Should cigarettes be sold under plain packaging? It depends. It depends on what we want from the policy. A lot of us in the evidence-based-policy and Lefty regions (two separate bits, I should stress, though partially overlapping in the Venn diagram) have a tendency to assume that improving public health is the highest goal. Other people do not; they think that the state has no business interfering with our decisions over our health. This is a perfectly reasonable position to take.
Personally, I don’t think the freedom of tobacco companies to sell cigarettes in one coloured pack or another is particularly important. This is, however, my view. Your mileage may vary.
That said, if we do want to improve public health and life expectancy – if that is the Government’s main aim for its policy decisions on cigarettes and plain packaging – then the Department of Health’s announcement yesterday that the move to plain packaging has been delayed is a bad move. “This is an important decision and we make no apology for taking time to get it right,” a spokesman said – which is interesting, since they’ve been keen to move swiftly, and in the face of fierce opposition, on reform of education and the NHS. But, they say, the evidence is “not yet 100 per cent” on whether plain packaging will reduce smoking uptake among young people.
Of course that’s true. The evidence is not yet 100 per cent smoking’s even bad for you, or that the sun will rise tomorrow. But there is a point somewhere short of 100 per cent where we can say, as we have with smoking and the imminent return of the sun, that we are sufficiently confident of something that we are prepared to act as if it is true.
That point has long been reached with tobacco packaging, despite the fact that the Australian packaging law has only been in place for six months and so has not had time to show results. Cancer Research UK (CRUK) reports that “All 19 quantitative studies found standard packs less attractive than branded equivalents, to both adults and children”, and that “13 qualitative studies found that standard packs consistently received lower ratings on projected personality attributes (such as ‘popular’ and ‘cool’) than branded packs”. A major piece of research by CRUK and the University of Stirling (pdf) found that “Branded packaging presented positive user imagery and functional and emotional benefits to young people. Conversely plain cigarette packaging was perceived as unattractive, reduced emotional attachment to the packaging and enforced negative smoking attitudes among young people.”
And, of course, tobacco companies are perfectly aware of this, which is why they are fighting so hard to keep the branded packs. CRUK quotes one tobacco executive as saying “Our final communication vehicle with our smokers is the pack itself. In the absence of any other marketing messages, our packaging is the sole communicator of our brand essence. Put another way: when you don’t have anything else, our packaging is our marketing.” Marketing works. We know that. And cigarette packets are, of course, marketing. (For good measure there is also no evidence that, as the tobacco lobby claims, plain packs increase smuggling or illicit trade in cigarettes.)
In an extraordinary interview on the Today programme this morning, the Conservative MP Mark Field said that advertising was an important right and freedom for tobacco companies, and that people like Dr Harpal Kumar, CRUK’s chief executive and Field’s opponent in the discussion, wanted to “ban” tobacco altogether. But no one, or at least no one sensible in the field of healthcare and public health, would want to ban tobacco. The evidence of the public health and public order disasters of the drug laws show that banning drugs is a terrible idea. It doesn’t significantly reduce use, and it does significantly increase harm. It would be dumb, and unrealistic, to ban cigarettes.
But there are excellent, simple ways to make it less appealing, to reduce the number of children who take up smoking, and reduce the number of them – the 100,000 or so a year – who will go on to die from smoking-related illnesses.
I don’t know why the Government has really shelved its proposals. But it’s not because of a lack of evidence that plain packaging works. If they want to improve public health – and they may not, in this case; that’s a reasonable position, as I said – then they have an easy way to do it. Pretending that they need to wait and see is frankly dishonest.
• Competing interests: the author occasionally gets drunk and steals cigarettes from his smoking friends.