How long can the Scotsman keep this up?

Plea from British Heart Foundation spokesman to sign petition in favour of packaging – Thursday
Plea from young scientist to sign petition in favour of plain packaging – Friday
Plea from Labour MEP David Martin to sign petition in favour of plain packaging – Friday


Go to Hands Off Our Packs instead!


By the way, the runner up in the race to plain packaging won't be the UK after all.

Pell's front-cover-of-the BBC premature birth speculation

h/tip Chris Snowdon, Pell now claims a 10 per cent drop in premature births since the smoking ban was implemented in Scotland.

There is no evidence for this (Chris takes apart the figures). Considering that as I write the BBC has given it a home page splash there is surprisingly little in the article to justify all the fuss,

But while their work suggests a link, it is not proof that one thing necessarily causes another. As with all retrospective studies like this, it is impossible to rule out entirely all other factors that might have influenced the finding. 

However, Dr Daniel Mackay and colleagues from the University of Glasgow say their findings "add to the growing evidence of the wide-ranging health benefits of smoke-free legislation" and "lend support" to the adoption of such legislation in countries where it does not currently exist.

Not only do the figures give a nil result, but the reporter acknowledges that even if there had been a result it might not have been explained by the smoking ban. (But the figures show that there was no significant result to corroborate the stated finding.) The report nevertheless reports the researchers claiming this non-result is evidence of a health benefit that should encourage the spread of smoke-free policies. And of course we get this:

[The British Heart Foundation] says the focus should now shift to the effect of smoking in the home and confined spaces, such as cars, especially where children are present.

Well, fancy this research appearing just as another anti-smoking offensive appears to be under way.

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.

Plain packaging to be rammed through Australian senate following limited debate

Not my words.

British Heart Foundation gleefully informs us that the Bill has been passed and that plain packaging is on the way. Why isn't the British Government following this example?

The EU has already been warned that legal action will follow any attempt to bring the legislation into Europe.

Success for tobacco companies is not unprecedented. This link tells of a Cincinnati court blocking a requirement to add graphic images to cigarette packs because the judge felt that tobacco companies had a high chance of success in challenging the requirement.

Shopkeepers warned to expect influx of underage smokers

Following the introduction of the vending machine ban in England yesterday, Betty McBride of the British Heart Foundation, which campaigned for the ban, urged shopkeepers to be on the lookout for underage smokers.

Is it just me? or is it really illogical to believe that 11 per cent of underage smokers rely on vending machines for their tobacco? If it's not true that a significant proportion of child smokers use vending machines, why have they told researchers that they do? Is it because it seems to them that the alternative is to shop a dealer who is breaking the law by supplying them or shopping an illegal dealer who also supplies additional drugs? Getting a name for grassing up illegal dealers isn't a good survival tactic.

The fact that children can obtain tobacco from machines in test purchases is very far from being evidence that most determined young smokers will turn to these expensive machines as a regular source of supply. The children will get tobacco from rogue traders or illegal sellers on the street.

I feel that the notion that hordes of teenagers will queue up in shops with faked ID just because there's no longer a tobacco vending machine in the Bull & Bush is far-fetched and reflects a level of official denial about the scale of unofficial/illegal sales of tobacco in Scotland.

North of the border restrictions are tightening too. Retailers of tobacco in Scotland are required to register, but as little as three days ago less than half the retailers had done so. On the alcohol side, 'buy one get one free' and similar offers are now illegal in shops – but since supermarkets have already simply lowered the unit price of wines and crates of beer it remains to be seen how quickly further restrictions will follow.

Ring-fenced funding, smoking cessation, social marketing and slave labour

Further to this post, a planning document has come to light (h/tip Eddie) entitled The Application of Social Marketing to Behaviour Change in Tayside – A Progress Report. It gives a budget for two items regarding smoking cessation totalling £540,000 and two items on social marketing totalling £162,000.

I am struggling to get hold of what social marketing is really about. Here is a very quick explanation using the smoking example:


Gerard Hastings is an international pioneer on this issue, and loves working with authority at the highest level on interventions supporting the official view of desirable behaviour change. An anonymous commenter on this blog assures me that social marketing is about behaviour change according to people's aspirations, rather than according to the grandiose notions of public health. Perhaps I should have attended this conference?

For the time being, Hastings is the only authority I have consulted, and I've yet to be convinced that there is anything politically radical or right on, or democratic, about 'top down' programmes of behaviour change. Democracy is about being represented – not being managed.*

Social marketing as developed by NHS Tayside is about top-down management. It's about NHS Tayside deciding on a desirable behaviour change, be it handwashing or smoking cessation. I would be the last to claim that the budget here was very high, but still would contend that a handwashing policy in a health service doesn't require a social marketing toolkit. It's basic hygiene.

The smoking cessation programme, with a target of 360,000, has got 800 into its fold of which around half abstain for up to three months. Its target is 1,800 quitters, or 2 per cent, over two years. Nothing startling there in marketing terms, especially if the targets are for a three-month quit. But do we really need to ring-fence that money for a very small number of people to quit smoking? Over half a million pounds?

Reading on we discover that the supermarket vouchers paid out to people passing their carbon monoxide tests probably come from Asda, since Asda is listed among the  'partnerships'.

Asda – now where did that name come up recently? Another initiative to reduce health inequalities? Oh no, it was this:

Unemployed people ‘bullied’ into unpaid work at Tesco, Primark and other multinationals 

Unemployed people are being sent to work without pay in multinational corporations, including Tesco, Asda, Primark and Hilton Hotels, by Jobcentres and companies administering the government's welfare reforms. Some are working for up to six months while receiving unemployment benefit of £67.50 a week or less.

On another page, another company participates in the no-work-no-benefit charade – a registered charity this time:

March 2009 was my first claim. The placement was seven months after. [Before that] I was going to college [to learn English]. I paid £50 for it. Then when I went to the job centre they told me: “Now it's the New Deal. You're going to a placement”. I told them my English was not good but they said: “It doesn’t matter, you have to go. If you're not going, we’ll stop your money.” They told me they would stop my JSA [Job Seekers Allowance] so I stopped my English course.

The first [placement] was with the British Heart Foundation. I worked from 9 or 9.30am to 4.30pm with a half hour break. I did everything. I went for one week and the manager was so rude. One day she ate something and left so much mess in the kitchen. Then she says to me: “Karina, you wash up.” The first time I didn’t say anything. I was scared they would stop my money.

My point isn't to 'get at' Asda or the British Heart Foundation. It's to show how companies that participate in top-down initiatives supposedly to improve our health are capable of profiteering from government initiatives to get people off benefits. Again: 'Instead of being represented, we are now being managed. The governments in all the western countries manage us on behalf of the international system.'*

*with thanks to Tony Benn (reply to second question)

Sheila Duffy wants ASH Scotland to be insulated from cuts

Well she would, wouldn't she? She wants to be assured that we don't get carried away by short-term concerns (life-saving treatments for example, crisis accommodation perhaps or investment in protection against STDs?) because smoking prevention is so important as to trump all these things. She reckons the cost of quitting is around £500 per quitter (without assuring us that this is a long-term quit rate and not a four-week one).

ASH Scotland is a charity that underwent an external review in 2007, containing the most recent figures I can access quickly (Table 6.1). As you can see from the review, Scottish Government provided about 60 per cent of the funding, with the rest split between the British Heart Foundation, Health Scotland (another government body), supporters/patrons and its own income from consultancy work. Charities are allowed to donate only to other charities, and so British Heart Foundation (privately funded for the most part) can only donate money on the strength of its charitable status. Voluntarily donated funding in 2006/7 ran to nil, with only £2,000 in previous years (a fraction of the money taken from government, £353K in 2005/6).

Why does this charity exist, since only those with a tobacco control agenda support it?, and without charitable status it would get no money from BHF either.

Sheila's blog post today says that Cancer Research UK funded the latest report, Beyond Smoke-Free (link in later post). Seems to be going round the houses for the Scottish Government to fund ASH only to have CRUK also fund it to frame tobacco control policy. As far as Sheila's appeal to retain ASH Scotland's funding is concerned, her recommending an extensive consultation on (among other things) the banning of smoking in cars, a policy she herself claims not to advocate, suggests that she hasn't grasped the seriousness of the economic climate.

Understanding the business of selling tobacco

Who knows more about selling tobacco. These people?

Or these people?

My vote goes to the former crowd. They sell tobacco, alongside other consumer commodities. They buy it every few days and sell it every day. The survival of their livelihoods depends on understanding the market environment, in tobacco and whatever else they sell.

They also believe in upholding the law around purchasing age. They make use of No ID No Sale (devised by the Tobacco Manufacturers' Association), a campaign designed to encourage age verification at the point of sale.

What about the British Heart Foundation? On the face of it they are an organisation designed to make the public aware of heart health. Nothing wrong with that. In this instance however they are using charitable donations to promote the tobacco display ban, which is a real waste of money when their expertise is not in the tobacco trade. Considering that many people who are in the tobacco trade consider that the display ban will make bootleggers stronger and sales to young people harder to control, they are using public funds to back a loser. And they claim (either in naive ignorance or untruthfully) that only the tobacco industry disagrees with their approach to the tobacco trade. In an era where universal benefits are about to be sacrificed on the altar of cost efficiency, just how stupid is this?

No doubt the British Heart Foundation works very hard to maintain its revenue stream, which is substantial (its Annual report is downloadable here). Their survival depends on successful fundraising (and significantly, legacy fundraising), running profitable second-hand shops and canny investments.

But it relies on naive arguments for its tobacco policies. There is no evidence that the display ban will work (I know I linked to this piece already but really, what are these people doing passing laws without knowing they will make any difference?)