Smoking is recognized to be the greatest single cause of preventable illness and premature death in the UK, killing around 106,000 (86,500 in England) people a year. (NICE.ORG.UK)
Overview and Introduction
“Smoking cigarettes is dangerous to your health,” is one of the most common terms we can hear wherever we go; we can see it on posters, on boxes for cigarettes, listen to it on the radio and on television, yet many people still have no inner sense for quitting smoking, if not reducing their acts.
Indeed, cigarette smoking- the most common form of tobacco smoking is a worldwide vice which could kill a person. More than that, the radiated harm of tobacco smoking does not just encompass the smokers themselves, it even poses a greater threat to secondary smokers which are otherwise known such men, as passive smokers, are more vulnerable to disease than the individual smoker.
Based on statistics, the United Kingdom scored the highest among the 28 European countries in terms of tobacco smoking control measures (Joossens, 2004). Despite this, UK still recorded, among Europe as the country which received the low score in terms of controlling smoking in public and workplaces.
With these, a major change was brought about by England- which recorded the a high percent of smoking prevalence in the UK. England responded to this call by enacting legislations and policies focused at diminishing the prevalence of smoking through the complete banning of the tobacco smoking in work areas. Aiming to lessen the prevalence rate to 21% by 2010 (DOH, 2004), the preventive measures done by England has, by far, gone through a series of roller-coaster events involving many groups which made influence, both pro and con to the purpose.
This article points out the trend surrounding the impact and impacts of interest groups on the formulation, application, and compliance of England’s Tobacco Smoking Policies. There is a desperate need to go beyond the basics of the subject at hand in describing such event. This paper would also discuss, primarily, what tobacco smoking is, how it affects the individual and the larger community, as well.
With these effects enters the control measures done by the government in order to reduce tobacco smoking, what are the rationale behind these laws and policies, how they are implemented and applied and more importantly, the manner in which they came to pass. In this certain part, the paper will integrate into its contents the roles and influences of interest groups, who they are, what role they serve and how significant are they to formulating policies and legislations.
An analysis of these circumstances is vital to the purpose of ceasing the occurrence and prevalence of smoking. Through tracing back its history, we may come to know the future possibilities which may arise out of these key events.
Furthermore, we may come to know the importance of these policies and legislations in creating a more humane and health-oriented community through targeting the prevalence of smoking in workplaces and public places.
Tobacco Smoking: Defined
“Tobacco smoking is simply the act of burning the dried leaves of tobacco for several purposes such as pleasure, self-medication, ritualistic aims, and the most common of all, physical dependence” (NISRA, 2006). Tobacco smoking is dated way back the ancient times, and until today, it continues to hold the title as one of the leading vices in the world.
Being the most widely-used type of tobacco smoking, cigarette smoking is the most profitable of all types of smoking since it has caught people from around the world under its addictive smokes. There are many other ways by which a person smokes tobacco like cigars, pipes and hookahs- yet the most convenient and easily obtainable are the cigarettes. In the United States alone, there is an estimated 46.5 million adult smokers- not counting the teens wherein occurrences of smoking are also increasing in their age-range.
In England, the prevalence rate in persons 16 and above, both men and women, are pretty high at about 24% (NISRA, 2006). Aiming to reduce it to 21% in four years time, England really needs to work extra-hard, considering that smoking is an addictive vice and dependents don’t quit easily- some even taking more than four years to completely clean themselves from smoking. More than that, based on the National Health Service reports, in order to achieve an optimum healthy lifestyle in UK, prevalence rate among adults should be lessened to at least 17% come 2011 (Wanless, 2004).
Due to these revealing facts, there are many programs through which the authorities rely on in order to achieve a rather intricate goal of lessening the prevalence of smoking such as ban of sale to minors, proper ads which does not promote its use, and the likes.
The Tobacco Industry
The tobacco industry is actually a very profitable business because it sells hundreds of thousands of packs a day. Considering its price in the market, cigarettes are already quite expensive because actually, tobacco is very easy to grow and always adaptive even to poor soil and climate.
Because of the great revenue and profit these tobacco industries gain, most governments made measures for this certain industry to be stopped such as imposing large tax cuts such that these industries would cease to existence as the predicted bankruptcy or failure goes. However, this aim did not materialize. Although it was foreseen that these industries would vanish from existence, the opposite happened. The reason behind this is that, although the cigarette is one of the heaviest taxed commodities in the market, the gains would not make that much decline.
First, though some have already quit because of the high rates per pack, which rose to about fifty-cent per pack since 1998 (Pubpol.edu, online), these are just few of the millions of tobacco-dependents and there are more and more people becoming addicted to smoking as years pass. Because of this, the large tax cuts have no much effect on the financial standing of these industries. In fact, more and more tobacco plantations are becoming members of the ITGA (International Tobacco Growers Association) which means that many are already engaging into tobacco industry over time (Pubpol.edu, online).
The Personal Harms of Tobacco
As most commonly referred to, tobacco smoking is equivalent to paying and spending your money for your own death. It’s ironic but it’s the real score- cigarette smoking is indeed a danger to the health of a person. Many claims and studies have been extensively conducted leading to the correlation of cigarette smoking and lung diseases, cardiovascular diseases and even psychological illnesses. The pioneer person in relating smoking to lung cancer was the American doctor Isaac Adler- who strongly believes and explicitly stated the relation of both aspects (Adler, 1912, reprinted 1980).
Many other professionals sided with the scientific evidence that smoking indeed leads to possibilities of lung cancer. Finally confirmed by the British Doctor’s Study leaded by Dr. Richard Doll which terminated only last 2001 (Doll, 2004), cigarette smoking started to become hot stuffs in the eyes of the authorities. Soon after, restrictions on cigarette selling and warning labels became imposed and strictly mandated.
In fact, during the years, 1920-1929, the worldwide mortality rate of smokers is three-times greater than that of non-smokers (Doll, 2004). Because of these concerning and frightening cases, restrictions made also paid the efforts of those advocates since last 2004, the number of quitters in smoking were about half of all the smokers in statistics (MMWR Weekly, 2005) fearing that lung cancer might be their cause of death. However, we must also take note that aside from lung cancer, there are many other diseases related to smoking, both active and passive.
Cardiovascular diseases are so much possible such as myocardial infarction, respiratory tract diseases such as asthma, emphysema, chronic pulmonary disease, laryngeal cancer and tongue cancer and many other complications, most especially if the person is unaware that he already has acquired diseases of this origin.
Societal and National Detriments of Smoking
Since tobacco is an addictive vice because of its nicotine content, it is already linked with the use of alcohol and prohibited drugs, even cannabis or marijuana. These are called”gateway” drugs in such as way that they open the portals for a person to engage in activities such as drug abuse and alcoholic addiction (Center on Addiction and Substance Abuse, 1994). As we all know, substance abuse is very detrimental to the society because it becomes an avenue for a person to involve himself in crimes such as rape, murder and other heinous crimes due to his euphoric sensation.
Aside from this correlation and possible cause of drug and alcohol abuse, some anti-tobacco smoking advocates argue that the amount of health-care costs covered by insurances public health increases because many are claiming for it, mostly because of the effects of tobacco smoking. Welfare dependence goes at a high rate, adding up to the expenses of the government in the treatment of these tobacco-smokers. In fact, the Center for Disease Control and Prevention (2002) claimed that in United States alone, the government spends seven dollars for every pack of cigarette sold with regards to the future liabilities of the government for the medical care.
Also, in most countries where tobacco smoking is still legal, the tobacco advertisers use catchy advertisements which aim to incite teenagers and even children to smoke. This certain acts lead to horrible outcomes such as the increase of prevalence rate in smoking especially to the lower age range- which would further complicate the unending detriment of tobacco smoking to society.
Preventive and Control Program of the Government
Because of the horrible effects of smoking not only to the smoker but even to the larger scale of society, many projects and programs were introduced to the public aiming at the prevention of tobacco smoking. In the entirety of the United Kingdom, which is including England, many policies were introduced such as the following: first is the advertisement ban of tobacco entitled The Tobacco Advertising and Promotion Act of 2002. This includes the cessation of advertising in print media, billboards, mails and even sponsorships. There is, however, an allowance wherein the advertiser can use an A5 size paper but one-third of the whole paper should cover the warning part of cigarette smoking.
There is also a protection for children so as banning the sale of tobacco to children under the age of sixteen. This warning should be explicitly stated in retail outlets and it is the responsibility of the retailers to implement it. Also, in England, the age at which tobacco smoking is legal was raised to eighteen years old just this first of October- this was to further ensure the lessening of their prevalence rate in smoking.
The regulation and labeling of cigarettes are also under the control of the European Union and local governments. Plus, the ingredients of tobacco were standardized and disclosed to the government so that the addition of addictive elements in cigarettes would be lessened and remained at a stable percent.
Tobacco Control Policies and Legislation
From the very first tobacco ban in the 1590s by Pope Urban VII (Heningfield, 1985), tobacco smoking has reached until the twenty-first century which only means that the combat against tobacco is indeed a difficult one because the primary shield against its cessation is the psyche of the persons who are addicted to smoking.
The government of the United Kingdom including England has already adopted many measures including the policies and laws governing the control of tobacco use. One example of this is the Stop Smoking Centers and Services which are being implemented in Wales and England. This certain service includes the therapy on quitting and cessation.
Mass Media campaigns are also increasing the Wales and England. Expenses on advertisements which promote tobacco smoking cessation have already reached up to 24 million pounds.
And just lately, England has also adopted the policy on Smoking Ban Public Places and Workplaces which was enacted only last July first. The Health Act in 2006 which contains this smoking policy has reached the Royal assent and already came to implementation in England three months earlier. This policy aims to lessen the incidences and prevalence of tobacco smoking and furthermore preventing the harms it may cause due to secondary smoking (passive smoking).
The smoking ban in England which was implemented just lately came with the specific guidelines of the law and the definitions of terms covered in the policy. The smoke-free premises were defined as places where work is done by more than one person, even there are shifts in the workplace and that it is open to members of the public; in either cases it should also be enclosed or substantially enclosed. There are also guidelines which helps further specify the being smoke-free of a particular place. Even public utility vehicles, except for private vehicles, are also banned since it is open the public (Implementation of smoke free legislation in England, 2007).
The enforcers of these laws are specified as lower-tier local authorities and port health authorities. Even some government agencies are also allowed to enforce the ban in a large scale in order to make it more effective and enforced.
Reaction of the General Public
The implementation of a Public and Workplace Ban of Smoking has collected various reactions from the general public, both good and bad. From the health care sectors and environmental advocates, there were impressive comments and reactions and the all-out support for the undertaking. From tobacco industries, however, the smoking ban was, as expected, deemed an exaggeration of the law.
In the early days of implementation, public compliance was as really high which indicated the success of the implementation. However, there were many controversies surrounding this smoking ban- mostly brought about by the tobacco industries which aims to interfere with the implementation of the law.
The Interest Groups and Their Role in Policy Making
Mainly, there are two types of interest groups with regards to the formulation, implementation and enforcement of the smoking ban- the pros and the antis. The pros have a significant role in such a way that they help in the enforcement and implementation of the said law. They also aid according to the classification of their advocacies, be it financial, volunteerism, medications, and other sorts which all helps to the success of the banning.
Pro-Tobacco Ban Interest Groups
With the call for a world-wide effort to control the harms done by tobacco smoking, volunteers in promoting the tobacco ban have increased over time. Projected the 10 million deaths caused by tobacco smoking in the near 2030 (Tobacco Smoking at a Glance, n.d.), reducing if not banning this certain societal problem have won the interest of many groups even external to the government and the WHO.
Examples of them are the business leaders who surprisingly showed their supports for the cause. Pharmaceutical companies also help in selling the cessation medicines and treatments like GlaxoSmithKline and Pfizer. Association of medical doctors aimed at ceasing smoking have also submitted their intention for support along with dedicated anti-smoking smoking groups, women’s groups, youth and even flocks of lawyers, economists and environmentalists. This manifestation of support against tobacco smoking is very blatant in most countries wherein the threats for health have been alarmingly increasing.
Allies external to the government also aids in the tobacco control policies by moving the tax increases through negotiation with the government like the International Tobacco Evidence Network (ITEN).
Anti-Tobacco Ban Groups
The anti-tobacco ban interest groups, on the other hand, make it harder for these rules to be applied- though indirectly. Examples of these interest groups are the tobacco industries, tobacco growers association and similar groups whose way of living and businesses would be greatly affected.
One example of this is the Big Tobacco Industry- a leading supplier of tobacco used for manufacturing of cigarettes. This interference of Big Tobacco poses the greatest hazard in the formulation and implementation of these laws. The threat is not just limited to one country but it encompasses all countries where tobacco smoking has been patronized by many and countries which impose large tax cuts to cigarettes.
Other interest groups which make the same threat are Philip Morris/Altria, British American Tobacco (BAT) and Japan Tobacco (JT). These groups use their influence on their ally politicians in “delaying, weakening and defeating tobacco legislations” (FCTC Report).
Response of WHO to Anti-Tobacco Ban Groups
In response to these threats, the WHO and the Framework Convention on Tobacco Control, including health officials and advocates made a consensus that tobacco industries should have no effect in public policy making. In fact, in the resolution of the World Health Organization and FCTC, they oblige all parties to ensure the safety of these policies against the vested interests of these tobacco industries. They also showed their support for the government in standing against these interest groups, more specifically against Big Tobacco- a leading international Tobacco Industry.
More than the formulation and founding of FCTC, the WHO also made cost-effective interventions to counter the anti-tobacco ban groups in their advocacy to delay policy implementation. These interventions vary from imposing higher tax cuts to cigarettes and other tobacco products, bans or restrictions in public places like schools, health agencies and the like, bans on advertising and promotion, consumer information through the hype of the media, large and direct warning labels to consumers and Nicotine Replacement Therapies and other types of therapies which helps those smokers who want to quit but simply can’t avoid and afford to (Tobacco Smoking at a Glance, n.d.).
Response of Anti-Tobacco Ban Groups to WHO and FCTC
However, the tobacco industries are really earnest on their propaganda regarding the delaying and tampering with the legislations. For instance, the Philip Morris/Altria hired a notorious firm to ruin the FCTC articles and undermine the treaties (Carter, 2002). In the case of the British American Tobacco, they also attempted to make a part in the legislation through sending large numbers of delegates in a negotiation in Geneva regarding the smoke bans (Corporate Accountability International, 2002). They also used the ITGA or International Tobacco Growers Association to be the puppet in raising their interests through working with the negotiators. In terms of Japan, which holds 50% stakes of the Japan Tobacco, they also attempted in undermining and making false image of FCTC through a connivance with British ideologue Robert Scruton and the media so that the treaties would be discredited by the public (Maguire and Borger, 2002).
Strategies of Tobacco Interest Groups to Policy Making
Tobacco Interest Groups, as defined earlier in this paper are those industries which produce cigarettes and tobacco products. It also includes other groups who, in any way benefit to the sale of tobacco products who intervenes in the policy making. These interest groups have several activities which they implement or do either legally or illegally in order to influence the law makers.
First is that the support the politicians in their race to political careers most especially the legislators. Campaign contributions are their second biggest activity next to tobacco product manufacturing. In the United States for example, Groups like Philipp Morris, RJ Reynolds, the Tobacco Institute, Brown and Williamson, Smokeless Tobacco have contributed almost $400,000 in the election cycles from 1996-2000 (Nixon and Glantz, 2001).
Secondly, the industries not only gives benefits and incentives to legislators but also to different offices of the house, giving them gifts, privileges and other lobbying tactics. Because of these techniques, there is really a big chance that the legislations and policies will be hampered and obstructed by the house itself- and this have been proven many times now.
Also, although it is a fact that the legislature has passed millions of funds for the health departments in order to control tobacco smoking, the release of these funds takes a lot of effort and patience because of the complexities in passing the permit to allocate and release funds.
In simpler terms, although there are many programs and agencies formed by the government in controlling tobacco smoking, and although the funds allocated are recorded to be in millions, because of the involvement of tobacco industries to the policy-making body, these advocacies and pro-tobacco banning groups have not been mobilized at an optimal level.
Local Effects in the UK
In the borders of the United Kingdom, the Tobacco interest groups not only infiltrated the government and the legislation but also several non-government groups which pose a real threat to the policy making of UK.
First is through funding academic institutions like the University of Nottingham which has been funded by the British American Tobacco with 3.8 million pounds. These tobacco industries maintain ties and bonds to prestigious universities by funding them in their researches and projects. Through this, there might be the impression to the young population that the tobacco industry should be maintained because of the help that they extend to schools and academes (Byrne, 2002). And the only way to pay the industry back is to patronize their tobacco products- which is absolutely detrimental.
Aside from penetrating these kinds of institutions and the government, these tobacco industries also pioneers the discrediting propaganda fro scientists and scientific researches which correlates and points tobacco smoking as a major cause for lung cancer (Yach, 2001). One example of this propaganda is the “Project White coat” which aimed to maintain a steady pace of controversy regarding scientific and medical releases against tobacco (Concar, 1998).
Although there are already bans and regulations as to the advertising of tobacco to the media, the industry still manages to campaign their deadly products to the young people. This is done by changing the packages and making it more teenager-oriented with the aid of advertisements on TV which could attract young people into smoking (Cummings, et al, 2002) and to become the new batch of lung-cancer potential patients.
More than that, the tobacco industry also uses the strategy of making their industry look like socially responsible companies (Hammond and Powell, 2001) by involving themselves into talks of sensitive issues and the like. Similarly, the US-Based Tobacco Company in UK named Brown and Williamson also made use of a slogan which makes their company look like manufacturers of healthy products.
A grave threat to a person’s well-being and to society’s health condition, tobacco smoking needs immediate policies in order to make illegal its use or if not, to diminish its prevalence. Not only is England the country which suffers because of its potential harms but many other countries which lack resources and initiatives in doing such acts.
The tobacco industry is so much connected to politics to the extent of even financing political plans of these politicians. It is also a general fact that the tobacco industry gives away millions and even billions in taxes because of the high tax cuts the government puts upon cigarettes. Because of this, it can also be concluded that the tobacco industries contribute to the general public fund which is used for several government projects and the like. Because of this, in the perspective of the tobacco industry, they may view this as something unjust to them that after they have complied with the control measures of the government such as banning of ads, large tax cuts, and prohibition to minor; the government will make an ultimate law to ban smoking at large.
On the other hand, we must also consider that although they have given taxes of large amount because of the heavy cuts, these taxes mostly go to the medications and insurances of the victims of tobacco smoking which accumulates as years pass. And because of this, we can say that the taxes they contribute are barely used for infrastructures and programs because it is expended mostly on health related problems caused by tobacco smoking.
In terms of England, although the implementation is pretty successful and making positive outcomes, we still could not eliminate the possibility of these tobacco industries to harass and suppress the legality of such smoke-free bans.
The tobacco industries have successfully enacted their techniques and strategies to preempt the proceedings of policy making and legislation. This can be very blatant most especially in places where these industries have lured the legislators and house into their traps of benefits and incentives.
In spite of the visible public policies and health advocates created, we can not conclude that the tobacco smoking prevention is already a success because these programs are a mere puppet just to make the public see that the large-scale efforts are working. But if we look at the inner side of the picture, we can see that the public policies in tobacco smoking prevention is still far behind a glimpse of success because of the advertent control of tobacco interest groups to the law making body.
The outcome depends on the public health advocates themselves. Since the law-making bodies have already been so penetrated by external forces, dependence to this branch of government should already be disregarded- instead, they should maximize whatever is given to them in order to mobilize their functions and restore the crusade against tobacco smoking without getting any help from the policies being hardly passed into laws. Continuance of dependence to the policy makers would further jeopardize the health of many people since time is so much of the essence. Everyday, more and more patients are being diagnosed with diseases related with tobacco smoking. Waiting for the implementation and passing of policies would be a kill on the part of the patients.
- Adler, Isaac 1980 Primary Malignant Growth of the Lung and Bronchi. New York, Longmans, Green and Company, 1912, pp. 3-12. Reprinted in 1980 by A Cancer Journal for Clinicians
- Byrne D. 2002 ‘The Warsaw Declaration – Turning the tide on the tobacco epidemic.’ WHO Ministerial Conference for a Tobacco Free Europe, Warsaw.
- Carter, Stacey M. 2002 “Mongoven, Biscoe & Duchin: Destroying Tobacco Control Activism from the Inside,” Tobacco Control 2002, Vol.11, Issue2.
- Center on Addiction and Substance Abuse at Colombia University 1994 ‘Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use’ Retrieved 27 October 2007 from <https://www.casacolumbia.org/supportcasa/item.asp?cID=12&PID=95>
- Concar D, Day M. 1998 ‘Undercover operation.’ New Sci 1998;2134:3-5.
- Cummings KM, Morley CP, Horan JK, Steger C, Leavell N-R 2002. ‘Marketing to America’s youth: evidence from corporate documents.’ Tobacco Control :11 Suppl. 1:i5-i7.
- Department of Health 2004 Spending Review Public Service Agreements.
- Doll R, Peto R, Boreham J, Sutherland I 2004 ‘Mortality in relation to smoking: 50 years’ observations on male British doctors’ BMJ (British Medical Journal) 328 (7455): 1519–1527.
- Framework Convention on Tobacco Control n.d. Retrieved October 27 2007 from <https://www.who.int/tobacco/framework/download/en/index.html>.
- Glantz, Stanton and Meredith Nixon. 2001 ‘Tobacco Industry Political Activity and Tobacco Control Policy Making in Washington: 1996-2000’. University of California: San Francisco.
- Hammond R, Powell A. 2001 ‘Trust Us: we’re the Tobacco Industry.’ Tobacco Free Kids Campaign/ASH.
- Henningfield, Jack 1985. Nicotine: An Old-Fashioned Addiction, Chelsea House Publishers, 1985, pp 96-98.
- Implementation of smoke free legislation in England: Guidance for local council regulatory officers
- Joossens, L. 2004 ‘Effective tobacco control policies in 28 European countries’ ENSP.
- Maguire, K and Borger J 2002, ‘Scruton in media plot to push the sale of cigarettes’, Guardian Unlimited, 24 January.
- MMWR Weekly 2005 ‘Cigarette Smoking Among Adults — United States’ Retrieved 27 October 2007 from <https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5444a2.htm>
- NISRA 2006 ‘Smoking prevalence data for England, Wales and Scotland is from the General Household Survey 2005 and for N. Ireland’ Continuous Household Survey. Belfast: NISRA.
- NYTimes n.d. ‘Cigarettes Cost U.S. $7 Per Pack Sold, Study Says’ Retrieved 27 October 2007 from <https://query.nytimes.com/gst/fullpage.html?sec=health&res= 9D02E1DA173CF931A25757C0A9649C8B63>
- Personal accounts by Corporate Accountability International (then Infact) representatives to INB5, October 2002.
- Pubpol.edu n.d. ‘Pro-Tobacco Interest Groups: Big Tobacco and Tobacco Farmers’. Retrieved 27 October 2007 from <https://www.pubpol.duke.edu/courses/ps145.02/project /group05/ interestgroup2.html>
- Wanless, D. 2004 ‘Securing Good Health for the Whole Population’ Final Report HM Treasury
- WorldBank.org. n.d. ‘Tobacco Smoking at a Glance.’ Retrieved 7 November 2007 from < https://www1.worldbank.org/tobacco/pdf/AAG%20Tobacco%206-03.pdf>
- World Health Organization n.d. ‘World Health Assembly Resolution 54.18’ Retrieved October 27, 2007 from <https://www.who.int/tobacco/framework/wha_eb/wha54_18/en/ index.html>
- www.opsi.gov.uk/acts/acts2006/ukpga_20060028_en.pdf www.nice.org.uk/page.aspx?o=502811
- Yach D, Bialous SA 2001. ‘Junking Science to Promote Tobacco.’ Am J Pub Health 2001; 91(11):1745-1748.