ENEWS::UK treads softly on smoking (fwd)

[Robert Weissman <rob@essential.org>]

UK treads softly on smoking

BMJ --  Warden 318 (7175): 9
by John Warden, parliamentary correspondent BMJ 

British Medical Journal (8906) 
;
Date: Saturday, 1/2/99
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The British government's long awaited action plan to reduce cigarette 
smoking contains 20 initiatives, but apart from a statutory ban on 
advertising these rely on persuasion rather than coercion. There are no 
new restrictions or bans on smoking, but an emphasis on cessation 
through cooperation. 

The main innovation announced in a recent white paper, Smoking Kills, is 
a £60m scheme to help adults stop smoking, with one week's free supply 
of nicotine patches for people on low incomes.
               ===================
The British government's long awaited action plan to reduce cigarette 
smoking contains 20 initiatives, but apart from a statutory ban on 
advertising these rely on persuasion rather than coercion. There are no 
new restrictions or bans on smoking, but an emphasis on cessation 
through cooperation. 

The main innovation announced in a recent white paper, Smoking Kills, is 
a £60m scheme to help adults stop smoking, with one week's free supply 
of nicotine patches for people on low incomes. The scheme will begin 
next April in pilot areas where general practitioners will be able to 
refer people who want to give up smoking to a course of specialist 
counselling. 

Other antismoking measures target teenagers and pregnant women, against 
a background of what the white paper sees as the beginning of a new 
upward trend in smoking that causes 120000 premature deaths a year and 
costs the NHS £1.7bn ($2.9bn). Despite this, the more robust approach of 
the health secretary, Frank Dobson, is tempered by the well known 
aversion of the prime minister, Tony Blair, to being accused of 
introducing a "nanny state." "We recognise that people have a choice," 
Mr Blair states. 

As a consequence, the force of law is used only against the tobacco 
companies, whom Mr Dobson accused in the Commons of "murdering people." 
The European directive banning tobacco advertising and sponsorship that 
was agreed last summer (BMJ 1998;316:1334) will be implemented this 
year, starting with an end to advertising in the media and on 
billboards. Most sports sponsorship will end by 2003, with an exemption 
for Formula 1 motor racing until 2006. 

By contrast, the government will put £50m into a publicity campaign. 
"For years, tobacco companies have spent millions on advertising. Now we 
are prepared to do the same," the white paper states. 

Other measures are largely voluntary by agreement with trade 
organisations. These include a proof of age card for young people, 
minimal advertising in shops, and siting vending machines to prevent 
their use by children. Criminal sanctions against retailers who 
persistently sell cigarettes to underage children are being considered. 

Pregnant women who smoke will be a focus of action at local level as new 
smoking cessation services are developed. Nicotine replacement therapy 
is not advocated for pregnant women, but this will be subject to further 
research. 

The government does not propose to ban smoking in public places or at 
work. It is, however, negotiating a "public places charter" for 
non-smoking areas and improved ventilation in pubs and restaurants. 
There is to be a new code of practice on smoking in the workplace. 
Smuggling of cheap tobacco is to be countered by strengthening customs 
surveillance. 

Health professionals are urged to advise patients to give up smoking. 
"When a doctor talks to a smoker about the benefits of giving up, it can 
be a powerful motivator," says the white paper. 

In the Commons, Dr Peter Brand, a Liberal Democrat MP, was disappointed 
at the minimal support for people who want to give up smoking. He said 
it took 6-12 weeks, and one week's supply of Nicorette was neither here 
nor there. Mr Dobson said a week's supply would cost about £15, which 
was less than smokers spent on cigarettes. With increasing incomes, 
cigarettes require 60% less purchasing power than in 1965. 

Through what it claims is a comprehensive, sustained, and resourced 
approach, the government hopes that 1500000 fewer people will be smoking 
by 2010. Mr Dobson said that smoking is a principal cause of the health 
gap that leads to poorer people dying sooner. That was why the 
government would balance high tobacco tax with real support to help 
smokers quit. 

Smoking Kills is available from the Stationery Office, price £11.50. 

The main points in the white paper are: 

*End tobacco advertising and sponsorship 

*New NHS service to help smokers give up 

*A week's free nicotine patches for the worst off 

*Mass media publicity campaign 

*National proof of age card 

*Prevent child access to vending machines 

*Choice for non-smokers in public places 

*Code of practice for smoking at work 

*Tobacco tax increases 

*Action against tobacco smuggling		
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11:39 AM on 1/4/99