Observations Tobacco Control

Cameron’s cave-in on plain packaging is a boost to industry

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3069 (Published 10 May 2013) Cite this as: BMJ 2013;346:f3069
  1. Mike Daube, professor of health policy, Curtin University, Western Australia,
  2. Simon Chapman, professor of public health, University of Sydney
  1. M.Daube{at}curtin.edu.au, Simon.chapman{at}sydney.edu.au

Australia has shown that governments can act on plain packaging of tobacco products. The UK government would do well to reflect on its responsibility for the deaths and suffering it could have prevented but didn’t

On 29 April 2010 the Australian government announced that it would introduce plain packaging of tobacco products as part of a comprehensive approach to reducing the prevalence of smoking. The final legislation was passed on 21 November 2011 and came into effect on 1 December 2012. The tobacco industry openly acknowledges packaging as its core form of promotion, and all tobacco advertising and promotion have been banned in Australia since 1992. This legislation closed a major remaining promotional door.

The three global tobacco companies that dominate the Australian market opposed plain packaging more fiercely than they did any other measure in the history of tobacco control. They spent tens of millions of dollars on advertising, lobbying, public relations, consultants’ reports, misleading surveys, campaigns aimed at retailers’ organisations, and covert operations. Having for two decades operated like cockroaches that spread disease but avoid sunlight, the three companies publicly re-emerged to defend their last bastion of marketing. British American Tobacco (BAT) even took to Twitter.

They argued that plain packaging would “not work” but also that this allegedly useless policy would put retailers out of business. That it would be a massive step towards the end of freedom, as a military officer boomed in a television campaign from Imperial. That it was against the constitution and international trade agreements and would cost the government billions in legal costs and compensation. That it would be impossible to implement in the proposed timeframes. That it would cause a dramatic boost to the illegal tobacco trade (the official estimates are that this is 1-2% of the market—they claimed a wonderfully precise 15.9%) and would result in an influx of “Chinese gangs.” That it would cause long queues at retail outlets. And that it should not be introduced because nobody had ever done it before.

The industry’s arguments in the United Kingdom were similar, apart from the claim that nobody else had done it. As in Australia, the industry tried to discredit the evidence, the research, the minister, the government, the health department, health organisations, and tobacco control advocates.

In Australia, the minister, government, and department remained resolute. Backing from all parliamentary parties was confirmed after the opposition’s most senior doctor in parliament, the general practitioner Mal Washer, robustly declared to the media, “The tobacco industry is jumping up and down because they’re worried about their businesses. I support these reforms unequivocally, and whatever my party decides to do I don’t give a shit.”

Since the introduction of plain packaging in Australia, all the companies’ dire predictions have come to naught. Implementation has been smooth, notwithstanding industry attempts at distraction. The biggest losers in legal expenditure so far have been the tobacco companies, which not only humiliatingly lost their High Court challenge 6-1 but had to pay the government’s costs.

In the UK, as in Australia, the case for plain packaging as part of a comprehensive public health approach was compelling—indeed stronger, as the prevalence of smoking in the UK is higher and has remained at a plateau in recent years.

But after clear earlier indications that it intended to act, the government has backed off.1 Whitehall sources reportedly cited other priorities (a long way from Disraeli’s view on the health of the people as the highest priority) and the lack of evidence of the effects thus far in Australia. This is a nonsensical argument, given that the main goal of plain packs has always been to see future generations of children grow up never having seen a box of 60 carcinogens beautifully packaged like a designer consumer good. No one aged under 21 in Australia has ever seen a local tobacco advertisement, and smoking by young people is lower than it has ever been.

The UK government’s decision to favour the interests of tobacco companies over those of public health is all the more distressing because many countries still look to the UK for a lead in this area. In a world where six million people die each year because they smoke, the UK government’s simpering cave-in will provide great encouragement to this lethal industry, which is eager to sell as many cigarettes as possible, with minimal constraints, to vulnerable populations in developing countries.

Overwhelming support from international and national health authorities and from the UK government’s own public health minister has been overridden by a government with a senior minister, Kenneth Clarke, who was formerly deputy chairman of BAT, and a former adviser to the prime minister, Lynton Crosby, whose Australian company still proudly proclaims its association with the tobacco industry. It is hard to reconcile the UK government’s approach with its commitment through article 5.3 of the UN Framework Convention for Tobacco Control that “parties shall act to protect these (public health) policies from commercial and other vested interests of the tobacco industry.”

Since 1950, when the BMJ published the first unequivocal evidence that smoking killed, smoking has been responsible for well over seven million British deaths. The government and industry alike know that cigarettes kill one in two regular users.

When Australia’s former health minister Nicola Roxon was asked about the need for action at the launch of the report that recommended plain packaging, she said, “By not acting we are killing people.” The UK prime minister and his colleagues would do well to reflect on their responsibility for the deaths and suffering that they could have prevented.


Cite this as: BMJ 2013;346:f3069


  • Competing interests: SC is on the board of Action on Smoking & Health Australia. MD is president of the Australian Council on Smoking and Health.


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