The Madness of the Khan Review | Edward Kendall

A government-commissioned review, whose findings were published on 9 June, recommends that the legal age for buying tobacco products should rise up a year every year until no one can legally purchase them.

This is one of four key suggestions that came out of the Khan Review to fulfil the government’s ambition of achieving a smoke-free Britain by 2030.

Dr Javed Khan’s paper laments the fact that during the Covid-19 pandemic “the proportion of young adults aged 18 to 24 who smoke rose from one in four to one in three.”

Well, who can blame them when they were commanded by the powers that be to stay in government-enforced self-isolation to the detriment of their mental and physical well-being. In such circumstances would it not be the most natural thing in the world to seek and find some solace in nicotine to take the edge off one’s predicament?

But regardless, if an action is legal then it should not be of any concern to the state whether the numbers voluntarily participating in legal practice are rising or falling.

Some of the suggestions proposed by the review are completely bonkers. For instance, it proposes that “all films, TV shows and online media that contain tobacco imagery onscreen should be classified as unsuitable for viewing by persons aged under 18 years, and television programmes that include tobacco imagery to be broadcast after the 9 pm watershed.”

This means, for instance, that a film such as The Lion, the Witch and the Wardrobe, which has given delight to both adults and children in equal measure and is classified as PG, would suddenly be classified as unsuitable viewing for those under 18 because in one scene the elderly professor happens to be shown smoking a pipe.

The same would also apply to other PG-rated films such as the 1982 classic The Scarlet Pimpernel because there are a couple of scenes in which the eponymous hero played by Anthony Andrews takes a pinch of snuff. It beggars belief!

But let’s return to the keynote suggestion of the review - the gradual increase in the age of sale of tobacco until it becomes outlawed to everybody.

When people think of tobacco by and large they think of cigarettes and my reading of the Review suggests that Khan makes the same classic assumption, seemingly using the two terms interchangeably.

But what this assumption glosses over is that almost all of the high mortality rates are related to the smoking of cigarettes, but not to the smoking of cigars and pipes.

By proposing a policy which will effectively outlaw all tobacco products in due course (supposedly on health grounds) Dr Khan seems to be demonstrating a remarkable ignorance in the differences between tobacco products and the varying degrees of health risks with which they come.

In 1964 a US Surgeon General report titled “Smoking and Health” (No. 1103, p. 36) highlighted the grave dangers associated with smoking cigarettes and consequently, that report did much to change attitudes towards smoking - smoking has been on the demise ever since.

However, what is often overlooked is that the very same report noted that the mortality “rates of cigar smokers are about the same as those of non-smokers for men smoking less than five cigars daily” and that mortality “rates for current pipe smokers were little if at all higher than for non-smokers, even with men smoking 10 pipefuls per day and with men who had smoked pipes for more than 30 years.”

This would suggest that smoking cigars or a pipe in moderation, where the smoke is not inhaled into the lungs, does not put the smoker at much greater risk of mortality than the non-smoker. It is quite clear, therefore, that different types of smoking pose different proportions of risk and that one cannot simply lump smoking as one single activity with the same health costs.

Yet this is exactly what the Khan Review has done and because of this cigar smokers and pipe smokers alike will have to suffer the loss of their pleasures due to the health risks associated with a form of tobacco smoking of which they have no part.

Furthermore, If we take it to mean that Khan envisages the prohibition of smokeless tobacco products like snuff too, then he is getting rid of a traditional means of nicotine delivery which is devoid of the health problems arising from smoking tobacco.

You would think he might embrace such a self-evident method of easing people out of smoking, but apparently not. Indeed, he doesn’t even give snuff a mention in his review, making me wonder if he’s even cognizant of its existence.

The Khan Review will make life more difficult for smokers than it already is. Smokers already go to extraordinary lengths to satisfy the requirements of the law - being forced to smoke outside even in the coldest and wildest of weather, huddled together on quiet street corners and alleyways whilst trying to ignore the puritanically disapproving looks of passers-by.

At the very least you would think that smokers trying their very best to contain their addiction and bend over backwards to obey the law should be applauded and not derided. But it seems the powers that be don’t share that attitude and wish to make things all the more difficult.

In addition to this, if the legal age for purchasing tobacco products is raised till it becomes illegal for anybody to purchase them, then the grounds for a thriving black market and smuggling trade will have been created.

Given the addictive nature of nicotine, there is almost certain to be an eager market willing to pay more for the ever scarcer supply.

The people who will also lose out will be the nation’s legally operating tobacconists (many of which have been running for generations) and all those in their employ - I only hope that the government will compensate them generously for their loss and give their staff generous pensions.

Indeed, they are duty-bound to do so if they are so hell-bent on making them redundant.

But perhaps the gravest flaw in Khan’s review is that its suggestions are motivated entirely on grounds of public health.

You would think that by now we would have learned our lesson from the pandemic that whereas health costs and mortality rates are quantifiable, this does not equate to a good measurement when it comes to evaluating the benefits and costs of highly interventionist policies on the greater wellbeing of the public.

Given that most people are aware of the health risks that come with practices such as smoking (or drinking for that matter) it should be fairly obvious that nobody takes up these habits for health reasons, but rather because of the lifestyle benefits that come with it or are associated with it.

People are free (and should remain free) to be able to make their own judgment about whether or not they are willing to take on those risks.

There is also a cultural argument to be made. Our nation is crowded with little balconies, patios, courtyards, and cafes teeming with ashtrays which may be little noticed but in fact the cultural engines, the little “Latin Quarters” if you like, of our nation.

Take smoking away from the equation and they become dull and boring.

The prohibition of tobacco will also mean the end of quirky but treasured traditions such as village pipe smoking contests in which contestants would compete so as to see who can keep their pipe lit the longest without relighting. A tradition that in many places goes back centuries.

Our nation will be much impoverished were we not to have a legal supply of tobacco to keep these cultural gems going.

The government should not be concerning themselves with trying to make the populace conform to pointless arbitrary targets such as being smoke-free by 2030.

Instead, they should be focusing their efforts on making sure that the populace has their basic rights and needs to be attended to at a time when the cost of living is soaring.

Given the sacrifices that have been asked of the British public these last couple of years, the very least the government could do is allow them to indulge in a cigarette if they so choose.

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