Tuesday 24 July 2018

A Perfect Population Level Experiment

The NNA spotted a superb statistic on Friday at the government's Tobacco Control Debate. I don't know about you but I think this deserves more attention.
Yesterday in a debate on the government’s Tobacco Control Plan in the House of Commons, Sir Kevin Barron highlighted the gulf between the UK and Ireland, two countries with identical traditional tobacco control policies but with differing approaches to e-cigarettes. Between 2012 and 2016 smoking dropped by nearly a quarter in the UK . In Ireland, where e-cigarettes are viewed with suspicion, the smoking rate actually went up in this period. 
Here is the Hansard entry for it.
I want to give a comparator and to refer back to my intervention on the Minister. I chaired the Health Committee in 2005, after we had fought an election on a manifesto commitment by the Labour party to introduce a ban on smoking in public places. I stood on that manifesto, but the ban proposed was not a comprehensive one. The Health Committee, of which I became the Chair, investigated smoking in public places. We went to Ireland to take evidence, because it had had such a ban for about two years. 
I will now demonstrate the effectiveness of e-cigarettes by comparing smoking rates in the UK versus those in Ireland, where every other approach to tobacco control is identical to those in the UK, such as plain packaging, retail display bans and marketing promotions all stopped. In recent years in the UK, smoking rates have dropped by almost a quarter—according to the Office for National Statistics, 24.4% of UK adults smoked in 2012 and 15.8% in 2016—and the UK now has the second lowest smoking rate in Europe. In Ireland, which has exactly the same tobacco control as we put through this place over many years, smoking rates have stagnated: 23% of adults smoked in 2015 and 2016, dropping to 22% in 2017, according to Healthy Ireland stats. That shows how the use of e-cigarettes has been good in reducing smoking in this country.
As the NNA has shown with their links, Hansard and Barron are actually wrong here. In Ireland the rate was reported as 22% in 2012 (chapter 3) and 23% in 2016. Maybe Barron was confused himself, perhaps it didn't compute. But both figures are derived from the same source, Tobacco Free Ireland.

But whether it is down by 1% or up by 1% matters not, this is a real life experiment which is just about perfect. In the UK smoking rates have nosedived, while in Ireland they have barely shifted. In the UK we have a supportive environment to e-cigs, in Ireland high profile politicians are doing everything in their power to turn smokers away from them.

We are not comparing the UK with a country with vastly differing levels of disposable income here, far from it. Ireland is a country on a par with the UK as far as the economy goes.

What's more, we're not comparing with Africans, south east Asians, Indians, Scandinavians, Americans north or south or antipodeans. We are comparing with our nearest cultural neighbours, so closely aligned are we that we don't even enforce passport requirements between the two countries.

The British and the Irish are about as good a comparison for ecological purposes as there can possibly be.

And, as Barron said, the only difference between UK policy and Irish policy is that over here our government cautiously welcomes new nicotine products whereas in Ireland they don't.

As I mentioned only yesterday, if politicians really want to get smokers to quit smoking - because that is really what they want, isn't it - this should be compelling stuff.

For a political class who consistently say they always wish to act on evidence, this is about the best quality evidence they can get. A population-level, real life study of two almost identical countries - with just the one difference in nicotine policy - but with vastly differing outcomes.

So why are other countries not scrambling to emulate the indisputable success of promoting safer alternatives to smoking that this inadvertent experiment proves? Well, I guess it also shows that the other tobacco control policies legislated for in that timescale - of which there have been many - are completely and utterly pointless. And I suppose there is always the fear that if smokers actually did what politicians pretend they want to see, tobacco tax receipts would also plummet, and they are fully aware that the economically fraudulent propaganda tobacco controllers spout about smoking harming the economy is utter bollocks.

So bravo to Barron for highlighting such a stark comparator in the House of Commons chamber. You just have to wonder why the tobacco control industry and other politicians, both sides of the Irish Sea, have been so silent about it, whereas if the results were the other way round they would be screaming it from the rooftops.

It's never been about health, you know. 

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