THURSDAY 18 NOVEMBER 1999

PROFESSOR LIAM DONALDSON, DR DAWN MILNER, MR TIM BAXTER AND MR PAUL LINCOLN

  140. Do you think tobacco companies target youngsters? I am thinking of the example that was given by Professor Donaldson. It seems too much of a coincidence, does it not, that it is such an attractive thing to little ones?
  (Mr Lincoln) The marketing of cigarettes is inevitably going to have an impact on young people, hence the whole reason for the advertising ban. That would be my opinion.

  141. I have read somewhere in your evidence that in America if the targets are not reached tobacco companies are going to have penalties imposed on them. That seems a novel approach. Would you think it is worth thinking about, give them an incentive for society to reach its target in reducing young people smoking?
  (Mr Baxter) I think that is as a result of recent litigation. So to get that one would have to go through the courts, unless we could have a voluntary agreement with the industry. I think it is something you might discuss with the industry. Obviously you will want to raise both their marketing strategies on young people and what further efforts they might make to reduce the access of their product to young people.

  142. Do you think that, as some of the tobacco companies put to us, the age at which young people may smoke should be raised to 18 or not?
  (Mr Baxter) First of all, Ministers have no plans to do so and, secondly, I do not know of any evidence that that would have any effect on prevalence. You might wish to ask why they are asking for that.

  Audrey Wise: It struck me as odd.

  143. What is your view as to why they are asking for that?
  (Mr Baxter) I think they want to differentiate an adult product from one not for children and the problem is, as Mr Lincoln has demonstrated, trying to differentiate it in terms of health promotion as an adult product and not for children has not worked. The more you use it as an adult product that is almost a rite of passage into adulthood. It is the forbidden fruits syndrome. If you are told not to do it and you are fifteen then of course you will do it, that is the problem. That is just a surmise on my part. You will have to ask them why they want to raise it to 18.

  144. Is it illegal for people under the age of 16 to smoke? It is not illegal to drink alcohol under the age of 16 but you are not allowed to buy it until you reach a certain age.
  (Professor Donaldson) It is the sale.

  Mr Burns: It is the sale. It is not illegal to smoke, is it? It is illegal to buy the product.

  Chairman: It is the smoking activity.

  145. With alcohol you have to be over the age of 5 to be given it.
  (Mr Baxter) Basically the criminal sanction, as I understand it, is against the retailer.

  146. It is not illegal actually to smoke, it is when you actually sell the product to someone under the age of 16?
  (Mr Baxter) Yes.

  147. I think it is generally accepted that very few people take up smoking in adulthood or certainly later in life, and the tobacco manufacturers in their advertising strategy say they are not seeking to recruit smokers, they are seeking to achieve a better share of the smoking market. Since half the people who smoke will die as a result, it is a fairly diminishing market unless they can actually recruit new smokers and since the vast majority of newly recruited smokers are the younger age group, is it not inevitable that that advertising strategy is aimed at young people?
  (Professor Donaldson) I think you have to look at the information that has been disclosed by the tobacco companies in the United States and also some of the information that has come out on the United Kingdom companies and look at what statements were made in their internal documents about the advertising strategy at that time and certainly in the United States documents there is clear evidence that such strategies were being pursued.

  148. It is often said, and it is clearly true, that peer pressure is a big factor, but the report which I have previously quoted itself quotes an OPCS (as it then was) inquiry which was commissioned by the Department of Health and which showed that young people who perceive no parental disapproval are seven times more likely to smoke than young people who perceive strong parental disapproval. So that does suggest to me that what the adults in the family do, and particularly parents, is extremely important. Do you think that adults and parents in particular have a habit perhaps of shrugging off some of this responsibility by blaming peer pressure, and do you think there should be more attention drawn to this "seven times more likely unless the parents show disapproval"? It is very striking.
  (Mr Lincoln) I wholeheartedly agree with you that the influence of adults and parents is of paramount importance in terms of educating children in smoking.

  149. Obviously we have talked a lot about advertising and from the evidence this morning obviously there is clear evidence that young people are influenced by tobacco advertising. Therefore it is doubly welcome that the Government intends to get rid of tobacco advertising as soon as possible, but what I want to ask is, what is the current situation, given that the tobacco companies now seem to have taken the Government to court to prevent them introducing the ban? What exactly is the current state of play?
  (Mr Baxter) I can give you the current state of play. The Government lost in the High Court recently. The Court of Appeal heard the appeal against that judgment over the last three days and we await judgment and hope to receive that as soon as possible. I cannot say exactly when because I do know but I would suspect some time next week we will hear the judgment of the Court of Appeal.

  150. Is it fair to ask what the Government feels about this challenge in the courts?
  (Mr Baxter) I think it is open to the companies to take the Government to court, as it is open to any other company if they disagree with the Government's policies. We regret it obviously but we believe we have a very strong legal case and obviously we will be looking forward to a decision.

  151. If the decision is against the Government what is the likely effect on the Government's plans?
  (Mr Baxter) Then ministers will have to consider next steps and they have said that they are determined to bring in the ban on advertising and there are a number of options, one of which would be a further appeal and consideration of primary legislation. Primary legislation has not been ruled out but neither has it been ruled in obviously. So there are several options. Another is to wait until the European Court of Justice gives a ruling, but the thrust of the Government's policy has been to bring a ban in as soon as possible, for reasons which are, I think, obvious. So that is really a matter for ministers to reflect on and to announce if the decision goes against us.

  152. Do we have any scientific evidence as to exactly how much of a reduction in smoking would be achieved by bringing in a ban?
  (Mr Baxter) I think it is an area where one goes in for complex modelling and various assumptions. The figure we averaged in our regulatory impact assessment was a 2.5 per cent. reduction in consumption as a result of this measure. One World Bank report published earlier in the year had a rather more optimistic figure for, I think it was the European Union as a whole, of 7 per cent. So I think we were being cautious, quite rightly, about the scale of the effect but still in the long term over a number of years it could lead to up to 3,000 lives per year saved effectively, in the short term 1,500.

  153. Is it actually then reasonable to say that if this ban were prevented for a further year, are you saying that 3,000 people ultimately might die because of it?
  (Mr Baxter) That is the long term effect. It is fair to say that if our assumptions and modelling are correct then the delay of the ban would inevitably have an impact on mortality and morbidity. If the industry is right and advertising has absolutely no effect then the reverse, but obviously the Government has taken a position that it does have an effect and two and a half per cent is the figure that has been put forward on the basis of which we have worked out the benefits, etc. If it is delayed then I think it does follow that some lives would be lost.

  154. This is really rather important because if we take a figure of 120,000 people a year dying from smoking in this country then two and a half per cent would equate to somewhere between 2,000 and 3,000 lives a year which presumably are now at risk because of the holding up of this policy?
  (Mr Baxter) I think you have to be careful because the excess risks to smokers decline over time. There are various lag features. That is why it is 1,500 to 1,600 deaths in the shorter term that are predicted. Obviously the industry disputes that figure, I should make that clear. They dispute that there will be any mortality and morbidity effects.

  155. If we accept reasonable scientific evidence and we say that the body of experts think 1,500 people will die this year, it is an awful lot more people than will die of BSE in the next year and yet a lot more effort seems to be going into that. This is just flagging up the point that this is a major hold up to the Government's plans to improve public health. As a Committee I think we need to take that very seriously.
  (Mr Baxter) You will have seen the Government's response after the High Court judgment. I do not have anything further to say.

  156. The tobacco industry themselves seem to think that relationships between them and the Government have deteriorated in recent years. Do you think that is a fair point?
  (Mr Baxter) The administration changed and policies have moved on and changed. Inevitably, given the changed policies, Government and the industry have come into greater conflict. Since I took over this job at the beginning of February this year, certainly I have had numerous meetings with the industry on a formal and informal basis. I have sought to listen to their views and reflect those to ministers, always on the understanding that ministers were likely not to accept what they said. I have personally sought to make sure that I have listened to their views. I have visited a cigarette factory and members of my staff have visited factories. There is actually a lot of formal and informal contact, some of it outside the High Court and the Court of Appeal at the moment, some of it here. We certainly listen to the industry's views and I would like to characterise it as a business-like relationship where both sides accept that they are not necessarily going to convince the other.

  157. Do you think it is because of the ban on advertising that the relationship has become difficult recently?
  (Mr Baxter) I think obviously the ban on advertising but there are other measures. I do not come from a position of thinking that the relationship is particularly bad, I think you will have to ask the industry and the TMA in particular in what respects it has got worse. Obviously there are policy decisions that have been made which they find difficult to accept and inevitably they are not going to find dealing with me and my colleagues reflecting ministers' views particularly comfortable.

  158. In terms of the impact of advertising, has any consideration been given by the industry to the impact of the use of the Internet for advertising the promotion and sale of cigarettes?
  (Mr Baxter) The regulations cover all forms of communication, so the Internet is covered as far as we have UK jurisdiction. There are wider issues over the Internet and the control of the Internet.

  159. I wonder if you can give me the Government's assessment of the dangers of passive smoking?
  (Professor Donaldson) The scientific evidence, as we assess it, is that there are dangers associated with passive smoking in a number of areas. There is an increase of the smoking related diseases amongst people who are exposed to passive cigarette smoke and a negative health impact on the offspring of women who smoke within pregnancy. In my view there is no doubt about the scientific validity of that.