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December, 2003:

Make Tobacco Illegal In UK

Make tobacco illegal in UK – says the Lancet

06 Dec 2003 – Medical News Today

Today the Lancet called on the UK government to make the sale, possession and consumption of tobacco illegal, to make it a criminal offence. They say that this single action would save hundreds of thousands of lives in the UK.

This is the most radical call to any government by a medical organisation. It comes just a week after 13 royal medical colleges in the UK called on the government to ban smoking in all public places.

The British Medical Association (BMA) has called on the UK government to ban smoking in public.  The Lancet’s proposal (make tobacco illegal) was greeted with scepticism by campaigners. The tobacco industry was horrified and said that this revealed ‘the true voice of the rabid anti-smoking zealot’.

The Lancet says that the UK government is ‘missing the point’. They say that the availability and acceptability of smoking is far more significant.

‘If tobacco were an illegal substance, possession of cigarettes would become a crime, and the number of smokers would drastically fall. Cigarette smoking is a dangerous addiction. We should be doing a great deal more to prevent this disease and to help its victims. We call on Tony Blair’s government to ban tobacco,’ it says.

Simon Clark, director of Freedom Organisation for the Right to Enjoy Smoking Tobacco (Forest) said the editorial was laughable and The Lancet had scored ‘a stunning own goal .’

He went on to say ‘Smokers are not victims nor should they be treated as criminals. Like it or not people choose to smoke just as they choose to drink alcohol and eat certain foods or take part in extreme sports. Do we ban everything that is potentially dangerous and turn the practitioners into social outcasts?’

Another organisation called Ash (Action on Smoking) said that 26% of the UK population were smokers (13 million people). They suggested that criminalizing such a number of people would be impossible and wrong.

Amanda Sandford of Ash said: ‘Tobacco has been legally acceptable for more than 100 years and unfortunately it became widely used before it was understood what damage it caused. We can’t turn the clock back. If tobacco were banned we would have 13 million people desperately craving a drug that they would not be able to get. It is ludicrous.’

Deputy editor of the Lancet, Astrid James, defended the article. The argument went along the lines that smoking was a major cause of disease and its role could not be ignored by doctors. ‘A huge number of papers we see here are about smoking-related disease so as a medical journal we felt we had to take it further.’

Smoking in the UK had fallen continuously since the end of The Second World War until the mid-1990s. However, since the middle of the 1990s smoking has not fallen any more. Measures such as increasing the price of cigarettes, imposing restrictions on smoking and work have not worked.

The Lancet’s deputy editor went on to say ‘I disagree that banning tobacco is hopelessly impractical. Any government can push through changes where there is a clear public health argument – such as on seat belts. It is taking the nanny state further but the public health gains are clear.’

The Royal College of Physicians rejected (and praised) the Lancet’s demands. Professor John Britton (Chairman of the college’s tobacco advisory group) said ‘A ban on tobacco would be a nightmare.’ He then went on to say : ‘What I applaud is that they have recognised that a health problem as big as that caused by tobacco needs a radical solution and we need a government that is prepared to face up to that.’

John Britton said that a ban on smoking in public (including restaurants and bars) was the first step. He said that a Nicotine and Tobacco Regulatory Authority to introduce new ways of delivering nicotine was the next step.

Many countries around the world are becoming stricter on smoking. Following the lead of New York and California, Ireland is to become smoke-free on 16th February, 2004 (New Zealand and Norway are just about there).

Professor Britton says that nicotine alternatives should be as easy to buy as cigarettes. He believes they should be sold alongside cigarettes in bars, tobacconists and corner shops (rather than just pharmacies). ‘You can’t go into a pub, put coins in a vending machine and get a nicotine inhaler out. It is a ridiculous restriction.’



Smoking causes 120,000 deaths a year in the UK and 364,000 hospital admissions in England. Smoking-related illness accounts for 8 million consultations and 7 million prescriptions. Half of all smokers die from the habit if they continue to smoke.


The Government earned £9.6bn in tax revenue on tobacco in 2000. The cost to the NHS of smoking-related disease was £1.5bn and the amount spent on helping smokers to quit was £138m. There were 5,043 people employed in tobacco manufacturing in 2000.


Three million workers are forced to breathe other people’s smoke when they go to work. Fewer than 20 pubs in England are smoke-free, but 73 per cent of people are non-smokers and 50 per cent think smoking in pubs should be restricted. A review of 100 studies showed no negative impact of smoke-free policies on the hospitality industry.


It is illegal to sell tobacco or cigarettes to children under 16. Cigarette advertising has been banned on TV since 1965, and all tobacco advertising was banned this year. Cigarette packs must carry health warnings and there is an upper limit for the tar, nicotine and carbon monoxide content.


New York and California have banned smoking in public places. Ireland, Norway and New Zealand are introducing similar bans in 2004. Smoking restrictions in the workplace have been established in Australia, Canada and Hong Kong.

Effectiveness of Health Warning Messages on Cigarette Packages in Informing Less-literate Smokers

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Cost-Benefit Analysis of Proposed New Health Warnings on Tobacco Products

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A Strategy For Controlling The Marketing Of Tobacco Products

A Strategy For Controlling The Marketing Of Tobacco Products: a regulated market model

Objective: To outline a novel strategy for controlling the tobacco market.

Arguments: More comprehensive controls over the tobacco market are essential and long overdue. Effective controls need to encourage the development of less harmful products; control commercial communication to ensure that potential harms are highlighted relative to any benefits; and provide mechanisms to move consumers away from tobacco use, or at least towards less harmful alternatives. Achieving this by regulating the existing industry is one strategy. This paper puts the case for an alternative: to have marketing controlled by an agency (called here the Tobacco Products Agency, or TPA) which tendered to manufacturers for product and which distributed to retailers in ways that reduce incentives to bend or break the law. The TPA would be backed by legislation that made tobacco a controlled substance with possession sale and use only allowed as permitted by the regulations, which in reality would be only as provided by the TPA.

Conclusions: The overall effect of such a model, which we call a ‘‘regulated market model’’, would be to eliminate most of the incentives and remaining opportunities for commercial promotion of tobacco and to create incentives to encourage the development of less harmful tobacco products. Such a model preserves the competition inherent in a free market, but directs it towards the challenge of reducing the harm from tobacco use.

See the full report on A Strategy For Controlling The Marketing Of Tobacco Products: a regulated market model

Impact of Tobacco Tax Reforms on Tobacco Prices

Full report here

Impact of tobacco tax reforms on tobacco prices and tobacco use in Australia

Objective: To document the impact of changes to tobacco taxes on the range and price of tobacco sold during the period when the National Tobacco Campaign (NTC) was run.

Data sources: Information about brand availability, pack size, and price was extracted from Australian Retail Tobacconist. A retail observational survey was undertaken to monitor actual retail prices. Data on cigarette prices, brands, packet configurations, and outlets from which they were purchased were obtained from the benchmark and three follow up population telephone surveys conducted to evaluate the NTC.

Method: Data from the three sources were compared to see the extent to which the impact of tax changes had been offset by greater retail discounting and a more concerted effort by consumers to purchase cheaper products.

Results: Smokers were unable to cushion themselves from the sharp price increases that occurred during the third phase of the NTC. Both average recommended retail prices of manufactured cigarettes and average actual cigarette prices paid by smokers increased by 25% in real prices.

Conclusion: The fall in smoking prevalence over the first two phases of the NTC was substantially greater than would be expected due to tax changes alone. The fall in smoking consumption over the first two phases was slightly less than would be expected and in the third considerably higher than would be expected.