Mission Creep: ASH's pivot to alcohol
The numbers tell a remarkable story. Smoking rates in the UK have plummeted to 10.6%, down from over 50% in the 1960s. For Action on Smoking and Health (ASH), the campaigning charity founded in 1971, this represents an extraordinary achievement.
Most people would say mission accomplished. Yet at the moment of its greatest success, the organisation appears to be quietly expanding its remit in ways that merit scrutiny.
Under a new Chief Executive, ASH has increasingly aligned itself with alcohol policy campaigns that mirror the controversial framing that there is no safe level of alcohol consumption. This represents a notable shift for an organisation whose very name suggests a singular focus on smoking and health.
The clearest evidence of this strategic pivot came in January 2024, when ASH joined forces with the Obesity Health Alliance and the Alcohol Health Alliance to publish "Holding Us Back: Tobacco, Alcohol and Unhealthy Food and Drink". The report called for a coherent government strategy treating tobacco, alcohol and unhealthy foods as a unified policy challenge, advocating for restrictions on alcohol advertising, minimum unit pricing and increased taxation. More recently, in December 2024, ASH published a blog post arguing that alcohol should face the same online advertising restrictions as tobacco and vaping products, stating that "alcohol remains a glaring exception" to marketing controls.
Collaboration and organisational sustainability
This collaboration with alcohol campaigners may not seem inappropriate. Yet public health organisations working together on developing regulatory frameworks governing different harmful substances invite uncomfortable questions about organisational sustainability.
Consider the financial context. ASH receives its core funding from Cancer Research UK and the British Heart Foundation, two organisations whose primary concerns extend well beyond tobacco. As smoking rates have declined dramatically, the rationale for sustained investment in anti-smoking campaigns becomes less compelling to funders and policymakers alike. Local authority spending on tobacco control has already fallen by £41.3 million since 2014/15, a 30% decline.
A victim of its own success?
With adult smoking rates now at historic lows and the government's Tobacco and Vapes Bill poised to create a "smokefree generation" by prohibiting tobacco sales to anyone born after January 2009, one might reasonably ask: What does a tobacco control charity do when tobacco control has largely succeeded?
The temptation to broaden the mission is entirely understandable. ASH has built considerable expertise in advocacy, media relations and evidence-based campaigning. It has established relationships with policymakers and commands respect in public health circles. Why not apply these capabilities to other pressing health challenges?
For alcohol brands, this matters. When multiple public health organisations align around a single framing, such as “no safe level”, they amplify and legitimise it beyond the boundaries of scientific consensus. What begins as a contested claim can quickly become received wisdom. Once that shift occurs, regulatory tools previously confined to tobacco, from advertising bans to sponsorship restrictions, become politically transferable with far less resistance. This is how regulatory contagion spreads.
The scientific debate
That strategic expansion carries risks for organisations like ASH, particularly when it involves adopting positions that remain scientifically contentious. The "no safe level" framing on alcohol has faced criticism from researchers who question whether moderate consumption truly poses comparable risks to tobacco use. Unlike smoking, where the dose-response relationship is clear and unambiguous, alcohol presents a more nuanced picture. Some studies continue to suggest potential cardiovascular benefits from light to moderate consumption, though these findings remain disputed.
Alcohol, in contrast to tobacco, occupies a different space in both scientific literature and social custom. Most adults in the UK consume alcohol responsibly and in moderation. The potential harms, while real and sometimes severe, are concentrated among heavy drinkers rather than distributed uniformly across all consumers.
Credibility and coalition risks
By embracing the most restrictive interpretation of alcohol risk, ASH may be straying beyond its area of established credibility. The organisation's authority derives from decades of rigorous work on tobacco. That authority does not automatically transfer to alcohol policy, where reasonable people can and do disagree about appropriate regulatory approaches.
Diversifying into alcohol policy risks diluting this focus at precisely the moment when finishing the job on tobacco requires renewed commitment. It also risks alienating potential allies. Many people who support tough tobacco regulation may feel differently about alcohol restrictions. By yoking these causes together, ASH may find its coalition narrowing rather than expanding.
So does expanding its remit serve the public interest or organisational self-preservation?
The most generous interpretation is that ASH genuinely believes its expertise in challenging corporate power and shifting social norms can be usefully applied to multiple risk factors. A more cynical reading would suggest that as smoking becomes less prevalent, anti-smoking organisations face an existential challenge that can only be addressed by finding new dragons to slay.
The truth likely lies somewhere between these extremes. Organisations, like people, resist their own obsolescence. There is nothing inherently wrong with that. But there is a difference between natural evolution and opportunistic expansion. ASH's pivot to alcohol policy, however well-intentioned, looks uncomfortably like the latter.
An alternative path
Perhaps the most honest approach would be for ASH to acknowledge that its historic mission is approaching completion. Rather than reinventing itself as a general-purpose public health campaigner, it might declare victory on tobacco, secure its institutional legacy, and either wind down operations or transition to a focused maintenance role supporting implementation of existing smoke-free policies.
That would be a fitting conclusion. Sometimes the best thing an organisation can do is recognise when the job is done and step aside gracefully, rather than searching for new problems that justify continued existence.
The broader implication
Whether ASH’s pivot is strategic evolution or institutional self-preservation is ultimately secondary. The more important question is what happens when multiple public health organisations align around a single moral framing. If “no safe level” shifts from contested claim to settled belief, regulatory expansion becomes politically straightforward. For alcohol brands, the risk is not simply more lobbying pressure, but the quiet consolidation of a narrative that reshapes what is considered legitimate before formal policy debates even begin.
