Flat White

Unhealthy public health

1 December 2021

4:00 AM

1 December 2021

4:00 AM

There was a time when public health people made a major contribution to our lives – ensuring the water in our taps was safe to drink, the air safe to breathe, our sewage carried safely away, and eliminating smallpox and polio, for example.  

They continue to play that role in developing countries – diseases such as malaria and Ebola remain a problem and there are still many people who do not have clean water and sanitation. But in developed countries like Australia, risks to the innocent and unwary are no longer their concern. Instead, they focus on risks that we can avoid by choice, so-called lifestyle issues. As a result, they have become the chief architects of the nanny state.  

People who work in public health, especially at the policy level, typically assume we all want to live forever and their mission is to ensure we do. They are convinced of both their superior intelligence and moral authority – that they are good people helping those who are ignorant and less intelligent to live longer and healthier lives. 

Psychologists have a term that applies to them – the Dunning Kruger effect. It is defined as a type of cognitive bias that causes people to overestimate their knowledge or ability, particularly in areas with which they have little to no experience.  

It is these public health people who are responsible for campaigns against smoking, alcohol and sugar, amongst others. As they see it, they are merely seeking to prevent us from consuming substances that might stop us from living longer. However, they view it in strictly technical terms; economic, social and political complexities are subordinated or ignored. And to the extent that they care about the niceties of democracy, which is not a lot, they take comfort in the dictatorship of the majority. If 50 percent are in favour, it is legitimate to switch from choice to coercion.  

Two examples illustrate the point. It is public health people who are responsible for the response of the state and federal governments to the Covid pandemic – the elimination strategy, lockdowns, curfews, border closures, gathering restrictions, and the rest. You might be unemployed, isolated, broke, depressed, or in need of surgery for a chronic illness, but as long as you don’t die from the virus, they’ve done their job. It is the same people who are insisting the vaccine be made mandatory.  


The second is the call by public health “experts” for an “end date” for the sale of cigarettes, supposedly to “provide tobacco retailers with certainty and assistance in future planning, make it easier for people to quit smoking, and assist the government to plan for reductions in tobacco tax revenue”. Moreover, a ban is OK because “research shows half of all adults in Australia, New Zealand, Canada, England and Hong Kong want tobacco sales phased out.” 

As we know, coercion in the name of public health is occurring in many countries right now. With people ignorant and fearful, there are few limits to what public health officials deem acceptable. As Lord Sumption put it, the absence of moral scruple in pursuit of what is thought to be a public good, is the first symptom of totalitarianism. The reduction of human beings to mere instruments of state policy is next.  

But when it comes to tobacco policy, Australia is in a league of its own. With the highest tobacco taxes in the world, the first to impose plain packaging, zero advertising or promotion allowed, no point-of-sale displays, huge restrictions on where smoking is permitted, severe limits on vaping, and even a ban on private imports, about the only thing left is an outright ban on smoking itself. So, no surprise, that’s what public health wants.   

The problem is, there is a very large elephant in the room. While our public health sector loves to brag about the measures it has implemented to reduce smoking, and has persuaded some other countries to do the same, the results tell a different story. As measured by the smoking rate, Australia is a monumental failure. All public health has done is create incentives for a massive crime wave of tobacco smuggling.    

As I have written previously, the 2019 Australian Institute of Health and Welfare National Drug Strategy Household Survey shows that, prior to 2012, the percentage of daily smokers aged 14+ had been steadily declining at a rate of 0.46% per year for over 20 years. When plain packaging and higher taxes were introduced, the rate of decline slowed to just 0.26% and has remained on this flattened trajectory ever since.  

Moreover, the proportion of smokers planning to quit has not changed; 3 in 10 smokers have no interest in giving up smoking, the same percentage (30%) as in 2010.   

What has changed is the illegal tobacco market, now accounting for 20.7% of all tobacco consumed in Australia and costing the government $3.4 billion in lost taxes. What’s more, illegal tobacco has become a worldwide industry, costing governments $40-50bn in lost tax revenue every year due to the ramping up of tobacco taxes around the world. Australia’s public health evangelism has contributed to this.   

The key driver of the illegal market is affordability – as tax increases make cigarettes less affordable, consumers begin to seek cheaper options. As they become 10% more expensive relative to incomes, on average illegal trade grows by 7%.  

Of course, illegal traffickers don’t pay taxes, so there is less money for governments to spend on enforcing anti-smuggling measures at ports and land borders, potentially exacerbating the illegal trade problem. But this is where the absence of other considerations becomes apparent. Enforcement might slow it down, but it can never be the solution, just as it is unable to block illegal drugs and guns.  

Public health people only see one dimension though – prohibit cigarettes and people will stop smoking. What they don’t understand is that smoking is driven by demand, not supply, which makes it an economic issue; smugglers are merely supplying the market. Smokers are also concentrated among lower-income groups, which means it is also a social issue. And while smokers are not organised into a political force now, prohibiting cigarettes is very likely to change that. But if you are a public health person, you probably won’t understand that either.  

David Leyonhjelm is a former senator for the Liberal Democrats.

 

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