This year has seen the debate regarding investment in the tobacco sector highlighted in a way that it has not in some considerable years.

In April the California Public Employees Retirement System, CalPERS, announced that it was reviewing its policy of divestment from certain industries, and in particular the decision it took in 2000 to divest from the tobacco industry. It was reported that CalPERS estimated that its decision to divest had cost it, at that point, some $3bn in missed profits.

It was also reported that Norges, the Norwegian Government Pension Fund, which has excluded most tobacco related investments since the end of 2009, had missed $1.9bn of potential profit and reduced its returns by 0.68% per annum from 2010 to 2015. Although CalPERS was reviewing its policy, Norges was not.

Subsequently, in May AXA announced that it would sell immediately its €200m own-account investments in tobacco company equities and stop all new investments in tobacco industry corporate bonds, running off its €1.6bn of existing holdings as they matured. It was not selling either equity holdings or bonds in funds managed as third party mandates. AXA argued that smoking posed the biggest threat to public health in the world today and that “tobacco will kill one billion people worldwide during the 21^st century”, citing statements from the World Health Organisation (WHO).

Alongside these debates has been the continuing and active debate regarding the safety or otherwise of e-cigarettes, their role in harm reduction, the regulation of the sector and the role of the tobacco companies in production and promotion of the category. This debate has seen a schism in “Public Health” with those in favour of the products being countered by others who claim “it isn’t yet known if they are safe“. Media headlines (“Vaping as bad as fags” for example) have played a role in changing public perceptions of the relative risks of e-cigarettes compared with combustible cigarettes, with ASH suggesting that the proportion of survey respondents thinking that e-cigarettes were equally or more harmful that tobacco cigarettes increasing from 12% in 2013 to 23% in 2015. In many cases the tactics and language used by the detractors of e-cigarettes are reminiscent of earlier chapters of tobacco’s history and not in a way which is flattering to the current generation.

The regulatory environment with respect to tobacco has been developing over many decades and, as the majority of the population in most countries are not smokers, the impact of that regulation is rarely considered as it does not, prima facie, impact upon most of us. Many of us may have welcomed “smoke-free workplaces” although at the time of the introduction of such legislation in the UK most of us were already working in smoke-free workplaces (according to the ONS by 2005 only 8% of adults were working where there were no restrictions on smoking). We may well have welcomed the restriction on smoking in pubs from a personal perspective, although the introduction of such legislation has undoubtedly been bad for the pub trade in the UK (with similar evidence overseas). The banning of point of sale display of tobacco products in the UK and the introduction of plain packaging this year will barely have made a ripple in most of our lives. Given that the majority of us are not tobacco users, and many may not personally approve of tobacco use, each of these further restrictions would have either gone unnoticed or have been welcomed as “a good thing”.

That the experience of tobacco control is being widely quoted as a template to be used in other areas “of concern” is probably less well recognised. The idea of a “slippery slope” in regulation of legal products has been vehemently denied by some supporters of tobacco regulation, but not by all as the following entries from the 2015 WHO Tobacco Atlas show quite clearly.

 

While restrictions on tobacco impact a minority, and a minority which has become wearily accustomed to being singled out, the fact is that the approach used in tobacco (which itself originally stemmed from the campaign for Prohibition in the US) is now starting to reveal itself in products which might be closer to home for many more of us. The reduction in “safe” drinking levels in the UK is a clear case in point with the UK now having the lowest “safe” levels anywhere in the world and being the only country where the levels are the same for men and women. Moreover “there is no level of regular drinking that can be considered as completely safe” (p17) according to the Chief Medical Officer. This is in stark contrast to the weight of evidence on this matter and therefore also completely counter to the introduction of the document which states “People have a right to accurate information and clear advice about alcohol and its health risks“. It does, however, follow as advice from a committee of experts who are by and large from a temperance background.

Concerns have been raised with respect to obesity levels in society, and this in turn has prompted the proposed introduction of the Soft Drinks Industry Levy in the UK with similar approaches taken in Mexico, France, Finland, Hungary and Philadelphia. The wide availability of low or no-sugar variants of “sugary” drinks does not appear to have influenced the decision to introduce the levy nor indeed the lack of evidence of either sugary drinks in excess calorie consumption or of success elsewhere from taxation. Any of us that prefers “core” styles of fizzy drinks will face either changes to the product and/or higher prices, and yet we would probably not have regarded ourselves as “at risk” and therefore not in need of reformulation or being charged more for a product we freely choose.

In the last 12 months, WHO has deemed Processed Meat to be a “Group 1” carcinogen, ranking it alongside plutonium, alcoholic drinks, coal fires in the home and sunshine, based on “limited evidence”. The report regarding processed meat caused an immediate reduction in demand from UK consumers for bacon and sausages. WHO has also deemed drinking very hot beverages as a “probable cause of oesophageal cancer” although coffee was granted a respite and is no longer considered “possibly carcinogenic to humans (Group 2B)”. Many probably looked askance at the idea that bacon was so high risk and have little intention on changing their consumption, and probably never considered that coffee had previously been deemed to be carcinogenic.

The apparently frequent and contradictory messages regarding the ideal diet (is it carbs, sugar, fat or something else that should be avoided this week?) capture headlines but do not inspire confidence in the scientific basis of the claims made. It is, perhaps, no wonder that Britain has “had enough of experts“, although it does highlight an understandable personal tendency to believe statements that chime with our own prejudices and behaviours but to discount those that do not.