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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Sunday 8th September 2013

I don’t agree with the apparent general consensus that MPs are either stupid or just in it for the money, or both. But, after last week, I’m close to revising my position on the issue.

My attention was directed to this transcript on the They Work for You site of this debate in Westminster Hall. It concerns plain packaging of tobacco products and reading a number of the contributions it is hard not to think that the MPs understand very little of the issue or they understand only what they are told by some lobby group or other.

In fairness, I should add that some of them may be easily blinded by concerns for constituents where a great number are employed in the tobacco industry. I remember, long ago, hearing someone set out a deeply held belief that manufacturing in Asia was not the way for a business to go only to discover that the exponent of the argument worked in UK manufacturing and his job was at risk.

There were claims that plain packs would lead to more counterfeiting, that plain packs would be more attractive, that advocates of plain packs were really in favour of outlawing tobacco altogether, that those advocating controls on tobacco would move onto alcohol and fatty foods if not stopped and even that the evidence that plain packs are less attractive than branded packs does not mean that they make smoking less attractive.

The only thing that stopped me exploding with screaming rage was that there were other MPs who clearly understood the situation and accepted the evidence. The point was made that there are very few certainties in the world so you can go on forever waiting for evidence and, also, that around 200,000 children start smoking every year in the UK. The government’s stated intention to wait for more evidence means that children will start smoking, and shorten their lives as a result, who might well have been deterred by plain packaging.

It is an interesting example of not applying the precautionary principle. The government was very keen on this principle when it introduced temporary class drug orders under the Misuse of Drugs Act 1971 in August 2011. The intention of this class is that New Psychoactive Substances (NPS) can be brought within the MDA while research is done to see if they are truly harmful.

A consistent approach would, therefore, suggest that plain packs should be introduced as soon as possible while evidence is collected to confirm or otherwise their impact on initiation of smoking. That the government is not taking that line reinforces the perception that it has been ‘got at’ by the tobacco industry.

Following all the talk of needing to gather more evidence, more evidence appeared. A research paper entitled ‘Adolescents’ response to pictorial warnings on the reverse panel of cigarette packs: a repeat cross-sectional study’ was published by ‘Tobacco Control’. I could only read the abstract but you might be able to access the full paper The paper is about the actual result of enhanced visual warnings on packs rather than the theoretical effect of standardised packaging (the government’s intention had been to require large images of harm on the front of packs so they would be far from ‘plain’).

The abstract suggests that, amongst 11-16 year olds, images on packs significantly increased ‘warning persuasiveness and thinking about what warnings are telling them’ for those who had never smoked and ‘[f]or experimental smokers, there was a significant increase from 2008 to 2011 for warning persuasiveness, believing warnings and considering them truthful’. There was no significant change for young people who were already regular smokers.

I’m not going to try and read across from this research to the wider issue but what it does show is that what’s on the pack affects what people think about the product. That ought to be a very obvious point but, judging by some of the MPs’ comments referred to above, it may not be.

What I found interesting was that the BBC made the non-impact on those already smoking its main point - ‘Graphic images 'don't deter young smokers'’. The main, and important, results of the study had to wait until the fourth paragraph and appeared as a ‘however’ point.

By coincidence, someone on Twitter posted a link to a 2012 story from NHS Choices ‘Half of medical reporting 'is subject to spin'’  that seemed to be particularly relevant.

Then, on Friday, NHS Choices published its own piece about the story. It makes the point that, though factually correct, the BBC headline ‘presents a negative spin’ on the research itself. As always, it is worth waiting for NHS Choices before believing any medical story in the media.

But, of course, there is the spinning that follows on from the reporting. I think we can be sure that people will repeat the BBC’s headline (minus the final word) to suggest that graphic pack images don’t discourage the young. 

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