First, the story. Last July's consultation document floated the idea that all cigarettes should be packaged in plain wrappers. It was welcomed by the health sector as a further advance in discouraging people - especially young people - from smoking. It was rubbished by the tobacco manufacturers and retailers as expensive and likely to encourage cigarette smuggling. Trade unions Unite and the GMB organised a petition claiming that it could threaten jobs in tobacco companies.
The consultation's responses are in, and they fall into two predictable camps. About 55 per cent of responses support all the recommendations, from NHS bodies, charities and groups of young people. About 40 per cent oppose them all, from the tobacco industry. Then there are the mass petitions: 430,000 signatures from smokers and the industry opposing the changes, and 230,000 from non-smokers supporting them.
The government's response is to wait. Australia introduced the world's first plain packaging legislation in December 2012. Our Department of Health has said that in light of the strength of the opposition, it will wait for the evidence of its effectiveness. While it is reassuring to hear the government speak at last about the importance of evidence, it is difficult to avoid the feeling that this issue is being kicked into the long grass.
It is not often described this way, but reducing smoking is almost entirely an issue about young people. Eighty per cent of adult smokers start before they are aged 20. The younger you start smoking, the more cigarettes you smoke each day, the sooner you become addicted and the harder it proves to stop. If you get to the age of 20 before ever trying a cigarette, you are almost certain never to become a smoker. Put simply, the only way to make a real impact on adult smoking levels is to reduce young people's start-up rates.
In the last decade, I was closely involved in developing public health measures for children with the previous government. I remember how hard it was for senior government figures to harness the courage to ban smoking in public places, especially pubs - the political risks of being accused of "nannying" are just so great. What eventually swayed them was the evidence we produced about how young people decide whether or not to take up smoking.
The evidence told us that constantly harping about the health risks makes very little difference to most young people. They know smoking is bad for you - they just don't really believe anything bad will happen to them. Being told that you may die of cancer when you are 40 is not a real threat to most young people. Most well-meaning school anti-smoking campaigns that focus on health risks are shown to delay the age of the first cigarette by a year or so, but in the long run there is often little difference. Some programmes actually seem to increase take-up.
To reduce take-up, we need to reduce any allure that smoking retains. That is why stopping smoking in pubs in particular is likely to be so effective. Smoking is seen as an adult thing, something cool to be done by people you admire; until recently, pubs and smoking went together like strawberries and cream. Now, with the ban, smokers in pubs have to stand outside looking pathetic in the rain, peering forlornly into the brightly lit smoke-free interior where cool non-smokers are doing adult things.
What's to like?
The firm evidence to prove this thesis is not yet in, and it will take a few more years to prove what is almost certainly true - that the pub ban is the single biggest factor in the continuing reduction in numbers of young smokers. Responsible government has always relied on using strong evidence, and then making judgments from it. The government's proposal that it awaits the results of the Australian change, which will take at least four years to produce robust results, is either cowardly or disingenuous.
I can't prove that requiring plain packaging will certainly reduce the attractiveness of cigarettes to young people. But I can say, from related evidence, that the way in which products are portrayed plays an important role in attracting young people. That should be strong enough evidence for a responsible government.
The big question we always have to ask ourselves when we hear of a political decision is "Cui bono" - who benefits? Who benefits from deferring this decision? Certainly not young people. Not health services. Only big business - the tobacco manufacturers.
It took the previous government many years to find the courage to introduce the smoking ban. But once that barrier was crossed, it learned that doing the right thing does bring rewards. This government still needs to learn that. The sooner it does, the better for all of us.
Sir Paul Ennals is a children's services consultant and former chief executive of the National Children's Bureau
