Monday, 7 April 2014

The Tobacco Control Scorecard: indisputable evidence of failure

Last week, the new Tobacco Control Scorecard (TCS) was published. You can download it here.

The TCS is the anti-smoking cabal's way of finding out whether governments have been naughty or nice. Anti-tobacco extremism scores highly while tolerance, sanity and the slightest deviation from tobakko kontrol orthodoxy places you on the naughty step.

The authors treat the whole thing with hilarious earnestness. You need to read the whole thing to get the flavour of it, but here is a sample...

Were this an exam with 51% needed to pass then 24 countries, almost 71% of the field, failed the exam – very disappointing. Their end-of-term report would undoubtedly say: “Must do better.” They urgently need to improve their tobacco control score in the next few years.

31. Czech Republic (27 ▼4). Tobacco control policy in the Czech Republic is set by the Ministry of Agriculture. There is a strong tobacco industry presence. For example all three Czech President have openly defended tobacco industry interests. The Czech Republic is one of the four countries who voted against the Tobacco Products Directive.

20. Slovenia (17 ▼3). No new initiatives, despite a positive attitude during the Tobacco Products Directive negotiations.

19. Romania (16 ▼3). Romania is one of the four countries who voted against the Tobacco Products Directive.

15. Italy (12 ▼3). No progress to report since 2005, disappointingly.

13. Netherlands (13 –). After a difficult time for tobacco control in the Netherlands, the current government is now supporting and implementing stronger tobacco control policy again, such as the reintroduction of smoke free bars in July 2014.

10. Ukraine (new) Ukraine recently introduced comprehensive smoke free legislation, advertising bans and pictorial health warnings. However, Ukraine also made a complaint against Australia's plain packaging law in the World Trade Organization.

As you may have noticed, a lot of this has got nothing to do with whether these countries are reducing their smoking rate but whether they toed the 'public health' line on the Tobacco Products Directive.

Ever since the Tobacco Control Scorecard began, the UK and Ireland have taken the top spots and this year was no different. Both countries get a pat on the head for proposing plain packaging and Ireland is thanked for helping to force through the EU Directive.

2. Ireland (2 –). Ireland introduced pictorial health warnings and might be the first country in Europe to adopt plain packaging legislation. The Irish Presidency was instrumental in forging a political agreement on the Tobacco Products Directive in June 2013.

1. United Kingdom (1 –). The United Kingdom remains number one and is doing well on five of the World Bank tobacco control policies, although spending on tobacco control has been reduced since 2010. The UK adopted legislation to ban tobacco displays at the point of sale and is considering the introduction of plain packaging legislation.

Rule, Brittania!

But whither Sweden? Where is the European country that has by far the lowest smoking rate? Alas, it still isn't a true believer. Sweden continues to allow bits of advertising, rejects graphic warnings, opposes plain packaging and - above all - allows the sale of snus (hence the low smoking rate. As none other than Simon Chapman admitted in 2007: "Sweden has attained the lowest prevalence of smoking among any nation, largely because of the major shift that has occurred from smoking to snus use in men"). And so it falls out of the top ten for the first time...

11. Sweden (9 ▼2). No significant progress to report since 2005. Surprisingly, given its distinguished tobacco control history, Sweden is often not in support of strong tobacco control measures at European and international level, such as plain packaging.

What more proof can be needed to show tobacco control's delusional state of mind than a league table that puts the country with the lowest smoking rate in mid-table, the country with the second highest smoking rate (Ireland) in second place and the country that hasn't seen a fall in its smoking rate since 2007 at the top of the pile?

If we graph the tobacco control scores against smoking rates (figures from the OECD), the anti-smoking lobby's idea of best practice is exposed as the fantasy it has always been.

You get the same result if you use the Eurobaromoter smoking figures. There is simply no correlation between adherence to the neo-prohibitionists' (cough) 'evidence-based policy' and lower smoking rates. None whatsoever.

When inputs so consistently fail to produce the expected outputs, you would expect a change of mindset, if not mass sackings. A movement that was genuinely interested in reducing smoking rates, rather than irritating the tobacco industry and hassling smokers, would look at the countries which have the lowest prevalence levels and emulate them. Instead, they construct a ludicrous league table to cover their blushes.

I've said it before and I'll say it again: tobacco control is not a results-driven business. We urgently need an independent audit of the anti-smoker racket so politicians can see what they've got for the money - our money - they've been spending all these years.


In response to questions in the comments, I should clarify that the scores are based on what policies are in force. Countries do not actually get scored down for not supporting the TPD or for not having done anything recently.

The criteria are: price of cigarettes (30 points), extent of smoking ban (22 points), spending on tobacco control (15 points), extent of advertising ban (13 points), size of health warnings (7 points), use of graphic warnings (3 points), and extent of cessation services (including whether government gives away NRT for free - 10 points).


Eric Crampton said...

Fun stuff.

If I'm reading this right, the scorecard is more about "what have you done lately" than absolute levels of stringency. If the scorecard is on changes, then you might want to have changes in smoking prevalence on the y-axis. Don't know if it would make any difference to results.

Fredrik Eich said...

I would add that the effectiveness of tobacco control on lung cancer rates is also questionable.
Plenty of those countries seem to have been dealing with their lung cancer epidemics with out the help of decades of anti-smoking activity and including countries that continued with high smoking prevelence eg Ukraine and Russia.

Chris Price said...

The UK is top of the league - a country where there were half a million more smokers in 2013 than in 2008. I must have read the results incorrectly: total failure means you win?

nisakiman said...

Well I'm gratified to see that Greece is shown on your chart as having the highest smoking prevalence and one of the lowest scores.

In fact you could probably 'reverse-engineer' that study to get a good idea of the countries in which there is the highest degree of personal freedom.

James In Footscray said...

In the UK 'spending on tobacco control has been reduced since 2010'.

Love it - success is measured by how much is spent!

On a serious note, success could also be measured by the rate of decline. But they don't look at that either.

Christopher Snowdon said...


Good question. See update above.

MJR Peel said...

Anti-smoking Nazis patting themselves on the back is one of the most sickening things about these ghastly people.

BrianB said...

It's a useful document for those of us who are planning holidays in Europe, though!

It so happens that we have already booked our main holiday for 2014, and it involves stays in Germany, Austria and Czech republic ...

... that'll be rankings 33,34 and 31 out of 34 then. Seems like we made a good choice!

On a more serious note, though, I now have a list of countries to help me decide where to go and live now that I have reached the point where I am desperate to leave this vile socialist hell-hole of a country and it's weird "let's pat ourselves on the back for being the most smoker hating" mentality.

Off to check property prices in Innsbruck, now.

Jean Granville said...

It's a "do something" classification. About as rational as religious processions during great plagues.