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Lies, damned lies and the tobacco packaging debate

Premature declarations that plain packaging is helping stamp out cigarette smoking don’t help. Neither side of the debate is fully committed to intellectual rigour.

While the row over plain packaging of tobacco in the UK makes life difficult for Prime Minister David Cameron, here in Australia plain packaging got another run with the release of a report purporting to show that plain packaging reduces enjoyment of cigarettes and makes smokers think more about quitting.

This produced a round of stories in Fairfax, the ABC, the Conversation, the West Australian and Reuters, after Health Minister Tanya Plibersek issued a media release trumpeting the study, which was commissioned by the Cancer Council of Victoria.

Problematically, however, if you actually wanted to read the study, you couldn’t, because it and the associated report hadn’t been published yet in BMJ (which used to be called the British Journal of Medicine). The story was published overnight on the BMJ site. Journalists yesterday were thus forced to rely on the say-so of the government and the public health industry that the report said what it said.

The essence of the study was a phone survey of 536 Victorian smokers as plain packaging was being rolled out, with a group of around 390 plain pack users compared to the remainder, who were still using branded packs. The survey, which is statistically rigorous despite the relatively small sample size, found plain pack users were less satisfied with smoking, thought their cigarettes poorer in quality and thought about quitting more. However, despite one public health industry executive claiming plain packaging “[makes] it almost impossible for smokers to ignore the devastating harms of smoking”, there was no difference in how much plain pack users and branded cigarette users thought about the harm of smoking.

As the study authors make clear, whether these differences are due to plain packaging itself, or that graphic health warnings are now larger, isn’t clear. That important nuance was only picked up by the Reuters journalists. Plibersek’s media release conveniently elides the issues. The study authors also emphasise that the study was undertaken while plain packaging was being rolled out.

BAT was asked for the sales data on which it based its statement by Reuters, the ABC and Crikey, but wouldn’t provide it on the basis of commercial sensitivity.”

But the key question is whether plain packaging has led to a drop in smoking. It’s key because plain packaging legislation was a significant government intervention into an already heavily restricted market, one that can only be justified on its own terms by a significant fall in tobacco consumption. Smokers’ satisfaction levels and thoughts about quitting mean nothing if behaviour doesn’t change.

British American Tobacco says there hasn’t been any impact. “There has been no noticeable impact on legal tobacco sales in the first six months due to plain packaging as smokers are still purchasing cigarettes just as they were before it was introduced,” BAT spokesman Scott McIntyre said in a statement, although he suggested any proper assessment of sales trends would need to be made over 12-18 months. BAT was asked for the sales data on which it based its statement by Reuters, the ABC and Crikey, but wouldn’t provide it on the basis of commercial sensitivity.

But both sides have some mixed motives when it comes to the impact on tobacco sales. One of the highest profile public health industry lobbyists, Professor Mike Daube, yesterday claimed “the primary focus for plain packaging was always to reduce smoking among children, but it is a real bonus that it has clearly had an impact on smokers”. That’s rather different to what Daube said when plain packaging was first announced, when he claimed “we know from research that it will have a significant impact on children and adults”. Is Daube readying for when we see that plain packaging hasn’t affected tobacco sales?

Either way, Plibersek’s media release statement that the study shows plain packaging is “working to put people off smoking” appeared at least a little disingenuous, though it depends on what you mean by “putting people off”. By the time some in the media had finished with it, we had “packs helping smokers kick the habit” (the ABC) and “plain cigarette packaging works: study” (the supposedly more rigorous Conversation). Perhaps the reports might have better if journalists had the actual report to work from, rather than a press release from one side of the debate?

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  • 1
    Anna Gifford
    Posted Tuesday, 23 July 2013 at 12:55 pm | Permalink

    Good points in this article, but it’s hard to really say either way without the sales data…even if they didn’t want to give gross quantities, surely BAT could indicate a percentage of any change to sales? That would then prove the argument either way.

  • 2
    jack jackson
    Posted Tuesday, 23 July 2013 at 1:02 pm | Permalink

    Note that it was BAT that cwas elected to be the spokesman for the tobacco cartel as they are beyond the reaches of ASIC in the event that they provide misleading information to the market. Any chance that the London Stock Exchange will investigate whether or not this information to the market is accurate?

  • 3
    StephenD
    Posted Tuesday, 23 July 2013 at 1:04 pm | Permalink

    One correction… BMJ was never the “British Journal of Medicine”. It was “The British Medical Journal”.

  • 4
    drmick
    Posted Tuesday, 23 July 2013 at 1:26 pm | Permalink

    Ha Ha Ha. This was meant to be a joke piece right?. I mean you wanted to get the f a c t s before you wrote a negative story? Why change the habit of a lifetime? Surely you will find a female member of the government kind to crucify over whatever it is you are writing negatively about. The fact is that the actual number of people who have stopped smoking, and who have been prevented from smoking may never be known,thanks to the same money that promotes smoking as a safe activity. But don’t let that get in the way of commercial activity.

  • 5
    Charles Richardson
    Posted Tuesday, 23 July 2013 at 1:48 pm | Permalink

    Yes, the “reports might have [been] better if journalists had the actual report to work from”, but more to the point they’d have been better if the journalists had refused to write them until they had the report. I don’t blame politicians for being dodgy; that’s what politicians do. I blame the media for letting them get away with it.

  • 6
    Lesley Gruit
    Posted Tuesday, 23 July 2013 at 2:18 pm | Permalink

    What I noticed was that BAT’s claim that there has been no drop in sales contradicts their claim in last year’s high court case and Phillip Morris International’s claim in the ongoing Investor State Dispute Settlement case that they need to be compensated because plain packaging will cause millions if not billions of dollars of harm to their business. If they are not losing sales, why do they need compensation?
    Lesley Gruit (Australian Fair Trade and Investment Network AFTINET)

  • 7
    zut alors
    Posted Tuesday, 23 July 2013 at 2:26 pm | Permalink

    Plain packaging laws are one of those very rare things ie: policy destined for long term benefit to society.

    I suspect the true statistics will not be gleaned for half a generation.

  • 8
    Will
    Posted Tuesday, 23 July 2013 at 2:47 pm | Permalink

    This is a silly article. If Keane had done even cursory research he would know that the primary goal of the reform has always been to deter new smokers and powerful behavioural effects of branding identification.

    It was NEVER pitched primarily as being about smoking cessation, though that would be a welcome secondary effect. He would know this if he bothered to follow original research and advocacy campaign which prompted the reform.

    Keane is generally wonderful, and I even agree with some of his points against the preventative health industry, but here he has simply let his snarky instincts get in the way of proper reporting and analysis.

  • 9
    Posted Tuesday, 23 July 2013 at 3:03 pm | Permalink

    BAT’s word on anything would have to be a lie, surely?

    It almost makes me wish I hadn’t given up smoking just so I could test the hypothesis, almost.

    BERNARDK: BTW, did you get my tweet yesterday?

  • 10
    Popeye
    Posted Tuesday, 23 July 2013 at 3:13 pm | Permalink

    What’s Keane on about? Another opportunity, apparently, for a member of the press gallery to put the boot into the government.

  • 11
    Kevin_T
    Posted Tuesday, 23 July 2013 at 3:28 pm | Permalink

    Quote: “Smokers’ satisfaction levels and thoughts about quitting mean nothing if behaviour doesn’t change.

    On a different level, if the plain packaging does not deter one established smoker, but reduces the take-up of the next generation(s) of smokers, I would suggest the policy would still be a success.

    As Zut Alors commented above: “I suspect the true statistics will not be gleaned for half a generation.”

    We criticise our Governments for not looking past the next election when drawing up policy, but when a policy like this is likely to have a long term positive effect on the health of the nation, and reduce some related costs in our health system in the long term, we are only too ready to criticise because the benefits are not cut and dried by the next election.

  • 12
    Malcolm Street
    Posted Tuesday, 23 July 2013 at 5:35 pm | Permalink

    This is the same plain packaging legislation that was fought tooth and nail by the tobacco industry in Australia, and which was torpedoed in the UK on the urging of Lynton Crosby who was inter alia a lobbyist for Phillip Morris? And who now say that it hasn’t noticeably affected sales but won’t release the figures? Look at their actions, not their words.

    And as a couple of other posters have pointed out, the *primary* purpose was to make it less likely for new smokers to start, which means that it will take several years to see the major effects. Existing smokers are in the grip of a physical addiction and hence the packs will have only a relatively small effect.

  • 13
    Posted Tuesday, 23 July 2013 at 6:03 pm | Permalink

    Plain packaging was introduced in September, the survey was conducted in November—before the existing stock of branded packaging had even been depleted. Keane isn’t happy because there was no instant mass quitting. I would have thought that in such a short timeframe, an increase in factors that contribute to quitting could be chalked up as an early success.

  • 14
    AR
    Posted Tuesday, 23 July 2013 at 9:19 pm | Permalink

    Sooo, BK, you are not just a political hack but will write anything to fill your daily verbiage quota?
    Facts are sacred, try consulting them before you hit the keyboard - on the one hand, on tuther isn’t journalism.

  • 15
    MJPC
    Posted Wednesday, 24 July 2013 at 7:56 am | Permalink

    But both sides have some mixed motives when it comes to the impact on tobacco sales”
    What like, if plain paper packaging results in less people taking up smoking, or more giving up smoking that is a good health outcome? or, conversley:
    If plain paper packaging is successful in reducing smoking, cigarette’s will reduce as one of the main causes of cancer therefore tobacco companies cannot claim some ‘benefit’ if consumers buy cigarettes? For once a government decided to take a stand against a health issue that no one anywhere in the world would attempt. Of course the LNP wouldn’t, they were getting donations from the tobacco industry!
    This is one confusing article.

  • 16
    Brian Smith
    Posted Wednesday, 24 July 2013 at 10:47 am | Permalink

    If BAT is saying it hasn’t affected sales, then they shouldn’t oppose it, should they? They can’t credibly argue both sides of the question, can they (we’ll all be rooned, it has no effect)?

  • 17
    andrew kelly
    Posted Wednesday, 24 July 2013 at 10:56 am | Permalink

    Asking tough questions is a virtue in journalists, but can become so ingrained a habit or even a pose, that it gets directed at things where the returns are meagre, or pointless. The problem with that is it begins to make them seem like the people they are trying to corner, handlers of show. This ‘hard hitting’ article is headed that way. Perhaps premature claims have been made. Oh well, wait and see, but hopefully no one needs to disembowel themselves just yet.

  • 18
    Nick the Hippy
    Posted Wednesday, 24 July 2013 at 11:05 am | Permalink

    Sorry, piss poor effort.

  • 19
    Harry Rogers
    Posted Wednesday, 24 July 2013 at 12:47 pm | Permalink

    Well Bernard you certainly know how to bring the rabid rabbits from their holes. Well done.

  • 20
    Andybob
    Posted Wednesday, 24 July 2013 at 7:33 pm | Permalink

    Tobacco sales are taxed. Have the tax receipts fallen ?

  • 21
    Malcolm Harrison
    Posted Wednesday, 24 July 2013 at 7:57 pm | Permalink

    As a smoker i never supported this legislation. In particular i did not support calling cigarette packs ‘plain’ when they were anything but. I was miffed by the government’s move to reduce the duty free quota on tobacco products which seemed petty, and i was appalled by the installation of a ‘sin’ tax whereby the price of tobacco rises every six months.
    Demonising tobacco and tobacco users has been a social parlour game for 25 years now. While gender and race are deemed unsuitable for condemnation everyone can feel free to pick on tobacco. While climate change is either being largely ignored or denied, there is consensus that it is perfectly okay to blame the many ills that beset us on tobacco. Those who dont smoke exude an aura of righteous virtue and those who have given up behave like born again religious fanatics.
    As for the public campaign around this issue in 2012, it focussed entirely on attacking tobacco manufacturers and totally ignored the plight or the interests of the long term user.
    Meanwhile alcohol continues to be the social drug of popular choice and public approval despite the decades of medical studies that suggest that, outside meth amphetamine and heroin, it is the cause of the greatest damage. m.

  • 22
    AR
    Posted Wednesday, 24 July 2013 at 8:58 pm | Permalink

    MH - “totally ignored the plight or the interests of the long term user.” err, NO, the best interests of smokers is to STOP.
    If you don’t give a shit about yourselves or early bereaved family, then the rest of us have an interest coz you cost us so bloody much, at least 2 or 3 times the tax paid for your fix, in cardio-pulmonary care alone, never mind the other malign effects.

  • 23
    MJPC
    Posted Thursday, 25 July 2013 at 8:28 am | Permalink

    MH, as a long term never smoker I have the opposing view. No wonder the govenrment is attemtping to stamp out smoking because the cost of paying for the hospitalisation of smoking related illness is prohibitive (and it isn’t only cancer, it is also the related respiratory diseases). The sadness is, as I recently observed attending a public hospital, and here are all the smokers outside having a gasper (despite the signs clearly saying no smoking).
    How much does a government have to do to save the populace from themselves. As for excise and duty of cigarettes, it can’t be high enough as far as I am concerned, if it saves my taxes from going to save people who seem to have little thought for their own welfare, or indeed others.
    It is no secret, the link of smoking to cancer was proved in the 1930’s, of course the tobacco industry suppressed that research, which was immmoral.

  • 24
    Bill Parker
    Posted Thursday, 25 July 2013 at 10:04 am | Permalink

    Just looking at the BMJ abstract reminded me of Vance Packard’s book the “Hidden Persuaders” Packaging DOES matter (Packard’s example of three versions of washing powder packages and the exact same formulation inside but only one was “effective”.) Or the relatively more recent way that Roche worked out how much carotenoid to put into chook pellets. Taste of the eggs was no measure - it was colour even when all the test birds were fed identical diets except for carotenoids.

    Give this fags process a bit of time and the dissatisfaction factor will grow.

  • 25
    Harry Rogers
    Posted Thursday, 25 July 2013 at 10:31 am | Permalink

    Malcolm Harrison

    Well said. I’m a non-smoker but happily run to your defence. Smoke as long as you like I’ll pay my tax for all to use the fat, the bigoted, the drunks, the righteous etc..There go I but for…

    Notice how they all run as soon as you mention alcohol. Sanctimonious bunch of …

  • 26
    MJPC
    Posted Thursday, 25 July 2013 at 11:30 am | Permalink

    HR, all haven’t run from alcohol as I do not drink alcohol and believe as MH does that this is a legalised drug that is just as damaging as cigarettes.
    I am all for introducing alcohol sold in plain bags, no advertising of liquor, even outside shops selling it as has been introduced in Canada.
    Neither am I righteous, if someone wants to drink or smoke excessively then it’s their funeral, just don’t criticise the government when they try to address one of the vices being marketed to underage users by tobacco companies, and hooking them on something that will kill.
    There you go but for…only if you make the choice to go that way.

  • 27
    Harry Rogers
    Posted Thursday, 25 July 2013 at 11:46 am | Permalink

    MJPC

    Thanks for your reply. You say:

    The sadness is, as I recently observed attending a public hospital, and here are all the smokers outside having a gasper (despite the signs clearly saying no smoking).”

    You appear to have a different view on humanity. Go to the diabetes ward or the leukaemia or countless others like road accidents and then do your auditing of life and make your judgements of where money is best spent.

    Most of the herd rely on judgements about OTHER people to give themselves comfort hence the celebrity culture and then get great gratificatiopn from tearing them down.

    Is it so difficult to stand back and accept the choices (an openly debateable subject)others make. Why always be a rope carrier in the crowd.

  • 28
    Posted Thursday, 25 July 2013 at 1:58 pm | Permalink

    ANDYBOB (20) Good one. I’ll bet that what has gone up is the amount of the taxpayers’ money spent in promoting health programs. Or, where oh where did we lose the tax receipts????

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