Undone by the facts once more

In yesterday's post I quoted the say-anything anti-tobacco shill Martin Dockrell (of ASH, natch) saying:

"By helping smokers who want to quit and protecting our children from the tobacco ad men this will be an enormous leap forward for public health, perhaps even bigger than the smoking ban," he said.

He was talking about the crazy plain-packaging ruse, but he would have said the same thing whatever the policy was. Fair enough, that's his job. If he weighed up the pro's and con's of each policy and then gave a reasoned and intelligent assessment, he'd soon find himself in a smokefree Jobcentre.

But by saying that plain-packaging could be an "even bigger" leap forward for public health than the smoking ban, he is clearly suggesting that the smoking ban was itself a leap forward. This is frequently stated by all sorts of people, and it is often assumed that the smoking ban led to a surge in people giving up smoking. But has it?

"Encouraging" smokers to give up was, of course, the true (and barely concealed) motive for bringing in the ban in the first place and woe betide anyone who cast doubt on whether this would really happen back in July 2007. In ASH's hilariously premature and ill-founded Myths and Realities of a Smokefree England document (which I wrote about at t'old place) they said that the idea that mass abstinence wouldn't happen was a "myth".

We haven't heard much about smoking prevalence since (the statistics for such thing are always slow in coming forth), so I'm grateful to regular reader Dave Atherton for sending me the Office of National Statistics' Life Style Survey 2008 (published 2010), which concludes:

The overall prevalence of smoking among the adult population was the same in 2008 as it was in 2007 at 21 per cent.

A similar phenomenon was found by the EU's Eurobarometer which found the UK's total proportion of smokers (all forms of tobacco) to be 28% in 2009, which is—again—exactly the same as it was in 2008.

And all after the biggest, most controversial, most costly and most socially divisive piece of tobacco regulation in British history. Good work guys. Have the rest of the day off.

The other thing the ONS's report shows is something that Dick Puddlecote and I often point out—drinking is not on the increase in the UK:

Following an increase between 1998 and 2000, there has been a decline since 2002 in the proportion of men drinking more than 21 units a week, on average, and in the proportion of women drinking more than 14 units 

That's yer "hazardous" consumption. This is overall consumption:

The average number of units of alcohol consumed in a week rose steadily in the 1990s and achieved a peak of around 17 units for men and 7.5 units for women in the period 2000 to 2002. These levels fell to 14.8 units for men and 6.2 units for women in 2006. The revised methodology shows that the average number of units consumed is continuing to fall from 18.7 for men and 9.0 for women in 2006 to 16.7 and 8.4 respectively in 2008.

So, to summarise:

• Rates of drinking are falling and have been for years

• The smoking ban had no impact on the number of people who smoked, unless by "impact" you mean "put an end to a ten-year decline"

I mention this just in case any journalists or single-issue activists accidentally give you completely the opposite impression.


(Coming up in your soaraway British Medical Journal next week: '"The smoking rate plummetted after the smoking ban and our computer can prove it", says Professor Anna Gilmore and Professor Jill Pell'.)

Share

Tweet

US smoking rate rises for the first time since 1994

Now that more than half of America is covered by smoking bans, could it be that the US is experiencing the curse of the smoking ban? From The Washington Times:

Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials' hopes that the U.S. smoking rate had moved permanently below 20 percent.

As with Ireland, where smoking rates have soared despite being the "world-leader" in tobacco control, advocates are putting their faith in still higher cigarette taxes.

Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. Perhaps the recession will have an impact, too.

"In general, when people have less money, they smoke less," Dr. Frieden said. "Time will tell."

So it is often said, but where is the evidence? Is it not the case that the poor smoke more than the rich? Even if it were true that people smoke less during recessions, it is not the amount people smoke that matters here, but the number of people smoking. The economic depression of the 1930s didn't see a fall in smoking prevalence. It saw quite the reverse. 

Evidence that recessions significantly affect smoking prevalence is thin on the ground, as is evidence that tax hikes make a major difference. There are examples of tax rises reducing prevalence (England in the 1940s, America in the early 1980s) but there are more examples of them making no difference or backfiring (America in the early 1990s, Ireland recently).

It's too early to say whether this (small) rise in US smoking prevalence is the start of an upward trend. It may be that the 2007 decline (from 21% to 19.8%) was a blip and that smoking rates have essentially been static in America for the last 5 years.

More interesting, I think, is how these statistics are generated. Always based on surveys, the figures very much depend on what questions are asked. The European journal Public Health has recently published a ground-breaking study which compares the Centers for Disease Control's surveys with those of the National Survey on Drug Use and Health. As co-author Brad Rodu explains on his excellent blog, there is a very significant discrepancy between the two.

In contrast to the decline reported by the CDC, we found evidence from another federal source that the number of adult smokers in the U.S. has been stable for about a decade. In 2005, for example, the CDC estimate was 45.1 million smokers; our analysis revealed that number could be as high as 54.2 million.

You would think that collating data for smoking prevalence would be fairly simple, wouldn't you? A simple yes/no question. But as Brad shows, nothing in tobacco control is ever simple and if the National Survey on Drug Use and Health is correct, the smoking rate has not fallen at all since 1998. Go read.

Share

Tweet

That's one way of putting it

Under the headline 'Early introduction of ban does little to reduce smoking rates', The Irish Times has reported that... 

More people continue to smoke in the Republic than in Northern Ireland, despite the earlier introduction of the smoking ban here, according to new research.

The One Island – One Lifestyle? report, which compares the health of individuals living on both sides of the Border, shows the introduction of the workplace smoking ban in the Republic in 2004 has done little to reduce overall smoking rates.

Done little? That's one way of putting it. A more accurate way of putting it would be to say that smoking rates have increased since the ban, as the same newspaper reported last year:

The number of people who said they were smokers fell from 33 per cent in 1998 to 27 per cent in 2002 but increased to 29 per cent last year

Using the post hoc ergo propter hoc logic so beloved of researchers when heart attacks are being counted, one might even say that the smoking ban "caused" more people to smoke. I wouldn't subscribe to that logic, but it is clear that the smoking rate was falling significantly before the smoking ban and has risen since.

It is interesting to note that there was also a significant fall in the smoking rate in Northern Ireland before the ban as well.

The effects of the workplace ban in the North have yet to be assessed, but the percentage of smokers there fell 6 per cent from 32 per cent in 2003 to 26 per cent in 2005.

We shall see whether this fall continues after 2007 or whether the curse of the smoking ban will hit the Irish North of the border too.

Share

Tweet