The Independent View: Tackling tobacco – a New Year’s resolution for the government

Christmas is the time for parties and fun – a last blast before turning over a new leaf in the New Year. Stopping smoking is the classic New Year’s resolution for good reason: those who give up can gain up to 10 years’ life expectancy and quitting is always worthwhile at any age.

Smoking is an addiction most smokers will come to bitterly regret. No one wants to be lectured or nannied but we cannot simply sit back and hope things will get better. The Liberal Democrat consultation on health, drawn up by Paul Burstow in the autumn, puts the argument well: “the State has a legitimate role in promoting healthier behaviour because of the impact of ill health on autonomy and life chances.”

A big part of this is designing an environment that makes it easier for people to choose what is best for themselves and for society. The book Nudge, written by Cass Sunstein, now working for the Obama administration, and Richard Thaler, who is advising the British Government, shows how powerful interventions that use behavioural psychology can be. For example, they found that changing the layout of a school canteen can greatly increase the amount of fruit children eat. They also showed that ‘social norms’ can have a huge effect. When people overestimate how common an unhealthy behaviour is, they are more likely to behave in that way themselves. Publicising the true ‘social norms’ can snap people out of the fantasy that their drinking, smoking or eating habits are the same as everyone else’s.

With the end of almost all cigarette advertising and no more smoking in enclosed public places, we have already changed the environment for our children for the better. Half as many 11-15 year olds smoke as they did in the mid-1990s but an enormous loophole in the advertising ban remains: the display of tobacco in shops. Often next to sweets and crisps, the brightly lit and colourful displays show off row upon row of cigarette brands like huge adverts for tobacco.

A powerful ‘nudge’ would be to deny this marketing opportunity for the tobacco industry by covering up displays. Ireland took this step a year ago and research has found that teenagers’ beliefs about the number of their peers who smoke have fallen considerably, making them less inclined to smoke themselves. They also think it is harder to buy cigarettes than before.

Reflecting the effectiveness of this measure, the tobacco industry has been using its usual tactics of promoting scare stories, misusing statistics, acting through front groups and mounting tenuous legal challenges. They have alarmed many retailers. Last week, the president of the National Federation of Retail Newsagents (NFRN) wrote in Lib Dem Voice. Despite the numerous papers in the peer reviewed literature showing the measure will work, he claimed there was no independent evidence for its effectiveness. He also said, wrongly, that retailers had suffered when it was introduced in Ireland and other countries.

John McClurey , a Lib Dem councillor and a former North of England President of the NFRN, shared these concerns so he travelled to Ireland to speak to retailers about their experiences and found the tobacco industry’s claims were totally unjustified. Existing smokers carried on visiting their local shops while retailers were able to make the necessary changes easily and cheaply – the Association of Convenience Stores found the average cost was £300 and the tobacco industry often covered the cost, a fact that they have not mentioned in the debate in the UK. Mr McClurey says “I prefer selling birthday cards to sympathy cards. If my customers live longer, I’m going to sell a lot more birthday cards before I sell a sympathy card.”

The Coalition Government is set to announce its decision on putting tobacco out of sight in the New Year and Cancer Research UK is urging them to put tobacco out of sight and out of mind. When thousands will be quitting, it’s the perfect time to help stop children starting to smoke in the first place.

Jean King is Cancer Research UK’s Director of Tobacco Control.

The Independent View‘ is a slot on Lib Dem Voice which allows those from beyond the party to contribute to debates we believe are of interest to LDV’s readers. Please email [email protected] if you are interested in contributing.

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79 Comments

  • I’m sorry, this is a Liberal Democrat website, Liberals believe in liberal solutions to social ills. Making the purchase of cigarettes “more difficult” is not in any way a liberal solution. How about new legislation meaning every time you buy a cigarette, you get punched in the face?

    Education and provision of support for “quitting” is exactly the right programme any government needs to pursue right now.

    And why is it okay to display sweets, which target children, have adverts and cause serious health problems, but not okay to display tobacco, which are illegal to sell to children and have no adverts?

    Consistency please.

  • Dave Atherton 23rd Dec '10 - 1:15pm

    Jean King is mistaken or misleading us.

    You have to of been in a coma for the last 50 years if you did not know smoking was bad for you. Lets go through the points one by one.

    1. Smoking is not an addiction, this Israeli paper said “Dr. Dar’s studies conclude that nicotine is not addictive as physiological addictions are usually defined. While nicotine does have a physiological role in increasing cognitive abilities such as attention and memory, it’s not an addictive substance like heroin, which creates true systemic and biologically-based withdrawal symptoms in the body of the user, he says..” (1)

    2. This paper produced by Dr. Patrick Basham of the Institute of Economic Affairs shows quite clearly that tobacco display bans have no effect on youth smoking, indeed the provinces in Canada that had one either youth smoking rose or remained static while provinces without display bans saw a cut in youth smoking. Not only that within a year convenience store closures reached 15% within a year. (2) Ireland has had an indoor smoking ban since 2004 and a display ban since 2009, what has happened? Smoking has risen. (3)

    “Minister of State for Health Áine Brady pointed to figures showing that 29 per cent of the population smoked despite the ban, the abolition of packs of fewer than 20 cigarettes, the ending of in-store displays and advertising, and the cost of cigarettes, which at € 8.55 a pack “are the highest in the world”.

    In fact in Ireland 24% of all tobacco now is smuggled, mostly by the Real IRA.

    3. On the cost of the display ban Jean King is grievously misleading us. Cancer Research, Action On Smoking and Health and the Department of Health blatantly misled Parliament. Under an FOI request author and historian Chris Snowdon obtained emails of the conversations. They quoted £120-£200 to Parliament when the Canadian manufacturers 4 Solutions said in plain English the cost is £2,000 at the very least. It appears Jean King is at it again. (4)

    May I also point out that heroin and cocaine come in plain packages.

    Quite frankly I find it disturbing that a charity in the face of such empirical evidence can print such misleading information. I think this a disgrace.

    1. http://www.sciencedaily.com/releases/2010/07/100713144920.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+sciencedaily+(ScienceDaily:+Latest+Science+News

    2. http://www.iea.org.uk/blog/pssst-wanna-boost-kids%E2%80%99-smoking-have-a-display-ban

    3. http://www.irishtimes.com/newspaper/ireland/2010/1217/1224285736185.html

    4. http://velvetgloveironfist.blogspot.com/2010/07/dark-market-redux.html

  • Dave Atherton 23rd Dec '10 - 1:21pm

    Iceland is often cited that a display ban led to less youth smoking, make your own mind up here.

    Regular smokers aged 15-21

    2000 14.4%
    2001 17.5% display ban
    2002 17.9%
    2003 16.9%
    2004 17.4%
    2005 15.7%
    2006 12.2%
    2007 15.2%

    Never smoked.1999 69.3%

    2001 70.0% display ban
    2002 70.6%
    2003 65.8%
    2004 72.6%
    2005 69.7%
    2006 67.7%
    2007 69.3%

    http://www.statice.is/?PageID=1406&src=/temp_en/Dialog/varval.asp?ma=HEI07102%26ti=Smoking+habits+by+sex+and+age+1994-2007++++++%26path=../Database/heilbrigdismal/afengiogreyk/%26search=SMOKING%26lang=3%26units=percent

  • Phil Johnson 23rd Dec '10 - 1:46pm

    I am afraid that I must agree wholeheartedly with “Dave Athert6on” (posted at 1.15pm), and further to his comments are we to assume that Liberals (UK) & Liberals (Holland) have two completely different meanings?
    You say government has a role to play in peoples lifestyles regarding health-no it hasn’t. It is simply interfering in what is regarded (now) as socially unacceptable. If people want to smoke then they have every right to do so and it is up to government to ensure that the two parties can harmonise, not leperise one section. My question is quite simple: as the health lobbyists clearly want everyone to live to a ripe old age where are they going to get all the pension funds from to sustain all these wonderfully healthy people-or are we supposed to exude healthyness but live in poverty?
    One more thing, please remove all funding from such as ASH (social pariahs) and let’s see just how much interfering they do when there are no fatcat wages to be had!

  • Simon McGrath 23rd Dec '10 - 2:01pm

    @Jean you say ‘No one wants to be lectured or nannied ‘ -and then proceed to reocmmend a huge increase in nannying. No-one has to smoke, we possess free will to choose and there cannot be a person in the country who does know the health risks.

    It is unpleasant, very bad for health, extraordainarily expensive. If people are dumb enough to want to do it they should be allowed to do so.

  • I welcome the lunatic comments from cheerleaders for the tobacco industry, because they (1) show us just how weak and unconvincing their proaganda is, and (2) bring into the open the close symbiotic relationship between the tobacco industry and the free market “libertarians” who are causing such havoc in this party.

    Jock Coats,

    You are clearly one of an extreme minority of tobacco misusers who, like Auberon Waugh, actually want tobacco to kill you. Waugh’s wish was granted, of course. However, you are rather at odds with those pro-nicotine fanatics who claim that smoking is beneficial to health.

  • Paul Hooper 23rd Dec '10 - 2:41pm

    The argument for restricting the advertising of this inherently dangerous product was won sometime ago and so is not the point today. What must now be concerned with is where advertising stops and legitimate display begins.

    I would urge those writing against the proposed ban on tobacco displays in shops to have another look at them the next time they go out shopping. It is quite clear that the tobacco industry have used the current ‘display’ loophole to continue to market their deadly wares in such a way that could easily influence young people to think of them as normal commodities. The displays are much more than would be needed to just sell cigarettes to existing smokers.

    A display ban would not mean adults couldn’t buy their usual brand from their usual supplier. (I don’t know of a single person who forgets that they are a smoker when they can’t see a tobacco display!) What might be achieved is less tobacco industry influence on the young – which must be the right way to go – and space behind the counter that can be used by shops to promote other goods.

  • Wea re told here that “A powerful ‘nudge’ would be to deny this marketing opportunity for the tobacco industry by covering up displays. Ireland took this step a year ago and research has found that teenagers’ beliefs about the number of their peers who smoke have fallen considerably, making them less inclined to smoke themselves. They also think it is harder to buy cigarettes than before”

    What Jean King omits to say is that despite this alleged change in beliefs, the Irish display ban has seen underage smoking rise slightly – and no fall in adult smoking. If that’s a “success” for CRC, God prevent us from failure. If Ms King is reading this, she might like to know that I cancelled my Direct Debit to CRC when they apparently stopped researching cancer and began to major on persecuting smokers.

  • I didn’t sign up to be a liberal to encourage children to kill themselves smoking. Since when was it liberal to turn a blind eye to the salesmen of death who want our kids addicted to their noxious products. What next a gin for everyone???

    Let’s be real about what matters. As liberals we have not signed up to the ‘laissez-faire let the market decide’ approach, even if some of our representatives have been seduced into power by such ideas.

  • Martin Dockrell 23rd Dec '10 - 2:53pm

    Dave suggests Jean is misleading us. If anybody is guilty of being “disgracefully misleading” it is Dave Atherton.

    Just to be clear, I am from Action on Smoking and Health. Also to be clear, Dave Atherton is from the right wing blog Progressive Conservative. http://progressive-conservatives.org/web/pages/executive.php

    IS NICOTINE ADDICTIVE?
    Dave quotes one study which takes the minority view. If you look at the Cochrane Centre who review all the relevant studies they have no doubt that smoking is addictive and Nicotine Replacement Therapy increases the chance of quitting by 50-70%. Dar points out that there are important psychological elements to craving, this is certainly true but few serious comentators (even in the tobacco industry) contest the idea that nicotine is addictive. http://www2.cochrane.org/reviews/en/ab000146.html

    HAVE SMOKING RATES IN IRELAND INCREASED?
    Quoting somebody else’s mistake doesn’t make it true. The rate of 29% comes from 2007 which is before the 2008 tax increase an the 2009 ban on tobacco displays. Since 2007 smoking rates in Ireland have fallen to 23.6%. Don’t take my word for it, see for yourself http://www.otc.ie/fig.asp?image=2010Charts/Fig2.1.jpg

    HAS YOUTH SMOKING IN ICELAND INCREASED?
    This can only be deliberately misleading. Even though the Public Health Institute of Iceland (who produce these data) have written to the UK tobacco industry to correct this, Dave persists in using this data. The survey Dave quotes is a survey of the whole population with only a few hundred young people included. For that reason the PHII have asked the industry to use the much more reliable ESPAD study. This is only done every three or four years but the sample is all year 10 students at school in Iceland. This shows a clear reduction in youth smoking. See for yourself. http://www.espad.org/sa/node.asp?node=730 Dave knows this but he didn’t want you to know.

    HOW MUCH DOES IT COST TO COMPLY WITH A DISPLAY BAN?
    Different regulations have different costs. In some parts of Canada all you need to do is fit a curtain over your display. That wont cost much. The UK’s Association of Convenience Stores did a survey of small retailers in Ireland to find how much it cost them. They found an average cost of just £300. (Implementation of the Tobacco Display Ban in Republic of Ireland. ACS 2009)

    In the end it is all about who you trust. Should Liberal Democrats trust Atherton’s far right organisation “Freedom2Choose” http://www.freedom2choose.info/
    or would you rather take your advice from, say, the Royal College of Physicians?
    http://www.rcplondon.ac.uk/professional-Issues/Public-Health/Documents/Preface-to-passive-smoking-and-children-March-2010.pdf

  • Steve Lawford 23rd Dec '10 - 3:01pm

    Can the Tobacco companies explain this to me : If they say the evidence suggests that the display ban will have no effect on youth smoking, why are they spending so much money trying to overturn the legislation ?
    I’d like to invite any of the big tobacco companies to accompany me on tobacco test purchases to see how poor the results have been e.g. 75 % sales to 15 year old children from cigarette vending machines.

  • In 2003 ASH said that the hospitality was crying wolf and that the smoking ban would be good for the industry. Since the smoking ban thousands of pubs have closed making tens of thousands of staff unemployed. Ash say that the closures are nothing to do with the smoking ban and blame the recession.
    Ireland and Scotland introduced their smoking bans before England and both saw massive pub closure in their first years, which were long before the recession.
    ASH say that a display ban would deter children from trying to buy cigarettes, but insist on smokers being seen smoking outside in full view of children. What will encourage a child to start smoking, seeing a packet of cigarettes on a shelf or seeing adults enjoying a cigarette?
    A display ban will cause the closure of thousands of corner shops which have been a life saver, especially to the elderly, during the past few weeks when they cannot travel far for their essentuals.

  • john mcclurey 23rd Dec '10 - 3:25pm

    Well, here we go again. As a retailer of cigarettes it is in my short term interest to sell as many cigarettes as possible. As a responsible adult and parent it is important that my children are not exposed to the false belief that smoking is normal. I fully support the display ban and I know through my own investigations in Ireland that it will not have a catastrophic effect on my business. If covering up my display helps one child make the decision not to smoke then it will be worth it. It is not aimed at current smokers, they can continue to smoke until their early, unpleasant deaths. As to the comment earlier that smoking is not addictive, there speaks someone who has never tried to quit. It is time we finished this debate and brought in the legislation and allowed the adults of the future the best chances of making the right decisions.

  • Steve Lawford: what have vending machines got to do with display in shops?

  • Donald Reid 23rd Dec '10 - 3:52pm

    I’m baffled by the reaction from some tobacconists to Jean King’s excellent article, for example the comment that a ban on point of sale display will cause corner shops to close, so removing a vital prop and stay for the elderly, who cannot go further than their corner shop during the bad weather. This is an absurd claim when we remember that with half of all smokers dying before their time from the habit, tobacconists are helping to ensure that many of their customers, sadly, will never reach pensionable age in the first place.

    And then there’s the tobacconist who cancelled a direct debit to Cancer Research UK because he claimed that they have stopped researching cancer and started persecuting smokers instead. He must have missed the comment from a previous CRUK Chief Executive who said that preventing smoking was more effective in reducing deaths from cancer than all of the anti- cancer drugs put together.

  • Who said I was a tobacconist???????????

  • I agree completely with Jean King. As a respiratory doctor, I see patients every day who have become ill because they smoke – many with lung cancer but others with pneumonia, emphysema, heart disease. The vast majority of them wish they had never started smoking and welcome any measure which puts tobacco further away from young smokers. There will always be some people who see these public health measures as ‘nannying’ but wearing a seatbelt was considered in the same way when it was introduced, and I doubt that you would find many casualty doctors or traffic cops who would agree with you now on that one……

    And I wonder if being a Liberal Democrat means caring about the health of children and health inequalities in general, not just letting industry do what they like and relying on people’s own judgement to overcome sophisticated and well-funded market pressures? If it’s not going to have any effect, why are the tobacco industry so interested in lobbying against it?

  • Prof. Martin McKee 23rd Dec '10 - 3:58pm

    I have some sympathy with the libertarian argument that people should be able to do anything they want as long as it does not harm others. No-one wants to see governments banning activities that, while dangerous, provide individuals with a sense of enjoyment, such as parachuting or hang gliding. Yet to extend this argument to tobacco is a gross distortion of the facts.

    First, tobacco IS ADDICTIVE, and it is simply perverse to argue otherwise. If readers are in any doubt about this they may wish to consult a review by the US National Institute on Drug Abuse (http://drugabuse.gov/PDF/TobaccoRRS_v16.pdf) which asks the simple question “Is nicotine addictive?” and answers with one word “yes”, before going on to explain in detail how it works on the brain.

    Second, of those activities engaged in legally, smoking is UNIQUELY dangerous. It leads to the premature death of 50% of long term users. To achieve the same degree of risk from dangerous sports, one would need to engage in them 3-4 times every single day for 35 years (http://www.medicine.ox.ac.uk/bandolier/booth/Risk/sports.html). Indeed, the only way to bring the risk even close to that of smoking would be to cut the cords of the parachutist or hang glider. There is no way that we would allow people to work in conditions so hazardous that they placed them at this degree of risk. So yes, people know that smoking is dangerous, but do they really understand how dangerous?

    Third, smoking DOES harm others, at least financially. At a time of austerity, it is simply incredible that governments would fail to act against an entirely avoidable cost estimated (in 2005-6) of £5 billion, equivalent to 5.5% of the entire NHS budget, to say nothing of the even greater cost of lost productivity at a time when the country needs all the economic growth it can get. The taxes raised from tobacco come nowhere near this amount. I know that the pro-smoking lobby disputes these figures but, unlike their back of envelope calculations, they were published in the peer-reviewed journal Tobacco Control).

    Then we turn to the distortions reproduced (with remarkable rapidity) in the responses to this piece. Point of display advertisements are aimed at children. Adult smokers rarely switch brands. The tobacco companies have been using extremely sophisticated methods to appeal to children including increasing the number of brands (so as to cover more surface area) and designs specifically intended to attract children who are more likely to make impulse purchases. Crucially, bans of point of display advertising do work. Dave Atherton cites figures for Icelandic 15-21 year olds but those aged 21 may have started smoking a decade or more earlier. More relevant are the data on 15 year olds, which show a decline from 18.6% in 1999, when the ban was introduced, to 11.1% in 2007. It is simply ridiculous to argue that a ban would not impact on teenage smoking.

    Finally, I suppose the one good thing about these remarkable responses is that none try to argue that a ban would hit newsagents and small shopkeepers, given the evidence to the contrary.

    A failure by the coalition government to implement a ban on point of sales displays would be a complete abdication of responsibility for the British population but, more importantly, would raise serious questions about the ways in which the tobacco industry may still exert its influence on our politicians .

  • I smoked for fourteen years, I didn’t enjoy every cigarette but I definitely enjoyed the persona of being a smoker, part of that was brand identification and loyalty. I was loyal to my brands as I believed they said something about me in the same way that I would drink pints not halves or shorts. I cannot say for certain but had I not had such brand loyalty I probably would have given up years before. I may still have started smoking at 14 but I may not have carried this into my adult years had the association with brand been so strong. So for what it is worth on a personal level I support the introduction removal form point of sale (RPOS) and of plain paper packaging (PPP) for cigarettes.
    As a nurse and an NHS employee I also support the introduction of RPOS and PPP. Why? Because anything that decreases the likelihood of people starting smoking is public health gold. Leaving all other facts aside smoking kills half of all lifetime smokers before their 65th birthday. full stop. dead. no pension. no life after work. nothing. dead.
    People can make all sorts of arguments about why this is a good thing but, like the more pension and less taxes for those who don’t smoke, they all turn out to be selfish arguments. Ask any 55 year old who’s presented with a prognosis of lung cancer and given 3 months to live how they feel. If that person’s a smoker you can then congratulate them on being so unselfish in giving up their pension contributions and saving their family and the NHS the burden of looking after them in their infirmity, see where that gets you.
    The issue should never be about pension funds and healthcare costs in old age. It should be about giving people the best opportunity to live a happy and healthy life. One of the problems with these type of discussions is the automatic shift to extremism, no-one from a health point of view is suggesting that smoking becomes criminalised, nor that smokers are punched in the face. Another problem is when people present statistics that are not much more than opinion as truth. As a counterpoint to David Atherton’s posts:
    The single study by Dr. Dar that you have found has such a small sample size and is of such specificity that it should not be used on its own as a ‘proof’ that smoking is not addictive. If you really want to look into the addictive nature of smoking then you should research the chemical changes that happen to the α6, α5, α3, and β4 subunits of the nicotinic acetylcholine receptor. In very basic terms this common receptor plays a major part in mood control regulating the release of the ‘feel good’ chemical dopamine. With long term exposure to nicotine its ability to react the body’s own chemical key acetylcholine is vastly reduced. This long lasting functional change forms part of the chemical addiction that nicotine creates in the user. For further reading I would also suggest finding out more about the learning chemical glutamate and the way smoking acts as a Monoamine Oxidise Inhibitor. There are literally hundreds of research papers out there to support these facts, I’m presuming you don’t have access to the various medical, social, psychological or nursing libraries so as a start you could check out some of the Wikipedia stuff and go from there.
    The report that you quote by Basham is misleading unless other factors are taken into account, Canada does not have a history of supporting smokers to stop in the same way as we do in the UK. Stop smoking services have been running for in some cases over 15 years now and that combined with other factors such as the national advertising ban, the Smokefree legislation and the raising of the age of sale have all contributed to the reduction in prevalence of smoking that we have seen in this country form about 28% in 1998 to around 20% in 2010. You yourself support this point by identifying the Ireland case. The reason smoking rates have gone up is because Ireland didn’t introduce other measures to help people stop smoking, ban it and they’ll stop doing it doesn’t work at all. Plain paper packaging or removal form point of sale on their own will not bring down prevalence, but they should help. Quoting Basham in this case is like saying there were life rafts in the water but everyone drowned, life rafts don’t work.
    I’m not even going to enter into a discussion about cost to the retailer as this is nothing more than elaborate misdirection. If it costs £2000 then that’s what it costs and I’m fairly certain the tobacco industry will be more than happy to foot the bill to keep the businesses that sell their products open.
    I fail to see any empirical evidence to support your postulations as fact and I would discourage others from regarding them as such themselves. Please people read around the subject yourselves and make your own minds up.
    I would never argue that someone’s right to smoke should be taken away from them, as long as it does not affect others then go for it. What I would argue against is that cigarette advertising in any form is designed purely to capture new smokers. I never changed my favoured brands because of an advertising campaign or a new packet, I know what I liked and I smoked them. Considering the majority of people who come to stop smoking services for help to stop, started smoking before they were 18 then I would say that that is too young to be making a choice that will so affect their life in the future. The longer we can delay that choice, the more time people will have to decide if they really want to start on a career as a smoker. Removal from Point of Sale and Plain Paper Packaging will probably not stop people from continuing to smoke, but that isn’t the point. The point is that it will deglamorise smoking for those considering starting and the only people that that will really harm are those whose income is derived from the peddling of highly addictive and deadly nicotine delivery systems.
    Please, please, please do not be swayed by people who have only their own interests at heart. Backing RPOS and PP is saying that I care about the future of the children of this country and I am prepared to do what is right to protect them.
    It may not be the solution to all life’s woes but it is a good step towards showing that we care.

    Dave

  • Full disclosure (so far I suspect I’m the only one): I’m a health economist working on tobacco control, among other things. Yes, this includes a relationship with the DH and ASH, but my work is staunchly independent. And published in peer-reviewed medical journals, not left on industry/consulting firm websites (with apologies for sounding like a jerk: this is nevertheless an important distinction).

    @Atherton, you are referencing a flawed study (paid for by industry). These reports, if you’ve read them carefully, are inconsistently selective about data and methods. In fact the data surrounding the display bans in Canada, Iceland and Thailand all are insufficient to make the claims made, and the methods of analysis used are worse – and also inconsistent, arguably the greatest methodological crime. The authors of these reports (there are a few) ignore contemporaneous policies and historical trends completely, and their conclusions are completely out of sync with even conventionally accepted supporting studies and economic/behavioural theory.

    The Irish experience has, on the other hand, included evaluation and more appropriate data and suggests that the display ban does what it should do: have a long-term impact on smoking initiation by young people. It does not immediately hit adult smoking (nor should it, unless adults smokers are very stupid) nor does it immediately hit retailers or other sellers (nor should it, unless they make all their money selling cigarettes to children).

    @David: adult smoking is NOT supposed to fall following the display ban: do you honestly expect adult smokers are so stupid that they forget how to buy their cigarettes? I would add that you are misreading/misrepresenting the studies: youth smoking did not increase beyond statistical significance and ageing/peer effects.

    Finally @Phil Johnson. People have the right to smoke, yes. They do not have the right to endanger others (e.g. family members, including children). Moreover, using the irrationality model we reserve the right to attempt to make consumers internalise now the future disbenefits of smoking (since people are proven to be bad discounters of future negative outcomes).

    More importantly we reserve the right (again, as a society) to prevent cynical attempts to normalise smoking in young people. The display ban does not affect adult smoking – so why is the industry so up in arms? Because it WILL reduce young people being marketed into starting smoking. Nudging (again @David) is already being done, and done strongly effectively, by the industry side, to ensnare young people. This is perfectly fine, but public health policy exists for a reason and that is to respond.

    Find me enough adults (including smokers) who willingly state that they want their children to smoke: to pay over the odds in taxes and enjoy less quality and quantity of life. It won’t happen.

  • Melodie Tilson 23rd Dec '10 - 4:07pm

    All Canadian provinces/territories have bans on the display of tobacco products at point-of-sale, with the first implemented in 2002 and the last in 2010. None of the dire financial consequences for retailers that were predicted has come to pass. As the President of the Atlantic Convenience Stores Association has said publicly, “Despite common fears, operating a convenience store in a dark market does not spell DOOMSDAY.” What a dark market does do is help change–over time–the social norms related to smoking. The significant change in the social acceptability of smoking has contributed greatly to the decline in Canada’s smoking rate, from 31% in 1991 to 18% in 2009.
    The bottom line is that tobacco is a highly addictive product that kills one out of every two long-term users. Such a lethal product should not be promoted by any means–not by prominent, eye-catching displays and not by attractive, alluring packages. Banning tobacco displays is about protecting youth. Young people are the targets of tobacco industry marketing and young people are the ones who become addicted to tobacco, before they are mature enough to fully appreciate the consequences of their actions.
    Melodie Tilson, Director of Policy, Non-Smokers’ Rights Association, Canada

  • Robin Hewings 23rd Dec '10 - 4:17pm

    Dear all,

    I work with Jean so it was interesting to read your comments.

    There was a theme of arguments saying that it is not liberal or part of the mainstream of Liberal Democrat thinking for there to be government action on tobacco. However, the very active chair of the all party parliamentary group on smoking and health is Stephen Williams MP, the Liberal Democrat MP for Bristol West and this measure would not have been passed in the Lords without support from Lib Dem peers. There is a very good discussion of public health and liberalism by Richard Reeves, who is now an adviser to Nick Clegg in No10. It is available here:
    http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_111697

    Andy thought that this measure would increase smuggling by making tax paid cigarettes indistinguishable from duty paid cigarettes. However, there is not any evidence that this is the case. They would still be readily distinguishable in terms of where they are bought from while the markers that show cigarettes are duty paid are such that they have to be handled to be verified. The basic designs of cigarette packets are pretty easy to fake.

    The proportion of smuggled cigarettes has halved in the last decade after growing rapidly in the late 1990s. The key reasons for this are tighter regulation of the tobacco industry and better anti-smuggling enforcement. Prices have continued to rise while this period includes the introduction of the end of most forms of tobacco marketing apart from in shop displays and through the pack itself.

    Dave Anderton made a series of comments. That smoking is addictive is not controversial for most people. The rest of his comments are largely based on the paper Patrick Basham wrote for the IEA. I have written a longer piece that shows that Basham’s various claims cannot be substantiated. These include his failure to declare his long-standing links with the tobacco industry. The World Health Organisation says the tobacco industry has a “long history of using seemingly independent ‘front groups’ to advance its case.” Basham’s paper appears to be an example of this practice.

    The piece is available here: http://scienceblog.cancerresearchuk.org/2010/09/13/patrick-basham%E2%80%99s-paper-on-tobacco-displays-doesn%E2%80%99t-add-up/

    I’m sorry that Mr Anderton accused us of lying. As he will see from the bottom of page 12, of the Association of Convenience Stores report ‘Implementation of the Tobacco Ban in Republic of Ireland’, we have reported the £300 figure for the average cost of conversion in Ireland accurately.

    Chas said tobacco displays are necessary to keep thousands of small shops open. However, apart from the initial costs of conversion – which the Irish found to be nothing like the figures claimed by some in the industry – it does not impose costs on small shops apart from the long term effect of reducing the uptake of smoking.

    The vast majority of smokers start in their teens and are then hooked. It is an addiction of childhood that has very serious health effects. Some have said this measure persecutes smokers. I cannot see how a product not being on open display persecutes anyone. Those who really persecute smokers are those who seek to get them hooked when young and profit from their addiction.

  • So “nudge” is a new word for Discrimination and Bullying, It is all very well for the Government to give advice on health matters and the like but it is Not their place to bring in Bans to stop Adults making their own lifestyle choices. The ill thought out Smoking Ban is a prime example, the public did not ask for a ban,industry did not ask for a ban,the only people who did were the taxpayer funded anti-smoking Quangos and control nuts. Has the smoking ban made the public more healthy ? No, Has the smoking ban made the country more wealthy ? No, just look at the massive Pub and Club closure rate since the ban was forced onto the country. The one thing the Government does not have the right to do is to take away the social lives of millions of people.the one thing the smoking ban achieved, time for the ban to be reformed in favour of Adult Choice.

  • One of the problems with arguing moderate and sensible positions about tobacco – for example, it kills a lot of people so how can it be OK to advertise or promote the stuff? – is that you then have to deal with a herd of trolls who wander from internet site to internet site posting nonsense and insulting people who actually know what they are talking about. Smoking tobacco is not addictive? Yeah, yeah, and climate change is not real, and the free market produces perfect results and, and …. zzzz

    The liberal (as opposed to right-wing libertarian) principle is that you are free to do what you like if you do not harm others. Promoting tobacco consumption does harm to others – who die across the world in their millions every year from a range of horrible diseases including cancer, emphysema and COPD. Therefore regulating tobacco – including preventing the industry from promotion of its products – is perfectly consistent with being a liberal. Duh.

  • Phil Rimmer 23rd Dec '10 - 4:33pm

    Many years ago, asked about the target market for cigarettes a tobacco company executive replied, “They got lips, we want them.” In order to replace dead, dying or quitting smokers the tobacco industry must recruit from two key groups – children and teenagers. Point of sale advertising bans are about ending the role of tobacco as part of ordinary, everyday life – part of growing up, part of moving from childhood to adulthood.

    Liberal legislation and regulation must pass the test that it is about protecting the weak from the strong. They don’t come much stronger than the tobacco industry and who is going to argue that children aren’t deserving of protection from Liberals whilst they develop the critical faculties they will need for adulthood? No, this isn’t about learning from their listakes, or being allowed the space to make mistakes. Tobacco is addictive, choice is reduced and the next stop for the smoker is cancer or heart disease.

    It’s no part of the role of Liberals to protect the profits of the tobacco industry. Neither is it our job to ban and prohibit. This measure will not even rstrict the choice of smokers who wish to continue. What it wil do is help protect the weak from the strong. It passes the classic Liberal test, it deserves the support of those of us who call ourselves Liberals.

  • I still fail to see the issue. Surely the only way a child can get their hands on cigarettes is through a dodgy shop owner (already illegal) or by asking an adult to buy them for them (also illegal, but that already means the child is not in the shop, not able to see the display).

  • Jonathan Bagley 23rd Dec '10 - 5:31pm

    Martin Mckee is incorrect in claiming that smokers consume more health resources than non smokers. The 5.5 billion he quotes takes no account of the health resources smokers would have consumed had they lived longer and died more expensive deaths. Dementia in the over 80s will be an enormous cost in the future. These calculations have been done repeatedly. The most recent I recall is a Dutch study (published in a peer reviewed journal, this time without the words tobacco or control in the title). Rather than a vague mention of some propaganda rag, I’ve even provided a link to something which at first sight looks remarkably like an academic paper and bears no similarity to the back of an envelope. The Healthy were found to be the most costly, followed by the obese and then the smokers.

    http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029

    McKee also makes no mention of the lower pension payments made to smokers. The straw he clings to is “loss of productivity”, a sort of “dark matter” in anti tobacco propaganda. Maybe there is a detailed calculation somewhere in the Journal of Tobacco Control, but if he wanted us to read it, he would have told us where to find it. And finally, as Mckee well knows, none of the people commenting here are “pro smoking”.

  • Jonathan Bagley 23rd Dec '10 - 5:45pm

    I forgot to mention the 10 billion in tobacco tax – £1500 a year for a twenty a day smoker. To put it in context, £1500 is the average amount spent by the NHS on each of us.

  • Definitions of ‘liberal’ – tolerant of the ideas and behavior of others; broad-minded.
    The party needs to change its name to the ”Illiberal and undemocratic’party.

  • Lynn Greaves 23rd Dec '10 - 6:25pm

    I am from the Canadian province of Saskatchewan which was the second jurisdiction in the world to pass a retail display law. Before 2002, prominent retail displays in every corner shop gave children and everyone the impression tobacco was a normal part of everyday life. This, despite the fact that the product is highly addictive and kills half its regular users.

    The 2002 ban on retail displays in our province was quickly accepted. Within six months, compliance was very high. There were no reports of financial impact in the media. Neither pharmacists nor inspectors frequenting the shops reported any evidence of negative economic impact. In fact, when I tell people that some are saying in other countries that there was an economic impact, the most common reaction is for them to laugh. They can’t believe anyone would say that. There’s no evidence.

    The only negative response was from the tobacco industry who took our government to the Supreme Court of Canada where their challenge to this important legislation was thrown out. Question – Why would they legally challenge something unless it is effective?

    Stick to your principles U.K. The tobacco industry shouldn’t promote to children.

  • Dave Atherton 23rd Dec '10 - 6:35pm

    @Robin Hewings

    You used the word ‘lying,’ let me prove it. These are copies of emails sent between Cancer Research, ASH, Dept of Health, the Canadian manufacturer 4Solutions display and the Association of Convenience Stores. if you think I am fabricating these emails, sue me.

    23/4/09 Lord Darzi (Labour Peer) sends a letter to all peers which includes the following statement: The Dark Market “This legislation is not going to come into force until 2013 and it will only cost small shopkeepers £200 to comply.”

    28/4/09 Phil Beder (display manufacturer) e-mails Deborah Arnott. (ASH) “I wanted to take a moment and clarify some of the issues surrounding the display ban covers that are presently being explored by your organization in the UK…” Beder explains that the £200 figure being quoted by ASH, CR-UK and the DH “does not include shipping, installation or specific changes or dimensions”. He also explains that the price was based on 1,500 units, and that the product described was “clearly temporary, lasting three to six months” and is not a permanent solution.”

    29/4/09 Shane Brennan of the Association of Convenience Stores e-mails Lucy Holdstock (DoH), saying:“I have recently received communication from 4 Solutions Displays, a Canadian shopfitting company and the source of the information that DH and others are using to explain a cost of £120 (in Lord Darzi’s last briefing to Peers) or £200 (in DH’s briefings to Parliamentarians.)

    “This communication shows quite clearly that information from 4 Solutions Displayshas been taken out of context and, frankly, has not been used truthfully by those who have made the case that compliance costs are lower than those stated in your own Regulatory Impact Assessment of December 2008. I am certainly prepared to accept that the reason that DH have briefed Parliamentarians with incomplete and misleading information is that you have yourselves been misinformed by whoever briefed you on these costs. Nevertheless it is a serious matter when briefings from government departments do not reflect the truth.”

    4/5/09 Phil Beder e-mails Suleman Khonat of The National Federation of Retail Newsagents. “We have made ASH aware of these points so presumably the misperceptionthat we can offer a display ban solution for £120 to small retailers will be dispelled by them shortly.”

    5/5/09 – 5.54pm Baroness Finlay has received an e-mail from 4 Solutions Display and plans to quote from itin the House of Lords debate the following day. She sends it to an unnamed Bill Manager at the DH and the Bill Manager writes:

    “I’ve just spoken with Baroness Finlay, who has agreed not to circulate the email she received from the Canadian display company (she had thought it might be a helpful rebuttal to the Lord Palmer/Baroness Golding letter, but in fact it’s the opposite!).”

    So the true cost of the display ban was never presented to Parliament when it appears they had been told in plain English the figures they were quoting were in your own words Hewings, lying.

    http://www.velvetgloveironfist.com/pdfs/thedarkmarketredux

  • Dave Atherton 23rd Dec '10 - 7:10pm

    This is taken directly from the Canadian Convenience Stores website. Along with the high taxation it looks like an Amageddon on illegal tobacco sales.

    “Study says contraband makes up 43 per cent of daily smoker’s use.”

    2October 26, 2010 – Contraband cigarettes, often sold in baggies and out of vans, account for 43 per cent of what daily smokers in high school are using, according to a new study by the Centre for Addiction and Mental Health.

    This illegal cigarette market is sabotaging traditional tobacco control policies, such as taxation and age restrictions. “Teenagers are more price sensitive,” said Davis Ip, a researcher for the study, which appears online in the journal Tobacco Control. “Since contraband isn’t taxed, the lower-priced cigarettes make it more likely teens will pick up the habit and increase consumption.”

    In Ontario, retailers are not allowed to sell cigarettes to anyone younger than 19. Someone hawking illegal smokes is not likely to care about age.

    “The most urgent (problem) is dealing with contraband,” said panel member Michael Perley, director of the Ontario Campaign for Action on Tobacco. “It’s the problem on the streets that’s hooking our kids and undermining everything else we do in tobacco control.”

    A legal carton of premium-brand cigarettes sells for about $80. A bag of 200 contraband cigarettes goes for $10 to $20, depending on where you live, said Perley.

    Most illegal cigarettes are smuggled from native reserves in the U.S., although some are manufactured domestically, explained Perley. Untaxed cigarettes intended for sale to status natives are also sold to the broader population.”

    http://www.conveniencestores.ca/index.php?option=com_content&view=article&id=365:illegal-cigarettes-lure-high-schoolers&catid=16:ontario-convenience-stores-association&Itemid=145

  • I’m afraid that I, too, fail to understand why this measure is necessary. Is the tobacco control lobby really suggesting that youngsters are so seduced by packets on which a stark warning covers more than a third that they will ask an adult to buy a packet (since they can’t buy tobacco themselves)? How do they know this? Since youngsters are tempted by the forbidden, I would have thought that banning display of tobacco would only heighten its appeal. Someone mentioned plain wrapping – why is this necessary if the product is to be banned from display? Someone also mentioned that point of display amounts to advertising. Actually, it doesn’t send any marketing message and is no different from biscuit manufacturers distinguishing their brands on the shelves. Let’s not forget that tobacco is every bit as legal a product as a chocolate digestive. Several people have mentioned denormalisation and I believe that this is the real objective. I, however, strongly disagree that this is an acceptable objective because it is not the activity that is denormalised but the person engaged in that activity and I, for one, object to contributing billions to the coffers of this country whilst the government encourages others to see me as abnormal, especially as the tobacco control lobby regards me as an addict and therefore someone who has no control over their behaviour. Moreover, I am not responsible for the youngsters in the UK – it’s the job of their parents to persuade them that they needn’t smoke. I would like to see the tobacco control lobby campaign to have smoking made illegal and I wonder why it doesn’t. Slightly off-topic, but I wonder also why it wishes to have e-cigs banned when they are an effective way of stopping smoking.

  • Dave Atherton 23rd Dec '10 - 7:26pm

    On the harm of second hand smoke (SHS) please do not insult my intelligence. This is an essay written by pulmonologist Dr. Jerome Arnett in 2008. I am not paid or expenced by tobacco companies, but why as a member of the public have I gone to so much trouble to research my subject? I do not like being misled.

    “In addition, influential anti-tobacco activists, including prominent academics, have unethically attacked the research of eminent scientists in order to further their ideological and political agendas. The abuse of scientific integrity and the generation of faulty “scientific” outcomes (through the use of pseudoscience) have led to the deception of the American public on a grand scale and to draconian government overregulation and the squandering of public money.

    Millions of dollars have been spent promoting belief in SHS as a killer, and more millions of dollars have been spent by businesses in order to comply with thousands of highly restrictive bans, while personal choice and freedom have been denied to millions of smokers. Finally, and perhaps most tragically, all this has diverted resources away from discovering the true cause(s) of lung cancer in nonsmokers.”

    http://www.heartland.org/policybot/results/23399/Scientific_Evidence_Shows_Secondhand_Smoke_Is_No_Danger.html

  • John Roffey 23rd Dec '10 - 9:13pm

    Surely it is time that alcohol has a severe warning on tins and bottles to remind people of the dangers of excess drinking. Smoking tends to reduce life span by about 5 years, but very few early deaths, whereas excess alcohol often kills people at an early age – also the knock on effect of drinkers causing harm to themselves through dangerous behaviour whilst under the influence or others through violence must be equally as great or probably greater than to those breathing secondhand smoke.

    New legislation is imperative.

  • Let me get this right: a non- smoker goes into a newsagents, sees the display of multi-coloured packets and suddenly develops the desire to take-up smoking. Hmmm.

  • I have just looked back at the posts. I was quite surprised to see how all the ‘professional’ pro-‘cover-up’ comments all came in quick succession around 4pm. It really is uncanny how all these people wrote quite complex posts all at the same time and then pressed their ‘post comment’ buttons one after the other in quick succession. Quite uncanny. There again, it might not be quite so uncanny if these posts were already written.

    I also noticed something equally uncanny, and that was the constant reference to ‘children’ in the ‘professional’ posts without anyone defining the word ‘children’. At least Jean King referred to ‘young people aged 11 – 15’ (but she also scattered several references to ‘children’ around in her article). I may be wrong, but I definitely had a feeling that the word ‘children’ was being used as emotive propaganda. I mean, does anyone these days refer to a 15 year old as a child? But notice the clever inclusion and emphasis on 11 year olds who supposedly smoke. Are we talking about that old ruse of including any such child who has taken a single puff on a cigarette as ‘a smoker’? I remember, about that age, asking my father for a puff. He willingly agreed and told me to suck the end of the cigarette and breathe in deeply. I did as he said – the consequence was that I nearly choked coughing, it tasted awful, it made me feel sick and I went dizzy. He knew exactly what he was doing, and that had a greater effect on me than any lectures would ever have had. I started smoking when I was 19 because I found that I ENJOYED it, and for no other reason – not advertising, not displays, not ‘to be cool’ or anything similar. I ENJOYED it – just as I enjoy a pint of bitter, or a chocolate, or a kiss (oh, and that is another example of emotive propaganda – “kissing an ashtray” – I, for one, never even thought about ashtrays when I was kissing a girl – all I thought about was this wonderful experience of kissing an absolutely beautiful, gorgeous creature!

    It is easy to pick holes in other people’s comments, and so I will not do that, but there is one post that makes no sense at all, and that is Mr john mcclurey. He said that he is a tobacco retailer but abhors ‘children’ smoking. He does not mind if adults ‘kill themselves’. But does he not see that, by his own admission, he is a murder by ‘retailing’ tobacco? He says so himself! “I sell tobacco. Tobacco kills people. Therefore, I sell that which kills people. Therefore I am (indirectly) killing people.”

    Eventually, Tobacco Control must and will die by virtue of its own internal contradictions.

  • Prof. Martin McKee 24th Dec '10 - 11:28am

    Jonathan Bagley is quite right. I am not pro-smoking. Nor am I pro putting asbestos in schools or cutting brake cables. The first patient I treated after qualifying as a doctor was a tobacco worker who was admitted a week after retiring with secondary lung cancer in his spine. He died a lingering and painful death. The company had supplied him with free cigarettes all his life – a good investment as they saved on his pension.

    He conveniently disregards lost productivity, even though the paper he cites explicitly states that it failed to take it into account, and we also know that half of those dying of smoking-related diseases die before reaching retirement age. He also seems to view the value of an extra year of life as zero. If we are to follow his logic, presumably we will cull all 65 year olds? (that is essentially what the tobacco company did with my first patient).

    If Dave Atherton thinks that second hand smoke is harmless he is living in a complete fantasy world. It surely seems superfluous to cite the extensive evidence of how heart attack rates fall substantially once bans are enforced but readers may want to look at our lancet paper where we revealed the remarkable secret operation by a leading tobacco company to conceal the evidence http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)66474-4/abstract

  • Good point Junican.

    Here we have a man who puts personal gain before principal, then proceeds to lecture the rest of us from what he imagines is the moral high ground.

    Hypocrite – just like his colleagues in Westminster.

  • Dave Atherton 24th Dec '10 - 11:39am

    @Professor Mckee

    You are supposed to be eminent scientists however you seem to be more political advocates and pharmaceutical apologists. Is there anymore junk science and twisted statistics you want to quote?

    In the USA the Rand Corporation commissioned the Universities of Stanford and Wisconsin to review 8 years of heart attacks covering all 50 states and 368 counties where there were smoking bans were implemented. Covering 2 million heart attacks and 217,000 deaths not only did they conclude that “In contrast with smaller regional studies, we find that smoking bans are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases.” That the reporting previously had been publication bias.

    “…comparisons showing increases in cardiovascular events after a smoking ban were not submitted for publication because the results were considered implausible. Hence, the true distribution from single regions would include both increases and decreases in events and a mean close to zero, while the published record would show only decreases in events. Publication bias could plausibly explain the fact that dramatic short-term public health improvements were seen in prior studies of smoking bans…

    The IOM and other policymakers have relied on the weight of the published literature when making decisions. However, it appears that publication bias did not receive sufficient attention. Our results suggest that only positive studies have been published thus far, and the true short-run effects of governmental workplace smoking bans would be more modest in the U.S.

    U.S. state and local governments have increasingly adopted restrictions on smoking in public places. This paper analyzes nationally representative databases, including the Nationwide Inpatient Sample, to compare short-term changes in mortality and hospitalization rates in smoking-restricted regions with control regions. In contrast with smaller regional studies, we find that smoking bans are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases. An analysis simulating smaller studies using subsamples reveals that large short-term increases in myocardial infarction incidence following a smoking ban are as common as the large decreases reported in the published literature. © 2010 by the Association for Public Policy Analysis and Management.

    http://onlinelibrary.wiley.com/doi/10.1002/pam.20548/abstract

    http://tobaccoanalysis.blogspot.com/2010/12/new-study-of-national-heart-attack.html

  • Dave Atherton 24th Dec '10 - 11:49am

    On heart attacks here is Dr. Anna Gilmore’s junk science on English heart attacks and the smoking ban. Strangely the biggest drop was when you could smoke in pubs. Mckee for someone as ‘educated’ as you to be out peddling junk science and publication biases is a disgrace. You are in danger of turning second hand smoke into a Lysenko situation, devaluing science and losing the trust that the British public have in doctors.

    English heart attacks.

    2002/03: 61,498

    2003/04: 60,680 (a fall of 1.33%)

    2004/05: 58,803 (a fall of 3.1%)

    2005/06: 55,752 (a fall of 5.19%)

    2006/07: 53,964 (a fall of 3.21%)

    2007/08: 51,664 (a fall of 4.26%)

    Here is more on Gilmore’s ‘methodology’ it appears she deliberately went out to get the result she wanted.

    “None of these calculations are shown or can be verified, but these manipulated data are then fed into a series of computer programs to arrive at an adjusted average daily admissions figure. Although Gilmore uses the July-June figures for all pre-ban years, she goes up to September 2008 for her post-ban year, thereby leaving in July and August, which is when the AMI rate is invariably at its lowest. It’s baffling and more than a little suspicious. Why not go up to June 2009? Or at least stop at June 2008?”

    http://velvetgloveironfist.blogspot.com/2010/06/latest-smoking-banheart-attack-study-is.html

  • Dave Atherton 24th Dec '10 - 11:51am

    @ Prof Mckee

    There are over 80 studies done into second hand smoke and lung cancer, 15% suggest statistical significance causation and 10% statistical significant protection the remainder of 75% no effect either way. (1) The remainder say nothing either way. The latest study published in October 2010 said in plain English.

    “Among never smokers in our population, we observed no association between either exposure to ETS at home or at the workplace and lung cancer risk (2)

    1. http://www.pnlee.co.uk/documents/refs/lee2010B.pdf

    2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927994/pdf/1471-2407-10-285.pdf

  • Dave Atherton 24th Dec '10 - 11:59am

    Lung cancer in non smokers is a different aetiology (causation) than in smokers, that is, it is not second hand smoke. Who says so your mates at the World Health Organization/International Agency for Cancer Research, McKee.

    “In 1998, Pierre Hainaut and his collaborators at IARC analyzed the mutations in lung cancers that were at the time in the IARC p53 database. They found that the positions of damage by benzo(a)pyrene spotted by Pfeifer and his team were frequently the sites of mutations in lung cancers of smokers but rarely in lung cancers of non-smokers.”

    “A number of molecular and clinical characteristics differ between lung cancer related to tobacco use and those not related to tobacco use. 62 % of lung cancers among never-smokers are adenocarcinomas and 18 % are squamous cell carcinomas, while corresponding numbers among patients who smoke are 19 % and 53 %. The K-Ras-gene is often mutated in tumours from smokers, but seldom in tumours from non-smokers; whereas the EGFR-gene is mutated in tumours from non-smokers, and not in smokers. Also, age and sex distribution, therapy response and prognosis are shown to differ between the groups.

    INTERPRETATION: Lung cancer in never-smokers should probably be regarded as a different disease-entity than smoking-induced lung cancer. This could impact prognosis as well as treatment.”

    “A number of molecular and clinical characteristics differ between lung cancer related to tobacco use and those not related to tobacco use. 62 % of lung cancers among never-smokers are adenocarcinomas and 18 % are squamous cell carcinomas, while corresponding numbers among patients who smoke are 19 % and 53 %. The K-Ras-gene is often mutated in tumours from smokers, but seldom in tumours from non-smokers; whereas the EGFR-gene is mutated in tumours from non-smokers, and not in smokers. Also, age and sex distribution, therapy response and prognosis are shown to differ between the groups.

    INTERPRETATION: Lung cancer in never-smokers should probably be regarded as a different disease-entity than smoking-induced lung cancer. This could impact prognosis as well as treatment.”

    http://www.ncbi.nlm.nih.gov/pubmed/19844277

    http://www-p53.iarc.fr/download/tobacco.pdf

  • I really don’t like this kind of campaign coming from our party as it confuses the message about what ‘liberal’ means. Can’t we leave this kind of thing to authoritarians and concentrate on civil liberties and other items from a liberal agenda. I fear that this will be seen as part of a ‘lecturing and nannying’ agenda that the Conservatives or Labour do on an ongoing basis without the need for us to join in.

  • Dave Atherton 24th Dec '10 - 12:27pm

    Sir Richard Doll’s precise words on Desert Island Discs were:

    “The effects of other people smoking in my presence is so small it doesn’t worry me.”

    http://news.bbc.co.uk/1/hi/health/3826939.stm

  • Dave Atherton 24th Dec '10 - 12:31pm

    Professor le Grand who was John Reid’s and the Department Of Health’s smoking advisor and I quote:

    “When we finished, Reid turned to his senior advisor and asked: “What do you think?” Julian Le Grand didn’t hesitate. “I agree with them,” he said, nodding in our direction.(Activists from Forest) Reid thought for a moment, then said (I paraphrase): “Yes, I’ve always been pretty dubious about passive smoking.”

    “Professor Julian Le Grand, the top advisor to the Department Of Health on the health impact on smoking, in February of this year on Radio 5 Steve Nolan show was asked about the health impact of ETS and his answer in context was ‘I don’t actually think the arguments on passive smoking are all that strong.”

    http://www.stogieguys.com/2008/02/02182008-stogie-news-governments-to-require-licenses-to-smoke.html.

  • There is no one in this country who doesnt know that smoking is harmful. We should stop trying to nanny citizens by making it more difficult to do things that they already understand, and we should instead put more effort into helping those existing addicts who do want to give up to do so.

  • The thing that bugs me in thee sort of calls, and touches on the issue of ‘liberal or not’ is that we’re being told that the only way to deal with this problem is yet more banning of things by the state, when in fact increasing choice could be more effective.

    Specifically, I’m talking about the fact that newsagents can sell nicotine in its lethal form, but only licensed pharmacists can sell nicotine in a less lethal form of patches, gum and inhalers.

    When I was quitting smoking, if I ran out of patches, places to buy more tobacco were always more prevalent and closer to my work than pharmacists. So, i’d buy more tobacco on the way to work to deal with my craving, and then wait until lunchtime to make the effort to go and buy patches. If lunchtimes were too busy at work, then that was me smoking again for the day.

    Surely the liberal approach would be to allow newsagents to sell nicotine replacement therapies alongside tobacco, so people have more choice, not less. Like with many other liberal approaches, it would, I suspect, be more effective than an authoritarian ‘ban’.

  • If the theories on passive smoking are true, how come pets don’t get lung cancer?

  • The simple fact is that there is no scientific proof of any dangers of SHS for humans, let alone pets. The war on Tobacco is being waged on the premise ‘the end justifies the means’. The ‘means’ are biased, often unscientific, and substantially financed by those with vested interests. Basically corrupt. It’s a poor state of affairs when we can no longer expect impartiality from doctors and scientists. What else are we being misled over?

  • Rory Morrison 24th Dec '10 - 3:17pm

    Getting back to the topic of display bans…

    @Dave Atherton

    You rely quite heavily on Patrick Basham’s IEA paper in making your case against a tobacco display ban. I wonder what your thoughts are on the CRUK rebuttal (which shows quite convincingly some of the serious flaws in Basham’s analysis) that Robin Hewings linked to in comments above.

    Also, regarding the smoking prevalence figures from Iceland that you cite in your second or third post. You were corrected on the use of these figures by a member of the Icelandic public health institute (who produce this data) in comments to another blog (in fact, the IEA one you cite as reference 2 in one of your own posts).

    There, you were informed that the PHII figures are from a survey with a relatively small sample size, making age sub-group analysis unreliable (and year-on-year variation high). Which is why the Icelandic authorities prefer another survey, the ESPAD (which has a much larger sample size and shows consistently declining youth smoking prevalence). Yet it appears you are continuing to cite the less reliable survey to make your point, despite being corrected by an individual who represents the agency that produce the data. Puzzling.

  • @ Rory Morrison.

    No one with any intelligence any longer believes anything that the tobacco control department of CRUK says. Nor do they believe anything that a tobacco control health department says. It is all propaganda. There is no doubt about it since the British Medical Association (through their journal, the BMJ) have said so. There is no doubt at all that what Mr Atherton says about the ‘neutrality’ of the SCOTH studies is correct – it is a matter of public record. The fact that the committee disregarded the evidence is mere public propaganda. I use the word ‘mere’ advisedly, since I mean indiscriminate use of false data by all concerned for political reasons.

    Your final sentence makes no sense at all since there are so many and so big confounding factors that none of the studies are anything but words.

  • Educating people about the evils of smoking is one thing, and I am more than happy with that, using governmental force banning smoking, I could also live with, but only if you then do it for everything that is bad for us, causes unnecessary deaths or related deaths… if we go all the way smoking, drinking, driving should be the top of the list… to save ourselves of course. (You know a pony and cart would be much safer and better for the environment).

  • Merry Christmas everyone. Have a safe day – remember, Christmas crackers contain explosives, stick to your daily recommended alcohol intake and eat sensibly (including a portion of sprouts, nuts and dates). And, if you must smoke a cigar, be warned that its smoke (including traces clinging to your new jumper) has the potential to induce an immediate heart attack in you, your nearest and dearest, and mother in law.

  • Dave Atherton 26th Dec '10 - 9:19am

    @Rory Morrison

    There are 2 major flaws in the ESPAD database. The first one is that the results are collected only 4 years and secondly it is only 14-15 year olds who are interviewed, those who are most to be influenced by their parents.
    Statistics Iceland is done on an annual basis and includes 15-21 year olds.

    More importantly Stefan Hrafn Jonsson who is an Icelandic public health official attached to the WHO has offered this document how Icelandic teenage consumption rates for tobacco, alcohol, cannabis and class A drugs were reduced. The main way was by parents patrolling the street and peer pressure. Not once in his paper is the display ban mentioned.

    http://www.hr.is/lisalib/getfile.aspx?itemid=12303More

  • Rory Morrison 26th Dec '10 - 10:18am

    Junican

    … since there are so many and so big confounding factors that none of the studies are anything but words.

    Untrue. The relationship between sample size and the confidence you can have in the data from a relatively simple survey (e.g. one that asks whether somebody smokes or not) is well understood. Hence to not cite known issues with data (like the sample size of a subgroup being so small that the results are extremely unreliable) when presenting them as fact is, to be generous, extremely misleading.

  • Rollo Tommasi 26th Dec '10 - 10:30am

    @ Junican – I hope you and everyone else reading this had an enjoyable Christmas.

    But your faith in Dave Atherton’s arguments are misplaced. Which is why, contrary to your views, it is Dave’s views that no one with any intelligence believes.

    When he tries to base his arguments on an article by Jerome Arnett – which is outrageously inaccurate – then you know something must be wrong.

    When he argues that Julian LeGrand was a “health advisor”, then you should also worry. LeGrand was a mere economist; the health advisers are the UK Chief Medical Officers, all of whom warn strongly of the risks of passive smoking.

    And when he (like pro-tobacco groups) tries to base the views of Richard Doll on an offhand, untraceable and selective misquote on Desert Island Discs, then you know his arguments are weak. Doll was almost 90 years old when he said secondhand smoke was of little risk to him personally. But his professional position was clear. He was part of the IARC working group which considered the health dangers of smoking in 2002. Doll himself then told the media that “Environmental tobacco smoke that people experience at work or at home is definitely a cause of lung cancer.”

    http://monographs.iarc.fr/ENG/Monographs/vol83/index.php
    http://news.bbc.co.uk/1/hi/health/2053840.stm

    And I can’t find any criticism “about the ‘neutrality’ of the SCOTH studies”. The SCOTH reports have professional standing. I’ve found no criticism of their reports, only a few attempts by pro-smokers to smear Committee members. And it and other overarching assessments of the evidence, like the IARC monograph and 2006 US Surgeon General’s report, reaffirm that no potential confounding factors can undermine the fact that passive smoking IS harmful to health.

  • Tobacco is the only product that, when used as directed, kills half its users. That’s the difference between tobacco and sweets, or any other products with which people are trying to draw comparison. The Tobacco industry LIES when it says a display ban hurts retailers – it did not do so in countries with display bans, but less kids took up smoking. Help our children stay healthy ans support the display ban.

  • Dave Atherton 27th Dec '10 - 2:34pm

    @Rory Morrison

    All I need to know about the standards and ethics of Jean King and Cancer Research is written in the prose above, “– the Association of Convenience Stores found the average cost was £300..” That is the cost of a temporary solution which will last 3-6 months. The cost of a permanent solution is £2,000 plus. Jean King is either mistaken or we have a charity grievously misleading Parliament, convenience stores and the general public.

    I call on Jean King to qualify her £300. Is that a permanent or temporary solution? if it is temporary what is the cost of a permanent solution.

  • Dave Atherton 27th Dec '10 - 4:58pm

    I have just read in detail Martin Dockrell’s rather desperate smear that I am “extreme right wing.” At the risk of dignifying his comment let me respond.

    Firstly I am “classical liberal” first and foremost, someone once described me as a Gladstonian Whig (Liberal). I believe in the minimum of regulation from government and free trade. Apart from Europe I sometimes find myself agreeing with the Lib Dems more than my own party.

    With regards to the coalition I am as a Conservative Party member a keen supporter of our pact with the Liberal Democrats and as an Executive of the Progressive Conservatives was the person who initiated closer ties with the Liberal Democrats Party. In fact in October any member of the Liberal Democrat Party is welcome to join us for our monthly meetings. In October 2010 we were lucky to enjoy two distinguished Lib Dems, Foreign Minister the Rt Hon Jeremy Browne and former Director of Communications of the Lib Dems Mark Littlewood.

    http://twitter.com/#!/torybear/statuses/28705692263

    You will also note that on the links below I have written articles for the Lib Dem blog Liberal Vision.

    Dockrell not only have you smeared me untruthfully but as demonstrated you could not quote one truism.

    http://www.liberal-vision.org/2009/06/01/guest-article-a-liberal-approach-to-the-smoking-ban-dave-atherton/

    http://www.liberal-vision.org/2009/09/24/guest-post-my-1st-libdem-conference-libertarianism-late-nights-and-luscious-lynne/

  • Rory Morrison 27th Dec '10 - 10:36pm


    All I need to know about the standards and ethics of Jean King and Cancer Research …

    That’s a mighty fine genetic fallacy you got there.

  • Dave Atherton 29th Dec '10 - 12:42pm

    @Rory Morrison of ASH Scotland

    Question Rory why did you not identify yourself as being a paid employee of ASH? Trying to disguise yourself as the man in the street? I said who I represented immediately.

    I am still awaiting Jean King’s reply whether the £300 is a temporary or permanent solution. Her silence I think tells its own story. Here are more extracts from the Freedom Of Information (FOI) requests on the real costs and how we all have been misled. It looks like I have been doing myself am injustice the cost of a PERMANENT solution is £2,800.

    6/3/09
    An ASH spokesman is quoted in The Telegraph as saying:

    “This legislation is not going to come into force until 2013 and it will only cost small shopkeepers £200 to comply.”

    23/3/09 – 9.53 am

    Shane Brennan of the Association of Convenience Stores e-mails the Department of Health to tell them that the Canadian Convenience Stores Association (CCSA) has stated that the figures being cited by the DH only refer to temporary solutions. Permanent solutions, say the CCSA, cost in the region of £2,800.”

    http://www.velvetgloveironfist.com/pdfs/thedarkmarketredux.pdf

  • Shirley Scott 29th Dec '10 - 5:04pm

    The poster Martin Dockrall must get a good wage from ASH (via the British taxpayer) and from the big drug companies.

    How can he dispute the truth and what a stupid idea to give so called ‘addicts’ more of what they are supposed to be addicted to (NRT)

    He states that NRT helps people stop smoking when everyone knows that the ‘success’ rate is less than 2% !!!!!

  • Rollo Tommasi 31st Dec '10 - 8:32am

    Jock – I don’t believe you’re fairly reflecting Richard Peto’s views. He certainly said that the smoking laws could save many lives if it encouraged smokers to quit.

    But he also takes the view that exposure of non-smokers to second-hand smoke “is going to cause some risk of death”. How big that additional risk is, he is not sure.

    He also argues that there is a particular risk of harm from passive smoking for ex-smokers, whose lungs would already have incurred some damage.

    So – to sum up – Richard Peto DOES recognise that passive smoking is harmful to people who do not smoke.

    http://news.bbc.co.uk/1/hi/health/6244926.stm#Peto

  • Rollo Tommasi 31st Dec '10 - 9:03am

    DaveA – Hello, for possibly the last time this year. Hope you’re well and enjoying the festive season.

    I see you’re challenging Martin Dockrell and Rory Morrison to justify points that you’ve criticised. Since you’re in that zone, would you care you try to justify points of your own that I’ve challenged earlier in this thread (see my message of 26 Dec to Junican). You claim “I do not like being misled”. But all of your sources which I referred to in that previous post show how easily you are allowing yourself to be misled.

    One other question. You claim “There are over 80 studies done into second hand smoke and lung cancer, 15% suggest statistical significance causation and 10% statistical significant protection the remainder of 75% no effect either way”. How did you get those figures?

    I’ve looked at the Peter Lee document. If my counting is correct, then his Figure 1 (the main figure re lung cancer risk) lists 77 studies. Of those, 58 studies show an increased risk of lung cancer from passive smoking, and only 12 show a decreased risk. 11 studies show a statistically significant increased risk of lung cancer from passive smoking and none show a statistically significant decreased risk. Those figures are VERY different from what you claim. They also show why it is, when results from scores of studies are analysed together, that scientific experts invariably confirm that passive smoking is harmful.

  • Rory Morrison 3rd Jan '11 - 7:38pm

    Dave Atherton wrote:
    Question Rory why did you not identify yourself as being a paid employee of ASH? Trying to disguise yourself as the man in the street? I said who I represented immediately.

    0_0

    Er, had I any desire to ‘disguise’ myself in the manner you suggest, then I (rather obviously) would not have used my real name.

    In any case, the questions I asked you were straightforward ones to do with data, and could be answered regardless of who you or I ‘represent’ or work for. Which it seems (again) you choose not to answer (well, beyond ‘I believe the original author to be wrong on this, so they must be wrong on that‘ fallacy).

    If I were to apply the same logic to your arguments, I would say that, since you are using misleading statistics on prevalence from Iceland to support your position, you are wrong on everything else. Which seems unfair, yes?

    I am still awaiting Jean King’s reply whether the £300 is a temporary or permanent solution. Her silence I think tells its own story.

    It tells you she might not have read the comments?

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