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Artillery Row

All smoke and no fire

An Impact Assessment on prohibiting cigarettes is unconvincing

Spare a thought for the folk who produce government Impact Assessments. It is the job of these anonymous but presumably highly educated pencil pushers to turn the sow’s ear of politician’s whims into the silk purse of cost-effective public policies. Impact Assessments are supposed to ensure that new legislation is sound and evidence-based. To make doubly sure, each Impact Assessment is itself assessed by the Regulatory Policy Committee who gives it a green, amber or red rating. But politicians do not make evidence-based decisions. Politicians make political decisions and then leave it to civil servants to marshal the evidence after the decision has been made.

The Tobacco and Vapes Bill is a case in point. Last autumn, Rishi Sunak announced that he wanted to ban people born after 2008 from ever buying tobacco. No country has ever raised the age of smoking like this and no one knows how it will pan out. Prohibition doesn’t work at the best of times and it seems destined to fail when the prohibited product is still on the shelves for most of the population to buy. Nevertheless, Rishi Sunak is set on the idea and so legislation was hastily drafted and an Impact Assessment commissioned. 

How on earth do you predict what will happen under this weird, untested policy, let alone show that the benefits will outweigh the costs? The approach of the civil servants  behind the Impact Assessment was to email 19 “expert stakeholders” and ask them what they thought would happen. Their combined wisdom led to the graph below which shows smoking rates over the next 76 years with and without Sunak’s prohibition. It predicts that the number of smokers will steadily fall without a generational ban but, for some bizarre reason, this comes to a halt after a few decades and it flatlines for the rest of the century. This, presumably, is “evidence” that a ban is needed and the blue line shows how terrifically successful it will be. Under the Sunak prohibition, the model assumes that smoking prevalence among 14-30 year olds will be “effectively zero by 2050”. Given that 15 per cent of 16-24 year olds smoke cannabis — a drug that has been completely banned for nearly a century — this seems a little optimistic.

The Impact Assessment not only needs to show that the policy will work but that it will be cost effective. This is difficult to do because tobacco duty raises £12 billion a year and smokers take less from the public purse than nonsmokers. Groping around for some plausible financial benefits, the authors of the Impact Assessment took some figures from the economically illiterate, single-issue pressure group Action on Smoking and Health (ASH) which purport to show the societal cost of smoking in England and produced the graph below.

You will notice that there are some unfeasibly large productivity benefits in the modelled scenario. This is because smokers earn less, on average, than nonsmokers and ASH stupidly assume that their low paid work would magically become high paid work if they stopped smoking. It is a ridiculous assumption, but it is the only way to conjure up a “societal benefit” that outweighs the very tangible cost to government of tobacco duty revenue collapsing. 

Last week, the Regulatory Policy Committee gave its verdict on the Impact Assessment. It expressed concern about the “over-reliance on evidence from ASH” and spotted the obvious problem that ASH’s productivity estimates “do not control for other factors that may affect a person’s earnings”. It suggested rethinking the assumption that the prohibition was “unlikely to have substantial impacts on tourism” since smokers may be reluctant to visit a country where they can’t even buy cigarette papers, let alone tobacco. And it politely recommended that more consideration be given to “the continued likelihood of some people buying cigarettes illegally for others”, an issue that is given astonishingly little attention in the Impact Assessment. 

Legislating for prohibition without considering the effect on the black market is almost comically negligent, but there is one other aspect of this policy worth mentioning that is ignored in both the Impact Assessment and the RPC’s opinion. A lot of people enjoy smoking and, if this policy works as intended, that enjoyment will be denied them. This is not a popular thing to say and the anti-smoking lobby goes to great lengths to deny it. They claim that people only smoke because they started in childhood and got hooked. The government claims that “most smokers want to quit”. But do they? There is enormous social pressure on smokers to say that they don’t want to smoke, but in the last Public Health England survey, only 20 per cent of smokers expressed a strong desire to quit and even among this minority, most did not intend to quit in the next three months. Moreover, it is no longer true that most smokers start in childhood. The majority of people who start smoking today have their first cigarette between the age of 18 and 24.

I get too tetchy without my vape to deny that nicotine can be addictive, but 69 per cent of all the people in Britain who have ever smoked are now ex-smokers and as the smoking rate declines it is perhaps inevitable that most of those who continue to smoke have no real interest in quitting and just want to be left alone. A recent study from Norway found “only 15% of those who currently smoke in Norway can be characterized as addicted”. The authors note that Norway, like Britain, is a country where everyone is aware of the health risks associated with smoking, where tobacco advertising was banned many years ago, where smoking is not permitted in any indoor public place, where only 1–2 per cent of children smoke, where tobacco taxes amply cover any conceivable costs to the state and where smokers are “a decimated and socially declassified group without influential spokespersons in the corridors of power.” 

The authors then pose an ethical question that is rarely asked in “public health” circles today:

… if consumers are informed and consonant, willing to pay the cost, act regulatory-compliant, appear unexposed to seductive marketing and possess a desire to continue smoking, do the regulators then have the right to tighten the measures further and in doing so, ignoring these people’s self-determination for the sake of their own good?

This question may be too philosophical for an Impact Assessment, but it would be nice to hear Rishi Sunak answer it.

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