Friday, 25 June 2010

Quitters, Inc. [updated]

A couple of folks have pointed me to this ROI at the New Zealand government's main tendering website. The link will almost certainly not work for you; it doesn't work for me either as I'm not registered in their system. But a friend's sent me a copy.

The Ministry of Health and the Health Research Council of New Zealand are seeking tenders, with full project costs of up to $5 million, for proposals that would reduce smoking by 50% by 2020.
Outcome: 50% reduction in the number of smokers in New Zealand by 2020
The research will inform strategies and facilitate efforts for achieving a drastic reduction in the numbers of smokers by 2020. The RTRHRP Steering Committee has identified a 50% reduction in the number of smokers in NZ by 2020 as a high-level health outcome for New Zealand. In order to achieve this outcome, the Tūranga will be required to develop evidence to support a suite of innovative mechanisms whereby large numbers of New Zealand smokers can be effectively supported to stop smoking in a relatively short period of time.
I don't apply for these sorts of things: that's why I'm not in their system. But odds are that a team consisting of some mix of Edwards, Thompson, Wilson and their various coauthors at Otago's school of public health at Wellington will get thrown another pot of money for some proposal involving a combination of tax increases, cigarette packs in plain brown wrappers with no identifying information about branding, banning of any kind of advertising, and possibly a move to make tobacco available only by prescription under doctor's supervision in the final years.

Now, if I had a million a year for five years, and if I reckoned the ends justified the means, I'm pretty sure I could come up with a proposal that would fully implement the protocols first outlined in Stephen King's short story Quitters, Inc. He claimed a 98% success rate. Now, some folks might reckon that the measures there proposed infringe on personal liberties too much. They might even wave their fingers and say nanny state. Pshaw. If we've already decided that folks can't be trusted to make their own decisions about smoking, why should we rule out more aggressive measures to force people to do what's best for them?

More seriously: the Ministry of Health, under National, will pay $5 million for proposals on how to reduce smoking prevalence by half by 2020. They're clearly seeking proposals from folks active in anti-tobacco scholarship. Would anybody who'd previously done work suggesting that third-hand smoke is a load of made up nonsense, or that the social costs of smoking are highly over-rated, ever be considered? My guess would be no. From the RFP:
A broad range of factors will need to be considered and addressed in order to achieve a significant reduction in tobacco-related harm. Therefore, a well-coordinated and adequately resourced approach is required. The purpose of this RFP is to establish a research Tūranga comprising a group of leading tobacco control researchers who will be charged with developing such an approach. The Tūranga will necessarily be multi-institutional and multi-disciplinary and will be charged with developing a cohesive, collaborative and dynamic programme of research to develop innovative strategies in reducing tobacco-related harm. Key research priorities have been identified in the New Zealand Tobacco Control Research Strategy 2009-2012 which may provide a focus for the development of this approach5. This fund is overseen by the Reducing Tobacco-related Harm Research Partnership Steering Committee with members representing the MoH, HRC, Māori, and health researchers.
Is there any way that anything worth $5 million can be produced from this?

Nanny just changed her skirt colour in 2008. Red to blue.

Update: here's the steering committee membership. But I'm sure that anybody who needs to will recuse himself when the relevant decisions are made. The grants will go to whoever is best for the job, regardless of the number of coauthorships anybody on the board might have with potential applicants. These sorts of problems are inevitable in small countries and I'm sure things wouldn't be rigged to give the grants out inappropriately in this the best of all possible worlds.


  1. Seen who sits on the Tobacco Control Research Steering Group

  2. Youdan's on there?! I mean, there's a lot of healthists on that list, but Youdan's the guy who runs the local chapter of Action on Smoking and Health - the multinational anti-tobacco lobby group. Wow.

  3. And the researchers likely to do the research!! (e.g. Richard Edwards is the boss of Thompson and Wilson!)

  4. Conflicts of interest anyone?

  5. Presumably Edwards would recuse himself from the room when the decision would be made.

    Yes, there are lots of different kinds of stink in this.

  6. What about fines for dropping cigarette butts? In many wards in Tokyo there is a fine of JPY30000 (about $NZD500) for dropping cigarette butts in the street, in London I heard similar fines of GBP300, or about $NZD600. Why not implement a fine here of $500, and use the proceeds for enforcement and street cleaning. After getting caught once I'm sure a lot of smokers would cut back and/or quit.

    Besides, surely the litter from cigarette butts constitutes an externality? Wouldn't this be a fair way to kill a couple of birds with one stone without upsetting any economists?

  7. @kiwipollguy This is one of my particular bugbears, I dislike littering in all its forms, and I especially despise the way smokers seem to think it is ok to drop their toxin ridden butts all over the country. As a group (and yes I know this is a sweeping generalisation) they seem to be an inherently selfish & thoughtless bunch.
    Now I'm usually all about personal freedom, but this is one nasty little habit that gets under my skin, so by all means fine the perpetrators. However the fine does need to reflect the seriousness of the crime, and I'd think stinging someone for $500 for "merely" dropping a ciggie butt on the ground might be considered disproportionately harsh...

  8. @Kiwi, Lats: there's already littering offences on the books. It's possible that it's underpoliced relative to the level commensurate with efficient deterrence given penalties; I really couldn't say. Mostly because I don't know the current probability of being caught or the marginal external cost imposed by the marginal litterer or the actual current penalty.

    Discarding lit cigarette butts from cars in dry high country conditions can be seriously dangerous rather than just unpleasant; I could see that going beyond normal littering provisions.

  9. I am all in favour of the MoH funding this contract, with one proviso: the contractees can only spend up to $2.5m on the project. Then, if smoking rates in 2020 are 50% or less of current rates the researchers can have the remaining $2.5m as tax-free income. If smoking rates have not fallen by that much, they have to pay the $2.5m back with interest. Up the limits on ipredict to allow approriate hedging if risk aversion is a problem.

  10. Can I ask, Seamus, would you be in favour (with that proviso) because you think the exercise is futile and so the funds will have to be paid back anyway, so there is no harm done. Or do you have paternalistic reasons for supporting the idea of government trying to get people to quit smoking?

    @Lats, although I don't disagree that smokers can seem selfish, I would defend them by saying it is at least partly a reaction to the anti-smoking rhetoric turning more and more from just being 'smoking is bad for your health' to 'smokers are evil/stupid/smelly/ugly' that seems to be coming disturbingly accepted. How much effort would you put towards caring about society when society actively encourages your ostracization?

  11. @rsw37: There is no current politically feasible option that would reduce smoking by 50% by the end of the decade. There are lots of politically infeasible measures, like smoking by prescription or several-hundred-percent excise tax increases.... Actually, scratch that. The way National's going, I'm not sure that having a prescription regime where smokers would have to show a prescription to a cop on demand would be out of the question. ACT would vote for it.

  12. @rsw37: I think you know the answer to your question already!

  13. @Lats, as I pointed out, $500 is a typical fine overseas (very roughly PPP adjusted,) and so I think it would be a fair starting point. It's definitely helped reduce littering and smoking rates in Tokyo, probably other cities where it's been tested as well. Why not just try the scheme and adjust the fine later as necessary?

    Many Japanese smokers now carry portable ashtrays; about the half the size of a deck of cards. If Kiwi smokers collectively started doing the same then how about a reduction in the excise taxes? Tit for tat. Optimistic result would be cheaper ciggies, lower smoking rates, and cleaner cities.

    @rsw37, it's a bit of a chicken or the egg problem isn't it? If smokers used to discard their cigarette butts appropriately, and only recently started turfing them on the footpath as a form of protest, then I think your position would have a bit more credibility.

  14. @Kiwi: Why should there be a separate fine for littering cigarette butts compared to littering in general? There'd be reason for it if the probability of detection were lower (optimal deterrence), or perhaps if cigarette smokers were less responsive to fines than were other potential litterers (which could also signal that the value of littering to them is higher so the optimal quantity of their litter then too is higher). But I'm not sure that either is the case.

  15. Leave smokers alone. Sure smokers are a drain on the health system, but more than compensate when they save taxpayers years of superannuation by dying (ave) 15 years earlier. (Based on ave life expectancy 79, smokers die at 64.)
    Just keep putting up tobacco taxes and widen smoking ban to beaches, parks and streets.
    Crampton- shouldn't this be your argument a la superfreakonomics?

  16. @Anita: Haven't yet read superfreakonomics, but that was basically W. Kip Viscusi's argument from 20 years ago. There's still no reason to overestimate the costs to the public health system though.

    I don't see any reason for putting up tobacco taxes if smokers are (far more than) covering the marginal external cost of their consumption through current excise levels. What costs are smokers on beaches imposing on others through their presence that would justify a ban?

  17. For the record I'm not anti-smoking in the rabid "I hate all smokers" sense that seems to pervade society at present. It is each persons choice if they smoke or not, and I support their right to make that choice. My problem arises when that choice effects me.
    So what impact does a discarded butt have on me you ask? Little, other than my aforementioned dislike of littering which I find unsightly. I especially don't understand smokers flinging butts out of their car window, cars still have ashtrays as far as I'm aware, although some modern ones may have done away with them.
    If I may share an anecdote regarding butts, I was driving in Chch one day with the top down on my MX5 (yeah, hairdressers car, I know, I've since sold it) when the chap in front of me tossed his butt out the window. It landed, still smouldering, in my lap, and I had to quickly pull over and extricate it to prevent either myself or my car seat getting burnt. It was an unpleasant experience, and the smoker continued on his merry way totally oblivious to the mayhem he left in his wake.
    This was a bit of a freak occurrence, and I think Eric's scenario of butts causing fires in dry grass is more likely. I tend to agree with Eric that the current littering laws should probably apply, although given the state of our streets I'm guessing precious little can be/is being done enforcement-wise. Movement on this could be done at a local authority level since they employ the crews to clean the streets, although they'd be more likely just to increase rates to cover the cost rather than try to target offenders with a by-law I'd think.