There are many disturbing facts and accounts in the Feeding Britain report on foodbanks and the financial problems of Britain s poorest. Admirably balanced and non partisan, the thoughtful, considered response it s had from most politicians is well deserved.

Still, there s one aspect of the report that seems a little under explored. Here s a quote from the document

“The other force at work is the addictions that many individuals and families have, but which particularly sharply affects the budgeting of low income families. We refer here to the size of income in some families going on drugs, tobacco and gambling.”

And another

” tackling these serious addictions is as crucial for the overall health of our society as it is in restoring a sense of dignity and control individuals have over their own lives and their tackling of these serious addictions is as crucial for the overall health of our society as it is in restoring a sense of dignity and control individuals have over their own lives and their own budgets. We make recommendations here on how food can be used as a way of kick starting a recovery process for individuals who find themselves in such desperate situations.”

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In other words, let s make sure poor people are eating properly, then we can help them smoke and drink and gamble less.

On that basis, the report then largely ignores the question of spending on booze and fags and gambling. While it discusses the share of household income being spent on food and non alcoholic drinks, utilities and the rest, it has almost nothing else to say about how much is spent on drink and tobacco.

I can understand why. There are too many people who want to focus on the issue in an attempt to argue or just imply that poor people are poor because they chose to be, that they go to food banks because they spend money on the “wrong” things instead of food. My best guess is that the authors didn t want to get into that debate, so they ignored the question.

To be clear, I don t want to make any such argument, or imply any such thing. I suspect some people will glance at the headline of this piece and conclude “Oh look, a heartless Telegraph toff sneering at poor people for smoking.” But that is not what I m about here. I offer no judgement on poor people who smoke if I was in the dire straits described in the Feeding Britain report, I suspect I d want the comfort of a cigarette, or any other earthly pleasure I could get my hands on. And for all that non smokers like me can be prone to look down on weak willed smokers, we should acknowledge that this is a monstrously addictive drug, and remember there but for the grace of God smoke I.

Still, facts are facts whether or not we find them convenient or comfortable. And the fact is that some poor people do spend some of their money on things like tobacco and alcohol. And obviously, a pound spent on cigarettes cannot be spent on food. For reference, the average packet of 20 cigarettes now costs f8.46. So surely a fully rounded look at the issues of food and poverty should include some analysis of spending on such things, shouldn’t it?

Let s start with the basics.

Because the price of goods like alcohol and tobacco is, broadly speaking, fixed, consumption of those goods is regressive a poor person who buys 20 fags a day will spend a much greater share of their income than a rich one. The IFS has estimated that people in the lowest income group spend roughly twice as much of their income on tobacco and alcohol than those in the richest.

There s also some evidence that poorer people are more likely to do things like smoke, and when they do, to smoke more than richer people

I m using 2013 ONS household expenditure data here, and using occupational group as a proxy for income not perfect, but the best I can find today.

The same data show that unemployed people smoke much more than those with jobs

Then there s drink. Poor people drink less often, as it happens

Smoking in particular is worth focussing on here, not least because the Feeding Britain report offers this thought

“A family earning f21,000 a year, for example, where both parents smoke 20 cigarettes a day will spend a quarter of their income on tobacco. Even if people buy illicit tobacco they will still spend 15% of their total income on tobacco. Budgeting support is terribly important, but budgetary support alone is often not enough to equip families to kick their addictive habits when addiction is being fed and defended by some very powerful lobbies.”

Read that again. Some poor families may be spending a quarter of their income on tobacco. A quarter.

That figure is actually even higher than an estimate produced last year by the Institute for Economic Affairs last year, which said that the average smoker from the poorest fifth of households spends between 18 and 22 per cent of their disposable income on cigarettes.

(The IEA also noted that tax on these cigarettes consumes 15 to 17 per cent of those families incomes. A cynic would note that central government therefore has a financial disincentive to reduce tobacco consumption.)

Surely any serious attempt to address food poverty should have more to say about this issue than vague accusations about “powerful lobbies” exploiting the poor? Surely any move to ensure that poor people can and do spend more money on good food has to include an attempt to reduce the amount they spend on tobacco? Surely it s not good enough to say that we have to sort out the food problem before we can sort out the tobacco problem? Because the basic economic fact is that tobacco is part of the food problem.

Again, just to repeat the caveat, I don t raise this to criticise or denigrate those on low incomes who spend money on tobacco. I raise it because any attempt to discuss the problems of those people that doesn t address their full spending patterns is incomplete and likely to fail.

If you care about poor people and want them to eat better, get them to spend less on smoking. Does that mean banning cigarettes? Taxing them even more? Or actually cutting the tax to make them cheaper? Or doing much, much more to help and encourage them to quit? There may well be an argument to be made for all of those options, and others besides. Sadly though, that’s not part of the foodbank debate today.

Some lung patients buy cigarettes along with meds at pharmacies: study

Cigarettes online Blog Archive Marlboro online » marlboro red

By Steven Reinberg
HealthDay Reporter

MONDAY, Oct. 20, 2014 (HealthDay News) While picking up a prescription for cholesterol lowering medication, about one in 20 people with conditions such as asthma, chronic obstructive pulmonary disease (COPD) or high blood pressure will also purchase cigarettes, a new study finds.

Six percent of people with asthma or COPD, and about 5 percent of people with high blood pressure or those picking up oral contraceptive bought cigarettes, the researchers found.

“While smoking itself can cause many health problems, it can worsen certain conditions and have other effects on medications,” said lead researcher Joshua Gagne, an assistant professor of medicine at Harvard Medical School in Boston.

For example, smoking can worsen respiratory conditions and can increase blood pressure, the researchers wrote. Smoking can also increase the risk of heart attack and stroke in oral contraceptives users, Gagne said.

In February, the pharmacy chain CVS announced that it would no longer sell tobacco products at its stores beginning in October 2014. CVS said it was making the move because selling tobacco products isn’t in keeping with a pharmacy’s mission of helping to protect people’s health. The company said it was the first national pharmacy chain to halt the sale of tobacco products.

“Ending the sale of cigarettes and tobacco products at CVS/pharmacy is the right thing for us to do for our customers and our company to help people on their path to better health,” Larry Merlo, president and CEO of CVS Caremark, said in a news release. “Put simply, the sale of tobacco products is inconsistent with our purpose.”

For the study, Gagne and his colleagues looked at data from CVS on more than 361,000 customers who filled prescriptions for statins (cholesterol lowering drugs) between January 2011 and June 2012. The researchers linked this data to all purchases at CVS stores.

The study found that people who purchased cigarettes while picking up a prescription made twice as many visits to the store compared to those who didn’t buy cigarettes.

Of course, it’s still easy for smokers to buy their cigarettes elsewhere, Gagne said. However, pharmacists can play an important role in helping patients stop smoking, he said.

“Pharmacists are trained in smoking cessation counseling and are often among the most accessible and most frequently visited health care professionals. Rather than providing an opportunity to promote smoking, pharmacy visits should represent an opportunity to help patients quit,” Gagne said.

Dr. Norman Edelman, senior scientific advisor at the American Lung Association, said, “Making the purchase of cigarettes easy for those most at risk from smoking is certainly not good public health practice.

“It would seem obvious that stores which are selling ‘health’ have a responsibility to avoid selling products which lead to death and disability,” he said.

The American Lung Association has entered a partnership with CVS to combat lung cancer, which is primarily caused by smoking, Edelman said. “We applaud their decision to discontinue selling cigarettes and hope other drug outlets will do the same,” he said.

When CVS announced its decision, its largest competitor, Walgreens, said that they planned to continue selling tobacco products.

According to published reports, Walgreens said in a statement that since tobacco sales in pharmacies make up only 4 percent of total tobacco sales, there would be “little to no significant impact” on smoking if they stopped selling tobacco.

The company noted that it sells a variety of products to help people quit smoking.

“We believe that if the goal is to truly reduce tobacco use in America, then the most effective thing retail pharmacies can do is address the root causes and help smokers quit,” Walgreens spokesman Jim Cohn said in the statement.

The new study was published Oct. 20 online in JAMA Internal Medicine.

More information

For more information on smoking cessation, visit the U.S. Centers for Disease Control and Prevention.

SOURCES Joshua Gagne, Pharm.D., Sc.D., assistant professor of medicine, Harvard Medical School, Boston, Mass. Norman Edelman, M.D., senior scientific advisor, American Lung Association Oct. 20, 2014, JAMA Internal Medicine

Last Updated Oct 20, 2014

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