British Heart Foundation cites survey of young people to support plain packaging

Press reports state that the British Heart Foundation's latest plea to the UK government for plain packaging of tobacco relies on a survey of young people. This is a reserved issue, but Scottish political representatives are being lobbied to put pressure on Westminster.

Other examples appear in the Independent and in Scottish regional papers. Resting a call for plain packaging on what a survey of under three thousand young people think is sadly not unprecedented (the invention of third-hand smoke precedes it: would you stop smoking if you believed that smoke clings to your clothes and kills your children?).

Who here thinks this paragraph convincing evidence that plain packaging would stop children being interested in tobacco?

A total of 2,771 young people took part in the online survey, carried out for BHF, which found 90% thought plain packs were less attractive than branded ones.

Did the survey ask whether tobacco in plain packaging would be found preferable to no tobacco at all? Considering that at least four fifths of those participating are likely to have been non-smokers, the answers are not surprising, especially since the survey designer, British Heart Foundation, has clear views on the issue. Even this document relies, not on facts but on what young people believe the facts are (p. 6):

 The research found that the proportion of young people believing that more than a fifth of children their age smoked fell from 62 per cent before the display ban to 46 per cent following it.

Granted it also cites more conventional sources of evidence in addition to surveys of young people. But its conclusions and arguments are far-fetched and unconvincing.

The EU Tobacco Product Directive, implemented in 2003, stopped companies using text and trademarks to suggest that a particular tobacco product is less harmful than others on packaging. However, the tobacco industry has continued to use gold and silver packaging on products to associate them as being ‘lighter’ or ‘lower-tar’ products.

Dick Puddlecote has more on the issue of whether different levels of tar present different levels of danger. All product lines from butter to baked beans alter colouring to reflect issues such as low fat levels or low salt or sugar, as a basic method of communicating clearly to customers what the product is. Being banned from using the words will increase the imperative to communicate with colour. Whether this same information leads people to believe that tobacco is safer if it has lower tar levels is moot. A public message that smoking is socially unacceptable is a poor vehicle for communicating the relative safety of different tar levels, since its core message is that smoking is always bad for you, and you are misled if you believe that any tar level is less dangerous than any other. In effect the levels of tar are no business of the smoker, who will use the information unwisely.

The British Heart Foundation does not consider the possibility that removing branding from the range of factors that prompt customers to choose their product leads the customer to decide on the basis of price, and could result in a price war, and certainly does not concern itself with the argument that illegal drugs are already sold in plain packaging. All scenarios assume that plain packaging will lead to customers seeing warnings more clearly, hence drawing the correct conclusions and desisting from smoking as a result.

Scotland youth smoking rising or falling?

Do you believe this (Youth smoking rate continues to rise, from 2008) or this: Teenage smoking falls to lowest level since 1982, from five days before Christmas)?

Knowing the authorities in Scotland, either version will be used as a good reason for repeating its annual reminder to smokers that now is as good a time as any to give up.

The Scotsman's version includes a choice quotation from Ms Sheila Duffy:

Chief executive of ASH Scotland Sheila Duffy said: 'Many smokers decide to quit and find it easier than they thought it would be.'

This depends on your definition of 'many'. NHS services acknowledge that only 8 per cent of quitters are recorded as successful at 12 months.

A Daily Record story from last month is downbeat about youth smoking rates and smoking rates in deprived areas, and takes the opportunity to attack cuts in tobacco control expenditure in Scotland to £11.4 million. This is a lot of money to spend 'controlling' a legal substance, especially when the results of expenditure result only in an uptake of pharmaceutical smoking cessation products, and complete cessation of smoking in so few cases.

The different stories about whether smoking is going up or down emphasise only that no one really knows what the smoking rates are. Even if it were clear that smoking rates were coming down, it would be no guarantee that people's choices would lead either to greater longevity or improved quality of life.

Secondary smoke issues at home in Middlesbrough and the Delaware county courts

Here is the background to this story. We are entering the territory of home smoking bans – except they will not be bans applied by central government, but restrictions written into the small print of tenancies. Action on Smoking and Health is keen to encourage people who (imagine that they) experience discomfort from their neighbours' smoke to investigate the terms of their leases for 'nuisance clauses'.

Using smoke-free laws as a clear basis for protecting the health and well-being of one section of the population at the expense of another is what we have come to expect from zealots of this order. They recommend 'reasonable' informal negotiation with smoking neighbours as a kick-off and graduate quickly to the point where complainants are advised to record their symptoms. This is deeply alarmist stuff, clearly intending to induce anxiety about the perceived harm from secondary smoke coming through ventilation shafts, wire ducts and who knows what else. Scepticism about the level of harm from smoke inhaled by householders is expressed clearly by anti-smoking scholar Simon Chapman:

Tobacco smoke also contains ultra-fine particles. Other sources of ultra-fine particles (UFPs) include "laser printers, fax machines, photocopiers, the peeling of citrus fruits, cooking, penetration of contaminated outdoor air, chimney cracks and vacuum cleaners."[8] Wallace and Ott's data on concentrations of UFPs in restaurants and cars found "cooking on gas or electric stoves and electric toaster ovens was a major source of UFP, with peak personal exposures often exceeding 100,000 particles/cm3 .... Other common sources of high UFP exposures [in restaurants] were cigarettes, a vented gas clothes dryer, an air popcorn popper, candles, an electric mixer, a toaster, a hair dryer, a curling iron, and a steam iron."[9]

It is important that research documents residuals from tobacco smoke. But it is equally important that consumers and policy makers are not led to believe that the chemical compounds thus located are somehow unique to tobacco smoke. Unless in the extremely unlikely event that residents burn copious quantities of solanaceous vegetables (aubergine, tomato) which contain small amounts of nicotine, tobacco is going to be the only source of nicotine in homes. But it will not by any means be the only source of many of the ingredients of "third hand smoke" that the unwitting or the fumophobic may believe are attributable only to smoking. The omission of this information in such reports risks harming the credibility of tobacco control. [emphasis added]

Middlesbrough then: here is the story of John Baker at Freedom-2-Choose. His local council left asbestos in his housing association apartment block decades ago and have now come back to clear up the mess. This will necessitate John moving upstairs, into a guest flat. The woman who informed him of this arrangement also advised him that there would be no smoking in the guest flat. At the time of writing he did not know if this restriction was written into any lease or just something the housing association representative felt like saying. But even if it was an empty threat, the climate is now such that it was a believable one.

Now to the Delaware courtroom, where the chips are on the table. Businesses affected by the smoking ban are fighting a lawsuit saying that the claims concerning the dangers of secondary smoke have no credibility. They have obtained under cross examination evidence of conflicts of interest: a witness promoting the smoking ban admitted receiving financial assistance from Johnson and Johnson, who manufacture smoking cessation aids. They have also presented evidence of a substantial drop in takings following the smoking bans. A result is expected in the next few days.

It is good that while Action on Smoking and Health and its Scottish cousin stride ahead with plans to stop everyone smoking at home, the basic premise that secondary smoke kills is far from being universally accepted. We have not yet established that people are harmed by smoke even emitted in the same room before seeking ordnances banning people from smoking in their own homes.

Offensive garments not allowed in the Chamber during sensitive debates

Slogan in video: Fans not criminals
Slogan in photograph: SNP Shame on you

No one expected the Offensive Behaviour and Threatening Communications Bill not to be voted into law yesterday, and so it came to pass. The Bill was voted in this afternoon. Also:

Today, the SNP-appointed Presiding Officer Tricia Marwick instructed Parliamentary security to prevent members of FAC entering the debating chamber of the Scottish Parliament. We intended to do no more than wear t-shirts spelling out the message 'FANS NOT CRIMINALS'. 

I joined up with this group outside the Scottish Parliament. We were led to a committee room by Hugh Henry MSP, who welcomed us to the debate: several MSPs also came to this room, including some of the Bill's supporters and a lively discussion ensued – more of a shouting match. It was clear that no understanding between the two sides would result, and in any case within ten minutes it was nearly time for the stage 3 debate. The MSPs drifted off and we were about to follow, when the message reached us that people wearing garments with slogans would not be admitted to the Chamber, although they would be admitted if the garments were removed.

It remains unclear exactly what actions, songs and so forth will be criminalised by the Bill – I heard one member offering the explanation that this was 'context-dependent'. This seems to offer little assurance to fans. Opponents of the ban point out how few people have been arrested over the years. The test is whether 'reasonable people' might find specific behaviour or songs offensive. Since so few people have been arrested for so-called sectarian offences at football matches over the last 30 years, many 'reasonable people' might find it hard to identify many offensive actions or remarks. It seems that the trend is to make crimes out of actions and utterances that might have caused trouble rather than those that do cause trouble.

Scotland has recently seen the jailing of a Rangers fan for threatening communications before the Bill was even passed.

During the debate itself (videos here), I noted a point from David McLetchie MSP (18.32 minutes in). He says that government attempts to imply that opponents to the Bill are somehow in favour of offensive behaviour and sectarianism. He urges that both sides should treat each other's positions with respect. He is not the only person who has made this point in the hearings and debates leading to the passing of this Bill (see also 36.19 mins into the video). Of course such tactics are very familiar to us in the smoking debate: we are accused of being indifferent  to smoking rates, disease from smoking, discomfort from smoke, if not actually being in receipt of tobacco company payments. "You're either with us or against us in the fight against terrorism," said President Bush, setting a poor example in democratic leadership, but a good example in browbeating opposition. I hope that those MSPs who feel insulted and undermined by this tactic will remember not to use it themselves in the context of the smoking debate.


Edit: Herald comment on the new Act
Coverage from Fife: Academic delivering 3,000-name petition in last-ditch bid to halt Offensive Behaviour bill
Protesters banned from chamber as SNP use majority to pass anti-bigotry bill

Eddie's interview, Leith FM, 2010

Eddie Douthwaite, until recently Chairman of Freedom to Choose (Scotland), gave the following interview to Leith FM nearly two years ago – when the skies were full of volcanic ash from Iceland. Eddie gave the interviewers some enlightening new angles on the smoking ban issue, and the switchboards lit up. Listen below.

                                      
   Click To Play
Eddie Douthwaite on Radio Leith FM

Eddie – the ferret – an exemplary interview and one we will build on. Thanks for all you've done.

Scottish smoking cessation statistics

Stunning success greets smoking cessation efforts in Scotland!

Source

I had a double take on seeing these figures – under the impression that quit rates were negligible, especially after noting that smoking rates in Scotland have risen in the last few years.

These figures are based on a three-year period spanning March 2008 to March 2011. The report reads that nearly 90,000 gave up in these three years. The figures are presented with a cumulative total, which gives the impression of a lovely steep incline – because the point of it was to show successful quits since 1 April 2008. Of course it wasn't the case that nobody gave up in March 2008, or that 90,000 people gave up in March 2011. If the graph showed individual totals for each three-month period, the steady incline suggests that the line would appear flat at around 30,000 per year or 7,500 a quarter.

The really important matter here is not brought to the fore: figures are for four weeks, and the rate at twelve months is given as 8 per cent. Fewer than 10 per cent of attempts at quitting are recorded as successful at one year.

Value for money? I find it hard to believe that finding a publicly subsidised market for smoking cessation treatments isn't a significant aim in this stupendous effort to stop people from smoking.

Dutch under fire for lax tobacco controls

As often this story is told effectively by Chris Snowdon, but the background is as follows. In brief, the Dutch rolled back their smoking ban about a year ago. Shortly afterwards Wiel Maessen of Forces International, a Dutch citizen who had been active in organising opposition to the ban, was approached by Stanton Glantz for an interview, as he was seeking to understand how the ban in the Netherlands had come to be overturned. The interview between these two was recorded.

The ban was reversed for bars with no employees, relying on the argument that the ban was about protecting workers. The fight has not ceased for overturning bans everywhere in the Netherlands. But there is a counter-attack from the international forces of tobacco control. This Dutch pro-tobacco control researcher's blog output over the last year has been four pieces lamenting the renegade tendencies of the Dutch in tobacco control. For not only has the Dutch government partially overturned the smoking ban – it has also cut the funding for the Dutch anti-smoking campaign organisation STIVORO.

The antis' retaliation to this insubordination: here from Stanton Glantz on the lifting of the smoking ban (or the 'failure of policy' on tobacco) and here from an army of professional tobacco control advocates on the cessation of funding to STIVORO and similar measures (or on why the Dutch government is 'abandoning smokers to their fate') – also reported here.

Stanton Glantz's efforts to connect action taken by publicans in the Netherlands to the tobacco industry fail because there is simply no evidence to connect them. Chris Snowdon explains. The other study, promising Dutch smokers an early death because of the direction of Dutch tobacco policy, is hardly more convincing.

Protest the Offensive Behaviour at Footbill Bill

The Stage 3 debate will take place on Wednesday 14 June, in the session beginning at 2 pm. A rally is expected to gather outside the Scottish Parliament around 1 pm.

Opposition to the Bill is growing:

MEPs don't have a smoking ban in the workplace

I've seen the room referred to in this article. It has nice big windows and extensive views.

Scotland's ten-year decline in heart disease and stroke deaths

Less than a week after we learned that the drop in smoking rates especially among Scotland's deprived communities has been disappointing, we discover that Scotland's heart and stroke deaths have dropped sharply over the last ten years, with most of the gains in deprived communities.

The source is Scotland's official source of figures: you can view the relevant chart by going to document MC1 (the top one) and clicking the tab at the bottom left hand side of the document (I don't know how to import an excel page into blogspot post).

The figures here are about the success of treatment rates – they concern an improvement in mortality after conditions have been treated, rather than prevention.  The impact that Professor Jill Pell's study declared was on hospitalisations, not deaths.

Taken together, what do we learn? The figures show no trace of the 17 per cent drop in heart attacks that were alleged to have followed the Scottish smoking ban: there is no sudden dip following 2006. There is also no real drop in smoking rates, making the claims originally made by Professor Jill Pell even more problematic (there can be no significant drop in smoke exposure if there is no significant drop in smoking rates). Finally there is a decline in heart attacks and stroke deaths in deprived areas, which have not seen a significant drop in smoking rates – although this is attributed to more successful treatment rather than a lower incidence.