My concern with smoking and smoking bans began one day in November 2004. I’d arrived at the River and bought a pint, and had sat down at my usual table to read that day’s Independent. On an inside page there was a small article saying that Sir Charles George, president of the BMA, and chairman of the BHF, was calling on the government to ban smoking in public places. He cited a new study which said that carbon nano-particles in smoke might cause an increased number of heart attacks.
‘Who the hell does he think he is?’ I wondered to myself, as I lit another roll-up. I’d never heard of any senior doctor calling for anything like this before, pulling in newspaper reporters and going public. Most doctors operated discreetly in the shadows. Not this one. I surveyed his smiling face in the photo, the jowls beneath his chin spilling over the collar of his shirt.
He wasn’t the last such swaggering doctor. Sir Liam Donaldson was soon to overshadow Sir Charles George, and there’ve been plenty of other doctors coming out of the woodwork of the Royal College of Physicians.
And I still don’t have an answer to the question ‘Who the hell do they think they are?’ or ‘How come they exert so much influence?’
But perhaps what happened was that there emerged a grand conjunction of a variety of antismoking organisations. In Britain there was Sir Richard Doll and Sir George Godber (not to mention my personal bete noire, the malignant Dr W, who inveighed against smoking like a hellfire preacher, and who regular attended BMA meetings). In the USA there was the AMA, a number of antismoking Surgeon Generals, the Robert Wood Johnson Foundation, and a variety of (at the time) grassroot antismoking organisations. And then there was Gro Harlem Brundtland, who on becoming head of the WHO in the 1990s, shifted its emphasis towards ‘lifestyle medicine’ – tobacco, alcohol, and food. And the WHO was of course part of the UN. And then there was the emerging EU political aristocracy, of whom Brundtland was herself one, having been Prime Minister of Norway.
Assemble together this constellation of interested parties, all of whom meet each other regularly at conferences all around the world, and pump in huge amounts of taxpayer’s money, plus hundreds of millions of dollars from the Master Settlement Agreement in the USA, plus even more money from pharma companies peddling NRT, and a very powerful informal global coalition comes into existence. Its members have access to senior politicians all around the world, and to banks like the World Bank. And they control huge amounts of public and private money.
A few years beforehand, somebody like Sir Charles George was just another nobody doctor. Same for Sir Liam Donaldson. Nobody had ever heard of them. But now they were part of a very large global coalition of like-minded people. And when they asked for things to be done, they started to get done. They had clout like never before.
When Sir Liam Donaldson threatened to resign when the UK Labour government showed signs of not wanting a total smoking ban, it would have been an insignificant protest 10 or 20 years earlier. But now that Donaldson was a player in the emergent global antismoking consortium, he was a bit more than just Chief Medical Officer. He had friends in high places all around the world, who could be persuaded to look less favourably upon a loan here, or a trade agreement there. So Donaldson got his total smoking ban. And he got his big office too.
One important feature of this coalition of interested parties is that none of their members have been elected. Not in the AMA or RWJF or BMA or BHF or ASH or the WHO or the UN or the EU. None of them. These were people who were meeting up with each other in conferences, working out between themselves what they wanted done. Since they weren’t elected, they didn’t need to consult the public. They didn’t particularly want to anyway. They were the experts, after all. They’d done the research. Their job as doctors and researchers and experts was educate the public, and tell them what was good for them.
And now they were finding that, whereas in the past the politicians had seldom done what the doctors asked of them, suddenly the politicians had become more than willing to accommodate their requests. Smoking bans in all public places, without any loopholes for small bars or private clubs? No problem. Bans in parks and cars? Certainly. Concealed displays of tobacco, and plain packaging? Done. Floggings and nose-slittings for first offenders?
The politicians were finding themselves dealing with a very powerful, influential, and wealthy global coalition who could make life difficult for them in all sorts of ways if they didn’t go along with their demands. And in this new political reality, all the key decisions were agreed in private among the key players in the coalition. The smoking bans. The fines. The display bans. Etc, etc. This was the new post-democratic order. It was government by experts and by committees. The job of elected politicians was to implement the instructions that filtered down to them from the coalition.
So when the second most senior member of the the Con Lib Coalition government, Nick Clegg – himself a smoker – , says that there’s no more chance of the smoking ban being repealed than capital punishment being re-introduced, he’s actually telling us just what power these people exert.
And the same is true elsewhere. It’s said that one of the conditions of the Greek bail-out was that they impose a strict smoking ban. The same is probably true of Spain, which may well be needing to be bailed out soon too. In the corridors of power in the EU, in some meeting of key players, some senior doctor insisted that the bail-out funds be conditional on rigorous smoking bans. The demand was probably made over lunch in some Brussels restaurant, just after the asparagus had been served.
The politicians know perfectly well that they’re screwing their own people. Smoking bans shatter communities and bankrupt pubs and cafes. That’s why they can’t look them in the eye and talk to them about the rain of undemocratic rules and regulations they keep imposing on them. That’s why Cameron and Clegg and all the rest of them won’t ever talk about it. Because they’re no longer serving their own people, but a confederation of powerful interest groups which can, at a flick of a switch, shut off funding, close off hard-won exemptions, and enforce previously unenforced regulations. They spend their days in Westminster trying to placate nameless eminences grises who have more direct and immediate power over them than an electorate which only gets to have its say every 5 years or so, and whose votes are soon to be counted in ways which will be designed to neutralise public opinion anyway.
If so, more and more people will wake up to learn that their governments are more interested in serving the interests of international power-brokers and bankers and pressure groups than in serving their interests. It will become the peoples against their governments, all across Europe.