When speaking to people in politics with whom I’m likely to have serious disagreements, one of the means I use to establish useful dialogue is to find points on which we agree.
Speaking to the tobacco company-funded smokers campaign group Forest and its supporters at an online meeting, ‘The Nanny State of the Nation’, over Zoom about the role of the nanny state in public health issues, I was pleased to find initial common ground with participants Pat and Jude.
I could only agree with their anger that the essential life skill of home economics, or cooking lessons, in schools has all but disappeared from the curriculum. That education should be for life, not just for passing exams, is a topic that I regularly speak about.
I was also in agreement with fellow webinar participant the soon-to-be fellow peer Claire Fox, when she argued that diets don’t work – based on solid evidence. She went on to say that the plan to use NHS funds to send patients to weight loss classes is certainly the worst element of the government’s obesity strategy.
While I continued to agree with Claire Fox in her saying that NHS treatments should be based on evidence, that’s where we parted company. Despite her arguing that “prescribing” free bicycles or gym access doesn’t work, the evidence suggests otherwise.
And I also had to push back against her point that doctors had been wrong to think that, in the early days of the pandemic, as we were just beginning to understand the threat of Covid-19, smokers would be particularly badly affected.
Given the lack of data at that stage about the specific impact of the coronavirus, but the extensive information about the general health impacts of smoking, it was an entirely reasonable assumption.
We know that smoking is the leading cause of preventable death in the UK, that it kills more than 200 people every day, and that it is responsible for half of the disgraceful disparities in life expectancy between rich and poor.
It is only reasonable that doctors should fear for these generally poor and disadvantaged patients, with the rates of smoking among those in manual and routine jobs (23 per cent) more than double those in managerial and professional roles (nine per cent).
As for the cost of smoking and the income from tobacco taxes, which does not cover it, I had to disagree with Pat in making the case for a further charge on hugely profitable tobacco firms, which is a logical way to fund the government’s SmokeFree 2030 plan (that being defined as less than five per cent of people smoking – with the current level at 14 per cent).
As it stands, smoking costs the UK around £12.5 billion a year, with lost productivity accounting for £9 billion, £2.4 billion in NHS costs and £880 million in social care.
Pat said she’d started smoking at the age of eight and had done so for decades – but that hadn’t cost her anything in extra medical expenses. While I hope it stays that way for her, hers isn’t the typical story – though her account of taking up smoking as a child is sadly very typical.
The money saved in smoking costs would go to helping the 50 per cent of smokers who say they want to quit, most of whom have been trapped in a vicious cycle of addiction by the tobacco giants since they were children. With up to 70 per cent of smokers saying they regret starting, this forms a strong argument for more measures to prevent the tobacco firms from promoting their deadly products across the world.
However, the main topic of our debate was not smoking, but rather the role of the “nanny state” in protecting public health.
And I agreed that there is such a thing as the “nanny state”, with “nanny” referring to the government. Through successive administrations, including those of the Labour Party, it has done a very effective job of nurturing the profits of multinational manufacturers, supermarkets and tobacco companies, while doing a terrible job of protecting public health.
Former Brexit MEP Brian Monteith talked about the “bureaucratic power” of the state: of course, through a disastrous food strategy of allowing supermarkets and multinationals to decide what we eat, and an approach to tobacco that has not gone nearly far enough for how deadly the product is, the government has handed over power of life and death to those whose sole motive is profit.
Several speakers suggested that when they were raising their families, healthy food was available to them and relatively cheap. But that’s not the case today: a healthy diet is three times as expensive as an unhealthy one.
This, of course, is no failing on the part of parents; after all, the supermarket shelves are packed with ultra-processed pap and parents and children are bombarded with adverts for junk food. Meanwhile, fruits and vegetables are relatively expensive, and, for those trapped in food deserts, utterly unavailable.
Later on in the discussion, the smoking ban for restaurant tables moved outside as a result of the Covid-19 pandemic was breached. Opposition to the partial ban was expressed by campaigners, but given the focus on “choice” – a word that was repeated again and again – I pointed out that they’d surely agree that staff should have the choice to remain non-smokers, rather than being forced to inhale second-hand smoke if they want to keep their jobs.
There was an irony in talking to Forest about the power of industry lobbying in government policy and the failure of governments to stand up against it. This considered, I mentioned the particular role of “astroturf groups”, apparently grassroots organisations funded by the industry they are supporting.