Letters from Home Office & ACMD

Consultation references:

Ref 7: ACMD letter
Ref 8: Caroline Flint letter
Ref 12: My letter to ACMD
Ref 18: Bob Ainsworth letter

 

Question:
Alcohol, tobacco and caffeine are drugs. Why are they not covered by the Misuse of Drugs Act?

Answer from Bob Ainsworth, 22nd January 2003:

… the main legislation concerned with the control of drugs in the United Kingdom is the Misuse of Drugs Act 1971 and the various Misuse of Drugs regulations made under it. The ‘drugs of misuse’ controlled under the 1971 Act are determined under United Nations Convention, the two main ones being the UN Convention on Narcotic Drugs 1961 and the UN Convention on Psychotropic Substances 1971. As signatories to the various United Nations Conventions the United Kingdom is legally obligated to prohibit those substances identified in the UN Conventions as drugs of misuse, where prohibition is regarded as the most appropriate means of protecting public health and welfare.

Tobacco, unlike cannabis, is not identified under the UN Conventions and therefore its usage is not classified as misuse and is not an offence under the law. Although tobacco acts as a stimulant and therefore can be considered a drug it does not contain the intoxicating properties of either cannabis or alcohol.

The Advisory Council on the Misuse of Drugs Technical Committee has been piloting a risk assessment framework that should prove more objective and comprehensive in terms of assessing the risks to health of drugs of misuse. The system consists of assessing the effects of individual drugs against nine criteria, acute physical harm, chronic physical harm, intra-venus harm, pleasure, psychological and physical withdrawal, intoxication, suicidal harm and medical harm. The assessment framework is being evaluated at the moment so I am not in a position to give further details on the results achieved so far.

The Advisory Council on the Misuse of Drugs whilst fully appreciative of the dangers to health of tobacco smoking has not considered recommending tobacco for inclusion in the Misuse of Drugs Act.

Smoking is the greatest single cause of preventable illness and premature death in the UK, and is responsible for around 120,000 deaths every year. It causes 84 per cent of deaths from lung cancer and 83 per cent of deaths from chronic obstructive lung disease, including bronchitis. Since evidence shows that demand for cigarettes is affected by price, it follows that high tax levels can play an important role in reducing overall tobacco consumption and dissuading people from taking up the habit. However, because the habit has a four hundred-year history of social acceptance in the Western world, the Government cannot simply ban it although it does encourage people to stop smoking. The Government believes that adults are entitled to make an informed choice and therefore ensures that full information on the dangers of tobacco are freely available.

The Secretary of State for Health will make and lay before Parliament shortly Regulations to transpose into UK law the EU Directive on the Manufacture, Presentation and Sale of Tobacco Products. These Regulations will require tobacco products to carry larger and starker health warnings, on both the front and back of the packet. A list of warnings to be displayed on cigarette packets has been agreed at Community level and the warnings will be rotated regularly from a list of approved warnings. The dangers of passive smoking are highlighted in the new warnings which include "Smoking seriously harms you and others around you" and "Protect children: don’t make them breathe your smoke." Article 11 of the Directive requires the European Commission to produce a report on the application of this Directive by no later than 31 December 2004. The Government considers that the wording of health warnings may be reviewed in the context of this report.

In addition, the Tobacco Advertising and Promotion Act 2002 received Royal Assent on 7 November 2002. This legislation has been a Government manifesto commitment and is a key element of the wider tobacco control strategy which encompasses education and prevention, service provision and enforcement. The Act bans press, billboard and most internet advertising of tobacco products and the promotion of smoking through free distribution of tobacco products, coupons and mailshots in the UK. Through regulations it will place restrictions on point of sale advertising. It will also bring an end to the promotion of tobacco products through the sponsorship of sporting and other events and will control brandsharing. Draft regulations covering these three areas have been consulted upon and the consultation period ended on 1 5 November 2002.

The Commencement Order setting out the timetable for implementing the various elements of the Act became effective on 20 November and some of the key provisions are as follows

• billboards, press, free distributions 14 February 2003

• in-pack promotion schemes 14 May 2003

• direct marketing contracts (set up before October 1 999) 14 May 2003

It is estimated that banning tobacco advertising and promotion will result in a 2.5% reduction in the number of deaths caused by smoking, eventually saving up to 3000 lives a year. More information can be found on the Department of Health’s website www. doh. gov.uk

I can assure you that we share your concern about teenage smoking. The measures likely to make a particular impact to reduce teenage smoking are:

Questions:
What is the legal definition of the word 'drugs' is in the Misuse of Drugs Act? Does the MDA definition include alcohol, tobacco and caffeine as the WHO and UN's definitions of 'drugs' does? Does the Advisory Council on the Misuse of Drugs have a statutory duty, under Section 1 of the MDA, to advise Government about the harm caused by alcohol, tobacco and caffeine?

The reply from Bob Ainsworth stated that "the 'drugs of misuse' controlled under the 1971 Act are determined under United Nations Conventions". This is untrue as there is no reference to the UN Conventions in the MDA. The MDA makes the ACMD responsible for advising Government about harmful drug use and they have advised about legal drugs such as GHB, the date rape drug, and volatile substances, neither of which are included in UN Conventions.

Answer from Caroline Flint, 27th November 2003:

The Misuse of Drugs Act 1971 (MDA 1971) refers to only controlled drugs, that is to say any ‘substances or product for the time being specified in Part I, II or III of schedule 2 to this Act. As alcohol, tobacco and caffeine are not controlled drugs, they do not fall under the remit of the MDA 1971. However, although alcohol, caffeine and tobacco do fall under the UN’s definition of drugs, the UN has not advised that these substances be brought under control as reflected through these substances not being listed under the Convention on Psychotropic Substances 1971 as controlled drugs.

I would like to clarify the responsibility of the Advisory Council on the Misuse of Drugs (ACMD). The ACMD is an independent non-departmental public body established under the MDA 1971 for the purpose of advising the Government on drug related issues. It therefore does not have an obligation to provide advice to the Government on how to tackle harm brought on by misuse of alcohol, tobacco or caffeine. Owing to the wide use of these substances over a long period of history in modern society and the general social acceptance that has resulted, it is not a realistic or practical option. To criminalise the supply and use of alcohol, tobacco and caffeine would inevitably result in widespread smuggling, law breaking and other associated criminal activity.

Nevertheless, the Government is fully appreciative of the harm caused especially by alcohol and tobacco and is therefore keen to receive the best possible advice. It is the responsibility of the Department of Health and not the ACMD to fulfil this function.

The Government has no intention to bring these three substances under control of the MDA 1971. This is not to say that the Government is not fully aware of the harm caused by them, especially alcohol and tobacco. Consumption of tobacco at any level is dangerous. The issues surrounding alcohol consumption are not as clear-cut. Alcohol in moderation is not dangerous but it can cause social and medical harm if it is misused. Neither the Government, nor the Royal Colleges such as the Royal College of Physicians, advise complete abstinence but instead promote the sensible consumption of alcohol. Over the years there have been numerous initiatives on alcohol that have been undertaken by the Department of Health. For example, the Department of Health in conjunction with the Prime Minister’s Strategy Unit is currently developing an Alcohol Harm Reduction Strategy for England. I understand that [you] responded to the joint consultation carried out by the Strategy Unit and the Department of Health last year. The Alcohol Harm Reduction Strategy for England will be the main vehicle for the Government and other key stakeholders to work together in the future to address the range of harms which can rise from alcohol misuse. The Strategy will be published in time for implementation to begin in 2004, in line with the commitment given by the Government in the NHS Plan.

In relation to tobacco, the Department of Health is taking forward a tobacco programme of work with the help of other key Government Departments. The UK has a good record on tobacco control with a wide range of action taken in the last five years to make it a world leader in tackling harm caused by tobacco. A comprehensive 6-Strand Tobacco Control Strategy is now in place. This includes the NHS Stop Smoking Services, the reduction of tobacco promotion, the reduction in exposure to second hand smoke, education strategy and tobacco regulations. Furthermore, the Government receives advice from the Independent Scientific Committee on Tobacco and Health (SCOTH) on tobacco related issues.

In reference to [your] final paragraph regarding the UK’s relationship with the UN, I would like to confirm that Bob Ainsworth in his letter of 21 January 2003 to [you] was correct to state that the UN has a great influence as to which drugs are controlled in the UK. Although this relationship is not explicitly stated in the MDA 1971, it is a condition which the UK is party to, due to it being a signatory to the three UN Conventions. Under international law the UK is required to bring under control through its domestic legislation any drugs that the UN includes under its list of controlled substances. A recent example of this is the control of Gamma Hydroxybutyrate (GHB), which became a Class ‘C’ drug in the UK from the 1 July 2003. However, the UK is also free to act independently outside of this international legal framework and the ACMD can advise the Government on drugs that it feels require control under the MDA 1971. However for reasons I have already outlined – alcohol, tobacco and caffeine will not be considered by the ACMD for control.

Advisory Council on the Misuse of Drugs, 24th January 2004:

Thank you for your letter to Caroline Flint dated 5 December 2003, concerning the Advisory Council on the Misuse of Drugs (ACMD). Your letter has been passed on to me to respond to.

I note that there has been a considerable amount of correspondence from you to officials and Ministers over several months, most of which focuses on the role of the ACMD with regard to alcohol, tobacco and caffeine within the context of the legal definition of ‘drugs’ as defined in the Misuse of Drugs Act 1971 (MDA 1971).

As you know, there is no definition of ‘drugs’ within the MDA 1971. Whilst it can be argued that the ACMD has a remit to consider alcohol, tobacco and caffeine it has, to date, declined to do so. The ACMD consider that its resources are best served by focussing on controlled drugs or drugs likely to be controlled by the ACMD 1971 [note: MDA 1971 meant]. Albeit independent, the ACMD as an advisory body has to be aware of the Government’s position, which has not given any intention to consider the control of alcohol, tobacco and caffeine.

Equally, I would like to draw your attention to what Caroline Flint stated in her letter of 23 October 2003 to Chris Ruane MP in which she stated that the responsibility of advising Government on alcohol and tobacco related issues largely rests with the Department of Health. As you maybe aware the Department of Health in conjunction with the Prime Minister’s Strategy Unit is developing an Alcohol Harm Reduction Strategy for England and that the Department of Health has also put in place a 6-strand Tobacco Control Strategy.

I hope this is helpful.

Yours sincerely

Saleah Ahmed

ACMD Secretariat

 

Complaint to ACMD about their Hidden Harm report, 22nd June 2003


I write as co-ordinator for Parents Against Lethal Addictive Drugs, a voluntary organisation concerned with drug education.

We are very concerned that the ACMD's recent report Hidden Harm - Responding to the needs of children of problem drug users is seriously misleading due to a very simple error. The word 'drug' in this report is used to mean 'controlled drug' only but there is no mention of this unusual and inaccurate definition.
The report aims to assess the number of children in the UK effected by parental problem drug use and concludes that "there are between 200,000 and 300,000 children in England and Wales where one or both parents have serious drug problems" and that "Problem drug use in the UK is characterised by the use of multiple drugs, often by injection". These statements are untrue. They are only true in reference to the use of controlled drugs and do not include the two drugs that cause the greatest harm, alcohol and tobacco.

The report does admit that legal drugs cause significantly more harm than controlled drugs in one paragraph of this 92 page report but then says "it was decided that it was beyond the scope of the Inquiry to do justice to these two major topics". Instead the report does no justice to these two major topics, omitting their statistics in the summary without comment. It continues: "Our main focus is therefore on problem drug use, with the impact of alcohol or tobacco being considered as additional factors". Again this wrongly implies that alcohol and tobacco are not drugs. This report about parental drug use harmful to children aims to establish "the size and seriousness of the problem" yet omits the two greatest causes, alcohol and tobacco, and so provides a distorted view of the problem. Anyone reading the front cover or summary would have no clue that parental use of legal drugs causes far more harm to children than use of controlled drugs - a vital piece of information.

We are concerned that such mistakes leave the ACMD open to charges of discrimination. The Government receives £20 billion a year from the legal drug trade and here is a report claiming to expose 'hidden harm' that continues to keep the harm from these legal drugs hidden.

As we understand it the ACMD has a statutory duty under Section 1 of the Misuse of Drugs Act to advise Government about drug use that may have harmful consequences for society. This refers to all non-medicinal drugs and is not restricted to controlled drugs since the latter are only defined in Section 2 of the Misuse of Drugs Act.
Why not simply say the report only covers controlled drugs?
Or alternatively the report could conclude that between 200,000 and 300,000 children in England and Wales are harmfully effected by parental controlled drug use; a similar number of children are harmfully effected by parental alcohol use; several million children are harmfully effected by parental tobacco use?

Could you explain the reasoning behind the ACMD's misleading use of the word 'drug' and give an assurance that this error will not be repeated?


Definitions:

* The Misuse of Drugs Act defines 'controlled drugs' as a subset of drugs. The name distinguishes them from drugs not covered by the Act.
* Home Office/DPAS publication Let's Get Real - communicating with the public about drugs states "we need to continue referring to alcohol, tobacco and caffeine as drugs".
* DfES Drugs: Guidance for schools draft for consultation prints at the bottom of every page in large bold writing: " 'DRUGS' refers to ALL DRUGS including MEDICINES, VOLATILE SUBSTANCES, ALCOHOL and TOBACCO".
* The Government's new drug education campaign Talk to Frank says: "Alcohol is the UK's most popular drug" and "Tobacco contains nicotine which is a stimulant drug".
* The United Nations International Drug Control Programme says: "What are drugs? ... This description covers alcohol and tobacco as well as other natural and manufactured drugs".


No reply.

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