ASA Adjudication on Department of Health

Ad

A TV ad, produced by the NHS, for the campaign "Smoke Free.co.uk". The ad showed a wedding reception. A woman lit a cigarette and blew thick black smoke across the room. Children and adults were shown inhaling the smoke. A voice-over stated "Most cigarette smoke in a room comes from the lit end. Unfiltered and even more toxic, it attacks vital organs of everyone who breathes it, increasing their chances of heart disease by a quarter, even if they've never smoked. But the scariest thing is you can't even see it. 85% is invisible. Second-hand smoke, the invisible killer". On-screen text stated "SECONDHAND SMOKE. THE INVISIBLE KILLER".

Issue

1.  Imperial Tobacco Ltd and 26 viewers challenged whether the claim "increasing their chances of heart disease by a quarter, even if they've never smoked" was misleading and could be substantiated.

2.  12 viewers thought the ad was offensive to smokers.

3.  Imperial Tobacco Ltd and 12 viewers thought the ad was an unjustified appeal to fear.

4.  Two viewers challenged whether the claim "it attacks vital organs of everyone who breathes it" was misleading and could be substantiated.

5.  Three viewers, who believed the evidence linking second-hand smoke to potentially fatal diseases was based on research into the effects of long-term exposure, challenged whether the ad was misleading, because it implied an increased risk of potentially fatal diseases from short-term exposure to second-hand smoke.

6.  Two viewers challenged whether second-hand smoke was "even more toxic" than directly inhaled smoke.

BCAP TV Code

Response

1.  The Department of Health (DH) referred to reviews and meta-analyses of the existing scientific evidence on the impact of second-hand smoke on non-smokers' health, including the update from the Scientific Committee on Tobacco and Health (SCOTH) from 2004 which reviewed evidence on second-hand smoke since 1998, a report by the House of Commons Health Committee from 2005 and "The Health Consequences of Involuntary Exposure to Tobacco Smoke" a report of the Surgeon General, US Department of Health and Human Services from 2006.  The SCOTH and Health Committee reports concluded that non-smokers exposed to second-hand smoke had an increased relative risk of coronary heart disease of 25%.  The Surgeon General's report estimated the increased risk at 25 - 30%.

The Broadcast Advertising Clearance Centre (BACC) considered that the evidence referred to by DH substantiated the claim.

2.  DH argued that the ad focused on smoke, not people.  They said the ad brought to life the fumes that were present but invisible in the air surrounding people in smoky environments.  DH pointed out that the smoker portrayed at the beginning of the ad was shown to be as oblivious to the invisible fumes as everyone else present and that she showed consideration by trying to waft the visible smoke away from her fellow guests.  They emphasised the intention of the ad was to educate and not to offend.

The BACC considered that, although the message might cause discomfort to some smokers, the evidence that linked second-hand smoke to potentially fatal diseases justified the visual treatment of the ad.

3.  DH said the aim of the ad was to show that second-hand smoke existed, that it was dangerous and that its presence could not always be detected by sight and smell only.  They pointed out that a large body of evidence linked it causally to potentially fatal diseases.  They considered the ad communicated that message straightforwardly and practically.

The BACC considered that the dangers posed by second-hand smoke justified the visual treatment of the ad and that, although the ad was sinister in tone, they did not consider it distressing.  They pointed out that no one in the ad was shown in distress and argued that the juxtaposition of the happy wedding scene and the unseen danger of second-hand smoke was powerful and thought-provoking but not gratuitous.

4.  DH pointed out that the evidence they had sent demonstrated a causal link between second-hand smoke and lung cancer and coronary heart disease.  They added that the evidence showed there was no risk-free level of exposure to second-hand smoke and that non-smokers exposed to second-hand smoke had raised levels of tobacco breakdown products and tobacco-related poisons and carcinogens in their bodies.

The BACC considered that the evidence referred to by DH substantiated the claim.

5.  DH reiterated that the evidence they had sent showed there was no risk-free level of exposure to second-hand smoke.  They explained that second-hand smoke made blood platelets more sticky within 30 minutes after exposure to smoke, which meant the non-smoker who inhaled it would develop a higher risk of a blood clot forming in a narrowed artery and blocking the blood flow, which could trigger sudden death, heart attack, angina pain or heart failure.  They referred to a report by the Royal College of Physicians which stated that platelets were very sensitive to the effects of tobacco smoke and that experimental studies had shown that smoking one or two cigarettes a day had a similar effect on platelet aggregation to that seen in non-smokers exposed to second-hand smoke for 20 minutes.  They added that the Surgeon General's report stated exposure to second-hand smoke had an immediate adverse effect on the cardiovascular system.

The BACC considered that the evidence referred to by DH substantiated the claim.

6.  DH referred to the Royal College of Physicians' report and explained that second-hand smoke was made up of mainstream smoke and sidestream smoke.  They explained that mainstream smoke was the smoke produced by the smoker drawing air through a cigarette in the act of smoking and that sidestream smoke arose from the lit end of the cigarette, mostly between inhalations or after smoking had finished. They said that, typically, sidestream smoke accounted for about 85% of second-hand smoke, and most of the remainder was exhaled mainstream smoke.  They said the Royal College of Physicians stated that, of the 16 known carcinogens in tobacco smoke under examination in their report, about three quarters had higher concentrations in sidestream smoke than in mainstream smoke and added that formaldehyde was present in sidestream smoke at about 15 times the concentration in mainstream smoke.

The BACC considered that the evidence referred to by DoH substantiated the claim.

Assessment

1.  Not upheld

The ASA noted the evidence to which DH referred.  We considered the general reviews of evidence by SCOTH and the Surgeon General demonstrated that there was a scientific consensus that exposure to second-hand smoke resulted in an increased risk of coronary heart disease of about 25% among non-smokers.  We concluded that DH had substantiated their claim and that the ad was not misleading.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rules 5.1 (Misleadingness) and 5.2.1(Evidence), but did not find it in breach.

2.  Not upheld

We acknowledged that some smokers might find the issue of second-hand smoke to be a sensitive one.  We noted DH's argument that the ad focused on smoke, not people.  We considered that the ad did not present stereotyped or negative images of smokers as people and that it concentrated solely on the issue of second-hand smoke's impact on the health of smokers and non-smokers.  We concluded that the ad was unlikely to cause serious or widespread offence.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rule 6.1 (Offence), but did not find it in breach.

3.  Not upheld

We noted that no one in the ad was shown in distress and that the tone of the voice-over was measured.  We considered that the visual treatment was a reasonable and effective way of alerting viewers to the presence of unseen, second-hand smoke.  We considered that the evidence of the harmful and potentially fatal effects of second-hand smoke sent by DH justified the claims made in the ad.  We acknowledged that some viewers might be alarmed by the implications of the claims made, but considered that the effect of second-hand smoke on health justified DH's approach and that the language of the ad was proportionate.  We concluded that the ad was unlikely to cause serious distress to many viewers.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rule 6.4 (Personal distress), but did not find it in breach.

4.  Not upheld

We noted that the evidence DH had sent demonstrated a causal link between second-hand smoke and lung cancer and coronary heart disease.  We considered that DH had substantiated the claim and concluded the ad did not mislead.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rules 5.1 (Misleadingness) and 5.2.1(Evidence), but did not find it in breach.

5.  Not upheld

We noted that the evidence sent by DH showed there was no risk-free level of exposure to second-hand smoke and that the Surgeon General's report stated exposure to second-hand smoke had an immediate adverse effect on the cardiovascular system.  We noted that the Surgeon General's report also stated that exposures to second-hand smoke in different environments were supposed to be additive and that it argued there was no biologically plausible reason to suppose that the effect of second-hand smoke exposure differed from one environment to another.  We acknowledged that the ad presented one scene of short-term exposure to second-hand smoke and did not narrate an example of long-term exposure, for example of a non-smoker cohabiting with a smoker.  However, we considered that the scene shown in the ad was an acceptable, illustrative example of one situation in which people might be exposed to second-hand smoke.  Because we understood that second-hand smoke had an immediate adverse impact on health and that any exposure, however short-term, could contribute additively to the development of potentially fatal illness, we concluded that the ad was not misleading.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rules 5.1 (Misleadingness) and 5.2.1(Evidence), but did not find it in breach.

6.  Not upheld

We noted that the evidence sent by DH showed smoke from the lit end of the cigarette had higher concentrations of many known carcinogens than exhaled smoke.  We considered DH had substantiated the claim and concluded the ad was not misleading.

On this point, we investigated the ad under CAP (Broadcast) TV Advertising Standards Code rules 5.1 (Misleadingness) and 5.2.1(Evidence), but did not find it in breach.

Action

No further action required.

Adjudication of the ASA Council (Broadcast)