a confidence trick. The appearance of confidence both creates confidence and demoralises the opposition. The week before the free vote, we made sure the government got the message that we knew we were going to win and it would be better for them to be on the winning side.
In the event, an overwhelming 91% of Labour MPs who voted came out against the position on which the party had fought the election two years earlier.15 Barron says the contribution from ASH and other charities was crucial to getting the legislation passed:
“The story that was not told at the time was that the charities were rallying their supporters and sending them to their MPs’ constituency surgeries to ask them if they would vote in favour of a comprehensive ban. This was vital information, as we knew what was likely to happen when the actual vote came along in Parliament – we knew we would probably win the first vote. That in the end was what got us the numbers and got us the ban.”
ASH also acted as the secretariat to the all-party parliamentary group on smoking and health and organised a visit by the health select committee of MPs to Dublin to see how the ban already enacted in the Irish Republic was working in practice. Arnott said the campaign went from nowhere to victory in a very short time. ‘Some ideas reach a point at which their time has come,’ she wrote. ‘But some will also often need a vigorous campaign before politicians notice the obvious.’
But ASH wasn’t finished yet. In 2008 the charity published a report reviewing the progress of controls on tobacco and calling for a new law prohibiting retailers from displaying tobacco products, and outlawing the sale of cigarettes and tobacco from vending machines.16 The report also called for the removal of all colours, corporate logos, branding and positive images from tobacco packaging. Within a year, the Health Act 2009 brought in the ban on vending machines, effective from October 2011, and on the display of tobacco products in shops in England, Wales and Northern Ireland. ASH and its coalition partners also campaigned for standardised packaging, which was made compulsory by the Children and Families Act 2014.17 This not only forced tobacco companies to sell their products in packets showing alarming images such as diseased lungs or children wearing oxygen masks, but also outlawed the sale of tobacco in small quantities. After May 2017, smokers were permitted to buy cigarettes only in packs of 20 or larger, and tobacco in 30-gram pouches. Menthol-flavoured cigarettes were banned from May 2020.
These new laws, promoted so effectively by one small charity, have been accompanied by a substantial fall in smoking, which is generally acknowledged to be one of the biggest causes of ill-health. An analysis of hospital admissions published in the British Medical Journal in 2010 showed that in the first year after the ban, emergency admissions for heart attacks in England fell by 1,200, saving the NHS more than £8 million.18 According to Public Health England, 14.7% of adults in England were smokers in 2018, down from 19.8% in 2011.19 In 2000, 26.8% of adults aged 16 and over had been smokers.20
Another campaign that played a part in changing public opinion in the build-up to the ban on smoking in public places was an unmissable TV and poster campaign by the BHF in 2003. It showed repulsive images of fat dripping from the end of a cigarette and fatty deposits being squeezed out of a human artery. It received extensive media coverage, and traffic to the BHF website spiked by 78%.21 Another BHF advert featured two young men in a pub looking at a smiling woman smoking a cigarette. “Ugh,” remarks one. “Like kissing an old ashtray.”
Alcohol campaigns
When the first national coronavirus lockdown began in March 2020, the volume of sales in alcohol shops shot up by a third, according to the Office for National Statistics.22 By September, however, it was clear that the increase in retail sales did not outweigh the loss of sales in pubs and restaurants: a total of 1.3 billion litres were sold in the four months to 11 July, compared with 2 billion litres in the same period the previous year.23 But the charity Alcohol Change UK published a survey in April showing that 20% – an estimated 8.6 million adults – of drinkers were drinking more frequently and 15% of them were drinking more in each session.24 Three months later the charity repeated the research and found that heavier drinking by a minority was continuing even though the first lockdown was easing.25
At the same time the charity also reported a fourfold increase in visits to its website, which has advice and information about how to keep drinking under control and where to find help and support. It also referred to research showing a link between increases in alcohol-related hospital admissions and decreases in spending on alcohol services since 2012. “By properly funding alcohol treatment services the government can save the NHS money, aid the national recovery effort and save lives,” said Dr Richard Piper, chief executive of the charity.
Like many charities, Alcohol Change UK thus led the way during a national emergency in analysing the situation in its area of expertise, coordinating help and support for citizens and arguing for policy change by the government. In doing so it was building on nearly a decade of campaigns by both Alcohol Concern (which combined with Alcohol Research UK in 2017 to form Alcohol Change UK) and CRUK. Dryathlon, which involved giving up alcohol for January, was launched by CRUK in 2013; it was primarily a fundraising campaign, but it also reduced supporters’ consumption of alcohol, which is a known cause of some cancers. In its first three years 170,000 ‘Dryathletes’ raised more than £17 million.26 Dry January, by contrast, was devised by Alcohol Concern as a public health campaign intended to counteract Christmas and new year binge drinking and the growing consumption of alcohol by the British. One study of global drug use suggested that Britons got drunk more often than the inhabitants of any other country in the world.27
The idea for Dry January came from one woman, Emily Robinson, who decided to run a half-marathon in February 2011.28 She found the training hard and decided to see if giving up drinking would help. She noticed not only that she slept better, lost weight and had more energy, but also that everyone wanted to talk to her about what it was like to give up drinking for a while. One year later, Robinson joined the staff at Alcohol Concern and the idea for Dry January 2013 was born.
In that year, 4,350 people signed up. The following year more than 17,000 reported that they had stopped drinking for the month.29 A study by the University of Sussex six months later found that of 900 abstainers surveyed, 72% had kept harmful drinking down afterwards and 4% were still not drinking.30 Alcohol Concern struck up a partnership with Public Health England, and the government contributed £500,000 to Dry January in 2015, funding the campaign’s first radio advertisements.31 That year, 50,000 people gave up alcohol for the month, and in 2017 a YouGov survey found that four million had taken part.32 Although Dry January did not start out as a fundraising event, several other charities joined the campaign as fundraising partners, encouraging supporters to take part and raise sponsorship. The success of Dry January and Dryathlon prompted Macmillan Cancer Support to create its own alcohol-abstinence fundraising event, Go Sober for October, in 2014.
Care of the mentally ill
Charities also led the way during the coronavirus pandemic in identifying its damaging effects on mental health, providing help and support and arguing for improved services. Two months after the first lockdown in March 2020, the Centre for Mental Health – a charity focused on research and policy – published a study estimating that 500,000 more people in the UK would suffer from depression and other mental health problems as a result of isolation, fear, grief, boredom and job insecurity in the expected recession.33 It called for a continued financial safety net, government advice to businesses and institutions and targeted support for former COVID-19 hospital patients and health workers. Mind – the new name for the charity formed when three pioneering organisations merged in 1946 to become the National Association for Mental Health – published a survey showing that 65% of people with experience of mental health problems said their mental health was getting worse, and created a section of its website with
