For part I of this article see https://fundacjapromocjazdrowia.wordpress.com/2014/02/25/the-eu-tobacco-products-directive-part-i/
How did the decision of the Polish MEPs to vote for weakening and limiting the Tobacco Products Directive fit into the research-policy nexus? Did they simply disregard the evidence at their disposal?
1. Lack of consensus over evidence
The first factor that influenced the decision to vote against stricter regulation of tobacco products taken by the Polish MEPs was the fact that the anti-tobacco evidence was complex and subject to various interpretations. Health advocates, including the WHO, the EU Commission, health researchers, and anti-tobacco advocates argued that larger health warnings or banning certain tobacco flavouring will have palpable positive effect on the health of Europeans by helping decrease smoking prevalence and initiation. However for changes aiming to modify tobacco consumption randomised experimental evidence is never likely to be available. Natural experiments from around the world were cited by the proponents of stricter regulation, but these were limited and criticised as not easily translatable to the European context. Making twenty the minimum number of cigarettes in a pack was countered by various ‘commonsensical’ arguments claiming that people will just smoke more. Similarly, the arguments over the ban on menthols, based on the evidence that they reduce throat irritation and facilitate initiation, were dismissed by the Polish media as a minor issue – the public opinion struggled to understand why flavoured tobacco products in particular should be banned. The health advocates also failed to link the most resounding argument, that tobacco use and exposure to second-hand smoke claim well over 700,000 lives in the EU every year, with the particular policies proposed in the TPD Revision.
Peter Taylor wrote in his 1984 book The Smoke Ring that smoking ‘is frequently seen only as a matter of industry “villains” versus public health “heroes”. In 2013 the situation was quite different. Health advocates did not have a monopoly on supplying Europarlamentarians with research evidence. Opponents of strict provisions contained in the TPD Revision were effective in providing competing evidence that was seen as credible by the policymakers. They were endorsed by European tobacco farmers, Ministries of Economy of many EU countries including Poland, various organisations coalescing small businesses, and of course the powerful tobacco industry. They proposed evidence suggesting the TPD Revision will have a negligible health impact, criticising the restrictions on ‘harm reduction’ products such as smokeless tobacco, and emphasising the economic toll the changes would have on Europe. Their arguments were promptly picked up by world and Polish media.
The pro-tobacco camp was much more effective at communicating its evidence, particularly to the Polish MEPs. They emphasised the huge revenue Poland gains from taxing tobacco, the amounts of jobs that will be lost if the TPD Revision is implemented in an unchanged form, the rise of cigarette smuggling, and the role of Poland as the biggest manufacturer of flavoured cigarettes and menthols in the EU. Unlike their opponents, they did not take the position of many health advocates who expected their evidence to be unquestioningly accepted. Instead, they made sure the evidence they used would be heard and reiterated by associations of Polish farmers, shopkeepers, and other groups with political leverage. The pro-tobacco camp was better at disseminating and communicating its evidence, but it also had the means to do so – Philip Morris allegedly spent over £1m in 2012 on lobbying MEPs.
2. Goals of policymakers and the existing social environment
On the surface, the TPD Revision provided a wide-open window of opportunity for the implementation of research-based evidence into policy. The Revision itself was proposed by the EU Commission and the Lithuanian government which held the Presidency of the EU in the second half of 2013 was its strong supporter. However, claiming that the political context in 2013 was conductive for the acceptance of this policy proposal would be forgetting the spectre of the ongoing economic crisis in Europe. While during the formulation of the original TPD health arguments were paramount, a decade later research on economic outcomes of the Revision was listened to much more attentively, even by those parties whose main responsibility was theoretically health. This was demonstrated most strikingly by the Polish Health Minister who in June 2013 declared that the Polish MEPs should reject the TPD Revision as its economic consequences could lead to rising levels of euroscepticism in Poland. Political decision-makers sometimes choose to overlook health-related evidence in order to accommodate other legitimate influences on policy that appear more significant in this particular context. This was how the Polish MEPs behaved in regards to the TPD Revision in view of the financial crisis and economic importance of tobacco growing and manufacturing industry in Poland.
In the previous policymaking cycles European health advocates were successful in imposing their framing of the discussion as one over lives saved or passive smoking. This was not the case this time. Successfully framing the debate over the TPD as one over ‘costs’ was an important element of the pro-tobacco lobbyists’ success of making the evidence that supported their case more resonant with the Polish MEPs. The economic costs of smoking were compared with the economic costs of a reduction in sale and manufacture of tobacco products in Poland. The health advocates tried to stand their ground, for example by questioning the high estimates the tobacco industry provided on how much smuggling costs will increase after the TPD Revision is accepted. However, disagreement on how much they should engage the tobacco industry on economic grounds was rife, and they failed to present a united front, with some arguing that certain provisions of the TPD Revision, such as the regulation of e-cigarettes, could be sacrificed. Meanwhile the pro-tobacco researchers and advocates overcame any differences between them forming a tighter policy community by simply rejecting all the proposals of the TPD Revision, which allowed them to present their evidence in a more cohesive and forceful manner. The evidence-based message that reached the policymakers was therefore that the negative economic impact of the TPD will be burdensome on the Polish economy rendered fragile by the financial crisis, and that the declining economic costs of smoking will not be able to make up for this loss.
3. The outcome
As with most policy decisions, policymakers faced tradeoffs – in this case between health and financial considerations – and they made a political choice based on the value that they saw as dominant in society at the time. The Polish MEPs, facing strong pressure from the media and business lobbies, used the research provided by the tobacco industry as ammunition to support predetermined positions. Policymakers therefore did base their decision on a base of evidence, albeit one that they chose strategically. Citing economic evidence, they voted for weakening the TPD Revision.