To: Assistant Secretary, Drug Strategy Branch
Attention: Tobacco Reform Section
Department of Health and Ageing
GPO Box 9848
Canberra, ACT 2606
From: Dr. Elizabeth Whelan, President, and Dr. Gilbert Ross, Executive/Medical Director
The American Council on Science and Health
1995 Broadway
New York NY USA 10038
Statement in Opposition to Australian Government s Proposed Plain Packaging for Cigarettes Legislation
The American Council on Science and Health
New York, NY USA
June 2nd, 2011
Introduction
The American Council on Science and Health (ACSH) has been in the forefront of anti-smoking education for the consumer since our founding in 1978. We have numerous publications on this most important public health issue, perhaps the most important being our monograph, What the Warning Label Doesn t Tell You, published in 1996 and revised several times since.
We have a mission: to evaluate health and science studies and claims based on sound science and peer-reviewed publications. The most important ethos we adhere to is to not take at face value assertions based on inadequate data, which we have found to quite often be agenda-driven or politically based rather than scientifically based.
In recent years we have become devoted proponents of harm reduction as a means of helping addicted smokers to quit deadly and addictive cigarettes. This has led us to work in common with those tobacco companies who have also shifted their emphasis from recruiting more cigarette smokers, towards a harm reduction philosophy. While we were at first uncomfortable in that arena, we continue to believe that reducing the toll of cigarettes is the most important task we have if we hope to save lives and prevent premature disease.
When we discussed the pending (at that time) U.S. legislation giving the FDA authority to regulate tobacco, we were struck by several issues relevant to that bill: Why were flavorings in cigarettes banned except for menthol? And what would the real benefits be to public health of banning flavored cigarettes. So rather than just jumping on the bandwagon, as other anti-tobacco groups had done, we decided to evaluate the science. Imagine our surprise when we discovered that:
a The toll of candy-flavored cigarettes was almost nil, so the public health benefits of such a ban while widely trumpeted were in fact ephemeral at best;
b Menthol was carved out of the ban due to its wide popularity and the potential for vast economic and societal disruption were it to be banned; moreover, when our independent research revealed that menthol in cigarettes added no health consequences as compared with non-menthols, we so stated before the FDA s Tobacco Products Scientific Advisory Council panel, and opposed the ban, asserting that it would do more harm than good especially when considering the likely growth of the market in smuggled and illicit menthol cigarettes that would surely ensue.
Our position re: Plain Packaging
With the above as background, ACSH scientists decided to look into the issue of plain packaging (PP) of cigarettes for its potential to benefit public health, by reducing cigarette consumption among adults, as well as any possible effect on youth initiation and inhibition of quitting/cessation. We as always planned to place any such PP benefits on the scale against clear, likely, and potential consequences, both as relevant to cigarette consumption as well as to the society in general.
This task became much simpler upon review of the evidence for PP benefits: there is simply no evidence to support an association between PP and a decline in cigarette consumption. In fact, no such studies have even been undertaken, to the best of our ability to find them. The same is true for effects on initiation and cessation.
This seems to be another issue which, while seeming to be an obvious approach to reduce the toll of smoking, turns out to be composed of smoke and mirrors upon careful inspection. In other words, mandating uniform PP for cigarette packs is analogous to the obvious benefits of banning candy cigarettes and menthol: the downside clearly outweighs the upside.
Non-health Concerns
PP implementation will likely have the unintended and unwanted or counterproductive effects enumerated here, not to be construed as inclusive as some issues are outside of ACSH s field of expertise:
a PP will likely force cigarette makers to resort to price competition as opposed to brand competition. Since the best documented method of reducing cigarette consumption is via price manipulation through taxation or otherwise, this effect will clearly be the opposite of that desired.
b It is obvious that PP cigarettes will be significantly more attractive to criminal counterfeiters. As discussed at the recent meeting of the U.S. Tobacco Merchants Association, which we attended, spokesmen for the General Accounting Office and the Bureau of Alcohol, Tobacco and Firearms are well aware of the extensive problem of illicit (untaxed) and counterfeit cigarettes already permeating our borders. While we are not so familiar with the analogous situation in Australia, we can only believe that whatever the extent of the problem now, it will be enhanced by several-fold if the counterfeiters need not be concerned about brand identities their only requirement will be a word processor with the appropriate font styles and sizes. This will probably become a bonanza for such smugglers, whose products will not only be sub-standard, but probably cheap enough to be purchased by young people, who will not be required to show age documentation to buy these illicit smokes.
From these perspectives, it seems that it is more likely than not that a PP mandate would actually increase rather than diminish cigarette consumption. Given the absence of evidence of actual benefit, ACSH strongly urges the Australian government NOT to legislate Plain Packaging for cigarettes. Such an extensive requirement has vast potential to wreak havoc and a small likelihood (if any) of enhancing public health.
As we here at ACSH are not well-versed in international trade accords, nor the nuances of intellectual property although we have learned a fair amount based on this topic relevant to the WTO and TRIPS issues we do not choose to weigh in on those aspects. That being said, there is no need in our opinion to even get to those points, as the lack of a positive risk-benefit equation for PP should, we hope and believe, lead to its defeat in Parliament.
Elizabeth M. Whelan, M.P.H., Sc.D.
President
Gilbert L. Ross, M.D.
Medical and Executive Director