Commentaries on five years of the Scottish smoking ban

Writing in the Herald, Harry Reid sticks his neck out by claiming that smoke-filled pubs are a sad loss in Scottish society. He takes a tour round places that he frequented pre-ban, and concludes:

The old Scottish pub was, emphatically, no place for a binge night out. It may have been filled with smoke, but it was also filled with wisdom, bonhomie, respect and – dare I use that often misused phrase – a sense of community.

(Yes he is right: we had a 'big society' before the public health community tore it apart.)

The best bars, and there were plenty of them, encouraged social cohesion. That can hardly be said of supermarkets, whatever their usefulness. 

Lindsay Moss's rather predictable piece interviews four people, 'smoker', 'publican' (against the ban), and 'doctor' and 'quitter' (supporting the ban), after the inevitably self-congratulatory comments from public health officials, Sheila Duffy of ASH Scotland and former public health minister Shona Robison. I can only agree with the comment from the smoker:

"The fact I have to go outside to have a cigarette is an irritation, but it's nothing compared to the sense of depression that there is no 'public' in Britain in terms of a public that organises its own affairs without having experts setting the agenda. [emphasis added]

(Who are these people?)

 We see all the boxes ticked, but the piece reads more like an extended press release from the tobacco control movement (albeit including some dissenting voices). A quitter supports the ban and won't let her husband smoke inside, and a doctor can't speak highly enough of the ban. Revolutionary stuff, but what about interviewing a health worker or non-smoker who opposes the ban, or even mention the chief constable who recently linked the smoking ban to increased domestic violence? The only people invited to criticise the ban are Forest, a smoker and a publican (and they would criticise, wouldn't they?)

(I prefer this as a comment on the fifth anniversary of the smoking ban in Scotland: it doesn't discuss Scotland but covers similar ground.)

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.

Plain packaging will remove last form of marketing (since display ban removed last advertising loophole)

The goalposts are moving ... The Press and Journal's report on plain packaging (treating it as a reserved issue) said this:

A spokeswoman from the Department of Health said colourful packs were widely accepted as the last form of marketing available for tobacco companies to recruit new smokers. [emphasis added]

Go back to the Stage 3 debate on the Tobacco and Primary Medical Services Act, 27 January this year, however, and the First Minister Minister for Public Health and Sport declares at Col 23103:

Therefore, I contend that the evidence for banning displays exists. For me, the most compelling point is the need to remove the last advertising loophole. [emphasis added]

In the Daily Record last June, she was quoted as saying:

"... for me it's about the fact that point of sale displays are important to the tobacco industry. Why are they important - because they are the last remaining advertising that they have. 

"For me that's the most compelling point, that we should remove that last advertising loophole." [emphasis added]

As a clincher to the argument as to whether the evidence supports the display ban (which Ross Finnie felt at that time was 'extremely inconclusive') this is poor stuff. Less than a year later they (at any rate their English counterparts), are describing branded packaging as 'the last loophole'.  Are they going to present every restriction as 'closing the last loophole'?

I can't wait for them to identify another 'last loophole'. Anti-smokers cannot trust tobacco companies to act in the spirit of the legislation, apparently unable to understand why they don't all dissolve themselves in a fit of goodwill to mankind, rather than continue to sell their products. Complying with the legislation is not enough: doing so inevitably involves 'exploiting a loophole' (such as making their displays bigger once actual advertising is illegal). I'll be looking for the next 'last loophole' that they find, and will give it about nine months.

Guardian poll on plain packaging