John Humphrys – Smoking v Calories: Has Rishi got it Wrong?

October 06, 2023, 12:10 PM GMT+0

Here’s a nice easy question to start with. Would you prefer to be a slim smoker or an overweight non-smoker? Let’s make that a bit more difficult. Assuming you have young children or maybe kids in their teens, which would you prefer for them? You’ll have spotted immediately why I have chosen this topic: Rishi Sunak’s announcement in his conference speech that he wants to bring in legislation that would make it illegal for teenagers to buy cigarettes. There was, of course, no announcement about childhood obesity. Many believe he’s got his priorities fundamentally wrong. Do you?

Under the plan, anyone born on or after 1 January 2009 – in effect anyone who is 14 or younger now – would never be able to buy cigarettes legally in England because the “legal” age would be raised by one year every year. What that means in theory is that as old smokers die out, the habit will die with them. England will become a nicotine-free country. That’s the way New Zealand is heading. Or, at least, that is its intention.

From next July the number of retailers able to sell cigarettes will be sharply reduced. The following year the amount of nicotine that is allowed in them will be cut and from 2027 the sale of cigarettes to anyone born on or after 1 January 2009 will be illegal. We don’t know yet the precise details of how it might work in England but the destination is the same: a no-nicotine country.

It's estimated that four out of five smokers today picked up the habit before they were 20. The Department of Health and Social Care says the new law would have “the potential to phase out smoking in young people almost completely as early as 2040”. It described it as “the most significant public health intervention in a generation”. The cost of smoking in cash terms is enormous. The charity Action on Smoking and Health says 207,000 children still take it up every year. Diseases caused by cigarettes cost the NHS and social care an estimated £17bn a year as well as causing people lost earnings from smoking-related illnesses.

The government has indicated that there would be a free vote in Parliament on the proposal and it’s assumed that it would get the support of opposition MPs.

The big health charities are, as you might expect, delighted. Sarah Woolnough, chief executive of Asthma + Lung UK, said: “This could be the gamechanger we’re looking for”. She said tackling smoking would be an incredibly positive step forward that would “protect the next generation from lung conditions caused by this deadly addiction.”

Michelle Mitchell, the chief executive of Cancer Research UK, said it would be a “critical step on the road to creating the first ever smoke-free generation.” The prime minister, she said, would “deserve great credit for putting the health of UK citizens ahead of the interests of the tobacco lobby.” But there’s been plenty of opposition too. It can be summed up in two words: “nanny state”.

Sue Reid, a lifelong smoker and Daily Mail writer, summed it up thus: “It raises the prospect eventually of a 51-year-old being able to buy cigarettes, but a 50-year-old being banned from doing so — and therefore, surely, a system of government ID cards to enforce the law. Court challenges will be sure to come before it reaches the statute book. If ever a nanny-state policy were destined to rile core Conservative voters, this is surely it”.

And anyway, Reid says, the new law wouldn’t work. Here’s why: “Most of the young smokers I know buy their cigarettes illegally from the internet, where the cost can be as little as £4 a packet. Prohibition has never ended happily. Ban something and people, particularly children and teenagers, tend to want it all the more.”

Sher uses prohibition in the United States to make her case: “When America outlawed alcohol in 1919, the market shifted from licensed sellers to gangsters like Al Capone. New York state, where 75 per cent of the income was from alcohol taxes, nearly went bankrupt. Theatres, restaurants, entertainment venues, breweries and distilleries all closed, leading to a huge hike in joblessness. The prison population soared. Prohibitionists had proclaimed that banning the demon drink would solve all the country's ills. But just 13 years after passing the 18th Amendment, the U.S. abruptly overturned it. A powerful lesson for the future.”

The Institute of Economic Affairs, a free market thinktank, agrees. It described Sunak’s proposal as a “prohibitionist wheeze [that is] hideously illiberal and unconservative”. It “will create a two-tier society in which adults buy cigarettes informally from slightly older adults and will inflate the black market in general”.

But The Times disagrees. It points out that the NHS attributes roughly 76,000 deaths in the UK each year to smoking, with many more people suffering from illnesses linked to the habit and says Sunak has “brought a blast of fresh thinking to a stale and stubborn problem: “a smoke-free generation”. This, it says, is a bold policy move that “ testifies to an unignorable reality: previous initiatives haven’t shrunk the addiction swiftly enough.”

It dismisses the nanny state objection thus: “Mr Sunak is not trying to stop existing smokers from buying cigarettes, but simply to prevent the tobacco industry creating a new generation of addicts; an aim with which numerous seasoned smokers would surely agree. Many were first drawn in by an advertising culture that swathed cigarettes in romance, associating smoking with freedom, rebelliousness, independence, cowboys and femmes fatales. Only once trapped in the habit, struggling to give up, did smokers realise that there’s no romance on an emphysema ward.”

The prime minister also won some praise for promising to crack down on vaping. The vaping market, says Gaby Hinsliff in The Guardian, is “notoriously flooded with cheaply made, counterfeit and black-market versions, prone to contain illegally high levels of nicotine or potentially harmful amounts of heavy metals… Manufacturers of vapes should be forced to produce vapes that do not appeal to children. They should market vapes as the boring, clinical tool for helping adult smokers that they’re actually supposed to be – no sexier than a blister pack of nicotine gum and definitely not mango ice blast-flavoured. Combining that with ramping up enforcement and safety checks to disrupt the black market in illegal e-cigarettes, to protect the health of those already hooked, could well make a difference.”

There’s something else that Sunak did not promise in his Blackpool speech and many believe it to be the biggest threat of all to our health of our children. A government report says it causes more than 30,000 deaths a year in England and is a bigger killer than smoking. Obese patients cost the NHS twice as much as those within a healthy weight range. If everyone were a healthy weight, one study suggests, the NHS would save nearly £14bn annually.

The lead researcher, Dr Jonathan Pearson-Stuttard, of Imperial College said the cost was borne not only from living with obesity but the myriad related conditions such as heart attacks and strokes. The latest statistics show that we have the third highest obesity rates in Europe after Malta and Turkey.

Last month a report by the Institute for Government said that while Sunak’s government says it wants to reduce obesity, it “has no serious plan to achieve that aim”. A failure to address the problem, it says, will lead to lower productivity, higher taxes, greater health inequalities and increasing pressure on the NHS.

And why are we so much fatter now than we were a generation or two ago” Because, say the experts, we are surrounded by UPF (ultra processed food), soft drinks, packaged snacks, biscuits, sweets and crisps, ready to -eat or ready-to-heat meals, instant noodles, “all of which are constantly on display and easily accessible to all.”

So the conclusion of many of those experts is this: if Rishi Sunak is really concerned about our health as a nation and specifically about the health of our children, he should deal not only with smoking but obesity too.

What’s your view? Do you think enough is being done to stop our children eating junk food? Do you approve of a new law to stop young people smoking and is it right to give smoking priority over obesity?

And what about you? Do you smoke and, if you do, are you trying to kick the habit? And are you overweight?

Let us know.

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