Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 620 - 639)




620  It is a fairly important point from the Health Committee's point of view, is it not?

  (Mr Clark) Of course it is, but you need to ask doctors. I am here to represent the freedom argument and smokers' interests.

Dr Brand

621  I am very impressed by your letterhead which list a Supporters Council which seems to be largely from the House of Lords and an Advisory Council with a large number of academics. I am afraid I do not recognise them all, but I can spot one or two economists and an historian or two. Do you think you might let the Committee have a list of the academic interests of the people on your Advisory Council? Before you give us the list, which you can do in writing, are there any medically qualified or life sciences qualified academics on your Advisory Council?

  (Mr Clark) I will be perfectly honest. I have been in the job for a year and I have never met any of them.

622  With all due respect, what is the point of having an Advisory Council if you have not met them and at the same time you are saying you are not qualified to evaluate evidence which relates to your activity. If you have an activity like promoting the freedom to smoke, then clearly you need to be informed on the various aspects related to smoking and therefore it is very sensible to have an Advisory Council. However, I would expect that Advisory Council to be made up of people with relevant experience and expertise so that it can actually advise you, so you cannot sit there and say you cannot answer that one because you do not have the qualifications.

  (Mr Clark) I can answer that question. We have never pretended to be medical experts. The arguments we get into have nothing to do, generally speaking, with health. Our arguments are all about whether adults, having been informed about the health risk, should have the liberty to continue to smoke.

623  I am sorry, but you said just now, in response to my colleagues' question on passive smoking and asthma in children, that you did not accept the evidence. How can you not accept the evidence if you have not put yourself in a position to evaluate that evidence by using your own advisory people?

  (Mr Clark) Because we see a lot of the reports which are in the newspapers and a lot of the comments about passive smoking. We see what the World Health Organisation has said about it, we see what the courts in America and Australia have said about it, we see what the Health & Safety Commission in this country have said about it and basically we make sure that journalists and politicians such as yourself hear that point of view as well. We are not saying we are medical experts, we are simply passing on what medical experts like the World Health Organisation have said about it themselves. We are repeating what they have said.

  Dr Brand: I am sorry but you are being frightfully selective in quoting reports by some very respected bodies. It is also true that the World Health Organisation has come out quite clearly saying that there is a direct link in childhood asthmas and childhood respiratory diseases and smoking, as indeed advisory committees to the British Government have come out with.

Dr Stoate

624  The Scientific Committee on Tobacco and Health, which is after all a fairly august and reputable body and this is evidence from them, have considered the effect of environmental tobacco smoke. They say that exposure to ETS is a cause of ischaemic heart disease. It is associated with risks in the order of 20 to 30 per cent increase in lung cancer. Smoking in the presence of infants and children is a cause of severe respiratory illness and asthmatic attacks. The main cause of neo-natal death, sudden infant death syndrome, in the first year of life is associated with exposure to ETS. The association is judged to be one of cause and effect. Middle ear disease in children is linked to pre-natal smoking and this association is likely to be causal. This is pretty solid evidence and you are saying that the jury is still out. If this is pretty solid evidence from the Scientific Committee on Tobacco and Health, how can your body seriously say the jury is out and you do not have either a knowledge or an interest in these matters?

  (Mr Clark) May I read to you a small section from this book by our Chairman, Lord Harris of High Cross. I have already sent a copy of this book to the Health Committee and am more than happy to send copies to each one of you. This talks about exposure to ETS as a cause of lung cancer and in those with long-term exposure the increased risk is of the order of 20 to 30 per cent which is what you have just said. This is a classic example of statistics being used to make a point. In actual practice let us put that in its real perspective. At the moment the average annual risk for non-smokers of getting lung cancer is apparently 10 per 100,000 people. For every 100,000 people, 10 non-smokers may get lung cancer although they do not smoke. If you add in the increased risk as a result of ETS, that is 20 to 30 per cent, we are talking about 12 or 13 people per 100,000, an additional two or three victims per 100,000 people. That is how you have to put it in its real perspective. It is no good just quoting 20 or 30 per cent; that is almost meaningless.

  Chairman: Not for the people concerned; not for those individuals.

Dr Stoate

625  I would take severe issue with that as I am sure anyone else would. The fact is that there were something like 14,000 to 15,000 deaths from lung cancer in this country, 80 per cent of which were tobacco caused. That means about 35,000 lung cancer deaths in this country are caused by smoking. If it is an increase of 20 to 30 per cent, the figures you quoted and the figures I am quoting simply do not add up. A 20 to 30 per cent increased risk is very significant. As the Chairman says, to tell the family not to worry because it is only two or three per 100,000, if we had a drug which caused two or three deaths per 100,000 it would be a serious public health matter and the Prime Minister would need to answer it.

  (Mr Clark) May I explain the FOREST position which is that even if smoking were twice as dangerous as it is said to be, we would still stick to our line because I do not get involved in the health debate. We accept that there are health risks associated with smoking. Our whole raison d'etre is to support an adult's right, if given the information, to be allowed to smoke. Words like epidemic have been used by the World Health Organisation, which seems a bizarre term to use. If it is such a terrible thing, such a terrible risk, then politicians surely would ban it. That is not happening, for a whole variety of reasons I suspect, financial and all sorts of other things. It can be twice as dangerous as it is said to be, but we would still support an adult's right to choose to smoke if that is what they wish to do.

626  Despite solid evidence that right infringes the right and indeed the lives of other people.

  (Mr Clark) I still say I believe, from the evidence we have looked at, the passive smoking debate, that the jury is still out.

  Dr Stoate: Not according to the Scientific Committee.


627  We have had evidence in respect of the amount of funding that FOREST gets from tobacco companies. Could you clarify how much of the funding overall, proportionwise, comes from the tobacco companies and how much from individuals? What is your total overall budget?

  (Mr Clark) Our total overall budget is about £250,000 a year and 96 per cent of that comes from the industry. We have certainly never hidden that.

628  But you describe yourselves as a wholly independent office.

  (Mr Clark) Yes.

629  How can you be independent when 96 per cent of your income comes from tobacco companies?

  (Mr Clark) I can explain the history of FOREST. It was originally set up in 1979 by a former Battle of Britain pilot. The story goes that he was standing on Reading station puffing away at his pipe and some lady walked up to him and told him to put it out. He basically decided to set up an organisation. It was not set up by the industry, but independently with this chap, Christopher Foxley-Norris, and a few of his pals. Obviously they had to look round for funding in order to set up an office. I would love to get funding from all sorts of different sources. I should love to go to other areas which I believe might be under attack in future years from what I call the nanny state. I should love to go to breweries for example. I should love to go to car manufacturers and ask for some money. Realistically they are not interested in the smoking debate. So for an organisation like FOREST to exist, we have to go to the tobacco companies; I make no apologies for it.

630  Frankly, rather than you being wholly independent, you are a front for the tobacco manufacturers basically.

  (Mr Clark) We would only be a front if they told us what to do, if they appointed the staff at FOREST. I had never met anybody from the industry before I came to FOREST.

631  Surely he who pays the piper calls the tune normally.

  (Mr Clark) I must confess in our case I can actually say it does not appear to be the case. I have not been told what to do at all. For the last 15 years I have been freelance, therefore I have had a lot of freedom to come and go, do whatever I want. I would not have taken the job at FOREST had I thought I was going to have a boss above me telling me what to do. It simply has not happened.

Dr Brand

632  You said you had never met the TMA before you took the job. Do you now report to the TMA as to outcomes of your campaigns?

  (Mr Clark) Absolutely not. I will say that there was one thing I did do for the TMA ten years ago which was that I used to run a thing called the Media Monitoring Unit, we monitored BBC and ITV for political bias. I briefly set up a little organisation called the Centre for Media Research and Analysis. We did a report into the media coverage of the smoking debate in 1989 and I did meet Clive Turner who was John Carlisle's predecessor, so he is the one person I have met from the TMA ten years previously. No, in the year since I have been at FOREST this is only the second time I have met Mr Swan. I met him a few months ago at my request because I wanted to go round the various companies and the TMA and simply meet people involved in the smoking debate. I even meet people from the anti-smoking side. I have obviously met Clive Bates of ASH through interviews. I have had lunch with a few people from the tobacco companies simply to make myself known and get to meet them. I have invited Clive Bates for lunch. He has not yet taken me up on my offer but I hope he will in the future.

633  Mr Swan, how do you determine whether you have had value for money from FOREST?

  (Mr Swan) I am sorry, there is a misunderstanding here. We have no financial or any other relationship with FOREST; none at all.

634  It is done through your members rather than through you as an organisation.

  (Mr Swan) Sure; absolutely; yes.

Mrs Gordon

635  You are describing yourself this morning as the voice and friend of the smoker. Can you give some or any examples of occasions when you have defended smokers' interests against the tobacco companies?

  (Mr Clark) Two things on that. First of all, there are so many organisations attacking the tobacco industry or claiming to be helping smokers either to give up or in their battle against the tobacco industry. We are a media lobbying group. The fact of the matter is that we have a sort of niche market. We are the only group which does what we do, which is defend the interests of the vast majority of smokers and help individual smokers if they have problems with the NHS or Customs & Excise or whoever it might be. We have a niche there. If we were to turn round and help smokers attack the industry, there are lots of other groups who can do that. If any smoker wants to do that and they ring us up, we simply give them the number of ASH and say that is an organisation which will help them. We are happy to do that. If any smoker rings us up and says they want to quit, we give them the Quitline number. That is not our purpose. That is not what we are here for. There are plenty of other organisations which do that.

636  You say you are aware of the health risks with smoking, so you have not taken any action on product information or concern about additives in cigarettes.

  (Mr Clark) As well as the money we get from the industry we have several hundred supporters who contribute to us each year from £5 to £200. To my knowledge we have never had one of those supporters ask us to take up one of those issues. If a number of our supporters asked us to do that we would certainly look into it. While there appears to be no demand for it from our supporters, the vast majority of whom are smokers, then quite frankly I am not going to waste my time doing something they do not appear to want us to do. They want us to get out there and sell this message of tolerance, courtesy, common sense, ways of accommodating smokers in society, and that is the message we put across.

Dr Stoate

637  You say in your memorandum that "... adults should be allowed to make up their own minds about whether or not they wish to start—or continue—smoking". We have had a discussion about this. Certainly with the parameters I mentioned of environmental tobacco smoke I would actually agree with you that if adults are fully informed they should be able to make up their minds as to whether to start or continue smoking. I have no problem with that at all. The question I want to ask is: what percentage of smokers do you estimate actually start smoking as adults?

  (Mr Clark) I have absolutely no idea to be honest. As long as they are adult smokers, we will defend their right to smoke. I do not have any statistics for the stage they start.

638  If I were to tell you then that something in the order of 80 per cent of smokers start smoking by the age of about 15 or 16 and that one third of 15-year-old girls are regular smokers, would that concern you, with your message?

  (Mr Clark) Our message is based on defending the right of adult smokers but clearly we are completely against under-age smoking. We come out very strongly and say that we would do anything we could to help children not smoke. I would put this in its proper perspective in society. I have two small children myself aged five and two. I do not want them to smoke. I shall hopefully influence them not to smoke by the fact that I do not smoke myself, but when they get to their teenage years if they show an inclination to smoke I shall probably give them some literature which will hopefully put them off.

639  I am not so worried about the late teenage years because it is legal, as you say.

  (Mr Clark) I am talking about early teenage years.

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