Ireland, plain packaging and cognitive dissonance

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.

I think the reason for the cognitive dissonance is that no cognition is going on at all. Tobacco Control is now (or was it always?) a religious crusade, an effort towards moral purification in which it's insufficient to Paraquat the crops, but it's apparently required to burn the barns and shoot the dogs.
The logic in this article is flawed, insofar as nobody knows how much the smoking rate may have increased since the time of the smoking ban, were it not for the ban. The reasoning for plain cigarette packaging having a dissuasive effect is presumably based on how would-be consumers behave when a product is packaged in a drab or disturbing way. In particular children are put off from engaging with products that don't come in colourful packaging.
@Ian Downey I think that given a steady downward trend over more than a decade, one could safely assume that in 2007, in the absence of a ban, that trend would have continued. That there would be a sudden, unaccountable rise in smoking prevalence in 2007 is so unlikely as to be not a significant consideration. So based on past trends, the logic is not flawed at all. Something changed the trend, and that something was the pogrom that was launched against smokers and smoking.
Wrong Mr Downey. The article referred not only the smoking ban but also tax-hikes and funding of patches and stuff. This combined assault on people who enjoy tobacco has failed, and failed miserably. To be seen as successful, the effect of the campaign would have been required to exceed the previously observed trend.
In relation to nisakiman's piece, even if we accept that the increase in smoking in 2007 could be due to rage against the ban, it's not unreasonable to suppose that the likely long term effect of the ban will be a further reduction in smoking. It's far too early to expect significant results.
Various measures by the anti smoking brigade will, over time, reduce smoking to about 20% of the population. The remaining smokers are the hard core ones. If you want to further reduce smoking, why not look to the only country that has achieved that. Yes I am talking about Sweden. The answer lies in Snus and E cigarettes. Simples.
And stop persecuting adults who enjoy tobacco and let people open bars, cafes and other places where smokers can meet in comfort.
Some of the discussion around this article seems to be based on the assumption that smoking bans are principally a way of reducing smoking. That's not necessarily the case. Ireland's ban that started, in its full extent, in April 2004 was for the purpose of creating smoke-free workplaces, on the basis that workers (including pub and restaurant staff), ought not to be unwillingly exposed to cigarette smoke throughout each and every working day. In this regard the ban in that country has already overwhelmingly achieved its purpose, even although smokers are smoking almost as much as before. The idea of plain cigarette packs is rather different, since it's targeting smokers or would-be smokers. Some of the discussion around this article is applicable here.

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