Opinionista Ivo Vegter 20 July 2015

Smoking: Shock and trauma as public policy

The department of health wants to force tobacco firms to sell their wares without branding, in plain paper packaging, decorated only with graphic and distasteful pathology images. This is nanny-statist, bureaucratic over-reach which limits the freedom people have as adult citizens to make their own choices in life.

Some time ago, I pointed out that the decline of honeybees has been substantially overstated. Aaron Motsoaledi, the chief nanny in the health department, provides an excellent example. He has a bonnet full of them.

One of his bonneted bees is to interfere in the everyday lives of people, to make sure they keep healthy lifestyles. If they don’t, he’ll pass laws that scold, tax, badger, sermonise and humiliate them.

Among his recent initiatives are laws to force tobacco companies to package their products in unbranded packaging, festooned with gory images of diseased lungs, tracheotomies, and cancerous tumours.

This law will not affect me directly. I am an ex-smoker, with no intention of ever taking up the habit again. I do not intend to defend smoking here, but to defend the rights of smokers as equal to the rights we all enjoy as human beings and adult citizens of South Africa.

If Motsoaledi has his way, South Africa will be one of the first countries (after Australia, the UK and Ireland), to implement the World Health Organisation’s draconian guidelines on tobacco product packaging and labelling.

While the Netherlands has been relaxing its tobacco control regulations, on the grounds that it is patronising and illiberal to dictate healthy choices to citizens, Motsoaledi holds the exact opposite view. In his eyes, it is the government’s job to protect citizens from themselves. To quote him: “We are not doing this because we are a nanny state, but because we are concerned about the health of the nation.”

I fail to see the distinction, and moreover, I cannot tell the difference. Nannies are paid to be concerned about the health of their charges. If Motsoaledi claims to be concerned about the health of the nation, he is acting like a nanny to the people.

If you’re unsympathetic to the plight of smokers, you’re not alone. That’s why Motsoaledi is starting there. Smokers are easy targets. The cigarettes that they find relaxing and enjoyable are unpleasant to many others, and are clearly harmful to their health.

But Motsoaledi has also declared war on alcohol, salt, sugar, fat, fast food, baby formula and anything else that might under some circumstances be described as unhealthy, or less healthy than alternatives.

Motsoaledi has built the mother of all slippery slopes to nanny-state fascism, and it starts with tobacco products. Once the precedent is set, he can do this with anything, on almost any grounds.

Before you know it, he’ll be whining that people who don’t go to gym every day cost the government healthcare system too much money, so regular exercise will henceforth be mandatory.

The point is not that he is wrong. Smoking is bad for you. Moderation in most things (and abstinence in some) is good advice, especially if you suffer from high blood pressure, obesity, heart disease or diabetes. But we do not all suffer these conditions. By contrast, the burden on producers to comply with the nanny in chief’s dictats does affect us all.

Gore’ is the popular term for uncensored and graphic imagery of medical procedures, deadly accidents or dread diseases. Gore was once safely contained in the seedy corners of the Internet. You had to go looking for pictures of gross diseases, horrifying injuries or corpses, if you wanted to be shocked. Motsoaledi wants to make gore available to everyone, by slapping it on every cigarette pack you happen to see, whether it be yours or not.

Should automobiles be fitted with graphic images of mutilated and burnt bodies, to discourage their users from abusing them? Should your bottle of table wine be adorned with images of cirrhotic livers, flaccid penises or nasty tumours? “Oh, waiter, I’ll have that delightful Sauvignon Blanc with the inflamed pancreas on it.”

It may well prove to be unconstitutional to deprive companies of valuable brands through legislation. If a brand is an asset, then legislation that destroys it is tantamount to expropriation without compensation.

In the US, similar regulations were struck down on the grounds that they infringe on the right to free speech.

Even if you do not smoke and dislike smokers, these are rights most of us can get behind. One can only hope the tobacco industry takes Nanny Motsoaledi to the cleaners in court.

The health department’s interventions have other impacts too, such as slashing employment at hard-hit firms, and reducing marketing or advertising revenue elsewhere in the economy.

Motsoaledi has said that he’d consider making up for the R400 million that the SABC claims it would lose in advertising revenue if alcohol advertising were banned, by simply paying the same amount out of the health department’s budget to flight public-service health advertising. Amid chronic pharmaceutical shortages and one of the world’s leading Aids and tuberculosis burdens, that’s a rather callous and manipulative way to spend taxpayers’ money. Besides, what’s stopping him from doing so now, and broadening public debate, rather than restricting it?

Even if he did pay off the SABC, what about the rest of the media, or the many arts, culture, sporting or civil society initiatives that are funded by the kind of marketing he wants to prohibit? These have already been hammered by tobacco advertising bans. Losing alcohol advertising, and having salt rubbed into the wound by seeing only the state-owned media being compensated for the loss, can only weaken the independent media further. Not even sugar can help that medicine go down. Who will be left to hold government accountable, or sing praise to Motsoaledi on Father’s Day?

Smokers have already been exiled from polite society. They cower outside in the wet and cold, forbidden shelter or entertainment. They spoil everyone else’s party with their frequent absence during social gatherings. They’re treated like lepers.

Does anyone really think that a graphic picture is going to make more difference than today’s ‘Smoking Kills’ labels? It isn’t like the message is unclear. Do you know any smokers who are not fully aware that smoking causes deadly cancers, and worse, will make them look ugly, blotchy, and wrinkly when they get older? I don’t. I can’t for the life of me think what a bigger, more graphic warning label will achieve in terms of consumer awareness of the dangers of smoking. Its sole purpose is to demonise and revile those who enjoy nicotine instead of caffeine.

There is limited and contradictory evidence for the benefits of plain packaging. In the US, the regulators estimated a decline in smoking of 0.01% as a result of such rules. This is, statistically speaking, equal to zero. Only Australia has implemented such a law. There, some evidence suggests that it encourages smokers to choose cheaper cigarettes, but that it does not decrease the number of cigarettes sold. It could also boost the sales of illegal, untaxed cigarettes, because plain packaging prevents consumers from using branding as a tool to make choices about the quality and authenticity of the cigarettes they buy.

Even if plain packaging is effective in reducing smoking that does not justify such an onerous imposition on liberty. Smoking is a risk some people are prepared to take, for their own pleasure and satisfaction. Taking risks is what makes a happy and eventful life. People eat rich meals, drink strong liquor, or indulge in decadent sweets, even though they know these to be bad for their health. Motsoaledi wants to crack down on all of them.

They go bungee jumping, bicycling, mountain climbing, driving, skateboarding, swimming in the sea, skydiving and listen to loud music, even though all those activities imply risk of injury, long-term harm or even death. No doubt Motsoaledi disapproves heartily of such health risks.

People have a fundamental right to enjoy life, while it lasts. How much risk is a reasonable trade-off for a full and exciting life is not a choice that ought to be made by a government bureaucrat on a moral crusade. Even if some people underestimate risk or engage in what is perceived to be reckless behaviour, it is not justified to restrict their liberties, and punish everyone else for their sins.

As much as cabinet ministers might believe themselves to be fathers and mothers to the nation, citizens are not children. The people’s rights supercede those of government, since government is the servant of the people.

If plain paper packaging for cigarettes doesn’t work, all Motsoaledi will have caused is unpleasantness, revulsion and probably some psychological trauma, not only to smokers, but also to the adults and children around them.

Motsoaledi disrespects the freedom an individual ought to have to be in control of their lives. As a precedent, his proposed measures takes us one step closer to a government that controls the production, packaging and sale of a wide range of consumer goods and services. This will leave products undifferentiated by brand or reputation, which means producers will need to meet only the lowest common denominator in standards.

Motsoaledi is on record as saying, “We are now gunning for alcohol advertising.” This gives the lie to the argument that smoking is bad for your health in any amount, while alcohol is no risk when consumed in moderation. That doesn’t matter to the minister. In fact, he brags to international forums of unelected bureaucrats, like the World Health Organisation, about how far his legislative reforms go.

He has also declared that electronic cigarettes and water pipes (‘hubbly bubblies’) will be included in future tobacco control legislation. This puts to rest the argument that smoking is a fair target because it is unusually unhealthy by comparison with other trappings of a pleasurable life, such as wine, coffee or crisps. Motsoaledi is strict, like an old-timey pastor or headmaster. He won’t let any wanton enjoyment of life happen right under his nose.

If we don’t oppose this sort of draconian, illiberal law, which harms both individual freedom and economic activity, we’ll end up wondering how we ended up in a totalitarian nanny state so quickly. To adapt Pastor Martin Niemöller:

First they came for the Smokers, and I did not speak out—

Because I was not a Smoker.

Then they came for the Drinkers, and I did not speak out—

Because I was not a Drinker.

Then they came for the sugar and salt, and I did not speak out—

Because I already avoid sugar and salt.

Then they came for me – and there was no one left to speak for me. DM


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