Tobacco advertising & Prof. Hugh High
Monday 20 April 1998
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|Media Briefing21 April 1998||ASH
Action on Smoking
Tobacco advertising & visit of Prof. Hugh High
On 21st April Professor Hugh High from South Africa will present new research ontobacco advertising at the invitation of the Institute of Economic Affairs. This waspreviewed in an opinion piece in the FT and on BBC Radio 4’s Today. It appearsthat Professor High intends to rehearse new variants of the familiar arguments of thetobacco industry – that tobacco advertising influences brand preference, while leavingtotal consumption untouched. The main research done without tobacco industry funds pointsthe other way:
- The most comprehensive study was published in 1993 by Chief Economic Adviser to the Department of Health, Dr. Clive Smee. After reviewing 212 ‘time series’ correlating advertising spend and total tobacco consumption Smee concluded “The balance of evidence thus supports the conclusion that advertising does have a positive effect on consumption.” Smee also examined in detail the effects of tobacco advertising bans in four countries. He concluded: “In each case the banning of advertising was followed by a fall in smoking on a scale which cannot be reasonably attributed to other factors”. Smee found that banning advertising resulted in reductions in consumption of 4-9% in the countries surveyed: Norway (9%), Finland (6.7%), Canada (4%) and New Zealand (5.5%).
- The US Surgeon General highlighted the difficulty of designing studies that prove the point definitively, but concluded in his 1989 report: “the collective empirical, experiential and logical evidence makes it more likely than not that advertising and promotional activities do stimulate cigarette consumption.” The Surgeon General also showed seven ways in which he believed advertising influenced smoking.
- A ‘meta-analysis’ of econometric findings from time-series research published in the Journal of Public Policy and Marketing (Andrews and Franke, The Determinants of Cigarette Consumption: a meta analysis, Vol. 10. 81-100, Spring 1991) concluded that “the results show that advertising and income elasticities are positive and significant across studies.” A positive elasticity means that as advertising spend increases, cigarette consumption increases. The study showed a weighted mean advertising elasticity of 0.060 – ie. a 10 percent increase in advertising expenditure would lead to a 0.6% increase in consumption. This is in line with advertising elasticities cited in Smee (above).
Selective quoting. The first two of these sources wereselectively quoted to give an opposite impression by Professor High at a WorldBank-sponsored conference in South Africa on the economics of tobacco control in February1998. For example, the relevant passage in the Surgeon General’s report (p.517) readsas follows (with Prof. High’s selective quote in capitals, finishing part way throughthe paragraph).
|“THERE IS NO SCIENTIFICALLY RIGOROUS STUDY AVAILABLE TO THE PUBLIC THAT PROVIDES A DEFINITIVE ANSWER TO THE BASIC QUESTION OF WHETHER ADVERTISING AND PROMOTION INCREASE THE LEVEL OF TOBACCO CONSUMPTION. GIVEN THE COMPLEXITY OF THE ISSUE, NONE IS LIKELY TO BE FORTHCOMING IN THE FORESEEABLE FUTURE. The most comprehensive review of both the direct and indirect mechanisms concluded that the collective empirical, experiential, and logical evidence makes it more likely than not that advertising and promotional activities do stimulate cigarette consumption. However, that analysis also concluded that the extent of influence of advertising and promotion on the level of consumption is unknown and possibly unknowable…”|
Clearly, by quoting only the first half of the paragraph a completely different meaningis offered to that intended. It would not be possible to accidentally overlook the rest ofthe paragraph – so the conclusion must be that there was an attempt to support aparticular interest. At the meeting in Cape Town one of the authors of the SurgeonGeneral’s report was there to correct the error. In many other circumstances, it would gouncorrected and a misleading impression would be left.
Other variables. The report of Professor High’s approachin the FT suggests he will try to show that consumption has changed in the oppositedirection to that expected from an advertising ban in certain countries, and thatcountries with less advertising may have more smoking. He will also argue that the removalof health warnings that would accompany bans could even have a negative effect. However,the absolute level of consumption and its change over time is determined by many factors,including price, retail restrictions, and, importantly, historical levels – whichdetermine the ‘smoking culture’ on which advertising and advertising bansoperate. This means it is possible for an advertising ban to be confounded by changes inother factors – the ban may be causing increases that are less than would otherwise beseen. Warnings would still be available on packs and it is unlikely that these are now themajor source of information about smoking and health. It is interesting to see theargument that the warning part of the advert can reduce overall consumption whereas thesmoking part makes no difference!
Dubious legal advice. A sure sign that Professor High isarguing for the industry rather than presenting academic data was his reference to theLegal Affairs Committee of the European Parliament. Following extensive tobacco industrylobbying, this Committee of MEPs had questioned the legal base under the Treaty. In factthe professional lawyers of the legal services European Parliament and European Commissionhave accepted the legal base (Article 100a) defined by the Council of Ministers andtherefore accepted by the Council’s legal service. All three legal services thusconcur with the proposed legal base. High has apparently done no research in this area andwas simply repeating the tobacco lobby’s current PR message. In fact he tried tojustify his point by drawing on common law arguments, whereas the legal issue in factrelates to the operation of the EU’s Maastricht Treaty.
Health benefit of banning tobacco advertising. The eminentepidemiologist, Professor Richard Peto of Oxford University estimates that some 548,000premature deaths per year can be attributed to smoking in the 15 countries of the EuropeanUnion. Though the changes in total tobacco consumption noted above are small in percentageterms, an advertising ban will create large absolute health gains – simply because thetotal death toll is so high. It is difficult to say what the health benefit would actuallybe as the current death toll of over half a million is the result of higher levels ofsmoking in the past. For the UK we estimate that an advertising ban that reducedconsumption by 5% would avoid around 4,000 premature deaths per year in the long run.Projecting this figure to the European Union would suggests that around 20,000 smokingrelated deaths could be avoided each year by banning tobacco advertising. This saving oflife is a long run would take time to ‘work through’ as it would include, forexample, avoiding the premature deaths in middle age of people that are currentlyteenagers.
Handling uncertainty in policy-making. Calls for‘definitive proof’ before action is taken effectively mean carrying on as ifthere is no problem – and has often been used as a stalling tactic by industries seekingto avoid regulation. In the face of any uncertainty, there are compelling reasons to erron the side of caution accept the authoritative, though qualified assessments above andban tobacco advertising in the EU. This ‘precautionary approach’ is now widelyaccepted as a sound basis for policy-making when definitive proof of an effect is elusive.There is already enough evidence to justify action and tobacco industry supporters wouldneed to be extremely confident that advertising had no effect before they could justifythe do nothing approach. Such confidence is not possible.
Politics. The arrival of Professor High at this timecoincides with a crucial vote in the European Parliament by the Environment Committee onthe text of a tobacco advertising Directive. The Committee is scrutinising the‘common position’ reached by the Council of Ministers in December and itssupport for the Directive without amendments is regarded as crucial if the measure is topass in the plenary vote of the European Parliament in the week commencing May 11th. Ifthe Parliament votes for it in May without amendments a Directive banning advertisingwould become law before the end of the UK Presidency and depending on the implementationtimetable most advertising would be banned with three years.
Creating “controversy”. Documents obtained by ASHfrom litigation in the United States show that the tobacco industry has deliberately triedto engineer controversy to deflect potential policy threats – notably in the area ofpassive smoking. When new findings supporting the tobacco industry view are released in ahigh profile ‘launch’ with politically expedient timing and without thediscipline of publication in a peer-reviewed journal, the work should be closely inspectedfor the fingerprints of a tobacco industry sponsor. Professor High has been acting as aconsultant for the South African Tobacco Institute and it must be legitimate to ask if heor the IEA are benefiting directly or indirectly from tobacco industry money – peoplequite reasonably expect academic credentials to be a badge of independence and should beaware if there is a conflict of interest.
The role of the IEA. Professor High acknowledged on Todaythat he was funded by the tobacco industry two years ago. He is now working for theInstitute for Economic Affairs – the question then is who is funding this work at the IEA?The organiser of the seminar at the IEA, Roger Bate is also a key member of somethingcalled the “European Science and Environment Forum”. This body has recentlypublished analysis that amounts to a attack on the UK Government’s SCOTH committeefindings on passive smoking. Both Bate, the ESEF and the IEA have had a dry run for theirwork on tobacco. Roger Bate came to fame as the author of an IEA book dismissing thewidespread scientific consensus on global warming “Global warming or hot air?”.The ESEF also published a book of so-called sceptical science – this was the work of asmall group of scientists. The word ‘sceptical’ dignifies something that was much morecynical. The aim was to create controversy and deflect public policy measures to combatclimate change – something very similar appears to be happening with tobacco.
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