1. Case study: alcohol and tobacco Professor Christine Godfrey Department of Health Sciences, University of York

2. Background: tobacco Alcohol and tobacco raise similar ethical issues, both legal, addictive harmful to users and others In 2005, 25% of men and 23% of women were smokers in UK In 2003, two thirds of children were exposed to smoke in the home Smoking associated with 1 in 6 of all deaths between 1998 and 2002 Smoking ban: welcomed

3. Background: alcohol Alcohol-related deaths have doubled from 4000 in 1991 to 8000 in 2005 8.2m people had ‘alcohol use disorder’ in 2004 Alcohol causes high level of harm to others: drink driving, accidents, violence Yet legislation on drinking has not been introduced as it has for smoking

4. Role of Government Government’s alcohol strategy has focused on education campaigns and voluntary labelling WHO-sponsored report found other measures to be more effective Conclusions –Government should introduce more stringent measures to tackle drinking e.g. increasing tax, restricting hours of sale –Analysis of longer opening hours needed

5. Costs to the NHS Should smoking or drinking affect access to NHS treatment? Alcohol consumption currently affects access to liver transplant Conclusions –No ‘victim blaming’ –Appeals to change behaviour could be justified if help offered –Government should encourage employers offer help to change behaviour

6. Role of industry Tobacco companies operate in countries with less stringent laws Conclusion: –Policies for greatest consumer protection should be adopted worldwide Industry lobbying to legalise ‘snus’ - smokeless tobacco Conclusion: –Not convinced allowing snus would be helpful

7. Protecting children Adverse effects of drinking and smoking on children is concerning Conclusions: –Banning smoking in the home would be very difficult to enforce –Intervention might be acceptable if child at very high risk of harm –Alcohol and tobacco industries should take more responsibility for preventing harm to child health