Friday, April 20, 2012

Tobacco policy experiment

New Zealand seems on course to mandate tobacco plain packaging legislation; we'll see how the Australian court challenge pans out.

There isn't any real-world evidence on the effects of cigarette plain packaging legislation, mostly because nobody's really done it yet. What we have are a bunch of surveys of smokers and non-smokers on how cigarette packaging makes them feel, whether they think different designs are more or less likely to encourage them to smoke, and the like. In other words, a bunch of hypothetical musings in low consequence environments.

If we're stuck having Tariana Turia's proposed legislation, let's do some good with it. Set it up as an experiment. Implement plain packaging in part of the country, but not elsewhere. Then see what happens. If it seems successful after a few years, implement it everywhere; if it doesn't, abandon it. Either way, publish all the results so we have a better handle on what works. So plain packaging in Christchurch but not in Dunedin, in Wellington but not in Rotorua. I'm sure there are plenty of folks who specialize in designing randomised control trials of this sort who'd be able to run things. We may need a third treatment group to avoid problems that can result when you know you're part of a treatment group as compared to the control, but other folks know more about these design issues than I do. We'd probably also need to compensate the tobacco companies for increased distribution costs over the duration of the trial - the excess of current tobacco excise revenues over demonstrable costs to the health system should provide plenty of money that could be used here.

If we apply plain packaging to the whole country at once, we have no way of knowing whether the policy does anything. A careful randomised control trial could tell us something useful.

I've reasonable "get off my lawn" opposition to the policy, but if we're going to be stuck with it, why not learn something at the same time?

9 comments:

  1. I wonder if all you would see is the originally labelled products driving out the plain packaging?
    i.e NZ is very small, wouldn't be hard to stock up on your fav. branded packets in a town not part of the trial.
    Although perhaps that would only happen with people who have the income.

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    1. You'd need to be careful in how you set up the districts. I don't think you could split Auckland DHB into parts without substantial border issues. Another way to check would be to run the trial in two parts, with regions trading treatment half-way through.

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  2. This is far too logical for them to accept because it defeats their agenda.

    From an article that appeared in the Guardian interviewing Australia's anti-tobacco lobbyist Simon Chapman.

    ''Although blind taste tests show that consumers detect little difference between most brands of cigarettes, the successful marketing of some brands as cool, or macho, or feminine, or "lite" has helped sustain a hierarchy in which premium brands sell for a lot more than budget lines, despite costing much the same to produce. (...)'Replace those colourful packets with nothing but a plain colour, the manufacturer's name and a massive health warning, and many people will stop buying the premium brands, he argues.''

    So what does this tell us? That plain packaging doesn't really have anything to do with health since he himself admits elsewhere in the interview that it will not immediately curb smoking but will slowly starve the industry off. Which industry? The bigger players in the tobacco industry or what he calls the premium brands. If anyone ever succeeds in ''starving them off'', tobacco will not disappear. It will only change hands to the smaller players and contraband sources which will slowly also get big. But... It will also make premium brands more affordable since the bigger players won't sit back and watch their market shrink, they will simply lower their prices to competitive levels.

    So as inadvertently admitted by Chapman, all a legislation on plain packaging would be accomplishing is to rob the bigger players of profits without doing a thing for public health and possibly making smoking more prevalent because of more competitive prices.

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    1. Will there really be that much contraband effect? The incentives for contraband already are very large given excise. Do the counterfeiters have that hard a time replicating the package branding and excise stamps?

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    2. I don't believe that the contraband effect is the bigger problem to worry about here and it was not my main point. The main point is that many societies have tried to eradicate tobacco in the past without any success. Starving off the big industry as Chapman is openly admitting he's trying to do, won't lower smoking prevalence, it will only lower prices and perhaps even the quality of the product. It will stifle any advancements the bigger players are attempting for a safer product. Where's the incentive to invest money to attempt to develop a less harmful cigarette when all brands look the same and you can't advertize it anywhere either? But suppose he does succeed to starve off the bigger players. Does this mean that tobacco will no longer exist? No, the smaller players (and contraband) will just take over and will eventually become as big as the big players are now. Absolutely nothing gained from a health perspective.

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    3. If the government cared about harm reduction, they wouldn't ban snus and they wouldn't make it hard to get e-cigarettes.

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    4. Precisely. From a well-meaning campaign, anti-smoking has morphed into a money generating business for governments, Big Pharma and anti-tobacco lobbyists. Health stopped having anything to do with it the minute they came up with the absurd notion that there is NO safe level of smoking or breathing in second hand smoke and the only option is to totally quit tobacco in any form or die.

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  3. Those people in our house of Commons parliament thought that cigarette purchase at a higher price will induce reduction in purchase.
    Our miserable NZ Parliament in a disgusting moment, voted for increase in price, and the Maori Party wanted this.
    Now they understand the pain. sweet jesus. addiction is addiction.

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    1. Higher prices do reduce consumption. But the effects on those who continue smoking are non-trivial.

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