Wednesday 6 August 2014

A fitting response

Chris Oakley, an occasional contributor to Liberal Vision and the Free Society, copied me in on his response to the government's plain packaging consultation last night and I liked it so much that I asked if I could post it here. He kindly said yes so here it is...

Do you, or the business or organisation you represent, have any direct or indirect links to, or receive funding from the tobacco industry? (required)


Do you have any observations about the report of the Chantler Review that you wish to bring to our attention? 

Chantler is not qualified to review a complex issue that extends beyond his immediate sphere of competence, is significantly and obviously biased and ignores evidence that contradicts his clearly partisan view. I have absolutely no confidence whatsoever in him. Subsequent to the review he has appeared on the BBC programme Burning Desires and demonstrated ignorance on the economics of smoking and its cost to the NHS. The Chantler review has a very narrow focus and is not objective. The DH runs the risk of being accused of misleading the public again if it continues to cherry pick evidence to suit ideologically preferred policies. 

Do you have any information, in particular any new or additional information since the 2012 consultation, relating to the wider aspects of standardised packaging that you wish to bring to our attention?

Dr Ashok Kaul and Dr Michael Wolf have analysed the impact of plain packaging to date on Australian youth smoking rates. The negative conclusions arrived at by highly qualified statisticians using data from a hopefully unimpeachable source have been ignored by the DH and Chantler in favour of weak data based on psychological models produced in many cases by people with a history of anti-tobacco and anti-industry activism.

Figures released by the Australian government show an increase in youth smoking of around 36% between 2010 and 2013. This data set includes a significant period after the packaging intervention in Australia. The data is not especially strong as it is based on a household survey but it is more robust than the public health estimates and assumptions that have been used to make the case for plain packaging.

To my knowledge, no hard data has been released on the growth of the illicit trade in Australia post intervention but anecdotal evidence courtesy of a national news broadcaster suggests that it is significant and Australian authorities are blaming the increase on the packaging legislation.

Further anecdotal evidence has circulated in the media suggesting that despite the airy assurances of tobacco control, those who produce and sell illicit tobacco products view the prospect of plain packaging as very positive in terms of their business potential. A great number of people and UK enforcement organisations agree with them and the DH would be failing in its duty if it ignores this argument and the attempts to deflect it through unpleasant ad hominem attacks by the tobacco control lobby. 

Do you have any comments on the draft regulations, including anything you want to draw to our attention on the practicalities of implementing the regulations as drafted?

As I completely disagree with this proposed legislation I can think of no way of improving it. Bearing in mind the psychobabble from the public health industry, the DH might want to consider the intellectual merits of an argument that seems to be based on a philosophy of reinforcing failure by shouting more loudly. The argument making warnings bigger, more noticeable and more graphic for example assumes that the current ones are having no impact because despite covering half the packs they are passing unnoticed. That is an utterly asinine notion that speaks volumes about the intellect of public health activists and their contempt for the intelligence of consumers. Personally speaking, if I were in government, I would be embarassed to be associated with such introspection, arrogance and intellectual incapacity. 

Are you aware of any further evidence or information which would improve the assumptions or estimates we have made in the consultation-stage impact assessment?
The impact assessment as it stands is utterly unsound, extremely subjective and untrustworthy. I have rarely read anything so overtly biased in favour of a policy and had I produced anything quite so lacking in objectivity within a commercial environment I would have rightly expected to be dismissed. I would expect standards in government to be even higher than those in industry but am often disappointed.

Throughout, the assessment relies on frequently nebulous poor quality research produced by self-styled public health experts. I contest that there is no such thing as a public health expert and question the objectivity of people who are producing evidence that supports policies that they are simultaneously lobbying for. The impact assessment relies heavily on Pechey et al 2013 to calculate potential impacts of the policy on smoking rates. Pechey et al were directly funded by the DH which is not good. However, what they produced is I am sure absolutely fine based on the evidence that they had. It is there that the problem lies. Pechey admits that their findings are based on subjective data produced by “experts”. I argue that however robust the Pechey methodology the fact is that the data it is based on is unreliable due to blatant author bias. A number of the authors involved are openly anti-industry or anti-tobacco and it is hard to imagine how they could possibly be objective about policies that they have campaigned for. The source data is unsafe and almost certainly heavily biased.

I am not alone in believing that the DH has hugely underestimated the potential effects on illicit trade and has been less than thorough in its assessment of the impact on SMBs. The assumption that loss in tobacco income for SMBs will be made up for by purchase of other goods for example is pure hypothesis that ignores for example the very real possibility that the other goods may be purchased elsewhere. The DH appears to have largely ignored the tobacco industry and for that matter virtually every other commercial source in performing its assessment. Favouring the views of Cyril Chantler over KPMG in a commercial context is an example of the lack of credibility that this introduces. Over reliance on sources such as the BMA, CRUK and The RCP is unsafe as none of these are expert bodies and all have vested interests. The BMA for example is a medical trade union and what it has to say about smoking uptake is inexpert and irrelevant. The RCP document referenced re the costs to the NHS of SHS impact on children relies entirely on multi layered estimates based on largely unjustifiable assumptions. It is not an expert analysis is not objective and has never been reviewed impartially. It is one of the most scientifically ridiculous documents I have ever read.

The most significantly flawed aspect of the impact assessment is the calculation of health benefits, which appears to be based on fantasy numbers that fail to take into account societal costs. No justification is provided for the figure of £60,000 per person year of extra longevity the policy might produce and it is hard to understand what possesses the DH to believe it can accurately monetise extra years of life, especially when quality of life cannot be taken into account. It is illogical to apply a fixed figure to longevity benefits that will obviously depend on age and state of health. If the DH insists on subjectively monetising longevity then it should at least distinguish between extra years gained for example for a productive 25 year old versus those gained for a 70 year old in poor health.

The only legitimate costs/benefit analysis within the context of a consultation such as this is a societal one in which the value of the extra years is calculated based on their contribution to society and offset by costs to society. Numerous studies have been performed in this area and the majority find that additional costs to society associated with risky behaviours such as smoking are more than offset by benefits such as fewer years in ill health, reduced pension provision etc. This is particularly true of smoking which has health impacts later in life when a person is more likely to be a beneficiary rather than a contributor to society.

The societal cost argument might be ethically challenging for the DH but does have the benefits of being quantifiable and being honest, two virtues sorely lacking in the current DH analysis. The DH may not like it but the evidence strongly supports the notion that smokers save society costs by dying young and relatively quickly. That does not mean that as a society, we should encourage smoking but failing to account for this in a financial analysis is unsound and could be construed as dishonest.

A major cost of the proposed intervention that the impact analysis fails to take into account is the time and money the DH will waste on future similar consultations should the anti-tobacco lobby be successful. The proposed legislation will be seen as a green light for every pressure group to campaign for similar measures against whatever industry it particularly dislikes. The potential costs are very significant.

The impact assessment as it stands is not sound, not objective and is not remotely credible. No legislation should ever be enacted based on work of such quality.

The consultation closes at 11.45 pm tomorrow (Thursday) so there's still time to give the government a piece of your mind. The details are here and you can send your e-mail to

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