The perils of devolution in public health

Haringey Council is denying that it has plans to extend the smoking ban to outdoor public places including beer gardens.

The Labour-run council was identified by the Telegraph last week as the protagonist behind a "list of demands from councils and health authorities in London."

When the idea came to light it was criticised by Marcus Jones, minister for local government, who said:

“We already knew that Labour councils charge higher council taxes and levy more red tape.

"Now Labour’s municipal killjoys have been caught with a smoking gun, trying to ban adults enjoying their local pub garden. If implemented, these ill-founded proposals would lead to massive pub closures.

"Conservatives in Government will be vetoing these Labour Party plans. Ahead of May’s local elections, local voters have a right to know the bad and mad ideas that are being peddled by Labour councillors."

See Smoking ban in beer gardens and al-fresco dining areas rejected by ministers (Telegraph).

Haringey Council has now told the Morning Advertiser it has "no plans" to ban smoking in public places but is looking into how it can "increase the number of smoke-free environments" (Council denies claims it led charge to ban smoking in pub gardens).

According to a spokesman:

It is clear that smoking and inhaling second-hand smoke is one of the biggest contributors to premature deaths in the country, and what we are committed to is looking at all the options for reducing the impact on our residents.

Through our health devolution bid, we hope to carry out detailed research into how increasing the number of smoke-free environments in Haringey and across London could improve the health and life chances of all out residents."

I'm not sure how they intend to increase the number of "smoke-free environments" without extending the smoking ban, so where do we stand on the matter?

One document I have seen – Haringey Devolution Pilot, Prevention Pilot, Outline Business Case, dated January 2017 – argues that:

Devolution will enable partners, employers and residents in Haringey to improve the health of local residents at pace and scale ...

Devolution will enable Haringey to shape a healthier borough to improve residents’ choices
and prevent people with health problems dropping out of employment.

According to the document:

Our vision is to fundamentally ‘normalise good health’ by supporting residents to make healthier choices and reducing unhealthy, risky behaviours.

This includes:

Primary Prevention: interventions through population/borough-level policy in order to shape the places where people live so that the healthier choice is the easier choice for residents.

We want an environment which promotes healthy eating and exercise, and is not dominated by premises that sell tobacco, or alcohol, or contribute to debt through gambling.

Primary prevention is the goal of our prevention pilot’s Healthy Environments strand. Local government plays a critical role in this. Devolution enables us to do this more effectively.

The plan proposes to use licensing powers "to create healthier environments" with a specific focus on tobacco and alcohol.

So far so general. However a second (draft) document – London Health and Social Care Devolution: Memorandum of Understanding – is pretty specific:

Some of the prevention policies put forward by the pilots to date would have implications for national policy and legislation [my emphasis] ...

London and national partners should "commit to collaborating on and contributing expertise to establish the opportunities and explore the evidence base for ..."

This is followed by three proposals one of which is:

Granting local authorities the freedom to extend smoke-free areas to include alfresco dining areas of restaurants and pub gardens [my emphasis].

Interestingly the parties to the draft agreement include not only the "London Councils representing the 32 London boroughs and the City of London" but also "national partners", among them the Treasury, the Department of Health and the Department for Communities and Local Government (DCLG).

Marcus Jones, the minister who spoke out against the plan to extend the smoking ban to pub gardens, works at the DCLG, so what exactly is going on?

Is the Government really opposed to extending the smoking ban to beer gardens or is this just Conservative Central Office making party political mischief ahead of the local elections on May 4?

Meanwhile, while most of the headlines focussed on the Conservative Government allegedly blocking the proposal, some newspapers chose a different angle.

Why smoking could soon be BANNED in pub beer gardens, trumpeted the Leicester Mercury:

Plenty of people in Leicestershire will be heading out to beer gardens this summer to enjoy a pint in the sunshine.

However, if you also enjoy a cigarette in a beer garden, that could soon be outlawed.

A London council has suggested "extending smoke-free areas" in the area to protect public health, Mirror Online reports.

If Haringey Council's plans go ahead, that could mean an end to smoking in pub beer gardens and restaurant terraces.

It is now believed that the approach could be adopted by other councils across the country.

The good news is that Haringey Council has been forced on the back foot. The bad news is that issues concerning public and private health are increasingly being devolved to local authorities and it only takes one or two to get behind a policy for it to develop momentum.

That's what happened before the introduction of the current smoking ban. Regional authorities in London and Liverpool wanted the power to unilaterally ban smoking in enclosed public places.

Councils in other towns and cities (Plymouth, Middlesbrough and St Albans to name a few) then began to explore the issue, inviting witnesses such as Forest to give evidence to various committees.

At one point the Labour government seemed happy to allow local councils to devise their own policies. And that's when the pub industry stepped in, demanding a level playing field across the country.

So that's why, despite Marcus Jones' welcome comment to the Telegraph, it's no time to be complacent.

In fact, anyone who recalls the debate about the tobacco display ban is entitled to remain deeply sceptical of anything any politician says.

As Philip Davies MP wrote, following the Coalition government's decision to implement Labour's tobacco display ban:

In answer to a parliamentary question, Mike Penning, then Shadow Health Minister said, “I have looked long and hard for evidence from around the world that the Government’s proposals (to ban displays at the point of sale) are sufficiently evidence-based, but I do not think that they are.” Why the sudden change of heart? It is simply to try to appease anti-smoking fanatics who can never be appeased.

Davies' comment hit the nail on the head. It's one thing for Conservative Central Office to try to embarrass Labour councils before local elections, but after the forthcoming elections (national and local) will a Conservative Government be prepared to ignore the fanatical anti-smoking industry or will there be more years of appeasement?

Yes, I'm encouraged by Marcus Jones' comments, and the Government's apparent refusal to bow to the demands of anti-smoking organisations to publish a new Tobacco Control Plan without further delay, but I remain wary.

We've seen what devolution has done in Scotland. My concern is that devolving even more responsibility for 'public' health to local councils would generate more grandstanding policies designed to grab headlines in order that local authorities are seen to be 'doing something'.

Opinion polls are clear. The public does NOT believe that tackling smoking is a high priority for either national or local government.

That's the non-party political message we have to get across ... to all politicians, national and local.


Danny Baker: Cradle To The Stage

Happy Easter to those of you who are not otherwise engaged.

On Friday night I went to Milton Keynes to see Danny Baker's one-man show Cradle To The Stage.

I've been a fan of Baker's since the early Nineties when I listened to his breakfast show on Radio Five, the precursor to Five Live.

The show combined the presenter's bubbling, effervescent personality and remarkable memory for trivia and pop culture with some great music selected by Baker himself.

The show was so successful that he was snapped up by Radio One, in hindsight a bizarre decision given that station's much younger target audience.

Baker was also the original presenter on 606, the long-running football phone-in that never recovered from his departure.

In his hands it was a conduit for eccentric tales from the terraces. In the hands of his successors it became what it is today – a platform for inane whinges and pompous commentary (and that's just the presenters!).

If Baker thought a caller was being stupid or, worse, boring, he frequently cut them off and moved on. Today we have to listen for what seems like an eternity to someone droning on and on about the fate of Arsene Wenger or whatever match we've just listened to on the radio.

Some years ago Baker was brought back to 606 – albeit sidelined to a graveyard slot in midweek – but it wasn't the same and he didn't stick around.

Instead he spent the best part of a decade hosting a daily afternoon show on BBC Radio London before that job was also taken away from him, much to his disgust.

Today this award winning (yet Marmite) broadcaster is restricted to just two hours on Five Live on Saturday morning.

Aside from his TV and radio career Baker is a gifted comedy writer who worked for the NME in its Seventies heyday before moving into scriptwriting.

He has written for just about every comedian you can think of (or so he tells us!), not to mention the likes of Jonathan Ross, Chris Evans and many, many more.

In recent years he wrote two bestselling volumes of his life story, with a third to follow this summer. They were great fun and I enjoyed them enormously.

I also enjoyed Crade to Grave, the 'sitcom' based on the first of the two books. If it wasn't quite as good as Baker would have us believe (like his career it can be described as "uneven"), it was nevertheless amusing and full of Seventies period detail.

And so to Friday's show in Milton Keynes.

The first thing to note is that Baker came on stage at 7.35, talked non-stop for almost two hours, broke off for a 20-minute interval, then returned for an 80-minute 'second act'.

Cradle To The Stage finished at 11.10 but I missed the final 30 minutes because, ironically, I had to slip out to do an interview for Five Live.

It didn't feel like a three-hour show but like his Saturday morning programme on Five Live it felt just a little self-indulgent.

It didn't help perhaps that I'd read the books and watched the TV show based on the first of the books so few of the anecdotes and stories came as a surprise.

I laughed along with everyone else but I'd heard and read most of it before and I could happily live to be a hundred without hearing yet another story about his old man Spud.

Hence my disappointment with the second part. We were promised a Q&A that would elicit gossip and stories about the many stars and celebrities he has worked with or encountered.

Instead we got a good story about Marc Bolan that drew an 'Aaahhhh' from the audience and another about Kenneth Williams (though if you've read the books you'll know them already) allied to yet more stuff about good ole Spud.

Indeed the very first 'question' – allegedly sent via text or Twitter from a member of the MK audience – was to ask what his father thought about his son's 'fame'. Cue a story (also in one of the books) about Harry Enfield and Spud's belligerent reaction to a perceived insult.

Baker is a natural raconteur but a show like this has to be better paced. Despite his rapid fire delivery (which was a bit exhausting to listen to over three hours) most of his career was left untouched and the promised Q&A was minimal with Baker taking just three questions in the 80-minute second 'act'.

And despite his many disagreements with producers and management over the years there was nothing to upset former or current colleagues. The closest he got was his description of The One Show - which he appeared on a few weeks ago - as "moribund", which is neither controversial nor the worst thing anyone has said about that programme.

In short this was safe entertainment for all the family (well, those over 40), an enjoyable but ultimately rambling diversion into the life of a man who, despite his protestations, evidently feels he hasn't received the credit he deserves for his scriptwriting in particular.

Apparently this tour was supposed to be a final hurrah before a move to Florida where he intends to devote himself to writing. According to Baker however Cradle To The Stage is already taking bookings for next year so he could be around for a while yet.

And why not? With the third volume of his memoirs out soon this could run and run. Florida may have to wait.


ASH Scotland poll avoids questions that really matter to smokers

The results of a poll commissioned by ASH Scotland and conducted by YouGov (whose president, Peter Kelner, is on the board of trustees at ASH London) has been published today.

I got a sneak preview of it yesterday, just as I was sitting down for coffee and a brownie at the Old Bicycle Shop in Cambridge.

The headline of ASH Scotland's press release stated, 'Scottish government action on smoking backed by both smokers and non-smokers'.

The full press release read:

The results from a new YouGov survey suggest people in Scotland continue to support government action on smoking, with smokers themselves indicating approval for recent government initiatives.

The survey results, released today by charity Action on Smoking and Health (ASH) Scotland, showed strong backing for recent legislation, with 91% of smokers agreeing with the ban on smoking in cars with children present. This was even higher than the 88% support amongst non-smokers.

At the same time 70% of Scottish adults (42% of smokers) support the ban on tobacco displays in shops, while only 9% (24% of smokers) are against.

Only on the introduction of plain, standardised packaging for tobacco products did the strong public support (60% support, 11% oppose) mask a balanced view amongst smokers (30% support, 35% oppose, 35% don’t know).

The Scottish public also indicated a strong appetite for further government action on tobacco and health. 87% of Scottish adults, including 85% of smokers, would support increased penalties for selling tobacco to children. 74% of adults, including 62% of smokers, would support requiring businesses to have a licence before they can sell tobacco.

Sheila Duffy, Chief Executive of ASH Scotland, said:

“When asked about specific government actions to tackle smoking both smokers and non-smokers tend to indicate support. This should encourage politicians that action to reduce the harm and inequality caused by smoking isn’t just effective, it is popular too.”

I'm trying to locate the full poll results, including questions, that YouGov are compelled to publish online.

It's interesting there was no reference to extending the smoking ban to outdoor areas, which is the one issue smokers would react most strongly against, the current level of tobacco duty or the bans on smaller pack sizes.

In contrast to the ASH Scotland/YouGov poll you may recall that last year a Forest/Populus poll found that a majority of adults in Scotland would allow smoking rooms in pubs and clubs.

In addition 61% thought that government policies to reduce smoking rates had gone far enough (44%) or too far (17%). Only 35% thought they had not gone far enough.

Anyway, Forest's response to ASH Scotland's survey, which was written during the 20 minutes I was waiting for my coffee (I like the Old Bicycle Shop but they do make you wait), read:

"The results of other polls conducted throughout the United Kingdom over the last 18 months suggest the public does not believe tackling smoking is priority for government.

"Smoking has consistently rated the lowest in a list of government priorities for the NHS, behind even obesity and alcohol issues.

"A Populus survey conducted in Scotland last year even found that 54 per cent of the public would allow well-ventilated smoking rooms in pubs and private members' clubs, with only 40 per cent opposed to the idea.

"There is no justification for further tobacco control measures until there has been a truly independent review of the impact of recent legislation including the display ban, plain packaging, the ban on ten packs and larger health warnings.

"Tobacco control measures have to be evidence-based and so far there is no evidence that any of these policies have had an impact on smoking rates.

"The most significant factor in the recent fall in the number of smokers would appear to be smokers switching to e-cigarettes. Vaping provides a free market solution to smoking cessation that no government policy can match.

"Instead of trying to force smokers to quit the Scottish Government should embrace the concept of choice and encourage smokers to switch to alternative nicotine products like e-cigarettes.

"It's important too that ministers engage with smokers, not nag or bully them to quit. Tobacco is a legal product and if adults choose to smoke that choice must be respected."

I knew only one or two sentences would be used but I wasn't sure how the media would report the poll so in terms of our response I had to give them several options.

To date, as far as I can tell, only one newspaper – the Herald – has covered the poll and their report was headlined 'Recent ban on smoking in cars with children receives backing from majority of Scottish smokers'.

Had I anticipated that I would have added:

"It's hardly surprising smokers support the ban on smoking in cars carrying children.

"Long before the ban smokers knew it was inconsiderate to smoke in a car with kids and the overwhelming majority didn't do it. The legislation was patronising and completely unnecessary."

Instead they quoted me as follows:

Simon Clark, director of the smokers' rights group Forest, said that the results of other polls in the UK in the last 18 months suggested the public does not believe tackling smoking is a priority for government.

He said, "Tobacco control measures have to be evidence-based and so far there is no evidence that any of these policies have had an impact on smoking rates."

Anyway, I know the cost of Scotland-only polls (they're not cheap) so a single report hardly represents good value for the taxpayer who funds ASH Scotland to the tune of £800,000 a year.

CEO Sheila Duffy will no doubt calculate that the real value of the poll will be the copies that land on the desks of MSPs including Scottish Government ministers.

Some might describe that as government lobbying government but I couldn't possibly comment.

Meanwhile you may recall Deborah Arnott's sniffy response to the poll Forest commissioned in Wales last month.

Commenting on the news that 58% of respondents would allow well-ventilated smoking rooms in pubs and private members' clubs, she said:

"The benefits of smoke-free laws are not a matter of public opinion."

In the crazy world of tobacco control opinion polls are fine when you get the result you want but when they are less conducive they must be dismissed and ignored.

Strange, that.


Groundhog day 

Groundhog day: a situation in which a series of unwelcome or tedious events appear to be recurring in exactly the same way.

There has been conjecture that the Government's new Tobacco Control Plan has been delayed because it's not a priority.

I'm sure that's true. I can think of lots of things – not just Brexit – that are far more important (don't we have enough tobacco control measures already?), and the public seems to agree.

Over the last two years polls conducted by Populus for Forest have consistently shown that tackling smoking is usually the lowest in a list of priorities for national and local government, below even obesity and alcohol issues.

The public isn't stupid. They know that smoking rates in Britain are the lowest they've ever been since the introduction of mass-produced cigarettes.

They know too that in the last decade successive governments have passed a series of laws from the smoking ban to plain packaging via the ban on the display of tobacco in shops and the general feeling, I believe, is "Enough's enough."

See Enough Is Enough: Attitudes to UK Smoking Policies (Forest).

Unfortunately when it comes to tobacco control the Department of Health tends to be a law unto itself – unelected mandarins calling the shots, working hand in hand with the likes of ASH, 'advising' (ie lobbying) health ministers on the 'next logical steps'.

So it's good to see the Government taking its time (although sod's law dictates that as soon as I've published this I'll get a call saying there will be an announcement early next week!).

It was encouraging too to read yesterday a comment from the minister for local government in response to the 'revelation' that some Labour councils have a "secret plan" to ban smoking in "alfresco dining areas" including beer gardens.

According to the Telegraph:

The proposals to extend the ban to outdoor areas have been included in a list of demands by councils and health authorities in London which has been supported by Sadiq Khan, the Labour Mayor of London.

However the Government has rejected the plans and condemned "labour's municipal killjoys" for making the proposal.

Marcus Jones, a minister for local government, said: “We already knew that Labour councils charge higher council taxes and levy more red tape.

"Now Labour’s municipal killjoys have been caught with a smoking gun, trying to ban adults enjoying their local pub garden. If implemented, these ill-founded proposals would lead to massive pub closures.

"Conservatives in Government will be vetoing these Labour Party plans. Ahead of May’s local elections, local voters have a right to know the bad and mad ideas that are being peddled by Labour councillors."

While this is good news let's not get carried away. To the best of my knowledge there is nothing to stop any local council introducing a by-law that would ban smoking in outdoor areas.

In other words, we have to remain extremely vigilant. We're still in the early phase of what promises to be a long war on smoking in outdoor areas, public and private.

In fact the whole situation feels extremely familiar, a note for note re-run of the long-running 'debate' about smoking in indoor public places, and these are the initial skirmishes.

Yesterday, for example, I did a couple of interviews for BBC Radio London and Five Live. In the course of those interviews it was suggested a good compromise would be smoking and non-smoking areas in beer gardens and 'alfresco dining areas'.

Years before the smoking ban was introduced pubs and particularly restaurants introduced smoking and non-smoking areas.

If I remember this was supported by ASH who insisted their only goal was more choice (ie 'smoke free' zones) for non-smokers.

No-one could really object to this (compromise is good, right?) but of course there were complaints from anti-smokers (who are never satisfied) that smoke drifted from the smoking to the non-smoking area.

Hence the proposal for separate smoking rooms but even that wasn't good enough because there were complaints that whenever the door to the smoking room was opened smoke – or the smell of smoke – would drift out into the non-smoking area.

The 'killer' argument was of course "passive smoking kills". Despite extremely dubious evidence we lost that battle because "passive smoking kills" was a slogan that was almost impossible to respond to in an equally succinct manner.

Have you tried explaining epidemiology and the risk ratios concerning passive smoking in a soundbite? It can't be done.

Well, I got an enormous sense of deja vu last night because I found myself going head-to-head with arguably the world's leading anti-smoking campaigner, Dr Stanton Glantz, who insisted, on Five Live, that smoking outside presented a serious threat to the health of non-smokers.

Presenter Stephen Nolan sounded sceptical and I declared the claim to be "nonsense" but Glantz was his usual bolshie self and became quite aggressive when I had the temerity to interrupt.

It was a slightly uncomfortable interview because I was standing, shivering, in the dark outside the Milton Keynes Theatre where I had gone to see Danny Baker's one man show, From Cradle to Stage.

The show began at 7.30 and finished – almost four hours later – at 11.10. I was booked to appear on Five Live at 10.45 so I had to slip out early.

Truth is, it wasn't my finest interview (if there is such a thing) because I do find Glantz a little intimidating and the argument became quite heated (or "passionate", as Nolan put it).

Anyway, despite the positive noises emanating from government, it all feels strangely familiar.

Update: During the Five Live 'debate' with Glantz I insisted repeatedly that it was "nonsense" to suggest smoking outside is a threat to non-smokers.

This morning I read this by Dr Max Pemberton in the Daily Mail:

As a doctor, you might expect me to support the call to extend the smoking ban to outside spaces. Actually, I think the Government was right to reject the plans as they did this week.

As a former smoker, I know that the more you’re told not to do it, the more there’s a tendency to dig your heels in. Brow-beating people into quitting rarely works.

There’s no doubt the smoking ban has brought about great benefits and, along with e-cigarettes, has gently nudged lots of people to quit.

But as a libertarian, I think there has to be compelling evidence before we ban things. It might not be pleasant to get a whiff of smoke as you walk past someone in the street, but it’s not going to kill you.

Time and again, public health officials, often in cahoots with busy-body councils, try to impose their will on people when there is flimsy evidence of any real benefit, riding roughshod over people’s basic right to choose how to live their lives.

Just because people make choices the experts don’t agree with doesn’t mean they should have those choices taken away.

To me, the attitude of public health officials embodies everything I dislike about doctors — the patronising, ‘we know best’ attitude of yesteryear that the medical profession has tried so hard to shake off.

Let people smoke outside if they want to. It’s their life and the Government has no place telling someone what to do if it doesn’t affect anyone else.

It’s just the nanny state interfering — which I like even less than smoking.

Glantz or Pemberton? I know who I believe. Click here.


The Global Forum on Nicotine – in Warsaw again!

Last year I questioned why the Global Forum on Nicotine, which promotes harm reduction, had introduced a ban on vaping during plenary and parallel sessions.

The self-imposed rule was odd, I thought, because delegates had arrived from all over the world to advocate the use of e-cigarettes and neither the venue - the Marriott Hotel in Warsaw - nor the Polish Government saw fit to restrict their use.

However, as I explained here, the organisers were concerned that:

Some non-vaping delegates last year felt that they were 'trapped' with the vapour, which they found unpleasant and distracting, particularly in the plenary and parallel sessions where there are a lot of people packed into a relatively small space;

The Polish government are pushing for indoor usage restrictions - there may be regulators present and we would like them to leave with a positive view of vaping and vapers, and indeed of the conference;

Since last year the majority of experienced vapers have switched to high powered devices and sub-ohming, which is fine for vape meets but not so good in the conference venue where it tends to create a rather disconcerting fog bank for those who are not used to it.

In my experience people's imaginations are generally worse than reality (the fear of flying being the obvious example) so if you're not a vaper and have never experienced a handful of people vaping in a room you're likely to imagine something far worse than the actualité, especially if your experience of vaping has been limited to seeing images of cloud chasing vapers in magazines and newspapers.

I would suggest therefore that you should let regulators experience people vaping but have a quiet word with vapers about the need to vape (or stealth vape) with discretion and consideration for others during the relevant sessions.

Instead the organisers chose to prohibit all vaping for a substantial part of the conference on the curious grounds that this was the best way to create "a positive view of vaping and vapers".

So how did this policy of appeasement work out? Well, shortly after GFN 2016 the Polish Government banned vaping anywhere smoking is prohibited!

While the anti-smoking law isn't as comprehensive as the UK legislation (clubs, bars, restaurants and other public places are allowed, apparently, to have a separate smoking room as long as it's properly ventilated and closed off from other public areas) the decision to extend it to vaping was nevertheless a substantial blow.

Why then is the Global Forum on Nicotine returning to Warsaw in June?

I don't know about you but if I was organising a conference that advocated the use of e-cigarettes I'd take my money – and that of my delegates – to a country where there are few if any restrictions on vaping in indoor public places.

I'd tell the media why we weren't returning and I'd praise the new host country for its positive and enlightened attitude to e-cigarettes.

What I wouldn't do is return to the same venue as if nothing had happened. Indeed, the GFN website has dropped any mention of a 'vaping policy' nor can I find any reference to the new law or how the organisers will accommodate those who want to vape.

There are tips about currency, electricity, safety and tipping etiquette, but nothing about where delegates can vape.

Compare this to another annual event, the Global Tobacco and Nicotine Forum (GTNF), a tobacco industry conference that does its very best to accommodate smoking and vaping.

Despite stringent regulations on smoking worldwide, the organisers have been heroic in their efforts to find smoker-friendly venues, although New York 2017 is going to offer a serious challenge!

Last year for example GTNF took place in Brussels. Belgium has tightened up its public smoking policy in recent years (previously smoking rooms were allowed in restaurants and even offices) but thanks to an exemption in the law (something to do with the fact that GTNF was a private event for which the entire hotel had been booked) the organisers were able to persuade the hotel to provide a designated smoking room on the ground floor off the main reception area.

The room (see below) was well proportioned, ridiculously ornate, with a high ceiling and comfortable armchairs and sofas, and we called it The Liberty Lounge.

On the penultimate evening before the gala dinner Forest hosted a small reception in The Liberty Lounge where guests could eat, drink, talk and smoke. (The absence of almost all the pro-vaping/public health speakers was noted but I'll let that pass.)

What I didn't know until very recently was that hotel staff were given the option to not go into the smoking room, which explains why the food and drink were served outside.

Nevertheless the organisers did everything they could to accommodate those who wanted to smoke – which I don't think is unreasonable at a tobacco industry conference – and I applaud them for that.

In my view the organisers of GFN should be doing the same for those who want to vape and finding a country where delegates can vape without being forced outside ought to be a priority.

Unfortunately (and this observation is not confined to GFN because I've experienced it at other conferences too) consumers are generally bottom of the pecking order. The role of the consumer (even at conferences like GTNF) is to sit, listen and learn from industry and public health 'experts'.

They know what's best for you, after all.

I'm not suggesting there's a long list of vape friendly countries because there isn't, but according to the Nanny State Index, launched last year, the following are among those countries that, as of March 2016, had no (or very few) restrictions on vaping indoors:

Austria, Bulgaria, Cyprus, Estonia, Germany, Ireland, Italy, Netherlands, Slovenia and the United Kingdom.

When the 2016 Nanny State Index was published Poland would have been on that list too so it will be interesting to see how many countries are still considered vape-friendly when the 2017 Index is published in May.

Meanwhile vapers attending GFN 2017 will just have to grin and bear it. I'm sure the organisers will find some way to accommodate your habit.

Below: The smoking room (aka The Liberty Lounge) at GTNF 2016.


From Galway to Dublin via Waterford, Clonmel and Tralee

Once a year John Mallon, our man in Cork, embarks on a media tour of Ireland.

The aim is to arrange interviews with as many radio stations as possible on a given theme.

The latest tour began on April 3 and the theme was 'Smoking: Pleasure or Addiction?'

The briefing we sent to the media began:

Why do almost one in four people in Ireland continue to smoke? The Tobacco Free Ireland Action Plan, including plain packaging of tobacco products, is doomed to failure because politicians and regulators aren’t listening to consumers and don’t understand why many people smoke.

A recent study of over 600 smokers in Britain and Ireland found that nearly all respondents (95%) gave pleasure as their primary reason for smoking, with 35% suggesting that smoking was part of their identity.

According to the study – which was conducted by the Centre for Substance Use Research in Glasgow and funded by Forest – the overwhelming majority of confirmed smokers say they light up not because they are addicted but because they enjoy smoking.

Helpfully the tour coincided with the launch of a new quit smoking campaign in Ireland.

Less helpful was the fact that the week before John set off the Irish government announced the 12-month implentation period for plain packaging. (It begins on September 30, 2017.)

Consequently John did several interviews about that before the tour even began so some stations didn't want to feature him again quite so soon, which is understandable.

Despite this John's schedule last week included interviews with radio stations in Galway (Galway Bay FM), Clonmel (Tipp FM), Tralee (Radio Kerry) and Waterford (WLR FM).

Yesterday he was in Tullamore (Midlands 103FM) and today he arrived in Dublin for interviews on Ireland AM (TV3) and The Pat Kenny Show on Newstalk, Ireland's leading independent broadcaster.

Tomorrow he's in Kilkenny (KCLR 96FM, tbc) and then it's home to Cork for Easter.


"There is never a situation where it is better to smoke than it is to vape." Never?

Further to yesterday's post Dick Puddlecote reports that the Independent British Vape Trade Association (IBVTA) has amended its code of conduct.

As I wrote yesterday one point previously read:

"Vape products are for current or former smokers and existing users of vaping devices, therefore [you should] never knowingly sell to anyone who is not a current or former smoker, or a current vaper."

The word 'sell' has been replaced by 'market' so it now reads:

"Vape products are for current or former smokers and existing users of vaping devices, therefore [you should] never knowingly market to anyone who is not a current or former smoker, or a current vaper."

Credit to the IBVTA for responding quickly to widespread criticism of this section of its code and making the necessary adjustment.

The bad news is that, like many vaping advocacy groups, they continue to insist that:

"There is never a situation where it is better to smoke than it is to vape."

They just don't get it, do they? Setting aside the fact that many smokers live long and healthy lives, smoking is not just about health. A great many people smoke because they enjoy it.

Pleasure brings its own benefits. David Hockney, 80 this year, is on record saying that smoking is good for his mental health.

Smoking works for him. I don't know why, I'm not an expert. It just does, and there are millions more like him.

Imagine saying "There is never a situation where it is better to eat a jam doughnut (or a hot cross bun) than it is to eat a cereal bar or a bowl of muesli."

Sometimes you need comfort food. For many smokers a cigarette is precisely that.

Yesterday the Telegraph reported that:

A hospital in Denmark has released a photograph of a patient fulfilling his dying wish – enjoying a cigarette and a glass of white wine while viewing the sunset from a hospital balcony ...

Although the hospital has a no smoking policy, an exception was granted for Mr Hansen, whose bed was wheeled out to the balcony for him to have a final drink and smoke while admiring a beautiful sunset.

Apart from the fact that this story demonstrates far more compassion than NHS administrators show to smokers, it also refutes the claim that "There is never a situation where it is better to smoke than it is to vape."

OK, this was an exceptional situation but the point – as The Pleasure of Smoking report by the Centre for Substance Use Research makes clear – is that many smokers take pleasure from smoking in a way they don't from vaping, not yet anyway.

To ignore the importance of pleasure and individual choice in favour of bland statements like "There is never a situation where it is better to smoke than it is to vape" is to ignore why so many smokers continue to smoke despite the well-publicised health risks.

It also underlines the arrogance that threatens to undermine the vaping industry because there are few consumers, in my experience, who like being lectured in such dogmatic terms.

There is a lot to commend e-cigarettes and other alternative nicotine products. But a little humility and a greater understanding of why confirmed smokers continue to smoke wouldn't go amiss.

Perhaps the IBVTA should invite Dr Neil McKeganey, lead author of The Pleasure of Smoking and director of the Centre for Substance Use Research, to address one of their meetings.

At the very least they should read his report.


How the IBVTA shot itself in the foot

Others have written about this already but, for what it's worth, I'll add my bit.

On Friday the Royal Society for Public Health published the results of a special investigation into the sale of e-cigarettes in vape shops in the UK.

The BBC report (Vaping shops selling to non-smokers) was typical of the way the story was covered by the media:

Almost nine in 10 e-cigarette shops in the UK are selling vaping products to non-smokers against the industry's code of conduct, an investigation reveals.

The Royal Society for Public Health (RSPH) said 87% of shops were knowingly or unwittingly prepared to sell e-cigarettes to people who have never smoked or vaped.

Only later in the report did it credit the "industry's code of conduct" to the Independent British Vape Trade Association (IBVTA).

The specific point the media focussed on reads:

"Vape products are for current or former smokers and existing users of vaping devices, therefore [you should] never knowingly sell to anyone who is not a current or former smoker, or a current vaper."

There are several issues here.

1. This 'investigation' could be said to amount to a form of entrapment. Non-smokers were sent in to vape shops with the specific intention of finding out whether they could purchase e-cigarettes in breach of the "industry code of conduct".

2. It is not against the law to sell e-cigarettes to adults so not one vape shop was doing anything illegal or even morally wrong.

3. The "industry code of conduct" is nothing of the sort. The IBVTA is one of several e-cigarette trade associations and cannot be said to represent the e-cigarette "industry" as a whole.

4. Membership of the IBVTA is, I believe, quite small (fewer than 50 members according to its website) and it was not disclosed how many of the shops 'investigated' by the RSPH were actually members. If many/most were not members of the IBVTA it was disingenuous of the RSPH to suggest that "nine in 10 e-cigarette shops in the UK are selling vaping products to non-smokers against the industry's code of conduct [my emphasis]".

If the RSPH does not come out of this 'investigation' very well, the IBVTA has suffered what is arguably a worse blow.

The RSPH, after all, is a leading tobacco control body. We know the depths to which they will sink to control people's behaviour. In contrast the IBVTA should be on the side of the consumer fighting for freedom of choice.

Instead the declaration that "vape products are for current or former smokers and existing users of vaping devices" and should not be sold "to anyone who is not a current or former smoker, or a current vaper" is beyond fatuous, it's nonsense.

I agree that e-cigarettes should not be marketed at non-smokers, teenagers or otherwise, but that's as far as any code of conduct should go.

The suggestion that a vape store worker should have to ask a potential customer whether they are a "current or former smoker, or a current vaper" is a disgaceful invasion of privacy.

If a non-smoker (me, for example) walked into shop and asked to buy a pack of cigarettes I would be appalled if I had to confirm or, worse, prove I was a smoker before they would serve me. I'm 58, for Christ's sake!!

I agree with the ban on proxy purchasing of tobacco for anyone under 18 but I might be buying it for an adult friend. Or I might simply fancy a smoke myself.

Unlikely perhaps but what business is it of anyone else, and why should the shopkeeper be put in that position?

The same is equally true of e-cigarettes. If, as a non-smoker, I choose to walk into a shop and buy an e-cigarette, that's my right.

The reality, of course, is that the number of never smokers who have taken up vaping is insignificantly small so on this point the IBVTA's code of conduct is a solution to a 'problem' that barely exists.

Even if never smokers are attracted to try e-cigarettes, so what? As long as they're adults they can make that decision for themselves.

What the IBVTA has done is to fall into the trap of trying to appease the tobacco control industry which sees e-cigarettes as a smoking cessation aid and nothing more.

The idea that anyone – smoker or non-smoker – might choose to vape for pleasure is anathema to them. Vaping, in their eyes, is merely a stepping stone towards a smokefree (sic) world, and after that ...?

As I have written countless times, the Utopian endgame is not smoke free, it's nicotine free.

Public health has far too many jobs invested in tobacco control to quit when smoking rates dwindle to five per cent or less. There will always be the 'next logical step'.

A code of conduct mandating shops to question their customers about their smoking history opens a can of worms.

Codes of conduct, like guides to etiquette and 'voluntary' bans, have a nasty habit of being enforced in law.

Put an idea into the head of a public health professional or politician and it rarely goes away. Like a nasty case of indigestion, it rumbles on. Often it's only a matter of time before campaigners lobby government to regulate ... and we know what happens next.

A few years ago a former Labour government advisor, Professor (now Sir) Julian Le Grand, proposed a £10 licence to smoke (BBC News).

The idea has yet to fly but I'm sure it will be resurrected at some point. After all, if you want to restrict the sale of cigarettes to existing smokers, or people born after the year 2000, one way to do that is to insist on some form of ID – a licence to smoke, for example.

Likewise, if you want to prohibit never smokers from purchasing e-cigarettes, the best way is to insist that "current or former smokers and existing users of vaping devices" are identified as such.

Insofar as protecting their members' interests is concerned, the IBVTA no doubt meant well. But appeasing tobacco control almost always ends in tears.

The RSPH 'investigation' and the way it was reported by the media is a classic example of that.

Anyway, here is a selection of blog posts on the subject. The growing antipathy towards the allegedly 'pro vaping' members of the public health industry suggests a welcome realisation that tobacco control will never be a friend to vapers or consumer choice in general.

Unfortunately, to use a Spitting Image analogy, there are some pro-vaping bodies who seem happy to play David Steel rather than David Owen. And how did that go, exactly?

Real implications of the RSPH “sting” of ecig vendors (Carl Phillips)
Dear Public Health: This is why we're angry (Fergus Mason)
Today's lesson in who not to trust (Dick Puddlecote)
Much ado about nothing (Paul Barnes)

Update: Here's another blogger less than impressed by the IBVTA.

Should e-cigarettes be sold to non-smokers? (Andrew Allison)

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