Select Committee on Health Minutes of Evidence


Examination of Witnesses (Questions 660 - 679)

THURSDAY 20 JANUARY 2000

MR S CLARK, MR D SWAN AND MR C OGDEN

660  If you accept on a definition that you may be prepared to accept that addiction may be a valid term, there is evidence that there is a pharmacological dependency. Would you accept that?

  (Mr Swan) I understand there is but I am really not qualified to come to a judgement.

661  If there were and if a large number of smokers begin smoking when they are under 16, it does somewhat knock on the head this notion of freedom of choice for adults, does it not?

  (Mr Swan) Yes, I understand the point, except that I would stress—and Mr Clark referred to Dr Macara's views—that even Professor Peto has said that if people really want to give up they can. I accept that some people will find it difficult. I can understand that it might be useful. My own view is that it may be useful in public health education terms to advise children that if they start they might later find it difficult to give up, as well as all the other things they need to be told. I have a problem with the whole thrust at the moment of the debate. If I believe and others more expert than myself believe that it is possible to give up by dint of willpower with perhaps some support from friends and family, why keep saying it is difficult to give up? If the public health objective is to encourage people to give up, why go around telling them it is difficult? A lot of people have given up. I have a problem with how that is played, but that is a personal view.

Mrs Gordon

662  Even if we accept this loose definition of addiction and habit, controversy, certainly the consequences are very different. We know that 120,000 people die in this country each year with smoking related illnesses. How many actor related premature deaths are there in this country or the other addictions which were mentioned?

  (Mr Swan) I do not know anything about health issues associated with illegal drugs.

Mr Gunnell

663  Mr Clark, your organisation publicises the rights of smokers. You are in the habit of giving awards to some organisations when they allow smokers particular rights. Could you tell me the circumstances in which you made an award to St James Hospital, Leeds?

  (Mr Clark) Yes. What happened in Leeds as I remember it is that two hospitals in Leeds—the second hospital was the Leeds Infirmary—were merged together. One of the hospitals had a complete ban on smoking and the other one had a smoking area or smoking room. When they were merged they decided to allow both hospitals to have a smoking room. We basically gave them an award for what we regarded as a progressive move because we think banning smoking in hospitals is actually a very negative thing to do both for staff and patients. It has led in some cases to patients standing outside hospitals in their pyjamas around the entrance when casualties have been brought in on stretchers. It is a bizarre sight. It has also proved to be a fire risk in some cases because patients have nipped off round the back where there might be some rubbish and obviously they are throwing their cigarettes away. We thought in that particular case they were effectively reversing their ban on smoking. They have said to us that they are reviewing it all the time, but we saw it as being a progressive step to allow smokers to have a small area in which to smoke.

664  I did see the publicity which was given in Leeds to this and, having views about smoking and whether it should be allowed in hospitals at all, I took the matter up with the chief executive of the United Leeds Hospitals Trust. He told me that he did not believe they had made any difference to the rights of smokers, that the award was unwelcome and that he had made it clear the award was unwelcome. Are you aware of that?

  (Mr Clark) No, I am not aware of that, but quite a few of our awards are unwelcome to people who receive them. We give awards to people who ban smoking in pubs, but it is a rather negative award shall we say and it gets publicity and yes, they often find that unwelcome.

665  Certainly the chief executive assured me that no action they had taken deserved the award.

  (Mr Clark) It is a rather sad reflection of modern society that it is so anti-smoking that a lot of chief executives in this position feel embarrassed to get an award from an organisation like FOREST, even though we feel we are upholding basic values and virtues such as tolerance and common sense. Such is the anti-smoking hysteria at the moment that chief executives do feel embarrassed about it and they will not admit that they are pleased to get that type of thing.

666  I would have thought it was natural that a hospital, which is concerned after all with public health, would be very embarrassed by such an award. Certainly I shall report what has been said to the chief executive of St James. I want to ask Mr Swan about what he tells us in his submission about the work of the Harrogate laboratory and its attempts to separate out the harmful components of tobacco smoke. You state that the mouse-skin painting experiments which had been conducted for many years stopped in 1970 following your predecessor body, the Tobacco Research Council, TRC's conclusion that "... the research could not provide any conclusive guidance on product modification". Did the people conducting the research succeed in isolating any potentially harmful chemicals in the condensate?

  (Mr Swan) I do not recall that detail, though I certainly read quite a few of the papers which were referenced in our submission. It is important that the Committee understand something which I think I made a couple of statements on in writing, that I really have no expertise to allow me to interpret the papers. What we did, hopefully for the benefit of the Committee, was to arrange to summarise in a digestible form, the papers which were produced reporting on the progress of all these activities. I really would not be able to interpret it for you.

Chairman

667  Would you be able to give us a written note on this? Mr Gunnell's question is a very important question from our point of view.

  (Mr Swan) I understand that. I was advised by the Clerk that you might wish to proceed along these lines. I really am not able to help you interpret the history: what we try to do is present it. I cannot really tell you much. I have brought with me today, if it is at all helpful, two large lever arch files of publicly available documents which report the progress of this research. These reports were shared with the appropriate Government agencies. You will know from the story that everybody kept changing their name all the way through this. It is fairly complex. I should be happy to give this to the Clerk if you think it would be helpful. I am sorry not to be able to satisfy you on that.

Mr Gunnell

668  We all understand that when you condense what comes from burning tobacco it is a very complex mix chemically and would contain many different substances. Gallaher told us in their memorandum that the research had to be abandoned as the complexity of the task became increasingly apparent. They said that in 1957 some 20 constituents had been identified in the condensate but now over 3,500 had been found. It does seem very curious to abandon this research simply because the detail it reveals is more and more complex. I would have thought you would in a sense have been doing similar research now because today's cigarette would seem to me as lethal as those which were being tested 40 years ago in Harrogate. Therefore nothing has been gained from this research in terms of getting a safer cigarette.

  (Mr Swan) All I gather from the history is that there was a lot of exchange of information between industry and government agencies at the time and the government agencies at that time decided to pursue the track of lower tar. There is a whole set of agreements associated with the product modification which leads through to the additives voluntary agreement which is still around today and which the TMA perhaps monitor with the Department of Health. The total thrust in terms of the exchange of scientific information between the Government and industry just moved off in this direction on tar reduction and that is all I have gathered from it. I really cannot comment. You would have to talk to the companies about whether or not they continued as individuals to do more research on tar condensates and what their results were. I would not know about that.

669  It certainly seems from the evidence in the United States that research must have continued there to some extent because they have worked on getting rid of nitrosamines from cigarettes and a company called Star claimed to produce cigarettes which were said to be free from nitrosamines. It would seem to be unusual if it were possible for the research to lead to a different product which though it might not be able to be described as safe, because I do not think any cigarette is safe, it might at least have a genuinely lower risk and not one which can be compensated for by the way in which you smoke.

  (Mr Swan) I know that the Committee has started to discuss this with the companies and I can only commend you to continue that. I really cannot help you in this area.

670  Do you think that is entirely a matter for the individual companies and not for the association as a whole?

  (Mr Swan) Discussions are going on at the moment which my colleague, Chris Ogden, may wish to comment on.
  (Mr Ogden) As explained, we are not scientists but we do as an association act as a facilitator to enable the company scientists to enter into dialogue with Government. Currently a series of meetings is going on with the Department of Health in which the company experts are cooperating fully with the Department's inquiries. I am sure any questions to the officials in the smoking policy unit at the Department of Health would confirm that for you.

Chairman

671  May I be clear? You are leaving some documentation with us today for us to look at.

  (Mr Swan) Yes.

672  You would have no objection to us following up our concerns with written questions subsequent to this session.

  (Mr Swan) No. All I would advise is that it would be more fruitful if you directed any detailed questions to the companies because we will not be able to interpret this.

Mr Gunnell

673  Is the Harrogate laboratory still operating?

  (Mr Swan) I do not actually know that. I do not know whether it is or not. I do not think it is; I do not believe it is. May I come back on one point? You asked whether or not it is appropriate for the individual companies to pursue this product modification on an individual basis. We would come into play if out of these discussions some new regulation, regulatory format, were put together. Then the industry might work together. At the moment product modification is really part of the marketing mix.

Chairman

674  You do not see that as any part of your role basically. It could be argued to be a very important health issue, at least from our point of view.

  (Mr Swan) We would try to facilitate that discussion and we are at the moment. The Department of Health has raised several technical issues with regard to additives and contents of cigarette smoke and we are facilitating that discussion. If from that comes a new regulatory proposal, then we would come into play and make sure that everybody understands it and set up the framework to make sure that it is observed.

Mr Hesford

675  What do you believe are the terms of reference of this Committee? What do you believe this Committee is looking into?

  (Mr Swan) I do not have it with me, but I think you are investigating the history of smoking and health. When it became apparent that there were health risks associated with smoking, what did the companies know in the past, what did the Government know, what have they done, reviewing that whole issue in terms of public health and the effectiveness of public health policy. In broad terms I think that is what you are about.

676  So you accept and you understand that a major facet of this inquiry is based around the health risks of smoking.

  (Mr Swan) Yes.

677  You understood that when you submitted written evidence to this Committee.

  (Mr Swan) We take it as a basic premise in our industry that the Government and medical experts advise us that there are—

678  No, you are going off on a different track I am afraid. You understood that this Committee was looking into the health risks of smoking when you submitted and drew together your submission to this Committee.

  (Mr Swan) Yes.

679  Why is it then that your submission deals virtually not at all with the risks of smoking?

  (Mr Swan) We do not have the expertise to comment on the issue like smoking and health. That is an issue which the member companies choose to speak about on an individual basis. They do not require us to speak on their behalf. It is a trade association. We speak on behalf of our member companies as they require. They do not require us to speak on this issue, nor do we have the expertise to make any helpful comment.



 
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