New public health alliance targets smoke free London

Two weeks ago a new anti-smoking ‘partnership’ was launched.

According to the London Evening Standard (Public health bosses launch plan to make London smokefree by 2030):

The NHS has joined forces with MPs, academics and the Greater London Authority GLA) to form the London Tobacco Alliance, which will highlight the harms caused by smoking and promote smoke-free environments.

The Standard quoted Bob Blackman, chairman of the All Party Parliamentary Group on Smoking and Health (run by ASH), Professor Kevin Fenton, regional director, London Office for Health Improvement and Disparities, and Tracy Parr, programme director of the London Tobacco Alliance and Stop Smoking London.

According to Parr:

"The London Tobacco Alliance will act as a regional voice to make London smokefree by 2030 and will focus on the inequalities around smoking. We already have a number of key partners including OHID, ASH, NHS England, the GLA as well as Directors for Public Health and London Trading Standards.”

Curiously the role of programme director for the LTA was first advertised on the Jobs Go Public website on June 6, 2021 (15 months ago) when the declared ambition was to achieve a smoke-free London by 2029, not 2030.

The position was described as 'part-time' (three days a week) with a salary of between £43,931 and £48,159 for the 21 hours, 'initially on an 18-month fixed term contract or secondment'.

Applicants were told 'This is a pan-London post with employment through the London Borough of Tower Hamlets, host of the London Smoking Cessation Transformation Programme.' However 'The programme is jointly funded by London’s local authorities, with significant in-kind resource provided by partners.'

The project was finally launched on October 26, 2022, with Tracy Parr in post. According to the sparkling new LTA website:

London Tobacco Alliance partners include Directors of Public Health, representatives from the Office of Health Improvement and Disparities, the NHS in London, London Councils, the GLA as well as voluntary sector organisations and academic institutions ...

More broadly we are local authorities, directors of public health, healthcare professionals, sector experts, volunteers, councillors, politicians and advisors – coming together with a strategic aim to make London smokefree by 2030.

The LTA, the website adds, is 'the culmination of years of work' and 'the first of its kind in the capital'. But is it? I don't want to burst their bubble but it reminds me of a long-forgotten campaign, SmokeFree London, that was active in the early Noughties.

Described as an “an alliance of NHS health authorities and other agencies” (sound familiar?), SmokeFree London initially campaigned for a unilateral ban on smoking in public places in London.

When that failed, following a London Assembly report on smoking in public places that failed to find sufficient evidence to justify a ban, the campaign seemed to lose steam and was last heard calling for a national ban on smoking in restaurants.

SmokeFree London was headed by Judith Watt who I nevertheless remember with some affection. On one occasion when we were chatting off air she asked me why I didn't do something more productive with my talents. I was flattered she thought I had any.

When she returned to London (having moved to Australia) to attend the E-Cigarette Summit in 2018, I wrote:

For a period Judith rivalled Clive Bates (who was director of ASH from 1998-2003) as the go to spokesman for the anti-smoking brigade.

She was a tough opponent with an occasionally sharp tongue but she was never unpleasant and I rather liked her.

On one occasion we were invited to Television Centre in west London to discuss some issue live in the studio. The item got pushed back so we had time to chat while we waited.

I thought we were getting on rather well. As soon as we were on air however we had a pretty fierce argument. I can’t recall what was said, or even what we were talking about, but I do remember that I enjoyed it!

We will monitor the work of the London Tobacco Alliance with interest (noting the absence of the most important stakeholder of all – the consumer) but I'm not convinced that such alliances are very effective.

Glasgow 2000 for example was an 'alliance of public, voluntary and academic sector organisations established in 1983 with the aim of making Glasgow a smoke-free city by the year 2000'.

Remind me, how did that go?

ASH is recruiting

ASH is currently in the process of recruiting what it calls an ‘NHS strategic lead’.

This is a senior role within public health charity Action on Smoking and Health (ASH) to engage the NHS in action to tackle smoking’.

The salary is £50-60,000, depending on experience, but what’s more interesting is the fact that:

This role is to deliver on an NHS England funded project.

It’s not clear if the taxpayer will also be picking up the tab for the new ‘NHS strategic lead’ but I can’t imagine ASH would take on that financial burden without additional funding.

If so, is ‘taxpayer funds senior role within lobby group ASH’ a first? I think we should be told.

The deadline for applications is 11.59pm this evening. Full details here.

So much for freedom of information

A few weeks ago I submitted a series of Freedom of Information requests to the Department of Heath.

They were mostly to do with Stoptober, the annual quit smoking campaign, and they included:

• The publication date for the Stoptober 2021 campaign evaluation.

• The full and final costs (including media costs) for Stoptober 2021.

• The total sum, including expenses, paid to Stoptober ‘celebrity ambassadors’ including [singer] Sinitta for their time spent promoting and/or developing content for the Stoptober 2021 campaign.

• The total sum, including expenses, paid to Stoptober ‘celebrity ambassadors’ including [professional dancer] James Jordan for their time spent promoting and/or developing content for the Stoptober 2022 campaign.

• The projected costs for Stoptober 2022 including the projected media spend.

Providing answers to those questions should have been pretty straightforward so on Friday I was surprised to receive the following email:

Dear Mr Clark,

Thank you for your correspondence.     

Due to the extremely high volumes of correspondence the department receives, we must regretfully inform you that we are not able to provide an individual response to every enquiry we receive from the public. We are, however, continuing to record all the correspondence we receive so that we can track the issues being raised. I am sorry if this falls short of the service you may expect to receive.   

Yours sincerely,     

Ministerial Correspondence and Public Enquiries     
Department of Health and Social Care     

To put this in perspective, when I have submitted similar FOIs concerning previous Stoptober campaigns I have always received answers to my questions.

For example, an FOI request submitted in 2020 revealed that the final cost of Stoptober 2018 was £2,038,000. In 2019 it was £1,717,000 while the projected cost of Stoptober 2020 was £1,748,000.

Bizarrely getting the same information for the 2021 and 2022 campaigns has been blocked ‘due to the extremely high volumes of correspondence the department receives’. How convenient!

Furthermore it’s now more than twelve months since Stoptober 2021 finished and there is not only no sign of the campaign evaluation report (evaluations are uploaded here) but the DHSC won’t even tell us when it’s due to be published.

Stoptober evaluations rarely tell us very much - which is why we’ve had to submit FOIs to dig out more information - but even the standard cursory report is better than nothing, and the very least the taxpayer deserves.

Meanwhile what are we to make of a government department that can’t answer the most basic queries?

Worse, the response came from a ‘no-reply’ email address so I can’t even respond directly to the civil servant who wrote to me.

Freedom of information? Yeah, right.

See also:
Welcome back to the Better Health Stoptober campaign (October 2022)

Chris Whitty wants to “destroy” the cigarette industry - my TalkTV response

Following Chris Whitty’s attack on the ‘cigarette industry’, which he wants to see “destroyed”, I was invited to discuss the issue with Vanessa Feltz on TalkTV.

Here’s a transcript of that exchange:

Venessa Feltz
“The cigarette industry should be destroyed in order to prevent needless deaths.” That’s according to Professor Chris Whitty. Speaking at a conference England’s Chief Medical Officer described the habit as an appalling way to die and urged ministers to get smoking down to zero. Joining me live from Cambridge is Simon Clark from the smoking lobby group Forest and from South London Deborah Arnott, the chief executive of Action on Smoking and Health. Good afternoon to you both.

Obviously I am going to start with you Simon. You heard what we see Chris Whitty has said. He said, “smokers face an appalling death”. He says, “Ministers are currently considering whether to bring in new policies to limit smoking.” He says “smoking is the biggest driver that we could easily deal with in the sense of the inequalities that we see across the UK. It’s an appalling way to die. It kills people in multiple ways. Everyone in this room, he says, and whatever room he is in, I suspect, would agree that getting smoking down to zero and destroying the cigarette industry should be an aim of public health.” What do you make about that?

Simon Clark:
Well I think it’s quite sad that someone in Chris Witty’s position is talking in such extreme terms. I mean arguing that the cigarette industry must be destroyed, well that ignores the fact that millions of adults know the health risk but they choose to smoke because they enjoy it and many get comfort from smoking. Now it’s their life, it’s not Chris Whitty’s, and if an adult chooses to smoke that decision must be respected. What he is doing is infantilizing millions of adults by effectively saying that the government and the public health industry know better and they want to take the decision out of the hands of adults and make it for them. So it’s Prohibition all over again. The tobacco industry is a legitimate industry that manufactures a legal product and is currently investing heavily in reduced risk products like e-cigarettes. So talk of destroying that industry is extremely unhelpful when government should be working with the tobacco industry because when we move forward the companies are part of the solution to the issue of smoking related death and disease. So the government has to work with the industry, not destroy it.

Venessa Feltz
But isn’t your argument, and you do usually use the same one, that what the cigarette industry is doing is producing a product that is legal, and legally absolutely fine to sell, to purvey and everything else. Shouldn’t that be changed to it is no longer legal to sell a product which it is known causes harm to unborn foetuses, lungs, people’s longevity? At the moment you are quite right, it is legal. Isn’t what Professor Chris Whitty saying about destroying the tobacco industry in it’s entirety [is ] that what they would do would be to make the product illegal?

Simon Clark
Yes, but we already know what happens when you do that. We saw that with the prohibition of alcohol in the United States back in the 1920s and early 1930s. Prohibition doesn’t work. All you do is you hand the trade over to the criminal gangs. They are the ones who will benefit if you ban the sale of cigarettes or destroy the cigarette industry. You simply hand over a huge industry, an industry that makes this government over ten billion pounds a year on tobacco taxation. You hand that industry over to the criminal gangs. It would be absolutely ludicrous and we have got to remember that smoking goes back centuries, if not thousands of years, before the tobacco industry. Yes, the tobacco companies came up with the idea of mass manufacturing cigarettes but there will still be lots of people who enjoy smoking and they will find ways to get cigarettes and tobacco on the black market. You will certainly not stop it.

Funnily enough this argument was borne out by the first caller, a smoker who, when pushed, insisted that whatever happened (cigarettes being made illegal, for example) he would continue smoking.

Arnott meanwhile had chosen to quote another Whitty comment, this one made at the launch of The Khan review in June when he argued that it’s dishonest to say the smoking debate is about health versus freedom.

He was clearly pointing the finger not just at the industry but at groups such as Forest but I didn’t get a chance to respond because that was when Feltz brought in the first caller. Had she come back to me I would have said something like:

The risks associated with smoking are well known and if adults choose to smoke that’s a matter for them. Take that choice away and you are clearly being denied an important freedom – which is the freedom to choose – so of course it’s an issue of freedom, and personal responsibility.

A longer version of this argument can be found in an article I wrote for the online magazine Spiked in June, shortly after Whitty made his “dishonest” jibe. You can read it here.

Chris Whitty - a Telegraph reader writes

Further to yesterday’s post about Chris Whitty (which I will come back to) I was invited to discuss the Chief Medical Officer’s intemperate attack on the ‘cigarette industry’ with Vanessa Feltz on TalkTV.

I’ll post a transcript of what I said later. In the meantime, here’s a letter from today’s Telegraph. H/T Madeline Grant via Twitter.

Sir Chris Whitty - ‘What an odious man’

England’s Chief Medical Officer has renewed his attack on Big Tobacco.

In a speech reported by the Telegraph:

The cigarette industry should be destroyed for the benefit of public health, Prof Sir Chris Whitty, the UK Government’s Chief Medical Adviser, has said.

It’s not the first time Whitty has raged against the tobacco industry but this time it seemed to strike a nerve, on Twitter at least.

Even though it was quite late when we tweeted his comment - with a link to the Telegraph report - the response far exceeded the usual reaction to a Forest tweet.

The comments too were almost universally hostile to the CMO. For example:

What an odious man.

Zealot who should not be in office.

People like him just make me wanna smoke more and more.

Next it will be alcohol, these people enjoyed their lockdown powers way too much.

He was prepared to destroy society in the interest of Public Health.

Tobacco puritans and nannies who want to define other people's lives.

I enjoy a few beers and I enjoy smoking it's personal choice and yes it might shorten my life but life is about risk. Jumping out of an aircraft next year from 1500ft. Yes I might die if the parachute doesn't open, my choice however.

I wish they'd stop treating us as 5 yr olds. Where does it end? We cant drink? We can't cross the road without government consent? We can't eat meat? Government sanctioned insect food? Only have heat when we're allowed? This isn't living, this is imprisonment!

Also (and more nuanced):

It's a difficult one. As a non smoker I can see that it's immoral to sell goods you know cause harm/death. But I also know people who have smoked moderately into very old age as one of the few 'pleasures' in their life. One man's meat is another man's poison.

More on this and the return of the stop smoking blob later.

Update: Discussed this with Vanessa Feltz and Deborah Arnott of ASH on TalkTV this afternoon. I say discussed. At one point it felt like Deborah was trying to usurp Feltz and take on the presenter’s role. Talk about pushy!

Tobacco control - in government and in parliament

A quick update on developments that may or may not have a bearing on the Government’s tobacco control strategy.

We have a new Secretary of State for Health, a new minister for public health and a new chair of the Social Care and Health Committee.

It barely seems credible but so far this year there have been three health secretaries, one of whom is now in his second term of office in 2022.

The year began with Sajid Javid in post. Appointed in June 2021 following the resignation of Matt Hancock, it was Javid who commissioned Javed Khan, a former CEO at Barnardo's, to conduct a review of the Government's tobacco control policies.

Published in June, The Khan Review: making smoking obsolete featured 14 recommendations including a proposal to raise the age of sale of tobacco by one year every year until no-one will be allowed to buy tobacco legally.

Welcomed by tobacco control campaigners, it was derided by critics including Clive Bates, the former director of ASH, who commented:

Too much of Khan’s proposed agenda involves measures to hurt, restrict or humiliate smokers and to press them to stop smoking in response.

We'll never know whether Sajid Javid would have embraced any of Khan’s ”crackpot” ideas because on July 5, the day of the Forest Summer Lunch at Boisdale of Belgravia (which is why I remember it so clearly), Javid resigned as health secretary followed minutes later by Rishi Sunak. Together they dealt Boris a blow from which his premiership never recovered.

Stephen Barclay, Javid’s replacement, but had barely got his feet under the table before Boris was announcing his own resignation and after Liz Truss won the leadership battle, defeating Sunak, Barclay was immediately replaced by Thérèse Coffey.

Six weeks later, following Truss’s resignation (keep up!), Sunak succeeded her as PM and in another reshuffle Coffey was moved to the Department for Environment, Food and Rural Affairs (Defra) with her old job being given to … Stephen Barclay.

Although I expected Coffey to lose her job as Secretary of State for Health, I was nevertheless disappointed. As I wrote here she seemed like a breath of fresh air.

Her appointment as health secretary hinted at a new, less bossy direction for government and in her brief period at the DHSC it was clear that the puritanical health lobby was getting impatient and twitchy.

At the very least, as an interview with Nick Ferrari on LBC suggested, a new tobacco control plan was unlikely to be top of her agenda.

Again, we’ll never know what would have happened had she remained at the DHSC but it would have been interesting to find out.

So what now?

Well, unlike Coffey - who voted FOR an amendment to the smoking ban (in 2010) and AGAINST the ban on smoking in cars with children (in 2015) - Stephen Barclay did the exact opposite.

His local paper reported:

Barclay said he felt children deserved the “same protection” as pub goers – who benefited from a ban in 2007 – and went as far as to praise the last Labour government for introducing it …

“The last Labour Government deserve credit for banning smoking in pubs, which as a non smoker I have benefited from. It is overdue that we now ensure children in cars receive the same protection.”

Unlike Coffey, he also supported plain packaging. (See The Tory MPs who sided with Labour to support the theft of intellectual property.)

Not a good look for any Conservative, let alone one who prefaced his support for banning smoking in cars with children by saying, “As a general rule … the Government should try to avoid interfering in people’s lives.”

Meanwhile, what of the new Minister for Primary Care and Public Health, Neil O’Brien?

Elected in 2017, O’Brien is a former director of Policy Exchange, the conservative think tank founded in 2002 by, among others, Nick Boles and Michael Gove.

I wouldn’t read too much into it - not yet anyway - but O’Brien was director when Policy Exchange published a report, Cough Up: Balancing tobacco income and costs in society.

Published in March 2010, it is summarised on the think tank’s website as follows:

Smoking is the single, largest preventable cause of serious ill health and kills tens of thousands of people in England every year.  It is a popular myth that smoking is a net contributor to the economy – our research finds that every single cigarette smoked costs the country 6.5 pence. In order to balance income and costs, tobacco duty should be progressively increased until the full societal cost of smoking is met through taxation.

In an email to supporters, O’Brien wrote:

Dear Friend

Whilst tax on tobacco contributes £10 billion annually to the Treasury coffers, the true costs to society from smoking are far higher, at £13.74 billion, think thank Policy Exchange’s latest report finds. This cost is made up of the cost of treating smokers on the NHS (£2.7 billion) but also the loss in productivity from smoking breaks (£2.9 billion) and increased absenteeism (£2.5 billion); the cost of cleaning up cigarette butts (£342 million); the cost of fires (£507 million), and also the loss in economic output from the deaths of smokers (£4.1 billion) and passive smokers (£713 million). 



The report, Cough Up, calculates that of this £13.74 billion, cigarettes – which comprise 93.3% of the tobacco market - cost us £12.82 billion a year. Currently, a pack of cigarettes costs just £6.13. But this would need to be increased to at least £7.42 for cigarettes to be revenue neutral to society and their true cost reflected by their price.

Tobacco control campaigners quoted these estimates and calculations for years but the backlash from more sceptical observers was immediate, prompting me to write:

I wonder if Neil O'Brien, director of Policy Exchange, is aware of the terrible damage a report like this has done to Policy Exchange's reputation in centre right circles. I won't forget it in a hurry, and nor will a lot of other people.

Needless to say ASH wasted no time welcoming O’Brien to his new role at the DHSC, tweeting:

Congratulations @NeilDotObrien. As Levelling Up Minister you rightly said govt needed to “think extremely radically and really floor it” on prevention and public health. We look forward to seeing you deliver #smokefree2030

For a so-called ‘charity’ you have to admire the speed with which they rushed to lobby the new minister. Ditto local authority-funded Fresh North East who tweeted:

Welcome to @NeilDotObrien and we look forward to meeting you to discuss vital role of tobacco control to address health inequalities and also levelling up.

Finally I’m sure you’ll want to congratulate the new chair of the cross-party Social Care and Health Committee whose role is to ‘scrutinise the work of the Department of Health and Social Care and its associated public bodies’.

Formerly chaired by Jeremy Hunt, who now has more important things on his plate, his replacement is Steve Brine who was public health minister from June 2017 to March 2019.

Within weeks of his appointment (by Theresa May) he had not only published a new Tobacco Control Plan but received public support from ASH who gushed:

ASH congratulates Steve Brine for showing his commitment to tobacco control by getting the new Plan published only weeks after taking over as Public Health Minister. The vision of a “smokefree generation” it sets out is a welcome step change in ambition from the last Tobacco Control Plan for England and should be achievable by 2030.

Since stepping down as public health minister (he resigned in protest against a possible no deal withdrawal from the EU) Brine has continued to actively engage in tobacco control.

In March this year he ‘joined colleagues from across Parliament at a parliamentary event to celebrate No Smoking Day’ (MP commits to a smokefree future), saying:

“I worked closely with ASH when I was at the Department of Health and they have a fine pedigree of informing Government and helping us transition towards smoke free. We’ve done a lot in 50 years but, as ASK (sic) are well aware, we have a lot more to do starting with a new ambitious and deliverable SmokeFree England plan this Spring."

Most recently he responded to reports that (former) health secretary Thérèse Coffey might abandon the Government’s smoke-free target by arguing that it would be a “massive own goal”.

PS. As an aside and nothing to do with tobacco control, Nick Boles, a co-founder of Policy Exchange, was a staunch Remainer who quit the party in April 2019 and didn’t stand at the 2019 general election.

Now a footnote in history, Boles’ Wikipedia entry is worth reading if only for this:

He endorsed the Liberal Democrats in the 2019 election but then revealed that he had in fact voted for the Greens. During the 2022 local elections, he announced that he would be voted Labour and said that he had also done so in 1997.

Ladies and gentlemen, a thoroughly modern ‘Conservative’!

Update: Today’s business in the House of Commons includes a ‘debate’ on tobacco control:

Independent review of smokefree 2030 policies
Bob Blackman
Mary Kelly Foy

That this House has considered the recommendations of the Khan review: Making smoking obsolete, the independent review into smokefree 2030 policies, by Dr Javed Khan, published on 9 June 2022; and calls upon His Majesty’s Government to publish a new Tobacco Control Plan by the end of 2022, in order to deliver the smokefree 2030 ambition.

It’s official - turkeys DO vote for Christmas!

You couldn’t make it up.

According to a poll conducted by ASH and reported by Sky News among others, shopkeepers ‘support increasing the age for buying tobacco from 18 to 21 in the UK and introducing mandatory ID for under 25s’.

Furthermore:

When asked whether tobacco manufacturers should have to pay a government fee to support people quitting and avoiding smoking, 73% agreed that they should.

Against that, the same poll of 961 small tobacco retailers found that 51% said their overall profits are reliant on the revenue from tobacco products. Moreover:

Although most shopkeepers agreed that cigarettes themselves do not make much profit in comparison to other items, stocking it does help increase the chances of the customer buying additional products.

So let me get this right. We’re expected to believe that small shopkeepers, many struggling financially, are happy to reduce their potential customer base by supporting a ban on the sale of a legal product to adults aged 18-20 when over half admit that their overall profits are reliant on the revenue from tobacco products.

As for supporting a tobacco levy to ‘help’ people quit, was it pointed out to the shopkeepers that the reason previous governments have rejected the idea is because it’s well known that the cost would simply be passed on to the consumer, making cigarettes even more prohibitively expensive.

The knock on effect for retailers isn’t hard to guess.

One, they will either be forced to cut down or quit smoking or, two, more smokers will buy their cigarettes not from legitimate retailers but from the unregulated black market.

Either way retailers will lose revenue that could be the difference between staying in business or closing.

And on top of all that, we are led to believe that shopkeepers support mandatory ID for anyone under 25 (not 18 or 21 anymore) with all the hassle and retraining of staff that may entail.

In short, if we are to believe this poll, turkeys DO vote for Christmas!