WTO ruling on the plain cigarette packaging case

Hi guys, I thought I'd do a follow up to the ongoing plain cigarette packaging case as it was something I had covered nearly a year ago. This is an issue that is not going to go away as people are never going to stop smoking, tobacco has been a part of human culture for over 3000 years and is probably going to be around for a lot longer than that. Interestingly, another substance which falls into the same category is alcohol and humans have been brewing fermented drinks for over 12,000 years. Somehow, we have got to find a way to reconcile the fact that people want to consume tobacco products and drink fermented drinks and of course, the role of the government is to take a harm-reduction approach when it comes to activities that can harm the citizens' health. Thus it is in this context that many governments have gone down the route of plain cigarette packaging, but has it worked so far? Do we judge a government by their noble intentions or the results of their policies? Is there a viable alternative to this harm-reduction approach, a better solution to this situation that isn't going away? After all, we have had plain cigarette packaging for a while in the UK already but have yet to see any corresponding fall in consumption patterns: clearly, it doesn't achieve anything and is but a token gesture. The reason why I am revisiting this issue is in light of the recent WTO ruling that basically endorsed plain cigarette packaging, which will enable it to be adopted in other countries despite the fact that latest evidence from Australia, UK and France has demonstrated little or not evidence that it has had any effect at all.

Before we proceed, allow me to make a disclaimer as always, I'm not a smoker. I don't work for the tobacco industry, I am however someone who believes in holding our governments to account for the decisions they make and if they are making a mistake, I believe we should speak up. Here's the main reason why I don't think it is right for various governments in the world to start implementing plain cigarette packaging: they are merely copying what other governments have done without properly evaluating whether or not it has done anything to reduce the amount of smokers (or the amount of cigarettes each smoker is consuming). What we need is proper, rigorous policy debate and industry engagement to find a better solution than plain cigarette packaging and instead, all we have seen so far are various governments painting tobacco companies into a corner, portraying them as the villains whilst promising that plain cigarette packaging will be the simple answer to reducing the number of smokers - well clearly, that hasn't worked at all: data emerging from early stages of the plain packaging implementation in the UK and France confirms that it has to done nothing to change smoking behavior and decrease tobacco consumption. As in Australia, smokers in the UK and in France have simply continued to buy and consume tobacco products in plain packs, despite their unappealing colors and more prominent health warnings. No surprises there as complex challenges often are not solved with simplistic solutions, you need to look at the data and understand the underlying reasons why those people want to smoke in the first place.

The fact is cigarettes (and other forms of tobacco products) are smoked by over 1 billion people in the world currently and if you were to look at profile of these billion smokers, some trends do emerge. For example, there are far more male smokers than female smokers, especially in the developing world but in richer countries, that is far less the case. For example, in Belarus, 46.2% of adult males smoke daily compared to just 10.6% of females; but in the UK, 19.9% of the men smoke daily compared to 18.4% of the females. Likewise, the countries with the highest rates of smoking are mostly in the developing world with countries like Belarus, Macedonia, Albania, Jordan and Russia featuring in the top ten. Also, this trend is reflected within the US, with the richer states like California and New York having much fewer smokers than the poorer states like Mississippi, West Virginia and Kentucky.  Young adults are far more likely to smoke with a marked decline in smoking rates with increasing age. The prevalence of smoking is strongly associated with socioeconomic disadvantage low earners and finally, smoking tends to be more prevalant in rural areas rather than urban areas. And that's just me scraping the surface, there is a lot more analysis that one can do when you look at the data regarding smoking: before you can talk about something like plain cigarette packaging, you need to understand who is smoking, where they are and why they are smoking in the first place. So, let's analyze the evidence together about this issue.

Looking at the statistics firstly as countries, it is clear that the countries that smoke the most tend to be Eastern European - I am just imagining the grim miner or farmer in Belarus or Albania who has a pretty hard life and perhaps smoking is one of the few pleasures in his life that he can afford, nobody will dare to tell him that he ought to give up smoking. Then in the middle of that list, you have the rich countries like Singapore, the UK, USA and Canada where the rate of smoking is about half to a third of what you would find in Belarus. Then at the very bottom of the list you get the world's poorest countries like India, Ghana, Guinea-Bissau and Mauritania where the people would rather spend their money on more vital things like food, education and healthcare and tobacco is seen as a luxury only the rich can indulge in. An interesting country to look at in this list is Latvia - it was once part of the USSR but today it is an independent country and part of the EU. Incredibly, the rate of smoking in Latvia is roughly half of that of Russia and nearly a third of that in Belarus . Latvia still shares with Russia and Belarus, but why have smoking rates dropped so dramatically in Latvia compared to her neighbours? Well, a simplistic answer is her wealth - Latvia is far richer than Belarus and Russia today and with this wealth comes a new middle class lifestyle where people don't have to work long hours to make ends meet. They have enough money to spend on luxuries like personal trainers, pilates, bikram yoga, organic muesli and super foods high in antioxidants. It is no surprise that the same principle applies in the US when you compare the lifestyle of trendy Californians and affluent New Yorkers to the very poorest Americans in states like Mississippi and West Virginia.

We see similar patterns in the patterns of alcohol abuse in the UK - the poorest sections of society are the ones most prone to drinking to harmful levels (exceeding 14 units a week). In Scotland, smoking is more than nearly four times higher in areas of highest deprivation than the lowest and alcohol-related mortality rates are eight times as high. The mainstream media is too politically correct to talk about poor people, so allow me as a blogger to speak bluntly on the issue: when your life is so miserable, when you are so poor that the only things that will bring you pleasure is alcohol and tobacco (and possibly other narcotics), you're hardly going to be dissuaded by plain cigarette packaging. It is downright disgraceful that the governments are ignoring the root causes of why poor people turn to tobacco and alcohol and simply offer this kind of token gesture in the form of plain cigarette packaging. This is a massive problem: the very people who can least afford to buy cigarettes and booze are consuming them to the point where it has become very detrimental to their health and the only response the governments can come up with is plain cigarette packaging? In this context, plain cigarette packaging is not the answer. It is but a token gesture when facing a huge problem. This is a slippery slope where you start using token gestures instead of tackling the root causes of the problems: we have seen this with the sugar tax in the UK. The government is seen to be doing something, but it is just not effective in solving the problem.

Staying with the UK, whilst it may appear as a fairly rich Western European country, all you need to do is to take a closer look at the way British society is divided and you will see a fairly huge divide between the rich and the poor. The UK is a pretty horrible place to be poor - say if you were poor in a country like Belarus, at least when you walk into a shop in Minsk, Gomel or Mogilev, at least the prices are relatively cheap even for the locals. The poor in the UK have to pay the same high prices for their basic necessities as the rich people who have good jobs and so arguably, they are probably even worse off than the poor in a country like Belarus as the poor in Belarus can make their meager earnings go a lot further in a supermarket in Minsk. So if you want to stop the poor people in the UK turning to booze and tobacco, well there's a simple and obvious solution: the UK government needs to look at the most deprived areas of the UK and lift the people living in these areas out of poverty. The challenge for the government is to make their lives much less miserable by putting more money in their hands, for example by raising the minimum wage since most of the poor people are earning exactly that, the minimum wage because they just don't have the education or skills to access any better jobs.

We need to look at the bigger picture - the government needs to help lift these people out of poverty. Once their lives are no longer haunted by poverty, there will be a change in their attitudes towards their bodies and how they take care of themselves. Of course, this is a much bigger project that goes way beyond trying to reduce the number of people smoking in the UK, we're talking about a bigger project that is designed to improve the quality of life for the poorest people in the UK, encompassing all aspects including their health. Increasing the minimum wage will not be sufficient, you need to invest far more heavily in education and skills training, so young people from these deprived areas will be able to get a decent job and not end up as poor as their parents. Telling people not to smoke or drink doesn't work - we need to understand why certain sections of society smoke and drink a lot more than others. This is a much bigger project that should be aimed at social mobility, not just reducing poverty or the number of people smoking. Most governments would look at the number of poor people in their countries and think, where the heck do we even begin? So they go for token gestures like plain cigarette packaging to show that they have done something, when really, it is but a red herring.

Where does that leave us with plain cigarette packaging then? Personally, I think it makes little or not difference to the decision of smokers to smoke. As I said in my last article on the topic, I believe it would be far more constructive to engage the tobacco industry and work with them, rather than paint them into a corner by alienating them altogether with measures like plain cigarette packaging. But there's a lot more we can learn from the alcohol industry - now nobody is suggesting that we ban alcohol outright despite the fact that alcohol is a huge problem in many countries and probably causes as many problems to public health as tobacco does. Sure there are health warnings about not consuming too much alcohol on all packaging on alcoholic drinks, but let's for a moment focus on high end, luxury, expensive alcoholic drinks. There's this interesting shop in Soho, London called Gerry's and they are a liquor store with a wide selection of exotic and expensive liquors - nothing in there is cheap, you don't go in there looking for a bargain. It is worth visiting even if you're not buying anything. Instead, you'll want to go there if you've been invited to a nice dinner party and you want to surprise your host with a classy and unusual gift like a limited edition Heloise Lloris 24K vintage champagne.

In the alcohol industry, there's a clear distinction between luxury brands and mass market brands - you're hardly going to get alcoholics ruining their health on the most expensive champagne (well, that may just happen in the upper echelons of society I grant you that), but the fact that luxury alcohol is so expensive means that those who are going to indulge in binge drinking will go for a cheaper alternative like beer or cider. What I find immensely frustrating is that way the tobacco industry isn't allowed to have that kind of price/brand identity differentiation - with plain cigarette packaging, any kind of brand identity is gone in the absence of marketing and how is the consumer going to differentiate one brand from another? When tobacco branding, advertising and marketing was allowed, there was a lot of differentiation from the finest luxury cigars to the cheapest (and nastiest) cigarettes the very same way there is in the alcohol market. The people buying the cheapest beer are certainly not the same people buying the finest champagne and it is clear that it is the former who are far more likely to be the alcoholics and not the latter (forget being PC about this, I'm going to be blunt). At least in this case, the government have a far clearer picture about whom they need to target to reduce alcohol abuse, making it easier for them to come up with more effective, targeted strategies. But in trying to reduce all tobacco products to a monolithic entity through plain cigarette packaging, not only does it totally distort the tobacco market today, it is going to be much harder to come up with more specific, targeted strategies to help the very people who most need help.

And whilst I'm being un-PC, let me be blunt here: the UK is a horrible place to be poor. The poorest of the lot live on grim council estates where the conditions are far worse than even the oldest HDB estates in Singapore. Plain cigarette packaging will have no effect whatsoever on people who live in such places if they want to smoke and the only effective strategy to stop them smoking or drinking is if you tax cigarettes and alcohol to the point where they no longer can afford even the cheapest beer and cigarettes. What do you think will happen then? Will these people suddenly adopt a much healthier lifestyle just because you make alcohol and cigarettes unaffordable? Hell no. They will just turn to some other narcotics and when you compare the alternatives, you would rather have a situation whereby you accept that the poorest people in society are going to turn to alcohol and tobacco than for them to turn to their local drug dealers. And if you accept as a government that there's no realistic way you can lift the poorest in your society out of poverty in the short run, then you're much better off dealing with the alcohol and tobacco industry than to try to reason with the drug dealers. This is called making the best of a difficult situation and choosing the least bad option: now if only the self-righteous would get off their moral high horses and start thinking about more practical ways to engage and work with the tobacco industry.

Lastly, let's look at the solutions we need in the world we live in today: Trump's vision of putting America first is embarking on a trade war with the rest of the world. In light of Brexit, we are possibly looking at various countries going into a tit-for-tat tariff situation. None of it is good news, it is a game that has no winners, only losers: so if plain cigarette packaging is going to hit the countries like Indonesia which are big producers of tobacco, they may retaliate by slapping tariffs on Australian imports and the Australians are hardly going to just sit there without retaliating. No, politicians look weak when they simply do nothing in light of this and strangely enough, that is what makes them look strong (and this has actually made Trump quite popular in America). And on top of all this, plain cigarette packaging is simply creating the perfect storm for a booming marketing of counterfeit cigarettes. Geez, in this context, the tobacco industry is hardly the villain and I am just left baffled as to why governments around the world are not engaging them to find a solution to the problems they really need to solve around smoking. But hey, you only have to look at the latest turmoil of resignations and reshuffles that hit the UK government just this month which should tell you something that is pretty obvious: these governments are pretty clueless and don't know what they're doing. And on that note, I will turn this over to you: what do you think about this? Do leave a comment below please, let's start a debate and talk about it. Many thanks for reading.