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Thursday
Jun282018

Smoking during pregnancy

As a general rule I don't comment about smoking during pregnancy unless I'm asked to.

Even then I think very carefully about it and sometimes decline. I'm just not comfortable talking about something that, as a man, is none of my business.

In fact, it's no-one's business except the woman concerned.

If push comes to shove I'd say that pregnant women should listen to their GP or midwife but the decision ultimately rests with the individual and no-one should be put under pressure to quit.

Smoking during pregnancy certainly shouldn't be made illegal, as it is in some US states.

I might also point out that in the Fifties 48 per cent of women smoked – many of them during pregnancy – yet the generation of babies born at that time is living longer than any generation in history.

The two aren't linked, of course, and I accept that advances in medical treatment are partly responsible for people living longer, healthier lives.

Nevertheless, if smoking during pregnancy is as dangerous as the public health establishment would have us believe, one might expect to see far more evidence of harm – within that generation in particular.

Anyway, I was asked last night to comment on a story, the gist of which was that the Royal College of Midwives Wales wants more money to help pregnant women quit smoking and manage their weight.

The crucial word here is 'money' because everyone wants more, especially if the taxpayer is paying. Hence my response:

"Ask the general public and many people would say this is not the best use of taxpayers' money.

"Most people want government to invest in new doctors and nurses, reduce waiting times in A&E, and address care for the elderly.

"Tackling smoking is not a top priority for most people because the health risks are already well known, and if women choose to ignore advice about smoking while pregnant that's a matter for them not government."

Full story: Midwives in cash call to cut smoking in pregnant women (BBC News Wales).

The only thing I'd add – not to this story but to a wider discussion on smoking while pregnant – is something that struck me during the abortion referendum debate in Ireland.

If, as many believe, a woman should have the right to abort a child because it's her body, surely the same argument applies to smoking during pregnancy?

I don't want to spell it out, but the impact of smoking whilst pregnant is hardly on the same scale as an abortion, not even close.

And yet, I'm prepared to wager, many people who correctly, in my opinion, support a woman's right to have an abortion are probably among the first to condemn pregnant women who smoke.

To be clear, I'm not advocating smoking during pregnancy (err on the side of caution would be my suggestion), but it's the hypocrisy that stinks.

Tuesday
Jun262018

Smoking and the NHS

I was asked yesterday to comment on a report, embargoed until midnight last night:

According to the press release:

A major new report released today [Tuesday June 26] by the Royal College of Physicians calls for a radical change in the way the NHS treats smoking, by providing opt-out cessation services as a routine component of all hospital care.

Giving smokers the help they need to quit smoking while in hospital will save lives, improve quality of life as well as increasing life expectancy for all smokers, and help to reduce the current £1 billion per year cost to the NHS of smoking by patients and staff.

The report ‘Hiding in plain sight: Treating tobacco dependency in the NHS’ from the RCP’s Tobacco Advisory Group says that:

– Treating tobacco dependency is not just about preventing disease: in many cases it represents effective disease treatment. Clinicians working in all areas of medicine can improve their patients’ lives by helping them to quit.

– Current models of delivering stop smoking services separately from mainstream NHS services, while successful in the past, may now not be the best approach because the patient has to seek help themselves.

– Most health professionals receive little or no training in treating smokers

– The NHS does not collect data on smoking treatment delivery, or have a payment tariff for treating tobacco dependency

– Smoking treatment also tends to be squeezed out, even in the management of diseases caused by smoking, by other, less cost-effective interventions

To address all these issues, the report recommends:

– As smoking cessation treatments save money for the NHS, in the short as well as the long term, they should be prioritised as a core NHS activity

– Smoking cessation should be incorporated as a systematic and opt-out component of all NHS services, and delivered in smoke-free settings

– As systematic identification of smokers and delivering cessation support doubles quit rates, health service commissioners should ensure that smokers are identified and receive cost-effective smoking interventions – failing to do so is as negligent as not treating cancer

– We should allow e-cigarettes to be used on NHS sites to support smokers to remain smoke-free and help to sustain smoke-free policies

– Legislation requiring hospitals to implement completely smoke-free grounds should be introduced, as the current guidance isn’t being implemented

– Training in smoking cessation should be introduced into all undergraduate and postgraduate healthcare professional training curricula and as mandatory training for the entire NHS healthcare professional workforce.

In response Forest issued this statement:

"Providing smoking cessation services to patients in hospital is at best a questionable use of public money.

"Smokers contribute £12 billion a year in tobacco-related taxes. That far exceeds the estimated cost to the NHS of smoking by patients and staff.

"According to polls, the general public would like to see taxpayers' money spent on providing more doctors and nurses and reducing A&E waiting times. Tacking smoking is not a top priority for most people.

"Smoking is a choice and if adults choose to smoke they shouldn't be pestered to quit while in hospital."

Most media reports today led with the recommendation that the use of e-cigarettes be allowed on hospital grounds, which we hadn't commented on.

Nevertheless we were quoted by the Daily Mail, Mail Online, ITV News the Daily Star and, thanks to the Press Association, hundreds of local titles (online).

Curiously, a journalist from The Times rang Forest for a quote but the subs cut it. (Help smokers quit, doctors tell hospitals.

Update: I shall be discussing this on BBC Radio 5 Live between 1.00 and 1.30pm.

Professor John Britton, chair of the RCP’s Tobacco Advisory Group and lead editor of the report, will also be on but he doesn't want to be on at the same time as me!

Update: On the insistence (apparently) of Prof Britton we were kept apart so we couldn't have a direct 'debate'.

Instead Britton was interviewed by presenter Nihau Arthanayake who then interviewed me.

Lo and behold, Britton was then given a second bite of the cherry and used it to attack Forest and our tobacco funding!

Needless to say I wasn't given a chance to respond.

Thanks, Five Live!

Monday
Jun252018

Time for a national debate about Scotland’s nanny state

I shall be in Edinburgh this week for the launch of a new Forest report.

'The McNanny State' by former MSP Brian Monteith features a foreword by journalist and novelist Allan Massie.

To mark the publication of the report Forest is hosting a private dinner at a celebrated Edinburgh venue. Guests include journalists and politicians.

The theme of the roundtable event is 'The nanny state we're in'. According to Monteith:

"Scotland has become a puritan's playground and it is going to get a lot worse before enough people wake up and decide to do something about it."

Special guest for the evening is journalist and novelist Allan Massie who has written the foreword to 'The McNanny State'.

According to Massie:

“Ever since the Scottish Parliament came into being in 1999, the politicians have chipped away at the liberties of the people.

"The Scottish state today treats adults as people incapable of managing their own lives and, if they are parents, as people who cannot be trusted with the unfettered care of their children."

Both the report and the dinner are perfectly timed. The Scottish Government's updated tobacco control plan, announced last week, is another blow for those who want less not more state interference in their daily lives.

Proposals to ban smoking in social housing and restrict the number of shops that can sell tobacco represent further attacks on consumers and convenience stores that are already over-regulated.

There will be a range of views and organisations around the dinner table so we don't expect our views to go unchallenged.

The aim is to launch a national debate on the role of government in people's lives and examine the way the issue is being addressed in political and media circles.

The goal is to put lifestyle choices back into the hands of consumers, not politicians and taxpayer-funded pressure groups like ASH Scotland.

Unfortunately we seem to be fighting a lone battle in Scotland. Perhaps the publication of 'The McNanny State' will mark a small but long overdue turning point.

Update: In the Sunday Times Scotland yesterday columnist Gillian Bowditch wrote:

An invitation has arrived to a dinner sponsored by the pro-smoking group Forest. It’s my own fault, I suppose. They aren’t to know that I hold a similar view of smoking to that taken by King James VI. “A custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs, and in the black, stinking fume thereof, nearest resembling the horrible Stygian smoke of the pit that is bottomless”.

From that unpromising beginning the rest of the article was a fairly thoughtful commentary on the Scottish Government’s plan to extend the smoking ban to people’s homes (social housing), restrict the sale of tobacco and ban smoking altogether in prisons and within 15 metres of hospitals.

She concluded:

Suffice it to say that like a bad horror movie the smoking ban part two is coming soon. It will undoubtedly be good for your health. What it does to your soul is a another question.

The article is behind a paywall but if you have a subscription you can read it here: Scotland's smoking ban II could be bad for your soul.

Meanwhile, in the Scotsman today, Brian Monteith wrote:

We live in a time when our politicians are disconnected from the public on many issues, and their desire to dictate our lifestyle choices, good or bad, is one of the most outrageous examples of this. The Tobacco Control Strategy proposes to take the McNanny State into your home like never before. Is there any elected politician or any party out there that will provide the opposition to it?

See Scotland has become a failing McNanny state.

I think the debate has just started, don’t you?

Saturday
Jun232018

'Healthier, happier, freer'

The Adam Smith Institute published a paper yesterday about tobacco harm reduction.

Using World Health Organisation 'estimates' of additional life expectancy from quitting smoking at different ages and Public Health England 'estimates' of the relative risk of e-cigarettes, the 'neoliberal' think tank calculated 'an overall estimate' (that word again) for years of life saved if more smokers (young women especially) switched to vaping.

Specifically, the author concluded, 'one million years of life could be saved' and the world will be 'healthier, happier, and freer'.

Leaving aside the dubious attention-seeking title, there's much I agree with in a generally well-written report (One Million Years of Life: How harm reduction in tobacco policy can save lives), but declarations like that are disappointing and even nauseating.

Healthier? Perhaps.

Happier? Not if you prefer smoking.

Freer? Hmmm, let's see.

The ‘freedom’ argument in relation to smoking has long been challenged by tobacco control campaigners on the grounds that smokers are in the grip of a serious addiction and need help to set them 'free'.

In reality, as the CSUR’s Pleasure of Smoking report discovered, a majority of respondents (confirmed smokers) believed they were addicted to smoking but it didn't bother them because their enjoyment of smoking trumped any worries they may have had about their addiction.

My concern is not just that the ASI paper is endorsing the tobacco control view that smokers will be 'freer' if they quit, but it's counterproductive even in the context of vaping.

Think about it. Most public health campaigners believe that addiction to any substance is unhealthy, hence very few vaping advocates in the public health industry want e-cigarettes to be a long-term 'solution' to smoking.

Nicotine, they argue, is addictive so vaping should be nothing more than a short-term smoking cessation tool. The endgame is to wean smokers and vapers off the drug so they are 'free' of their addiction.

In my view the conclusion of the ASI paper plays to that narrative.

It is of course true that vaping has been a free market success story so I understand why free market think tanks are supportive of e-cigarettes. But this subservience to the tobacco control playbook is foolish and short-sighted.

Indeed, it amazes me that people who routinely mock bodies like the WHO and PHE when they pontificate on other issues (alcohol and obesity, for example) will happily cite the same organisations' apocalyptic claims about the dangers of smoking.

Since when has the World Health Organisation become the arbiter of truth and honesty in tobacco control? If you accept without question their ‘estimates’ on life expectancy and smoking, it becomes almost impossible to challenge the WHO on other issues (including vaping) because you have effectively accepted their 'expert' status.

Meanwhile a self-confessed "nanny state" senator has urged the Irish government to develop a policy on e-cigarettes to reduce the number of smokers in Ireland.

Catherine Noone, who last year accepted an award from Forest for being 'Ireland's Nanny-in-Chief', said:

"I'm known for having nanny state policies on alcohol, sugar and things like that, so I'm not in favour of e-cigarettes really.

"I think they look a bit ridiculous but they help people quit smoking and we need to develop a policy that recognises that."

As it happens I have a soft spot for Senator Noone who was a perfect if surprise guest at Forest's Golden Nanny Awards in Dublin last year.

Nevertheless I can't help noting the increasingly strange bedfellows that are effectively promoting a 'healthier', 'happier', smoke free future:

Free market think tanks, "nanny state" politicians, anti-tobacco campaigners, the World Health Organisation – and Philip Morris.

United or not, that's some coalition.

Wednesday
Jun202018

Scotland's new tobacco control plan tightens the net on smokers

I was expecting the Scottish Government to publish its updated tobacco control plan this week or next, but the timing, late yesterday afternoon, still took me by surprise.

I was on a train at the time, returning from London where I had been doing an interview for BBC Look North on an initiative by Hull City Council to ban smoking at the gates of local schools.

Suddenly I began getting requests for a response to the Scottish Government's proposals to create a 'smoke free generation' by 2034.

The plans include 44 measures some of which – banning smoking in prisons and hospital grounds, for example – are already in the process of being implemented.

As a result the papers that have run the story have focussed on a 'new' idea – that of banning people from smoking in social housing:

We will explore with local authorities and housing associations the idea of tobacco-free clauses in tenancy agreements and smoke-free housing alternatives being offered in social housing.

I say 'new'. It was first flagged in October last year following which ASH Scotland denied that they wanted to ban people smoking in their own homes.

Anyway, back to yesterday's announcement. The Times took a slightly different tack, leading its report with the headline 'Smokers face minimum price for tobacco'.

You can read Forest's response here. So far we've been quoted by The Times (Scotland), The Scotsman, Scottish Daily Mail, Scottish Daily Express, Daily Record and Edinburgh Evening News.

Indicative, perhaps, of a certain anti-smoking fatigue, the Scottish Government announcement has not been reported universally. BBC News Scotland, for example, has ignored it.

Personally I'd like as much coverage as possible so we can demonstrate how little public support there is for further anti-smoking measures.

The plan to ban smoking in social housing is particularly egregious. Last night I was trying to get my head round it because it wasn't clear whether the idea is to ban smoking in people's homes or in communal areas such as stairwells.

This morning I read that some people are already banned from smoking in their homes by their tenancy agreements. The result is they smoke in stairwells and other communal areas, hence the proposal to ban smoking outside their homes as well.

In short, it's clear that the goal is to ban smoking inside and outside social housing. That, along with the ban on smoking in hospital grounds (under threat of prosecution if you light up), is truly despicable.

Inch by inch the net is tightening on smokers despite (as our latest poll suggests) a general lack of public support for further anti-tobacco measures.

The good news? Some of the Scottish Government's plans are, for now, merely up for consideration so there's time to make as much noise as we can. And we will.

Sunday
Jun172018

Government versus the people

The Scottish Government is expected to announce its new tobacco control strategy before the end of the month.

It will almost certainly go further than the tobacco control plan announced last year by the Conservative government in Westminster.

That stopped short of further legislation although it did include a target of reducing smoking rates from 15.5 per cent to no more than 12 per cent by 2022.

In contrast Scotland's previous tobacco control strategy, published in 2013, set 2034 as a target date for reducing smoking prevalence to just five per cent.

Earlier this year however doubts were expressed that Scotland is on course to meet this target so it doesn't take a clairvoyant to predict that Shona Robison, Scotland's under pressure health minister, is likely to respond with some headline-catching initiative.

Anyway, ahead of the forthcoming announcement, Forest commissioned a poll of 1,000+ adults in Scotland.

Conducted by Populus, the results demonstrate for the umpteenth time that the general public is not as anti-smoking as politicians and tobacco control campaigners want us to believe.

Here are the headline findings:

  • Most Scots think government policies to reduce smoking rates have gone too far or far enough.
  • A majority would allow smoking rooms in pubs and clubs and permit designated smoking areas in prisons and hospital grounds.
  • An overwhelming majority think smoking should be allowed in the home and in private vehicles.
  • The public believes the Scottish Government has more pressing concerns than tackling smoking.

Specifically:

  • 54 per cent think government policies to reduce smoking rates have gone too far or far enough. Only 37 per cent think they have not gone far enough with nine per cent undecided.
  • Nearly three in five adults (57 per cent) think pubs and private members’ clubs, including working men’s clubs, should be allowed to provide a well-ventilated designated smoking room, with only one in six (16 per cent) opposed to the idea and a quarter (27 per cent) undecided.

Significantly, given that banning smoking in prisons and hospital grounds are flagship policies for the Scottish Government, Populus also found that:

  • Overall there is support for inmates in Scottish prisons to be permitted to smoke, with two thirds (66 per cent) of respondents agreeing that prisoners should be allowed to smoke in designated smoking areas.


  • Over half of all respondents (56 per cent) – and 82 per cent of frequent smokers – believe that NHS hospital trusts should be allowed to provide designated smoking areas in hospital grounds for patients, visitors and staff.

Meanwhile, in response to those who want smoking prohibited in social housing and in all private vehicles in Scotland, Populus found that:

  • 86 per cent think smoking should be permitted in the home.
  • 74 per cent think smoking should be permitted when smokers are alone in their own vehicle.

You can read our news release here.

The Sunday Times Scotland has published a short report that begins:

Most Scots believe smoking should be allowed in special ventilated rooms in pubs and private clubs, it has emerged as ministers prepare to announce stronger tobacco controls.

A poll of more than 1,000 Scots, for Forest, the pro-smoking lobby group, found that 57% thought bars and clubs, including working men’s clubs, should be allowed to provide smoking rooms.

The paper includes this quote from me:

“The Scottish political establishment is clearly out of step with the general public who support fair and reasonable restrictions on where people can smoke, not prohibition.

“The fact that a majority of adults support designated smoking rooms in pubs and clubs suggests that the smoking ban is not as universally popular as we are led to believe.

“Any further regulations to tackle smoking would be a distraction from other more important issues facing central and local government in Scotland.”

The headline however reads: Expert stubs out pub ‘smoking room’ idea.

And who is the 'expert'? Why, none other than taxpayer-funded lobbyists Sheila Duffy, CEO of ASH Scotland. You couldn't make it up.

Truth is, the paper has missed the real significance of the poll and it's this.

Most people in Scotland do not support comprehensive smoking bans (even in prisons and hospital grounds) and the majority are in general far less anti-smoking than our so-called elected 'representatives'.

Unfortunately it's difficult to condense that into a short, snappy headline, nor does it suit the narrative the Scottish establishment, including the media, likes to promote.

Anyway, we'll do our best to get the message across although, understandably, the news in Scotland is dominated by the Glasgow School of Art fire that broke out on Friday night.

Friday
Jun152018

Come dine with us

Currently at Dublin airport waiting for a flight to Stansted.

Last night's 'Burning Issues' dinner, with guest speaker Ella Whelan, former assistant editor of the online magazine Spiked, was a fairly boisterous affair.

Twelve guests, including four opinionated journalists and a troop of forthright Irish libertarians, was always going to be lively.

The evening began at 6.30 with drinks on the smoking terrace. An hour later we sat down to dinner in a small private dining room.

Ella spoke for ten minutes on the subject 'Smoking is a feminist issue'. It was then thrown open for general discussion.

I'm not a great moderator at the best of times and keeping guests on topic proved an impossible task so I soon gave up.

The main aim of these events however is to build upon a small network of like-minded individuals and in that respect the evening was a success.

There were the usual familiar faces but we also attracted some new people one of whom enjoyed herself so much she invited us to host the next dinner at her house.

Perhaps we should rename the event 'Come Dine With Us'.

Anyway, I got back to my hotel shortly after midnight and, not for the first time, I wasn't the last to leave.

Ella, meanwhile, was on the radio this morning talking about feminism during which she was asked about smoking during pregnancy. That was quite lively too, apparently.

Update: Our next 'Burning Issues' is in Edinburgh on June 27. Guest speaker is former MSP Brian Monteith who now writes a weekly column for the Scotsman. Watch this space.

Monday
Jun112018

Beyond nicotine

To no-one's surprise:

Jennifer Motles Svigilsky detests cigarettes. A former human rights lawyer with the United Nations ... [she represents] one of the world’s largest cigarette companies, Phillip Morris International (PMI).

But wait, there's more:

"[In the short term,] we need to provide alternative choices to smokers who cannot quit [or cannot quit yet]."

In the long term, she says, "we may not even be in the nicotine business."

Let that sink in.

"In the long term, we may not even be in the nicotine business."

You couldn’t make it up.

Full article: Philip Morris Is Quitting Smoking — But Don't Take Their Word for It (Sustainable Brands).