"Too little and too late": To what extend is this statement an accurate reflection on successive UK governments policy to the tobacco industry

This can be contrasted though with the agreement of the Europian union and Philip Morris for example which does not depend on goodwill but sanctions which could amount to millions.

UK GOV ATTACKED

As professor Sir George Alberti quoted: “The humble cigarette is responsible for a dozen times more deaths in the UK in the past 40 years than British casualties from World War II - over 5 million”

Is “too little and too late2 an accurate reflection of successive UK government policies then? Some measures over time have helped, although it is mostly the people with the help of their doctors who have managed to fight the addiction.

Looking back in the 50s 14% of the whole revenue of taxing was generated by the tobacco industry. This was an astonishing percentage. When the cabinet was warned by the treasury for the adverse effects on the tax revenue if people smoked less they softened the drafting of the bill. A lot of the original Government policies were seen as “its up to you” to decide whether to smoke or not and the press was keen to emphasise extensively the tobacco industry’s generosity which gave money to the Medical Research Council.

In his letter to Norman Fowler, the Secretary of State for Social Services, presenting the Third Report of the ISCSH, in 1983, the ISCSH’s chairman, Dr Peter Froggatt, as he then was, stated:

"We attach great importance to the need for research intended to demonstrate the effects on human health of product modifications and we are grateful therefore to the tobacco industry for providing us with £3 million for this purpose. Indeed, I am pleased to say that we maintain a fruitful working relationship with the industry and derive great benefit from our continuing discussions both with the industry as a whole and with individual companies."

On the other hand in May 1956 the idea of a ‘national publicity campaign’ was rejected, while in 1960 the cabinet decided that “no action was needed” as they believed that they had fulfilled their duty to inform the citizens about cancer-tobacco. At that stage they were not trying to make people stop smoking. All they did was to inform people about the possible effects. This was due to lack of undisputed scientific evidence which could back the battle against tobacco usage. Furthermore the revenue generated by the tobacco industry was so great that the government of the time was afraid to do anything, which could drastically reduce that overnight. They also believe that informing the people was enough. They didn’t try to persuade them to give up.

In the conclusions and recommendations of the First ISCSH Report 1975 relating to the testing of products containing tobacco substitutes prior to their launch and the testing and use of additives in tobacco products, the Committee stated:

"Cigarette smoke is a very complex mixture and though considerable research has been carried out there is still much to be learned about its composition, the effect on its composition when substitutes or additives are used with the tobacco, and the deleterious effects of the smoke on biological systems."

"The Committee has been gratified by the readiness of companies to co-operate with it."

The RCP concluded, in their first report in 1962, that cigarettes which sought to reduce the risks associated with smoking could be, but were not necessarily, "safer":

"It should be realised that since we cannot identify the substances in tobacco smoke that may be injurious to health, no firm claims for the safety of modified cigarette tobaccos or filters can be made. It would, of course, be many years before it would be possible to detect any effect upon death rates resulting from the use of cigarettes with filter tips, or of modified tobaccos. A reduction in the prevalence of smoker's cough among those who had used such cigarettes or tobaccos might give early evidence of a beneficial effect."

In 1962 the Royal College of Physicians made a rare public intervention, which resulted in a fall in cigarettes sales, while filtered ones became more popular for the first time and according to the Financial Times: “although tobacco tax accounted for 14% of total public revenue, the financial aspect of the matter must firmly be given second place.  The tax on cigarettes must be raised - not by a small amount . . . but by an amount so large as to risk an actual loss of revenue.” The Minister of Health, Enoch Powell said in parliament that smoking “demonstrates authoritatively and crushingly the causal connection” with cancer

The Royal College had made seven recommendations for Government action.  These were scrutinised by the interdepartmental committee. The first recommendation concerned public education while the second recommendation was for “more effective restrictions on the sale of tobacco to children”. The third was for restriction of tobacco advertising and wider restriction of smoking in public places was their fourth one. Increased taxation, especially on cigarettes was the fifth recommendation, which was rejected; as was the printing of tar and nicotine yields on cigarette packets. Lastly the College recommended investigating the value of anti-smoking clinics. The immediate results of the report were confined to £50,000 awarded as a subsidy to clinics. A positive step forward was finally made in 1964 when labour took power and Kenneth Robinson, the health minister, banned tobacco advertising on television. Soon after followed a ban on the radio as well  

On 16 March 1971, Sir Keith Joseph, Secretary of State for Social Services, made the announcement about health warnings in Parliament. He stated:

"The tobacco manufacturers have agreed voluntarily - and I would like to pay a tribute to the responsible and helpful way in which they have approached these discussions - to print in clear type a warning on each cigarette packet, that, and I quote the words agreed, 'Smoking can damage your health’."

The Tobacco Products Research Trust ("TPRT") was established and registered with the Charity Commissioners in 1982 as an entity independent of the UK tobacco manufacturers. Its purpose was to administer the funds provided and to select and supervise research. Shortly after the termination of the TPRT, in 1996, its Chairman, Sir Peter Froggatt commented on the involvement of the tobacco manufacturers: 

"The industry, especially though not exclusively the companies' scientific research staff, took a healthy interest in the progress and results of the research programme, and in all ways relationships between the Trustees and the industry were amicable and constructive. This contributed greatly to the success of the programme."

Since 1962 over four trillion cigarettes will have been smoked, and five million lives will be ended prematurely as a result of smoking over the 40-year period in Britain, although on the other hand if the rates of the 60’s had persisted today then the NHS would had been crippled as it would not be able to cope. As 1.6 trillion cigarettes have not been smoked approximately 6 million lives have not been ended by tobacco-related disease. I believe that it would be safe to say that most governments since did nothing, accurately reflecting “too little and too late”. It was not until 1997 when the first ever tobacco paper was announced by the Labour government “Smoking Kills”. A lot had changed since towards dealing with the issue although still the transformation is slow and a lot of policies have been delayed or relaxed.

It was just in the 1990’s that the tobacco industry acknowledged that tobacco was harmful, but even then they used moderate language, but even today the tobacco industry questions the findings: “With smoking, the many laboratory investigations over the years have proved more problematic, and science has not to date been able to identify biological mechanisms which can explain with certainty the statistical findings linking smoking and certain diseases, nor has science been able to clarify the role of particular smoke constituents in these disease processes. Science is still to determine which smokers will get a smoking related disease and which will not. Nor can science tell whether any individual became ill solely because they smoked”

The Royal College of Physicians’ report in 2000 ‘Nicotine Addiction in Britain’ elaborated extensively as to the addictive properties of nicotine. The 2000 report concluded: “Nicotine is highly addictive, to a degree similar or in some respects exceeding addiction to ‘hard’ drugs such as heroin or cocaine”.

By 1988, however, the definition of addiction used by the US Surgeon General had varied so that it included tobacco:

"Cigarettes and other forms for tobacco are addicting. Nicotine is the drug in tobacco that causes addiction. The pharmacologic and behavioural processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine."

Before 1998 only a small amount of money was spent on anti-tobacco campaigns relative to the problem, the White Paper in 98’, which was a landmark in fighting back the tobacco industry, was seeking to raise spending for educational purposes to £50million over 3 years. Even though this was a big step forward still the money spent on anti-smoking campaigns was far less than the money spent on advertising via different means. Smoking costs the NHS  £1.7 billion a year. This drains the already limited resources of the system  

Only since 1999 the NHS has been given money to help people stop and fight the addiction of smoking as previous governments were saying that if people can afford to smoke then they can afford to pay to stop smoking passing therefore the burden to individuals and the private sector. Furthermore the cost to lone parents that smoked was estimated to be £357 million in 1996. The White Paper recognised the fact that people should have a choice whether they want to smoke or not as still over a quarter of people smoke but “ with their right to smoke, too, comes the responsibility to others who choose not to smoke”but “smoking is the greatest single cause of preventable illness and premature death in the UK. We will therefore ban tobacco advertising”

Even though tobacco advertisement was banned years ago the industry still manages to advertise its products by sponsorships of various sports and in particular formula 1 racing which is a global sport watched by millions of people including a lot of youngsters. The sponsorship in the UK was worth approximately £7.5 in 1998. Attempts to ban it completely in 1997 and 2001 respectively failed as it was not included in the Queens speech after the elections. Before the elections the Government was promising to bring a complete ban. The ban was to come in force before the ban in the European Union. By 2006 there should be a complete ban of advertising and sponsorship throughout the union as a result of the European Directive, which was adopted on 22nd June 1998, was a further step towards harmonisation and banning of sponsorship

As sales of tobacco products are directly influenced by their price the Government is trying to affect demand by increasing the price via taxation. Indeed the UK has the highest tax on cigarettes in the world, being twice as expensive, on average than anywhere else.   From the £12 billion spent on cigarettes in 1997 about £10 million was tax. This is a great measure as the elasticity for the product is –0.4 (i.e. 10% increase in real price causes a 4% reduction in demand) therefore it attacks smoking directly but this could promote black markets and even further smuggling. Furthermore the actual ‘affordability’ of cigarettes has not changed much since the 1960’s as the minutes of average worker’s time required to purchase a pack has not changed either. The graph below shows the affordability of cigarettes since 1965, when people first became aware of the great health risks associated with smoking.

Cigarettes were still over 60 per cent more affordable in 1995 than in 1965 even though the Government increased the duty on tobacco in an attempt to decrease demand. V.A.T and duty accounts for 80% of the price of cigarettes. Between 1996 and 1998 the average cost of a packet of cigarettes increased by 55 pence. The Government was often accused for exploiting smokers especially those with low income that are affected the most because of the difference in disposable income that they have left compared with those who are better off.

As a result of the European Union directive on product regulation (2001/37/EC) in 2001, the health warnings on packs were increased to a third of the actual pack and since 2003 the misleading ‘light’ branding was abolished.

When it comes to underage smoking not a lot has been done to prevent children from smoking and getting addicted. The focus should be on changing the social attitudes towards smoking than trying to restrict is as young people are more likely to rebel against any restrictions imposed on them

In 1908, sales of tobacco to persons under 16 were prohibited in the Children's Act and remain so by further enactments in 1933, 1963 and 1986. The most recent applicable legislation is the Children and Young Persons (Protection from Tobacco) Act 1991.

Entrepreneurs are worried that a complete ban of smoking in public places will result in business loss especially for bars and restaurants. Such a ban has been enforced in Ireland for a year now and any fear of loss of business has been disproved to a great extend. A survey showed that 98% of the people there were in favour of that ban a year after it was enforced.

If tobacco was to be introduced today it would not be legal in any possibility

I don’t believe we can point the finger at any particular Government and say they did less than the other. All of them collectively could had done much more. Recent changes in social attitudes have prompted the Government of the day to finally take some serious measures against the tobacco industry together with the backing up of the EU

More recently, Baroness Cumberlege, the Junior Health Minister, stated in Parliament, that:

"The Government have been working actively with the tobacco industry over the past 20 years to reduce the tar yield. It has been a highly successful policy."

In 1956, Gallaher and other UK tobacco manufacturers established and began funding the Tobacco Manufacturers' Standing Committee ("TMSC")(1956-1963) to assist with research into the question of smoking and health

The importance of consumer acceptability was recognised by scientific authorities in the 1970s and early 1980s. One such authority was the ISCSH, which was appointed

        

voluntary agreements and key provisions

1971 Advertising and Labelling

Health warnings to be introduced on cigarette packets:

"WARNING by HM Government. SMOKING CAN DAMAGE YOUR HEALTH".

References to this warning in press and poster advertisements were also prescribed

1995 Sponsorship of Sport

Signage and advertisements at sporting events to carry health warning:

"TOBACCO SERIOUSLY DAMAGES HEALTH" and occupy 20% advertising space.

---