THE POISON GARDEN website       

Monday 16th April 2012

Though it has been long-trailed, today is officially the start of a government consultation about forcing tobacco companies to use plain packaging on cigarettes and their other products.

In the past couple of weeks, I’ve been spotting a number of stories about this and other aspects of tobacco control so this seems like the right time to run through some of them.

The pro-smoking organisation Forest (Freedom Organisation for the Right to Enjoy Smoking Tobacco) has established a separate website for its campaign against plain packs. Though I disagree with what Forest stands for I have to congratulate them for being open about the fact that their funding comes from the tobacco industry.¹ There are other lobby groups and think tanks that would do well to be as open.

Nicotiana, tobacco

The Institute of Economic Affairs (IEA), for example, is known to have received tobacco company funding in the past but refuses to say whether it still does so. The IEA came to attention because its director, Mark Littlewood, has been asked to join a government initiative looking at ways to reduce ‘red tape’ for business. The Independent² reported concerns that he might be able to influence government policy on plain packs.

I have not found anything to suggest that Mark Field MP has any connection with the tobacco industry so his opposition to plain packaging has to be accepted as the matter of principle3 he declares it to be. The thrust of his argument seems to be that, though he accepts the harm tobacco does and believes young people should be discouraged from starting to smoke;

‘…I also believe passionately in freedom of choice; the decision whether or not to smoke should remain that of the informed adult, without gratuitous interference from the State.’

This libertarian view appears to be less than universal as he supported the introduction of ‘Temporary Class Drug Orders (TCDO)’ in March 2011.⁴

Aside from the personal freedom issues, which have been used in every campaign against every tobacco control measure and are, therefore, unlikely to have much impact this time, the main thrust of objectors seems to be that there is no evidence that plain packaging will have any impact on sales. It would be easy to ask why, if it is not going to affect sales, the tobacco industry is investing in the fight against its introduction? The industry, as it did with moves against advertising, argues that individual companies are only interested in protecting market share and they are not trying to increase the overall size of the market.

It may be possible to argue that there is no evidence that plain packs will reduce sales but it is not possible to deny the evidence that the right pack design increases sales. There is a wealth of evidence from marketing academics, much of it directly related to tobacco products proving that what is on the pack has a significant impact on a potential buyer’s impression of the product.

Nicotiana, tobacco

In Australia, the first country to introduce plain packs, a lot of work has been done and this report from Cancer Council Victoria⁵ provides a detailed review of the evidence. It offers 138 references including findings from tobacco industry documents about the impact of pack design.⁶ One of the difficulties in collecting direct evidence of the impact of plain packaging is that it is unethical to conduct trials that might encourage subjects to smoke more. Studies are, therefore, done on attitudes to packaging rather than the direct effects.⁷

My concern is that, in the same way that the new rules on retail displays in supermarkets have been subverted to make tobacco sales points more obvious, the tobacco companies will do their best to turn plain pack regulations to their advantage.

I’m not sure how the fight against plain packs will end but I was sure about the situation in the USA that I wrote about in November and February. As expected, the district judge who granted a temporary injunction preventing the introduction of larger, more graphic warning images on cigarette packs recently ruled them to be unconstitutional.⁸ That decision will be appealed.

In Australia, the campaign against plain packs focussed on the 'nanny state' aspect. An interesting piece on 'The Conversation'¹³ website points out the irony of this. 'Nanny state' was a term coined by British politician Iain Macleod, a heavy smoker who died at the age of 57. It came to prominence when repeatedly used by Auberon Waugh, a heavy smoker who died at the age of 61.

Also, the US Food and Drug Administration FDA is making further regulations⁹ under The Family Smoking Prevention and Tobacco Control Act. These will require manufacturers to provide the FDA with details of the twenty substances held to be harmful that can be found in tobacco products. Perhaps, because of the court proceedings on graphic images, the FDA is not saying that packs must detail the contents but it intends to collate the information and make it available to the public.

Though most of the attention is focussed on the harms caused to smokers from tobacco, I’ve also been reading a number of items about the risks in cultivating Nicotiana tabacum.

In May 2011, a South African newspaper carried a story about child labour in Malawi in the tobacco industry and the serious illness arising from it.¹⁰ It reports a high incidence of Green Tobacco Sickness (GTS)^11,12 where non-smoking agricultural workers are found to have levels of nicotine and other harmful chemicals equivalent to those found in the heaviest of smokers.

In 2008, then Columbian Vice-President, Francisco Santos Calderon, who is now President of that country, tried to make cocaine users in the west area of the harm being done in his country in the production of the substance whose criminal use is often characterised as ‘victimless’. That approach didn’t seem to have any impact on the use of cocaine so I don’t suppose that awareness of the harm being done to children and adults involved in producing tobacco would make much difference to the majority of smokers.

References

^1.Plain Packs. About the Campaign
^2.The PM, his pro-smoking aide, and a dirty war over cigarette packaging. The Independent 13th March 2012 
^3.Mark Field MP: Plain packaging of cigarettes should be resisted as a matter of principle by all Conservatives.
^4.Voting Record — Mark Field MP, Cities of London and Westminster. The Public Whip.
^5.Plain packaging of cigarettes: a review of the evidence. Prepared by Quit, Cancer Council Victoria, April 2011
^6.The cigarette pack as image: new evidence from tobacco industry documents. Tob Control2002;11:i73-i80 doi:10.1136/tc.11.suppl_1.i73
^7.The evidence is in – plain cigarette packs turn young smokers off. The Conversation 24th May 2011
^8.Tobacco health labels unconstitutional: U.S. judge. Reuters February 29th 2012
^9.U.S. FDA: Big Tobacco must tell you what you're smoking. AlertNet/Reuters 30th March 2012
^10.Tobacco poisons Malawi's children. Mail & Guardian online 6th May 2011
^11.Health risks in tobacco farm workers—a review of the literature. Journal of Public Health Volume 15, Number 4, 255-264, DOI: 10.1007/s10389-007-0122-4
^12.Green Tobacco Sickness in Children and Adolescents. Public Health Rep. 2005 Nov-Dec; 120(6): 602–606.
^13.Nanny knows best: Why Big Tobacco’s attack on Mary Poppins ought to backfire. The Conversation 21 June 2011