Episode 76 – 18th March 2011


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Plain Cigarette Packaging (1:56) by Simon Howard
Susan Blackmore Interview (8:08) by Jon Treadway
E-Book Bill Of Rights (16:16) by Salim Fadhley
The Guttenberg Affair (25:10) by Sven Rudloff
Brain Scanning (34:14) by Dean Burnett
The Grant Museum (41:22) by Liz Lutgendorff (ft Jack Ashby)

Follow-up links:

Pod Delusion EXTRA:

10 thoughts on “Episode 76 – 18th March 2011

  1. Simon,

    The problem with your argument is that it can be applied to pretty much any change in policy. You can’t have widespread research about the effectiveness of a policy if that policy isn’t implemented anywhere, so if you take this line of reasoning you can shoot down any truly original policy.

    As you acknowledged, Ben did cite research, even if you didn’t like it – whereas your scenario of people buying illegal cigarettes because the legal ones don’t look pretty, is just your thought and isn’t backed by any research. So, his side of the argument is backed by some research, yours is not backed by any, but you insist that your position should be the default because its currently the way things are.

  2. Pete,

    I’m not saying at all that the status quo should be maintained – far from it.

    Granted, Ben has cited some weak evidence for his position, so I’m saying we should actively go out and trial the new policy. This would most usefully be on a regional basis, although I can see an argument for practicality’s sake that we should trial it on a national basis.

    My argument is that there is no real evidence for the policy, so we should gather it – not just maintain things as they are.

    I just have my doubts about introducing a whole new national policy without any form of trial. Imagine that my thoughts turn out to be the case (and there’s no evidence against that being so). Is there any real hope that the Government would then turn back and ask the cigarette manufacturers to design pretty packaging? I doubt it, because that policy would be counter-logical, even if it is evidence based.

    However, if a trial of plain packaging were introduced, say in Northern Ireland, and the effects studied, the evidence would still be less than perfect but a hell of a lot stronger that it currently is. I cannot then imagine any outcry if the study showed evidence of harm from the policy and hence it wasn’t rolled out nationally.

    That may delay things for a couple of years, but it potentially avoids us falling into a trap which makes future smoking reduction programmes much harder to implement. I think that’s worthwhile.

  3. Your idea of people going to bootleg cigarettes because legal ones don’t have pretty packaging has no evidence for it, at all. I’m not sure why you describe Ben’s evidence as ‘weak’ – it seemed fairly clear to me.

    He also makes the point, that you haven’t addressed, that cigarette manufacturers have always been able to adapt to legislation on their marketing. Plain packaging puts a stop to a regulatory race that the government can never win.

  4. I have no dispute with Ben’s evidence that packaging is effective in changing beliefs about tobacco (except for the small point that most of his evidence refers to brand names, which will still exist even with plain packaging).

    I do have a dispute that packaging influences behaviour ergo removing packaging will decrease consumption. That’s a big leap.

    I am fully aware that there is no evidence to say that plain packaging will increase the rate of illegal tobacco purchasing. But there is also no evidence that plain packaging will decrease the rate of consumption of legal tobacco. At least, none that I’ve come across.

    Why not get some evidence before changing national policy?

    Even if you don’t accept the logic of the bootlegging argument, there’s a school of thought (which I think is more tenuous) that suggests that smoking is most prevalent in socioeconomically deprived groups, who are more frequent purchasers of plain packaged ‘value’ supermarket products anyway, so wouldn’t be put off by plain packaging of cigarettes.

    There’s also the argument that prices will drop. With no branded packaging to differentiate or create loyalty to individual brands, you set up competition based primarily on price, which drives prices down towards the level of tax only.

    And what’s to stop the plain packaging becoming a ‘refill’ for a pretty outer box sold separately? Or even the plain wrapper being no more than a brown paper cover for the normal packaging within?

    Would it not be better to look for the real-world existence of any of these logical flaws and address them before imposing the policy nationally?

  5. You’ve made your case on the idea that logic and argument alone can’t be used to justify something, and then you’ve gone and tried to just that.

    “Even if you don’t accept the *logic* of the bootlegging argument, there’s a *school of thought* (which I think is more tenuous) that *suggests* that smoking is most prevalent in socioeconomically deprived groups, who are more frequent purchasers of plain packaged ‘value’ supermarket products anyway, so wouldn’t be put off by plain packaging of cigarettes. ”

    Any evidence for this lot?

    It seemed to me the case for doing this was not to eliminate brand names anyway, it was to eliminate types of branding (such as using certain colours on the packet) that manufacturers use to surreptitiously imply healthier cigarettes. You don’t seem to object to legislating against specific instances such as ‘mild’ or ‘light’ cigarettes but you do seem to object to a measure that would stop the comparatively slow-moving legislature having to keep up with the slippery fuckers in cigarette marketing?

    On the one hand, you decry a lack of evidence (despite there being some evidence provided) for the benefits of neutralizing tobacco packaging, claiming that the case is based on logical argument alone (which it isn’t) – and then you make your case that tobacco packaging should remain as it is without offering any evidence at all for the benefits of doing this (or the detriments of neutralizing the packaging.) and try to back up your points with logic and argument.

    So which is it? Do you think policy should be decided by evidence (in which case, the evidence such as it is supports the policy) or by argument, in which case the fact that there is not much evidence on either side would seem to invalidate your original criticism of Goldacre.

  6. It’s the former. Policy should be decided by evidence. And I can see no evidence that plain packaging will reduce smoking rates.

    There is evidence of several things around and about the issue, which then require the use of apparent logic to come to the conclusion that plain packaging will reduce smoking rates. I’ve gone on to provide examples of apparent logic coming to alternative conclusions to show to the flaw of relying on logic alone.

    You say “the evidence such as it is supports the policy”. Presumably, the aim of the policy is to reduce the burden of harm caused by smoking. If that is the case, then I don’t see what this evidence is. Goldacre cites no evidence that plain packaging will reduce smoking rates, presumably because no such evidence exists as yet.

    Policy should be based on evidence, not apparent logic. There is no evidence cited to say that plain packaging reduces rates of smoking. Therefore, we should study the effects and get the evidence before changing policy.

    I am patently not making the case to keep the status quo. I’m making the case for researching changes before introducing them, instead of just taking a random stab which may unintentionally cause harm.

  7. Simon,

    Considering that you are applying a stringent standard of evidence for any new policy, and no standard of evidence whatsoever for the existing policy, how is this not an assumption of the status quo?

    It isn’t the case there is ‘no’ evidence, there just isn’t strong evidence for the exact policy in question. Such evidence there is, indicating that health warnings are more noticeable and memorable on plain packaging, does indicate the policy will have an effect. And considering that health warnings do have an effect:

    http://eurpub.oxfordjournals.org/content/15/4/389.short
    http://tobaccocontrol.bmj.com/content/15/suppl_3/iii19.short

    it does not seem massively unreasonable to say that, given the evidence that exists, this is a worthwhile policy. Especially given that your notion of such a policy causing harm has no evidence behind it at all.

    You admit yourself that, if cigarette packets were currently plain, it would be impossible to make an evidence-based case to re-introduce branded packets – and yet you oppose a policy to move from branded to plain packets because, even though there is some (admittedly sketchy evidence) for to support the new policy. Your position seems to be that the status quo doesn’t require evidence-based support.

    It is possibly to block any new policy by simply raising the bar for how much evidence would make you accept it to above the level of evidence that currently exists. If you are not willing to apply the same level of evidence for policies you personally support, this is not evidence-based policy making.

  8. Pete,

    Clearly, we’re not going to agree on this.

    I think that if you’re trying to effect behaviour change from an intervention, you need good evidence that your intervention affects the behaviour you’re aiming to change in the way that you want. You disagree; and I guess that’s fair enough, because after all, these things are a judgement call.

    We know the effect of branded packaging: it’s bad. We don’t know the behaviour-related effects of plain packaging: they may help or hinder in our quest to change behaviour.

    I don’t want to fall into a bear trap that doesn’t change behaviour in the way we want, and actually makes future work harder. On the basis of the evidence we’ve seen, you think that’s unlikely; I’m not convinced. I think the lack of evidence of harm may well be due to the fact that we haven’t studied the specifics of the policy and looked for harm. As I say, I guess that’s a judgement call.

    Perhaps we should agree to disagree!

  9. I grant the lack of evidence and the possibility of the Law of Unintended Consequences kicking in to make things worse.

    There are ways to mitigate the effects of the latter – enacating a law that is in effect for a limited time, for example.

    The best argument, in my mind, for plain packaging is the effort that the tobacco industry puts into package design. These lads do a lot of research, and have a pretty good idea of what promotes sales and what doesn’t.

  10. Lech,

    A time-limited law with a review of evidence is one approach that seems sensible.

    I think a regional approach might be politically easier to swallow – a ‘stepped wedge’ approach, with close study of the results in the roll-out areas and the understanding that roll-out will stop (or the policy will be adjusted to respond) if the evidence suggests that there are unintended negative consequences.

    To my mind, the danger is that we introduce a new (well-meaning) policy on a national level, don’t bother to properly study the effects, and end up in a worse position than where we started… especially with the slipperiness of the tobacco industry, no doubt has a cunning plan to continue to give out their messages if plain packaging laws are enacted.

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