IEA Blog

Public health regulations frequently serve exclusively to prevent legal capitalistic acts between consenting adults. But the fact that prohibition’s history is a history of failure never stops the good people in the public health establishment from promoting the next ban, or the next one after that.

This brings us to the tobacco display ban, which would require shopkeepers to hide all tobacco products from sight.

Since the UK battle commenced over tobacco displays, those in favour have confidently argued that a ban here would have the same outcome as display bans in other countries, especially Canada. We continue to be promised that, critically, a display ban will reduce youth smoking.

What has the Canadian ban on tobacco retail displays done for public health in that country? Analysing the data produced by Health Canada leads me to conclude that display bans do not lead to lower rates of youth smoking. Nowhere – anywhere – in Canada is it possible to find evidence that display bans result in less youth smoking. Adult smoking is equally unaffected by display bans.

To be fair, however, I must acknowledge that display bans do have a positive impact upon youth cigarette consumption. By positive, though, I don’t mean good. By positive, I mean display bans boost the average number of cigarettes consumed daily. In the province of Nova Scotia, for example, youth consumption jumped 15% in the two years after introducing a display ban. Nationally, smoking among 11-15 years olds rose 46% and smoking among 15-18 year olds rose 16% between 2007 and 2009, according to Health Canada’s biannual survey released last month.

My statistical analysis comparing smoking prevalence before and after the implementation of display bans in the relevant provinces shows display bans are associated with increased prevalence for both young people and adults in Canada and no decline in consumption. 

Any careful reading and balanced assessment of the Canadian situation can only conclude that Canada’s display bans have been harmful to her public health.

Click here to download Patrick Basham’s report, “Canada’s ruinous tobacco display ban: economic and public health lessons”.

Alcohol consumption is now a major problem in British society. Drunken teenagers are running rampant in our town centres. Accident and emergency wards are chock-a-block with people who have fallen over, been in a car smash or engaged in a fight because there was too much drink in their blood.

The long term damage can be even worse – even if you aren’t turned into a violent maniac immediately, your heavy consumption of alcohol will mean that you’re going to suffer from cirrhosis of the liver before too long. Therefore, something must be done. And we have a plethora of bureaucrats and politicians employed at the taxpayer’s expense to work out what this thing is, and then to do it.

 
This – in essence – is the mainstream view of alcohol consumption in Britain in 2010. It is a disastrously misguided, wrong-headed and highly dangerous view. The problem in British society is not the consumption of alcohol; it is the loss of personal responsibility. If you choose to consume so much beer that you collapse on the pavement and crack your head open, you can be taken by ambulance to an NHS hospital and be patched up at my expense.

If you drink yourself slowly to death over several decades and need costly long-term health care, I will pick up the bill too. If you commit a violent crime because you’re drunk, you will be sent through the criminal justice system. In very extreme circumstances, you may even be sent to prison. In any event, the bill for your irresponsible activity is sent to me…

Read the rest of the article in The Yorkshire Post.

A new report from Policy Exchange (strapline: David Cameron’s favourite think tank) has apparently “re-ignited” the “controversial” debate about tobacco.

The document is an enthusiastic embrace of central planning dogma over free market common sense. As Ayn Rand said, if you end with the wrong conclusions you should always check your premises - the authors seem to start with socialist principles and they reach correspondingly extraordinary conclusions.

The British government have got tobacco tax pretty much spot on, the authors have concluded. The only marginal failing is that cigarettes aren’t taxed quite enough – a packet of twenty cigarettes should cost you £6.36 rather than the prevailing price of £6.13.

They have totted up the costs of tobacco consumption to “society” – including (but not limited to) NHS treatment of smoking-related illnesses, house fires, employee absenteeism, litter collection and even lack of economic productivity caused by early death.

The last of these assertions is particularly offensive. If I drop dead in my mid 40s from lung cancer, I have – I’m told – let the side down. I should have been economically productive for another couple of decades, for the sake of the nation’s GDP. The authors do not seem to realise that people get paid to work. They benefit from their own productivity. Their productivity is not a social benefit – except very marginally – from which society as a whole gains.

The cost of smoking-related diseases is very real. And the NHS picks up a fair chunk of the bill. But if every smoker quits their habit tomorrow, they are still going to die of something. The question isn’t how much smokers cost the NHS – but how much less would they cost the NHS if they didn’t smoke. The Policy Exchange research assumes they would cost nothing. But dying of Alzheimer’s as an ex-smoker (or non smoker) in your 80s is going to cost much more than dying as a chainsmoker of heart disease in your 50s. And that doesn’t start to factor in the saving made on state pensions by smokers having the courtesy of dying many years younger.

A second collectivist fallacy perpetuated by the report is to assume that illness or absenteeism (in the form of cigarette breaks) is somehow a burden on society. It is not. It is a matter entirely for the employer and employee – though it could be argued that anti-discrimination legislation prevents employers from choosing (if they wish) to employ only non-smokers. I would have been surprised if the IEA had not hired me on the grounds that I smoke tobacco, but I would have respected their right to reach such a conclusion. If legislation stopped them from not employing me on those grounds, it should be repealed.

With regard to house fires, buildings insurance companies – just like life insurance companies – are certainly entitled to charge higher premiums to smokers if they wish. The fact that they do not suggests that the risk is too trivial – why should the government step in and over-rule them by collecting extra taxes on cigarette smokers to cover the costs of extra house fires (indeed, this raises the issue of whether the tax would be distributed to fire insurance companies…)?

But the most exasperating element of the document is its reliance on the theory of Marxist false consciousness. What we smokers really want is to give up smoking. And what we need is taxpayers’ money spent on encouraging us to do so. It’s not enough that 65% of smokers apparently want to give up. It is not sufficient that pharmaceutical companies can – and do – spend millions advertising their array of chewing gums and nicotine patches on primetime television. You would have thought that allowing Pfizer to advertise nicotine products in the middle of Coronation Street whilst simultaneously banning tobacco companies from being allowed to decorate a Formula One motor racing car would be advantage enough. Not according to this report. The two thirds of smokers mercilessly trapped in their habit need an extra shove from the public purse. So, whilst even the most evangelical public-spenders accept that slashing public information budgets is an easy win, the authors actually advocate increasing the government’s advertising budget by £100m.

It seems that the authors suffer from two problems identified by Hayek. The first is the “fatal conceit”. They believe they have calculated the exactly correct tax to internalise all social costs – an additional 5%. This is remarkable. If a government has the information to do this, then central planning in the Soviet Union would have been effective. And maybe we should do this for all products: 4.3% tax for chips, 11.45% for cream cakes, a 2.657% subsidy for footballs (because of the “social” benefit of exercise). Why pick on cigarettes? Secondly, as Hayek identified, once the state provides and regulates certain things (e.g. the provision of health or labour market contracts) the lovers of state control see external costs and benefits all over the place. There is then literally no limit on the government intervention that can address those costs and benefits and the inevitable result is serfdom.

It is not always necessary to contradict politicians; it is often better to wait until they contradict themselves. A case in point would seem to be Health Secretary Alan Johnson’s recent speech at the Royal Society of Arts.

Johnson apparently rejects the notion that people are able to make sensible choices about their health and lifestyles: “[N]ot everyone is able to defer the instant gratification of that one cigarette or glass of vodka or a meat pie too many in favour of longer term health benefits.”

The health secretary prefers a therapeutic state: “No responsible government can morally justify a retreat to the touchline. To be mere spectators as the waistline of the nation expands, lives get shorter and deprivation intensifies. …Those who cry “nanny state”, at the merest suggestion that we should change our behaviour, trivialise a debate that is critical to the future wellbeing of this country.”

Johnson recounts how, in tackling smoking, “banning advertising, restrictions on the promotion of cigarettes” have been key features of a successful strategy that saved lives. The Health Secretary then goes on to make clear that “milder” forms of government intervention into people’s behaviour, such as campaigns that merely “lecture” them about the dangers of smoking and obesity, are insufficient: “While it’s very easy to point out the pitfalls of smoking, which are now widely understood, advertising cannot promote positive behavioural change on its own.”

So hang on a minute: tobacco advertising makes people smoke and therefore it must be banned, but anti-tobacco advertising cannot be relied upon to deter people from smoking. Advertising seems to lead a double life in Alan Johnson’s world. 

In the whole speech, alternatives to government paternalism do not get a single mention. Johnson praises several “innovative” initiatives by Primary Care Trusts (PCTs) who have begun to experiment with financial rewards to promote healthy lifestyle choices. But he omits to mention that outside of the NHS, such financial reward schemes are by now commonplace. Most private health insurers in the UK offer packages including discounts on gym membership, smoking cessation and other preventive actions.

Maybe an altogether more promising approach to public health would be to leave more room for private providers and insurers, and to let them devise their own incentive schemes. But naturally, due to the way Alan Johnson formulates the agenda, this option cannot appear on the radar: “We need to consider whether we’ve done enough, whether our approach is the right one and what further action we need to take.”