Framework Convention on Tobacco Control to slash travel help for least developed economies

Participation by leaders of less developed countries in all FCTC events will be more expensive after the next COP, according to this announcement following COP-4. Before travel assistance was introduced to delegates from poorer countries in 2000, participation by their leaders was very limited.

The announcement ends with a recommendation to lobby their government representatives for a reversal of this policy to ensure maximum participation of leaders of poor countries.

It is difficult to see how the FCTC can really be an immediate benefit to countries that struggle to afford an airfare to attend an international conference. There are more immediate demands on every health budget in the world than tobacco control: tobacco control is a blunt instrument hacking clumsily at a single factor among the myriad causes of non-communicable diseases.

Imperial Tobacco attacks Welsh tobacco control policy

This has been reported on at least three blogs already but top prize to The Big Yin for calling his piece Welsh Rarebit. For rare it has been over the last few years to see tobacco companies leading from the front.

Yet here it is: Imperial's reply to the Welsh tobacco control consultation. Forest dubs it winner of its Plain English Award, and not without reason: it is clearly set out and structured:

• Good  –there is a tobacco control policy aimed at reducing youth smoking
• Bad – it has been incompetently conceived and designed
• Ugly – Welsh tobacco policy relies disproportionately on ASH Wales, raising the question whether improper pressure is being applied by 'the anti-smoking lobbying industry'.

Imperial Tobacco demands transparency in tobacco control, not only regarding the interests and involvement of tobacco companies but of all bodies involved, mentioning specifically ASH Wales and the pharmaceutical industry. The document consistently commends the aim of reducing youth smoking, but maintains that the strategy is wrong. It is wrong in describing smoking as a cause of health inequalities, and rebukes the tobacco control policy for simplistically trying to force a change in behaviour rather than trying to understand the reasons for such behaviour.

It is also wrong because it attacks the legal market in tobacco:

In many communities, where smoking rates are well above the national average, a high proportion of smokers will be sourcing their tobacco from illicit sources and criminal gangs ... Attempts to limit the availability of tobacco from legitimate sources will be undermined by an increase in the supply from organised criminal gangs who will welcome the broadening of the market share.

Addressing also civil liberties, property rights and the self-defeating method of denormalisation as a means of persuading adults to give up smoking, this consultation response makes good reading.

As The Big Yin points out, Imperial Tobacco is not the first tobacco company to start openly opposing official policy. There is so much to be done, and I hope this kind of document will now surface frequently – my way of saying Up With This Sort Of Thing.

Smoking not a cause of health inequalities

ASH Scotland makes the astonishing discovery that poor people smoke more than wealthier people, and urges the Scottish Government to do something about it. That something is 'tackling tobacco addiction', because:

Deaths from heart disease are nearly five times higher in poorer areas, and cancer deaths almost twice as high. 

Smoking being the only thing that makes people ill. Not genetics, stress from chronically unstable living conditions, toxic working conditions – it's all caused by smoking. Top marks to Sheila Duffy for this observation:

Life expectancy, health problems, smoking rates and deaths from smoking are all markedly different between Scotland’s richest and poorest communities.

Bottom of the class for this:

To challenge health inequalities we must tackle smoking.

Suggested edit:

To bring down smoking rates we must tackle health inequalities and poverty.

Removing smoking and placing it with a cocktail of nicotine patches and whatever other illicit substance the poor might use to alleviate the worst stresses of poverty is not a route out of poverty. Smoking is a lifestyle choice/habit/addiction (whatever) associated with poverty rather than wealthier circumstances, and the best way to get the smoking rate down is to boost living standards.

Clearly this is contentious: everyone has a view about what causes poverty – what balance of circumstances and fecklessness brings people to living on the breadline. There are no easy answers.

However I can guess that ASH Scotland's sympathies would have been firmly behind Patrick Reynolds in the Al-Jazeera video, and agreed that the International Tobacco Growers Association should have been excluded from international tobacco discussions under the auspices of the World Health Organisation. In other words they have ideological sympathies with a set-up that excludes the poorest workers in the system from participation in high-level talks involving highly paid public servants and other personnel occupying influential positions in society. These talks discuss the banning of ingredients from tobacco, affecting the marketability of tobacco plants, leaving the farmers with no livelihood. Such is the sympathy of anti-tobacco for the need to alleviate poverty.

More on Cancer Research UK Funding of Tobacco Control Strategy

I've been back to the Cancer Research discussion on possible cuts to charity funding. Among their committees is the Tobacco Advisory Group, which awards funding for projects relevant to the following priorities.

• Current UK policy priorities, e.g. see the 'Beyond Smoking Kills' report.
• Greater regulation of all products containing tobacco and nicotine.
• Greater tax and/or smuggling measures in the UK.
• Tackling health inequalities and addressing the needs of groups with particularly high rates of tobacco use.

Research must support existing tobacco control objectives.

The Tobacco Advisory Group is just one of 11 funding committees. However smoking-related research grants are awarded by other committees including more clinical work. This link shows a search of ongoing CRUK-funded research on smoking. You will find nothing here to challenge the official consensus on tobacco control or smoking cessation. I particularly like this logic-defying piece:

Most smokers who quit successfully do so spontaneously, without planning or support. However, most will make multiple 'spontaneous' attempts to quit before succeeding to long term abstinence from smoking. Treatments such as nicotine replacement therapy increase the chances of quitting; it is therefore logical to try to find ways of encouraging those making a spontaneous quit attempt to use additional sources of support.

In other words, give nicotine therapy to people who are trying to 'quit' unaided even though 'most smokers who quit successfully do so spontaneously, without planning or support'. Has the researcher seen this gem from Action on Smoking and Health, 16 July 2010:

We know NRT can improve people's chances of giving up smoking, but it doesn't mean you won't start smoking again. In one study, 9 in 100 people quit smoking for a year with the help of NRT, but only 5 in 100 were non-smokers eight years later.

Other ongoing research projects include plain packaging, tobacco display and much more on cessation. You can read the future of tobacco control here.

I guess I expect the planning for tobacco control to come out of public funding, but not necessarily from medical charity funding.