Smoking guns as Cuthbert and Colin go to war: lessons from down under?

Parts of last week felt a little surreal. For example, is it just me who thinks it rather strange that the national health care uniform consultation, relaunched after a pause for the pandemic, doesn’t mention our medical colleagues at all? Perhaps they aren’t part of that same team mentioned in the second paragraph. Another one of our public services, the police were at the centre of different story. It appears the long running (26 years) TV police drama, The Bill, which was last seen our TVs in 2010 is set to return. Many of the original cast are likely to be part of the new series. Maybe British TV is like NHS reorganisations, wait long enough and things will come full circle. Then there was the news of the milk tanker which crashed into the River Dulais in Wales It was a similar accident to one where, 40 years ago, I rescued a milk tanker driver who crashed into a river just over a mile away from the River Dulais. I don’t like being on or in water and the news report brought back unwelcome memories that’s for sure! And, will there be many colleagues working in the NHS buying Benefit cosmetics or going for their beauty treatments ever again. I don’t think so, in the words of Julia Roberts (Pretty Woman) – ‘big mistake Benefit, big mistake!’

In my mind the most surreal story has to be the Cuthbert the Caterpillar Cake court case. Last week, media coverage of the M&S action against Aldi swept away the wall to wall reporting of the Derek Chauvin trial, as he stands accused of killing George Floyd. Social media lit up with ‘free Cuthbert’ type messages. Why Aldi was singled out is unknown. Most other supermarkets have their own versions of the M&S Colin Caterpillar cake – there’s Cecil, Wiggles, Clyde, Curly to name just a few. We don’t know all the details, but I’m sure, once again Julia Roberts might be saying ‘big mistake’ M&S. Time will tell.

Now amongst all this strangeness there was a story that caught my attention for the right reasons. It was the announcement that New Zealand was taking one more step to achieving their ambition to being a smoke free country by 2025. Regular readers of this blog will know that over the years I have periodically focused on the disastrous health impact of smoking cigarettes. I was a smoker once, but gave up many, many years ago. These days I hate the smell of cigarettes, and the smell on people who smoke. I’m very proud of my J who decided to give up smoking 2 years, 2 months, 1 week, 3 days and 9 hours ago. Yes, it’s a tough one to achieve, but it can be done. 

In New Zealand 4,500 people die each year from smoking related causes. In the UK around 78,000 people die each year from smoking and across the world smoking accounts for more than 8 million deaths. If you are a man, who likes to have a smoke after sex, beware! The NHS website warns of impotence being a common side effect of smoking cigarettes. Apparently, smoking limits the blood supply to the penis – just saying. As Julia Roberts might say to male smokers ‘big mistake’.

Apart from the health risks, smoking is expensive. As I was writing this blog, I looked up the cost of a packet of 20 cigarettes in the UK. They cost a staggering £9.50 for the cheapest and £12 40 for the more expensive brands. That’s a heck of a lot of money literally going up in smoke. In New Zealand the average cost of a packet of cigarettes is £16 a packet. And if you think as an e-cigarette smoker you get off scot free, have a look at this WHO report on the dangers and costs of vaping and smoking e-cigarettes. Not good.

What interested me about the New Zealand approach was their governments willingness to achieve change over time. In public and population health, and certainly from a health promotion perspective, this is simply remarkable and courageous. Most governmental policy decisions are limited by the fact they will need to be re-elected in 4 or 5 years’ time. Many population health interventions, like smoking cessation programmes can take much longer before the beneficial outcomes are seen. Additionally, there is no doubt that there are big tax incomes for governments in ‘allowing’ smoking to continue. In New Zealand, a big part of their approach is to gradually raise the legal smoking age. The current proposal is considering banning the sale of cigarettes and tobacco products to people aged 24 and under – in effect making smoking illegal for people of that generation.

There are also plans to only allow cigarettes with significantly reduced levels of nicotine to be sold and restricting the number and types of locations where cigarettes can be sold. Some might say these measure might lead to the development of a black-market in cigarettes and tobacco and/or threaten the livelihoods of some small corner shops. Both are fair comments, but against the huge harm smoking can cause, it shouldn’t be a prime consideration.

Like others, I think the more important debate is probably over how much should the State intervene in our lives. For me, this is a more serious consideration. The pandemic has brought these challenges to the fore. I think our government might have done things differently, made better decisions in how the pandemic was managed. That said, I remain frustrated, angry, ashamed, and alarmed in equal measure over those people who feel the Covid pandemic is somehow a government ploy to control us all. Likewise, with such huge numbers of people who have died worldwide, why it is there are so many people, the anti-mask wearers, and those who are anti-vaccinations, who continue to oppose the pandemic restrictions. I’m also sure that if Julia Roberts were ever to be in conversation with Jacinda Ardern about her governments anti-smoking plans I doubt she would be saying ‘big mistake Jacinda, a big mistake’. As with her governments management of the pandemic, there is much we in the UK could learn about what improving population health might look like. 

Leaving smoking, caterpillar cakes and accident prone milk tanker drivers to one side, I could not post this blog without reflecting on yesterdays funeral of HRH the Duke of Edinburgh, Prince Philip. Like so many other families this year, the Covid pandemic impacted upon the arrangements for his funeral. It was a dignified, private affair that we could all, in our own way be part of. I thought the lack of crowds, the simplicity, perfect order, and completeness of the service would have met with both Prince Philips and Julia Roberts approval – it certainly met with mine.