cigarette pack Elevating Mediocrity.
Dr. Louise Hassan / Dr. Edward Shui
Health warnings on all cigarettes.
cigarette pack

Dr. Louise Hassan and Dr. Edward Shui, both academics at the Bangor University Business School, claim to have conducted experiments with smokers to find out whether or not they felt the concept of warnings printed on every cigarette stick to be so repellent that they'd consider quitting.

They say they "recruited" 88 smokers found in the vicinity of two university campuses in Scotland and a further 120 found hanging around inner city cafés in Greece.

Their "study" consisted of running up two cigarettes that had warnings on the cigarette tube itself. One listed all the harmful ingredients contained in the tobacco, while the other consisted of ruler type warning showing they'd take 11 minutes off their life whilst smoking it.

Rather grandly they claim two parts to their study. In part one they showed the participants a photograph of what was printed on the cigarettes, then noted their reaction. In the second part they were allowed to hold the cigarettes, and again a note was made of their reaction. Then they went back to their offices, did a lot of calculations and came to the conclusion that 16% said it may result in them considering quitting.

Based on these findings, Hassan intends to petition to have warnings on all cigarette sticks included in the plain pack review, currently underway.

A brief report of their study was published in the BMJ on 13 Dec 13 (1). I see it was submitted in July and accepted in November 2013, however the real hoopla took place on the 22 December. That was press release day, with minor details like examples of the cigarettes being notable by their absence. Nevertheless the Mail did what it could with stock photos and included the comment that early evidence from plain packs in Australia has shown them to be highly effective, with an Australian study claiming it has led to smokers being 81% more likely to quit (2).

That's odd because Chris Snowden brought us details of a separate study, also published in the Mail one month earlier. That shows there has been no reduction in cigarette consumption in Australia one year after plain packs were introduced (3). In fact the only real difference is the way smokers source their cigarettes - increasingly through "alternative means", and Australia's notorious for its superb customs officials. Well that's what the television programmes would have us believe!

So it seems there's quite a difference between what a small sample of smokers really mean when they say they may be inclined to quit and what researchers imply. In fact they're poles apart. I know many Greek people, and "may" do something is a world away from giving it a second thought. They're not unique, I know a good many people in Scotland who do exactly the same thing!

From what I can gather of the Hassan/Shui study they, or their alternates, quite literally sat down with people they saw smoking in cafés in Greece and, after the usual preliminaries, launched into their so called survey. Greeks are, by and large, fairly tolerant people but a couple of foreigners, presumably with a translator in tow, is something you want to be rid of real fast. Tell them what they want to hear and they go away. Don't and they'll hang around causing extreme embarrassment - and that is not cool in front of your mates.

The Scottish part of the survey involved individuals they saw smoking in the vicinity a couple of university campuses. Again I suspect it was a very casual "hi, do you mind if we ask you a couple of questions?" sort of thing. Certainly it's an environment where Hassan and Shui might feel at home, especially Strathclyde Business School. But some patronizing, vertically challenged misocapnist, trying out their notion of an experiment, wouldn't get the time of day in the working class areas of Glasgow.

And this is perhaps the most obvious flaw of their little experiment. It had nothing to do with trying to survey a representative cross sample of smokers, just those seen as convenient to them.

So what an outsider - with their own agenda - might take as a "positive response" actually turns out to be a quick and easy way to get rid of a pain in the butt. We've seen Tobacco Control claims that non-smokers would take up the slack after the smoking ban were pie in the sky fabrications. Also that 70% of us really want to quit smoking, or that we'll "spend our money elsewhere". And with Fire Safe Cigarettes, price hikes and plain packs we've turned to tubes, rollups and "other sources". This study is no different; it's facile, overblown, not impartial - and they conveniently ignore the remaining 84%.

I'd have expected to see examples of the cigarettes they doctored. There may be reasons for this. Seems they did not have the cooperation of a cigarette manufacturer, nor did they get a cigarette, empty the tube, print on the tube, then replace the contents. Trying to get a list of toxins on a fag tube involves a very small font size, in fact it's barely legible (hence the photographs of what was on the "warning"). Most likely what they did was buy a pack of fags, then print their warnings on a separate piece of paper which they then gummed to the original fag tube. It looked as it was, a Heath Robinson lash-up.

Were someone to sidle up to me whilst enjoying a coffee and a fag to inquire as to my thoughts they'd get seriously short shrift. I haven't bought or smoked manufactured cigarettes for quite some time. Normally I roll, however I do sometimes smoke tubed tobacco, so an uninformed outsider may well think I'm smoking manufactured cigarettes. These prats wouldn't have a clue, so if I were to say I wouldn't smoke their concoctions, that doesn't mean I'm going to quit smoking.

But that's the problem with back office desk jockeys, they don't have the first idea of what they're dealing with. Their subjects generally loathe them with a passion and once identified, were I a Greek, I'd have fun with the pair of them, especially as it seems they had the arrogance to bring along some half baked fag with bits stuck to it. I assume they had sufficient respect for the Greeks to have their warnings translated into Greek, but somehow I suspect they didn't.

In fact I suspect what we're seeing here is a re-hashed project they carried out when they were both at the Strathclyde Business School in Glasgow. Shui moved to Bangor in 2011, while Hassan flitted around a series of Scottish Universities before moving briefly to Lancaster University (4), then shifting to Bangor.

So it seems the Glasgow side of things was done years ago, and the old hoary 11 minutes thing doesn't quite pan out when one considers Peter O'Toole (he consumed them at a staggering rate for nigh on 40 years and still hit 81). Things have moved on in TC-speak and now it's more likely they'll claim it takes five years off your life.

My contacts in Greece can find no reference to any study of the type described, so I can only assume it was an informal thing, probably part of a holiday one or both had, and almost certainly paid for as "research".

Still, when you're going for funding and seek an elevated status amongst your peers, then why not run something up for Tobacco Control (she's a Co-investigator for the International Tobacco Control project (5)). They don't ask searching questions and when you're bottom feeders, just getting this sort of flawed, superficial, amateurish junk published is about as good as its going to get. And TC do pay rather well for "further research", which is at the core of this "study".

Eddie Shui doesn't shy from the camera, so he can be viewed along with the stuff he's had published on his staff profile (6).

Louise Hassan on the other hand prefers to stand behind her numerous studies. A couple a year, mostly shared with Shui, and many run up for publication by Tobacco Control (7). No photo, but one of her chums snapped her in 2007 and slapped it on the web. So, in the interests of transparency, lets put faces to the researchers who would very much like you to conform to their notion of acceptability. Shui's on the left, Hassan's the one in a dress.

Dr Louise Hassan Dr Edward Shui and friends 2007
Dr. Eddie Shui, Dr. Louise Hassan and friends.

My understanding is the plain pack review is being overseen by Sir Cyril Chantler and he's likely to be swamped by suggestions from both sides of the abyss. The Hassan/Shui study simply add to those in favour of larger health warnings and graphics. Sir Cyril has until March to produce his recommendations, so not much time to consider everything in great detail.

He won't ask what the relevance is of Greek attitudes, because this most certainly won't affect them. He won't ask for the exact percentage of Scots who might consider quitting, nor the exact time of the so called survey in Scotland. An impartial reviewer would demand to know this, rather than simply accept their - rather convenient - combined result. The year they questioned Glaswegians is also paramount because attitudes have hardened amongst smokers in Scotland - and that's saying it nicely.

The issue of practicality comes into this as some of the ultra-slim cigarettes are only 4 or 5mm in diameter (8), meaning any warning on the tube itself will be illegible. Sir Cyril may be biased toward the plain pack argument, but he's also a pragmatist - and he'll be made aware that cigarette tubes are not all white paper as this illustrates rather well (9). That's an issue when it comes to satisfactory ink.

The stated reason for plain packs is to deter youngsters from being bedazzled by the existing wonderfully glitzy boxes. They get discarded and continue to act as a magnet for said youngsters. Warnings on cigarette tubes are of course destroyed, however this may well be the only item of interest in the Hassan/Shui study; they make no pretext that it's to save itsy bitsy tiny little kiddies. Nope they make no bones about it, they want warnings on the tube to deter us from smoking!

The Australians have not taken this route; they barred cigarette manufacturers from printing their brand name on the tube. The warnings and the images are at the point of sale - finish. My understanding is that by insisting that any form of print be added to the cigarette tube, they run a real risk of increasing the number of harmful ingredients!

Do that in Australia and those responsible could be held personally liable for any adverse side effects. Hassan/Shui may be oblivious to that possibility. I trust Sir Cyril is not.
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Smoking Scot
January 2014