The BMA: censorious, busybody killjoys

The British Medical Association’s demand for the censorship of ‘smoking imagery’ suggests doctors fancy themselves as the new priests.

Tim Black
Columnist

8th July 2008

Here, Tim Black argues that the British Medical Association, always demanding restrictions on smoking, drinking and other fun activities, has got too big for its boots. Further below, Joel Cohen visits an exhibition that reminds us that, even though lots of people have always hated smoking, it wasn’t always criminalised.

Permanently with fag-in-hand, a drink on the go, and a persistent anxiety over her errant, frequently incarcerated boy, it’s not difficult to see the pernicious influence of EastEnders’ Dot Cotton on Amy Winehouse.

It’s there in the magnificent bouffant, in the sadness-shot eyes, but most of all in the ‘ciggies’, the endless dragging on which has helped induce in poor Winehouse the onset of the lung disease emphysema. Of course, the ‘if onlys’ resound all too loudly: if only EastEnders hadn’t portrayed smoking in such a positive light; if only it hadn’t imbued the fag with pension-book glamour; if only the yoof weren’t so damn impressionable… then perhaps, just perhaps, Winehouse would have been spared her current suffering.

At least, this seems to be the reasoning of the British Medical Association (BMA), which this week launched a new report, Forever Cool: The Influence of Smoking Imagery on Young People (1). The BMA argues that our social environment is replete in pro-smoking messages. From its ‘normalisation’ through seeing friends and family smoke, to advertising and ‘evocative brand imagery’, smoking, says the BMA, is either tacitly approved or openly advocated.

And nowhere is smoking made more enticing than in ‘popular media depictions’, the BMA claims – that is, in movies, TV soap operas, or by the aphids of the public sphere: celebrities.

‘All this serves to reinforce the habit as being “forever cool”. Smoking remains the leading cause of preventable ill health and death in the UK and children will only be truly protected from it when the UK is tobacco free’, declaimed Professor Vivienne Nathanson, the BMA’s head of science and ethics. ‘We all have a role to play in protecting children and young people’, she continued, ‘and the UK government should act now to introduce policies that will limit young people’s exposure to pro-smoking imagery, thereby helping to prevent a new generation falling victim to tobacco addiction’ (2).

Fresh from the BMA’s petty nostrum factory come the following proposals: ciggies should come in brand-free packets; there should be a ban on cigarette-vending machines; 18 certificates should be given to movies that feature puffing protagonists; and in soap operas, a nicotine-loving character should die of a smoking-related disease. Bye bye, Dot – the BMA cannot tolerate your wicked presence on our TV screens. The best way to prevent ‘exposure to pro-smoking imagery’, according to the BMA, is to ‘eradicate’ pro-smoking imagery. We used to call this censorship.

The rationale for the BMA’s proposed measures is shoddy indeed. For every example of influence – where a kid might, according to Nathanson, be inspired to smoke cigars after seeing Will Smith light one up in Independence Day every time he dispatches an alien – there are hundreds more who refrain from the temptation of Cuba’s finest, no matter how cool shooting aliens might be.

The argument that the media is responsible for glamorising smoking also overlooks why smoking might seem increasingly attractive today. For the paradox of the BMA’s and others’ censoriousness is that the more smoking is demonised as something viciously anti-social, a threat to oneself and to others, then the more alluring it becomes. In other words, the association of smoking with rebellion, no matter how posey, is not accidental but concomitant with its demonisation. From the incipient counterculture of the 1950s, be it Albert Camus or James Dean, to the paragons of contemporary vice, be it Winehouse or Pete Doherty, the humble cigarette comes to symbolise individual expression amidst stifling conformity.

Moralising about the negative influence of the media is nothing new, however. From the German National Socialists in the 1930s, who even organised an exhibition of morally degenerative art, to Mary Whitehouse, the bane of the BBC throughout the 1970s and 80s, there have always been conservative gadflys proclaiming the morally degenerative effects of culture on the mass of the population.

Yet, as this week’s newspaper headlines reveal, the contemporary outbreaks of moralising have a different form: ‘Doctors fume at glamorisation of smoking in film’; ‘De-glamorise smoking, say doctors’ (3). The predicate here is not the British Medical Association, but those they represent – doctors. What is effectively the opinion of a group of people commissioned by the BMA is passed off as the pronouncement of the medical profession itself – an unquestionable, doctor-supported pronouncement at that.

These unelected arbiters of public mores are in many ways even more insidious than those who came before. At least Mary Whitehouse, the self-appointed president of the National Viewers and Listeners Association, was an unabashed prude, an uppity citizen openly hectoring others. The BMA, on the other hand, and its rent-a-gob science and ethics head, Vivienne Nathanson, solicit the authority of the medical professionals on whose behalf they speak. The nakedly moralising Mary Whitehouse was as nothing compared to the new Priesthood of Experts, who hide their distaste for the public behind, as Forever Cool puts it, ‘evidence-based recommendations for policy’.

The sanctimonious stance of the BMA, and the propensity of Nathanson to dispense pearls of mean-spirited diktat, is nothing new. Last summer, there was Nathanson again, taking the battle to the middle classes, soaked with mid-price Cabernet Sauvignon and Belgian beer. For the ever-vigilant Nathanson, the government wasn’t doing enough to save people from the drinks aisle of Waitrose. ‘It is not the nanny state’, she blurted, ‘it is about informed choices. It is hard for the average person to work out how many units are in a drink these days. Glasses of wine are much larger than they used to be and many beers and wines are much stronger.’ (4)

No scourge of modern society has been too fearsome for Nathanson and the BMA, it seems. She even had a pop at the Ultimate Fighting Championship. ‘Ultimate fighting can be extremely brutal and has been described as human cockfighting’, she said, citing, perhaps unwittingly, Senator John McCain. It was the responsibility of a civilised society actively to campaign against Ultimate Fighting, she added (5).

From the perspective of a distant managerial elite and its retinue of lobby groups and think-tanks, grinding out reports and turning over policy, never has social existence appeared so potentially corrupting, nor citizens so easily seduced. The aim for such contemporary moralists, it seems, is to create an environment cleansed entirely of temptation, be it an image of Uma Thurman sparking up in Pulp Fiction or a two-for-one deal on plonk. For those of us who lack the lofty vantage point of the elite, temptation is more often than not experienced as autonomy rather than degradation.

Tim Black is senior writer at spiked.

Puffing in the Big Smoke
By Joel Cohen

The far-right wall of the Museum of London foyer is currently home to The Big Smoke, an exhibition tracing the history of smoking and charting the start of its decline from the early anti-smoking activists up until last year’s ban on public smoking in England.

The exhibit, though not very big, is filled with a rich assortment of historical and cultural references, facts and artefacts from the cigarette’s past. ‘Smoking’, one part of the exhibit notes, ‘was considered by most people to be a harmless part of everyday life, on par with drinking tea and marriage’. So why is it that, today, we are so willing to accept the criminalisation of this historically everyday activity?

‘A woman is only a woman, but a good cigar is a smoke’, wrote Rudyard Kipling. Twice prime minister Stanley Baldwin used his image as a friendly ‘pipe-smoking Englishman’ as the selling point of his election campaigns. By the late 1940s, 80 per cent of British men and nearly 40 per cent of women were smokers. Amongst celebrities for a time, smoking was the new black – and from 1985 to 1988 you could get ‘House of Commons’ cigarettes.

Two sets of headphones allow you to listen to 12 Londoners’ accounts of their interaction with smoking – ranging from those who reflect on their youth, starting smoking as young as eight in some cases, to those who have to deal with the repercussions of the smoking ban today, including 34-year-old Sue from east London, who seriously considered quitting her job after it meant that she was only allowed one cigarette break each morning, and Mohamed, an Egyptian shisha bar owner, who gives a sobering account of how his business suffered after the ban came into force on 1 July 2007.

Meriel Jeater, the exhibit’s curator, says: ‘We will probably get so used to the smoking ban that in the future it will seem bizarre that people were allowed to smoke in public places at all. I thought it was important that we not forget how things used to be.’

When confronted with this traditional image of lighting up, what has really changed about cigarettes? They are still the same old fags. They still cause you health problems – even if the effects of passive smoking are tenuous at best, as Rob Lyons recently pointed out (see The crazy world of England’s smoking ban).

What has changed is the attitude we have not towards smoking per se, but to the anti-smoking lobby. For almost as long as there has been smoking, the exhibition shows us that there has equally been anti-smoking groups. For example, King James I is identified as a prominent anti-smoking figure, describing the act as ‘Lothsome to the eye, hateful to the Nose, harmefull to the Braine, dangerous to the Lungs’ in A Counterblaste to Tobacco in 1604. Magazines like Punch satirised the anti-smoking lobby for some 200 years.

However, when not even a feudalist monarch considered enforcing an outright ban on a substance that he hated, one has to ask: does New Labour have no commitment to personal liberty at all? A self-congratulatory Patricia Hewitt MP, former New Labour health secretary, recently stated: ‘When people come to look on this decade and more of Labour I think going “smokefree” will be one of the big things people remember and give not just government but parliament credit for.’ (6)

The medical case against smoking is plastered all over the exhibit. As David Willets, the shadow secretary for innovation, universities and skills, points out, ‘the drip, drip, drip of information on not just the dangers of smoking but the dangers of passive smoking has changed popular attitudes [and] made the ban possible’ (7).

A long tube entitled ‘A week’s worth of butts’ displays a week’s collection of discarded cigarettes from One Square Mile of the City of London – an attempt to induce guilt, no doubt, in the smoker. Smokers are increasingly made to feel guilty about their lifestyle choices, and for the effect that their habit has on the health system more broadly.

Walking back to spiked’s offices, it was hard not to notice the line of banished smokers hovering outside their buildings or the endless row of ‘No Smoking’ signs which litter windows of shop-after-shop-after-shop like a constant reminder of the over-arching and unforgiving nature of lifestyle politics.

As equally self-congratulatory as its former secretary, the Department of Health reports that Local NHS Stop Smoking Services have experienced over 20 per cent increased demand as a result of the smoking ban; 87 per cent of people believe that ‘smokefree’ legislation is being obeyed; and nearly 234,060 people quit smoking with the help of local NHS Stop Smoking Services between April and December 2007 (8).

In short, smokers are being singled out, demonised and for the first time in their habit’s history, criminalised. Their numbers are declining; but what is also declining is the spirit of Britain’s pub culture and free and open nature of our cities. The Big Smoke exhibition demonstrates very well that the big smoke, city life and interaction, is getting smaller by the day.

Joel Cohen is an intern at spiked.

The Big Smoke is taking place from the 1st July – 21st September at The London Museum. For more information see here.

Previously on spiked

Rob Lyons looked at the crazy world of England’s smoking ban, and accused UK health campaigners of smoking smokers out of polite society. Nathalie Rothschild reported on a rare protest against the English smoking ban. Basham and Luik argued that advertising censorship was built on junk arguments. And Brendan O’Neill said that advertising is a free speech issue. Or read more at spiked issue Smoking.