The Costs Of (Not) QuittingBelinda Cunnison
24th August 2008.
For once, a headline draws attention to the amount of money spent by health authorities in failing to stop people lighting up. The same article, headlined 'Millions spent in battle against tobacco' in the Bath Chronicle and '£3.7m up in smoke as 47% fail to quit after seeking NHS help' in the Western Daily Press', sets out the losses, while pointing out the relatively high success rate in the South West ('second only after Dorset'). Money spent on 'successful' quitters amounts to £4.2 m as against those who fail to quit at £3.7 m (since Bath claims a success rate of 64 per cent this makes failure per head more expensive than success). I imagine this cost covers treatment only, not the enormous amount spent on literature and other anti-smoking promotions.
Pertinent points:
1. There has been a drop in the success rate since the smoking ban came in!
2. 'Success' is not defined. It is not stated how long someone must have stopped smoking to get a pass mark. Long term success rates for the year since the ban came in are not available, and it is not shown whether those that stopped the year before are still not smoking. With plenty of telephone and/or group support in addition to pharmaceutical aids, smokers can quit for short periods with relative ease. In the longer term when such support might not be available, quitting becomes harder.
3. The claim at the end ot the article, 'You are four times more likely to quit with the help of NHS Stop Smoking Services', is not provable, and is little better than a marketing gimmick. The experiences of those who quit without such help are not likely to be of interest to those who make such claims.
The low level of success in smoking cessation expected by bodies such as NICE is remarkable. A press release earlier this year states that Strategic Health Authorities and Primary Care Trusts 'should set minimum realistic targets for their communities with an aim to treat at least 5% of their population who smoke each year and to aim for success rate of at least 35% at 4 weeks'.
An NHS document describing its cessation services puts the success rate at 52 weeks even lower – at 15 per cent ('comparable with earlier clinical trials').The next bullet point describes this as 'cost effective'.
Cost effective?
Each year, health authorities are treating around 5–10 per cent of smokers, in the expectation of a success rate ranging between 65 per cent at 4 weeks to 15 per cent at one year. Balanced against the claimed smoking-related losses to the NHS of £1.5 billion admittedly the cost is not high, but all it achieves is a ready market for pharmaceutical aids, and it is not certain that it will have any impact on the £1.5 billion in the foreseeable future.
Perhaps in the future we should be adding about 85 per cent of £50 m (approximate costs of smoking cessation services to the NHS each year) to the £1.5 billion p.a. claimed losses to the NHS caused by smoking.
The NHS report repeats the claim that NRT and ZYBAN are four times more likely to quit than 'willpower alone'. Smokers wishing to quit by this method should consult WhyQuit. John Polito's site and writings include a wealth of information about the drug trials of cessation products, and turns the NHS comparison of the success rates of NRT vs. willpower on its head.
Alternatively, the late Allen Carr similarly offers smoking cessation without recourse to pharmaceutical aids. To close I will quote his open letter to Tony Blair:
'Your government, aided by the medical establishment, the NHS, ASH and QUIT, under the powerful influence of the pharmaceutical industry, is pouring .. millions of pounds of taxpayers’ money each year into the pockets of the pharmaceutical companies which are, in effect, competing with the tobacco industry to supply the nicotine addicted market and perpetuate nicotine addiction.' (November 2006)
The whole letter is worth a read.
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The Law - The Misery ContinuesPhil Johnson
12th August 2008.
"The law is an ass".
Charles Dickens declared this truth before our time but we are seeing the wisdom behind those words on a daily basis now!
It really is inconceivable how those that have authority over us more humble beings seem to attempt to outdo each other with the severity of the punishments meted out to victims of the smoke ban.
It is also inconceivable that these people, sitting behind a bench, feel no pity for those standing before them. Here are some examples as to why "the law is an ass"
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Keeping Tobacco VisibleBelinda Cunnison
9th August 2008.
At least two voices have spoken out for prohibition of tobacco. Avril Boyle MEP has taken the issue to Europe: see discussion here. She also wants to outlaw political lobbying in certain policy areas by tobacco and associated interests, in line with the Framework Convention on Tobacco Control: 'In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.'
Here in the UK the Royal College of Physicians wandered into the public health policy formulation field nearly a year before the introduction of the UK ban, and produced this. Note the heavy reliance on 'safer methods of nicotine delivery', which translates as transferring the nicotine market into the hands of drug companies. There is frequent reference to 'medicinal nicotine'. Interim measures include proposals to introduce compulsory ID procedures for any customers buying tobacco who appear to be under 25.
Now for the main story. REMOVING TOBACCO FROM DISPLAY IN SHOPS is a very important step in this policy. A consultation document is attached to this story, which you can support, or you are invited to make your own response. A link to an online petition is also supplied.
The article itself (main story, link below) can be printed off and handed in to local newsagents, supermarkets and off-licences.
Remember that a faction is at work in Europe to ensure interests associated with tobacco are prevented from lobbying on health-related issues.
The article points out that there is a small window of opportunity to protest (consultation closes on 8 September) ... this is not just in terms of facing legislation that will cost the average retailer thousands of pounds, and enormous inconvenience and potential hostility at the sales counter. This is bad enough; but the plan is that anyone whose voice is perceived to represent tobacco interests will be prevented from influencing policies designed to improve the public health.
It is magnificent that a trade body has directly challenged the government on this issue, and they deserve, and will need, all the help they can get.
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Barsprung DurkTechniikPhil Johnson
30th July 2008.
Today has heralded great news for smokers - IN GERMANY!
Germany is,apparently, to be forced to reverse its ban on smoking in small pubs, the country’s top constitutional court has ruled. The court said a ban on smoking in small one-room bars in two states – Berlin and Baden-Wuttermberg – was discriminatory as similar pubs that had extra rooms were legally allowed to offer one for smokers.
Now isn't that amazing - note the word "discriminatory".
Bars owners were up in arms as revenue dropped - drastically - especially in 'one roomed bars'. You see, the Germans used something called the brain when they imposed their smoking ban. Two roomed bars were allowed to segregate -smokers in one room and non smokers in another. So life went on.
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Pubs in PovertyPhil Johnson
26th July 2008.
The happy scenes of thriving pubs has long gone.
Once vibrant businesses are now struggling to survive at all.
Pubs are closing down at an alarming rate and unemployment is rising at an equally alarming rate.
Yet what does this government say about all of this?
"The Smokeban Law is a raging success"
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They get sicker by the minuteSteve Cross
26th July 2008.
No depth has ever been too low to sink by the anti smoking hate campaigners, the following advert shows their contempt for any common decency and their utter hatred of smokers....
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Some Enchanted EveningPhil Johnson
25th July 2008.
Gordon Brown must now be the loneliest Prime Minister in the world (possibly excluding Mugabe!)
The devastating result in Glasgow East has shown this buffoon exactly what the people think of his 'great' leadership.
This government have ruled the country by fear of stealth taxation for too long and are now paying the price of dictatorship.
Smokers are finally getting their slow but sure revenge on a vindictive government whose leader was never even elected in.
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Future 3000's Future Looks Bleak In 2008Phil Johnson
24th July 2008.
The misery continues across the land and has now taken hold on the south coast, the stronghold of the holiday and tourism trade.
We already know that misery is rife in Bognor, Littlehampton & Chichester as the tourist trade, or rather the lack of it this year, has seen profits plummet and in many cases turn into losses.
Now we can add Bournemouth & Poole to the ever growing list of "places not to visit" due to lessening hospitality venues!
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Success From A Different PerspectiveTim Paton
16th July 2008.
INSIDE LOOKING OUT
or
OUTSIDE LOOKING IN
Success from a different perspective
Part 1 - Compliance
On the first anniversary of a smoking ban, every single person is suddenly blessed with a gift. They all know the day before that magic date what the news headlines are going to be, “The Smoking Ban is a Success”. This was excellently foretold by Forces International on 30th June 2008, a day before celebration of the ban in England, see: http://forces.org/News_Portal/news_viewer.php?id=1268
As Forces point out, you know what the article is going to say, because they all say the same things. I have chosen the Welsh version, (it is a bit like the Bible, there are many versions, but they all have the same message). What I will do is to quote certain sections, and put a different perspective on it, a perspective which comes more from common sense than anything else.
“Just 79 people have been issued with fines for breaking the smoking ban during its first year… and it corresponds to high rates of compliance and growing support for the public health legislation, which outlawed smoking in all enclosed public and workplaces.”
Let us take a look at this public health legislation, and the reason for what they say is a surprisingly low figure as far as non-compliance is concerned.
First, the issue of enclosed public and workplaces. Here is a list of enclosed public places:
Shops/Indoor Precincts and Malls/Public Transport/Cinemas/Theatres/Concert Halls/Swimming Pools and Leisure Centres/Bowling Alleys/Stately Homes/Museums/Aquariums/Enclosed areas in Zoos/Hospitals/Surgeries and Health Centres/Dentists/Churches.
I am sure you can add to this long list. The main thing is that all these enclosed public places had been non smoking for years, decades, even centuries! So what was the difference when the smoking ban started, none, except that they all had to have ugly signs put up!
What about enclosed places of work? Offices and warehouses, workshops and depots, schools and universities. I know that the majority of office blocks had already become totally non smoking inside, as had schools and other educational establishments and many other large indoor work areas. Like other enclosed public places, this had been established for years. There were still a few places which had a designated indoor area in canteens and/or rooms for breaks, but not many. A very small minority of workplaces were still not non smoking, but this was mainly sole traders or an office/workshop with only a couple of employees. This also applied to work vehicles.
So the majority of enclosed places of work were already non smoking, and what was the difference when the smoking ban started? Same again, just the ugly signs.
People who smoke are not selfish people, and for years have been willing to not smoke in enclosed public areas and places of work. In many cases, a sign was not even needed, in other cases; an unimposing, often polite sign was visible, which was respected.
I am now going to look at the places I have not yet referred to. These places are different. They are places where you relax, places where you socialise, places where you may be entertained, places some people choose to go, and others don’t. You don’t have to be there, and in many cases they are for adults. I am of course speaking of places of hospitality:
Pubs/Clubs/Hotel Bars/Bingo/Casinos/Nightclubs/Restaurants/Cafes, and large and small variations on this kind of place. These are the places which were hit by the smoking ban.
I will have a look at these places before the ban, and then give the reason for compliance.
Restaurants and Cafes. In both cases, many had already gone non smoking throughout, the majority of those that had not did have a separate smoking area. Alright, I know the joke about that being like having a non pissing section in a swimming pool, but I will come to that later.
Hotels and Guest Houses/B&B. Again, a fair number had gone totally non smoking. Most of those that had not only allowed smoking in the bar area.
Night Clubs and Casinos. As far as I am aware, these had no non smoking policy to speak of, but they had excellent ventilation.
Bingo Halls. Separate smoking area.
Working Men/Social Clubs (including British Legion, Labour Clubs, Conservative Clubs etc). Like the restaurants and cafes, these had designated areas in what is often known as the concert room. Those with more than one bar usually had a non smoking bar, this also being the bar where they served food.
Now onto the British Pub. Some pubs had already chosen to become totally non smoking. Larger pubs which served food were non smoking in the food area. Any pub which was large enough, especially those with more than one bar/room, had a designated smoking/non smoking room.
Many places of hospitality, and just about all night clubs and casinos, had installed top of the range ventilation systems.
So, you can see from this information that the hospitality industry was already making significant inroads into accommodating smokers and non smokers. This however was not good enough; it was apparently not protecting the workers from the alleged danger of second hand smoke, (that is an issue I will deal with in another part).
What then is the reason for these high rates of compliance - FEAR. It is bad enough knowing that you can be fined £50 on the spot, even worse that the owner/manager can be fined as much as £2500 for each offence.
Is it protecting the workers? Well, I know some it isn’t protecting: the staff of the four pubs which close every single day. The staff of the workingmen’s clubs which have closed down. The staff of the Bingo Halls which are no longer there.
There is a lot more I could say about this decimation of the hospitality industry by not allowing free choice. I could also speak about the unfair treatment of those smokers dying from old age, being denied their last bit of comfort and pleasure in their final weeks due to incapacity. I could mention the fact that in our enormous airports, they cannot even provide a well ventilated area for smokers after they have gone through security. I will however finish part one with the most inhuman imposition of suffering on fellow human beings, people who are vulnerable and weak, those who have suffered severe mental and emotional breakdowns, whose illness has made it necessary for them to be confined indoors for their own safety. Compliance? If they smoked, (and many of them did), they have now given up, not because they wanted to, but because they were forced to. To allegedly protect others, they have had to lose what to them was an important part of their medication.
Powerpoint, Propaganda and 40,000 Lives SavedBrian Bond
11th July 2008.
As a smoker, I don’t suppose that I was alone in dreading the arrival of July 1st 2008. One year on from that dreadful day, when England was declared to be ‘smokefree’, and another contrived new bastard word was added to the NuLabour addendum to the Oxford English Dictionary. One year of misery that will have been felt by smokers across England. 12 months. 52 weeks. 366 days of listening to the unrelenting whine, the sound of gloating, emanating from that sanctimonious, bloated army of bigots that is the anti-smoking lobby.
I knew that the gloating would be reaching its crescendo as we arrived at the 1st anniversary of that ‘glorious’ day. I knew that we would be bombarded with wondrous tales of good news, of how much healthier we are, as a nation, now that we are ‘smokefree’, of how our pubs and clubs and restaurants are experiencing an unprecedented boom in trade, now that they have been liberated from the shackles of having to accommodate we dreadful smokers, and how the lives of 540 enslaved non-smoking hospitality trade workers have been miraculously saved. (Well that’s what we were told would happen, wasn’t it?)
And, much as I tried to maintain my resolve to keep well away from all TV and radio news on 1st Jul 2008, I failed. I just couldn’t help it! It was everywhere! Good news oozing out of every pore of every BBC/ITV/Sky presenter, every tabloid journalist (almost), and, worst of all, every politician. Oh the politicians! How they love to preen, so self-satisfied and smug, positively wriggling with the orgasmic pleasure of having saved their citizens from that toxic cloud of noxious chemicals that previously enveloped the whole country. They remind me of our cat when she sits at the back door of the house at dawn, loudly purring while hovering over the grizzly remains of the poor unsuspecting mouse that she had spent the previous night hunting, taunting and torturing – and all so she can demonstrate to us (her pets) what a caring and clever animal she is. I think I know how that mouse must have felt!
As expected, the good news inevitably came wrapped around a host of impressive statistics. “99% of people think that the smoking ban is the best thing since sliced bread”, “the air in our pubs is 89% cleaner than it was a year ago”, “78% of pub landlords, think bankruptcy is a small price to pay for the fantastic benefits of smokefree air” and so on and so on. OK I made most of these up, but can anyone honestly distinguish between these dodgy numbers and the ones that really did pepper the news bulletins on that day? And are my numbers any more bogus and fabricated than the statistics being touted to prove that the smoking ban is “the single most important political event in the last million years”, or words to that effect that were attributed to the ASH spokesman? But then he would, wouldn’t he?
But two statistics were to stick in my mind – possibly because they were the most widely quoted on the day, possibly because they were the most obviously hyperbolic. “400,000 smokers gave up due to the smoking ban”, yelled the headlines, and this means that “40,000 lives will be saved over the next 10 years”. Wow! We don’t do things by half in England, do we? Not only have our glorious nannies saved the lives of 540 passive-smoking hospitality workers between now and July 2017, but they have been so successful that an extra 39,460 souls have been added to the roll of immortality too! Stupendous news! – and quite rightly it needed to be shouted over and over again; (and it was - over and over and over and over…).
But, being of an unfashionably numerate bent, and also somewhat quizzical (some would call me sceptical – but I’m not so sure about that), I decided to look behind the news headlines and see if I could gain some greater insight into just how our betters were able to achieve such a remarkable success in such a short time. This proved to be quite a voyage of discovery indeed. So, let me temporarily park my cynicism and - as the estimable Lloyd Grossman would say – “let’s examine the evidence”.
1 The Press Release
Cancer Research UK (or CRUK) is the organisation behind the ‘research’ that revealed these statistics. The main news headlines were directly quoting from this press release, issued by CRUK on 30 June, their own headline being “Smoking ban triggered the biggest fall in smoking ever seen in England”. This press release was timed to coincide with the UK National Smoking Cessation Conference, being held in Birmingham on, surprise, surprise, July 1st. Here are the main paragraphs from the release:
Smokefree law in England has helped more smokers to quit than ever before and will help prevent an estimated 40,000 deaths over the next 10 years – according to new research being presented in Birmingham tomorrow (Tuesday).
The Smoking Toolkit Study – funded by Cancer Research UK, McNeil, Pfizer and GlaxoSmithKline and presented at the UK National Smoking Cessation Conference* - interviewed more than 32,000 people in England over the nine months before and nine months after last year's smokefree law took effect on July 1.
The decline in smoking prevalence for the nine months pre-July was 1.6 per cent compared to an impressive 5.5 per cent in the nine months post July. Based on the findings researchers estimate that at least 400,000 people quit smoking as a result of the ban. There was no difference by age, gender or social grade.
This is the first study in the world to examine in detail the impact on smoking rates solely from smokefree legislation without the influence of any other tobacco control measures.
Professor Robert West, Cancer Research UK's director of tobacco studies at the Health Behaviour Research Centre based at University College London, who carried out the study, said: "These figures show the largest fall in the number of smokers on record. The effect has been as large in all social groups, poor as well as rich smokers. I never expected such a dramatic impact and of course there are no guarantees that smoking rates will not climb back up again. But if the Department of Health can keep up the momentum this has created, there is a realistic prospect of achieving a target of less than 15 per cent of the population smoking within the next 10 years."
So there we have the source of all of the media headlines, faithfully and unquestioningly reproduced from Robert West’s press release.
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