On 1 July 2007, England introduced a ban on smoking in enclosed public places. This was the first major blow in a decades-long campaign against the habit and, in 2019, the government set an objective that England should be smokefree by 2030 (this would mean only 5% of the population at most would smoke). In order to reach this goal, the government commissioned a review led by former Barnado’s chief executive Dr Javed Khan. The review has been published, and although it is framed as a big step forward for health, it also reads like a giant step backwards for civil liberties. Here’s why the Khan review should worry us all.
Much though I think it’s a daft decision to smoke, adults should have the right to make their own choices and the government should respect those choices
The report found that urgent action was needed to hit the 2030 target – without it, England would miss the target by seven years, and the poorest areas might not be smokefree until 2044. So what should be done? The report suggested that there should be increased investment in smokefree policies, stop smoking services and a mass-media campaign to discourage smoking (this would likely be funded by more taxes on the tobacco industry). It calls to increase the age of sale from 18, by one year every year, until no-one can buy tobacco products. It also demands the promotion of vaping and other preventative measures, and licences to limit where tobacco can be sold. These were the major measures – there were a host of others in the report to further speed up the process.
Let me get two things out of the way early. I’m not a smoker – I’ve never smoked, never had any issue in doing so, and I wouldn’t be sad to see the habit die out. I just don’t see the appeal of smoking at all, and I’m baffled when people take it up. Coupled with that, we know how unhealthy a habit it is – it causes cancer, strokes, heart disease, and a myriad of other illnesses. Recent data shows that one in four deaths from all cancers were connected to smoking, and tobacco remains the single biggest cause of preventable illness and death. If we lost it overnight, our population would be so much healthier as a result. Between these two points, you see that I’m hardly invested in smoking’s survival. And yet, I read the Khan review with great discomfort. Although the ultimate aim is broadly a good one, a lot of the measures suggested are very questionable, and the ways that they could be applied and extrapolated elsewhere should worry us. Broadly speaking, the smoking issue is about two things – individual health and freedom. The public health dilemma essentially vanished after the habit was disallowed in enclosed public places, and the duties on tobacco have long outstripped the health cost to the NHS from their use. We all know the health risks of smoking by now, and much though I think it’s a daft decision to smoke, adults should have the right to make their own choices and the government should respect those choices.
Smokers are the canaries for civil liberties
– Josie Appleton for Forest
In a report published in 2019, the smokers’ group Forest argued that “smokers are the canaries for civil liberties” – it’s hard to imagine the government making a similar argument about alcohol, for example, something that is far more of an immediate health danger. Forest also noted that the call for a ban then “directly violates the harm principle that assumes a person has autonomy over their own life and body as long as they do not hurt other people”. If you accept these rules are necessary, what could be banned next? Alcohol, junk food, caffeine – they could all fall under Khan’s urge to ban “addictions”. It should never be the business of the government to regulate our bodies, yet this review is a framework for just that.
Smoking is falling anyway – the Khan review was written against a backdrop of the number of smokers declining. In the UK, 14% of adults smoke today, compared with 45% in 1974, and smoking rates among under-18s have been falling for decades. The only real recent surge in 18 to 34-year-olds came during the first lockdown, rising by a quarter from 21.5% to 26.8%, as a result of the stress of the situation. Another situation, lest we forget, in which the government imposed tyrannical restrictions on our civil liberties in the name of public health, and we’re only just beginning to see the dreadful consequences of that
There are pros and cons to this debate, and it’s highly likely that we’re seeing the dying days of smoking whatever happens. This review feels entirely the wrong way to tackle the challenges posed by smoking and would lead to an excessive and unacceptable level of government interference. Although the report frames this as a health question, it’s also about freedom of choice and personal responsibility, and the last thing we need is the government to feel like it has the right to restrict those, or we’ll all be in trouble.