Plain packs, e-cig bans and the triumph of ignorance

Today marks the publication of the Chantler Review into standardised packaging for cigarettes, which follows the proposal from the Welsh government to ban the use of electronic cigarettes in enclosed public spaces. I haven't read the whole of Chantler's review but it's summary contains the observation that:

There is very strong evidence that exposure to tobacco advertising and promotion increases the likelihood of children taking up smoking. 

We know that advertising does not act to raise demand both generally and specifically for products such as cigarettes. So I have to assume that the 'evidence' relied on by Chantler is primarily the qualitative studies undertaken by tobacco control researchers that essentially show how children prefer pretty colours to drab colours. This may be true but there's a leap from 'I like pink' to 'I'll start smoking because I like the pink pack' that simply doesn't have evidential support.

Chris Snowden points out that Chantler finds only a 'moderate' impact on uptake - something that would be very difficult to prove one way or another especially since advertising (even where it is still permitted) has only a marginal impact on the decision of a person to experiment with smoking. More importantly Chantler says that this impact will only be realised 'over time' creating more vagueness and imprecision. I remain unconvinced that this is the best option for public intervention if our aim is either (or both) to reduce levels of smoking adoption or increase rates of smoking cessation.

Indeed, if the evidence is right that it is the person's environment (do parents, other family members and peers smoke) that plays the dominant role in the decision to experiment with smoking then the emphasis should be on smoking cessation rather than smoking adoption. And this brings us to the proposal in Wales to apply the same restrictions to using electronic cigarettes as apply to smoking tobacco.

The Welsh health minister, Mark Drakeford, said officials were considering a ban amid concerns that the products could "re-normalise" the use of conventional cigarettes.

He said there were also concerns that their spread could undermine the ban on tobacco smoking in enclosed public spaces, making it more difficult to enforce.

This is a truly egregious proposal since we know that electronic cigarettes are widely adopted by smokers to either quit or reduce their use of tobacco and that they eliminate nearly all the personal as well as all the environmental risks associated with smoking tobacco. Worse still, the argument made here contradicts the rationale for the smoking ban - protecting the health of others in the smoking environment.

Since we want fewer smokers then we should be supporting the adoption of electronic cigarettes by current smokers. Not just to benefit the health of those smokers but to reduce the probability of their children, brothers, sisters and friends taking up the habit. By seeking to denormalise electronic cigarettes, the Welsh government is describing the devices as no different from tobacco with the result that children are as likely to adopt the latter as the former. Plus, of course, increasing the likelihood that the vaper will switch back to tobacco - a point succinctly put by Tim Stanley:

Force me to stand outside and I’ll calculate that I may as well go back to the Marlboro Lights.

Although these proposals are filled with analysis and wrapped up in stuff that looks like science, they are at best selective and at worst simply ignorant. In the case of packaging, the review relies on studies by non-marketers working in tobacco control research and completely ignores the substantial body of research evidence on the role and effectiveness of brand advertising. And for electronic cigarettes, the assumption is that they will act as some sort of gateway for tobacco rather than (as the evidence suggests) quite the reverse.

It does seem that what we have here isn't an example of good evidence-based policy but rather a victory for anti-smoking obsession and a triumph of ignorance.

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