More on ASH Scotland's alliances

As if the Scottish Coalition on Tobacco were not enough, ASH Scotland also coordinates the Scottish Tobacco Control Alliance.

They also support what they call local alliances. The thoroughness of their briefings must be considered in light of their 27 staff (just take a look at their media briefing for the Lothians).

The resources put into attempting to reorder everybody's priorities so as to blame smoking for all ills, deaths and inequalities (who wants to live forever?) are significant. However, page 3 of SCTA's 2010 annual report shows that of the 119 or so member organisations involved with it, the largest groups are involved with NHS smoking cessation and NHS health promotion. It's a career move, rather than a popular cause.

SCTA holds events, has members and topics groups, produces a bulletin and annual report (all accessible from here), and has gained a grant from Cancer Research UK towards the formulation of what has become Scotland's tobacco control strategy. Their output includes a discussion of the new mental health guidelines, Smoke-free mental health services in Scotland – Implementation guidance at a meeting for mental health professionals in Glasgow in June (you get Learning Outcomes for attending too – all free of charge). Never mind that the then Scottish Government specifically exempted mental health services from the smoking ban when it was passed in 2005, and no reason has been offered for any change from this position, nor has any such change been endorsed by the public.

Sheila Duffy's latest (comments-free) blog post urges all parties to support a new tobacco control strategy (while announcing that most of the parties have promised this already). She had a column in today's Scotsman (20 April) that appeared as 'Platform' beside the editorials, claiming that tobacco control still had to eradicate the differences in mortality rates between Scotland's rich and Scotland's poor, and that continued support for Scotland's tobacco control was essential.

Impressive although all this networking is on one level, it's hard to see how it helps resolves any of the difficulties that face most Scots these days. Sheila Duffy's conclusion to her opinion piece in the Scotsman today concludes:

The challenge for our politicians is to reduce the health inequalities gap caused by smoking ...

An interesting economic analysis, that such inequalities are caused by smoking. Duffy is right to point out that higher mortality exists in more deprived areas. But this is not simply because people smoke: even if smoking is a factor, so is chronic unemployment, homelessness, anxiety and all the other consequences of being at the bottom of the economic heap. It's as if the powers that be are saying to the deprived: societal problems are too complicated to work out. But your problems will be marginally less severe if you don't smoke. So don't do it. You know it makes sense.

It's a top-down analysis. It's taken committed smokers out of 'polite society' too: they can no longer relax with peers and be seen to enjoy themselves in public places. It's made it harder for many smokers to assume positions of leadership, because the act of smoking has been so deliberately stigmatised. In the end it distorts all experience to the single plane of whether or not people smoke (see the discussion of the young mother on page 4 of the annual report).

It does all this very largely on government funding and with the blessing of all the main political parties in Scotland.