Taking long-delayed action on climate change is not the only bold move by the federal government at the moment. However, progressing with legislation for plain packaging of cigarettes — the move that could make the bold target of smoking rates below 10% by 2020 a reality — appears set for cross-party support in Parliament. That should put a cap on how bloody the plain-packaging debate can become. However, the tobacco industry has certainly not stopped trying to scuttle this legislation and it is working hard to win public support. Its allies in the libertarian and conservative think tanks are also still fighting hard.

The main argument from the tobacco industry, retailer associations and the libertarian and conservative think tanks is that plain packaging is one of the worst cases of the nanny state in action and any independent thinker will always oppose the nanny state. I’m sure for some people that is a telling argument.  Nonetheless, there are several reserve arguments against plain packaging that we are also supposed to take seriously, including that it will increase cigarette smuggling.

An increase in cigarette smuggling might not seem such a big deal. After all, the tobacco industry makes obscene profits that most of us are not concerned about protecting and, if the government loses out on some income from tobacco excises, that would seem a small price to pay for the anticipated benefits of reduced smoking uptake among adolescents and increased quitting among existing smokers. That’s certainly my initial response. However, I am willing to consider some of the more detailed arguments about the negative consequences of plain packaging.

Here is an alarming warning from Tim Andrews, from Menzies House think tank, about where plain packaging could lead us:

“Intellectual property rights and trade marks are one of the strongest protections we have against counterfeit goods, and by violating them we are giving an open door to smugglers. According to the World Health Organisation framework convention on tobacco control, there are an estimated 600 billion counterfeited and smuggled cigarettes crossing national borders each year with severe consequences — people die as a result of the illegal cigarette trade just as they do as a result of drug and human trafficking, and tobacco smuggling has also been found to directly finance terrorism. Furthermore, a 2003 report by the BBC noted that counterfeit cigarettes contain 75% more tar, 28% more nicotine and about 63% more carbon monoxide than genuine cigarettes — leading to worsening health outcomes.”

Tim Andrews isn’t alone in expressing these twin concerns about smuggling. On the www.plain-packaging.com website, we are given much the same message in bullet points:

“Illicit cigarettes:

and

  • Counterfeit cigarettes have been found to contain rat droppings, fibreglass, as well as higher levels of toxic chemicals.

Terrorism and toxic chemicals obviously form a terrifying mix in the minds of some libertarian and conservative public intellectuals and apparently the thought of “genuine” cigarettes being made in nice, orderly factories, administered by people who wear very expensive suits, comforts them greatly. Whether the rest of us should share in this vision of things is another matter. I will leave questions about cigarette smuggling, organised crime and terrorism to others with more knowledge on those matters and confine my attention to the question of whether counterfeit cigarettes are likely to be more dangerous to smokers than “genuine” ones.  Whether cigarettes differ significantly in harmfulness and what we can do, if anything, to limit their harmfulness are questions I have researched for 10 years. The best short answer I can give is to turn one of the tobacco industry’s verities around on it: any cigarette is basically cured and cut tobacco rolled up in paper. There isn’t anything we know about that could be done to make the “genuine” cigarettes on the market much less harmful than they are now and there isn’t anything that could be done to make them much more harmful either.

An Australian factory-made “genuine” cigarette contains about 700mg of tobacco, which in turn contains around 12mg of nicotine. Average smokers unconsciously seek a nicotine dose of 1.3mg from each cigarette to get the rewarding sensations they crave. If they get too much less than their target dose, they are left feeling unsatisfied. If they get too much more, the sensations are unpleasant (as all “beginner” smokers can attest). What this means is that smokers will smoke different strength cigarettes in different ways — they puff a lot less hard on a strong-tasting cigarette than a so-called “light” one. That is the main reason why Tim Andrews’ figures in the above quote are uninformative. While a smoking machine puffs on cigarettes the same way every time (a 35ml puff once a minute using the standard protocol), smokers change their behaviour. The now obsolete tar, nicotine and carbon monoxide yield figures he relies on are an indication of how strong cigarettes will taste and how hard smokers will have to work to get their nicotine doses but they are not an indication of what doses smokers will actually receive.

Cigarettes certainly contain quite a range of additives. However these only constitute a small percentage of the weight of a cigarette and do not yield combustion products that are any more harmful than the combustion products of tobacco. Most additives — things like cocoa, liquorice, sugars and fruit extracts — are there to make the smoke taste sweeter and smoother. They help the toxins in cigarette smoke go down (which is why we should not accept their use) but they are not a major source of the toxins in themselves. This is probably much less well understood by the public than it should be. There appears to be widespread belief among smokers that some of the nasty things in cigarette smoke, such as benzene and formaldehyde, are there because the tobacco industry specifically adds them. In fact, they are unavoidable by-products of tobacco combustion. Further, the tobacco industry doesn’t need to add anything to cigarettes to make them addictive; nicotine is highly addictive already.  In short, counterfeit cigarettes are unlikely to be more harmful than “genuine” ones due to any additives.

Cigarettes vary in terms of the particular cocktail of carcinogens and other toxins smokers receive but it appears to be largely a zero-sum game, where cigarettes high in one carcinogen are low in others. Heavy metals may be an exception to this rule of thumb but they probably account for a small proportion of the overall harmfulness of cigarettes and it is implausible that counterfeit cigarettes would have massively higher loads of heavy metals than do “genuine” cigarettes.

I’m sure things such as fibreglass fibres and rat droppings have been found in counterfeit cigarettes but I would hazard a guess that they have been found in “genuine” ones as well.

It’s just a bit rich for the tobacco industry’s allies to be talking about “quality control” and “regulatory oversight” of a product that kills in the order of 20,000 Australians a year (and millions around the world). They are trying to scare us about “counterfeit” cigarettes, while seeming to be strangely lacking in concern about the damage caused by “genuine” ones.

*Bill King is a Melbourne writer and public health researcher.