Are plain cigarette packets a great public health achievement?

I heard that we had just had ‘a great public health achievement’ a couple of days ago, and I wondered. I’m one of those reformed smokers who hates the smell of tobacco smoke anywhere, and has no doubt that smoking is bad for you, even if you don’t die of lung cancer or emphysema. It is also about as expensive as buying petrol for your car, just in terms of the extra tax you pay. A quick piece of rough arithmetic tells us that if a pack costs $12, and the tax in it (at nearly 67 per cent) is $8, and you smoke a pack a day, then at $8 x 365 = $2920 you are coughing up nearly $3000 a year in tax for your habit. As a non-smoker I benefit from all this, as I do from poker machine taxes, so in a sense I have an interest in your continuing to smoke as well as to gamble.

But at the end of your life, you will need a lot of medical care, and then I have to help pay for you. You could point out that, if you are, say 78, and you’ve smoked a pack a day since you were 18, you might have paid in today’s dollars about $180,000 in extra tax, so that should help — and it will. Yet I have mixed feelings about all this, because my interest in public health — and that is long-standing — is matched by my even more long-standing interest in Australia’s being a good society in which people can live the kind of life they would like to live, all things considered, without being told what to do, or not to do, by the state. In the area of cigarette-smoking my interests collide.

There is little doubt that we Australians love to regulate one another. We are arguably the most authoritarian democracy in the world. Our income tax act has 10,000 pages, and we add a few thousand new laws and regulations every year. What is more, most of us try to obey them, too, and believe that we should. Our system has as its basic proposition that we decide who will rule us at elections. Those who win the most votes get into power, and they deserve to rule. If we don’t like what they do we can kick them out next time. But in the meantime we obey the new laws, because we agree that the people who have the power, won legitimately, have the right to pass new laws.

My view now is that we don’t need so much regulation. We do need lots of good information, but so much of what we get is tainted or ‘cherry-picked’ by those pushing a point of view, that it is not wholly reliable. You see a lot of this in the ‘climate change’ debate, where the orthodox point to this paper, or this set of data, while the dissenters point to another paper, or another set of data.

From my perspective the last word on all this was said by John Stuart Mill in his essay on liberty, and he mentioned health, too:

‘The only freedom which deserves the name is that of pursuing our own good in our own way, so long as we do not attempt to deprive others of theirs, or impede their efforts to obtain it. Each is the proper guardian of his own health, whether bodily, or mental or spiritual. Mankind are greater gainers by suffering each other to live as seems good to themselves, than by compelling each to live as seems good to the rest.’

He also said that ‘stupidity is much the same the whole world over’. So, to pursue the Mill line, provided that there is ample and reliable public information about the true dangers of smoking, provided that smokers are taxed to the point where the public cost of their ill-health is, on average, already paid for, and provided they don’t smoke near me, wherever I am, I don’t see the great need to do anything more.

I would say the same about illegal drugs, too. Making doing things to yourself illegal is a counter-productive way to go, since it leads to many evil social consequences and doesn’t stop whatever the practice is. Finally legalising the private possession and ingestion of cannabis has not, on the face of it, led to the widespread adoption of marijuana.

Alcohol presents a more difficult issue. The American experience with prohibition gives us plenty of warning about what would happen if we go down that path. Violence that is the apparent consequence of too much grog is dealt with by the police. Too-frequent violence  at the same venue can lead to the venue’s being held responsible. Alcoholic beverages are easy to make, so taxing alcohol out of existence won’t work.

Ultimately, as with so much else, the buck stops with ourselves. Some of what we see, like violence outside pubs and clubs, is plainly engaged in by the young. They will presumably grow out of it. All of us have to learn through experience, and most of us remember the lessons. We do our best as parents to shield our children from what is harmful but ultimately, as was true for us, they will need to find out a lot for themselves.

I am no supporter of the nanny state, and see the plain packaging of cigarettes as a success for would-be regulators more than as a great victory for public health. Perhaps it will reduce even further the tendency for young people to take up an expensive and unhealthy habit. But I would have preferred the path of more good information, treating people as rational, rather than as dummies.