Comment // Health

The London Health Report: No smoke, Just Mirrors

This week the media reported on the London Health Commission's proposal to ban smoking in London's public spaces, such as parks and other green areas. The report suggests that children take up smoking because they are influenced by the adults around them. Whilst this may have some truth to it, the statement is being used to justify the removal of a right that people have enjoyed for centuries. Recently, the state has used issues of health and child safety to go as far as making policies for smokers in their own cars, so it is little surprising that these same issues are being raised again, as the state moves to nudge people towards an outright ban. 

If we cast our minds back to the 1920's, smoking was both popular and a perfectly acceptable behaviour. People smoked in public places, houses and buildings, and, in fact, smoking was once prescribed to patients by doctors only a century ago. It was not until the 1930's information began to surface that smoking could be attributed to life threatening illnesses, and thus smoking became a 'problem'. The 'reaction' from the public was moderate at first, but, through campaigns and legislation, smoking has become a 'habit' that we must be 'rid' of.

It was during the Blair years that the anti smoking drive really got going. In 2002 the Government created a ban on all tobacco advertising and sponsorship, which was followed 5 years later by a ban on smoking in public houses, bars, restaurants and work places. A year later came another little nudge in the form of graphic images on cigarette and tobacco packets, alongside bold health warnings designed to scare people away. Much like the Edward Bernays campaign discussed last week, such advertising is designed to play on human emotion, this time guilt. In 2011 there came a ban on tobacco vending machines, and a further ban last year on displaying cigarettes in shops. This year, parliament voted to ban smoking in cars when children are present.

What we have witnessed over the last decade is divide and conquer, resulting in a marginalised group of people who are now being refused access to public spaces (open spaces) if they smoke.  And why should we care? We should care because it is a liberty, regardless of our personal opinion; so long as it is exercised responsibly and with reasonable consideration it should be of no concern to others, least of all the state --- who is charged with protecting our rights and customs --- should we wish to smoke in a public space.

If our argument is that smoking is harmful to non smokers then we should consider the effects that traffic fumes have on our body, or the many chemicals in perfumes and smells that sully the air we breath. If our argument is that smoking is an annoyance, then perhaps we should consider drunken behaviour in public, or foul language or mobile phones. Once we have considered all these things do we then decide to legislate for those decisions, or could we encourage each other to act responsibly?

As repugnant as smoking may be to some people, to remove a right, even one that most people disapprove of, is the beginning of the removal of all rights. Today it is smoking in public, tomorrow it may be dog walking, playing music, gathering wild flowers, self medicating or not vaccinating. This statement may seem ridiculous now, but we should also consider this: had people been told that they would be prohibited to smoke in public spaces, or even in their own conveyances, back in 1920,  there would have been a much greater backlash from the public than there was this week. One only has to consider the prohibition of alcohol in America to see how people react when a right is suddenly taken away. In consideration, it is remarkable how quickly people's opinions have been changed through various campaings and legislation.

The point of nudging is to make incremental changes to peoples perceptions in order that Government may make a policy change that is in line with peoples 'new perceptions', which is ultimately the desired perception of the state. Like the frog in boiling water, we do not see the incremental changes to the policies and attitudes that lead to the suspension of people's rights. Nudging seeks to remove rights silently, most commonly from marginalised groups that society disapproves of, or, at least, are conditioned to disapprove of through popular culture and media. Legislation follows after months, sometimes years of media campaigns from organisations seemingly working independently, yet somehow operating for the same goals; the campaigns act as a cushion for the legislation.

The Better Health for London report was compiled by the London Health Commission and chaired by Lord Darzi of Denham, who believes that the Commission's model could be a blue print for the rest of the country. The report can be found here.   

When reporting on the Commissions proposals the media decided to focus on the smoking issue. As important as that was, they might also have reported on the proposals to create 'Wellbeing programmes' for people with mental health issues, or the 'Better Parenting Programmes' for people suffering in deprived areas where children might be vulnerable; both of which seek to bring government closer to the people, or rather the people under the government's wing. The media may also have considered reporting on the plan for an institute for Digital Health that will be run by MedCity, in conjunction with the Farr Institute, to help build capabilities in analytics on 'Big Data'; your data.

The suggestion that the Mayor of London, Boris Johnson, should create an institute for Digital Health comes at an interesting time. Boris Johnson, who supported the commission's report, just so happened to launch MedCity on 8th of April this year, with £1.2 Million from his own office.

 The report itself is recommended reading and is littered with 'nudging' words that try to poke us in the right direction. The document is rich with 'new political speak', with words like 'sustainability' and 'global city', which prepares us for a new global order and a new way at looking at the world. Readers will encounter glimpses into the methods and motivations of the state, with phrases such as: "Making smoking less acceptable and more difficult [campaigns and legislation]has encouraged people to try quitting and discouraged people from starting" as well as "Taxation [legislation] has long been used as a way to reduce consumption of harmful substances."  [my emphasis] Both of these phrases elude to coercive techniques that have been used by Governments in the past to nudge the population in a particular direction, as has been described in this blog.

It is not for the state to decide what people should or should not do. We all have a duty to each other to make sure that our rights do not infringe on other people's rights. Prohibition in public buildings and workplaces is understandable, but surely open spaces is a stretch too far into our private lives.

The Commission's report believes that smokers are polluting open spaces and parks whilst setting a bad example for children. If this is truly the case then we should consider banning smoking in films, as well as popular celebrity culture and media, which have just as much, if not greater influence on younger generations than people smoking in parks.  

We may choose to agree with the London Health Commission's report, but to ban smoking in public places because it is offensive paves the way to banning other activities that other people may find offensive, such as: dog walking, barbecues, couples holding hands or kissing, offensive language, religious practices such as prayer or meditation or even fashion or single men, incase they are possible sex offenders. At some point the madness has to end. 

If we do not support the rights of others, even those we do not exercise ourselves, one day it may be our rights that are legislated against.