Sad day for preventive medicine
Authors: W. Russell
Journal: BMJ (1982)

It costs the Health Service some ?150m a year to treat smoking related disease and loses the country approximately 50 million working days each year. Cigarette smoking is also the single most preventable cause of death and disease in the United Kingdom and is responsible for at least 50 000 early deaths a year. Now that is a fairly horrific catalogue, and nobody could be blamed for assuming that it had been extracted from something prepared by Action on Smoking and Health in the light of the Government's recent pronouncements on cigarette advertising and the sponsorship of sport by the tobacco industry. In fact, it comes from the preamble to the long written answer in the Commons by Mr Norman Fowler, the Social Services Secretary, announcing the state of play in his discussions with the tobacco industry about advertising. Mr Fowler said he had been deliberately conducting his talks with the companies on what is to follow the present voluntary agreement so painfully negotiated by his predecessor?it ends in July?in the broad context of prevention. He then announced that the industry is to fund an independent research programme, aimed at the young, into maintaining good health to the tune of ?3m a year for as long as the new agreement lasts, and that a joint working group is to be set up by the industry and the Department of Health and Social Security to develop specific proposals. He hoped that this project would be under way by the autumn, by which time the outstanding issues regarding the renewal of the agreement would have been resolved. It seems that the industry is going to agree to more controls on advertising and to better presentation of the Government's health warnings. It was surely no accident that Mr Fowler chose to announce all this in written form; an oral statement would have received short shrift from those who agree with him that cigarette smoking is the single most preventable cause of death and disease in the UK. As one critic put it privately, the Government has sold the pass. Mrs Gwyneth Dunwoody, Labour's health spokesman, went on the record to accuse him of having let the companies buy their freedom by his acceptance of their cynical little research scheme. We already know the answer to those studies?namely, that action must be taken now to control advertising and sponsorship, she said. Only then can we begin to reduce the number of deaths from smoking, the ?150m a year cost to the NHS, and the unnecessary suffering of the sad victims of commercialism. Nor did Mr Neil Macfarlane, the Sports Minister, fare any better in his talks with the tobacco barons on the sponsorship of sport. The voluntary agreement he reached with them runs until the end of 1985 and the only marked concession they have made is that the Government's health warnings will appear on press and poster advertising for sponsored sporting activities. For the rest, things will go on pretty much as before and they will continue to exploit the sports they sponsor as a means of getting their products on to the television screens. It is cheap at the price, since according to ASH the companies spend only around ?4-5m a year on sponsor? ship, whereas one penny on tobacco duty would, if the Chan? cellor was to direct where it went, raise ?60m for the benefit of sport. All in all, it is a fairly sorry tale from the point of view of preventive medicine and one that would not now be being told had the Prime Minister not reshuffled the team at the DHSS last year?a reshuffle now completed with the departure of Dr Gerard Vaughan and Mrs Lynda Chalker from the DHSS and their replacement by Mr Kenneth Clarke (Minister of State for Health) and Antony Newton, who will be in the social services team.