ASH Wednesday (part 2)

I didn't finish writing about the UK government's 'new' tobacco strategy last week (the strategy being to do whatever ASH say despite their appalling record of failure and broken promises).

Reading the government's Tobacco Control Plan 2011, the first thing that struck me was that it was identical in style and content to the numerous public health papers that came out in the Labour years. Now, obviously I didn't expect Andrew Lansley to write the thing himself but, seriously, it was indistinguishable. I would hazard a guess that the whole thing was the creation of ASH, Cancer Research and other "stake-holders" in collaboration with the same people from the Department of Health who were instrumental in dictating policy to the previous lot. And we know from the Dark Market e-mails how closely these groups like to work together.

The headline news is that the ludicrous display ban is to be brought in as planned and the bat-shit crazy plain packaging plan will probably follow. Why both should be required is a mystery. Common sense dictates that they both do the same job of shielding evil colours and fonts from the eyes of naive young consumers. Bring in one and you don't need the other. Still, ASH are "delighted".

Plain packaging is not yet a done deal. There is to be a public consultation. Perhaps it's started already, who would know? It's not as if they advertise these consultations to the public, but you can be sure those in the club are always kept well informed. We know how this process will work. The fake charities and the quangos will collect names by e-mail using state funds and the voices of private citizens will be expunged from the record. Like this guy said:

"It will come as no surprise to us if the Department of Health has funded organisations that provide the responses to consultations that the Government is looking for. The public are understandably cynical about the way Labour consults the public—it's time we had a Government that treats the public and their views with the respect they deserve.”

Those are the words of Andrew Lansley, speaking about the consultation for the display ban while he was in opposition. The same Andrew Lansley who has just given the green light to the display ban and has authorised another pretend consultation on a measure that even the Labour party seemed unsure about. Funny old game, politics, isn't it?

What is the evidence that any of this will further the government's arbitrary goal of reducing smoking prevalence to 18.5% by 2015? There is almost nothing to go on. ASH's "evidence" that plain-packaging had public support was such a pathetic concoction of wishful thinking that even they seemed embarrassed by it and resorted to getting Martin Dockrell to launch it on a left-wing blog. Every media outlet, including the BBC, ignored their what-if survey.

A few countries have tried the display ban but there has been no effect on the smoking rate. Evidence from Canada and Ireland suggests that it has increased both smuggling and youth smoking. No one's tried plain packaging.

But evidence just doesn't come into it. It's about being a world leader at the lowest possible cost and that's something that's always attracted politicians to tobacco control. It's cheap and you can look like a tough guy for a day. We'll try anything now. England has been sprung into the position of having Californians pointing and laughing at us for a change. How very embarrassing. We are now the test bunnies for moral entrepreneurs everywhere. We are in the do-anything business. It's as if the anti-smoking lobby is throwing anything and everything out there before they start being judged on results.

And time is running out. Even in their line of work, you cannot keep making promises and failing to deliver indefinitely. This, from the BBC's report on the plans:

A fifth of adults smoke - a figure which has remained steady in recent years after decades of rapid falls.

Every other report made a similar point but failed to grasp its significance. Before 2007, Britain had almost nothing in the way of anti-smoking legislation. There were no graphic warnings on packs. You could smoke at 16. You could smoke in a pub, in an office, in a nightclub—pretty much anywhere so long as the owner of those private premises agreed. Taxes went up every year and there were no cigarette advertisements, but that was about it. And then everything changed. The whole professional anti-smoking blueprint was unleashed like a flood. It was never out of the news.

And what happened? Smoking rates suddenly stopped falling after dropping for many years. For the first time since they were behind the bike sheds, smokers weren't just people who smoked. They were an identifiable community. The government was turning the act of lighting a cigarette into an act of defiance once more.

If you inclined to such theorizing, you might go even further and say that, in its small way, smoking is becoming—and with these new policies will become more so—a political act. It's certainly a more effective political act than voting these days. As this policy document makes crystal clear, voting changes nothing when it comes to public health legislation. Nothing could make this more apparent than the fact that both Tories and Lib Dems opposed the display ban in opposition and then pushed it through in power.

Public health rolls on regardless of which government is in charge. If you want to see what legislation will come about this decade you only have to look at the list of what legislation they want to come about (12 Steps to Better Public Health).

Does it not seem perverse and strange that all three parties are behind measures which are widely derided by the public? The most common response I've encountered to both the display ban and plain packaging is a tut, a shake of the head and perhaps a swear-word. Even the BBC's coverage could not disguise the fact that most of the population thinks these schemes fall somewhere between stupid, pointless and loopy. How can it be that the majority of people who think these ideas are barmy have to vote for minority parties if they want to voice their democratic disapproval? Has something not gone badly awry in the political class when this happens, and happens so often?

Yay-sayers are quick to point out that none of this prevents people buying cigarettes. It will be a major cost and inconvenience to shop-keepers, of course, and that is deplorable, but the consumer goes untouched. This is true. In a way, we should be thankful that the anti-tobacco industry has found a way of attracting derision without penalising smokers more directly.

But this misses the point. Regardless of who is being directly penalised here, I don't want a government that treats its people with such contempt that they think we cannot see some cigarettes without wanting to buy them. I don't want to live in a country where a product consumed by millions of ordinary people is sold in Soviet grey behind curtains and boards with a nudge and a whisper. Nor do I want to live in a country where those same millions are denormalised by people who are anything but normal themselves.

It is an absolute racing certainty that the temperance movement will demand graphic warnings and plain packaging on alcohol in the fullness of time. It would be not just inconsistent but hypocritical to do otherwise, and surely we no longer have to demonstrate that the slippery slope exists.

The most plausible reason for Lansley's headlong into anti-tobacco extremism—as hinted at elsewhere—is his desire to throw the neo-prohibitionists a bone in the area of smoking while disappointing them in the area of drinking. In the last few days, he'll have noticed that such a policy doesn't work. The neo-pros' attempts to undermine the government on drinking will have shown him that they always bite the hand that feeds it. This should be a lesson learned for the coalition. No matter they do, the prohibitionist beast will keep howling. You might as well starve it instead.


UPDATE: Somewhat related from Prime Minister's Questions today:

For me, the significant moment was Mr Cameron’s response when Mr Miliband reminded him that the British Medical Association has criticised Coalition health plans.

The PM’s response was agressive, a full-frontal attack on the BMA as just another trade union opposing public sector reform.

The BMA opposed foundation hospitals, longer GP opening hours and every others significant reform of recent years, Mr Cameron said.

Mr Miliband couldn’t resist backing the BMA because he instinctively sides with the sectional interests of organised labour, the PM said:

“Just as he has to back every other trade union, he comes here and reads a BMA press release.”

The attack on the BMA reflects ministers’ private anger at the doctors. Aware of the public standing of the medical profession and the central role GPs will take in a reformed NHS, Coalition criticism of the BMA has so far been muted. Does Mr Cameron’s flash of anger signal a new willingness to take on the doctors?