Plain packaging for tobacco appears to have been rejected by the UK's Coalition government, just as it was rejected by the previous Labour government, but the idea continues to appeal to politicians who wish to make a name for themselves. The latest figure to express an interest is Irish Health Minister James Reilly. It is reported this week that Reilly has persuaded his cabinet colleagues to draft plain packaging legislation of a similar nature to that seen in Australia, the only country to have so far taken the step.
Campaigners will feel optimistic about the prospects of Irish politcians rubber-stamping the law. Ireland is, in many respects, the poster boy for tobacco control. It was the first European country to ban smokeless tobacco in the 1980s and was the first country in the world to ban smoking in enclosed public places. It has the highest cigarette prices in the EU and its government partially funds the sale of nicotine replacement therapy and other stop-smoking drugs.
Ireland's eagerness to be tobacco control's guinea pig has made plenty of headlines in the last decade and it has won plaudits from the public health lobby, but in one crucial respect it has been a failure. As the graphs from the OECD show, Ireland (IRL) has one of the highest smoking rates in Europe and it has seen the smallest drop in smoking prevalence of any Western European country since 1990.
There is an important lesson here for those who have the eyes to see. Grandstanding politicians and headline-grabbing legislation are no guarantee of successful outcomes. Years of slavishly following the 'neo-prohibitionist' model of public health—which ignores the reasons why people smoke in favour of an obsesive focus on petty bans and restrictions—have conspicuously failed to have an impact on the smoking rate. To continue down the path of extremism in the light of this fact suggests the same cognitive dissonance that was displayed last week by Welsh anti-smoking campaigners who complained that smoking prevalence had barely fallen despite the most aggressive wave of tobacco control legislation in the country's history.
England has seen similarly disappointing results. A report commissioned by three British anti-smoking groups in 2011 concluded that “whilst there has been a downward trend in smoking prevalence over several decades, this appears to have stagnated since 2007.” The authors did not dwell on the uncomfortable fact that this stagnation coincided with an unprecedented wave of neo-prohibitionist policies including a comprehensive smoking ban, steep tax rises, graphic warnings and raising the age at which tobacco could be purchased, in addition to gory advertising campaigns such as those showing the faces of smokers severed with fish hooks. In the four years before the English smoking ban was introduced in 2007, the smoking rate dropped by five percentage points. In the four years afterwards, as in Wales, the rate dropped by just one percentage point.
The response of anti-smoking activists to this record of failure? More "bold action", of course. Their commitment to looking to the future is understandable. For a lobby that claims to be "evidence-based", they are strangely reluctant to look at the recent past and assess whether their policies have fulfilled their promise. As Ireland resorts to reductio ad absurdum policies such as plain packaging, it may not be long before someone notices that the Emperor is wearing no clothes.
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