• May 22, 2024

A Pipe Dream?

 A Pipe Dream?

Photo: Filipa

Photo: Filipa

Britain’s plan to create a smoke-free generation could be momentous if implemented properly—and herein lies the problem.

By George Gay

The Guardian newspaper on Oct. 6 published a trenchant cartoon by Ben Jennings that showed an angry-looking U.K. prime minister driving or stuck in traffic on a road heavily polluted with vehicle fumes. But it is not the vehicle fumes that are making Rishi Sunak angry. He is shouting at a pedestrian student choking on the fumes as he makes his way to school: “Maybe you should stop smoking.”

For readers not based in the U.K., I should explain that, two days earlier, the prime minister’s office had issued a news bulletin titled, “Prime Minister to create ‘smoke-free generation’ by ending cigarette sales to those born on or after 1 January 2009,” while, previously, we had been told that Sunak was considering taking away the powers of local governments to protect children by preventing cars being driven right up to school gates.

I hope that the Jennings cartoon was seen by those public health officials who are quoted in the bulletin as not only supporting the policy, which is a reasonable stance for them to take, but as heaping praise on the prime minister for looking after the interests of young people. They might like to ponder the way Sunak, as chancellor under prime minister Boris Johnson, resisted calls for extending the provision of free school meals to needy children; the way he has served in a government that has allowed more than 100 schools to become structurally unsound; the way he remained in government while it rolled out a chaotic pandemic-period education program, possibly ruining the life chances of countless children; the way he has in mind to prevent local governments from introducing lower speed limits and car-free zones, both of which have positive consequences for children; the way he has condoned the placement of lone asylum-seeking children in hotels, despite the high court’s having found the practice unlawful; and, possibly most heinous of all, the way he condoned the painting over of cartoon murals at other centers housing children seeking asylum lest the centers became too welcoming.

I hope the public health people concerned do think about these matters, which are by no means exhaustive, and each of which will negatively affect the mental and physical well-being of children under the care of Sunak, a committed fossil fuel aficionado. And I hope that, in the future, before being drawn into the political sphere, they bear in mind that politicians regularly use children much as conjurors use their assistants.

I should let it be known also that Sunak heads a party that has been in government for 13 years, that is deeply divided and unpopular and that faces an election next year. In fact, his situation puts me in mind of Maynard Keynes, who apparently once made the point that when something momentous was at stake, the last things you needed in the mix were politicians trawling for votes.

The success or otherwise of this policy will hinge on satisfying, clean nicotine products remaining available even to young adults who will not be able legally to buy cigarettes.

Objections

Having said all that, I must admit that I think the proposed policy could be important, if not momentous. Nevertheless, I am conflicted because whereas I think the policy could offer huge advantages, it will do so only if it is implemented properly, and herein lies the problem. It is being rolled out in its initial phase by politicians trawling for votes.

One of the objections put forward by those opposed to such a policy is that it amounts to a creeping prohibition that aims eventually to disallow smokers from obtaining the products they seek. But is this correct? I can sympathize with those who worry about how such a policy might lead to a “creeping” overreach that takes in current smokers, but I wonder whether this could be described as “prohibition.”

Look at it this way: If there is one message that most tobacco harm reduction advocates have been keen to get across in recent years, it is that smokers smoke for the (benign) nicotine while being laid low by inhaling the tar that is a product of tobacco combustion. So, in fairness, while granting that the government is not proposing that current smokers should not be allowed to obtain cigarettes, it must be conceded also that it is not even proposing that they, or future generations of people, should not have access to nicotine, the substance that smokers want. And even if there is policy creep, the way things currently stand, smokers will not be subjected to a true prohibition because they will have access to nicotine. The proposal seems to my way of thinking to be only about stopping future generations and, given a bit of creep, current generations from inhaling tar, which, apparently, is not what smokers want but the thing that masks the otherwise unpalatable taste of nicotine and harms them.

Meanwhile, some people believe that a major issue with the proposed policy is that it simply won’t work—that those who are underage will be able to obtain cigarettes through family members, friends and retailers who turn a blind eye to the law. There is clearly truth in this because the underaged can obtain cigarettes now, but I cannot see that this matters a great deal, at least at a societal level. In fact, it might provide something of a safety valve for the policy. We have vehicle speed limits in the U.K. that are broken by most people on most days, but those limits nevertheless tend to reduce the speed at which people would otherwise drive. People might drive at 35 mph in 30 mph areas, but few do 45 mph. That such a system works can be seen from the fact that few outside of those on the lunatic fringe of libertarianism would agree to speed limits being abolished, allowing petrol heads to drive through cities at 150 mph. And so it is that the tobacco purchasing age law, along with the continuing availability of satisfying, cleaner nicotine products, would have the effect of reducing the number of people taking up smoking. But, of course, it would not stop it.

The way things currently stand, smokers will not be subjected to a true prohibition because they will have access to nicotine. | Photo: VPZ

Offering Alternatives

Nevertheless, as suggested above, the policy does raise concerns in my mind to do with the timing of it and the commitment to it of the current government and even a future government of a different stripe. Also as suggested above, the success or otherwise of this policy will hinge on satisfying, clean nicotine products remaining available even to young adults who, because of their age, will not be able legally to buy cigarettes. This is fundamental to me. I cannot imagine, as others apparently can, a future unchanging utopia where no one uses recreational drugs. And given I am correct in my assumption, cleanly delivered nicotine should have its place in the future. It is a popular and relatively safe drug, especially when compared with something such as alcohol, which, for reasons I can only guess at, is given a free pass by most public health people even though its consumption is a bigger drain on society than tobacco consumption.

But I digress. The reason I am not convinced the policy will be implemented in a coherent way is that the government, as part of its Oct. 4 news bulletin, said it was planning “a further major crackdown on youth vaping by announcing an intention to consult on plans to reduce the appeal and availability of vapes to children.” The consultation is to take in flavors and product descriptors, disposable vapes, point-of-sale displays, and packaging and product presentation.

It doesn’t take a genius to know which way this is going. The government says it wants to ensure it gets the balance right between protecting young people and supporting adult smokers to quit, but this is politics, and the “child epidemic” lobby will be allowed to have its finger pressing down on its side of the balance. And if the appeal to adults of clean nicotine products is significantly reduced, then it’s game over. The policy will simply pass the ball to those waiting to fuel the illegal trade in vaping devices and, probably, cigarettes.

Rushed Policies

But having said that, the policy could work in theory even though satisfying, cleaner nicotine products were not available, though it would take an investment in policing, the judiciary and the prison service to which no government would commit. The news bulletin said that “[e]nforcement activity will also be strengthened, with an investment of £30 million ($36.42 million) to support agencies such as local trading standards, HMRC [tax collection] and Border Force to take action to stop underage sales and tackle the import of illicit tobacco and vaping products at the border.” You would have to be terribly naive to believe that this amount would be guaranteed, and, in any case, it would be nowhere near enough and would probably not even make up for the disinvestment made in respect of these agencies during the Conservative governments’ 13 years of austerity. The major reason why young people are currently able to obtain vapes so easily is that the funding of trading standards was hugely undermined.   

Another reason why the policy, though not without merit, is likely to fail is that it probably has not been thought through properly. The U.K. currently is awash with policies rushed out in order to make it appear, ahead of the election, that the government has a purpose. A recent announcement on railway investments was shot through with errors and failed even to place Manchester, the U.K.’s third-most populous city, correctly on a map.

The tobacco news bulletin is a rambling, repetitive affair that apparently aims to make up with quantity what it lacks in quality. Consequently, we are told on seven occasions that smoking costs the country billions. There are 77 references to smoke or smoking, but you could be forgiven for missing the point that the ban on sales will apparently apply to tobacco products, not just combustible products, because this gets only two mentions. It is full of the usual platitudes that don’t stand up to any sort of scrutiny, such as “[n]o parent ever wants their child to start smoking.” It appears to include one glaring error in saying, “It is already illegal for children to vape.” And it quotes the chief executive of Cancer Research U.K., Michelle Mitchell, as saying, “[t]he prime minister deserves great credit for putting the health of its citizens ahead of the interests of the tobacco lobby,” without adding a caveat to say that if the government had listened to Philip Morris International years ago, the country would already be a long way down the track to being a smoke-free nation.