Are these tobacco stooges reporting from Moscow?

Were this a report from Western Europe, accusations would fly. According to this report, Moscovites have endured sweeping anti-tobacco measures, including the closure and actual demolition of properly registered small shops, and a general prohibition on smaller shops selling alcohol or tobacco. Kiosk owners have protested at the measures, which have been brought in far more quickly than the drip, drip process adopted here, with tobacco sponsorship, sales restrictions, a display ban and a smoking ban coming in all together.

As everywhere, big business wins out as smaller enterprises feel the brunt of these measures:

The laws also go against the agenda of supporting and protecting entrepreneurs recently announced by the government, which has appointed a federal ombudsman for the preservation of businessmen’s rights.

Neither the Moscow Department for the Protection of Businessmen nor Opora Rossii, an organization aimed at uniting and supporting small and medium-sized businesses, agreed to comment on the issue.

But what's this?

Tobacco companies agree with the store owners.

Shouldn't that be the other way around? Doesn't the tobacco industry always lead the agenda with the shops meekly following in its wake?

Source

No ... for whatever reason, this report is telling it like it is. The shops are at the coal face, with anti-tobacco and anti-alcohol measures directly affecting their enterprises, without evidence that any tangible health benefits will result. Well done, Moscow News.

Scotland slips behind in the race to control tobacco (says ASH, Australia)

I almost feel sorry for Michael Matheson, but not quite. The story tells how a visiting speaker to Edinburgh University from ASH Australia this week will rebuke the Scottish Government for falling behind in the race to tobacco control. She perhaps does not realise that the Scottish Government does not have legislative competence to bring in plain packaging, which is reserved to Westminster. She accuses ministers of being afraid to stand up to tobacco companies, whose lawsuits have delayed the implementation of tobacco display and vending machine legislation. Matheson expostulates (reasonably enough) that he can't stop the tobacco companies challenging their legislation in court.

Another accusation bears a second look:

“Almost one in four people in Scotland smoke. The cost to Scotland in terms of lives lost, NHS bills, healthcare and other related costs is staggering,” [Anne Jones] said.

 One in four seems to be used quite frequently:

• One in four babies is born to a mother that smokes.
• One in four adults in Wales smokes.
• One in four smokers who started as teenagers die in middle age as a result of their habit.
• Smoking accounts for one in four cancer deaths.
• In 2004, the most recent year for which we have data, it was estimated that almost 13,500 deaths - nearly one in four of all deaths in Scotland - were attributed to smoking.

Best of all is this:

• Within the UK, historically, smoking rates have been higher in Scotland than England and Wales, but in 2004, the prevalence was similar in all three countries, at about one in four adults. 

It would show quite clearly that the impact of tobacco control policies in Scotland has barely changed the picture in smoking prevalence in Scotland over the last few years – if there were evidence that the smoking rate was based on anything more reliable than a figure plucked out of the air.

Matheson should not be distressed by this hurtful display of one-upmanship from the Australian branch of ASH. Tobacco control laws are nothing to be proud of, especially when characterised by absurd races to be ahead of other countries.

Tobacco pharming

When is a tobacco company not a tobacco company?

The WHO, FCTC, EU, national governments and the anti-smoking lobby, as per article 5.3 of the Framework Convention on Tobacco Control, refuse to sit round the table with tobacco companies yet quite happily accept representation from Pharmaceutical Companies. The question that must be asked is "What is the difference when Big Tobacco and Big Pharma are working together?"

The company annual report for 2010 shows that Japan Tobacco International has an R&D section which has worked on producing drugs to combat osteoporosis and HIV and that licences have been agreed with Pharmaceutical Companies both inside and outside the USA. Companies include GlaxoSmithKlein, Roche, Merck, Torii, giving a global reach.

Clearly tobacco companies will not be chastised if they get involved in pharmaceuticals, because pharmaceuticals are an approved activity. (Nor will the pharmaceutical companies which collude with companies that are engaged in pharmaceutical research – even though the likes of Japan Tobacco is still involved mostly in tobacco.) 

Article 5.3 seeks to 'protect health policy with respect to tobacco control from commercial and other vested interests of the tobacco industry'. This means in the ideal world of tobacco control, the tobacco companies don't get a look in, and despite their products being very highly taxed are expected to be listened to politely and dismissively without any hope of being able to influence the outcome in tobacco or health policy. The same applies to anyone who sells or distributes tobacco (those involved in tobacco vending machines are endangered and soon to be extinct).

So if the tobacco companies turn their attention to medicinal drugs will they be invited back to the table? because they won't have an axe to grind in the pharmaceutical area of their operations. To paraphrase the British Medical Journal, 'an obvious escape from this negativity is to quit the tobacco market'. 

Personally I think it's highly questionable whether overloading the pharmaceutical market is necessarily beneficial to health, and in general I would prefer a business environment where investment decisions were not guided by government-sponsored vilification/denormalisation/negativity campaigns ... whatever you choose to call them (and Simon Chapman and Becky Freeman, writing in the British Medical Journal, couldn't have described the process better if they were trying to slander themselves). 

Tobacco funds Australian Coalition government

You would think the tobacco companies were the only companies to apply pressure to politicians by offering money, or that they did it in a uniquely evil way. No matter what else happens, tobacco companies remain the only source of unethical funding, and accepting tobacco money should be enough to destroy any party's credibility. Fortunately some of those commenting on this article seem aware that condemning corporate donations to political parties doesn't wash if you turn a blind eye to all but tobacco companies. That doesn't make you anti-corruption, it just makes you anti-tobacco.

In fact other people do bad things with their influence too.

In spite of opposition taunts, donations from the tobacco companies will probably not prevent a law being passed  to mandate plain packaging. Just like tobacco displays in shops and brand packaging, the effects of tobacco company donations are not always as predictable as anti-tobacco campaigners make out.

Stakeholders

Hat tip to Simon Clark for this, which includes the Secretary of State for Health Anne Milton's answer to a Parliamentary Question from Philip Davies MP. The question concerned whether lobbyists should be required to disclose any links with pharmaceutical industry or any public funding. The answer:

The Government are under obligation to protect tobacco control from the vested interests of the tobacco industry, under The World Health Organisation’s Framework Convention on Tobacco Control.

Our policy on this is set out in Chapter 10 of 'Healthy Lives, Healthy People: A Tobacco Control Plan for England'. This does not extend beyond the tobacco industry and the Department, as with all other policy areas, engages with a wide range of stakeholders including the pharmaceutical industry, organisations in receipt of funding from the pharmaceutical industry and organisations in receipt of funding from the public purse.

We can therefore take it for granted that acceptable stakeholders in tobacco policy might include pharmaceutical interests and publicly funded bodies.

The government may not count the tobacco industry as a legitimate stakeholder in tobacco policy because of the demands of the Framework Convention, specifically Article 5.3. Pharmaceutical companies, on the evidence, are meant to 'represent health interests', and are thereby 'good guys' who would never abuse their enormous financial clout by applying improper pressure?

They are effectively the tobacco companies' chief competitors in the market for recreational nicotine. Thanks to the stipulations of the Framework Convention on Tobacco Control, they don't even need to apply any improper pressure, as the rules exclude the tobacco companies from proper participation. The bad guys have been chucked out of the club so only the good guys are left?

These stipulations can also encourage the public to believe that all the 'bad guys' are being sidelined, when they are actually very much in the game. Governments and their agencies agencies can attempt to chase a big player out of  the market only with the help of an even more powerful player – and the big and powerful inevitably involve interests that can clash with those of the general public.

Demands such as those made by the Framework Convention damage the political negotiation process in EU member countries with their one-size-fits-all approach. They make certain elements of policy non-negotiable, even though the essence of politics is negotiation. The Secretary of State actually claims to have no power to include tobacco interests in tobacco policy discussions. In the Mother of all democracies this is a sad state of affairs, and one that badly needs correcting.

Denormalisation: 'an obvious escape from this negativity is to quit smoking'

So says a 2007 BMJ report (Australian) about denormalisation and smoking: bear in mind that this is a publicly funded study. Entitled 'Markers of the denormalisation of smoking and the tobacco industry', it delinates some of these 'markers', such as: 

Smokers as malodorous
Smokers as litterers
Smokers as unattractive and undesirable housemates
Smokers as undereducated and a social underclass
Smokers as excessive users of public health services
Smokers as employer liabilities

(h/tap Rose for this neat summary, writing on Frank Davis's column). So much for smokers: and let nobody say in future that this is about denormalising smoking, as opposed to smokers. This is the horse's mouth. This section describes the ways in which a denormalisation campaign seeks to portray smokers ('smokers are framed as mindless, almost criminally anti-social polluters'; 'recent public debate about whether smokers should be given lower priority than non-smokers in surgical waiting lists or even denied elective surgery paid for by the public health system have drawn on implications that smokers are somehow unwilling to assist in improving their own prognosis').

As for denormalising tobacco companies: universities will not accept funding from them, credit card companies and courier companies have ceased involvement with internet sales of tobacco, and so it goes on. Tobacco companies have been spurned by ethical investment companies and promoters of Corporate Social Responsibility.

The paragraph on negative consequences asks the pertinent questions: 

Are smokers less likely to seek medical help due to public debates around whether they “deserve” medical treatments? Will they feel ashamed when doing so, adding to their stress and perhaps prognosis? Are smokers unreasonably discriminated against in the workplace, even when they do not smoke indoors and put others at risk? [emphasis added]

But it continues by quoting a referenced paper by Bayer and Stuber: 'policies and cultural standards that result in isolation and severe embarrassment are different from those that cause discomfort … Acts that seek to limit the contexts in which smoking is permitted are different from those that restrict the right to work, to access health or life insurance, or to reside in communities of one’s choice' [emphasis added]. If that isn't moral equivocation I don't know what is.  A 'utilitarian calculus' must be applied, whatever the hell that is. (If it means benefiting the greatest number I couldn't agree more but they got it wrong because they forgot to include the smokers who don't want to stop smoking when told to.)

In conclusion, the markers of denormalisation are meant as a measure of the progress of tobacco control in different localities. Since its authors promote tobacco control, they commend these markers and recommend their regular reporting and analysis. Their inherent purpose is to demoralise and marginalise a specific group in society. The smoker's only possible recourse is to stop smoking (see title of this post): they see smoker cessation as intrinsic to their goals:

For governments, this negativity foments a public climate that is highly receptive to tobacco control legislation, polices and programs. We would argue that there is a dynamic, synergistic relationship between formal tobacco control interventions and policies, falling smoking prevalence and the increasing range and growth of the markers we have listed.

Would they acknowledge failure if the numbers of smokers were unquestionably shown to increase, revealing the propagation of denormalisation and victimisation as an activity limited to zealots?

The paper was funded publicly by the Australian Government, and has to be among the most appalling I have ever read. In its war against tobacco companies, Tobacco Control declares that its manifesto is demonising and lowering tobacco users in the eyes of the public and states that their remedy is to succomb to bullying and stop using the product: even while admitting that smokers subjected to denormalisation for smoking could absent themselves from necessary medical treatment, at risk to their lives (i.e. admitting that the denormalisation process could be more damaging than actually smoking in the short term). In its crusade against tobacco companies, it is not only denormalising smokers, it is also disenfranchising them, and not only smokers but also anybody who is employed or otherwise associated to the tobacco trade, howsoever marginally.

I am delighted that Frank Davis has concluded, three years on, that denormalisation hasn't worked (as above)!

Link to more of Rose's research (a forum in the Forces Tavern: (free) registration required)

Scotsman report on backlash against tobacco display ban

Expect a retaliation from ASH Scotland on Monday morning! The Scotsman reports that opposition to the tobacco display ban, expressed in consultation responses on the legislation, runs at 90 per cent. Figures in England showed a very different picture: most of the responses were in favour of the legislation, but most of the support from England came in the form of responses from Department of Health-funded bodies. This means that Scottish retail trade organisations have effectively mobilised their members to respond to the consultation.

Next year supermarkets will have to cover their tobacco displays, with small shops following in 2013. In essence the changes mean that tobacco must be concealed from view at all times, and time will only tell if enforcers are prepared to be sensible about stocking-up times, busy selling periods and other complications involved in shop work.

ASH Scotland's view is that opposition to the display ban is the work of tobacco companies. Myths and Realities explains how shops are a front for tobacco companies, and any concern about whether the legislation will work, or whether it will drive customers into the hands of illegal traders, is quite misplaced (see p 4 of this consultation response from ASH Scotland).

A similar allegation appears down under: wily tobacco companies are using tobacconists as a respectable front to campaign against plain packaging.

As far as I understand the tobacco trade, competition between brands is far more important to tobacco companies than luring new smokers into the habit, which is why they have taken the display bans and the threats of mandatory plain packaging far more seriously than the smoking ban. Branding also marks out genuine products from counterfeit products and a branding ban would all but destroy any distinction between genuine and counterfeit products and make it much easier to pass off counterfeits as real. This seems to be a serious impediment to trade and it is not surprising that the tobacco companies are taking the threat seriously. I am quite surprised that health authorities are not worried too.

Article 5.3. of the Framework Convention on Tobacco Control seeks to limit tobacco industry 'interference' in policy making. It runs against a tradition of 'stakeholder consultation', which means asking affected parties about policy proposals (more discussion here). Regulation of all industries is part of government, but it goes too far by routinely excluding the affected industry. Excluding the tobacco industry from discussions about regulating tobacco is not only unfair, it also leaves policy makers with an incomplete picture often informed only by hostile outsiders to the industry. Clearly tobacco companies are being advised that their word is as good as dirt, and if they want to fight for their interests they should do it through third parties.

As far as industry lobbying on either the display ban or the issue of plain packaging, it is absolutely imperative that such a debate takes place. Plenty of money is being thrown at the pro-ban side of the argument, but the only people who have money to fight back are tobacco companies: the other sector of the trade, tobacconists and the retail trade, don't have the margins or manpower to orchestrate a campaign to oppose the anti-tobacco lobby. As anyone who has ever tried to get into politics knows, influence doesn't come cheap.

In any case – well done the Scottish retail trade for mounting an effective campaign: let's keep it going!

Trade warns of more illegal tobacco trading if display ban goes ahead

The daily news bulletin of ASH Scotland on Wednesday included several links to Scottish papers and the trade press reporting the warnings of the trade that the display ban will cause smuggling to grow. A further version of the story appeared yesterday south of the border.

Sheila Duffy can't see the problem with the display ban:

Throughout the debate over removing tobacco displays, a measure intended to protect young people from tobacco promotion, the tobacco industry has tried to divert attention away from the important health issues at stake by exaggerating fears based on unfounded claims.

The reality is that there is no substance to these claims. There is no reason to think that adult smokers who currently buy their product legally from responsible retailers will suddenly switch to illegal sources because the product is no longer on display. Smokers will be able to go on buying what they normally buy, where they normally buy it. Why would they suddenly go somewhere else?

What about price?

'Putting tobacco under the counter will make smokers feel like they’re doing something illegal when they buy tobacco from a shop' [says a shopkeeper]. 'If they think that, they might as well get it from a smuggler who sells it at half the price I can.'

There's also the stigma and the sheer bloody inconvenience, to say nothing of the fact that tobacco sales will slow down queues, to the (real or imagined) annoyance of other shoppers.

The English version of the story states that Andrew Lansley, Health Secretary, has been swayed by a rise in smoking rates in Canada since the display ban was introduced there. I hope the Scottish Health & Sport Committee is paying attention!

Sheila's attitude to the retail trade is extraordinary. It is part of her faith that tobacconists, who sell tobacco every day for many more hours every day than she spends working for ASH Scotland, rely completely on the manufacturers for knowledge of the tobacco trade. As for this:

This [the idea that a ban on displays would encourage the black market] looks to me like a classic case of tobacco industry smoke and mirrors. They spread misinformation and alarm amongst retailers, survey the concerns they create, and present the results as if they were genuine evidence.

A direct description of the way the scare of Third Hand Smoke was created.