Saturday
Mar182017

Friendly fire

I agree that snus should be legalised.

That said, this headline seemed a little strident to me:

If we want to benefit from Brexit, the first thing we should do is make snus legal (Spectator Health).

The article – by Chris Snowdon – highlights the low rates of smoking in Sweden where the sale of snus is legal.

Noting this "quiet revolution", Chris quotes a New Scientist report that began:

Sweden is lighting the way to a cigarette-free world [my emphasis]. The Swedish government has released data showing that the proportion of men aged between 30 and 44 smoking fell to just 5 per cent in 2016 ...

Overall, just 8 per cent of Swedish men now smoke on a daily basis – itself a record-low percentage – compared with a European Union average of just over 25 per cent. The proportion of Swedish women who smoke also continues to fall, and is now 10 per cent.

Let me be clear. If you believe in choice, or the principle of harm reduction, it makes complete sense for snus to be legalised.

Adult consumers must be allowed to buy a wide range of nicotine products, some 'safer' than others.

In an ideal world the legalisation of snus would be accompanied by an education campaign giving consumers all the information that's available about the health risks of snus in relation to smoking, vaping etc.

They can then make an informed choice and if, as a result, smoking rates fall, that's fine. That's how market forces work.

But advocating the immediate legalisation of snus post Brexit with the principal aim of reducing smoking rates in Britain strikes me as a potential own goal because it tacitly accepts that smoking cessation should be an urgent priority for government when it clearly isn't.

See Enough Is Enough: UK Attitudes to Smoking Cessation, 2016.

The primary reason we should legalise snus is not because it will arguably reduce smoking rates but because consumers have a right to purchase an alternative nicotine product that evidence suggests is not risk free but is significantly 'safer' than smoking tobacco.

In other words, if the legalisation of snus leads to a reduction in smoking rates, fine, but it shouldn't be the principal reason for doing it.

In fact, as soon as you accept the argument that reducing smoking rates is a priority (because it will 'benefit' Britain) you're on a slippery slope. Worse, it's exactly the sort of thing tobacco control would say.

To be clear, as long as there's no coercion or dubious propaganda involved I've no problem with smokers quitting or switching to a 'safer' nicotine product. It's their choice.

But how, exactly, does smoking cessation 'benefit' Britain?

I know we shouldn't talk about smoking in purely economic terms, but if millions of smokers quit will it improve Britain's balance sheet? No.

Regardless of the estimated cost of treating smoking-related diseases, there will be a significant net loss of revenue that alternative nicotine products will never fully replace unless they too are taxed at exhorbitant levels.

More important, if the smoking rates should ever fall to single figures in the UK you can be sure that intolerance of smoking – far from easing – will reach a peak.

As smokers become an ever smaller minority they will become an even easier target for discrimination. The merest whiff of smoke will be enough for someone to call the nearest environmental protection officer, or worse.

Parents who smoke will be accused of child abuse; smoking in public (if it is allowed at all) will be restricted to a handful of designated smoking areas marked out with thick yellow lines. (I haven't written about this yet but it's coming, believe me.)

The 'benefit' to Britain of single figure smoking rates is a middle-class fantasy in which people live longer and 'healthier' lives, travelling the world on expensive package holidays funded by lucrative private pensions and the tens of thousands of pounds allegedly 'saved' by not smoking!

For many people of my generation (and younger) that is la-la-land. Increasingly however even free marketeers and campaigners for individual liberty are buying into this vision of a 'smokefree' (sic) world.

This weekend The Freedom Association is hosting its annual Freedom Festival in Bournemouth. One of the sessions is entitled 'Vaping: has science beaten smoking?'.

Forest supports vaping, like snus, because we believe in choice. We also embrace the concept of harm reduction. (Who wouldn't?)

But what's with this idea of 'beating' smoking? No-one who genuinely supports choice and personal freedom should be at war with smoking.

'Vaping: has science beaten smoking?' is exactly the sort of title I would expect to see at a tobacco control convention.

A better title (for a 'libertarian' event) might have been, 'Vaping: has science beaten tobacco control?'. Alternatively, 'Vaping: has the free market beaten tobacco control?'.

But no, they went for 'Vaping: has science beaten smoking?' because vaping is all about 'beating' or making smoking obsolete, right?

Wrong. It's about choice.

Something else that's worth mentioning is the implication that if snus is legalised millions of smokers will switch, as happened in Sweden.

No, they won't. Snus is to Sweden what chewing tobacco is to America. There will be a niche market for it in Britain but nothing more (and I'll stake my life on that, as Phil Neville might say).

In the long-term e-cigarettes and heat-not-burn devices have a far better chance of replacing combustible cigarettes because (a) they mimic the act of smoking, and (b) the technology will evolve and improve.

But snus? Like snuff it is what it is.

But let me finish with an anecdote.

Prior to our balloon debate last month (subject: 'The Most Pleasurable Nicotine Delivery Device in the World') I invited a former CEO to advocate snus.

At work he regularly produced a tin of snus before slipping a sachet under his lip. He spoke enthusiastically about the product so I thought he would be ideal for the role.

Instead he declined my invitation and said:

"I used snus when I couldn't smoke in the office. Now I'm working from home I smoke because I prefer it."

In my experience he's far from alone.

Friday
Mar172017

In the brave new world of public health, less information is more

It would be an exaggeration to say we've been inundated with complaints.

In the past few weeks however we have received a number of emails suggesting that since the introduction of plain packaging the taste of some cigarettes has changed.

One complaint concerned a well known brand so we asked the manufacturer and they assured us that "the content/recipe/formula hasn’t changed at all" so there is no logical reason why it should taste different.

Interestingly there were similar complaints following the introduction of plain packaging in Australia:

Long-term smokers find the taste of plain-packaged cigarettes worse than that of branded cigarettes, new research suggests.

I can't speak for other manufacturers because I haven't asked them but from what little evidence there is the effect does seem to be psychological.

I suspect too that it's very short-term because I don't remember the Australian 'story' lasting more than a few weeks.

Likewise there were very similar complaints that followed the introduction of self-extinguishing or lower ignition propensity (LIP) cigarettes a few years ago.

I don't remember them lasting more than a few weeks either.

Another complaint, or query, we've been responding to in recent weeks concerns the removal of information about the tar, nicotine and carbon monoxide levels on the new cigarette packs.

'They have to list ingredients on food packets. So why not cigarettes?' asked one aggrieved correspondent.

Another wrote: 'The new packaging give details of carcinogens in nicotine without specifying any information about the strength of the tar or CO2 components. So one buys completely blind. What exactly do the contents contain?'

The removal of the tar, nicotine and carbon monoxide levels has nothing to do with standardised packaging. It's part of the revised Tobacco Products Directive introduced across all member states by the European Union.

Instead of the TNCO levels the TPD stipulates that 50 per cent of the sides of packs must be covered with more health warnings – for example, 'Smoking kills – quit now', 'Tobacco smoke contains over 70 substances known to cause cancer' etc.

The argument, I believe, is that printing the TNCO levels on packs might lead consumers to think that some cigarettes are 'safer' than others.

In other words, consumers are too stupid to make informed choices based on hard facts so let's dumb down and remove anything that might confuse them.

The traffic light label developed by the Food Standards Agency to 'help you make healthier choices' works on a similar principle.

Nuance is for nerds. Propaganda, on the other hands, requires brevity, and slogans.

In the brave new world of public health, less information is more.

Friday
Mar102017

Boxing news

Good luck to my son who is representing Oxford in the 110th Boxing Varsity Match at the Cambridge Corn Exchange tonight.

I'm not sure how he's done it, to be honest, because he took up boxing – having previously played rugby – less than 18 months ago.

The first time he went in the ring to spar was, I think, this time last year and his first competitive boxing match was six weeks ago in the annual Town v. Gown event at the Oxford Union.

Training – which included a week in Tenerife where they got up at 6.00am and ran to the top of the local volcano several times – has been pretty intensive.

However he's not the first person in my family to take an interest in boxing. Both my grandfather (on my mother's side) and his son (my uncle) were very keen on the sport.

If I remember correctly my grandfather, a GP in Wembley, had a role with the British Amateur Boxing Association. My uncle, also a doctor, was medical officer to the British Olympic delegation in Seoul before being appointed chairman of the British Olympic Association Medical Committee.

My own interest in boxing is limited to watching the occasional fight on TV. I put it down to being punched in the face, once, when I was 15 or 16. I remember everything about it – the time, the place – and I didn't like it.

Since then my life has been dictated by a simple desire never to get punched in the face (or anywhere else) again.

Anyway, my son's last supper before tonight's bout was a couple of protein bars and a pot of cottage cheese.

I'm sure he'll make up for it after the fight.

PS. I like the understated way the event is being promoted online:

Cambridge go to war against Oxford on home ground in the violent realisation of one of the world’s greatest rivalries. History will be made as the Women’s Varsity is fought in Cambridge for the first time; prepare for a night of drama and intense action.

Update: Very proud of my son last night. He lost on a split decision but the MC summed it up when he hailed both boxers with the words, "It was a war in there!"

Parental pride aside, I have huge respect for all the boxers on both teams. It's one thing to train and spar in the local gym. Stepping into a ring in front of 700 raucous spectators is something else.

Friday
Mar102017

As we've been saying, food is the new tobacco

Some of you may have read reports this week about plain packaging for high calorie food.

According to the Guardian:

Selling high calorie foods in plain packaging could help in the battle against obesity according to a leading researcher who has won a share of the most lucrative prize in neuroscience for his work on the brain’s reward system.

The colourful wrapping and attractive advertising of calorie-rich foods encourage people to buy items that put them at risk of overeating and becoming obese in the future, said Wolfram Schultz, a professor of neuroscience at the University of Cambridge.

“We should not advertise, propagate or encourage the unnecessary ingestion of calories,” Schultz said at a press conference held on Monday to announce the winners of the 2017 Brain Prize. “There should be some way of regulating the desire to get more calories. We don’t need these calories.”

“Colourful wrapping of high energy foods of course makes you buy more of that stuff and once you have it in your fridge, it’s in front of you every time you open the fridge and ultimately you’re going to eat it and eat too much,” he added.

There was a flurry of excitement on Twitter with lots of 'I told you so' tweets.

I avoided the temptation but it's worth pointing out that the Tobacco Tactics website – which is the work of the Tobacco Control Research Group at the University of Bath – still has an entry that reads:

In the plain packaging debate in the UK, Forest has led the Hands Off Our Packs campaign, which claims that if cigarettes are to be sold in plain packaging, it is only a matter of time before plain packaging and large health warnings will be applied to other consumer products, such as fizzy drinks, fatty foods and alcohol. However, although some public health advocates are calling for increased regulation on alcohol and food, the case of tobacco is unique.

Perhaps they should edit that page before they look even more stupid.

PS. Long before plain packaging was a serious threat I gave a speech to the Independent Seminar on the Open Society (ISOS), an annual one-day conference for 200 sixth-form students organised by the Adam Smith Institute.

The year was 2004 and the subject was 'Food is the new tobacco'. I got a decent reception but I don't think many believed me.

Now, perhaps, people will start listening.

Wednesday
Mar082017

No Smoking Day: who will put this zombie event out of its misery?

I'm currently in Dublin but I shall be listening with interest to the Chancellor's Budget statement.

Hopefully there won't be a nasty surprise awaiting smokers. A tax increase on cigarettes of inflation plus two per cent (the policy George Osborne introduced) was bad enough but ASH want that increased to inflation plus five per cent.

Last year rolling tobacco got hit with (off the top of my head) a 15 per cent increase and the same could happen again.

The reasoning behind that is that as the cost of cigarettes has gone up smokers have switched in increasing numbers to cheaper rolling tobacco so let's clobber that as well.

There's also talk of a minimum excise tax (MET) which will effectively mean that the cost of the cheapest cigarettes brands will go up.

Again, this is partly to counteract the trend – provoked by high excise duty and, more recently, plain packaging – whereby smokers are increasingly driven to purchase the cheapest brands.

In practise of course many smokers by-pass ordinary retailers in favour of the black market.

Anyway it's also No Smoking Day today which may come as a surprise to some of you because I've not seen a single mention of it in any national newspaper.

Regional newspapers will give it a mention, especially if there's a local No Smoking Day stunt or initiative – but, as I've commented on before, NSD is a pale shadow of its former self.

In 2011 the No Smoking Day organisation (which used to have a budget of, I think, £600,000 a year) merged with the British Heart Foundation but it's hard to tell who's running NSD this year.

The event doesn't have a dedicated website and I can't find any mention of it on the BHF website, which is bizarre.

Interestingly, if you click on the URL nosmokingday.org.uk it redirects you to a page on the BHF website that mentions smoking but not No Smoking Day.

The No Smoking Day Twitter profile has two links – one to a site called Health Unlocked, the other to a stop smoking page on the NHS Choices website.

NSD tweets are also written in the first person which is generally an indication of just how small the 'organisation' is.

Despite that the Health Unlocked (No Smoking Day) site says that NSD is "supported by an alliance of UK health bodies and charities" which suggests the British Heart Foundation has decided it no longer wants to run it alone, but it's still not clear who's in charge.

Meanwhile, if you Google 'No Smoking Day 2017', the first thing you'll see is a promoted link to the Nicorette website.

The next link takes you to a page on what appears to be a Scottish Government website (NHS Inform).

After that there are a couple of calendar style websites that mention No Smoking Day followed by NSD's Wikipedia entry that was last updated, it seems, in 2011.

In typical Wikipedia fashion it states that 'No Smoking Day in the UK takes place on March 11 annually' which is obviously wrong because No Smoking Day takes place on the second Wednesday in March every year so the date varies.

The organisers of No Smoking Day (whoever they are, or were) have always been at pains to stress that the event was targeted only at people who wanted to quit.

It may have started that way but in the years I've worked for Forest the organisers have been more than happy to embrace many anti-smoking initiatives, including local smoking bans and other policies designed to restrict the freedoms of everyone who wants to light up.

Before the smoking ban, for example, No Smoking Day was seen as a great way to get publicity for a local business.

All you had to do was announce that from No Smoking Day you were introducing an office smoking ban and you could almost guarantee the story would appear in the local paper.

Since then it's been more difficult to use NSD as a promotional or campaign tool but it hasn't stopped people trying.

This morning for example I was on BBC Radio Suffolk discussing a decision by Ipswich Hospital to ban smoking anywhere on site.

Naturally they chose No Smoking Day to start enforcing the policy which includes demolishing the existing smoking shelters.

How kind – and considerate.

But that's what No Smoking Day does to people. It brings out the worst in some because it legitimises fear and discrimination.

Thankfully No Smoking Day is rapidly becoming a zombie event. Someone should put it out of its misery.

Sunday
Mar052017

Burning your £££s to help overseas smokers quit

We know about the millions of £££s of taxpayers' money squandered on stop smoking services that fewer and fewer smokers actually use.

We know about the millions of £££s of public money given to anti-smoking groups such as ASH, ASH Scotland and ASH Wales.

We know too that the tobacco control industry wants the government to spend millions more on mass media campaigns designed to 'persuade' smokers to quit.

Crazy though that expenditure is, at least the money is being targeted at UK residents.

In contrast, consider the £15,000,000 (at least) of UK taxpayers' money that has been allocated to help non-UK residents to stop smoking.

This isn't a new story – it first appeared in November ('Britain's aid budget is being used to support 'quitting measures' in less developed countries') – but today's papers suggest it's an issue that's gaining traction.

According to The Sun:

About £15 million of Britain’s health budget will go on helping foreigners quit smoking.

It is part of £150 million from the Department of Health money pot which went on overseas aid last year — a figure which has ballooned in three years.

The same story appeared in the Mail and the Express but the headline in the Express summed it up best – Foreign aid farce.

Don't hold your breath but perhaps MPs will now demand a full independent audit that identifies every penny of taxpayers' money that is being spent on all smoking cessation initiatives overseas.

Initiatives, for example, like last year's "researcher links workshop" in Uruguay. According to the UK Centre for Tobacco and Alcohol Studies (UKCTAS) website:

Following a successful grant application, a group of UKCTAS researchers have in collaboration with colleagues in Uruguay’s University of the Republic organised a workshop to explore how research into smoking and alcohol use in pregnancy can be used to develop and implement effective policies to curb the use of these substances, which remain a problem in many parts of the world, including the UK and Uruguay.

The British Council, which sponsored the event, receives funding from the UK Foreign and Commonwealth Office (ie the taxpayer).

And according to UKCTAS the taxpayer-funded British Embassy also chipped in.

The question is, how many more smoking-cessation projects like the Uruguayan workshop are funded with our money?

Sending a group of researchers on a round trip of 13,600 miles to link up with public health professionals on the other side of the world may not be the most scandalous or extravagant use of taxpayers' money but it all adds up.

With the UK one of the first countries to commit to funding the next phase of the Framework Convention on Tobacco Control (FCTC) negotiations, and the former tobacco programme manager at the Department of Health now on secondment with the World Health Organisation in Geneva, questions must be asked about the DH's global ambitions and the cost and relevance to the British taxpayer.

Saturday
Mar042017

Philip Morris and ASH want government to increase tax on cigarettes

Gotta love Philip Morris.

The world's biggest tobacco company certainly knows how to grab a headline.

Three months ago when Andre Calantzopoulos, PMI's chief executive, announced that he wanted to work with governments to "phase-out" conventional cigarettes it was a huge story and his comments were reported worldwide.

Today the Telegraph reports:

The world’s biggest tobacco company has for the first time asked to be taxed more by Chancellor Philip Hammond – to encourage smokers to switch to healther alternatives.

Philip Morris, which makes brands such as Marlboro, said it backed an increase in taxes on its cigarettes as part of its bid to move to a “smoke-free future”.

According to UK managing director Peter Nixon:

“We want to move towards a smoke-free future and a lot of that is incentivising people to move across from cigarettes to something that is less harmful.”

To avoid any misunderstanding, I don't have a problem with any tobacco company developing 'safer' products that give consumers more choice. Quite the opposite. I welcome it.

I do however have an issue with anyone who supports an increase on what is already punitively high taxation on cigarettes and rolling tobacco because we all know who will bear the brunt of that increase – the consumer.

And let's be clear. When the Chancellor raises the tax on cigarettes by inflation plus two percent or worse (the so-called tobacco escalator) on Wednesday it will have very little impact on PMI whose market share in the UK is less than ten per cent.

The groups that will suffer most are small retailers (who may lose business to the black market) and law-abiding smokers, especially the less well-off, who don't want to quit or switch to alternative nicotine products.

Remarkably I see very little difference between PMI's call for higher taxes on combustible tobacco and ASH's pre-Budget statement that calls on government to increase the tobacco tax escalator from two per cent to five per above inflation.

In contrast, City AM yesterday reported that:

The Tobacco Manufacturers' Association [which represents Imperial, JTI and British American Tobacco] said the government's policy of increasing taxes on tobacco above the rate of inflation each year has already pushed British consumers into the black market, and the group called for the government to scrap the tobacco duty escalator.

Or, to put it another way:

The TMA is urging the government to adopt a “more effective tax policy”, starting with the removal of the excise duty escalator, in which the tax on tobacco products rises by 2% above inflation every year.

TMA director general Giles Roca said: “Tobacco taxation in the UK is the highest in Europe thanks to successive government’s raising tax notably with an-above-inflation escalator, meaning that on some of the lowest-priced cigarettes, tax can account for 90% of price.

“This simply encourages people to buy from the black market and takes business away from the legitimate trade,” he says. “The government therefore needs to review its approach to tobacco taxation, starting with ditching the failing escalator and it could usefully do this at the upcoming Budget.”

See Trade urges government to re-think tobacco tax policy (Talking Retail).

Clearly the message didn't reach PMI or, if it did, they ignored it.

So here's an idea. Prior to the autumn Budget perhaps Philip Morris and ASH should consider a joint submission to the Chancellor.

That way smokers will know exactly where they stand, and who their friends are.

Friday
Mar032017

Groupthink and the bully state

It was Ranald MacDonald, MD of Boisdale Restaurants, who coined the phrase 'the bully state' in relation to lifestyle freedoms.

I remember the moment. It was shortly after breakfast, in September 2006. Ranald, Claire Fox and I were sitting outside our hotel in Bournemouth discussing the events of the previous night.

'Politics and Prohibition', a drinks reception organised by Forest, had been a huge success, one of the best events we've done, attracting 400 guests to the main ballroom at the Royal Bath Hotel.

It was the last occasion people were allowed to smoke indoors at a party conference event so we wanted to do something special.

Claire was one of the speakers, struggling to make herself heard above the noise. When Ranald took to the stage he immediately lit a large cigar and began his 'speech'.

Within half a minute actors dressed as policemen had pushed their way through the crowd, climbed on stage and 'arrested' him for "inciting people to enjoy themselves".

The rest of the performance (which included a song and dance routine) was a blur but it finished with hundreds of people singing 'Always Look on the Bright Side of Life' as Ranald was led away in handcuffs.

The following morning, as we nursed a variety of hangovers, it felt a bit surreal. Inevitably the subject of the nanny state came up and after a few minutes Ranald declared, "It's not a nanny state, it's a bully state."

Three years later, in an attempt to embed the term in the public mind, we published a book – by former Forest spokesman Brian Monteith – about the mounting attacks on individual freedoms and called it The Bully State.

Today, as next week's Budget will demonstrate, the bully state is alive and well, although tobacco duty is only one example of how the state is trying to force smokers to quit.

The policy of increasing taxation is being driven by well paid politicians and tobacco control campaigners whose lack of empathy for those who enjoy smoking and are less well off never ceases to amaze.

However we're not alone in feeling uncomfortable about this ongoing assault on the poor. Even members of the public health community are beginning to express concern.

Lisa McNally is a bubbly and committed public health consultant who has always struck me as a fundamentally decent and engaging person. On Wednesday however she made a BIG mistake. She upset ASH.

Describing the thrust of ASH's latest briefing document – 'Ditch or Switch: Give Yourself a Pay Rise!' – as 'insensitive', she tweeted, 'I'm worried this message lacks empathy with the severe deprivation that so many ppl are experiencing.'

'Public Health,' she added, 'must not be about the affluent telling the poor how to improve their lot.'

According to a further tweet this led to an 'angry call' from Deborah Arnott, CEO of ASH, who allegedly told McNally her comment was 'unhelpful'.

We'll never know exactly what was said between the two, or the tone, but following Arnott's call McNally tweeted that she felt 'a bit' intimidated.

And that's the problem with tobacco control. If you don't embrace their groupthink philosophy you get told off or worse.

But the tweets I found even more interesting were posted by Tom Pruen, chief scientific officer for the Electronic Cigarette Industry Trade Association (ECITA).

Responding to McNally's 'angry call' tweet, vaping advocate Pruen wrote, 'I suggest doing this through a medium other than twitter. Baiting the powerful is only fun when its BT.'

Translation: it's OK to bait the tobacco industry but not tobacco control, especially Deborah Arnott and ASH.

When McNally replied that she was 'not having fun ... I am fairly furious! I won't stay quiet ...' Pruen warned:

'Fair enough. It's obvious that you're right, but rocking the boat still has its risks.'

Translation: don't upset tobacco control – it won't end well!

A tweet or two later he added, 'It's certainly the case that making enemies more powerful than you is rarely career enhancing' to which McNally replied, 'Are you saying that criticising ASH may harm my career?'

Here are some of those tweets in full. You couldn't make them up.

H/T to Fergus Mason for bringing them to my attention.

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