Opinion: Plain Packaging: Will Tobacco Be the End or Just the Beginning?

While I think I was pleased to see the vote by MPs earlier this month, introducing plain packaging for tobacco products, it did also set off faint alarm bells – with me at least. There is something rather drastic about passing a law that requires legally produced and distributed goods to be wrapped in plain card or paper – even if the move was approved by Parliament based on medical evidence. I almost feel it would have been better to actually ban tobacco products altogether.

To be honest, obesity is not that far behind smoking as a leading cause of early death. We know that obesity is partly fuelled by attractively-packaged foods, high in sugar and fat, freely available on every supermarket shelf in the UK. High-street fast food chains – whose rise has been, seemingly, unstoppable – are another contributor to the problem. Britain now spends over £45 billion each year dealing with the health and social care costs associated with an increasingly overweight population.  

Should high-fat, high-sugar products therefore not at least carry a health warning (which is where it all started with cigarettes after all)? Some supermarket chains already have a traffic light system for foods, labelling them green, amber or red according to their content, but, given the law change for tobacco products, wouldn’t the next logical step be the plain packaging of unhealthy foods?  Also, what about the effects of fizzy drinks on dental health and alcohol on liver disease – and behaviour? How many people are now clogging up A&E because of alcohol abuse, which is also associated with violent behaviour, including domestic abuse? Are we going to take the labels off bottles of spirits and insist on plain lager cans?

Some would say that tobacco is the worst offender in terms of the damage it causes to health through lung cancer and respiratory disease, therefore warranting the plain packaging move, but as long ago as 2009, a longitudinal study of adolescents in the British Medical Journal identified obesity as being as significant a cause of early death as smoking because of the link between obesity and diabetes, heart disease and stroke. A more recent US study has confirmed this conclusion. And while 24.5% of the UK adult population is classified as obese (and a much higher 64% designated as either obese or overweight), a lower percentage – 22% of adult men and 17% of adult women – now smoke (Source: ASH, 2015)

Plain packaging of cigarettes is probably a good idea because of the particular and deathly hazards of tobacco and the unacceptable risks associated with passive smoking, but how far do we go? While no one wants to live in a world where we walk into the supermarket to find a significant proportion of the food or alcohol products in plain packaging, we do need some consistency here.

The dilemma in a nutshell is this: extending plain packaging to certain foods, alcohol or fast foods, might be seen as highly authoritarian; some would even say insisting on the plain packaging of cigarettes is authoritarian. But on the other hand we need a consistent approach because medical evidence points to the fact that obesity is now becoming as significant a cause of avoidable death as smoking.

* Until recently, Judy Abel was Head of Health Policy at Policy Connect.

Read more by or more about , or .
This entry was posted in Op-eds.
Advert

34 Comments

  • So the wedge is pushed further.

    Judy, just leave people alone, I would hate to live in your drab world.

    Also you appear to have misidentified the cause of obesity.

  • I’m a bit unclear as to what this article is proposing. So plain tobacco packaging is a bit worrying, but maybe we should consider extending it to food? As nobody is seriously suggesting it at the moment I would let the issue lie.

  • “I almost feel it would have been better to actually ban tobacco products altogether.”

    Because that approach has worked so well with illegal drugs….

  • Judy –  it is worth pointing out that your hunch about the number of deaths from tobacco  and the number  of deaths from obesity seems to be  at variance with the facts.

    The sources you provide not actually confirm what you suggest in your article.

    The Swedish research which you provide a link to is actually entitled – “Combined effects of overweight and smoking in late adolescence on subsequent mortality”

    Your second link to the particular US research points out that “the USA is the fattest society in the world” — not necessarily a good basis for calculating world deaths from obesity.   It is worth remembering that for billions of people hunger is still a greater threat to health than obesity.

    Your second link also provides a direct link to the December 2014 research of The American Cancer Society which says –
     “Reducing smoking prevalence as rapidly as possible should be a top priority for US public health efforts to prevent future cancer deaths,”  see below –

    In the UK we ( and the state acting on behalf of all of us ) need to do much more on prevention of ill-health and premature unnecessary deaths from both smoking and obesity.

    Playing one off against the other in policy terms just plays into the hands of Big Tobacco.

    December 9, 2014
    Source:
    American Cancer Society
    Summary:
    Despite significant drops in smoking rates, cigarettes continue to cause about three in ten cancer deaths in the United States, a study has found. “Reducing smoking prevalence as rapidly as possible should be a top priority for US public health efforts to prevent future cancer deaths,”

  • “As nobody is seriously suggesting it at the moment”

    Plain packaging for sugary products and ‘junk food’ IS being seriously discussed. The health lobby see it as a natural progression from cigarettes. Here’s one example…

    http://tobacco.health.usyd.edu.au/assets/Slideshow-Movies/Plain-Packs-Sydney-Institute.ppt

    http://2.bp.blogspot.com/-Bc-v_hiLIjI/UFoMpfX4WZI/AAAAAAAACJ0/fJrUdk3ARSU/s1600/ChocFrog.png

  • Stephen Howse 26th Mar '15 - 11:38am

    Remember when people in this supposedly liberal party actually believed in freedom to make your own choices without being harangued and judged by the government and wider society for doing so?

    I was strongly opposed to plain packaging of cigarettes for exactly this reason. It’s the thin end of the wedge. I don’t smoke but frankly I couldn’t care less if others choose to do it. I do like cake and fizzy pop, and what’s it to you if I do?

  • @ Stephen Howse
    You and others have missed the key point I was trying to make. In the article I do raise concerns about the potentially authoritarian nature of plain packaging (in the first and last paragraphs). I do fear that it is just the thin end of the wedge. I was trying to say, if we have started down this road, where will it end? Ideologically there is no reason to stop here. I was just using obesity as an example as it is now on a par with tobacco in terms of harm to health. Indeed, there are already campaigners in Australia pushing for plain packaging of junk food.

    It is the majority of MPs, not I, who voted for this. I have real concerns about it, but I think it is not the last we will hear of it.

  • Eddie Sammon 26th Mar '15 - 1:02pm

    I am not too fussed about plain packaging on cigarettes, but I don’t want to see any more of these laws. However I agree that the principle of consistency is important, but we can’t go back and undo it now and passive smoking is a special factor.

    The only part of the article that I disagreed with quite strongly was the half hearted suggestion of banning cigarettes. I know you didn’t actually suggest it, but we shouldn’t even be getting “almost” to that stage without reassuring those who smoke that we have an alternative plan in place (prescriptions, perhaps, but they would need to be well stocked and widely available).

    Passive smoking is a big problem and liberals can’t just trumpet the rights of the individual completely. We need a balance.

  • Judy – The tobacco products packaging legislation isn’t for “plain packaging” it is for a particular style of packaging that has been designed to provoke negative emotional associations with the contents of the packet, hence it is highly misleading to refer to it as “plain”.

    Secondly the use of the term “plain packaging” in the context of food is also highly misleading, as any one who has visited a supermarket will know we already have plain packaging! It being used on ALL fresh foods and discount brands. Interestingly enough it is worth reading the labels as often I’ve found the low cost plain label brand has contained less sugar, fat, salt etc. than the product in the brightly coloured packaging…

  • Stephen Howse 26th Mar ’15 – 11:38am

    “Remember when people in this supposedly liberal party actually believed in freedom to make your own choices without being harangued and judged by the government and wider society for doing so?”

    Eh no, we don’t remember it because the right to harangue and judge people has always been part of Liberalism.

    “I don’t smoke but frankly I couldn’t care less if others choose to do it.”

    Ah such compassionate conservatism is surely an indication you are in the wrong party.

    “The thin end of the wedge” – isn’t everything ? Isn’t selling tobacco the thin end of the wedge to selling heroin ? Isn’t heroin the thin end of the wedge to selling horse tranquilisers to people who want to take them.

  • Stephen Howse 26th Mar '15 - 3:21pm

    “Ah such compassionate conservatism is surely an indication you are in the wrong party.”

    So believing that individuals should be able to exercise their own judgement when deciding which products to buy and what to do with their own bodies is a *conservative* ideal now? We are through the looking glass, people!

  • @ Stephen Howse – “frankly you couldn’t care less” is not a liberal attitude – it indicates your indifference to people harming themselves.

    It is a nonsense to suggest all people are capable of exercising their own judgement all the time. Smoking being a particularly clear example of where 80% of smokers wished the did not smoke but are addicted to the habit. Alcoholism and heroin addiction being two other example. Similarly just because the age of consent is 16, I don’t think that makes people immune from grooming and sexual exploitation just because someone has given “consent.”

    There is a difference between advocating temperance and responsible drinking as I do and prohibition of alcohol which I don’t.

  • Stephen Howse 26th Mar ’15 – 3:21pm
    “So believing that individuals should be able to exercise their own judgement when deciding which products to buy …”

    Children of 13, 14 and 15 getting addicted to cigarettes that will kill them or ruin years of their life through disease and disability is not a fine example of anyone “exercising their own judgement”.

    This is why medical and scientific opinion and the the agreed policy of all political shades of government across the world recognises the need to take action.

    Action to prevent the millions of deaths that will result from Big Tobacco recruiting new generations of smokers Is entirely in line with longstanding Liberal beliefs.

    In the past we took action against cholera by building decent water and sewage systems. We removed the disability and death that came from polio by mass vaccination.

    Or would you like to go back to a time when people “exercised their own judgement” to suffer and die from those diseases?

  • Thank you for comments (at least most of them!)

    The dilemma I was trying to get at was:

    1. ‘Plain packaging’, let’s call it that Roland as it is the widely used term to refer to the legislation adopted, seems authoritarian but it might save a significant number of lives so the decision is clearly not easy (which everyone knows). Imposing it is, however, a very significant departure from commercial practice and the free market.
    2. If one accepts, however, as the majority of our MPs have, that in order to prevent harm plain packaging is justified then there is no logical reason not to adopt a similar approach to alcohol and possibly junk food. These questions are already being asked overseas Eg: http://www.bloomberg.com/news/articles/2015-01-23/junk-food-and-booze-could-follow-tobacco-in-plain-packaging-push.
    3. Is this the kind of society we want to live in?

    That is all I was asking – not advocating.

  • I think some people will try to extend plain packaging, just because as Judy says the precedence has been set. I suspect given the comments here and the debate todate about food, I expect some will want to extend it to all food products…

    Interestingly, part of the problem may actually be down to the move away from specialist shops to supermarkets with little restriction on display of goods such as alcohol and sweets.

    But thinking about the practicalities of ‘plain packaging’ the question must arise as to just what constitutes ‘packaging’. Take fast food for example, whilst the nutritional value of some offerings can be debated, I suggest to many ‘fast food’ means takeaways which raises the question as to whether the packaging is actually the entire street presence of the outlet rather than the wrapper (if any) in which the food is handed to the customer. Taking a slightly different tack, if we wish to target fat say then should deep fried fish be provided in a ‘plain package’, even though the nutritional value of the fish is the same as if it had been steam cooked (it is the batter that contains the oil).

    Judy – given your clarification on your usage of the term, I happy – I just dislike the term being used without clarification (in the body of the article) as it is easily misinterpreted – as has happened on the various articles here on LDV concerning tobacco products.

  • A Social Liberal 27th Mar '15 - 2:02am

    Why not bring plain packaging to obesity inducing products?

    Tobacco is a lifestyle choice. Making the packaging less attractive by either making it plain or by putting photographic evidence of the result of smoking will reduce the incidence of people making that choice. It doesn’t prevent them from making that choice, just prevents tobacco companies from making their product more attractive (and in the case of disease photos actively making them less attractive).

    For many however food high in fat is used as a staple food in the diet of their families. Many know no better but many also buy that food because it is in their budget. So when the much maligned (and for good reason) turkey twizzler costs less than a pound and a chicken costs four pounds, poor parents will choose the latter. Reconstituted meat high in fat and sugar will continue to be bought because those on tiny budgets cannot afford better.

  • It would be a very bizarre world indeed where packaging regulations could be reasonably condemned as “authoritarian.”

    Luckily it isn’t the real world.

  • The logical corollary would be that in an ideal society, corporations should, without regulation, be able to market any adulterated poisonous rubbish that they pleased, and blatantly lie to consumers about what they contained. Caveant emptores. But how is that remotely related to liberalism?

  • David-1. Good point. Maybe its the contents we need to regulate; then the whole packaging question would become more of a side issue. Solutions are needed though. The cost to the NHS of alcohol abuse and obesity are, combined, £60 million. (£20 billion figure on alcohol-related harm comes from Government’s Alcohol Strategy Report 2012). When health budgets are stretched – as we know all too well at this Election time – solutions must be found. Maybe more money on public health campaigns could be an answer? The 5 a day campaign worked pretty well.

  • I am curious about the comment “Remember when people in this supposedly liberal party actually believed in freedom to make your own choices without being harangued and judged by the government and wider society for doing so?” I have been a member of the Liberal party and Lib Dems for over 30 years and we have always been at the forefront of improving laws and regulations to improve public health, is that the party you mean?
    Liberals for example supported the law to make the wearing of safety belts compulsory. And what a success that was, there is no serious attempt by anyone to repeal that law.
    You may be comfortable about other people smoking, but how would you feel if your children started smoking? The point about “choice” is ridiculous. Once you start smoking you become addicted and then exercising choice becomes far more difficult, which is why most responsible parents try very hard to persuade their children not to smoke in the first place. And if you are a child with irresponsible parents, then hard luck. You have to find out the hard way.
    The government should do what the research suggests is the best way to improve public health.
    No one is suggesting that cigarettes should be banned. That would be too hard on people already addicted and who can’t give up. Just like the introduction of the law to make wearing safety belts did not lead to the banning of car driving.

  • I agree with Sara.

    Plain packaging is authoritarian and illiberal.

  • matt (Bristol) 27th Mar '15 - 12:02pm

    Hmm. I am less against plain packaging than I was against the law on smoking in cars with children, although I recognise it as more activist behaviour from the state than we’ve perhaps come to expect.
    This is because:
    – the state is not intervening in the choice of the consumer, nor removing the product from the market.
    – the laws on car-smoking took police time that should be spent on preventing traffic accidents and proposed a situation in which it might be focused on intervening in and policing individual behaviour.

    I think it is a bit stiff to call this ‘authoritiarian’ as if that were a black-white state, as if we look at the range of options open to the state to police access to products or proven felt to be harmful, a considerable number of more hard-edged ‘authoritatian’ interventions exist:

    – restricting the hours in which the product is sold (see the Defence of the Realm Act on alcohol)
    – restricting further the age of customers, requiring more stringent ID
    – prohibiting the sale of the product through anything other than state-managed channels (as happens in Ontario, Canada, with alcohol)
    – total prohibition
    – licensing manufacturers more rigidly in a deliberate attempt to manage the number of products in the market

    It is interesting to note that some of the above (in the case of alcohol) where they did arise in history, did so at the behest of the old Liberal party and its sister parties in other commonwealth country. So it is not ‘illiberal’ in one sense, in that the Liberalism of the past sfound it very easy to contemplate the restriction of products that do harm to the population.

    I do think, however, that efficacy of plain packaging may be overjudged in a world of internet commerce. So I say it is not an evil law, as some would try to pretend, but it may not be the best-conceived, either.

    And government has ALWAYS to a greater or lesser extent judged the choices of its citizens, and still is. It’s better when it tries to do so rationally and with a light touch, after democratic consultation, allowing for a plurality of outcomes, but it’s not in a position to not do so, without not being a government at all.

    The more I come on this site, the more I suspect usages of the word ‘illiberal’ in a way that’s intended to end the debate then and there. I feel that ‘liberalism’ is being made by some into some sort of holy creed or religion, rather than a coalition of perspectives within which there is debate.

  • Dave Atherton 27th Mar '15 - 12:17pm

    Judy is quite wrong to say that smokers and the obese cost more to treat than the “healthy,” in fact it is the opposite.

    In 2008 the Dutch government looked into the cost of treating people from the age of 20 to death. They had three categories, the healthy, obese and smokers. The results were not what the health gurus were looking for, the paper says:

    “Until age 56 annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions.”

    The lifetime costs were in Euros:

    Healthy: 281,000

    Obese: 250,000

    Smokers: 220,000

    It really is quite dishonest of the anti smokers to say that smoking is a burden on society. To the contrary are cheaper to treat and pay £10.3 billion in tax, plus all the employment the tobacco industry generates. The Czech Health Ministry costed it at a positive ratio of 10 to 1.

    http://www.plosmedicine.org/article/slideshow.action?uri=info:doi/10.1371/journal.pmed.0050029&imageURI=info:doi/10.1371/journal.pmed.0050029.t002

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

  • Dave Atherton 27th Mar '15 - 12:21pm

    The State of California last year passed a law that mandated health warnings on fizzy drinks. #SlipperySlope

    “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”

    http://www.breitbart.com/london/2014/06/05/government-forgets-plain-packaging/

  • A Social Liberal

    “For many however food high in fat is used as a staple food in the diet of their families”

    It’s in mine, and you can keep your hands off my cheddar.

    JohnTilley
    “We removed the disability and death that came from polio by mass vaccination. Or would you like to go back to a time when people ‘exercised their own judgement’ to suffer and die from those diseases?”

    Ah, some things have become clear are you under the impression that vaccination is compulsory? Well, it isn’t. People are free to choose to vaccinate their children, most do.

    “In the past we took action against cholera by building decent water and sewage systems. […] Or would you like to go back to a time when people ‘exercised their own judgement’ to suffer and die from those diseases?”

    Are you also under the impression that people are banned from collecting water in a hole in their gardens, disposing of their own waste in it and then drinking it? Someone could do that if they really wanted (but no one would) but they voluntarily choose to make use of modern plumbing.

    Caracatus
    “Isn’t selling tobacco the thin end of the wedge to selling heroin ? Isn’t heroin the thin end of the wedge to selling horse tranquilisers to people who want to take them.”

    Well I take the liberal position, which is that I would allow people to choose to do harm to themselves and offer them help to not do so. Your paternalistic position is “compassionate conservatism.” I think, as Stephen Howse point out, you have passed “through the looking glass.”

    Liberty actually means something, and that is not being forced to behave exactly has the doctor orders and to live as long as possible. It can be hard to see other people harming themselves and making decisions we would not wish to make but the liberal response is not to push them around using state power it is to offer help.

  • Matt (Bristol)

    Just because a party the uses “Liberal” in the name implements a policy does not make it “liberal.”

    Also, if you think the Defence of the Relm Act was there to improve public health I think you may have missed the point of it.

    “government has ALWAYS to a greater or lesser extent judged the choices of its citizens”

    Does this argument work for you often? Historical inertia is not a reason for anything. There are plenty of nannying, interfering people in society who will want to judge others, that is not a reason not to resist this tendency.

  • matt (Bristol) 27th Mar '15 - 4:55pm

    “Just because a party the uses “Liberal” in the name implements a policy does not make it “liberal.””

    Psi – there are lots of people on this site who like to play historical-political-dressing-up and consider themselves heirs to Gladstone, Lloyd George, Asquith etc etc. So they could do worse than consider the actual policies such people pursued.

    Restrictions on harmful products were very popular with the radical Christian noncomformist activist-base in the Liberal Party before the first world war – not just for religious reasons but because they felt such products and the addicitions they produced harmed the productivity and social mobility of the working poor. DORA was of course not a public health bill, but the reason alcohol was licensed under it was very much for public health reasons, as it was perceived as a way of improving worker health to therefore improve industrial productivity (and, maybe just also, to keep on-side the Christian nonconformists, many of whom were also pacifists and therefore sceptical about the war effort).

    I am intrigued that you seem to be claiming that you never make a judgement of the morality or quality of other’s actions in your campaiging for political outcomes.

    I am not arguing that we should give in totally to the tendency for government to pass judgement, but at best we can only mitigate it.

    My feeling is one needs to set policy and critiques of policy within a narrative, and a historical one at that. Stephen Howse (whom I often respect) seemed to be arguing that with this legislation we are moving from a period in which government did not judge its citizens, towards one in which it does. I cannot find hisotircal evidence for that, myself.

    What may be true is that what government judges its citizens for, how it judges them, and how it intervenes to effect its judgements, is changing. Homosexuality is legalised and smoking is critiqued. Receiving benefits is stigmatised and tax-avoidance is … well, of ambiguous status depending on whom you are. But that’s all a different kettle of mackerel.

    I’m just saying that there may be good reasons within the liberal traditions for government to consider restricting access to harmful substances and that past interventions in this and other western democracies in this regard have been considerably more stringent than the plain packaging legislation, which may not be ideal, but is not the work of an ‘illiberal’ Antichrist.

    Honestly, the usages words are put to … in the same way, ‘socialism’ is used in a way that would condemn utterly Harold Macmillan, among many others, as holepess lefties.

    Everybody needs to calm down and get some historical perspective.

  • Dave.
    I don’t think I said that. I was just quoting Government figures on the costs to society associated with obesity and alcohol abuse. I didn’t say treatment of smokers and the obese costs more than treating the healthy. I suppose whereas people can avoid smoking etc (although it’s hard to give up once on has started ) they cannot avoid getting cancer. When tough spending choices have to be made – and some aspects of NHS care are in meltdown – we have to try to get avoidable deaths – and the treatment costs associated with the related conditions – down.

    It’s a question of what strategies we use: pricing/tax, product regulation, plain packaging, health education etc. Obviously policy on this must be, as far as is possible, evidence-based. I suppose we could give up and do nothing, but that doesn’t seem like a very good solution.

  • Judy, I’m not so sure that “we have to try to get avoidable deaths … down”. Yes NHS funding and provision of treatment is an issue, but surely the issue with smoking and alcohol isn’t so much the deaths but the route to the death where the NHS often finds itself involved as it tries to treat the conditions related to the excessive usage of these substances. I think a reduction in the numbers of avoidable deaths is a (happy) side effect of the steps being taken to reduce the NHS resources devoted to treatment.

  • @ Roland
    Yes, of course, the avoidable deaths are just the culmination of years of ill health with the associated costs to the NHS. You are quite right.

  • Matt (Bristol)

    People wanting to dress them selves in historical figures reputations are wasting their time. We can never know what historical figures would have done with modern knowledge. Besides think back to what those three did for Women’s suffrage. I would want to be far from those poor reputations on that let liberal matter.

  • Matt (Bristol)

    “I am intrigued that you seem to be claiming that you never make a judgement of the morality or quality of other’s actions in your campaiging for political outcomes.”

    I don’t claim that super human capability. Everyone will form judgements on the decisions of others. What matters is what you do in responce.

Post a Comment

Lib Dem Voice welcomes comments from everyone but we ask you to be polite, to be on topic and to be who you say you are. You can read our comments policy in full here. Please respect it and all readers of the site.

If you are a member of the party, you can have the Lib Dem Logo appear next to your comments to show this. You must be registered for our forum and can then login on this public site with the same username and password.

To have your photo next to your comment please signup your email address with Gravatar.

Your email is never published. Required fields are marked *

*
*
Please complete the name of this site, Liberal Democrat ...?

Advert



Recent Comments

  • User AvatarDavid Allen 19th Aug - 12:01pm
    I'd like to apologise for my previous post. https://www.libdemvoice.org/lord-tony-greaves-writesso-how-would-an-interim-government-actually-work-61748.html#comment-506745 It's far too generous to Tony Greaves. Corbyn made a simple, clear proposal - That a...
  • User AvatarDavid-1 19th Aug - 11:52am
    @Matt: If Brexit goes through, it's not the EU but the UK that will fail to survive the next decade. How am I supposed to...
  • User AvatarMartin 19th Aug - 11:51am
    p.s. I posted this before being able to see Rif Winfield's contributions, which I largely agree with. The factors that Corbyn would encounter would largely...
  • User AvatarNonconformistradical 19th Aug - 11:49am
    nvelope2003 has a good point about the police not doing anything about certain crimes. I suspect the only reason most property crimes are reported to...
  • User AvatarGeorge Miles 19th Aug - 11:47am
    lets hope a compromise is reached to stop No Deal, and stop war breaking out on the Irish border again, even if it mean accepting...
  • User AvatarMartin 19th Aug - 11:36am
    Let's suppose for a moment that in the absence of another mechanism to depose Johnson and co, Corbyn has to head a 'Government of National...
Sat 24th Aug 2019
Thu 29th Aug 2019
Mon 9th Sep 2019