I recently interviewed Nicola Roxon, the former minister responsible for cleaning up Australia’s public health policy through legislation on standardised tobacco packaging. It shed some light on how public support was won there.
The legislation was a world first but won’t be replicated in England after the government announced in July that it was shelving proposals to follow suit.
Since then, headlines have focused predominantly on the influence of the big tobacco companies’ lobbyists on the decision and the primary target was Lynton Crosby, Prime Minister David Cameron’s election guru, whose firm Textor-Crosby acts for tobacco giant Phillip Morris.
It’s not about the lobbyists
Having watched the story unfold while working in public health in Australia and in the UK, I couldn’t help but be struck by how the focus on lobbying has detracted from the health messages.
In the UK, more than 200,000 young people start smoking every year. That’s 200,000 more people a year taking up a habit that over a lifetime, is proven to kill at least half of them. Smoking related diseases cost the NHS 5 billion pounds a year.
So-called plain packaging could contribute to saving lives and taxpayers money. Surely, the British public care more about these facts than the minority who may or may not have the Prime Minister’s ear?
The Department of Health cite the need to wait for more evidence to emerge from Australia. But the need for more evidence is paradoxical here. We know that public health measures like this take years, sometimes generations to show their benefit. As Roxon said: “These people are asking for evidence that can’t exist yet”.
Some early evidence is emerging from Australia: standardised packaging makes tobacco less attractive, improves the effectiveness of health warnings and is therefore likely to reduce the number of those 200,000 plus children and young people who start smoking each year.
If it doesn’t work why do they care?
To the public, this surely makes perfect sense? Tobacco companies don’t spend millions of pounds on the way they market their product, the colours, the feel, the shape, the touch of the pack, for nothing. “They didn’t fight us [The Australian Government] tooth and nail because they think it makes no difference,” said Roxon.
The Labour Party’s response to the dropping of the proposals was to produce cigarette packet adverts with Crosby and Cameron’s heads on them; a “Bensons and Hedge Fund” quip from Ed Milliband at Prime Minister’s Questions, and a letter to the Cabinet Secretary asking for a inquiry into Crosby’s access to Ministers. But where in all of this was the health message to the public?
Capturing the public’s imagination
I realise three things that helped Australia win the battle to get this life saving piece of legislation implemented. This included building a strong grassroots and community led campaign to support the proposals. This type of community activism was critical in Australia, with NGO’s - such as the Australian Cancer Council - organising local campaigns that mobilised local people, visiting electorate offices and talking to people.
Roxon cites the “wonderful doctors, public health advocates, non-government organisations and academics” who time and time again spoke out against the claims made by the tobacco industry. Claims including the suggested impacts on illicit trade, the economy, and threat to jobs. Similar claims were made, and subsequently disproved in the Australian example.
Roxon also cites the importance of a united Cabinet on the issue. Although she was the face of the campaign, with Mayor of New York Mike Bloomberg famously calling her a “Rock Star” in tobacco control, she says there was never any “backgrounding or complaining” from other Ministers on the proposals. Maybe this is where the proposals fell down in England: you need strong cabinet, and crucially, Prime Ministerial support.
Cabinet relationships aside, Roxon is adamant, and I have to agree, that this is “a battle which will be won or lost in the court of public opinion.” The Observer recently published details of a Phillip Morris strategy which included collecting polling data from the most vulnerable Tory marginal seats.
Tobacco companies understand the importance of public opinion. The Australian Government understood it, and used it to their advantage. Standardised packaging was one of the few issues that “really captured the public’s imagination” during Roxon’s time in office.
It is now time for public health advocates, committed politicians, NGO’s and other supporters to re-capture the publics’ imagination. I for one am fed up with hearing about the lobbyists. Plain packaging is a measure that will eventually save lives, and the best lobbyist we can hire in a democracy is the public.