Wednesday
Dec202017

Questions that need answers

Further to yesterday's post about the prison smoking case, I can reveal an interesting response to a Freedom of Information request on a related issue.

On November 30, the day after I published a post about Deborah Arnott and the hitherto unknown national smoke free prisons project board, I emailed the Ministry of Justice as follows:

Dear Sirs,

In a response to a written question tabled by Philip Davies MP and answered on 28 November 2017, Parliamentary Under Secretary of State for Prisons and Probation Mr Sam Gyimah MP replied:

"There have been no representations received from Action on Smoking and Health (ASH) on the banning of the use of tobacco on the prison estate.

"The Director of ASH, Deborah Arnott is a member of the national smoke free prisons project board and is informed of the progress of the roll out."

1. Please provide a list of all members of the national smoke free prisons project board.

2. When was the national smoke free prisons project board set up?

3. How many times has the board met since it was set up?

4. Please provide the name of the chair.

5. How is the national smoke free prisons project board funded?

6. Are minutes of board meetings available to the public? Can they be accessed online? Alternatively, please provide a copy of the minutes of all meetings of the national smoke free prisons project board.

7. Please provide copies of all correspondence between the Director of ASH, Deborah Arnott, and the Ministry of Justice on the subject of prison smoking bans between 1st January 2014 and 30th November 2017.

Two days ago I received a response from Her Majesty’s Prison and Probation Service via the Ministry of Justice and to say I was staggered is an understatement.

Incredibly they have declined to answer any of my questions, citing the "cost limit". An edited version of their reply reads:

I am unable to confirm if the MoJ holds the information you have requested within the cost limit. Section 12(2) of the FOIA means public authorities are not obliged to comply with a request for information if it estimates the cost of complying would exceed the appropriate limit. This represents the estimated cost of one person spending 3.5 working days determining whether the department holds the information.

In this instance to determine if all of the information requested is held we would be required to search a large number of electronic and paper records and collate and analyse them to produce the information you require, which would exceed the appropriate limit. Consequently, we are not obliged to comply with your request.

Now, I get that Q7 ('Please provide copies of all correspondence between the Director of ASH, Deborah Arnott, and the Ministry of Justice on the subject of prison smoking bans between 1st January 2014 and 30th November 2017') may have been a bit ambitious, but how long can it take to answer the other questions.

Let me remind you what they were:

1. Please provide a list of all members of the national smoke free prisons project board.
2. When was the national smoke free prisons project board set up?
3. How many times has the board met since it was set up?
4. Please provide the name of the chair.
5. How is the national smoke free prisons project board funded?
6. Are minutes of board meetings available to the public? Can they be accessed online? Alternatively, please provide a copy of the minutes of all meetings of the national smoke free prisons project board.

Are they seriously telling us they can't answer simple questions like that without searching a "large number of electronic and paper records", thereby exceeding "the cost limit".

Clearly they are using Q7 as an excuse not to answer questions 1-6, which begs the question, why?

According to the MoJ letter:

If you are not satisfied with this response you have the right to request an internal review by responding in writing within two months of the date of this response.

Not satisfied? Ye gods. Not only will we request an internal review I intend to take this up with Sam Gyimah himself.

ASH is a taxpayer-funded lobby group. Their CEO, according to Gyimah, is on the board of something called the "national smoke free prisons project", a mysterious and previously anonymous group no-one had ever heard of.

It's so shadowy the MoJ can't even tell us when it was set up, who else – apart from Deborah Arnott – is on the board, how many times it has met and who funds it. (Frankly, I'm beginning to wonder if it actually exists.)

If the MoJ think they can fob us off with their feeble response they really don't know us, do they?

Tuesday
Dec192017

Hypocrisy of government's prison smoking ban exposed

A prisoner who wanted smoking banned in jail because he feared the impact of secondhand smoke on his health has lost his case.

According to BBC News (Inmate loses jail smoking ban fight at Supreme Court):

Paul Black, an inmate at HMP Wymott in Lancashire, wanted the same protection against passive smoking as "non-smokers living in the wider community".

Five justices dismissed his case against the government following his defeat in the Court of Appeal.

The BBC added:

The case centred on the 2006 Health Act which places restrictions on smoking in public places and workplaces, making it a criminal offence to smoke in an unauthorised place and also an offence for those in charge of the premises to turn a blind eye to smoking.

The 2006 Health Act did of course allow exemptions and they included, in particular, "any premises where a person has his home, or is living whether permanently or temporarily (including hotels, care homes, and prisons and other places where a person may be detained).

The exemptions for prisons could not have been any clearer and it's a mystery how Black won the original case in 2015.

Nevertheless, listening to his lawyer on Five Live this morning it was interesting to hear him say his client never wanted smoking banned in other inmates' cells, nor did he want smoking prohibited in outdoor areas.

The goal, according to the lawyer, was merely to have smoking banned in communal areas indoors.

How ironic therefore that after successfully challenging Black's 2015 High Court victory in the Appeal Court on the grounds that a "particularly vigorous" ban could cause discipline problems and risk the safety of staff and inmates, the government ignored its own warning and is currently introducing a prison smoking policy that is far more draconian than Black ever intended.

How hypocritical is that?

Another issue the Supreme Court ruling raises is this: if exposure to 'secondhand' smoke is as dangerous to non-smokers as current anti-smoking orthodoxy would have us believe, it begs the question why any court (Supreme or otherwise) would not uphold an indoor smoking ban.

And yet, by dismissing Black's case following his defeat in the Court of Appeal last year, it would seem that both the Appeal and Supreme Court judges have indeed rejected the fallacy that even regular exposure to other people's tobacco smoke is a serious risk to the health of non-smokers.

Final point. The lawyer representing Paul Black works for Leigh Day, the controversial 'personal injury and medical negligence lawyers'.

By coincidence this is the same firm that has represented ASH (Leigh Day acting for ASH in High Court tobacco plain packaging case).

Fancy that.

Thursday
Dec142017

Risk and responsibility

A long-awaited report about the health risks of heat-not-burn tobacco products was published this week.

According to BBC News:

The Committee on Toxicity (COT) looked at the available evidence about the risks of two heat-not-burn products that have recently gone on sale in the UK - IQOS and iFuse.

The devices heat tobacco to a high enough temperature to create a vapour but not smoke.

They are different to e-cigarettes, which vaporise a liquid containing nicotine - the highly addictive compound in tobacco smoke.

The committee found that people using heat-not-burn products are exposed to between 50% to 90% fewer "harmful and potentially harmful" compounds compared with conventional cigarettes.

Despite this all the reports I’ve seen were keen to focus on the negative. The BBC report, for example, was headlined ’Heat-not-burn tobacco 'is a health risk.

Other reports followed suit. ’Heat not burn' cigarettes still harmful to health, say government advisers (Guardian), ‘Heat-not-burn' tobacco is still a health risk even if 'smokeless' devices are safer than cigarettes (Daily Mail), while Reuters headlined its report, ‘Heat-not-burn' tobacco may be safer but still a risk: UK panel.

The BBC quoted COT chairman Professor Alan Boobis who said:

“The evidence suggests that heat-not-burn products still pose a risk to users. There is likely to be a reduction in risk for cigarette smokers who switch to heat-not-burn products but quitting entirely would be more beneficial."

The Guardian quoted Deborah Arnott, CEO of ASH, who said much the same thing:

“The COT concluded that while ‘heat not burn’ products are lower risk than smoking they are not risk-free, so quitting tobacco use completely is still the healthiest option.”

Boobis warned, “We have to be very much on our guard that these are not seen as recreational devices.” Goodness, no.

(Small point. Why is the chairman of the Committee on Toxicology making such partisan, even tendentious, comments? Surely he should be impartial and comment only on the facts?)

The BBC also noted that:

The panel was concerned that young non-smokers might start using the products.

There were also worries that the products could lead people to take up smoking cigarettes.

Now where have we heard that before? Clue: exactly the same thing was and is being said about e-cigarettes despite the lack of evidence that e-cigs are a gateway to smoking or tobacco in any form.

More important though is the insistence that because heat-not-burn products carry some risk then complete abstinence is the best course of action.

The risk posed by e-cigarettes may be even less (95 per cent according to Public Health England and the Royal College of Physicians) but as long as there is any risk public health campaigners will continue to insist that quitting all forms of nicotine (patches and gum excepted, no doubt) is the preferred outcome.

Significantly the Guardian reported that:

If you are having trouble stopping smoking, [Boobis] said, first try the licensed nicotine replacement therapies, such as patches and gum. “Then think about e-cigarettes. If that really doesn’t work, there are the ‘heat not burn’ devices,” he said.

You can read Forest’s full response to the COT report on the Asian Trader website (Smokers’ group welcomes heat-not-burn tobacco report). BBC News used this short quote:

“Electronic cigarettes are a step too far for many smokers so if the government wants smokers to quit there has to be a range of products that fills the gap between combustible tobacco and e-cigarettes."

In the light of the COT report it’s worth reminding ourselves that Carl Phillips has commented many times on the wisdom of vaping advocates pinning their hopes to the claim that e-cigarettes are ‘95 per cent less harmful than combustible tobacco’ and here’s why.

Every headline that greeted the COT report on heat-not-burn products could be applied just as easily to e-cigarettes.

Replace the words ‘heat-not-burn’ with ‘e-cigarettes’ and the following headlines are no less valid:

‘E-cigarettes still harmful to health, say government advisers’, ‘E-cigarettes still a health risk even if 'smokeless' devices are safer than cigarettes’, ‘E-cigarettes may be safer but still a risk’.

The point is, most things carry some element of risk. Today however we live in a risk averse society so anything that is not proven to be 100 per cent ‘safe’ is going to be a target – sooner or later – for the public health industry.

Whether the risk of using e-cigarettes or heated tobacco is 50, 90 or 95 per cent less than the risk of smoking cigarettes is largely irrelevant.

As far as the anti-niconistas are concerned it’s still a risk and if you believe all the scaremongering about smoking even a small risk relative to smoking is significant. It's certainly not harmless.

That 'fact' alone is enough to keep public health activists busy for decades because I don’t expect them to rest until every recreational nicotine user on the planet has been saved from this “highly addictive” drug.

That’s why the battle we face goes way beyond health and harm reduction. It’s also about choice and personal responsibility.

Truth is, if the public health industry gets its way e-cigarettes and other harm reduction products are merely stepping stones to the prohibition of all nicotine devices.

The battle we have to win therefore is the right for adults to make informed choices about a range of products that offer different degrees of risk, and the right to take responsibility for those choices as well as our own personal health.

Adults must also have the right to consume a range of nicotine products, from combustible tobacco to heated tobacco to snus to vaporisers and electronic cigarettes, without excessive regulations (or taxation) dictating their choices.

Harm reduction is great but ultimately this is a war on choice and personal responsibility. If we lose no product is safe.

Tuesday
Dec122017

Brazen CRUK targets cigarettes

It's not enough, apparently, to have graphic health warnings and 'plain' packaging on tobacco products.

A study published yesterday by Cancer Research UK (CRUK) advocates that a health warning ('Smoking kills') should be printed on the side of every cigarette.

Moreover manufacturers should be forced to change the colour of the traditional cigarette from white to an "unappealing" green.

This, we are told, will discourage more smokers to quit and will also discourage teenagers from smoking.

It's rubbish, of course. Similar studies were produced to support plain packaging yet there is still nothing to suggest the policy has helped reduce smoking rates anywhere it's been introduced.

Likewise graphic health warnings that were ignored almost as soon as they appeared.

Ignoring the failure of these policies, anti-smoking campaigners now want to target the humble cigarette.

It's not a new idea and I'm certain it won't go away which makes the complacency that greeted the announcement of the UK government's tobacco control plan in July all the more baffling.

Apparently we can all relax because the current government shows little sign of wanting to legislate further on tobacco.

Well, I've been here before – several times – and I can tell you that the tobacco control industry is relentless and never stops lobbying or bullying politicians (ministers included) to bend to their will.

I'll address this issue properly in the new year. In the meantime, here's Forest's response to CRUK's latest initiative:

Campaigners have dismissed a call for a health warning to be printed on the side of each cigarette to deter people from smoking.

Responding to a new study by Cancer Research UK that argues that making the cigarette itself unappealing could reduce smoking rates, Simon Clark, director of the smokers’ group Forest, said:

“We were told that graphic health warnings and plain packaging would make cigarettes less desirable but there’s no evidence that either policy actually works.

“Printing a warning on the cigarette or changing the colour of the stick will achieve nothing other than highlight the failure of existing policies.

“Clumsy and heavy-handed state interventions that rely on scaremongering invariably fail because the health risks of smoking are already well known to teenagers as well as adults.

“If the government wants fewer people to smoke the solution is not to impose more regulations on cigarettes but to encourage existing smokers to switch voluntarily to products like e-cigarettes that provide a safer yet pleasurable alternative.

“Smokers need a carrot not a stick with yet another warning they will almost certainly ignore.”

To date we've been quoted by The Times, Herald, Independent, London Evening Standard and the National (Scotland).

Monday
Dec112017

Breaking news ... Austria overturns smoking ban

In the last hour it’s been reported that Austria is to drop its planned smoking ban, ‘bucking Western trend’.

According to Reuters:

Austria passed a law banning smoking in bars and restaurants as of May 2018. But that will now be overturned under a deal between the conservative People's Party (OVP) led by Sebastian Kurz and the far-right Freedom Party (FPO) reached during their ongoing negotiations on a governing coalition, according to a person familiar with their discussions.

I’ve only visited Austria once, in 2011, but I liked it very much and wrote about it here:

If you've never been to Vienna I strongly recommend it, if only for the legendary coffee houses. This time yesterday I was enjoying breakfast – or should I say frühstück – at Café Landtmann which is said to have been popular with Sigmund Freud, Marlene Dietrich, Burt Lancaster and Paul McCartney.

According to their website, "The Café Landtmann offers a big non-smoking area as well as large facilities for our guests who wish to smoke". We were sitting in what appeared to be the largest indoor area and as far I could tell there was an ashtray at every table allowing customers to eat, drink and smoke at the same time. A more civilised way to start the day I cannot imagine.

Café Landtmann wasn't the first coffee house I visited yesterday and smoking was allowed in every one. An increasing number of Viennese restaurants ban smoking indoors but not the one where I had lunch, so everyone has a choice, including staff.

The previous day I wrote:

Currently in a Viennese bar overlooking the Danube. People are smoking ... just as they were in the hotel restaurant last night. Writing as a non-smoker, I genuinely consider it to be the height of civility and quite wonderful to behold. I can't understand why Britain doesn't try it.

I’m not yet sure of the full details of this volte face (it may not be as dramatic as it sounds) but I’ll try and find out.

In the meantime ... rejoice!

Saturday
Dec092017

Beer and burgers in Brussels 

Just back from Brussels.

On Thursday I joined 45,000 pro-Catalan protestors marching in support of independence.

Just kidding.

The weather was foul and nothing would have tempted me to take to the streets.

Instead I spent most of the afternoon in a meeting. When it finished I checked in to my hotel before getting a taxi to Be Burger, venue for the third in a series of ‘Burning Issues’ dinners organised by Forest EU.

As the name suggests, Be Burger is a restaurant specialising in, er, burgers - albeit a large and luxury version of the popular delicacy.

The format of these events is simple. Guests are invited to enjoy a complimentary burger (with chips) and a bottle or two of beer.

Last night, in keeping with the season, the restaurant also provided a small vat of mulled wine.

While guests eat and drink our speaker talks for 15 or 20 minutes. That’s followed by a short Q&A.

After that we stand around chatting until the booze runs out. We then totter off into the night, or the bistro next door.

Speakers at the first two dinners in Brussels were Dr Neil McKeganey, director of the Centre for Substance Use Research, who talked about his report, ‘The Pleasure of Smoking: the views of confirmed smokers’, and Claire Fox, director of the Institute of Ideas, who reprised a subject she addressed at another Forest event in Dublin in May, ‘Is health the new religion?’.

Last night it was the turn of Sinclair Davidson, professor of Institutional Economics at RMIT University in Melbourne and an honorary senior fellow at the Institute of Public Affairs in Australia.

Sinclair is an increasingly familiar face at tobacco-related events worldwide. I first met him in Chicago in 2015 where I had dinner with him and his wife Dominique (Dom).

Last year I particularly enjoyed his speech at the Global Tobacco and Nicotine Forum in Brussels when his gently humorous tone was a welcome antidote to some of the more corporate speeches.

The subject of his talk on Thursday was ‘How to torture data to justify public policy’. In hindsight it didn’t really lend itself to a lighter approach so - rightly, I think - Sinclair played it fairly straight.

Plain packaging featured heavily because, it could be argued, few policies have been introduced (and justified) with so little evidence that it actually works.

Having written several papers on the subject, Sinclair is one of Australia’s leading voices on plain packaging. On Thursday however his greatest feat was simply turning up.

Truth is, he had no plans to be in Brussels this month. Our paths crossed at GTNF in New York in September and he mentioned he was taking a few weeks off in December to visit Europe with his wife.

He told me they were staying in Paris for a few days and I asked him if he would interrupt his holiday to speak in Brussels.

He agreed. What he didn’t tell me was that December 7, the most suitable date, was Dom’s birthday.

So not only did he interrupt his holiday, he also left his wife in another city on her birthday. Brave man!

The real drama though was getting a message at 4.30pm that said he was still in Paris where his train to Brussels had been “delayed”.

At that point I seriously thought I might have to speak myself. Thankfully all was well and the train arrived in Brussels at 6.00, 30 minutes before the event was due to start.

Thanks, Sinclair, you almost gave me a heart attack.

Thanks too to Guillaume Perigois, director of Forest EU, who organised another successful evening - 64 guests, many of them attending their first Forest EU event.

Sadly, owing to the weather (it never stopped raining), our smoking area was entirely redundant - despite the lighting and heaters Guillaume hired for the occasion.

Viewed through the floor to ceiling glass doors it looked nice, though.

Friday
Dec012017

Plain packaging: five years of failure

Today is the fifth anniversary of the introduction of plain packaging in Australia.

On December 3, 2012, I wrote:

Plain packs came into force in Australia on Saturday ... Seen for the first time, or in a gantry with lots of very similar packs, the effect is, I admit, quite gruesome.

That said, people reacted in a very similar way the first time they saw the graphic warnings that currently adorn branded packs. Very quickly people got used to them and the impact has been marginal at best.

Another reason graphic warnings don't work is this: most of the pictures portray something that, in reality, few of us witness first hand so why should we take them seriously.

When was the last time you saw someone with severely rotten teeth? Or oral cancer? I'm not saying that smoking isn't responsible for these things but putting such images on the packet is disproportionate to the risk so consumers tend to ignore them.

Anyway, the public health industry has been forced to develop a new shock tactic – even more grotesque packaging. Tobacco control calls it plain or standardised packaging but they can call it what they like. It will make no difference.

Standardised packaging is all the evidence you need that graphic health warnings have failed and there is no reason to think that plain packaging will be any different.

Five years on that comment seems rather prescient.

Plain packaging has had a negligible impact on smoking rates in Australia. In fact, since 2013 smoking prevalence has barely changed and with an increasing population it's said there are more smokers in Australia than before the policy was introduced.

Despite the evidence that plain packaging hasn't worked (or the lack of evidence that it has worked), the UK, France and Ireland have all chosen to adopt the policy.

Hungary is also introducing the measure and other countries that are considering it include Canada, New Zealand, Norway, Slovenia, Uruguay, Thailand, Singapore, Belgium, Romania, Turkey, Finland, Chile and South Africa.

Anyway, today's milestone reminds me of an event Forest organised at the Institute of Directors in London in February 2015 shortly before MPs voted in favour of introducing plain packs in the UK.

Nine speakers representing a variety of think tanks and organisations including the Adam Smith Institute, the Institute of Economic Affairs and the Institute of Ideas lined up to condemn the policy.

One of the speakers was Angela Harbutt, my colleague on the Hands Off Our Packs campaign, who had this to say about plain packaging in Australia:

Wednesday
Nov292017

It's all about the money

Talking about Deborah Arnott (see previous post), I sense ASH is genuinely concerned about future funding from the Department of Health.

A day after Lord Rennard and Lord Faulkner tabled questions concerning grants for organisations to support for the government's new tobacco control plan (see Please, minister, we want some more), the government has published replies by health minister Stephen Brine to four very similar questions tabled by Bob Blackman MP.

Blackman's first question, which is almost identical to one of two questions tabled by Faulker, read:

To ask the Secretary of State for Health, whether the grant competition to support implementation of the Tobacco Control Plan for England will contain provisions for future year funding to cover the full length of the Plan from 2017 to 2022.

In comparison Faulkner's read:

To ask Her Majesty's Government whether any plans to support implementation of the Tobacco Control Plan for England will contain provisions for future year funding to cover the full length of the Plan from 2017 to 2022.

You can see what they're up to. They want a commitment from government for funding not for one year but FIVE. Nice work if you can get it.

Responding to Blackman's question, health minister Stephen Brine has replied:

The Department is still considering the scope and procurement process for grants to support the implementation of the Tobacco Control Plan. Cabinet Office standards require all new grants to be subject to competition. Our intention is to make any future grant available on a multi-year basis, subject to an appropriate business case and satisfactory performance on the part of the funded bodies.

Blackman's other questions – with Brine's answers in italics – were:

To ask the Secretary of State, what plans his Department has to open the competition for the grant to support implementation of the Tobacco Control Plan for England this year.

The Department is still considering the scope and procurement process for grants to support the implementation of the Tobacco Control Plan. Cabinet Office standards require all new grants to be subject to competition. Our intention is to make any future grant available on a multi-year basis, subject to an appropriate business case and satisfactory performance on the part of the funded bodies.

To ask the Secretary of State, when his Department plans to complete the approvals process to enable the competition for a grant to support implementation of the Tobacco Control Plan to proceed.

The Department is still considering the scope and procurement process for grants to support the implementation of the Tobacco Control Plan. Cabinet Office standards require all new grants to be subject to competition. Our intention is to make any future grant available on a multi-year basis, subject to an appropriate business case and satisfactory performance on the part of the funded bodies.

To ask the Secretary of State for Health, how much his Department has budgeted for 2017-18 for a grant to support implementation of the Tobacco Control Plan for England.

The Department is still considering the scope and procurement process for grants to support the implementation of the Tobacco Control Plan. Cabinet Office standards require all new grants to be subject to competition. Our intention is to make any future grant available on a multi-year basis, subject to an appropriate business case and satisfactory performance on the part of the funded bodies.

Like Rennard and Faulkner, Bob Blackman has a very close relationship with ASH, being chairman of the All Party Parliamentary Group on Smoking and Health which ASH runs. Reynard and Faulkner are also vice-chairmen of the APPG so this is almost certainly a move coordinated by ASH to determine future funding.

If so it indicates a nervousness I've not seen before.

The irony of course is that any grant ASH receives from the DH will come with a clear stipulation that it cannot be used to lobby government.

Lobbying, however, is what ASH is particularly good at – hence this sudden burst of activity. So here's another question:

What part of ASH's funding is currently being used to lobby government to grant the group funds to support the government's tobacco control plan?

Tricky, isn't it? Perhaps it would be best to exclude ASH from the process entirely so there is no confusion.

Either way, may I suggest that public health minister Steve Brine changes his Twitter banner as a matter of urgency?

It currently features the CEO of a certain anti-smoking lobby group that is seeking a grant from the Department of Health in what should be an impartial bidding process.

That process should not only be fair, it should be seen to be fair and impartial. Just a thought.

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