Health fascism triumphant - liberty put into plain packs

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So there we are walking through Hull - I forget quite where but it doesn't matter - and, as was are wont, we were smoking. Anyway a young lad walks up to John de Forte waving a slightly scrunched fag.

"Gotta light mate?"  John looks at the child, snatches the cigarette from him and screws it up before throwing it to the ground where he stamped on it.

"Disgusting. Disgusting." Exclaimed John as he reached for his jacket pocket from which he brought out a packet of Capstan Full Strength. "That's not a cigarette. This is a cigarette."

That kid is either coughing his guts out on some council estate in Hull or else hasn't toughed tobacco since - kill or cure as John put it at the time. And the truth is that that child hadn't opted to smoke because of the shiny gold and silver packets. He smoked because his mum did or because all his mates did or because he thought it made him look tough.

Still the government has taken another step towards introducing plain packs for cigarettes. This is mostly because those nasty Labour people said we wouldn't do it not because it's a policy that has loads of public support. In the end it probably doesn't matter a great deal - smokers will go on smoking, kids will carry on trying a cigarette they nicked off their mum or a drag from the old brother.

Nevertheless the legions of health fascism will be raising their glasses of filtered water (or whatever it is that puritan teetotal fussbuckets drink these days) to Jane Ellison the Minister for Public Health. And this utterly illiberal measure - the stealing of someone's intellectual property for a supposed health benefit that simply doesn't exist. Put bluntly, plain packaging (rather like advertising bans and banning smoking in pubs) will not make a jot of different to either the prevalence of smoking or the propensity of children to take up smoking. There is precisely zero evidence showing that the suppression of brand advertising reduces aggregate consumption - whether we're talking about fags, booze or butterscotch.

The very worst thing about this is that we now have open season - every fussbucket with a cause (usually a state-funded cause) to plug will be out there calling for plain packaging for their chosen demon. Plain packs for booze, plain packs for burgers, plain packs for sugar...for sweets, for chocolate, for fizzy drinks...there really is no end to the things those hideous puritan teetotal fussbuckets don't want us to see. And stupid politicians - the ones like Jane Ellison with no spines - will skip around the health fascists cooing and purring because they're good at getting headlines on the BBC or in the Daily Mail.

It is depressing, sad and pathetic.

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I was right. Plain packaging doesn't reduce tobacco consumption.

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In March 2011 I wrote this:

My main concerns in all this – leaving aside the issue of personal rights – is that, if the aims are twofold: first to increase rates of smoking cessation and second to reduce rates of smoking adoption, then we are barking up the wrong tree. By way of illustration, between 2003 and 2005 all forms of tobacco advertising in the UK were banned. If the arguments for a ban were correct – less tobacco use and fewer tobacco users – we would have expected the rate of tobacco consumption to accelerate. However, the ban (like the smoking ban in public spaces) had no discernible impact on the long-standing decline in use.

In simple terms introducing plain packaging for cigarettes simply won't work (if the aim is to reduce tobacco consumption or smoking adoption). And it seems I was right:

Ronald Coase famously argued that if you tortured the data long enough they would confess. In this paper we have tortured the data, but there has been no confession. At best, we can determine the plain packaging policy introduced in December 2012 has not reduced household expenditure of tobacco once we control for price effects, or the long-term decline of tobacco expenditure, or even the latent attributes of the data.

To the contrary, we are able to find a suggestion that household expenditure of tobacco has, ceteris paribus, increased. In our forecasting exercise the actual data come close to breaking through the 80 per cent confidence interval. While we do not want to over-emphasise these results, we do conclude that any evidence to suggest that the plain packaging policy has reduced household expenditure on tobacco is simply lacking.

Now I'm sure the tobacco control folk will redouble their efforts - despite being completely wrong. But I hope one or two of them consider whether some different strategies might be more effective in reducing the consumption of tobacco and the adoption of smoking.

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"White Hat Bias" - fixing results to support what you think is righteous

When we look at research in public health fields - those matters relating to lifestyle choices especially - we often see what we suspect is a search for evidence to substantiate an ideologically-predetermined position. So, for example, the ideology decides that standardised packaging would be a way to reduce the uptake of smoking among the young and this is followed by a set of studies that appear to show just how much packaging influences the decisions of young people considering taking up smoking. Except that, when we pull these studies apart, we find that they show nothing beyond the (rather obvious) fact that people prefer attractive, bright colours to drab unattractive colours.

This is "white hat bias" - a term coined by US biostatistician Professor David Allison:

It was Professor Allison and Dr Mark Cope who coined the phrase in relation to obesity research. They defined it as: “bias leading to the distortion of information in the service of what may be perceived to be righteous ends”*

 

It seems to me that this problem is endemic in evidence-gathering for the development of public policy and especially social policy. Examples would include starting with the presumption that inequality is a negative indicator of health - there isn't any consistent evidence to support this contention yet is remains an assumption in healthcare planning and, in particular, planning around public health.

 

Alongside this prejudiced approach to evidence we also find the use of 'evidence' that is not supported by the facts -  so one of Bradford Council's public health consultants presents as 'fact' that, without further intervention, hazardous drinking will increase in the City. This ignores another fact - that alcohol consumption (especially among the young) has fallen significantly. It seems odd, given this change, to make an argument stating that 'hazardous' drinking will increase unless 'something is done'. We see an intelligent, well-informed man allowing his presumptions about health to run ahead of the actual evidence simply because he believes that drinking is something to be discouraged.

This problem would be fine if it wasn't the case that lay people can be easily dismissed when they challenge this 'white hat bias'. From sweeping statements such as 'we have evidence to support this from the literature' (I got that one when I challenged some facts), to simply ignoring the challenge and falling back on the logical fallacy of 'I'm the expert so I'm right'. We also get 'Macclesfield is in Greater Manchester' answers where the 'white hat bias' allows the person to simply ignore a fact. A good example here is the fact that consumption of non-dairy extrinsic sugars (that's all the sugar we add to stuff plus honey) has fallen significantly over the past 30 years. Meaning, of course, that sugar cannot be isolated as the guilty party in rising rates of obesity.

The problem of 'white hat bias' isn't limited to public health - I've seen it in work around regeneration, local economic development and retailing - but it is that case that such bias is now so ingrained in public health research as to cast doubts on the entire corpus. As the researchers at the University of Alabama pointed out:

UAB researchers examined ways in which scientists writing new research papers referenced two studies reporting the effects of sugar-sweetened beverages on body weight. They found that less than one-third of the papers that cited the beverage studies accurately reported the overall findings, and more than two-thirds exaggerated evidence that reducing sugar-sweetened drink consumption reduced weight or obesity. The UAB researchers also found several examples in breastfeeding studies in which the authors selectively included some data and discarded other research to support the theory that breastfeeding decreases the risk of obesity.

 And the result of this is that we get public policy initiatives that are not appropriate to the problem - plain packaging for cigarettes is unlikely (indeed one year on in Australia evidence now supports this argument) to make any difference to either the take up of smoking by teenagers or the overall consumption of tobacco. Yet the bias of researchers means that the only studies considered are those limited, qualitative studies showing that kids like bright colours.

The same problem can be seen with policies to limit or control fast food takeaways despite there being little or no evidence linking fast food to obesity. However, we still get Councils pushing through planning controls (banning takeaways near schools, for example) that won't change anything. 

We went through a time when 'evidence-based policy-making' was all the rage. What we should now realise is (as those cultural studies students could have told you from the start) that scientists and researchers wedded to a particular position will be selective in their interpretation and presentation of evidence so as to provide support for that position. 

 

The researchers who coined the phrase 'white hat bias' should be commended for their efforts and for the warning. But I fear it will fall on stony ground - the ideologues of public health are simply uninterested in any evidence that questions or contradicts their prejudged policy prescriptions.

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More crime, more smokers, fewer jobs - hey let's do it! The story of plain packs for cigarettes.

I heard an interview on the radio about plain packs for cigarettes. The public health doctor being interviewed (I forget his name, they all blur into one hideous nannying blob in my mind) explained that it's a wonderful idea - lot's of words like'colours', 'cool', 'shiny' and 'children' were uttered capped off with the killer line, something like:

"...these are used to make people choose a particular brand."

That was it, a statement of advertising truth - it's about brand choice not product choice. And this is the basis for introducing plain packaging. There is absolutely no evidence at all that supports the idea that the shininess or otherwise of the packaging is the crucial factor in some thirteen-year-old's decision to try a fag. Indeed, if you think about this for a minute or two (especially if you were once that thirteen-year-old), you'll know it's nonsense. Of all the myriad reasons for someone starting to smoke, "it's in a gold pack" or "the pack is all pink and girly, I have to smoke" are such vanishingly small reasons as to be irrelevant.

But that doesn't stop them:

The policy – designed to make smoking less appealing to young people — appeared to have been put on hold four months ago. But Government sources indicated that ministers had decided to implement the scheme after an outcry from doctors and the Opposition.

I'm guessing that the last two words in that quote are the crucial ones - we're having a review because the government want to close off another line of criticism from Labour. This is despite what evidence we have showing what an utterly stupid and ineffective policy 'standardised packs' is:

...the accountancy firm KPMG released a report on 4 November, which highlighted how the Australian government has lost $1 billion Australian dollars in the 12 months ended in June, as a consequence of the vast jump in black market sales of cigarettes.

There was also a rise of 154 per cent in sales of manufactured counterfeit cigarettes and fake brands (known as ‘illicit whites’). One of these is called Manchester; it has a market share of 1.4 per cent, which is staggering considering they are illegal. In terms of total shipments, illicit sales of cigarettes have increased from 1.5 per cent to 13.3 per cent. And most significantly – cigarette consumption has not changed.

So there you go - these public health idiots and a ministerial class more bothered by headlines than whether a policy works propose an idea that will increase crime, cost jobs and, at best, have no effect at all on rates of smoking. It makes me want to scream - partly because these idiots still don't understand brand marketing (or even bother to ask people who do understand brand marketing what they think) but mostly because this is policy-making based on prejudice masquerading as science.

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Smoking and advertising - some hints why plain packs won't cut smoking rates

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For many years I've been carefully pointing out to people that advertising for cigarettes doesn't work the way they think it works. The "they wouldn't do it if it didn't work" argument is entirely true. It's just that what you think "works" means in this context isn't the same as what us marketers mean by "works".

The truth is that there's almost no relationship between the amount of advertising and marketing spend on cigarettes and the quantity sold. The advertising is targeted at the smoker not the non-smoker and aims to get that smoker to prefer one brand over another. This preference allows for the marketer to get a bigger margin because the consumer's choice set is limited by that advertising. Incidentally the same goes for soap powder, dog food and lemonade.

By way of proving this, here's US ad spend on cigarettes set against cigarette sales:

As you can see here there isn't any connection at all between advertising spend and cigarette sales - the advertising bans and restrictions have all been "shoot the messenger" campaigns made worse by the fact that the messenger wasn't talking to children or indeed any non-smoker but to smokers.

These facts suggest to me that introducing plain packaging for cigarettes will be just as pointless, just as ineffective. Inconvenience, annoyance and the further ostracising of the smoker will result but it won't make a jot of difference to either take up or consumption of cigarettes.

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...in which we are reminded that plain packs won't stop people smoking

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These proposals come from people who neither understand brands nor appreciate the point or purpose of marketing. As I wrote a while ago:

...brands do not act to recruit customers to a given product – we choose to buy the product and then we select the brand. Nobody starts buying bread because they saw a Warburton’s ad – they buy bread because, well, they want bread! What the brand provides is a heuristic – a short cut, if you will – allowing the consumer to make a choice quickly and confidently. What we do know is that it is the search for a benefit that makes consumers choose to buy a product rather than the shininess of the brand presentation.  Or is you prefer: we buy bread because we want to eat it not because the advert featured a brass band playing chunks from the New World Symphony!

So I was pleased -although not surprised - to see this view confirmed by a branding expert:

...the notion that selling cigarettes in logo-free dull green packages will deter smokers fails to take into account both human nature and the way brands work.

Advocate of plain packaging believe that smokers and aspiring smokers will be repelled by unattractive plain packages.  I doubt that this will have much effect. Nobody smokes because the packages are cool; people start smoking because smoking is cool – at least in their eyes.

You the problem is that the anti-tobacco lobby - rather like Naomi Klein - haven't the first idea about brands, advertising or the point of marketing. They - like most non-marketers - confuse 'marketing' and 'selling' assuming that the two words are interchangeable, that 'marketing' is merely a posh word for 'selling'. And they are wrong.

The result of this isn't better public health, it isn't the incipient collapse of the tobacco industry (perhaps the anti-smoking lot might care to visit Peru or Afghanistan to look at the growing of coca and opium poppies) - what we get is job losses, businesses closing, a new criminal class of smugglers and no further progress in reducing the harm caused by smoking. As Andrew Hennigan, who I quote above, concludes:

Reducing the number of people smoking and, most importantly, the number of young people starting is a key public health goal, but I fear that we need to find some other solution than plain packaging...

Perhaps shifting from denormalisation to harm reduction might be a start?

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Now about that cigarette smuggling that isn't increasing...

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...now it's starting to grow in Bradford too:

The amount of black market cigarettes smoked on Bradford streets has more than doubled in only one year, claim tobacco industry investigators who raided the city’s bins to gather their evidence.

One-in-five discarded packets were for smuggled cigarettes or were fake brands manufactured for illegal sale – a 100 per cent increase on the results of a similar survey in 2011 which put the figure at 9.5 per cent.

And of course more price increases and plain packs will stop this!

Mind you Labour Councillor Val Slater seems happy to see a load of the folk who elect her lose their jobs - cigarette packaging employs over 1000 people in South Bradford:
 

The tobacco industry claims Government plans to insist on plain packaging for cigarettes without any complicated logos or artwork will only make things easier for the crooks and gangsters without altering smoking trends.

But Bradford councillor Val Slater (Lab, Royds) who chairs West Yorkshire Trading Standards Committee said she doubted that claim: “Personally, I can’t see the logic of that argument, because obviously the criminals are perfectly able to copy what’s out there at the moment,”

The point is Val that plain packs make it even easier and even cheaper to copy. Or did that bit of logic pass you by?

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More livelihoods that plain packs will destroy...

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Corner shops are going to close and people who work in corner shops are going to lose their jobs if the nannying fussbuckets get their way:

Almost one in 12 independent corner shops could be at risk of closure or reducing staff due to tobacco smuggling and cross-border shopping, a survey revealed today.

The findings, published by the Tobacco Retailers Alliance (TRA), show that almost eight per cent of shop owners were considering ceasing trading directly due to a rise in the sale of illegal and counterfeit cigarettes.

A further 26 per cent of the businesses questioned in Yorkshire and Humber admitted they were contemplating cutting staff as a result of a decline in tobacco sales.

But I guess the New Puritans and prohibitionists don't care. They will crow and cheer at the demise of these jobs and the closure of these businesses. Another nail in the coffin of community banged in by the righteous and their desire to pass judgement on our personal choices.

It won't stop the smoking of course. That'll carry on, supplied by the man with a van. Unlicensed, unregulated, unchecked and uncaring. He's there already - nearly half of the top twenty "tax dodgers" named by the Mirror are wanted for dodging duty - millions of pounds of duty - on cigarettes. And just as we won't be winning the war on drugs any time soon, we won't be stopping the man with the van selling smuggled fags and illicit booze. It's only a matter of time before he's selling burgers I guess!

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The public aren't so keen on nannying fussbucketry after all!

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A little glimmer of hope. A small break in the dark New Puritan clouds. It seems that the British public - or a large proportion of it - aren't so very keen on nanny:

There is little support for nannying.  Asked if Government should provide advice on what foods to eat and how much to drink, 48 per cent disagree and only 22 per cent agree.

I'm guess that the fussbuckets will carry on - after all they know so much better. Shame then that that British public rather doubts that they do:

Asked if politicians and civil servants are well-equipped to make personal decisions on their behalf, nearly two out of three Britons (65 per cent) disagree, versus only 9 per cent who agree.

Perhaps, in the light of these findings the Church of Public Health will back off a little especially given that the good old British public things their latest wheeze, plain packs for fags, won't work and is an imposition.

Just a quarter of people in the UK (28 per cent) think that selling cigarettes in plain packaging would discourage younger people from taking up smoking, the stance that health organisations are currently taking to push the law in this territory. Only 25 per cent of smokers agree that plain packs would put children off trying cigarettes.

And all the evidence suggests that the British public have got it right.

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The police, the unions, business and the public think it daft. Can we ditch the idea of plain packs for fags now?

It seems that everyone bar the paid lackeys of The Churchof Public Health is against the idea of plain packaging for cigarettes.

The police:

Health Secretary Andrew ­Lansley’s plans to force ­cigarettes to be sold in plain packets have been blasted by police.

Nearly nine out of 10 officers – 86 per cent – believe the move will lead to a rise in smuggling and sales of fake ­cigarettes, a poll claimed yesterday.

The findings also show that six out of 10 believe that the clampdown would drive teenagers towards illegal ­cigarette suppliers where they could buy counterfeit branded packs.

And senior officers make clear the problem – 24 of them wrote to the Times about it:

Sir, Plain packaging risks fuelling tobacco smuggling. We are concerned at the possibility of the Government introducing standardised packaging of tobacco products. We do not wish to get involved in the public health debate. However, our concern is very much on the impact that it could have on crime and in particular on serious organised criminals who are the target of the major law enforcement agencies.

Tobacco products are relatively small, high-value items and are smuggled in extremely large quantities, depriving the Treasury of billions of pounds in tax revenues. Those who smuggle tobacco products are often involved in other forms of serious criminality. The introduction of standardised packaging would make it even easier for criminals to copy and sell these products to the unsuspecting public, including children. This would place further pressure on already stretched law enforcement agencies and at a time when the Government needs to secure much needed tax revenues.

To my thinking that ought to be enough but we can add trade union opposition – they’re worried about jobs (like I am since 1000 of those jobs are in Bradford):

The FDT National Committee has serious concerns that these measures are ill-thought through and not evidence based, and in some parts of our sector, particularly tobacco and alcohol, could simply make it much easier for criminals to sell (unregulated and untaxed) counterfeit and smuggled goods and thus have flow-on affects such as a significant impact on jobs in our sector.

And the packaging industry agrees:

A considerable amount of the business of both Weidenhammer and Chesapeake involves the printing of cigarette cartons for the export trade. At Wiedenhammer’s Bradford site a large proportion of the work involves the production of drums for loose tobacco and, if this business disappeared, then it is estimated that turnover would decrease by at least a third. The threat to the business is, therefore, very real and...there would be major implications for investment, jobs and the tobacco packaging supply chain across the UK. 

So the police think it will increase crime and make it easier for children to get hold of tobacco; the unions and industry think it will result in job losses and the public? Well they think it’s a daft idea too:

72% of those questioned in Populus poll today say that #plainpacks will cause people to turn to the black market http://ow.ly/cqEgr

So there you have it folks – the police, the unions, business and the public all think plain packaging for cigarettes is a daft and counterproductive idea. Can we dump the idea now?

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