'Zealotry plain and simple': e-cigarettes to be banned from Glasgow's Commonwealth Games

So says the Scotsman leader today. The games organisers, after taking advice from the public health community, announced their intention to ban e-cigarettes at the games, having last year announced their intention to ban tobacco.

Public health illuminary Sheila Duffy said:

“The Commonwealth Games will showcase excellence and aim to build a healthy legacy for the next generation. Providing smoke-free environments during events will help deliver on that commitment, and the decision to exclude e-cigarette use should make enforcement more straightforward and also help put the appearance of smoking cigarettes out of fashion.”

And from Health Minister Michael Matheson:

“I welcome this, as e-cigarettes are not regulated, nor have they been proven to be safe and effective.”

This is nonsensical: Matheson's doubts about the 'effectiveness' of smoking are based on the assumption that they are designed as a smoking cessation tool. As an alternative to smoking there is no doubt of their effectiveness. You just put down a roll-up and pick up an e-cig: job done. As to the appearance of smoking cigarettes, these devices appear more like inhalers than cigarettes these days.

These people, especially Duffy, have made a career choice out of the desire to stop people smoking. You would have thought that an anti-smoking sports event would be a lifetime's opportunity to encourage people to quit smoking because 'the single best thing you can do for your health is to stop smoking'. But that's not good enough, because it's not actually enough to stop smoking – you must do so in the approved way.

A Scotsman reader also remarks:

Clever of them to wait until all the tickets have been sold before imposing this ban - and whatever others will be announced before the summer.

For the avoidance of doubt, I don't approve of a smoking ban at the Commonwealth Games either. The public health community only seems to count as public health hazards things that they can blame on the general public: habits, including eating, drinking and smoking. The biggest offender in public health terms is multiple deprivation, and the Commonwealth Games stirred up controversy by accepting sponsorship from ATOS, the company notorious for declaring people of all shades of invalidity fit to work. Clearly there is more to this event than a friendly opportunity to compete internationally in sports, and even the public health community is set on laying unhelpful conditions to participation.

Bafflement on devolution from Scottish tobacco control

The bit of Sheila Duffy's letter that I don't understand comes right at the top.

JORGE da Motta of JTI claims that devolving powers on tobacco duty to Scotland could harm our economy (“Tobacco chief fires up debate over duty”, News, 5 January). But World Bank reports show clearly that tobacco is poor value to any economy, on economic as well as on health grounds, as the diseases smoking causes cut down many in the prime of their working lives.

She's writing a response to the article here. But the article doesn't say that JTI says that devolving powers might harm our economy. He warns that the wrong policy choices will bring about more bootlegging – not the tobacco duty, but failures in policy-making, which will lose the Scottish government money. So apparently Sheila claims that JTI fears that tobacco duties will somehow ruin the economy, and contrasts this with the World Bank view that tobacco is poor value to any economy.

Not a lot of contrast there. Perhaps Sheila has been the victim of a bad sub-editor.

I was hoping for some enlightenment on the finances of post-devolutionary Scotland, but I'll have to go elsewhere!

On illegal tobacco undermining legitimate sales

Sheila Duffy once more attempts to make a case that tobacco retailer groups are only arguing against tobacco control because they are supported by tobacco companies. And fails.

After a long and loud campaign telling their members that counterfeit tobacco is damaging local shops, the TRA asked shopkeepers whether they thought their shop was at risk of closing due to counterfeit and smuggled tobacco. 

We are not told how those involved made sure of an unbiased sample or whether they just relied on their existing friends and contacts.

Of those who responded, 92 were from Scotland.

So the dramatic “one in ten” headline is based on nine individuals across Scotland giving their personal opinion.

That kind of survey sounds like the way thirdhand smoke was invented: the difference being that the fairy story about high taxes making opportunities for black market traders is written by the Tobacco Retailers Alliance, and the other story is created by somebody wanting to create a bad press around tobacco, and using the 'scientific' press to achieve it.

It is true of course that people giving opinions does not make fact. The argument that illicit tobacco results from high taxes has the benefit of being plausible. The hypothesis that higher taxes on tobacco creates opportunities for illegal traders cannot be argued by suggesting that it is generated solely by tobacco companies and their associates. Black market opportunities arise when there is a large gap between the production cost and the official price, and that gap is deliberately enlarged in the case of tobacco, since high taxes are meant to be a deterrent, especially to the young. The larger the gap between production and retail costs, the more illegal traders will be able to live comfortably off the margin. Tobacco control advocates must show evidence to refute this logic – it is not enough simply to deny it simply on the grounds that tobacco companies claim it to be true.

Nor is it convincing to say that HMRC deny any increase in smuggling. How can HMRC comfortably give estimates about how much illegal trading goes on, when it is by definition part of the mission of the illegal trader to slip under the radar? And how can HMRC confidently state that less smoking goes on? (or that people are not abandoning tobacco in favour of more dangerous substances)? Nothing appears straightforward in the world of illicit tobacco detection.

In the world of Smoke Free North East, the story that tobacco smuggling is under control no doubt has a robust following. The number of smokers is declining too (isn't it?). An independent survey that Smoke Free North East commissioned gives heartening news about the decline in illicit tobacco that you can read here. Deborah Arnott of ASH throws in her wisdom:

This survey is important new evidence that Britain is getting to grips with the illicit tobacco trade. Thanks to hard work by customs, trading standards, police, health and tobacco control groups around the country the level of tobacco smuggling is continuing to fall. Every independent survey shows this.

Can this be interpreted to mean that any survey not showing the UK getting to grips with the illicit tobacco trade is by definition not funded appropriately and is not to be trusted? Surveys (which produces a limited range of answers on a basis of self-selection) do feature reliable results sometimes, then, in the eyes of tobacco control?

ASH Scotland and the tobacco control lobby talk nonsense about profits and health

Two extraordinary statements have arisen this week from the anti-smoking lobby that reflect its bizarre approach to ethics, business and health.

On the issue of regulating e-cigarettes, tobacco control is faced with a dilemma. The controlling interest in the field is tobacco's competitor, namely the smoking cessation market (and I use the word 'market' deliberately). E-cigarettes muddy the water, as they are a clear alternative to smoking, but they're made by those rascals the Chinese (!), and so cannot be trusted as a legitimate alternative to smoking. It may be that the existence of these products will force the more honest among tobacco control advocates – those who actually recognise that smokers have a legitimate range of options if they want to quit – to admit that some of their more extreme allies might have an agenda other than helping people to stop smoking. 

It looks as if Sheila Duffy has quite a long way to go before she can bring herself to applaud the existence of e-cigarettes as an alternative to smoking: 

 Ms Duffy said: "Quitting tobacco is the single best thing a smoker can do to improve their health. We do not support banning e-cigarettes as they could help many smokers to move to a less risky product. However e-cigarettes are produced by commercial companies, with a profit motive." [Emphasis added]

Ms Duffy has of course observed that smoking cessation medication, much of it laced with nicotine, is also made by commercial companies. In fact these companies are major pharmaceutical companies, some with eye-watering turnover. 'Health' is one of those goodies that we buy all the time: the demand is enormous globally, and the question is whether drug companies can keep their mind on the job of improving health and off the balance sheet. Pharmaceutical companies co-sponsor the UK's annual smoking cessation conference (one might as well call it a trade fair), and Chris Snowdon spotted that the main sponsors all have a slots on the conference programme (click on the figures in this link to enlarge). In fact Ms Duffy knows quite well that smoking cessation products are [also]produced by commercial companies with a profit motive. She knows quite well that she's talking nonsense. Doesn't she?

The Scottish government awaits the conclusions of UK regulators before deciding what action they should take on regulating e-cigarettes, so Ms Duffy can afford to sit on the fence for a little longer. 

But there was an even worse clanger in a letter from various tobacco control personalities to the Guardian on the subject of plain packaging, which claimed: 'Tobacco, unlike other causes of disease, has a global and powerful industry promoting its interests' [emphasis added]. We-e-e-ll, as Sheila Duffy observed 'mosquitoes don’t have PR agencies and expensive promotions budgets', which means that it's not really worth fighting malaria because it's no fun unless you can blame a company for the fact that people get ill. 

But can't we all blame companies for people getting ill. Bhopal? Who makes asbestos? What about illegal levels of pollutants in the air? It is completely absurd to claim that tobacco companies the only corporate entities that give people health problems. I return to a passage from George Monbiot's Captive State (2002):

As big business infiltrates the research agenda, ever wider zones of public enquiry are placed off limits. In 1999, the government published a White Paper on public health called Saving Lives: Our Healthier Nation. The only atmospheric pollution named in the report is radon. It also happens to be one of the only pollutants in Britain which does not result from the activities of large corporations: it is naturally occurring. The report warns us about the dangers of cancer resulting from 'exposure to radon gas in certain homes or excessive sunlight', but nuclear power stations are not mentioned, and nor are any other chemicals, even though the paper concedes that 'Pollutants in the atmosphere may cause cancer if inhaled or swallowed'. The language in which this warning is given is interesting: it creates the impression that breathing or ingesting pollution is something we can avoid. The paper informs us that the government hosted 'the largest ever Ministerial conference on environment and health in 1999. It fails to tell us that the links between cancer and industrial pollution were dropped from the agenda soon after the meeting began. [link added] 

Monbiot is clear that somehow environmental issues came off the agenda in 1999, suggesting not that tobacco is the most powerful company that causes ill health but that it is the least powerful, because it couldn't get its product taken off the danger list. He points out that while universities are happy to boast that they won't take money from tobacco, they are also happy to take money off any other powerful investor, in effect offering up their research facilities to the highest bidder. There are many reasons that tobacco has such a bad press (the power of the medical establishment and the perceived uselessness of tobacco are two of them), but the fact that tobacco has been pushed off the debating table (denormalised) is not really good news for the public. For years, we have been asking who is going to be denormalised next.

Both Sheila Duffy and the health lobbyists who signed the letter to the Guardian are misguided in their judgements. Shortcuts taken by competing companies on a global scale do injure people and make them ill, It's a fact, and pretending that only tobacco or e-cigarettes benefit from an absence of regulations is either quite dishonest or deplorably ignorant.

Tobacco control activists anticipate publication of new Scottish strategy

In this article in Holyrood Magazine, not only old favourites Sheila Duffy (ASH Scotland) and Ben McKendrick (British Heart Foundation) weigh in, but also the convenvor of the Cross-Party Group on Tobacco Control in the Scottish Parliament (did they have more than one meeting last year?).

Willie Rennie combines the convenorship of this group with his position as leader of the Scottish LibDems. Clearly this is a high-profile post.

This Cross-Party Group has authored the new Scottish tobacco control strategy to be published 'shortly'. They are not messing about:

The CPG was briefed on a draft version of the strategy late last year and Rennie says that while he is encouraged by the ambition within it, there were concerns about the lack of detail. “You can go for a smoke-free Scotland, which is technically below 5 per cent. But you need to have the policies that detail how you are going to get there."

The CPG wants to 'bring down' the smoking rate from the high 20s to 5 per cent within 15 to 20 years. This involves a faster rate of decline in prevalance than at any time in the last ten years, and comes at a time when the drop in prevalence has slowed (if the trend in prevalence reflected below has continued into 2013). I am sure that we all look forward to reading the detail on this process of coercing, or persuading, people to drop a habit that they are being persuaded to believe is extremely addictive, and wonder whether this amount of coercion or persuasion will represent better value for money than it has in the past.

Figures on tobacco control and smoking cessation expenditure obtained December 2012.
Smoking prevalence figures from Scottish Household Survey.
Click to enlarge.
 

The argument for tobacco control rests on the assumption that tobacco removes people's choice: its addictive qualities mean that people are not free agents and need the government's help to get out of the weed's clutches. Whether people have free will or not is an argument deployed vigorously in all walks of life – it is not unique to arguments about whether the government should offer assistance programmes in smoking cessation. In this field the government fails to respect individual autonomy declaring that tobacco is uniquely dangerous and demands official intervention, and then saying disingenuously to adults: 'Smoke if you like, we're doing this for the children.' If you protest, you're an addict, and if you're kids protest they've got it wrong too (probably because they have followed your evil example). Furthermore recent history suggests that the more money that is thrown at tobacco control, the less effective it becomes in persuading people not to smoke – perhaps because people resent the intrusion, perhaps because the proportion of people who want (or feel the need) to smoke will always be higher than 5 per cent.

The plight of tobacco growers: ASH Scotland misses point of reader's letter

On Wednesday the Herald published a letter drawing attention to the importance of tobacco growing in parts of the world. It reminded readers that while it is worthy to have health goals, the degree to which certain economies depend on tobacco makes the prospect of a non-smoking future troublesome. (In fact, no one wants to be entirely dependent on a single product, and as we hear below it is unlikely that the tobacco industry is likely to shrink any time soon.) The author of this letter, Alex Flett, clearly criticises the anti-smoking agenda of ASH and other bodies in this light:

Are organisations such as Action on Smoking Health, local authorities, the Scottish Government and others going to replace lost dollar income to those countries that desperately need it and help them find other ways to earn hard currency?

Essentially he is asking whether a drive to eradicate smoking is really ethical.

You would think the reply by Sheila Duffy, published the following day, related to a completely different letter. She does not even address the question, 'How ethical is ethical?' in relation to her anti-smoking policies, indeed she opens her own letter, 'Alex Flett is right to raise concerns over the impact of growing tobacco in developing countries'. But this is not what he does.

Sheila Duffy does it however, but not in the most convincing terms:

The tobacco industry argues that it brings economic benefits to tobacco-growing countries. In fact the majority of profits go to the companies, while, as the World Health Organisation points out, tobacco farmers often become trapped in a cycle of poverty and debt. Farmers are forced by tobacco companies to enter into contracts to buy seeds, fertilizer and technical advice and sell their product at a set fee lower than the cost of production.

     

The tobacco crop's labour-intensive nature means it requires large amounts of pesticides and fertilizers, which farmers must buy in advance at great cost. Should crops fail the farmers themselves are liable to cover these costs. This doesn't even take into account the level of damage these chemicals cause when they end up in the soil, waterways, and the food chain. Child labour is also common, with poor families dependent on their children working on tobacco farms from an early age.

This is highly selective activity on the part of the WHO, and highly selective reporting by Sheila Duffy. When I googled 'farmers forced to buy seed at high prices', I got a page of entries about Monsanto and genetically modified agriculture. No doubt this does occur in some tobacco plantations, but pretending that it is unique to the tobacco companies, or that farmers will be safe from it by embarking on some other crop, is extremely irresponsible. (In fact when the antis were talking some time ago about how tobacco companies exploited children, I went to the website of
the International Labour Organization. Not only was there no mention of tobacco but the video on the first page shows a tobacco plantation that is shown as a model enterprise because of the education it offers children whose parents work there.)

Ms Duffy concludes her letter, still without making any reference to the issues raised by Mr Flett. She does however point out beans and maize are less labour-intensive than tobacco – a point no context as she clearly has little knowledge of agriculture.

This brief interview puts some issues in context: President of the International Tobacco Growers Association is interviewed by the BBC. He puts the points:

1. that the world tobacco market is growing;
2. that the Framework Convention on Tobacco Control has created an uneven playing field since only the signatory countries are bound by it. In the case of tobacco, many major players in the tobacco industry, such as the US, will benefit from any tightening of FCTC provisions, since these big players are not bound by them.
3. that the World Health Organisation continually freezes tobacco farmers out of opportunities to consult about converting from tobacco to alternative crops.

NHS Tayside responds to complaints about smoking shelters

Late last year Smokers Justice presented a complaint to NHS Tayside about their smoking policy following this story.

Phil Johnson of Smokers Justice sent me this reply from NHS Tayside.

NHS Tayside, along with other Health Boards in Scotland, considers smoking to be the most serious threat to the health of the people of Tayside. In accordance with this view we believe that, as a public health organisation, it should contribute, in every way possible, to continuing the de-normalisation of smoking. A key component of this is NHS Tayside's policy which bans smoking in its grounds. Our own staff, visitors, other Health Boards and the Scottish Government has strongly supported our Smoking Policy.
[Links added]

In line with any other Policy, the smoking ban has to be enforced and our experience since 2006, (when the Policy was launched), has indicated that the employment of a Liaison Officer, along with support from NHS managers, is the most effective approach. The Courier and Advertiser is trained to persuade those NHS staff and visitors who smoke in our groundsto put out their cigarettes and signpost them to support services to help them quit smoking permanently. In the case of staff, he can also report smokers to their line managers for potential disciplinary action. Given the fact that our staff are viewed by the public as exemplars for health, then their behaviour can have a significant impact on the beliefs and attitudes of others. This is particularly important in the case of smoking.

I should stress that NHS Tayside staff who smoke are offered, and receive, considerable support from smoking cessation experts to quit smoking. Many of our staff have actually sought support to quit smoking as a result of our Policy.

We do have one smoking shelter in each hospital for in-patients to smoke. We decided not to have any others because our experience showed that this would dilute the message of our Policy. Also, when we tried to have more shelters pre-2006, staff and visitors saw this as an excuse to smoke anywhere they liked.

Therefore it is essential that we maintain the strength of our message within the Smoking Policy, which, along with other tobacco control initiatives, will eventually lead to a smoke-free Scotland. [Emphasis added]

Good luck with that one, NHS Tayside. The direction of travel has changed since anti-smoking rhetoric became an international government obsession, reflected in the smoking rate seen against anti-smoking government expenditure in Scotland:

Figures on tobacco control and smoking cessation expenditure obtained from FOI request from the Scottish Government, December 2012

Number of smokers taken from Scottish Household Survey reports

It is hard to find a way to say how unproductive tobacco control spending is on actual outcomes regarding smoking levels. And since we know so little about that, the figures on heart attacks and other health indicators are fairly meaningless as it remains as impossible as it ever was to measure either smoking levels or passive smoke exposure.

On the issue of smoking in hospitals, the casus belli in this case, read Smoking Scot, whose research and detailed accounts are worth pursuing.

I am very familiar with General Hospitals and their smoking shelters and I've had ample time to observe the dynamics of several shelters. During daylight hours the main users are hospital staff, able bodied patients and outpatients. During visiting hours those patients who need help with drips, catheters and such frequently enlist the help of family and friends - and they park themselves close to the entrance. There's nothing rebellious about this, the simple fact is the entrances to the shelters are not wide enough for a standard wheelchair and - in almost all cases I witnessed - we're talking about the aged or severely infirm, some with a terminal condition and all with something medical attached to them. Exposing them to rain, snow or extreme cold in a flimsy hospital gown is simply not an option for those who really care about them. Reality is so very far removed from the idealistic little vacuum of Simpson and McMahon.

After dark was a time of great poignancy when those without family had to make it to the entrance on their own. I spent a couple of evenings chatting to an aged widow (close to the entrance; even a hospital gets quiet after 21.00 hrs), who was remarkably candid about her condition and immediate future, despite having to wheel her drip which had her catheter reservoir dangling precariously on a hook. However they all had one thing in common, considerable personal dignity. None of us wanted to be in hospital yet those places, the entrance (after everyone had naffed off), or the shelters were great levelers. Met many very interesting people, got lots of tips and advice, even made a friend, and was delighted for him when he finally got what he wanted and passed over. And not one of them had any smoking related illness. Guts, bowels, breasts and brain cancers mainly.

Continue reading

Smoking Scot continues, discussing the perils of developing a culture of covert smoking, questioning who is demanding smoke-free health services, despairs at the myopic medical establishment view of smoking itself. The piece stands by itself but raises points that have been touched on this blog many times.

The main point is that actions enforcing the denormalisation agenda have no effect whatever on smoking rates, except perhaps to retard their decline. Like Sheila Duffy, NHS Tayside is living in a dream world if it believes the present trajectory will lead to a smoke-free Scotland.

£10 for twenty

If I am not mistaken they even charge a premium price for cigarettes at retail outlets on railway stations, and so learning that cigarettes are sold at £9.99 for twenty at Glasgow Airport is not surprising.

(As a side note here I could suggest the Scottish Government ban cigarettes being sold at such outlets because staff are too busy to deal with age verification. Just as they are doing with cigarette vending machines. Super-expensive tobacco obviously has some special allure for children that adults will never understand, so it's best to ban their sale from such outlets, just to be on the safe side.)

The leading paragraph says:

MAGAZINE shop WH Smith already has a pack of 20 on sale at £9.99 at their Glasgow Airport branch and it is feared the price hike could lead to a surge in the black market as crooks cash in.

There is growing awareness that making cigarettes  more expensive will drive customers in these hard times into the arms of smugglers. But Sheila Duffy appears to believe that there is no illegal market: all she can say is tobacco won't 'pay its way' against smoking-related costs to society even at that inflated price.

Hiking prices for tobacco reached a point of diminishing returns for the economy a long time ago.

No comment from ASH Scotland on PE 01451?

After the Scotsman article on Friday detailing our petition I have been waiting all weekend for Sheila Duffy's response. She can usually be relied upon to make a robust rebuttal of anyone who challenges the wisdom of tobacco control in the pages of the Scotsman.

I've had to wait until today for the daily ASH Scotland news bulletin (not posted online yet), only to find that neither Friday's coverage at the Scotsman, nor Sunday's at the Scottish Sunday Express (which was not online, but they cover reports regularly that are not online) even made it to the daily news bulletin!

I wouldn't even mention this had I not found their coverage in the past to be pretty reflective of what's out there in the mainstream press: not all of it favourable to their cause.

Can it be that Sheila and her crew are lost for words?

Not equal under the law under smoking restrictions

The latest smoking story to hit the Scottish broadsheets tells how the Scottish Court Service has banned its employees from smoking in front of the court building. Sorry, was that a request or a unilateral change to conditions of employment? not too sure:

The Scottish Court Service has told lawyers and their staff to stop smoking outside the Court of Session, Edinburgh, and use a designated shelter.

Whatever. Solicitors working in the building are not obliged to follow the same rules as employees. Althouth they have been requested to accept the restriction on smoking in front of the building Donald Findlay, one of the better known local solicitors, gives his views: 'until somebody shows me a law which I am breaking, I will adopt my usual policy on these things and do what I like within the law'. 

Well, quite. 

And doesn't this show how anti-smoking restrictions divide those that have freedom from those that don't? Employees in a building are at the mercy of their employers, but those who are self-employed are not in a contract with an employer.

And before anyone points out that this is not about a law – no it isn't. But the law also hits those at the bottom of the income heap harder than those at the top. Who is more likely to be dismissed for transgressing the smoking ban? of course, it is the employee who is cheaper and easier to replace and probably less likely to sue for unfair dismissal. When you employ a successful professional, you won't want the expense of dismissing that person and having to appoint someone else because of what seems like a trivial issue. But for those at the bottom of the pile, isn't the smoking ban just another useful rule to keep them in order? 

It's supposed to be about reducing health inequalities, isn't it? but while the children of the stockbroker play outside in the garden, the children of the checkout worker get to go to the play park, if their parents can cope with not being able to smoke when they get there. This is making it harder, not easier, to iron out inequalities. 

The (so-called) Labour Party did its members a grave dis-service by supporting the war on smokers and pretending this was in the interests of workers. From destroying many of their social outlets, to treating them as drones who must stop smoking in order to address health inequalities, this and similar laws treat people, not as autonomous beings responsible for their own welfare, but as social statistics. 

Sheila Duffy, predictably, applauds the outdoor restrictions of the Scottish Court Service, claiming that they will protect the public from exposure, and praises them for going beyond the letter of the law. 'Nuff said. 

The Herald covers this story here.

ASH Scotland: polite disagreement over plain packaging

Admittedly the Scotsman's reasoning was a little flawed in this report, which begins:

POLICE fear smuggling counterfeit cigarettes could become easier if the Scottish Government introduces plain packaging as a way of tackling smoking.

and continues:

However, they stopped short of saying it will trigger an increase, saying there is no hard evidence to support that. [emphasis added, here and above] 

It is not credible to suppose that if conditions for smugglers are made easier, they will not increase their activities. This is wayward report writing, and Sheila Duffy is right (to some extent) to be critical of it. If all the police say is that plain packaging will not put smugglers off, the headline of a report on the police view should not say that plain packaging is a 'smugglers' charter'. The report goes on:

It follows a poll of England and Wales officers which found that almost nine out of ten believed the change would lead to a rise in smuggling and counterfeit packets.

“It is likely that the production of counterfeit cigarettes will probably be made easier by less attention to packaging, and by that logic those already involved will probably seek to continue,” the SCDEA said.

As if anyone imagined that the introduction of plain packaging would persuade anyone to stop smugglers' involvement in the trade. This seems a very cautious assessment from the Scottish Crime and Drug Enforcement Agency.

ASH Scotland has taken initiatives in fighting illicit tobacco in the past, such as organising this conference in 2010, in which SCDEA participated. (It seems necessary in terms of their PR to be seen to care about the impact of illicit tobacco in the light of their policies; but it also seems a little disingenuous since they don't want people to use the genuine article either. They won't tell people to support their local shop, or to buy genuine tobacco rather than fund criminals in the black market.)

Sheila Duffy offers a resoundingly ineffective argument to counter the assumption that plain packaging will increase smuggling:

That this represents a “smuggler’s charter”, as your headline suggests, is also a well-worn yet unfounded response by the tobacco industry. Enforcement officers use hidden markings that are hard to copy to check whether packs are illicit.

After threatening tobacco smugglers with hidden markings that can be detected only by equipment that is used by enforcement officers, she then goes on to discuss penalties for smuggling and promoting her organisation's policies more generally. She has said actually nothing to suggest that the 'hidden markings' on brand packaging will stop smugglers from taking advantage of the removal of brand packaging.

Scottish Grocers' Federation attacks ASH Scotland on transparency

A letter in the press comments critically on ASH Scotland's opinion piece on transparency. John Drummond of the Scottish Grocers' Federation points out that there is openness around the relations of grocers with all their suppliers, and believes (reasonably) that grocers have a place in national public health activities.

As chief executive of SGF, I am well aware of my obligations to declare our members legally and responsibly sell tobacco products and that we have links with some tobacco companies in the same way as we do with producers of milk, bread or confectionery. 

I do not, however, share the view of Ms Duffy that this, therefore, precludes SGF or retailers from playing a role in determining public health policies. A point, I would suggest, with which the Scottish Government would agree given our close working relationship through its Alcohol Industry Partnership and the SGF Healthy Living Programme, to support public health objectives and promote wellbeing.

It has also been ASH's faith that shops are capable only of representing the interests of tobacco companies, when in fact they have their own interests to defend as low-margin operations in a huge and aggressive market. Even if they wanted to put tobacco interests before their own (a most unlikely scenario) it would not necessarily benefit them to do so. Action on Health's shamelessly aggressive list of people whose views simply cannot be taken seriously in relation to plain packaging betray a lack of respect for participative democracy. You simply cannot exclude people from public debate on the assumption that their links with tobacco will dictate everything they contribute.

Drummond points out that 'retailers do not have the luxury of organisations like Ms Duffy’s to derive most of their income from public purse', and concludes:

In summary, a desire for transparency should cut both ways. Just as SGF has to declare its interests Ms Duffy’s organisation – paid for by government to tell it what it wants to hear – should be open to the same scrutiny.

The more the tobacco company stooge list circulates, the more people's awareness will grow that a publicly funded organisation wants to limit the voice of ordinary people on public health issues, just because their lives might have a tangential, or even tenuous link at some level with Big Tobacco.

And don't forget: there is a slippery slope: see interview:

More on the blatantly one-sided plain packaging consultation

Over the last two days, even more reasons to feel this whole consultation arrangement falls far short of a transparent and all-inclusive consultation.

1. The study commissioned as an 'independent academic review' is not only authored entirely by tobacco control professionals, but as DP points out, it relies on a collection of studies that are not only specifically tobacco control studies and funded as such but nearly half of them are authored by the authors of the so-called independent review.

2. (h/tip Xopher, from his own consultation response)

Previous consultations have been criticised as quoted below :

 “The Government has been accused of fixing the outcome of public consultations on health policy after it emerged that reviews were flooded with block votes from groups funded entirely by the taxpayer.”  

“…….. said the disclosures summed up Labour's "cavalier" approach to consulting the public.” 

…… said: "It will come as no surprise to us if the Department of Health has funded organisations that provide the responses to consultations that the Government is looking for.” 

"The public are understandably cynical about the way Labour consults the public - it's time we had a Government that treats the public and their views with the respect they deserve." 

Can we be assured that this consultation will be impartial and free of the above criticism? I hope so since these are the words of Andrew Lansley MP who in his current Government role has a full oversight of Health Department activity and as an elected Member of Parliament is duty bound to uphold democracy in this Country. 

What's the difference between being in Opposition and being in Government? Quite a lot, it would seem.

Of course Action and Smoking on Health (and now ASH Scotland) both know that there are reasons the public cannot be trusted with fully open consultations. Action on Smoking and Health recently published its tobacco company stooge list, which included the CBI, major trade unions and everything in between. Sheila Duffy today publishes an opinion piece in the Scotsman, explaining why Scottish ministers should fully implement Article 5.3 of the Framework Convention on Tobacco Control.

Article 5.3 of the FCTC recognises the “irreconcilable conflict” between public health and tobacco industry interests and requires governments to engage with the industry only so far as is absolutely necessary to organise effective regulation. 

If Scottish ministers were fully to implement Article 5.3 that would mean agreeing to transparency in all contacts with the industry. 

It would involve a policy of disinvestment of public money from tobacco shares. It should require a special declaration of any tobacco interests from any individuals and organisations engaged in public health policy discussions.

In the real world where the rest of us live, the world is full of interests that can endanger health if left unchecked. It is not only bad products but corrupt practices that contribute to poor public health outcomes. For example from the US (just to illustrate) an executive from Monsanto has undue power in the FDA. This is of no concern to the Sheila Duffys of this world because they are still in the nursery where food is good for you and tobacco is bad for you.

Sheila also has a go at defending the current consultation process but does not begin to address the issues. One suspects that she does not really understand them.

Over the last month a joint UK and Scottish Government consultation on requiring tobacco to be sold in plain packaging has been met with industry-funded opposition, scaremongering stories and misleading information.

There is nothing misleading in what Dick Puddlecote, the Hands off our Packs Campaign, I or anyone has said in pointing out that the Department of Health wants to listen only to tobacco control and they attempt to make a virtue of this one-sidedness by invoking article 5.3 of the FCTC.

More scribblings from the ASH Scotland CEO

Sheila is keeping well busy these days, and in the pages of the Caledonian Mercury continues her crusade against the tobacco companies. Scotland is pictured as the heroic small country fighting against the evil tobacco that causes most of the country's premature deaths. She champions the Framework Convention on Tobacco Control, congratulating the Scottish government for distancing itself from the tobacco industry (much like its sister organisation has done, characterising everyone up to seven degrees of separation from tobacco companies as tobacco-smeared).

Tomorrow, she informs us, is the next court appearance for tobacco companies fighting the vending machine ban. Lies and trickery characterise these tobacco manufacturing demons who will not go gently into extinction when threatened by wee Eck and the mighty tobacco control arm of the Scottish government.

Enough. 'The tobacco industry is a public pariah,' she tells us, quoting Yougov. Has anyone done a survey about what percentage of the population believes tobacco control?

Sheila Duffy falls back on academic study

Sheila Duffy's latest letter to the Scotsman. Without a hint of embarrassment, she puts forward the 'independent' academic study by Hastings et al. as clear evidence that plain packaging will reduce child smoking:

Alongside the consultation document launched last week, the UK and Scottish governments published an evidence review by Stirling University. This collated 37 academic studies and concluded there was “strong evidence… plain packaging would reduce the attractiveness and appeal of tobacco products”. In one study, 87 per cent of children rated plain packs as “uncool”. 

It seems, therefore, that the evidence is plain to see.

Magnificent: an open admission that a predetermined agenda, supported by a so-called academic review written by people who share that agenda, using sources that address only that agenda and none of the wider issues, is all the evidence that the government needs to pursue tobacco control. My comment:

The academic study referred to by Sheila Duffy acknowledged two weaknesses: one that it isn't possible yet to evaluate the policy in practice, and two that 'a number of types of literature were not covered by the review'. http:phrc.lshtm.ac.ukpapersPHRC_006_Final_Report.pdf 

IMO the study (described by Lansley as an 'independent' academic review) also fails as it doesn't include anyone outside the narrow confines of tobacco control among its list of authors. Nobody qualified to offer expert analysis in branding, marketing, communications or the international black market in tobacco was involved. The range of literature (Table 4.1) reflected this obsession with tobacco control and failed to reflect concerns from beyond the tobacco control community: 'barriers' to plain packaging were a nod to the idea that not everyone agrees with it. Considering we are awaiting judgement in a court case and Ukraine and Honduras have both risked the ire of the Framework Convention on Tobacco Control by challenging the legislation, an independent review should have been authored by all, or at least more, of the interests at stake. 

If you support the policy, and your source material supports the policy, and you don't include anyone who doesn't support the policy, then hey presto, your study will also support the policy.

This letter was a response to this by Robert Dow, who also comments on Ms Duffy's letter.

Let's just do it! says Sheila

Just when I thought we'd finished this topic for the night, Sheila Duffy comes in with her first blog post of 2012.

First quote:

A systematic review of the proper, academic evidence on plain packaging was published alongside the consultation. Produced by Stirling University researchers, this review considered 37 published studies and concluded “that plain packaging would reduce the attractiveness and appeal of tobacco products; it would increase the noticeability and effectiveness of health warnings and messages; and it would reduce the use of design techniques that may mislead consumers about the harmfulness of tobacco products.” [emphasis added]

Dick Puddlecote gives an example of proper academic evidence (illustrating how they showed that plain packaging would speed up transactions). The proper academic evidence is listed in this 'independent' review, carried out by professional tobacco control advocates, starting on page 91. All the studies featured in this review look at the issue of packaging from close range. No study attempts to take a different view, or even substantively addresses the wider legal problems of intellectual property. This is what passes for 'proper, academic evidence': select only studies that support the policy of the government that commissioned you to carry out the review (and select very carefully the authors of the review). Can she actually believe this is objective?

Second quote:

There is clear support for plain packaging from academic researchers, public health professionals and the Scottish public. We at ASH Scotland believe that the debate over the evidence for plain packaging has been settled and that plain packaging will make tobacco products less appealing to young people, resulting in a slow decline in smoking rates as fewer young people are recruited to replace those who quit or who die. The fact that the tobacco companies are so worried suggests that they think so too. [emphasis added]

The debate is over. She does believe it then.

Nonsense from ASH Scotland on plain packaging

Sheila Duffy writes in a press release today about overwhelming support for plain packaging measures for tobacco, found in a Yougov poll. In today's ASH Scotland bulletin she links to a briefing on 'what the tobacco industry says', as if the tobacco industry were the only significant opposition to the tobacco display ban. The Institute of Ideas article by Chris Snowdon discusses other issues, citing several other bodies all concerned enough about plain packaging to get together and issue a warning about it (original press release no longer available) – all dismissed by Ms Duffy as the ravings of a 'right wing think tank'. Just shoot the messenger, why don't you?

Responding to the slippery slope argument, that this will pave the way for plain packaging to be enforced on other product categories, she also declares:

Tobacco is a special case. It is the only legal consumer product which is lethal to its user when used exactly as the manufacturer intended. Tobacco is the single largest cause of preventable death, killing many more people than alcohol, road accidents, homicides and illegal drugs put together. White bread or crisps do not do this – and plain packs for tobacco will not set a precedent for other consumer products.

This 'special case' argument also appears in her letter to the Herald dated 21 February. Tobacco is a special case only because fighting it is what gives you a livelihood, Ms Duffy.

Only a month later (on the sixth anniversary of the Scottish smoking ban!) the Commons Select Committee on Health announced a public consultation on alcohol. This covers a multitude of issues including minimum pricing, raising the minimum age for drinking, and an advertising ban and plain packaging. There's always an exception, isn't there?

It may be that plain packaging will stop kids smoking

This is what the Scotsman says, and it could be true. It may be the case that plain packaging will defy the expectations of everyone with any common sense.

Arguably this is also true, if you make certain allowances:

“The comprehensive review of evidence which accompanies the consultation makes it clear that a large body of academic tests and research consistently show plain packaging makes tobacco products less appealing to young people." [Sheila Duffy, ASH Scotland]

If you allow for the fact there is no way to test results empirically, yes, it is easy to believe that the only way to get a study in plain packaging published is to find that it would help reduce child smoking.

But no study can show such a result as there are no empirical data. There is no plain packaging in the shops yet. Studies can only speculate. Even if they find that plain packaging  reduces the appeal of tobacco in a controlled experiment, this has no bearing on what children will experience in the real world and young people have no way to predict their future wants and needs as their awareness increases in their progress to adulthood.

Consulting mosquitos

Yet again the Dutch come under fire for their lax attitude to tobacco control, because they have rolled back the tobacco campaign and withdrawn the funding for smoking cessation campaigns.

Chief among the complaints of the anti-smoking campaigners is the attitude of Anne Mulder, Public Health spokesman for the Liberal Party. He admits that the health department 'does hold meetings with the tobacco lobby':

'It's a legal product, I think it's right I speak to everyone and that's what I'm doing. I don't have any problem speaking to the lobbyists. If you want to make policy you have to speak to people on all sides then make your own decision.'

The inevitable objection (see earlier example):

'If you want to control malaria you don't invite the mosquitoes to negotiate with you on these issues. This is so illogical. It is absolutely irresponsible what they're doing, it's not a health policy not at all.'

The mosquito is a very poor example to illustrate why relevant interests should not be consulted over policy. Politicians don't control malaria, nor do they prevent disease. They legislate on policy. If you want to control malaria as a medic, you go to war with the mosquito and if you need the support of the law then other considerations might become relevant. The fact that mosquitos cannot speak for themselves has absolutely no bearing on the propriety of consulting all relevant parties to issues on which laws are being passed. (Sheila Duffy also had a go a few months ago when she blogged,
 'Malaria kills people, but mosquitoes don’t have PR agencies and expensive promotions budgets,' a consideration that is absurd as well as irrelevant.)

In consulting with tobacco companies the Dutch are flouting Article 5.3 of the WHO's Framework Convention for Tobacco Control. This measure seeks to 'protect' health policy from tobacco industry influence – because the FCTC is the first global multilateral treaty of the World Health Organisation. It should worry people that the WHO believes tobacco should be the subject of its first multilateral treaty, or that the tobacco industry is the only one supposed to be a threat to national public health policies, and whose influence must be resisted.  (More here.)

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.