Britain beware: Australia’s data on plain packs isn’t reliable

Back when the Tories were exploring introducing plain cigarette packs, health secretary Jeremy Hunt said he’d wait to see what impact the rules would have in Australia – at that point the only country to have implemented them – before making a decision.

That promise got a bit lost in the mix. Plain packaging was passed by the Commons last March and quickly made it through the Lords. The new rules will go into effect in just a few months’ time. As the UK prepares to switch out branded cigarette packages for uniformly unsightly plain ones, it’s worth taking a look at how the project has been going for Australians, especially since its Department of Health released its a post-implementation review (PIR) last week.

The review asserts rather emphatically that plain packaging is to thank for a “statistically significant decline” in smoking rates among both adolescents and adults. How statistically significant?  As it turns out, the PIR concludes plain packaging account for a drop of just one half of one percent (0.55%, to be exact) of a 2.2% overall decline in the smoking rate. On the whole, the percentage of Australians who smoke has fallen from 19.4% to 17.2%, rates of tobacco use among Aussies were already declining at a consistent clip before any of the measures under review were even put into effect.

Some outside observers harshly critiqued the review’s methodology and statistical evaluations, highlighting the difficulty of trying to isolate the impact of plain packaging (as opposed to other measures, like tax increases) and issues with the data models themselves. We are basically taking the government’s word for it.

Measures like plain packaging don’t make for convincing arguments on a statistical basis, but they do help stigmatise smoking and the individuals who buy cigarettes by “denormalising” cigarette use. Once smoking has been pushed beyond the pale of acceptable social behaviour, what is to stop its outright criminalisation? Quite a few public health advocates would likely applaud an initiative to make cigarettes outright illegal, and the British Medical Association has already mulled the idea of banning cigarette sales to anyone born after the year 2000 – even once those minors have become adults. Cigarettes are just one of a slew of legal products and activities that have an adverse impact on an individual’s health. Once they have been outlawed, will public health officials take the same course of action to stop people from drinking (or eating fast food, for that matter)? The idea might seem preposterous now, but the precedent of legislating life choices is already being set.

In terms of pure efficacy, the abolition of brands and trademarked packaging doesn’t ultimately seem to deserve much credit for the drop in smoking rates. The PIR itself admits this, estimating that only a quarter of the drop in overall smoking rates since 2012 can be chalked up to plain packaging. Much of the rest of that drop might be attributed instead to four 12.5% annual increases in excise taxes that were put into place beginning in December 2013. The third of these increases, for example, raised the price of a pack of cigarettes in Australia’s Northern Territory to $23 AUD (£12). For consumers, the price tags might be more frightening than the warning labels.

If Australia’s political class has its way, anti-smoking measures will make it practically impossible to maintain a smoking habit (at least legally). The Labour opposition has already announced its intention to push the price of a pack of 25 cigarettes up to $40 AUD (£20) if elected. According to opposition leader Bill Shorten, this would be accomplished with four more 12.5% increases, purportedly raising $47.7 billion in revenue over the next decade and theoretically forcing smokers to quit on account of cost if nothing else. Tax hikes, however, come with a downside: as legally sold cigarettes decline, it would hardly be surprising to see a growth in black market smuggled cigarettes. We can expect an increase in the record illegal cigarette busts Australia has already experienced over the past couple of years.

For every successful bust, it would also be safe to assume many more illegal “chop chop” cigarettes will make their way into Australia’s already-lucrative black market for tobacco. As taxes on cigarettes shoot skyward, profit margins for smugglers can safely be expected to jump accordingly. Little wonder that the country has set up a dedicated ‘tobacco strike team’ to deal with organised cigarette smuggling rings. As the Australian Border Force (ABF) assistant commissioner for investigations put it:

“The Australian tax rates on cigarettes are amongst the highest in the world, for good reason, and that means that smuggling of tobacco is more profitable here than it might be overseas.”

Other countries considering their own anti-smoking measures, such as Slovenia, will likely need to make significant investments in border security.

If the British government is still looking to Australia as a template for its own plain packaging rules, it would do well to take a more measured approach to implementing and evaluating the effects of its decision. David Cameron and Jeremy Hunt are still Conservatives, for who the rights of companies and citizens are ostensibly held in high esteem. At least in Australia, it appears that doing away with the former has not been the silver bullet public health advocates promised. Even so, it is no stretch to think those same advocates will continue working until cigarettes themselves, and not just cigarette branding, are legislated out of existence.



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