Current affairs

To mark national No Smoking Day (9 March), we bring to you the following abridged version of an interview conducted in Sesame in 2009 with Gerard Hastings, Professor of Social Marketing and founder/director of the Institute for Social Marketing and Centre for Tobacco Control Research at Stirling and The Open University.

Tell us about your interest in the subject of tobacco...
Well, my interest is actually broader than tobacco, looking at health behaviours generally and the impact that marketing can have on these. Tobacco comes into the picture because it is so lethal: one in two smokers who do not manage to quit die early as a result. No one concerned with health behaviour can ignore it. ISM’s initial interest dates back to the mid-1980s with a focus on advertising and its impact on young people. Cancer Research UK funded us to do a series of studies on the links between tobacco promotion and teen smoking and this contributed to an evidence base that compelled the new Labour government to introduce a comprehensive ad ban in 2005.

 Is the reduction in passive smoking the only significant issue to do with the introduction of smoke-free public places in Britain?
Passive smoking is a serious problem and did push the government to take action. Before our pubs went smoke free it was estimated that one UK bar worker a week was dying from secondhand smoke, and this among a work force that is non-unionised, poorly paid and disempowered. If such levels of toxin had emerged from ceiling tiles or poorly cooked food, Trading Standards would have simply closed the offending establishments down. Instead, a special Act of Parliament was needed.

Our research shows that, while a small number of old fashioned, male-dominated ‘wet houses’ have suffered, modern family and food-oriented ones have flourished. Pubs are having a hard time at present but this is driven by other factors – in particular the advent of dysfunctional pubcos and deep discounting by supermarkets – not the move to healthy, clean environments. From a public health perspective smoke free’s greatest contribution is as a symbol of the UK’s move away from tobacco. Thanks to smoke free and a raft of other initiatives that give us one of the world’s most comprehensive and radical tobacco control agendas, it is now being predicted that smoking will disappear altogether within the next couple of decades.

It’s often discussed how much a burden tobacco-related illness is on the NHS. What is the reality?
The economics of tobacco are both very complex and very simple. The complex version has to take into account the immense health costs, employment (a relatively minor issue because tobacco production is so highly mechanised), superannuation savings (few smokers live to collect their pensions) and tobacco taxation. The answer is reassuring: complex modelling, by the World Bank among others, has concluded that the disappearance of tobacco is as good for the economy as it is for public health.

Are there lessons that can be taken from issues related to junk food, and the fight against obesity, and alcoholism?
Tobacco is unique in that it kills even when used as recommended by the manufacturer, and brings no compensatory benefits. The only sensible outcome is to avoid smoking altogether. In one sense, however, the issues are identical: public health has to take on the might of corporate bodies who will push their shareholders’ interests over that of public welfare.

Isn’t there a simple problem to do with tobacco companies in that they exist to make a profit – it’s not as if they can diversify into similar markets, unlike energy companies (i.e. renewable energy), so will fight aggressively to survive?
Yes. Public health will be under threat as long as tobacco companies remain in business. One of the paradoxes of modern life is that we know that tobacco is appallingly dangerous and addictive, we understand that it is a profoundly undesirable behaviour to which children are drawn and by which adults are trapped, and we enact policies to protect and help the vulnerable. And yet we continue to license powerful multinational corporations to enrich themselves by pushing in the opposite direction. It is like fighting malaria whilst breeding mosquitoes.

What are the obstacles in implementing a UK ban on tobacco products, and could you see it being successful?
Banning tobacco is not the answer – though banning tobacco companies probably is. There have been enormous successes in weaning the British off tobacco, and smoking rates are a quarter what they were a generation ago. Nonetheless around 10 million people still smoke and nicotine is powerfully addictive: simply cutting off their supply would be as impractical as it would be unethical. Instead we should think very seriously about how to take the profit motive out of the market. As long as companies can profit from tobacco so they will subvert and evade public health controls.

Smoking is often shorthand for ‘cool’ or ‘sexy’ when depicted in movies and to a lesser extent in TV. Do you think that iconography (think Humphrey Bogart in Casablanca) will ever erode?
Smoking in films and other media is extensive – much more extensive than it now is in real life – and this does increase the appeal of smoking to the young. Screenwriters and directors need to recognise that they have power here and exercise it with responsibility. As other marketing channels are choked off there is a real danger that films and TV become one of the tobacco industry’s last remaining routes to young hearts and minds – and lungs.

Read Gerard's thoughts on the proposals to ban packaging of tobacco products.

Gerard is also Director of Cancer Research UK’s Centre for Tobacco Control Research. Through his research and the application of social marketing, his findings have had a significant influence on policies relating to alcohol, tobacco and the impact of advertising on dietary behaviour. In 2009 he was awarded an OBE for services to healthcare.

Useful links

• OU course Marketing and society (B324)
• A profile of Gerard at Cancer Research UK
• See Gerard interviewed by BBC journalist Jon Sopel