OT; It had to happen.

[<me9]

A 16YO, too young to buy tobacco products, in the article I read.

[Dave Plowman (News)]

He made a comment something like this:-

'Thought the law was about smoking at work. I paint houses - not vans.'

[Dave Plowman (News)]

A house painter who pays tax?

[The Medway Handyman]

None however substanciate the Roy Castle myth, because they can't.

I could enter into a pissing contest here and quote as many articles that show no connection, some from FOREST. You would no doubt 'rubbish' any of these as being biased in favour of smoking. You need to be aware that the sources you quote are certainly not gospel, they are also heavily biased towards the anti smoking lobby.

You need to look at who is making the real money out of smoking. Its not the ciggarette companies.

The tax on 20 cigs retailing at £5.66 is £4.33. So the retail price without excessive tax would be £1.33 a pack, £9 a week for a light smoker, half of that in many countries. A weeks supply of patches/gum/whatever would be at least £16. The profits margins for 20 million 'prospective customers' are simply huge. Especially if you get Guvmint & public opinion on your side.

The multi national pharmacuticle companies have incredible influence on political & public opinion, in my other life as a magician I've worked for many of them.

One example; a multi national pharmacutical company developed a drug that could be used for treatment of bone diesese. Every consultant in the field was invited (with partner) to a four day 'seminar' at a top London hotel (£200+ per night).

They were wined & dined at no concern for the expense. I was the after dinner entertainment for one evening, at a fee that many people don't earn in a week, booked via an event management company who provided everything - at a huge margin. The next evening was a river cruise along the Thames, after that a giant scalextrix race track evening.

Total cost for about 100 guests? No actual figures, but at a rough estimate over £150K. Was that drug reccomended & prescribed? Of course it bloody was.

[Andy Hall]

Unfortunately, ignorance of the law has never been an acceptable excuse.

[dennis]

Shhh they will be Part y if he hears you.

[Andy Hall]

The tobacco and drinks companies are pharmaceutical companies as well - they just have a more limited inventory

Probably and actually rather cheap for th ROI

Did it work? Almost certainly This is therefore a marketing event. Perfectly normal business practice.

[The Medway Handyman]

But a "Perfectly normal business practice" that shapes public opinion and political action with no regard for the truth of the matter.

[Andy Hall]

That's an assumption. There is nothing wrong with shaping public opinion provided that the product does what it says on the packet. If it doesn't then that's a different matter.

Given that the company will have spent probably tens of millions developing the product and will have a relatively short period to recover costs and make a profit before the patent runs out, they need to hit the ground running in terms of growing sales rapidly, especially if the drug is prescribed on an ongoing basis.

With that scenario, obviously they are going to target their marketing towards the decision makers in terms of sales.

It's perfectly normal and reasonable marketing. All industry sectors do the same, perhaps in different ways. Corporate entertainment is nothing new. It's irrelevant how much they spent, bit it needs to be enough to be effective while not so much that the marketing budget is blown.

Do you feel bad about the fee? You shouldn't. If it's more than some people earn in a week, that's a separate issue.

[The Medway Handyman]

And if it vaugely does the job, sort of, in some cases, as part of a healthly lifestyle? Statins being a prime example, no direct evidence that cholesterol levels are associated with cardiac problems, huge cost to the NHS in prescriptions, huge profits for the drug companies.

Missing the point. They could equally spend their huge maketing budgets to ensure smoking was demonised - and they have.

But when the size of the budget is enough to change public opinion regardless of the truth?

Not at all. I always add 50% + to my fee when working for ,ulti national pharmacutical companies.

[Grimly Curmudgeon]

We were somewhere around Barstow, on the edge of the desert, when the drugs began to take hold. I remember Andy Dingley saying something like:

That Old Toupé?

[Steve Firth]

That's FOREST as in 100% sponsored by the tobacco industry?

Because of course the repeated assertions of a tobacco addicted odd-job man are so much more valuable as insights than the evidence published in peer reviewed journals. And someone who thinks that absence of evidence is evidence of absence is obviously so qualified to make observations on statistical risk.

Studies have consistently found that non-smoking spouses of people who smoke at home have 20-30% higher risks of lung cancer.[44] And a review of 22 studies found that people exposed to second-hand smoke in the workplace have 24% higher risks of lung cancer. Those who were exposed to the highest levels of second-hand smoke at work had twice the risks of lung cancer.[45]

One study estimates that passive smoking may kill over 11,000 people every year in the UK from cancer, heart disease, strokes and other diseases[46].

Second-hand smoking also causes other health problems in non-smokers including asthma and heart disease. One study showed that even 30 minutes of exposure to second-hand smoke can reduce blood flow in a non-smoker's heart [47].

[44] Taylor, R., F. Najafi, and A. Dobson, Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent. Int J Epidemiol, 2007.PubMed [45] Stayner, L., et al., Lung Cancer Risk and Workplace Exposure to Environmental Tobacco Smoke. Am J Public Health, 2007.PubMed [46] Jamrozik, K., Estimate of deaths attributable to passive smoking among UK adults: database analysis. BMJ, 2005. Epub ahead of print.PubMed [47] Otsuka, R., et al., Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA, 2001. 286: p. 436-41.PubMed

No doubt the long words confused you.

[John Rumm]

Its a grey area... driving to and from your place of work is not considered "business mileage" by most insurers.

[Andy Hall]

Still legitimate. There are a lot of drugs that are in that category.

There are relatively few drugs where it's possible to guarantee that they will have a clear and positive benefit with no downsides under all conditions of use, when used at the same time as other drugs and so on. Large scale, long term clinical studies are needed to determine that.

It is obviously necessary for drug companies to make profits. Their shareholders (e.g. the investment plans and pension schemes) are entitled to expect that. Moreover, R&D and regulatory procedures are very expensive. OTOH, patents limit the time window of when these costs can be recovered before the product goes generic. That is the environment that has been imposed on them. If it is considered to be desirable that they don't charge as much for on-patent drugs then the period of the patent needs to be extended.

I would far rather see NHS funds spent on statins than on treating people with emphysema through smoking.

That's legitimate too provided that they are selling nicotine patches, otherwise probably pointless.

Now we are back to scales and periods of studies. In medicine there are a certain range of drugs and procedures where there is a measurable and definable short term benefit - e.g. break a leg, get it plastered etc. There are some where a benefit such as symptomatic improvement can be seen in a few weeks or months. There are others where it's considerably longer and may even take a lifetime - in other words the measurement can only be made when the patient dies. The study can only be completed to a reasonable degree of statistical accuracy by the use of a large population of patients.

In that sense, what defines truth? in th examples mentioned only the fixing of the broken leg can be described as a clear cut truth. For the others, it is much more analogue and is based on growth of evidence over a period of time. It becomes "true" when there is enough evidence and data such that there is a high probability that outcomes are as predicted.

So what is to be done? Wait until there is a large weight of clinical evidence for something before wide scale introduction? If that route is followed, the clinical evidence can't be gathered because of lack of numbers. This is pretty much the situation with statins. As far as we know, there are not significant downsides in taking a statin and where there are issues they can be readily identified and an alternative one used. We won't finally know for a generation, whether they can make a positive and identifiable improvement and so are using circumstantial evidence and gathering the data using a large population because that's the only way to do it.

On the point of smoking, we have known for a great deal of time that smoking can harm the health of the smoker in numerous ways, many of them due to the various toxic chemicals produced. Evidence for the effects of passive smoking is less detailed and more needs to be gathered. Given that we have some data covering several generations where passive smoking has taken place, we clearly now need to gather evidence for the effect of not having it. That needs to be done as accurately as possible and the only way to achieve it is to a large degree to create a situation where people are not forced to passively smoke in public buildings or places to which there is public access.

Thus it becomes possible for the first time, for the non smoker to avoid smoke altogether in places that he normally goes by virtue of work and other activities and measurements can begin to be made. Given that there is almost always an ethical element to clinical studies and control groups are difficult, it wouldn't be reasonable to say that smoking is allowed in 50% of workplaces and not in the other

50%. If it is determined that those in the non passive smoking group had improved outcome over the passive smoking group, the latter would not be happy. Hence the studies are necessarily longitudinal.

Is that all? I would have charged double. This is not a price sensitive customer.

[Andy Hall]

That is true for employees going to a fixed place of work each day. They don't get reimbursement on a tax free basis for such mileage either and this is easy to define.

It becomes complex when said employee drives to the nominal place of work, then goes to a customer (business) and finally drives home. There are HMRC rules for it, though.

Coming back to our taffy painter... How does he do his daily activity? Most likely he goes to the suppliers of paint and wall paper on his way to the customer or on the way home. I suppose it's possible that he always goes to the customer, then to the merchants and back and finally home, in which case the home to work bit is separable. I think it's a bit unlikely as a way of working however. Even more unlikely is that he orders all the materials by phone or internet and has them delivered to site. That would be the only way to say that the vehicle is used purely for non business purposes.

As it is now, he has opened himself up to being pursued by his insurers in regard to the vehicle being used for business with only personal insurance, and by implication the police by not having valid insurance.

He would have been better off paying the fine and keeping quiet. Clearly he hasn't thought the matter through before going to the press. I didn't know that nicotine also creates muddled thinking.

[Frank Erskine]

If it's a 'fixed' place of work, such as an office, 'home to office' is usually considered to be private, but this guy is presumably going to different places for different jobs, so his travel would definitely be classed as business mileage, especially if carrying tools and materials about.

[Rod]

But the Roy Castle story (whether myth or verifiable) is only one story that is used against smoking.

Ignore it completely, in fact, ignore lung cancer entirely and there is still plenty of evidence that smoking has a mostly deleterious effect on human health. And I am pleased to see smoking on the wane (hopefully that will continue).

But I wouldn't wish to see everyone banned from smoking if that is their wish.

And one side effect of the recent bans has been on those with mental disorders for whom smoking had long been recognised as providing some benefits. The other day I heard of an expensively built centre for sufferers which is no longer used - because they cannot now smoke there

- not even outside.

[Rod]

The question I am always asked is whether I am carrying things related to work. I always declare that I might occasionally have a disc drive or book or something (not just my personal laptop), they have always been perfectly content for that to be included in driving to work. They appear to care about carrying samples, tools, and similar and delivering items or driving to different places regularly (i.e. not usually at one fixed place of work).

[Bob Eager]

I found the difference in insurance rates for occasional 'business use' was very small. Principally I just drive to work, but do go out and give presentations etc. to schools and colleges, or take people to events.

[Huge]

None so blind as those who will not see.