Forest response to white paper on public health
Tuesday, November 30, 2010 12:30 ... Still waiting for the details of the Government white paper on public health. According to one BBC report, "Details on how the government aims to tackle individual problems, such as obesity, smoking and drinking, will not be spelt out in full until the new year." However Radio 4's World At One has just reported that tax on high strength beer is to go up, so there may be more detail to come.
Here is Forest's response, based on Health Secretary Andrew Lansley's comments earlier today:
NEWS RELEASE Tuesday 30 November, 2010
WHITE PAPER "A CHARTER FOR SOCIAL ENGINEERING" SAYS SMOKERS' GROUP
A consumer group has warned that the Department of Health white paper on public health could be a "charter for potentially oppressive social engineering".
Simon Clark, director of the smokers' group Forest, said: "Government has no business micro-managing people's lives. For all the talk about nudging, the white paper could be a charter for potentially oppressive social engineering.
"We know what happens when people refuse to be nudged. Campaigners demand more and more regulations and ministers are happy to indulge them.
"The white paper merely transfers that power to local councils.
"We are in danger of creating an immensely dull, zero risk society in which freedom of choice and personal responsibility are consigned to history."
Update: the Guardian has the story, and a quote from our press release, online: White paper hands responsibility for public health to local authorities.
In contrast the Telegraph's medical editor Rebecca Smith appears to have swallowed the Government's line without query: No more nanny state on health: Andrew Lansley
Simon Clark
13:45 ... Tobacco to be the subject of a 'Tobacco Control Plan' to be published in the New Year. Can't wait.
Simon Clark
14:05 ... Press release and white paper, Healthy Lives, Healthy People, now available on DH website.
In brief, "The White Paper sets out the Government’s long-term vision for the future of public health in England. The aim is to create a ‘wellness’ service (Public Health England) and to strengthen both national and local leadership".
What Government will and won’t do
The Government will take a less intrusive approach, staying out of people’s everyday lives wherever possible. This follows a model called the Nuffield Council of Bioethics Ladder of Interventions, which means that instead of reaching for choice-limiting regulations at every opportunity, the Government will employ a range of evidence based approaches to improve health.
The ladder increases in intrusiveness as follows:
* Do nothing or simply monitor the situation. Some behaviour trends are minor and fizzle out, so intervention isn’t needed.
* Provide information. Giving people the information and education to make a choice for themselves based on evidence.
* Enable choice. Give people a ‘nudge’ in the right direction so they can change their behaviour. For example, through access to public exercise facilities, cycle paths, or safe playgrounds.
* Change the default to help guide choice. Using positive ‘social norms’ is a way of encouraging this.
* Guide choice through incentives. A ‘points mean prizes’ approach, for example the more a child walks to school, they earn points for healthy prizes like an activity day.
* Disincentives, such as taxation or other price related action, to discourage people from smoking or drinking.
* Restrict choice, probably through regulation, such as raising the legal age for smoking or banning trans fats.
* Eliminate choice altogether. Rarely used, but most common examples include making seatbelts compulsory and making dangerous drugs illegal.
Local control, better health
Directors of Public Health will be employed by the Local Authority and be the ambassadors of health issues for the local population. In practice, this means that they will lead discussion about how the ring-fenced money is spent to improve health. This will include influencing investment decisions right across the Local Authority, with the goal of enhancing health and well-being.
Crucially, they will be able to make sure that public health is always considered when local authorities, GP consortia and the NHS make decisions.
To make sure that progress is made on issues like obesity and smoking, Public Health England will set a series of outcomes to measure whether people’s health actually improves.
Less intrusive? I think we'll be the judge of that ...
Reader Comments (52)
And those that don't or won't conform become the new lepers in society to be shunned by all others.
What a wonderful prospect to look forward to - I don't think!
Never mind deaths 'directly' related to all these forbidden fruits, the death rate due to these new tactics will likely escalate dramatically as leaving this mortal coil becomes a much more appealing choice.
Succinctly expressed!
Couldn't have put it better myself Simon.
Have a look on ConservativeHome here
Andrew Lansley is saying "Every time someone smokes a cigarette they do themselves some harm." You can comment.
Didn't take them long to abandon 'nudging' (only step 3 on the 8 rung ladder), did it?
And very well put, Simon. The electorate isn't going to be hoodwinked by the "It wisnae me" Lansley apprach to accountability.
When are the Government going to give us back our freedom of choice?
Stunning that on page 28 of the white paper it says "We will treat capable, responsible and informed adults as adults" Yet on page 37, one of the reasons given for banning tobacco sales from vending machines is that such machines "are a source of temptation for adults trying to quit" . So on this basis why don't they just spare us all obviously "incapable", "irresponsible" and "unformed" smokers and ex-smokers the agony and ban the sales of cigarettes from anywhere? Especially so given that, again according to the white paper (pg 14), "Good wellbeing does not just mean the absence of mental illness - it brings a wide range of benefits, including reduced health risk behaviour (such as smoking)......... So there you have it - 25% of the British Population are at a stroke the official underclass in society and must be made "well" whether they like it or not. This isn't "nudge", it's "grudge" against anyone who dares to be different from the elitist public health norm. The fact that this white paper seeks to spawn a whole plethora of Directors of Public Health should make anyone who believes in freedom shudder!
"Good wellbeing does not just mean the absence of mental illness ...."
Pity my mental health has suffered so much since the ban! Not done me any favours has it?
A system of incentives ignores the fact that other reasons may affect whether someone walks to school/ work, and whether they use currently licit "drugs" such as alcohol and tobacco to "self-medicate" themselves for stress, saving the NHS thousands of pounds in psychtropic medications and doctor/ nurse appointments!
I am sure I can recall reading in "The Psychologist" journal that smoking optimises arousal levels (wakes you up of you are dozy, calms you if you are nervous) - that must have been back in 1978/9.
Its a very sad country that we live in now, where governments attempt to dictate lifestyle choices. A couple of million of us that do not wish to be leperised have stopped going to pubs; rather than stand or sit outside in the cold and rain. The smoking ban has decimated our social lives and businesses. How could it possibly get any worse? Clearly the coalition are a bunch of dictators, no better than New Labour.
Was it a coincidence that George Osborne also announced a massive investment programme by Glaxo Smith Kline.
The title " Local Control, Better Health" should be renamed " Local Control,More Control" as this country moves from the "Nanny State" to "Nanny Statelets"
POLICY SOLD FOR PHARMA GOLD,
WHAT A PARCEL O' ROGUES IN A NATION.
This is very disturbing, I thought the coalition intended to rebuild the country, not demoralise it further.
The Conservatives could have at least given us a hint, like calling themselves NuConservative or something.
I voted on their past form in opposing such infantilising interference.
I apologise for my dreadful mistake.
Who knew when I abandoned my lifelong Labour Party membership because of their monstrous nannyism that the Tories would be just as bad? Actually, I did suspect it wasn't just a Labour thing but I believed the Tories among you when you assured me I was wrong. Meh.
Utterly depressing that a Conservative led government seems to think that this is an intelligent way to squander scarce resources. Pubs continue to close because of the smoking ban and revenues from smokers are lost as we increasingly turn to cheap imports as tax on cigarettes is unfairly high. Yes, I know the imports are illegal, but I rather thought that the only advantage of EU membership was free trade? Not on alcohol and tobacco for some odd reason!
As seen on the ASH website in response to the white paper:
http://ww.ash.org.uk/media-room/press-releases/:public-health-white-paper-a-step-in-the-right-direction
“Consultation on plain packaging for tobacco products is to be welcomed but it should be as well as, not instead of, putting tobacco out of sight in shops. It’s an anomaly that brightly coloured tobacco displays which are already illegal on a bus stop or a billboard are still allowed in shops. The Government must confirm that the legislation to put tobacco out of sight will be implemented as planned from October 2011 without further delay, or the strength of its commitment to improving the public health will be put in doubt.”
"Must confirm" , "without further delay" ?? I had hoped (but am obviously completely wrong) that we lived in a parliamentary democracy and that this new government would make its own decisions while at the same time protecting its citizens from the overbearing influence of unelected pressure groups like ASH. Some hope! Will the last smoker to leave the country kindly extinguish his/her cigarette before doing so!
THE TOBACCO COMPANIES SHOULD CLOSE DOWN ANY MANUFACTURING PLANTS IN THE UK IMMEDIATELY AND MOVE ELSEWHERE.
It's a white paper. Doesn't it still have to be voted through the House?
It's perfectly sensible to review the issues of plain packaging and display restrictions at the same time BUT with two important caveats
1 there is genuine and considered consultation with all interested parties and interrogation of all the relevant evidence and research and
2 there is simultaneously a review of all the other significant issues relating to tobacco and smoking, for example
- smuggled and counterfeit tobacco products, which aside from revenue losses for HMRC create the significant law & order and health & safety issue attenuant to wholly unregulated products
- how the harm caused smoking can be reduced, ie ensuring availability and access to smoking cessation products and also less harmful smokeless products like snus and electronic cigarettes
- how those that still choose to smoke can be encouraged to change their littering behaviour; noting that over 122 tonnes of cigarette litter is dropped daily and the UK's annual street cleaning bill has risen by +£300m since the smoking ban introduced in 2007
These are'nt unreasonable suggestions. Indeed they are suggestions that should resonate with a Government committed to Responsibility, saving public money and working collaboratively with the private sector and the wider community.
Any other approach panders to the tobacco control health lobby and pays lip-service to the wishes of more than 10 million people who choose (and you've surely got to be an idiot not to know that smoking carries with it certain health risks?!) to continue to smoke and I suspect an even larger number of people who believe in the freedom of others to consume and enjoy what is a legal product.
Charles Hamshaw-Thomas
Principal, CSR Solutions
Charles:
I would suggest a totally INDEPENDENT review of the smoking ban and an IN-DEPTH examination of the junk science that led up to it.
"Can the Tories be trusted ?"
Absolutely NOT!
Eddie
I would concur 100%!
Junk science is a major problem. The problem is that blatant inaccuracies get repeated and repeated to the stage that they become accepted as facts.
Last week we were told authoritatively - by the World Health Organisation no less -that 600,000 people die each year across the globe from second-hand smoke. If that figure were extrapolated backwards ie to include numbers of cigarette smoked/number of smokers to create the deadly smoke you'd have a truly and ludicrously large number of people who die each year from first hand and second-hand smoke collectively. And which if true would on compassionate grounds compel governments worldwide to unite together to ban tobacco overnight.
I suspect the approach of the tobacco control lobby in this case however is not to let a blatant inaccuracy spoil a good headline?
Charles
Spot on, Charles! ;-)
'Eliminate choice altogether by making dangerous drugs illegal'
I thought dangerous drugs were illegal.
I think this new coalition admires and wishes to follow in the footsteps of that nutter dictator in North Korea.
Who said the BNP would be a disaster?
I always thought that our career politician, Lansley, was not to be trusted. He is just New Labour in sheep's clothing! Nudging is the same as nannying - absolutely no difference just a different word meaning the same thing. Why do our ruling classes seem to think they have a god-given right to DICTATE the way we live our lives. Cameron, if you carry on like this, especially with this pillock Lansley in place, you are guaranteed to be a one-trick-pony!
I wonder how much the Spin Doctors got paid for that weasel word - Nudge.
They must have been burning the midnight oil with the Dictionery to come up with that one.
Wonder did they get paid overtime as well?
Ann:
"Nudge" stands for the "National Unit for Dissemination of Government Edicts"
"THE TOBACCO COMPANIES SHOULD CLOSE DOWN ANY MANUFACTURING PLANTS IN THE UK IMMEDIATELY AND MOVE ELSEWHERE."
Actually, that's not such a bad idea. Imagine if tobacco companies immediately pulled out of the economy entirely - no more production in-country and no more deliveries in country to boot.
Overnight - the tax loss would be immensely visible as would all the consumers flocking to the illegal black market or overseas purchases.
Government would have an immediate and definite fit.
Police would be unable to keep up with all the black marketeering.
Smokers currently thinking there's no problem going on would become immediately enraged and react vocally and loudly towards all government levels against the bans, taxation, packaging, retail restrictions, anti-smoking propaganda, etc.
A very loud and common voice would arise, overnight, in multitudes.
It doesn't even need to be forever such a tobacco industry policy need be established. Within days to a few months, it might force the government to come to its senses.
Honestly, something like that, initiated by the tobacco industry, might actually force the government into a corner on bans, taxation, packaging, the whole bit - force them to negotiate instead of being so steadfastly authoritarian.
Perhaps I have been a little hasty. I assumed that the Conservatives knew exactly what had been going on and would want to put a stop to it quickly, but they were not in power when the ban came in and ASH may have been somewhat economical with the truth.
Perhaps someone would ask if the Conservative leadership had approved the denormalisation campaign. Or pass this summary to them.
Markers of the denormalisation of smoking and the tobacco industry
Methods: This paper identifies a diversity of generally undocumented yet pervasive markers of the “spoiled identity” of smoking, smokers and the tobacco industry, illustrated with examples from Australia, a nation with advanced tobacco control.
Results: We caution about some important negative consequences arising from the stigmatisation of smokers.
Denormalisation
THE SPOILED IDENTITY OF SMOKERS
Smokers as malodourous
Smokers as litterers
Smokers as selfish and thoughtless
Smokers as unattractive and undesirable housemates
Smokers as undereducated and a social underclass
Smokers as excessive users of public health services
Smokers as employer liabilities
As smoking becomes increasingly denormalised and communities vocal about their dislike of smoking, there is abundant evidence that smokers internalise this negativity."
http://tobaccocontrol.bmj.com/content/17/1/25.full
Prepare to be ostracised, all you smokers of England
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article1913299.ece
It is a little late for "nudging" law-abiding people, when they have already been hit very hard with a base-ball bat.
I never could stand Andrew Lansley anyway. However, scratch his boss, Daisy Cameron, and you'll find Lansley's twaddle repeated. This lot are not Tories but socialists in Tory drag!
I suggested something like that myself, Jane, but I was talking about California, where they intend to stop people smoking in the open air. Maybe if the tobacco companies, alcohol companies and fast food people got together and refused to supply California, people would see what is going on. Think of all the tax revenues going to adjacent states, when California is already bankrupt!
I worry about tobacco companies. I wonder to what extent they already 'diversifying' into big pharm investors.
I've so many thoughts about Lansley's and the Governments's betrayal of their principles and the electorate. and many have already been mentioned Hopefully many established Tory MPs will also wake up the the betrayal of their principles.
Don't they realize that there are many parts in OUR Country where an intentional NUDGE will result in a purposeful SLAP and the sooner the better.
Simply because they're in power they forget that we gave them the honour of serving this Country and its people not the country of their dreams where many of us are alien to their prescribed design.
FACT - some of us are FAT, some SMOKE, some GAMBLE, many have other distinct characteristics BUT we willingly work within reasonable guidelines to benefit OUR Country.
We created and supported places where some of our 'less desirable' activities were hidden from sight, we had places where we could relax and share our problems with friends, we had places where strangers could avoid isolation, we had places where we could socialise ............... OUR solutions that did not openly promote the pleasure of smoking to our youth and places where drinking was controlled by us; we had lives that were sufficiently content that we had little need for binging to provide comfort in an empty world.
None of this matters to our political superiors whose dream world has no place for individuality, free-thinkers or anyone who tries to wants them down.
A quick design note-- plain packaging will not be enough - They will soon realize (or is this already in the plan) that plain packets will need to be hidden since, in a shop with every other product brightly promoted, the most noticeable item and the one many will be most curious about will be the one in plain packaging --- Many of started smoking through curiosity!
Junican:
Read Page 26 of the Japan Tobacco International Annual Report for 2009 and you will see their involvement with Big Pharma.
Pharmaceutical Business
FY 3/2009 Business Performance Summary
• Net sales: ¥56.8 billion, up 15.7%
• EBITDA: ¥ 4.9 billion, up ¥ 11.2 billion
• Operating income: ¥ 1.0 billion, up ¥10.7 billion
http://www.jti.com/documents/annualreports/annurep2009
THIS, Ladies and Gentleman, is what a One-Party state looks like. British-style.
And the ONLY way to end it is by refusing to VOTE for its continuance every few years. Those who fail to recognise this self-evident fact cannot be allowed to complain that they're getting sick of The Same Old Thing.
The Electorate are rather like the poor oysters in 'Through The Looking Glass': they end up getting eaten by both the Walrus AND the Carpenter. But even Alice came to her senses at last:
"Well! They were BOTH very unpleasant characters."
But then Alice always was a sensible girl.
"No more nanny state on health" from Lansley, I don't suppose it matters now
that New Labour and their smoking ban has stopped a couple of million of us from
going to the pub. I don't agree that they had the right to impose any outright indoor ban in private business premises anyway.
What we really needed to here, is that the nanny state is to be rolled back with an amendment to the smoking ban so adults can again choose for themselves, to socialise where they are most comfortable. The coalition are just New Labour all over again, they clearly don't give a damn about the general public so long as the likes of the EU and ASH are satisfied, everyone else can be totally ignored.
Surely this is another opportunity for us smokers in the UK to all write again to our elected MPs & MEPs & Councillors and demand that the law be changed regarding smoking in pubs and clubs in our local areas. Are we living in a democracy or under a Dictaorship?
Does our vote or opinion mean anything any more? Well, we shall see...
There is only one way for the government to show that they are going to be less intrusive... and that is to Amend The Smoking Ban so that publicans have the freedom to choose what goes on in their establishments. We should have the choice of clearly marked Smoking Pubs & Clubs & non-smoking Pubs/Eateries... and I bet I know where the punters will be!
The Netherlands was the first country to partially overturn its smoking ban. Smokers in small bars and pubs will now be able to light up without fear of a fine... see:
http://www.dailymail.co.uk/news/article-1327226/Smoking-ban-u-turn-Holland-ALLOWS-lighting-2000-bars-pubs.html#ixzz16oXggahS
There was a update at the beginning of 2010 to the German law for no smoking... Smoking is now be allowed in one-room bars and clubs smaller than 75 sq meters where no food is served.
Also as the the Greek government face harsh reactions by bar, cafe and restaurant owners, they are preparing to do a partial about-face on the anti-smoking law. The law has been largely unobserved in Greece anyway.
http://greece.greekreporter.com/2010/11/19/government-rethinks-smoking-ban/
However, EU Health commissioner John Dalli has said he wants to put a stop to this.
OUT OF EU NOW! The European Commission is preparing to introduce legislation in 2011 to ban smoking in public places right across the union. The EU bill may also attempt to make packaging uninteresting and outrageously plans to REDUCE the amount of nicotine and other toxic substances contained in the product! Read:
http://euobserver.com/9/31021
We must protest now at this assault on our personal freedom or face a stronger straitjacket. I rarely go to the pub these days as I want a smoke with my drink, but I went to my local today and the subject of the ridiculous anti-smoking policy came up (as usual)... I then discovered that the eight people in the pub, including the publican, were ALL SMOKERS - how ridiculous that we should all have to go out & stand in the freezing cold snow to have a cigarette! There should be less regulation and more liberty to make our own choices in adult establishments.
Tell those you voted into positions of power now... Write now: http://www.writetothem.com
I note from Lansley's website bio that he describes himself as 'an active member of the Church of England', as well as being a graduate (in what, we don't know) of Exeter University. This makes perfect sense. Exeter was subject to infestation by two peculiar social phenomena in the Eighties: the Sloane Ranger, and the ardent, inflexible and/or neurotic living-in-a-different-world-from-the-rest-of-us 'Christian'. The fact that Daddy ran a pathology lab might also be relevant in this context. As might the fact that Jesus was a non-smoker, too.
Take it from me - you'll get no change from our Bible-reading Andrew. But please DO expect a lot more rendering-unto-Caesar (whoever's playing Caesar at the moment) in the secular arena, and a lot more saving-us-from-ouselves in the spiritual (smoking having become The Eighth Deady Sin).
Arnott was on C4 news last night again getting away with 'the ban is popular' and 'smoking rates have dropped' memes. In his introduction to the issue Jon Snow talked about tobacco abuse!
I wish to God ASH could be exposed instead of having so much access to the airwaves to spout their lies.
(Needless to say, Debs wasn't happy because she doesn't think that 'nudging' goes far enough.)
Eliminate choice altogether. Rarely used, but most common examples include making seatbelts compulsory and making dangerous drugs illegal.
I noticed this and wondered, that if with the seatbelt law, medical exemptions would apply? I have a seat belt exemption, which has to be renewed every 5 years at a cost of around £25 but I also have to see a psychiatrist so he can confirm that my claustrophobia is not getting any better and is not liley to be successfully treatable. Perhaps the psychiatrists can do the same for smoking?
Probably not, I know!
"the ban is popular................."
In which case, of course, I expect Scrumptious Deborah's full support when I - as the newly-appointed Protector of the Realm - pass an edict to the effect that one in five (got to a bit 'incremental' on this one) of all pubs be designated as 'smoker-friendly.'
A grateful drinking populace will FLOOD into the smoke-free pubs - leaving the smoker-friendly ones to languish and die (probably within a month or so). Thus, the Great British Public will ITSELF have decided the issue once and for all - without recourse to the opinions of the Experts (loved and valued as they are), and my manservant Lansley (can’t get the staff these days) can cease his grumbling about those unsightly spittoons.
Of course, if Deborah is wrong.....................................
As for Jon Snow: he's never been the same since being dumped by that deep-breathing brunette bird (yclept 'Anna', I believe). And him a Student Rebel, too…………..(once).
Cannot say I am surprised. This government has been a train wreck from start to finish and none of them have any scruples or morals at all.
Anyone who voted for this lot expecting change has been had. These policies are an even worse continuation of those of the previous administration. The CONservatives and their leader CamerCON have shafted you. All you Tory voters busting a gut to put this shower into government have been stiffed. But there is nothing you can do about it now because you voted them in.
Are you all still so pleased with the election result?
You think this is bad?
Think what it could have been like under hard-labour!
Jack Straw. I echo that sentiment. Anyone reading the debates in parliament can see certain Labour members frustration that Andrew Lansley has not gone far enough and are seething at his reluctance to say whether we are going to have a display ban or not.as arranged by the previous government.
Thank you sheila, nice to know there are some people on here with a modicum of sense.
That is true - just imagine what another 5 years of Labour, emboldened by another election victory, would have been like!
The British electorate are in the unfortunate position of being "thankful" that they are just being kicked in the nuts on a daily basis rather than having shards of bamboo shoved under their fingernails.
A sorry state of affiars when that is the BEST any voter can hope for when they cast their vote.
@Jack Straw.
Jack, my friend, I don't think that your last comment was very kind! If you hang around for a while, I am sure that you will see that the vast majority of us have more than a little sense. This site is not essentially about the deficiencies of the government - it is about the idiocy of the smoking ban, That is what Sheila was talking about.
Junican, As sheila's unofficial spokesperson, maybe you should have read what she actually said before rushing to her (unneeded) defence.
“The government believes the wider remit of councils in areas such as housing…..puts them in a stronger position to tackle smoking”
Could this be a hint towards a ban in social and then eventually in private housing?
And in case you've forgotten. Jack, it was essentially passed by the 220 NuLab MP's who voted for it.
Jack Straw -
As one of those totally lacking in any kind of 'sense' (they never taught it in my school), I'd greatly appreciate your assistance in pointing me in the direction of the changes wrought by the Cameron Ministry - you know, the sort of changes that would have any good Socialist doing star-jumps. For example, which measures has Cameron REVERSED in respect of:
1) The massive growth in a largely pointless bureaucracy (around half a million) ?
2) The huge increase in taxation ?
3) The generalised assault on our liberties ?
4) The asset-stripping of our Constitution ?
5) The 3000-plus new criminal offences created by Blair and Co ?
6) The haemorrhageing of our what few powers of self-government we have left ?
7) Child-snatching by the State ?
8) The use of our fine troops in cruel, morally indefensible 'wars' ?
9) The wasting of our resources in the scientifically indefensible Climate Change Act and the wholly fraudulent 'Green' agenda it supports?
To name but a few (as they say). My mental deficiences, and those of my co-contributors to this particular thread, have clearly blinded me to the Obvious. Kindly point it out to me.
Adam:
I have no doubt that the "Councils" will extend their Anti-Smoking role when they get the power to do so.
The Scottish Tobacco Control Alliance ls an example of "Councils" involvement even before any new devolved power.
http://www.ashscotland.org.uk/ash/3371
Their aim is to set up Local Alliances which will no doubt stifle any opposition to their views. The voice of the ordinary member of the public will be outnumbered by the Partnerships for Health and Removal of Tobacco Sales(PHARTS).
http://www.ashscotland.org.uk/alliances/local-alliances
THIS IS A REAL THREAT TO DEMOCRACY.
That's right, Eddie -
The New Localism - Working For YOU !
Bet you feel the same surge of 'empowerment' coursing through your veins as I do...