It's Time to Leave the FCTC

Last week I came across this terrible, frightening article http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02720.x/full

I sent the following email to both authors explaining their errors and ignorance and thought some of you would like to read it and pass it on. No reply as of yet (I don't expect that to change either)

Dear Ms’ Gartner and McNeill,

I have just come across the paper “Options for global tobacco control beyond the Framework Convention in Tobacco Control” and have some comments, if I may.

Firstly, you state “Retail display bans and mandatory plain packaging of tobacco products are simple extensions of advertising bans. It is accepted widely that cigarette packs provide brand imagery, convey promotional messages, are displayed to maximize imagery and positioned at eye level in the most visible position in shops [1,2]. Restricting packaging and placement are accepted by the public for other products, such as ‘prescription only’ medications [3].”

Whilst this is true, the paper fails to note that prescription only medicines are visible at eye-level and in brightly coloured packages. Tobacco products are banned from advertising, so a display ban is not necessary. The simple fact is that tobacco is never not behind a counter, meaning children do not have access to it unless the shop proprietor is willing to break the law (in which case, a display ban is useless). Products being at eye-level is no conspiracy, it is simply so consumers are able to see what is available. Moreover, plain packaging and display bans will encourage criminal gangs. Tobacco smuggling is big business now and with plain packages it will be incredibly difficult to tell the difference between legitimate and illegal. There is also the risk that illicit tobacco contains unregulated ingredients that could cause any level of harm to the user. There is also proof that display bans increase youth smoking rates – see this link http://blog.iea.org.uk/?p=3468

Secondly, the paper says that “Many jurisdictions ban distracting activities while driving, such as using a mobile phone. Smoking while driving has been linked to traffic collisions [4], and a good case can be made that lighting a cigarette, smoking it and disposing of it are unnecessary distractions that increase risk [5] and expose other car occupants to high levels of second-hand smoke [6].”

Indeed, using a mobile phone has been banned, but only using a handset – it is not illegal to use a hands-free kit, with the premise being that both hands are free. Smoking permits both hands to be free to drive, as the smoker can place the cigarette in their mouth or the ashtray. Lighting and disposing require less time than initiating a phone call via a hands free kit, using satellite navigation equipment or changing the radio station – all of which are legal. It is also legal to eat and drink while driving, despite the fact both activities are far more distracting than smoking. If the driver unscrews a bottle lid and drops it, it will be a huge distraction as they will wonder what to do with the open vessel. Similarly, if they take a bite from a sandwich and spill the ingredients over themselves, they will be distracted. The paper also overlooks the very real psychological effects of not smoking. By that I mean that if a smoker has a long drive, the stress of not smoking will be a far greater distraction than the act of smoking itself. Psychological distractions will cause decreased awareness, while craving a cigarette can also trigger decreased awareness, as well as mild anxiety and stress, which could prompt the driver to drive less sensibly in order to get to the destination quicker or find somewhere to stop.
The other simple fact is that a car is one’s private possession, like a home. Banning smoking inside takes government interference a step too far and removes any degree of responsibility for the owner. While second-hand smoke exposure will be higher inside a car than outside a car, it is up to the passengers to decide if they think the risk is too great for them or not. Moreover, a smoking ban in cars would be blanket, meaning that even a single person with no children who only drives alone would still be banned from smoking.

Thirdly, “Adolescents' exposure to movies containing positive smoking scenes has been found to be associated with greater likelihood of smoking initiation [7]. Research also suggests that this effect can be reduced by screening anti-smoking counter advertising prior to these movies [8]. The net effect of these measures, in addition to those in the FCTC such as tax increases, is likely to be a slow but steady downward trend in smoking prevalence.”

This is a falsehood. Smoking rates were declining year on year until the smoking ban, at which point it increased. People will not stop smoking just because they are told to, in fact it will cause the opposite effect. Furthermore, increased taxes will not lower smoking rates but will merely drive trade towards the black market, causing economic problems, a strengthened criminal activity and the introduction of unregulated tobacco products. It should also be noted that while current measures mean children can only purchase cigarettes from licensed premises, criminal gangs will have no problem in pushing their products on the streets, in clubs and outside schools. I have made that last point bold because the enormity of it cannot be overstated.

Fourth, “However, more radical approaches need to be considered to achieve a faster impact on smoking prevalence and related harm. In this category we place: harm reduction with low nitrosamine smokeless tobacco (LNSLT) and/or high dose recreational clean nicotine products [9]; improving the regulatory structure [9]; restrictions on where tobacco can be sold and the number of outlets [10]; regulated market models, i.e. moving retail sales from the open market to a government controlled monopoly [11]; and smoker-licensing schemes that require smokers to obtain a licence to purchase a restricted quantity of tobacco always accompanied by advice as to its harmfulness [12].”

Why is smoker reduction so important? It is not a case of cost, because smokers pay into society far more than their estimated health costs withdraw. In a free society people are allowed to consume legal products and engage in risky activity. There is simply no reason to hound smokers or force them to quit. In this day and age, no one is ignorant to the risks or dangers, meaning each smoker made a conscious choice to smoke, in the same way that alcohol users choose to do so despite consuming a neurotoxin and risking alcohol poisoning or disease later in life. Unlike alcohol, tobacco does not make a person violent, nor are there ‘smoke driving accidents’ like there are drink driving accidents. Alcohol suffers no display ban nor packaging rules, indeed alcohol is promoted at exceptionally low prices, and not behind a counter where children are unable to reach it.

I await your response.