits. New York State wants smokers on either real tobacco or pharmaceutical drugs.
Even ASH Scotland dedicates a section to harm reduction. Its sole item for 2011 so far shows that a few dozen smokers in the US prefer nicotine lozenges to snus. Its briefing on e-cigarettes is full of waffle, but essentially it wants e-cigarettes regulated by the MRHA along with any other smoking cessation treatment.
Unofficially, smokers find an alternative to smoking that's acceptable to them and take to it in their thousands. Officially, the authorities realise that they no longer control the nicotine market (the punters do – shocking!), so they set out to regulate it – although it does look strange when e-cigs are banned before they are known to be hazardous, and other drugs and tobacco itself are not banned, in spite of reported harms, lawsuits and vastly expensive health campaigns by the government.
The ironic result of a ban is that all those in New York State who gave up smoking using e-cigarettes are left without their product of choice. Many will go back to smoking rather than abstain completely or take to pharmaceutical nicotine.
Harm reduction must involve some level of autonomy for the smoker.
All this is bad enough. I now refer you to a post entitled 'If you pretend to be doing honest research, don't punish people for believing you'. Paul Bergen recounts the story of a tobacco cessation delegate who was thrown out of a conference for discussing 'harm reduction' as if it meant anything other than compliance with a medicinal nicotine regime. He then recounts his own similar experience. People like Paul Bergen and the other delegate have learned that people who want to stop others from smoking are not working to an agenda that concerns health.
E-cigarettes are, of course, an obvious example of harm reduction. Whether or not you believe that smoked tobacco is as serious a problem as the authorities wish us to believe, it is unarguable that using an e-cigarette doesn't involve inhaling in the way that smoking involves inhaling, and that it creates water vapour and not smoke.
Many e-cigarette users are far more politicised than smokers, and it is small wonder. Having given up the trouble to give up smoking, perhaps having swallowed anti-smoking propaganda in the process, they that find the product (e-cigarette) that has enabled them to stop smoking is about to be banned in New York, on suspicion that it might present some kind of health risk to the user.
At least that's the official version. In fact they are banning e-cigarettes but not real cigarettes (from which they derive huge levels of tax, but which (officially) carries enormous health risks), or drugs such as Champix, which is the subject of hundreds of lawsuits. New York State wants smokers on either real tobacco or pharmaceutical drugs.
Even ASH Scotland dedicates a section to harm reduction. Its sole item for 2011 so far shows that a few dozen smokers in the US prefer nicotine lozenges to snus. Its briefing on e-cigarettes is full of waffle, but essentially it wants e-cigarettes regulated by the MRHA along with any other smoking cessation treatment.
Unofficially, smokers find an alternative to smoking that's acceptable to them and take to it in their thousands. Officially, the authorities realise that they no longer control the nicotine market (the punters do – shocking!), so they set out to regulate it – although it does look strange when e-cigs are banned before they are known to be hazardous, and other drugs and tobacco itself are not banned, in spite of reported harms, lawsuits and vastly expensive health campaigns by the government.
The ironic result of a ban is that all those in New York State who gave up smoking using e-cigarettes are left without their product of choice. Many will go back to smoking rather than abstain completely or take to pharmaceutical nicotine.
Harm reduction must involve some level of autonomy for the smoker.
All this is bad enough. I now refer you to a post entitled 'If you pretend to be doing honest research, don't punish people for believing you'. Paul Bergen recounts the story of a tobacco cessation delegate who was thrown out of a conference for discussing 'harm reduction' as if it meant anything other than compliance with a medicinal nicotine regime. He then recounts his own similar experience. People like Paul Bergen and the other delegate have learned that people who want to stop others from smoking are not working to an agenda that concerns health.
Tuesday, 25 January 2011
Smoking in cars declared out of order by Greater Glasgow Health Board
Last week, many articles in the Scottish news media warned the public off smoking in cars, because the dangers to children were said to be phenomenally high: concentrates were higher, we were told, than in Scottish pubs before the ban. Don't bother opening your window, we were also told, because it won't make any difference (or enough difference).
Mr Gray in Glasgow is persuaded.
Mr Gray in Glasgow is persuaded.
... I am certain most of the public will feel the same and condemn those who continue to puff away when they have kids in the car.
The law should be changed to deal with this, as serously as being caught, say, using a mobile phone while driving.The Executive Summary of the NHSGGC report that kicked this off leaves much unanswered. The report shows an alarming picture of particulates in a smoky car at 14 times what they are in a car where no smoking was taking place, and peak concentrates at shocking levels:
The arithmetic mean PM2.5 concentration during journeys where smoking took place was 95 µg/m³, approximately 14 times higher than the mean figure of 6.8 µg/m³ measured during non-smoking journeys. Peak levels across the 26 smoking journeys averaged 410 µg/m³ compared to 12 µg/m³during nonsmoking journeys. The highest peak PM2.5 concentration of 886 µg/m³ occurred during a smoking journey.
At no point in any of the non-smoking journeys did PM2.5 concentrations exceed the 35 µg/m³ US EPA outdoor air guidance concentration for unhealthy air. All smoking journeys exceeded this threshold at some stage of the journey with the percentage of the time when concentrations rose above 35 µg/m³ ranging from16 to 100% (mean 49%).Here's a useful analysis:
As a preface it is important to note just what [the Scottish Centre for Indoor Air] has chosen to measure and report on in compiling the report, something called “FPM 2.5.” FPM 2.5 is the designation given to any particulate matter in the air that is 2.5 micrometers (microns) in diameter or smaller. Normal people call it smoke or smog. If you allow smoking in a place most people will realize that you will probably have smoke (FPM 2.5) in that place. If you go outside on particularly smoggy day you’ll be able to see FPM 2.5 in the outdoor air as well.
But there’s something very fundamental and important to remember when speaking of FPM 2.5: it is simply a measurement of a certain size range of particles. It says nothing about what those particles consist of or how dangerous they are. To pretend that the particles produced by the quiet burning of a few leaves in a scrap of paper is the same as the particles produced by the high temperatures and/or pressures of internal combustion engines, industrial processes, commercial incinerators, or even a roaring fireplace is simply false. It’s like pretending that a teaspoon of sugar crystals is just as deadly as a teaspoon of arsenic crystals simply because both happen to have crystals of the same size.
And yet it is this false premise that lies at the very base of the SCIA Report. Are the FPM 2.5 levels produced by cigarette smoke dangerous in the same way as the chemical air pollution produced in the air of our cities? It could be argued that it is possible but it certainly can not be argued that it is known. It could very well be that it is indeed like comparing arsenic crystals and sugar crystals, and it could also be that just as concentrated amounts of sugar can be unhealthy for certain small populations (e.g. diabetics) that concentrated amounts of FPM 2.5 from tobacco smoke could be unhealthy for certain small and sensitive populations (e.g. those with impaired breathing, those with severe cardiovascular disease, those who are very old or very young.)
Note however the importance of the word “concentrated.” If two chain smokers are driving for hours in a car with such a sensitive person and keep the windows rolled up tightly all during their trip, then yes, it could well be rationally argued that a real problem might exist. To argue that the same problem exists when moderate smokers roll a window or two down a few inches while driving at normal speeds and smoking is something else entirely: the all-important “air changes per hour” that ventilation engineers concern themselves with is probably about 2 or 3 with the windows closed tightly, but more like 200 or 300 when the windows are opened. To equate the two situations is simply a lie.And there is more:
In addition to the above problems the SCIA report seems to deliberately make another very fundamental error, one that it would be difficult for the authors to plead innocent of. While it is true that according to agencies such as the US EPA that urban, automotive, and industrial air pollution has been shown to be unhealthy or even dangerous when it reaches higher levels for periods of 24 hours or more, it is also true that the EPA doesn’t set standards for FPM 2.5 for shorter periods because there is no sound medical reason to believe that shorter episodes of such exposures actually pose a threat to health. When the SCIA takes readings during car journeys that typically last less than several hours and tries to apply the EPA’s 24 hour standards to those readings, it is explicitly violating the very guidelines of the EPA itself.
Explicitly? Deliberately? Am I being unfair? I don’t think so. Here is the relevant passage from page 42 of the EPA’s own GUIDELINE ON DATA HANDLING CONVENTIONS FOR THE PM NAAQS for the use of its calculations:
If measurements are available for less than 75 percent (17 or less) of the hours during the 24-hour period, you must treat the 24-hour average as invalid, unless the concentrations are too high to be ignored, as determined by the following calculation:A. Compute the lower bound. Substitute zero for each missing hour and compute the average over all 24 hours.B. Round the lower bound. Round the lower bound to the nearest 1 µg/m³ for PM concentrations (round up decimals 0.5 or greater). Round the lower 2.5 bound to the nearest 10 µg/m³ for PM concentrations (round up integers 10 of 5 or greater).C. Compare the rounded lower bound to the standard. If the rounded lower bound exceeds the level of the 24-hour standard, use the unrounded lower bound as the valid 24-hour average. Otherwise, treat the 24-hour average as invalid.
Michael J. McFadden
What measurements do we have to go on?
- the EPA safe level for healthy air is given as 35 µg/m³
- peak levels of particulates in the non-smoking car were about 12 µg/m³
- peak concentrations in the smoking car averaged 410 µg/m³ in the smoking journeys (while what they call the mean average was about 95 µg/m³).
The report (so far we only have access to the summary) doesn't define the lower bound but surely in a range with peak average of 410 µg/m³, an absolute maximum of 886 and an overall average of 95 µg/m³, the lower end of the range must have been very very low. Nor does it tell us how long the journeys were, but it's hard to see why journeys of this experimental nature should exceed two or three hours. We do know however from the Executive Summary that for up to 15 per cent of the smoking journeys the meter read <35 µg/m³, and it therefore seems clear that the pollution described in this report is insignificant in the terms defined by the Environmental Protection Agency (who set the 35 µg/m³ safe level), indeed that the SCIA has violated the EPA standard by its use of the figures.
So ... in the first place, we don't even know for sure that the particulates from smoke do any damage, just because of their size. In the second place, since the EPA levels are designed to apply to prolonged exposure, the pollution levels actually fall comfortably within the safe ranges defined.
In the Evening Times article, further misconceptions come to light. For example:
Dr Sean Semple, of the Scottish Centre For Indoor Air, was part of the research team. He said: “The air quality during smoking car journeys is much worse than normal outdoor air pollution levels.”
This seems to miss most basic toxicity lessons. A car journey is often quite short, and even when it is long, smoking might occupy a very short part of it. Outdoor air pollution in busy cities will vary with the time of day and the weather but in general is much more constant than what you will find in a car. (Even in the non-smoking car, particulates didn't measure zero.) Furthermore particulates are only part of the story of outdoor air pollution – particulate measurements won't pick up noxious gases.
MJM concludes:
The final paragraph of the Summary consists of three sentences, each of which is important enough to be examined on its own:
1) PM2.5 concentrations in cars where smoking takes place are high and greatly exceed levels that are deemed to be unhealthy in outdoor air.
The above statement was dealt with in the opening paragraphs of this Critique. The comparison with EPA type 24 hour standards violates the very conditions of the guide and as such it should never have been permitted in such an official document as this Summary. Not only are the FPM 2.5 measurements measuring something chemically and probably clinically quite different from the EPA measurements setting “unhealthy” level guidelines, but the EPA itself forbids usage of its guidelines while disregarding the 24 hour exposures for which they were set.
2) Smoking in cars leads to exposure to SHS that is likely to be damaging to health.
This statement is not in any sense supported by the data in the Report. The Report does not show any data, at least not as indicated in its Summary, that would support such a claim for brief exposures at the levels measured. This statement should also be stricken from the Summary.
3) Measures to restrict the exposure of children to SHS should be considered at both an individual and a societal level.
This final statement is reasonable, but it should be more open about what it is urging: it is calling for the government to enact legal measures and remedies to “restrict the exposure of children” to SHS by their parents, not just in public places, but in the confines of vehicles and private homes. It would have been a more honest concluding statement if it had said:
“Measures to enact laws to restrict smoking in private homes and vehicles where minors are present should be considered even if the minors in question are themselves smokers. Such measures obviously will also require the consideration of proper penalties and the removal of such children in the face of persistent parental smoking. Since the eyes of the government cannot be in every home, children should be empowered and encouraged to report on their parents if such exposure occurs with the parents being duly dealt with through fines and imprisonment.”ASH Scotland has not yet nailed its colours to the mast and demanded a smoking ban in cars.
Monday, 24 January 2011
Spain intensifies smoking inspections
The Spanish Director of Public Health has announced plans to step up enforcements of the smoking ban, following widespread reports of floutings.
He said, 'he had received no indications that financial losses, claimed by businesses as a result of the smoking ban in enclosed public spaces, were generalised, and asked for time to make "relevant evaluations." "No other country has suffered economic losses after applying a law like this," he concluded.' [emphasis added]
I have to say that surprises me.
He said, 'he had received no indications that financial losses, claimed by businesses as a result of the smoking ban in enclosed public spaces, were generalised, and asked for time to make "relevant evaluations." "No other country has suffered economic losses after applying a law like this," he concluded.' [emphasis added]
I have to say that surprises me.
Friday, 21 January 2011
Wales hospital criticised for tobacco mess on surrounding streets. Watch them not learning
A Swansea hospital has been criticised for not providing smoking facilities for its staff and patients following growing litter problems since it banned smoking from its site in 2009. There is no acknowledgement on the part of the Trust of any problem with this outright ban, which involved moving smoking bins off the premises to the gates of the site (ffs!), and effectively dumping the waste in the street, rather than offering patients, staff and smokers a smoking room. The usual volley of counter-insults appears in the comments column below.
Worse still, Cardiff and Vale University Health Board plans to follow suit this year with plans for a ban in hospital doorways from April, and the Welsh Health Minister even considering outlawing smoking on hospital premises. They seriously think it will save money.
Today's Daily Record (I learned from the daily news bulletin of ASH Scotland) carries a letter from a woman aged 40 with a terminal lung condition. (No url.) Her complaint (and she feels she has the right) is that she has to get through a barricade of smokers to get to her hospital appointments. Unfortunately she blames the smokers, rather than blaming the authorities for not allowing the hospital's catering department to accommodate them in a large room, where visitors could rest with a coffee while waiting for their loved ones, and patients could take their relatives or just go for some time away from the ward. I know what I would do in her case: rather than claiming a 'right to complain', I would go to war with the hospital authorities and the Government, rather than hope to influence smokers by writing to the papers about them.
What will it take this country to come to its senses on this issue?
Worse still, Cardiff and Vale University Health Board plans to follow suit this year with plans for a ban in hospital doorways from April, and the Welsh Health Minister even considering outlawing smoking on hospital premises. They seriously think it will save money.
Today's Daily Record (I learned from the daily news bulletin of ASH Scotland) carries a letter from a woman aged 40 with a terminal lung condition. (No url.) Her complaint (and she feels she has the right) is that she has to get through a barricade of smokers to get to her hospital appointments. Unfortunately she blames the smokers, rather than blaming the authorities for not allowing the hospital's catering department to accommodate them in a large room, where visitors could rest with a coffee while waiting for their loved ones, and patients could take their relatives or just go for some time away from the ward. I know what I would do in her case: rather than claiming a 'right to complain', I would go to war with the hospital authorities and the Government, rather than hope to influence smokers by writing to the papers about them.
What will it take this country to come to its senses on this issue?
Thursday, 20 January 2011
The toxins in contraband tobacco, discussion on Talksport
In case you want feel like listening to chat about toxins in tobacco, presenter Ian Collins on Talksport (until 1 am) considers the news that contraband tobacco seized recently contains 30 times the toxic residues of legitimate cigarettes. Other subjects covered too. Background story from the BBC here.
The anti-tobacco brigade struggles to accept that it contributes to the problem every time it pushes the government to raise duty. Also, every time it tries to denormalise smoking , it pushes the legal product further into the shadows with no concern for smokers' health.
The anti-tobacco brigade struggles to accept that it contributes to the problem every time it pushes the government to raise duty. Also, every time it tries to denormalise smoking , it pushes the legal product further into the shadows with no concern for smokers' health.
Arguing with ASH on packaging
Today I continued an argument with Action on Smoking and Health that started last week, on an article published by the European Parliament. The article described how addiction could be eliminated by simply banning branding and forcing tobacco companies to sell their wares in plain packaging:
What I was arguing with Action about was the claim in the article by Leon Joosens that "Unique codes and invisible ink along with the quality and packaging will indicate whether the cigarettes are illegal, ...So there is no reason to suggest it will increase illegal trade". I pointed out that invisible and ink and unique codes wouldn't be much use to customers trying to avoid counterfeit tobacco. Action said that provided customers bought tobacco from shops they would be safe from the danger of counterfeit products. It took me precisely ten seconds to find a story of illegal cigarettes (not necessarily counterfeit ones) being seized by officers in a shop. Already shops are handling illegal products.
ASH wouldn't accept that producing counterfeit cigarettes would be any easier to produce and distribute if branding were banned, but tried to convince me that branding was aimed at kids and was effective in 'making' them smoke. One of the articles it/he/she posted declares that 'perception is everything':
They don't know. They can only hope.
Meanwhile the Scottish war on tobacco continues with an interesting article in the Press & Journal that describes progress over the last ten years:
I find it odd that the people who have seized the initiative on illicit tobacco control in Scotland are those (the Scottish Tobacco Control Alliance) who appear to want to blur the distinction between legal and illegal tobacco, and wouldn't dream of advising you to support your local shop by buying the legitimate product, because they don't want you to buy the product at all. They are against the product and will not deal with industry representatives, but seek to protect legitimate trade in the product – while planning an attack on industry brand identity. What a mixed bag of aims and motives.
Karine Gallopel-Morvan, a lecturer at Rennes university in France, found that a plain pack design with health warnings would deter almost all non smokers from taking up smoking and would reduce the desire amongst smokers to take a cigarette from the pack.Does this work better than patches? A delegate from Stirling, Crawford Moodie (well known in tobacco control circles) was also present:
Moodie, of the institute of social marketing at Stirling university in Scotland, conducted an online survey, which found that almost one in three young people admitted to choosing a certain brand of cigarettes because they were attracted by the pack's appearance.This is very far from proving that young people wouldn't start smoking without the visual cues found on brand packaging. Deriving certain impressions from cigarette packaging is surely inevitable, but it doesn't demonstrate that the product wouldn't have a market without the branding.
What I was arguing with Action about was the claim in the article by Leon Joosens that "Unique codes and invisible ink along with the quality and packaging will indicate whether the cigarettes are illegal, ...So there is no reason to suggest it will increase illegal trade". I pointed out that invisible and ink and unique codes wouldn't be much use to customers trying to avoid counterfeit tobacco. Action said that provided customers bought tobacco from shops they would be safe from the danger of counterfeit products. It took me precisely ten seconds to find a story of illegal cigarettes (not necessarily counterfeit ones) being seized by officers in a shop. Already shops are handling illegal products.
ASH wouldn't accept that producing counterfeit cigarettes would be any easier to produce and distribute if branding were banned, but tried to convince me that branding was aimed at kids and was effective in 'making' them smoke. One of the articles it/he/she posted declares that 'perception is everything':
"Cigarettes have created a brand for every personality trait," Hanewinkel says. "If you are looking to project independence and masculinity, think of the lonely cowboy in the Marlboro ads. On the other hand, if you're looking to project a desire for romantic relationships, and friendships are playing a role, then you will choose Lucky Strike if you are a man and Virginia Slims if you are a woman."Generalisations are all very well, but how can they project that demand for these products will disintegrate in the absence of branding? Or that customers will reach the right conclusions about which cigarettes are the most addictive?
They don't know. They can only hope.
Meanwhile the Scottish war on tobacco continues with an interesting article in the Press & Journal that describes progress over the last ten years:
Since the launch of a strategy to stop tobacco smuggling in 2000, more than 14 billion cigarettes, worth £4 billion, have been seized, more than 350 criminal gangs have been broken up, and £35 million has been collected through confiscation orders.Three hundred and fifty gangs is a lot of people and one wonders how many more got away. The articles were published following a press release from ASH Scotland reporting the publication of the recommendations of a conference on illicit tobacco held in September 2010 in Perth. To its credit, the Press & Journal quoted Chris Ogden from the Tobacco Manufacturers Association, which was not invited to take part in last September's conference (he pointed out that high taxes were not helping the situation regarding illegal tobacco).
I find it odd that the people who have seized the initiative on illicit tobacco control in Scotland are those (the Scottish Tobacco Control Alliance) who appear to want to blur the distinction between legal and illegal tobacco, and wouldn't dream of advising you to support your local shop by buying the legitimate product, because they don't want you to buy the product at all. They are against the product and will not deal with industry representatives, but seek to protect legitimate trade in the product – while planning an attack on industry brand identity. What a mixed bag of aims and motives.
Wednesday, 19 January 2011
Greeks not given licence to smoke, despite hard times
In spite of Monday's report on smoking licences, the Greek Health Minister has now signalled that the government will draft in extra enforcement staff and ensure that the smoking ban in Greece is made to work. There will be no modification of the smoking ban policy. Is it to do with pride:
Knowing the EU's position on Cyprus, it's not hard to see them putting pressure on Greece in the smoking ban department. Just speculating.
"The Greek State cannot continue to be made a laughing-stock," [Health Minister] Loverdos stressed, insisting that the law would be enforced in its current form.Or is something more at stake? Why would the state appoint 800 public servants to punish people for a social enjoyment they had practised for hundreds of years – to enforce a smoking ban that would aggravate the austerity already imposed on Greeks, driving down incomes and threatening livelihoods.
Knowing the EU's position on Cyprus, it's not hard to see them putting pressure on Greece in the smoking ban department. Just speculating.
Tuesday, 18 January 2011
Licence to let people smoke in Greek hospitality venues
Under pressure from over 400 penalty notices and who knows how many more breaches of the law since last September, Greece will shortly announce the introduction of smoking licences, bringing an end to an experiment in smoking bans that the authorities really thought would work this time round.
I said earlier that I don't really think licences are a solution. I still don't think they are, but if I'm honest if the opportunity arose to apply such a thing in Scotland tomorrow I'd go for it. Anything to prove that smoking facilities have market value, which many anti-smokers have awkwardly tried to deny from day one. Anything to reverse this deplorable situation that gives smokers and their friends nowhere to light up anywhere in the country, in spite of their contribution to the health budget and council taxes.
Better that smoking indoors isn't seen as a right that one has to purchase from the council. It's a natural right, or a God-given right, or a common law right, depending on your point of view. Tobacco is legal, and anyone can say that they don't want it on their premises – there is no reason to be heavy handed. However much money they spend trying to persuade us that smoking damages the body beyond repair within minutes (more than anything else?), the inherent injustice of the smoking ban remains: it's a weapon to denormalise smoking, and, by association, smokers.
I said earlier that I don't really think licences are a solution. I still don't think they are, but if I'm honest if the opportunity arose to apply such a thing in Scotland tomorrow I'd go for it. Anything to prove that smoking facilities have market value, which many anti-smokers have awkwardly tried to deny from day one. Anything to reverse this deplorable situation that gives smokers and their friends nowhere to light up anywhere in the country, in spite of their contribution to the health budget and council taxes.
Better that smoking indoors isn't seen as a right that one has to purchase from the council. It's a natural right, or a God-given right, or a common law right, depending on your point of view. Tobacco is legal, and anyone can say that they don't want it on their premises – there is no reason to be heavy handed. However much money they spend trying to persuade us that smoking damages the body beyond repair within minutes (more than anything else?), the inherent injustice of the smoking ban remains: it's a weapon to denormalise smoking, and, by association, smokers.
Sunday, 16 January 2011
Professor in Public Health claims Dutch government swayed by tobacco lobby
Thousands of licensees united to campaign against the smoking ban in the Netherlands, which was never fully enforced before recently being scrapped for bars without employees. The change to the law was made by the incoming Coalition government in the Netherlands, and endowed Professor Marc Willemsen blames the tobacco interests of the Defence Minister for the policy change. Over twelve hundred publicans voice their opposition to the ban in campaigns, and yet the tobacco industry's influence on a single cabinet minister over-rides all other considerations.
To Professor Willemsen, Minister Hillen's presence on the Cabinet as a lobbyist tobacco undermines Dutch compliance with Article 5.3 of the Framework Convention on Tobacco Control. This is meant to protect health policy from tobacco industry influence. Or, perhaps, to ensure that anybody with any (alleged) interest in tobacco, however peripheral, is excluded from discussions of tobacco policy. The fact is that no lobbying interest should dictate government policy, and while it might not be unreasonable to have laws or guidelines on lobbying, excluding interests from lobbying at all is not reasonable or rational.
Professor Willemsen alleges that 'the tobacco industry has strategic connections in government circles', although it isn't clear that he has evidence of financial interests in tobacco for anyone other than Hillen. No other minister is specified in his blog post. It's arguable whether Mr Hillen's presence on the Cabinet made any difference to the outcome of the Dutch licensees' rebellion. No one asks which Cabinet ministers get freebees from Big Tobacco's rivals in the nicotine market: Big Pharma, or whether such influence is improper.
Professor Willemsen's solution? He 'argues for confrontational campaigns which clearly show the damage smoking causes to the body. He also favours higher duties on tobacco and a less prominent location for tobacco products in supermarkets'. None of which has much relevance to smoking ban policies. As for tobacco in shops, its position behind the counter means that it is out of the reach of pilferers and easily accessible to shop staff. Nothing could be more sensible.
More on the Dutch story here.
Professor Willemsen's recipe for success
To Professor Willemsen, Minister Hillen's presence on the Cabinet as a lobbyist tobacco undermines Dutch compliance with Article 5.3 of the Framework Convention on Tobacco Control. This is meant to protect health policy from tobacco industry influence. Or, perhaps, to ensure that anybody with any (alleged) interest in tobacco, however peripheral, is excluded from discussions of tobacco policy. The fact is that no lobbying interest should dictate government policy, and while it might not be unreasonable to have laws or guidelines on lobbying, excluding interests from lobbying at all is not reasonable or rational.
Professor Willemsen alleges that 'the tobacco industry has strategic connections in government circles', although it isn't clear that he has evidence of financial interests in tobacco for anyone other than Hillen. No other minister is specified in his blog post. It's arguable whether Mr Hillen's presence on the Cabinet made any difference to the outcome of the Dutch licensees' rebellion. No one asks which Cabinet ministers get freebees from Big Tobacco's rivals in the nicotine market: Big Pharma, or whether such influence is improper.
Professor Willemsen's solution? He 'argues for confrontational campaigns which clearly show the damage smoking causes to the body. He also favours higher duties on tobacco and a less prominent location for tobacco products in supermarkets'. None of which has much relevance to smoking ban policies. As for tobacco in shops, its position behind the counter means that it is out of the reach of pilferers and easily accessible to shop staff. Nothing could be more sensible.
More on the Dutch story here.
Professor Willemsen's recipe for success
Saturday, 15 January 2011
Aberdeen City Council moderates no-smoking policy for foster carers
From this:
What's this about smokers not being recruited to care for children from a non-smoking birth family? Of all the categories of children they wish to protect from smokers, this is the most bewildering. They actually register when a child (at whatever tender age) is taken into care whether either one or both its parents or carers smokes, for the purpose of deciding future care arrangements? Nothing would surprise me less, but how incredibly irrelevant to a successful outcome in fostering or adopting children can they get?
Not everyone welcomes the city council's slightly less draconian position: '... social work committee members were warned yesterday that the council could face legal action in the future if the health of youngsters who are placed with smokers is damaged'. Whoever issues these dire warnings (the news report doesn't identify them) clearly believes the council's first concern should be protecting itself against the future claims of children exposed to secondary smoking during their time in foster care. The city council's future liability drove the move towards a total ban: 'The move will be considered amid fears the council could be held liable if youngsters in care develop future health problems linked to passive smoking.' Is this really likely? Part of my letter to the Social Work convener said:
It's not as if Aberdeen City Council hasn't plenty of children on its hands.
Former smokers would have to provide “evidence” that they had stopped for at least a year before being considered for foster care or adoption placements, while no child born in a non-smoking family would be placed in the care of a smoker.To this:
It was agreed that smokers will no longer be recruited to care for children who are under the age of five, have respiratory problems, are from a non-smoking birth family or have a disability which means they are unable to play outside. [emphasis added]I suppose that's some kind of progress. The basic difference is that Aberdeen Council no longer intends an outright ban, but still draws the line at allowing smokers to adopt or foster under-fives and children in certain other exempted groups described above.
What's this about smokers not being recruited to care for children from a non-smoking birth family? Of all the categories of children they wish to protect from smokers, this is the most bewildering. They actually register when a child (at whatever tender age) is taken into care whether either one or both its parents or carers smokes, for the purpose of deciding future care arrangements? Nothing would surprise me less, but how incredibly irrelevant to a successful outcome in fostering or adopting children can they get?
Not everyone welcomes the city council's slightly less draconian position: '... social work committee members were warned yesterday that the council could face legal action in the future if the health of youngsters who are placed with smokers is damaged'. Whoever issues these dire warnings (the news report doesn't identify them) clearly believes the council's first concern should be protecting itself against the future claims of children exposed to secondary smoking during their time in foster care. The city council's future liability drove the move towards a total ban: 'The move will be considered amid fears the council could be held liable if youngsters in care develop future health problems linked to passive smoking.' Is this really likely? Part of my letter to the Social Work convener said:
I simply cannot believe that neglected, abandoned or orphaned children would agree that institutional care is preferable to being placed with a family, provided the commitment was there to support them in that family, just because someone in the family smoked. Any decision about care, access or custody that considers smoking as any way relevant is a very poor judgement call for the vast majority of children.No child will thank the council for depriving it of a family home out of a fear of liability. This is absolutely not the criterion on which adoption policy should be judged. Those responsible for children's welfare must consider the overall suitability of those offering to adopt and foster children, not be driven by peripheral policy considerations that exclude many such people.
It's not as if Aberdeen City Council hasn't plenty of children on its hands.
Thursday, 13 January 2011
Swedish landlord pays tenants to inform on smoking neighbours
In a non-smoking private apartment block in northern Sweden, the landlord wishes to offer cash incentives for information on which tenants are breaking the rules: a move criticised by a tenants' association leader.
Bad move. Paid informers are among the least credible. Niclas Sundell of the Swedish Union of Tenants is quoted extensively explaining how unwelcome and unwise this plan is, and the landlord has no comment to make to the reporter.
Bad move. Paid informers are among the least credible. Niclas Sundell of the Swedish Union of Tenants is quoted extensively explaining how unwelcome and unwise this plan is, and the landlord has no comment to make to the reporter.
Cyprus position on smoking ban bothers EU
According to a Cyprus local paper there is concern in Europe about the possibility that Cyprus could water down its smoking ban in response to reports that trade is suffering.
Compliance is strong, but resentment high, according to this report from last January. Nobody is blaming supermarket prices or recession for a 40 per cent drop in takings in the first few days of 2010.
In today's Cyprus Mail report, Police Spokesman Michael Katsounotos says: “ I have just received an email from the [EU] Health Ministry saying that an article in the Cyprus Mail has caused concern in the European Union that smoking laws in Cyprus were about to be changed after complaints from night club owners.”
There seems a high degree of awareness in Cyprus that national decisions about smoking bans matter to Brussels. Is this really what the European Union was meant to be about?
Compliance is strong, but resentment high, according to this report from last January. Nobody is blaming supermarket prices or recession for a 40 per cent drop in takings in the first few days of 2010.
In today's Cyprus Mail report, Police Spokesman Michael Katsounotos says: “ I have just received an email from the [EU] Health Ministry saying that an article in the Cyprus Mail has caused concern in the European Union that smoking laws in Cyprus were about to be changed after complaints from night club owners.”
There seems a high degree of awareness in Cyprus that national decisions about smoking bans matter to Brussels. Is this really what the European Union was meant to be about?
Wednesday, 12 January 2011
Smoking bans not enforced in ...
Tuesday, 11 January 2011
Kenya split on tobacco growing
Growing pressure on the tobacco industry has encouraged the Kenya Tobacco Control Alliance to call on Kenyan tobacco farmers to abandon their crop – a call resisted by tobacco farmers who have seen no viable alternatives opening to them.
The Tobacco Control Alliance has no doubt that its anti-tobacco policies are sound policy. Following the lead of the Framework Convention on Tobacco Control, they have instituted bans on smoking in public places. The tobacco farmers don't like it because tobacco is a staple crop. But because they have also recently fought the tobacco companies over working conditions, the Tobacco Control Alliance can't understand the farmers' support for the tobacco trade.
Nowhere is it reported that any alternatives have presented themselves for tobacco farmers, however. Their problem of being tobacco farmers might be linked to their poverty, but being without a trade won't make them any better off. The agenda of the KTCA is fighting tobacco in collaboration with their colleagues elsewhere in the world. They are not fighting for the interests of the farmers, and can't even understand why the farmers wish to defend an industry that grinds them into the ground. Because of the KTCA's heavy anti-tobacco agenda it is even hard to ascertain whether tobacco farming is always as exploitative and environmentally destructive as they describe. They certainly don't have the detachment required to assist the farmers to change to another crop, or even to advise whether this is their best option.
The first story tells us that British American Tobacco are also defending the tobacco trade in Kenya, describing anti-tobacco measures as attempts to restrict trade rather than to promote health. It's hard not to agree, knowing the agenda of the FCTC. A village elder stresses the dangers of transferring to the uncertainties of an alternative crop. Health problems from tobacco farming appear to be tangible, but so far the alternatives aren't presenting themselves (as Mr Abrunhosa of the International Tobacco Growers' Association complained in this video).
It would seem as usual that the rural poor in Kenya are pawns in the games played by larger players. In the meantime I am quite glad that they can express opposition to the tobacco manufacturers on one side and the Kenya Tobacco Control Association on the other.
The Tobacco Control Alliance has no doubt that its anti-tobacco policies are sound policy. Following the lead of the Framework Convention on Tobacco Control, they have instituted bans on smoking in public places. The tobacco farmers don't like it because tobacco is a staple crop. But because they have also recently fought the tobacco companies over working conditions, the Tobacco Control Alliance can't understand the farmers' support for the tobacco trade.
The health toll on tobacco workers, according to the tobacco control alliance, is indeed heavy: It is no longer news that women and children from tobacco growing areas continue to suffer from Green Tobacco Sickness (GTS), damaged lungs, amputated legs and other diseases caused by growing and home processing of tobacco ... Not even the wild animals move closer to the leafy crop.... And so on. The article continues to report the environmental devastation wrought by tobacco: 'Chiefs in this area decry of the fast declining soil fertility and the environmental degradation caused by tobacco curing. They complain of persistent drought, lack of water, famine and death of animals which share the same water source for watering tobacco.'
Nowhere is it reported that any alternatives have presented themselves for tobacco farmers, however. Their problem of being tobacco farmers might be linked to their poverty, but being without a trade won't make them any better off. The agenda of the KTCA is fighting tobacco in collaboration with their colleagues elsewhere in the world. They are not fighting for the interests of the farmers, and can't even understand why the farmers wish to defend an industry that grinds them into the ground. Because of the KTCA's heavy anti-tobacco agenda it is even hard to ascertain whether tobacco farming is always as exploitative and environmentally destructive as they describe. They certainly don't have the detachment required to assist the farmers to change to another crop, or even to advise whether this is their best option.
The first story tells us that British American Tobacco are also defending the tobacco trade in Kenya, describing anti-tobacco measures as attempts to restrict trade rather than to promote health. It's hard not to agree, knowing the agenda of the FCTC. A village elder stresses the dangers of transferring to the uncertainties of an alternative crop. Health problems from tobacco farming appear to be tangible, but so far the alternatives aren't presenting themselves (as Mr Abrunhosa of the International Tobacco Growers' Association complained in this video).
It would seem as usual that the rural poor in Kenya are pawns in the games played by larger players. In the meantime I am quite glad that they can express opposition to the tobacco manufacturers on one side and the Kenya Tobacco Control Association on the other.
Monday, 10 January 2011
Don't let science get in the way of a good policy
So says one Ray Pawson in the Journal of the Canadian Medical Association and reported here. This English-educated high flier in sociology concludes that although there is too much complex evidence to come to a sure conclusion about the level of exposure and the harm it will do, there is enough evidence to warrant the passing of legislation to prevent anyone from smoking in a car with a child in it.
A further account goes as follows:
I can't help feeling that the anti-smoking campaign did things the wrong way round if it wanted to convince us that it cares about children. First it went for smoking in the workplace and in pubs, in spite of warnings that people would smoke more at home. The rationale was to protect the workers. Only having achieved this did it start on protecting children in private spaces, with some local authorities prohibiting foster carers from smoking at home (claiming a stake in the shape of the children's health) and now cars are under discussion.
A policy based on children's health would have gone all out to make the claims about children first. This didn't happen because it would have meant an immediate intrusion on private space. The way it was done was the politically acceptable way: it has meant gazillions of car journeys have taken place in the meantime with children fully exposed to secondary smoke.
Not that I think it's done them any damage, or the ones exposed to smoke from their foster parents. If there is a genuine health issue many parents will respond to it by controlling smoke, but why disempower people with this 'no safe level of secondary smoke' nonsense?
If it comes to it, there's no safe level of anything.
A further account goes as follows:
While trying to determine the risks involved, the authors first looked at the mixture of chemicals that make up second-hand smoke and its concentration in cars under different conditions such as volume, speed and ventilation. Second, they looked at how long a person would be in the car. Third, they observed how long a person would be exposed to the second-hand smoke. Fourth, the extent of difference between how second-hand smoke affects children compared to adults was added to the risk equation and finally, the authors looked at the health impact, which is hard to determine because of all the different chemicals and toxins a person is exposed to in their lifetime.I can't find much in the composition of smoke to get excited about: the diagram shows that smoke is about 90 per cent air and about 10 per cent a combination of other gases (further discussion here if you're interested). The account continues:
"Policy based on science and evidence has to exist amid uncertainty and this is managed by acknowledging the contingencies," write the authors. "Thus, i) because of the confirmed [confined?] cabin space, and ii) under the worst ventilation conditions, and iii) in terms of peak contamination, the evidence permits us to say that smoking in cars generates fine particulate concentrations that are, iv) very rarely experienced in the realm of air-quality studies, and that will thus constitute a significant health risk because, v) exposure to smoking in cars is still commonplace , and vi) children are particularly susceptible and vii) are open to further contamination if their parents are smokers."In the absence of any evidence on the smoke exposure levels in any individual car but taking a worst-case scenario, the authors attempt to pass this off as 'science', and use it to justify a policy that prohibits smoking in cars. They are correct (if this table is to be believed) that particulates of smoke are exceptionally fine (although the word 'concentrations' puzzles me as this depends entirely on the amount of smoking and air exchange). But calling this approach 'policy based on science and evidence' is taking the mick, when they're also saying that actual evidence isn't necessary.
I can't help feeling that the anti-smoking campaign did things the wrong way round if it wanted to convince us that it cares about children. First it went for smoking in the workplace and in pubs, in spite of warnings that people would smoke more at home. The rationale was to protect the workers. Only having achieved this did it start on protecting children in private spaces, with some local authorities prohibiting foster carers from smoking at home (claiming a stake in the shape of the children's health) and now cars are under discussion.
A policy based on children's health would have gone all out to make the claims about children first. This didn't happen because it would have meant an immediate intrusion on private space. The way it was done was the politically acceptable way: it has meant gazillions of car journeys have taken place in the meantime with children fully exposed to secondary smoke.
Not that I think it's done them any damage, or the ones exposed to smoke from their foster parents. If there is a genuine health issue many parents will respond to it by controlling smoke, but why disempower people with this 'no safe level of secondary smoke' nonsense?
If it comes to it, there's no safe level of anything.
Saturday, 8 January 2011
Smoking not a cause of health inequalities
ASH Scotland makes the astonishing discovery that poor people smoke more than wealthier people, and urges the Scottish Government to do something about it. That something is 'tackling tobacco addiction', because:
Clearly this is contentious: everyone has a view about what causes poverty – what balance of circumstances and fecklessness brings people to living on the breadline. There are no easy answers.
However I can guess that ASH Scotland's sympathies would have been firmly behind Patrick Reynolds in the Al-Jazeera video, and agreed that the International Tobacco Growers Association should have been excluded from international tobacco discussions under the auspices of the World Health Organisation. In other words they have ideological sympathies with a set-up that excludes the poorest workers in the system from participation in high-level talks involving highly paid public servants and other personnel occupying influential positions in society. These talks discuss the banning of ingredients from tobacco, affecting the marketability of tobacco plants, leaving the farmers with no livelihood. Such is the sympathy of anti-tobacco for the need to alleviate poverty.
Deaths from heart disease are nearly five times higher in poorer areas, and cancer deaths almost twice as high.Smoking being the only thing that makes people ill. Not genetics, stress from chronically unstable living conditions, toxic working conditions – it's all caused by smoking. Top marks to Sheila Duffy for this observation:
Life expectancy, health problems, smoking rates and deaths from smoking are all markedly different between Scotland’s richest and poorest communities.Bottom of the class for this:
To challenge health inequalities we must tackle smoking.Suggested edit:
To bring down smoking rates we must tackle health inequalities and poverty.Removing smoking and placing it with a cocktail of nicotine patches and whatever other illicit substance the poor might use to alleviate the worst stresses of poverty is not a route out of poverty. Smoking is a lifestyle choice/habit/addiction (whatever) associated with poverty rather than wealthier circumstances, and the best way to get the smoking rate down is to boost living standards.
Clearly this is contentious: everyone has a view about what causes poverty – what balance of circumstances and fecklessness brings people to living on the breadline. There are no easy answers.
However I can guess that ASH Scotland's sympathies would have been firmly behind Patrick Reynolds in the Al-Jazeera video, and agreed that the International Tobacco Growers Association should have been excluded from international tobacco discussions under the auspices of the World Health Organisation. In other words they have ideological sympathies with a set-up that excludes the poorest workers in the system from participation in high-level talks involving highly paid public servants and other personnel occupying influential positions in society. These talks discuss the banning of ingredients from tobacco, affecting the marketability of tobacco plants, leaving the farmers with no livelihood. Such is the sympathy of anti-tobacco for the need to alleviate poverty.
Citibank predicts that smoking will cease
Citibank predicts that smoking in the UK will expire by 2050 in the UK. It produces a table with data based on national smoking rates across several countries:
I find it interesting that two countries that have announced that they will eradicate smoking in the medium term, Finland and New Zealand, according to this table, won't actually achieve it until relatively late: New Zealand in 2058, and Finland in 2193. Netherlands (where there has been a huge backlash to the recent smoking restrictions) kicks the habit in 2048, but France carries on till 2118, 70 years later, and the Greeks for more than a century after that.
The predictions are based on fifty years' decline in smoking rates, and reports stress that 'if this continues', smoking will die out by the dates indicated.
If this causes any jitters in the stock market I doubt they will last. Ireland's smoking rate appears to have increased again after a short-term decline following their ban in 2004, and Scotland is failing to meet targets.
| % of the population that smokes | Citi's earliest prediction for end of smoking | |
|---|---|---|
| Australia | 17 | 2030 |
| Belgium | 20 | 2051 |
| Canada | 18 | 2040 |
| Finland | 21 | 2093 |
| France | 25 | 2118 |
| Germany | 23 | 2280 |
| Greece | 40 | 2231 |
| Iceland | 16 | 2033 |
| Italy | 23 | 2091 |
| Japan | 24 | 2054 |
| Netherlands | 28 | 2048 |
| New Zealand | 18 | 2058 |
| Norway | 21 | 2042 |
| Spain | 26 | 2056 |
| Sweden | 15 | 2028 |
| United Kingdom | 21 | 2040 |
| United States | 21 | 2046 |
I find it interesting that two countries that have announced that they will eradicate smoking in the medium term, Finland and New Zealand, according to this table, won't actually achieve it until relatively late: New Zealand in 2058, and Finland in 2193. Netherlands (where there has been a huge backlash to the recent smoking restrictions) kicks the habit in 2048, but France carries on till 2118, 70 years later, and the Greeks for more than a century after that.
The predictions are based on fifty years' decline in smoking rates, and reports stress that 'if this continues', smoking will die out by the dates indicated.
If this causes any jitters in the stock market I doubt they will last. Ireland's smoking rate appears to have increased again after a short-term decline following their ban in 2004, and Scotland is failing to meet targets.
Friday, 7 January 2011
Anti-smoker interviews international representative of tobacco growers, video
Al-Jazeera presents this important interview:
They discuss the exclusion of the tobacco growers from COP-4: the recent conference of parties to the Framework Convention on Tobacco Control. Patrick Reynolds, grandson of R.J. Reynolds, declares that tobacco growers were excluded because they represent tobacco interests and they want to distract attention from the public health issues around smoking. Antonio Abrunhosa stresses that he represents growers rather than manufacturers. He points out that since the people at the Framework Convention don't understand what their International Tobacco Growers' Association is about, they should have been invited to the conference in Uruguay, and not excluded. Mr Reynolds's continued accusations that Mr Abrunhosa is funded by the tobacco industry and references to 'blood money' are rather tedious. He insists that the business of COP-4 was about public health, not the fortunes of a few small farmers, and also that nobody was planning to stop tobacco from being grown (although I think everyone is aware that the vital ingredients were to be banned, meaning that the crops could be grown but the market for them would plummet). He smiles benevolently and suggests the farmers grow corn or wheat instead of tobacco.
Riz Khan chairs this discussion without the hostility normally directed at (perceived) tobacco industry interests, and he gives Mr Abrunhosa time to expand on his organisation's concerns and hopes for the future. Mr Abrunhosa refers to the support given by many African heads of government to ITGA, against the articles brought forward to the Uruguay conference. On alternatives to tobacco as a crop, Mr Abrunhosa again refers to being excluded from COP-4. Health officials had been meant to assist in finding viable alternatives to tobacco growing, but since FCTC refuses to take information from the growers no progress has been made.
Some questions addressed to the show by email are also addressed by both sides – when the parties stop talking over each other (top prize for being ill-mannered goes to Mr Reynolds).
Enjoy the interview, and let's insist that tobacco growers are allowed more media opportunities.
They discuss the exclusion of the tobacco growers from COP-4: the recent conference of parties to the Framework Convention on Tobacco Control. Patrick Reynolds, grandson of R.J. Reynolds, declares that tobacco growers were excluded because they represent tobacco interests and they want to distract attention from the public health issues around smoking. Antonio Abrunhosa stresses that he represents growers rather than manufacturers. He points out that since the people at the Framework Convention don't understand what their International Tobacco Growers' Association is about, they should have been invited to the conference in Uruguay, and not excluded. Mr Reynolds's continued accusations that Mr Abrunhosa is funded by the tobacco industry and references to 'blood money' are rather tedious. He insists that the business of COP-4 was about public health, not the fortunes of a few small farmers, and also that nobody was planning to stop tobacco from being grown (although I think everyone is aware that the vital ingredients were to be banned, meaning that the crops could be grown but the market for them would plummet). He smiles benevolently and suggests the farmers grow corn or wheat instead of tobacco.
Riz Khan chairs this discussion without the hostility normally directed at (perceived) tobacco industry interests, and he gives Mr Abrunhosa time to expand on his organisation's concerns and hopes for the future. Mr Abrunhosa refers to the support given by many African heads of government to ITGA, against the articles brought forward to the Uruguay conference. On alternatives to tobacco as a crop, Mr Abrunhosa again refers to being excluded from COP-4. Health officials had been meant to assist in finding viable alternatives to tobacco growing, but since FCTC refuses to take information from the growers no progress has been made.
Some questions addressed to the show by email are also addressed by both sides – when the parties stop talking over each other (top prize for being ill-mannered goes to Mr Reynolds).
Enjoy the interview, and let's insist that tobacco growers are allowed more media opportunities.
Thursday, 6 January 2011
ASH Scotland spreads the truth about smoking
Kindly supplied by ASH Scotland via Twitter.
All these facts seem very speculative, and one wonders what they expect to do about the problem?
All these facts seem very speculative, and one wonders what they expect to do about the problem?
SMOKE - The Convenient Truth
View more presentations from Empowered Presentations, Honolulu, HI.
Trouble in Spain, and they don't like the smoking ban either
There appears to be rebellion in Spain against the smoking ban. Faced with austerity measures for the sake of stabilising international markets, the authorities there couldn't let the public take solace in a smoke and a drink, but the austerity measures had to include a ban on public smoking too. There are reports that some licensees will not enforce the law.
The unhappiness shows itself in a fight over smoking, resulting in a hotelier needing stitches. I remember hearing about a bar tender in Leith who was hit by a glass in the early days of the ban in Scotland: reported here. Such incidents have been rare in Scotland, at least not widely reported. A landlord in Bolton was rewarded by a broken leg for enforcing the smoking ban. Bar staff should not have been used to police a ban against their customers that must have been soul-destroying for thousands of people on both sides of the bar.
Feelings about watching Spain go through what we've already been through are inexpressible ... their ban is worse because it applies to certain outdoor areas.
The Dutch example could help them. What can the rest of us do?
The unhappiness shows itself in a fight over smoking, resulting in a hotelier needing stitches. I remember hearing about a bar tender in Leith who was hit by a glass in the early days of the ban in Scotland: reported here. Such incidents have been rare in Scotland, at least not widely reported. A landlord in Bolton was rewarded by a broken leg for enforcing the smoking ban. Bar staff should not have been used to police a ban against their customers that must have been soul-destroying for thousands of people on both sides of the bar.
Feelings about watching Spain go through what we've already been through are inexpressible ... their ban is worse because it applies to certain outdoor areas.
The Dutch example could help them. What can the rest of us do?
Wednesday, 5 January 2011
Learning about the Framework Convention on Tobacco Control
Frank Davis has covered this important international treaty this morning here, including a startling map showing countries that have so far ratified the Framework Convention on Tobacco Control (even though much land is covered that has very low population levels). As usual, his readers follow up with further enlightening links.
Frank rightly points out that this treaty binds its members to certain courses of action regarding tobacco, which is one reason that it will be difficult to make governments backtrack on the smoking ban or other related legislation. They consider their FCTC treaty obligations bind them more than loyalty to their electorates.
He is also correct to point out section 5.3 (links and quotes provided), which seeks to stop tobacco industry interference (for 'tobacco industry', read 'anyone that disagrees with it'). Such clauses explain, for example, why tobacco growers were excluded from the recent COP-4 tobacco talks in Uruguay – they were a dangerous distraction from the issues being discussed.
It can't be emphasised too much how important such international agreements are in making it an uphill struggle even to talk properly about the smoking ban (never mind fight it). They do actually undermine governments' relationships with their people, by destroying the normal course of political accountability.
Reconciling different interests in society is essentially a perennial problem. Not being a student of international relations, I don't know how much international agreements help to keep the peace internationally. But this one seems to be bad news all round. In spite of all its claims to be about health, representatives from a very poor sector in society, tobacco farmers, were excluded from a major global conference that threatened their livelihoods, while those from the richer sections of society dominate the scene, claiming to represent the interests of such poorer people. It still astonishes me that the first multilateral treaty created by the World Health Organisation is about smoking, rather than communicable diseases suffered by the poorest in global society. Can it be because the poor struggle to afford drugs, while rich countries can be duped into spending billions of dollars on anti-smoking treatments?
Frank rightly points out that this treaty binds its members to certain courses of action regarding tobacco, which is one reason that it will be difficult to make governments backtrack on the smoking ban or other related legislation. They consider their FCTC treaty obligations bind them more than loyalty to their electorates.
He is also correct to point out section 5.3 (links and quotes provided), which seeks to stop tobacco industry interference (for 'tobacco industry', read 'anyone that disagrees with it'). Such clauses explain, for example, why tobacco growers were excluded from the recent COP-4 tobacco talks in Uruguay – they were a dangerous distraction from the issues being discussed.
It can't be emphasised too much how important such international agreements are in making it an uphill struggle even to talk properly about the smoking ban (never mind fight it). They do actually undermine governments' relationships with their people, by destroying the normal course of political accountability.
Reconciling different interests in society is essentially a perennial problem. Not being a student of international relations, I don't know how much international agreements help to keep the peace internationally. But this one seems to be bad news all round. In spite of all its claims to be about health, representatives from a very poor sector in society, tobacco farmers, were excluded from a major global conference that threatened their livelihoods, while those from the richer sections of society dominate the scene, claiming to represent the interests of such poorer people. It still astonishes me that the first multilateral treaty created by the World Health Organisation is about smoking, rather than communicable diseases suffered by the poorest in global society. Can it be because the poor struggle to afford drugs, while rich countries can be duped into spending billions of dollars on anti-smoking treatments?
Tuesday, 4 January 2011
Beauly–Denny pylons: writing to the Minister
Following October's story on this, I wrote to the Minister for Enterprise, Energy and Tourism for clarification on the relative risk issue.
Regarding the risks to residents of an overhead pylon, the Government has taken advice from the Health Protection Agency (a UK body), and 'their view accords with that of the World Health Organisation [no less!] – that despite extensive research, there is no evidence to conclude that exposure to low level Electro Magnetic Fields (EMF) is harmful to human health'. [emphasis added]
Well, that's very interesting, as the relative risk of childhood leukaemia from exposure to power lines is over three times higher than the risk of lung cancer from secondary smoke. 'Extensive research' in this case shows this to be a risk so unacceptable as to leave everyone terrified of secondary smoke exposure.
The letter didn't comment on secondary smoke exposure or the smoking ban. I've written again tonight:
Maybe I should ask the World Health Organisation too. How do they come to the view that a relative risk of 4 is not dangerous, when a lower relative risk is responsible for this carnage?
In your capacity as Energy Minister I am interested in your views on how a power line can be authorised and not undergrounded in a heavily populated area, even though the relative risk of childhood leukaemia in areas close to high voltage power lines can be up to 4 (compared with relative risks of lung cancer and heart disease resulting from exposure to secondary smoke commonly given as 1.2–1.3, yet is held to be dangerous enough to justify a comprehensive smoking ban).In the Minister's reply (written by a Government officer) I was told that Ministers don't have the authority to order a power line to be laid underground. Their powers are limited to overhead lines.
Regarding the risks to residents of an overhead pylon, the Government has taken advice from the Health Protection Agency (a UK body), and 'their view accords with that of the World Health Organisation [no less!] – that despite extensive research, there is no evidence to conclude that exposure to low level Electro Magnetic Fields (EMF) is harmful to human health'. [emphasis added]
Well, that's very interesting, as the relative risk of childhood leukaemia from exposure to power lines is over three times higher than the risk of lung cancer from secondary smoke. 'Extensive research' in this case shows this to be a risk so unacceptable as to leave everyone terrified of secondary smoke exposure.
The letter didn't comment on secondary smoke exposure or the smoking ban. I've written again tonight:
Thank you for the reply to my email (reference xxxx) from Gemma Gallacher.
Her final paragraph stated:
'Naturally the health of the Scottish people is of major importance to Scottish Ministers and consent would not have been granted to the application were they not utterly confident that residents along the route of the line will not be threatened.'
She did not contest the basis of my letter, that relative risks of leukaemia in persons exposed to high voltage lines rise up to four times the risk to non-exposed persons, while the risk of lung cancer to persons exposed to secondary smoke run at around 1.2 times the risk to non-exposed persons.According to Gemma's letter the government is 'utterly' confident' that the risk to persons exposed to leukaemia (generally children) is negligible to non-existent – while the risk to those exposed to secondary smoke, although much smaller, is considered so unacceptable as to merit a smoking ban in adult venues. I've asked the Minister to comment, but it may be a month or so before he does so.
Maybe I should ask the World Health Organisation too. How do they come to the view that a relative risk of 4 is not dangerous, when a lower relative risk is responsible for this carnage?
Sunday, 2 January 2011
Scottish Government implores smokers to get NHS help to quit
In a press release that resembles a glossy magazine feature, the Scottish Government urges smokers to resolve to quit smoking 'for good', using NHS help. For the umpteenth time, we are told: 'you're more likely to succeed if you get help, rather than relying on willpower alone'.
The reports used to justify this claim are examined here by Chris Holmes. Even Tim Coleman of the UK Centre for Tobacco Control Studies declares that nicotine replacement therapy has a 75 per cent failure rate at 12 months (of course he wants money to fund provision of smoking cessation treatments for longer than four weeks, as clearly it does not work within this time frame). So when we are told in the Scottish Government's health budget paper, 'There has been an increase of 73 per cent in smokers successfully quitting (one month post quit date) with the support of NHS Scotland stop smoking services', it is hard not to take it with a pinch of salt ... and a feeling that the Scottish public is being sold short.
Whatever Ms Shona Robison's credentials for giving medical advice, the suggestion that 'giving up smoking is the biggest single thing anyone can do to improve their health' is particularly silly. There is obviously no glib advice for non-smokers, who can expect more individually tailored suggestions to suit their specific situation. Health is not politics, and we don't go to politicians for medical advice.
In terms of the overall health budget the amount allocated to tobacco control (£12.3 million) is relatively small (although we might question why health budgets are allocated 'to support people in Scotland to maintain their health through commencement of the implementation of the recently enacted tobacco control legislation'). The budget for smoking cessation is separate (see question S3W-38042 at the foot of this link), amounting to a further £13 million – not a huge amount in budgetary terms, but too big given the high failure rate of the treatment.
Finally, the Scottish Government refers to a patient who has successfully stopped smoking using Champix (Chantix or varenicline). Given the reputation and record of Champix for inducing suicidal thoughts in hundreds of users (resulting in some actual suicides: see this link and others on Champix by following the label at the side of the blog), this should have been accompanied with a caution to readers.
The reports used to justify this claim are examined here by Chris Holmes. Even Tim Coleman of the UK Centre for Tobacco Control Studies declares that nicotine replacement therapy has a 75 per cent failure rate at 12 months (of course he wants money to fund provision of smoking cessation treatments for longer than four weeks, as clearly it does not work within this time frame). So when we are told in the Scottish Government's health budget paper, 'There has been an increase of 73 per cent in smokers successfully quitting (one month post quit date) with the support of NHS Scotland stop smoking services', it is hard not to take it with a pinch of salt ... and a feeling that the Scottish public is being sold short.
Whatever Ms Shona Robison's credentials for giving medical advice, the suggestion that 'giving up smoking is the biggest single thing anyone can do to improve their health' is particularly silly. There is obviously no glib advice for non-smokers, who can expect more individually tailored suggestions to suit their specific situation. Health is not politics, and we don't go to politicians for medical advice.
In terms of the overall health budget the amount allocated to tobacco control (£12.3 million) is relatively small (although we might question why health budgets are allocated 'to support people in Scotland to maintain their health through commencement of the implementation of the recently enacted tobacco control legislation'). The budget for smoking cessation is separate (see question S3W-38042 at the foot of this link), amounting to a further £13 million – not a huge amount in budgetary terms, but too big given the high failure rate of the treatment.
Finally, the Scottish Government refers to a patient who has successfully stopped smoking using Champix (Chantix or varenicline). Given the reputation and record of Champix for inducing suicidal thoughts in hundreds of users (resulting in some actual suicides: see this link and others on Champix by following the label at the side of the blog), this should have been accompanied with a caution to readers.
Saturday, 1 January 2011
UK National Smoking Cessation Conference 2011
The dates and venue have been announced for this year's major annual trade conference in the calendar of the anti-smoking industry. It'll be held in London on Monday 13 and Tuesday 14 June, at the Novotel London West Hotel.
Further details will be released closer to the date, but expect a line-up of seasoned tobacco control advocates from throughout the UK, sponsorship from major pharmaceutical companies and the manufacturers of breath-testing equipment, and hundreds of publicly funded delegates assembled to learn how to push medicinal nicotine (they'll all walk out of the conference with folders and hessian bags emblazoned with the UKNSCC logo).
These are guesses based on last year's conference. A few of us waved banners outside the Radisson Hotel, Glasgow last June, and it did have an impact: one or two delegates seemed genuinely astonished that anyone would want to protest against their conference.
You'll get an idea about the likely agenda of the conference here. The home page of the UKNSCC site gives a brief preview of the 2011 conference (we can look forward to a nicotine vaccine, for example), mentioning treatments that are 'known to be effective such as nicotine replacement therapy'. See this paper to discover how untrue this is: 'Currently stop smoking services are evaluated on the percentage of 4-week quitters, but around three-quarters relapse after this date,' says Tim Coleman of the UK Centre for Tobacco Control Studies, in a bid to keep smokers on nicotine cessation medication for the longer term.
For the smoking cessation industry, smoking restrictions represent marketing opportunities. Smoking bans already exist in workplaces, but last year's conference reported local projects that discourage parents from smoking at home: this slide presentation features a Glasgow project. Using potential damage to children as a pretext, 'intervention' to make smoking difficult at home will become more popular among enforcing authorities (discussed today at Dick Puddlecote's place).
Pressuring people to use nicotine substitutes rather than expose their children to smoke will become more common: this seems to be what the smoking cessation industry means by 'harm reduction'. Given the lack of any significant evidence linking passive smoking to specific cases of ill health or mortality, I find it hard to believe that exposing children to smoke is usually harmful (and the idea that it can be described as child abuse is absurd). The idea that pharmaceutical companies are helping to create pressure to 'denormalise' smoking in the home is far more likely than the idea that secondary smoke harms kids, in homes where fresh air is reasonably abundant.
So I will be looking out for the agenda of this conference. It won't be the only smoking cessation conference this year, but it involves significant players in the UK anti-smoking industry.
Further details will be released closer to the date, but expect a line-up of seasoned tobacco control advocates from throughout the UK, sponsorship from major pharmaceutical companies and the manufacturers of breath-testing equipment, and hundreds of publicly funded delegates assembled to learn how to push medicinal nicotine (they'll all walk out of the conference with folders and hessian bags emblazoned with the UKNSCC logo).
These are guesses based on last year's conference. A few of us waved banners outside the Radisson Hotel, Glasgow last June, and it did have an impact: one or two delegates seemed genuinely astonished that anyone would want to protest against their conference.
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| Our placards: the slogan on the right has also been used on demos in the US |
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| Eddie poses with Sheila Duffy: Radisson Hotel, Glasgow |
For the smoking cessation industry, smoking restrictions represent marketing opportunities. Smoking bans already exist in workplaces, but last year's conference reported local projects that discourage parents from smoking at home: this slide presentation features a Glasgow project. Using potential damage to children as a pretext, 'intervention' to make smoking difficult at home will become more popular among enforcing authorities (discussed today at Dick Puddlecote's place).
Pressuring people to use nicotine substitutes rather than expose their children to smoke will become more common: this seems to be what the smoking cessation industry means by 'harm reduction'. Given the lack of any significant evidence linking passive smoking to specific cases of ill health or mortality, I find it hard to believe that exposing children to smoke is usually harmful (and the idea that it can be described as child abuse is absurd). The idea that pharmaceutical companies are helping to create pressure to 'denormalise' smoking in the home is far more likely than the idea that secondary smoke harms kids, in homes where fresh air is reasonably abundant.
So I will be looking out for the agenda of this conference. It won't be the only smoking cessation conference this year, but it involves significant players in the UK anti-smoking industry.
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