Tasmanian Times

Economy

Why tobacco prohibition won’t work

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The eighteenth amendment to the United States constitution came into force on 29 January 1920. The manufacture, sale, transportation import or export of intoxicating liquors was prohibited. Thus began the greatest social experiment, perhaps, in human history.

As the world now knows, the experiment failed. A shade under fourteen years later, on 5 December 1933, came the twenty-first amendment, ending prohibition and regulating alcohol rather than banning it. Prohibition did not stop people drinking. Mostly, it changed the suppliers rather than the consumers. While the population went on drinking, those importing, making and selling the stuff ceased to be the owners of licensed, regulated businesses. Their role was immediately taken by organised criminals selling bootleg liquor, often of poor and dangerous quality. The Mafia, Al Capone – and the FBI, which got massively increased funding and powers – did very well. The nation did badly.

In just fourteen years that disastrous experiment, with the people of a nation as the guinea-pigs, landed America with an organised crime problem with which they are still dealing. When prohibition ended the mob changed its focus from alcohol to sex and drugs, and from speakeasies to casinos.

But the lesson was not learnt. Prohibition was extended to a vast range of other drugs – opiates, cocaine, amphetamines, cannabis. The result was much the same: a boom in organised crime and in law-enforcement, poor quality drugs on the market being sold outside of any regulation of quality, customers self-administering drugs of unknown strength and adulteration in conditions which invited disaster. Fatal overdoses followed in massive numbers. The high cost of illegal drugs led customers to inject, getting more bang for their buck but risking overdose, AIDS and hepatitis C.

As drug prohibition spread around the world, crime followed. Criminal gangs took over whole countries. As insurgencies in Africa, Asia and South America looked around for a source of funding, their armies moved into the drugs trade. Drug crime fuelled civil wars and millions died.

But in the 1960s and 1970s, when the link between tobacco and lung cancer became undeniable, the lesson – for once – was learnt. No country in the world has banned tobacco; the focus has been instead on regulation, education and control. Australia – and, recently, Tasmania – have a good record. Fifty years ago, smoking among adults was almost ubiquitous: the rate has since plummeted. According to the most recent survey, taken in 2011 by the Australian Institute of Health and Welfare, only 15.1% of Australians aged 14 and over were smoking every day. In Tasmania, the rate has gone from 24.4% in 1998 to 15.9% in 2011, with a dramatic drop between 2007 and 2011 as price increases, smoking bans in restaurants, bars and cars with kids took hold and swung public attitudes more strongly against smoking. The debate over plain packaging may prove to be as beneficial in changing community attitudes as the measure itself.

Control over smoking is working. Most young people do not begin: this is revealed in the statistics on the numbers of people who have never smoked. Nationally, an extraordinary 57.8% (52.8% in Tasmania) have never used tobacco; another 24.1% (28.7% in Tasmania) have managed to kick the habit. Prohibition would destroy this extraordinarily successful strategy by placing tobacco use outside of the range of regulation and control, and into the far more dangerous limbo of underground criminal supply.

Australia compares well with other nations, though almost everywhere – including in China and India – smoking is on the way out. According to the Organisation for Economic Cooperation and Development, Australia is substantially better than the OECD average both in the level of daily smoking and the rate at which people are giving up – or, in the case of the young, not starting.

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Those supporting the proposal to ban tobacco supply to everyone born after 2000 deny that it amounts to prohibition. But it does. It replaces the successful means of tobacco control we now have – education and regulation – with what will in time become a blanket ban. People who are now twelve years old will never be able (legally) to smoke as adults; those who are now thirteen will be able to.

As time passes more and more people will become subject to the ban. Eventually it will become total. But nicotine is perhaps the most addictive of all recreational drugs. Anyone starting to smoke, at any time in their lives, has a significant chance of becoming addicted. There is already an illegal, criminal supply of tobacco, driven by increases in the excise paid on commercially available cigarettes. The history of drug prohibition shows that people who want a drug are likely to get it anyway, legally or illegally – particularly if they become addicted.

The patterns of cannabis use show how powerfully attractive a drug – even a relatively non-addictive one – can become, particularly to the young, if the allure of mild outlawry is bestowed upon it. Naughty is nice, even when it isn’t really nice at all.

It is a fantasy to say that this ban will result in a smoke-free generation. It won’t. It will lead instead to the criminalisation of an entire generation of law-abiding people. It will spawn a powerful and dangerous new pack of organised criminals, and the consequent corruption of police and officials. And it will mean, eventually, an end to our chances of genuine and effective tobacco control.

Nowhere else in the world has such a measure been enacted. Perhaps there’s a reason for that.

Martyn Goddard is an independent health policy analyst based in Hobart. He is a former journalist with the ABC in Melbourne and Sydney. His analyses of national and state health systems are here

First published: 2012-08-24 06:37 AM

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24 Comments

24 Comments

  1. Guess The Word

    March 8, 2013 at 2:47 pm

    Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point. You definitely know what youre talking about, why throw away your intelligence on just posting videos to your site when you could be giving us something enlightening to read?

  2. Ala

    December 6, 2012 at 10:55 pm

    The numbers of deaths caused by tobacco use are too easy to verify. “Do you smoke”? If yes, then your death is caused by smoking.

    The long term consumption of tobacco does cause death in a certain manner, but who says this kind of death is unacceptable? Are we being programmed into dying in a proscribed manner?

    Perhaps the ideal death is one that supports those who benefit from your long and lingering subversion into the mysterious ways of the medical industry.

    Smokers defy the ‘ideal death’ by dying quickly, and they don’t lose their life savings….except for the tobacco taxes….yes, got you smokers there!

    For a fleeting moment Tasmania may see itself as a world leader in a risky experiment in social engineering. Too bad Tasmania benefits to the tune of 70c (to stack it’s shaky revenue) out of every dollar spent by consumers purchasing tobacco.

    Tasmaina is the world’s second supplier of opiates, marijuanna flourishes in it’s benign climate as do certain strains of tobacco.

    Common sense is absent in this social experiment.

  3. John Alford

    August 29, 2012 at 2:42 pm

    #22″We need to do everything possible….to PROTECT our children from know harm, as well as getting rid of harmful, unsafe products.” Well, Margaret, that’s a pretty long list, and if we are looking at products and harmful behaviours that cause the greatest harm, then we would not begin with tobacco. Just a few things we would deal with first include junk food, nuclear weapons, SUVs, war, plastics, environmental pollutants (non-smokers also die of lung cancer), semi-automatic weapons in the suburbs, alcohol (this is the drug most likely to kill our young people in the first half of their life)…I think you get the point.

    As a former drug educator, there were numerous problems with getting the no-smoking message across to young people. One problem was that they saw the effects of smoking happening to old people (everyone over 25 is old according to my former secondary college students). Another problem was the continued use of scare tactics in drug education programmes and prevention campaigns. Research over many years tells us that scare campaigns do not work with the majority of people and their effects atrophy over time.

    Young people also have a keen radar for hypocrisy or perceived hypocrisy, as many parents of teenagers can attest. They see adult abuse of alcohol and other drugs (have not even mentioned the widespread abuse of pharmaceuticals here – an epidemic), a sometimes violent and cruel world, the greed and selfishness promoted in our consumer society and say to themselves, who are they (adults) to tell me not to smoke? In this context, as well as if you are having an awful life, drug use can be seen as way of dealing with challenging circumstances.

    We need to clean up out act as adults first and provide the models that young people would want to emulate. Sometimes, its our young people that need to be protected from our well-meaning but misguided attempts to ‘protect’ them. Life is inherently risky; best to provide people with the skills to manage these risks so that they will make intelligent choices.

  4. Margaret Hogge

    August 27, 2012 at 3:03 pm

    Prohibition or Protection?
    Our Governments have known for 60 years that tobacco-smoking kills. They’ve known for more than 20 years that second-hand tobacco smoke kills. Tobacco kills more Australians than any other single product. And costs us billions more than any tax revenue.
    And yet our governments/political parties continue to accept donations from Big Tobacco and its mates (the risibly named hospitality industry) and do their bidding – example – a three year delay of smoke-free outdoor dining in NSW due to an agreement with Clubs who then put money into party coffers prior to elections. That’s another three years that families will be subjected to unhealthy alfresco dining and children will see smoking as a normal part of life.
    With a government like that why are we concerned about black-market and smuggling? As the former Australia Hotels Association boss once said, following a query about a particularly smelly monetary exchange regarding the definition of smoke-free areas, “Democracy isn’t cheap”.

    Tobacco is an unsafe product, not only to its users but also to everybody in the vicinity of users. If you can smell tobacco smoke it’s going into your lungs and doing harm. The nicotine in tobacco is highly addictive, to such an extent that many smokers find it difficult to quit even when they know it will possibly, no probably, cause them a slow and painful illness and death.

    Here’s the rub – on any supermarket shelf or at any pharmacy and even free through some programs, a smoker can find an alternative source of nicotine (patches, gums etc.) which will neither kill them nor cause harm to everyone in their vicinity. Smokers have an alternative, relatively safe source of their drug of addiction.

    We need to do everything possible (seat-belts, helmets, tobacco bans) to PROTECT our children from known harm, as well as getting rid of harmful, unsafe products.

  5. Douglas Tutt

    August 27, 2012 at 1:10 pm

    I get so sick of this this trite mantra ‘ prohibition doesn’t work’ with usual reference to the US and alcohol.

    Like any policy or law , forbidding something ( forget this emotive term ‘prohibition’) never works perfectly. The only policy question is will its nett benefit overwhelm any possible negative side effects.

    There are tons of examples of prohibitions that work every day in our society . We prohibit murder, we prohibit possession of semi-automatic firearms, we prohibit driving on the right hand side of the road, we prohibit drink driving, we prohibit child sexual abuse. None of those works perfectly to wipe out things society believes we should get rid of… but seriously, would any rational person call for the abolition of prohibition on those things? Of course if we did, then at a stroke we’d have reduced “crime”, but a lot of people would be dead or miserable.

    And while illicit drug users and dealers may experience some pain around the prohibition of their drugs of choice, its quite clear that nowhere near as many people use these drugs as use alcohol or historicaly have used tobacco – the legal fun drugs.

    No-one is suggesting we imprison someone with a cigarette or two they brought back from overseas or a bit of tobacco they grew ( but its a very nasty tasting product if not manufactured). It’s just being suggested that some more retail sales may be prohibited. Sales to under 18s are already prohibited.

    And maybe eventually all retail sales will be bannned . Isn’t that what we did with another death dealing product’ asbestos?

  6. Kathryn Barnsley

    August 27, 2012 at 2:47 am

    Yes #19 you are quite right. Maybe we should all try it! I offered one of my nieces $100.00 to give up but it clearly wasn’t enough. But she did quit later.

    Dr.David Kessler et al concluded in their article entitled Nicotine Addiction:A Pediatric disease in The Journal of Pediatrics April 1997 that:

    “The practice of pediatricians has long been oriented to detecting and preventing diseases and disorders that can wreck the quality of their patients’ lives. Tobacco is the leading preventable cause of disease in America today. It is more important than ever for pediatricians, as parents and as citizens,to get involved in the struggle to save the children from a lifetime of nicotine addiction.”

    David A. Kessler, MD
    Sharon L. Natanblut
    Judith P. Wilkenfeld
    Catherine C. Lorraine
    Sharon Lindan Mayl
    Ilisa B. G. Bernstein
    Larry Thompson
    U.S. Food and Drug Administration
    Office of the Commissioner
    Rockville, MD 20857

  7. Wining Pom

    August 27, 2012 at 12:11 am

    ‘Smoking has been described as a pediatric disease, because it is children who become addicted. Rarely adults.’

    So Kathryn, read my post at #3. It works.

  8. Philip Lowe

    August 26, 2012 at 11:37 pm

    Poor old Stephan No14.Exposing his smoking mentality negativity.I tend to agree that a prohibition won’t work,but a will to discourage the foul,evil stupidity of it might.Stephan,for the price of one packet of twenty cigarettes you could feed a child in the third world for a week.
    Think on that next time you purchase your nicotine fix.

  9. Kathryn Barnsley

    August 26, 2012 at 10:46 pm

    #15 re Bhutan. I only mentioned it because martyn’s final comment implied that more innovative or radical approaches to tobacco control had never been tried. I also mention Bhutan because as a comparison it demonstrates that small places can do very exciting new things.

    You are right I did nt mention why people use drugs, but without writing “war and pece” I thought I wrote enough.

    However, children smoke because they want to be adults and to impress their peers, and to feel more mature, and to get a good feeling from nicotine. Adults smoke because they become addicted as children. Most smokers want to quit – well over 80%. Even child smokers don’t think they will be smoking in one year’s time. Reasons for using other drugs vary. I like the occasional glass of good wine. I like the taste. My father was a viticulturists, i grew up in next to a winery. Like most other people I can use it in moderation. Unlike tobacco Which I had to quit completely because of the addictiveness of the drug.

    Smoking has been described as a pediatric disease, because it is children who become addicted. Rarely adults.

  10. Kathryn Barnsley

    August 26, 2012 at 10:14 pm

    #15 re Bhutan. I only mentioned it because martyn’s final comment implied that more innovative or radical approaches to tobacco control had never been tried. I also mention Bhutan because as a comparison it demonstrates that small places can do very exciting new things.

    You are right I did nt mention why people use drugs, but without writing “war and pece” I thought I wrote enough.

    However, children smoke because they want to be adults and to impress their peers, and to feel more mature, and to get a good feeling from nicotine. Adults smoke because they become addicted as children. Most smokers want to quit – well over 80%. Even child smokers don’t think they will be smoking in one year’s time. Reasons for using other drugs vary. I like the occasional glass of good wine. I like the taste. Like most other people I can use it in moderation. Unlike tobacco I had to quit completely because of the addictive ness of the drug.
    I

  11. John Alford

    August 26, 2012 at 8:21 pm

    #12 and #13 What you do not address in your comments are the reasons why people use drugs. Population health approaches are appealing because they appear to be easier than addressing the root causes of problematic drug use, legal or illegal. Such drug use is rooted in broad cultural issues which require a more sophisticated and longer term approach.

    Tobacco, alcohol and other drugs may be relief from an otherwise challenging or stressful life for some. This is not to justify problematic drug use, merely an attempt to understand it. #13 Bhutan is not Tasmania and we need to be very careful about such comparisons merely on the basis of comparative population levels, as you do here.

  12. Stephan

    August 26, 2012 at 8:09 pm

    Kathryn #13

    Bhutan is doing well but then it IS a dictatorship so I guess we get to believe and do what the King tells us yeah?

    As for Brazil. You DO know where tobacco actually comes from, right?

    Just as mariajuana is a weed in the asias, tobacco is a weed in the americas.

  13. Kathryn Barnsley

    August 26, 2012 at 7:14 pm

    Martyn
    I forgot to say that Bhutan has banned cigarette and tobacco sales completely. It now has a 4% smoking rate. Bear in mind that it has porous borders with many other high smoking countries. The opportunity for smuggling is huge. This is a very low smoking rate for any country, especially an Asian country, probably as low as you can go.

    It is about the same as the smoking rate for doctors in Australia I think.

    Bhutan has a population of about 700,000, Tasmania has a population of 500,000.
    Brazil has banned additives.

  14. Kathryn Barnsley

    August 26, 2012 at 6:01 pm

    Hi Martyn
    Between 2001 and 2006 there were 3460 deaths caused by smoking, 151 from illicit drugs and 611 from alcohol in Tasmania: plus 437 suicides, 337 road vehicle, 35 assault and 34 fires. There are more deaths from tobacco than all of these other causes put together.

    We should take smoking rates to very low levels because of the high cost to human life, and to our health system. 60% of acute admissions to the Royal Hobart hospital are smokers, yet less than 25 % of the population smokes.

    These are not just numbers to me but real people. These deaths are neither pleasant nor peaceful. Lung cancer deaths in women exceed breast cancer deaths – but no one notices.

    It is drawing a long bow to call this prohibition, as it is a long term phasing out. Currently about twelve hundred 17 year olds smoke who will turn 18 and then be able to buy cigarettes. That number is likely to fall by 2018 when the first cohort of child smokers reaches 18 years. Therefore there would only be a small number of new smokers. Unable to buy the product.

    Remember in 1996 we raised the smoking age from 16 to 18? One day these kids were permitted to buy smokes, the next day they were not. Did the mafia take over? Was there a crime wave? No. Was there a massive increase in illegal tobacco or untaxed tobacco or “chop chop”. 1998 and 1999 proceeded as any other year. Remembering that they are not punished for smoking. Smoking itself is not penalised under age.

    If we look at Wayne Hall’s excellent work on prohibition he says that
    “The standard account of the effects of national prohibition in the United States is wrong in claiming that it had no effect on alcohol use.

    On balance, Prohibition probably reduced per capita alcohol use and alcohol-related harm, but these benefits eroded over time as an organized black market developed and public support for NP declined.

    Those who remain unconvinced by the historical evidence of its effects on alcohol use should similarly moderate their confidence in conclusions about its effects on crime, because the same type of evidence is used in each case.”

    …It is incorrect to claim that the US experience of NP indicates that prohibition as a means of regulating alcohol is always doomed to failure. Experience with the raising the MLDA in the United States shows that partial prohibitions can produce substantial public health benefits at an acceptable social cost, in the absence of substantial additional expenditure on enforcement.”
    Hall W. What are the policy lessons of National Alcohol Prohibition in the United States, 1920–1933? Addiction 2010; 105: 1164–73.

    Another writer says:
    “Today, it is easy to say that the goal of total prohibition was impossible and the means therefore were unnecessarily severe—that, for example, National Prohibition could have survived had the drys been willing to compromise by permitting beer and light wine—but from the perspective of 1913 the rejection of alternate modes of liquor control makes more sense.

    ….. Nevertheless, the possibility remains that in 1933 a less restrictive form of Prohibition could have satisfied the economic concerns that drove Repeal while still controlling the use of alcohol in its most dangerous forms.”

    There is an appetite for banning drugs like heroin and crack and marijuana, so we already have selective prohibition of drugs, and yes the illicits are associated with crime.

    We should be looking for different ways to deal with all harmful drugs, and partial or phased or “managed prohibition” (like the use of medical methadone programs need to be supported).
    Blocker goes on to say;
    ” Arguments that assume that Prohibition was a failure have been deployed most effectively against laws prohibiting tobacco and guns, but they have been ignored by those waging the war on other drugs since the 1980s, which is directed toward the same teetotal goal as National Prohibition.

    Simplistic assumptions about government’s ability to legislate morals, whether pro or con, find no support in the historical record. As historian Ian Tyrrell writes, “each drug subject to restrictions needs to be carefully investigated in terms of its conditions of production, its value to an illicit trade, the ability to conceal the substance, and its effects on both the individual and society at large.”

    From a historical perspective, no prediction is certain, and no path is forever barred—not even the return of alcohol prohibition in some form. Historical context matters.”
    Blocker J. S. Jr. Did prohibition really work? Alcohol prohibition as a public health innovation. Am J Public Health 2006; 96: 233–43.

    We need to come up with more innovative solutions to reduce tobacco intake, and this idea is one of a suite of measures that should be considered, not dismissed out of hand.

  15. Philip Lowe

    August 24, 2012 at 5:39 am

    How about calling the poor buggers who smoke, ‘Saddicts’?Their breath stinks and so do their clothes.They’ve got enormous package bulges where they have to carry their smoking tackle-how inconvenient.They have to keep leaving the room to get a fix-I wouldn’t employ a smoker,they are always off the job fixing up.They are more prone to coughs and chest infections,and giving them to other people.They create litter and create fire dangers.Yeah,what a bunch of saddicts.And they can be very aggressive when confronted with the truth.

  16. Dr Kevin Bonham

    August 24, 2012 at 1:36 am

    “Smoking is a problem and we are in 2012, not 1012.” (#8) – sure, but while in 1012 it may have been acceptable for paternalists to respond to problems by telling people what to do with their lives and bodies, in 2012 it should not be.

    I’d suggest if Peter (#9) is worried about “wholly evil, deadly menace(s)” he should start with those where harm is done to people who do not even choose to be involved in a risky practice in the first place. And no, I don’t mean abortion.

  17. Peter Bright

    August 23, 2012 at 11:01 pm

    The first [i]essential[/i] step towards nationwide health recovery from this wholly evil, deadly menace is to outlaw the entire tobacco industry immediately.

    No ifs, no butts, no warnings, no excuses and no compensation. One day legal – next day not.

    That’s the long-overdue central core of solid integrity around which all remedial processes can be structured.

  18. John Alford

    August 23, 2012 at 9:32 pm

    How about restricting the sale of junk food instead? It costs us more. As a former drug educator the evidence clearly indicates that prohibition does not work, yet this value-laden area is one that has always appealed to people’s prejudices rather than the facts. Obama has already indicated that the 40-year war on drugs in America has failed, so why jump on that bandwagon when its wheels have already fallen off? The narrow-mindedness of the bourgeois mindset in Australia seems to be getting worse; so much for the ‘education revolution’ which does not appear to be enlightening the masses or our masters.

  19. phill Parsons

    August 23, 2012 at 9:10 pm

    #5. Yes. #4. You mean like the sudden conversion to marriage for any who want it.

  20. Isla MacGregor

    August 23, 2012 at 2:11 pm

    Do we restrict the sale of arsenic?

  21. Leah Bond

    August 23, 2012 at 1:02 pm

    It’s just a scam to get Tasmania’s name in the media around the world. Prohibition never works!

  22. Wining Pom

    August 23, 2012 at 12:34 pm

    We told our kids that if they hadn’t smoked when they reached 18, they got $1,000. All three of them got it. Our son said that when he was he was fourteen a friend at school was passing round a cigarette daring all to try it and he declined saying that it would cost him a grand. And that’s the danger age.
    It’s one dollar per week from birth. All parents can afford that.

  23. A.K.

    August 23, 2012 at 12:16 pm

    Couldn’t agree more, prohibition of any kind always fails in a free society. The best thing to do is ban the sale or trading of tobacco, it’s use in public and allow growing it for personal use only. Double the penalties for those committing criminal acts whilst under it’s influence and put penalties in place for health costs for tobacco users and their associated illnesses. Jail any one selling or trading it in the state. Sure some may not want to grow it, but they either grow it or not smoke. Those stupid enough to flout such simple but workable laws, deserve to be locked up.

    If we did that with cannabis and other drugs, including pharmaceuticals, we may soon end up with a reasonably responsible society. Educate people in the ramifications of breaching the laws but give them the freedom to experiment to a degree and then its on them, not the society or their victims.

  24. Stephan

    August 23, 2012 at 11:43 am

    Tobacco is a plant. Just as is mariajuana. Tobacco seeds are miniscule – really, really quite small and the plant can be grown literally anywhere. Quality sunshine, warmth and water help though.

    Anyone know how to recognise a tobacco plant?

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