Scotland’s smoking targets are a fantasy

 

To slash the number of smokers, the government is going to have to slash personal freedoms.

The number of adults who smoke in Scotland is 19%: the Scottish government wants to cut this down to less than 5% by 2034 but the best estimates suggest it will be at 10%. This should not be a front-rank issue, not because it’s unimportant, but because it’s impossible. It certainly could be possible to eradicate smoking eventually, but not in the next 20 years without the use of unjustified force.

To put our current rate in perspective, Scotland has one of the lowest smoking rates in the developed world. The number of adults smoking in Scotland is lower than in most of Europe, but not as low as in Canada or Oceania. Without stating the obvious, clearly too many people still smoke in Scotland. But what I’m pointing out here is that there is no political or social precedent for smoking rates to be lower than 5% in a developed country. For the foreseeable future, it will be impossible to eliminate smoking. This is partly down to the target set. As smoking becomes less fashionable and anti-smoking campaigns become more effective, we are broadly seeing individuals smoke less, but not at the levels the government wants. 

So, why isn’t the government able to cut smoking rates to the level it wants I hear you ask! It boils down to policy limits and economics: anti-smoking laws are as strong as they can be in the current socio-political climate we are operating in. Many smokers are affected by low socio-economic issues which need to be addressed before tackling smoking directly. 

Much of the decline in smoking since the 1960s is of course down to these policy limits such as educating smokers. But even with education, long-term health risks can be abstract to many people and often convenience and pleasure outweigh the negatives. To combat this, the state intervenes. By reducing the convenience (by increasing the cost) it’s easier for people to put health over short-term pleasure. When the state intervenes to tax tobacco, set a minimum age and ban it in certain places this is known as soft-paternalism, the policy of restricting and dissuading citizens from doing something but not banning it.

The smoking ban (all public places, then hospital grounds) and the removal of tobacco products from view are the strongest policies enacted so far with significant success. Someone has to have the informed, sustained and inconvenienced desire to smoke before they can do so in Scotland. The problem is that with all these barriers and educational campaigns, there is no evidence to suggest everyone will give it up in the near future. Pulling people out of poverty clearly reduces smoking rates but this is long-term and is not a complete solution. High-earners still smoke, and rates in wealthier countries like Norway and Switzerland are actually higher than Scotland. The problem is that, however inconvenient we make it, some people will still choose to put pleasure before health, and our current policies are as hard as soft-paternalism gets. 

If the government really wants to cut the smoking rates significantly (below its target of 5%) in the near future it’s going to have to clamp down. This could look like increasing the purchase age to 21, taxing it even further or even a complete ban on its sale, making tobacco not just inconvenient to use but impossible. Not only are these ideas moral failings of such policies but there are also practical issues. By increasing the age and price we are implying smoking is significantly more harmful than alcohol and fast food. Not only are the direct health impacts of eating fast food and using tobacco comparable, but alcohol also has the added externality of increasing crime (over half of violent crimes involve alcohol). So if tobacco’s risks compare to obesity and it doesn’t torment our cities with crime, it is not consistent to legislate one without legislating the others. 

On the question of bans, one might ask what right the state has to stop its citizens from activities that harm only themselves? Is it the state’s responsibility to ensure the mutual liberty of its citizens or total welfare on their behalf? And is not the control of one’s own actions a basis for good welfare? The government has as much right to demand every citizen jog twice a week as it does to ban smoking if it can legislate health at the expense of autonomy. If tobacco is going to go so must alcohol and high-calorie foods. Addiction plays a big part obviously, but banning it on those grounds implies no one can rationally smoke and ignores the illegal-substance addiction epidemic in Scotland. 

We can give people the economic and educational means to choose between an inconvenient, damaging pleasure and long-term good health. The smoking rate will fall (albeit not to the levels the government desires), but we cannot go further without opening the door to a dangerous new standard of government. If the harm is only to the individual and they are informed and dissuaded, anything more is a violation of personal liberty.