Tuesday, 22 July 2014

Plain packaging porky pies

In the last post—about the deceitful claim that there has been a "huge drop" in smoking rates since plain packaging was introduced in Australia—I mentioned that no UK newspapers had been dumb enough to report this propaganda. That was true at the time of writing, but, in the end, the Daily Mail and the Financial Times fell for it.

The Mail will print anything, but I expect more from the FT so I was pleased to see that they have at least published a couple of letters to help put the record straight...

Sir, Your report of the fall in smoking rates in Australia (“Australia smoking rates tumble after plain packaging shift”, FT.com, July 17) painted the results as strong evidence that plain packaging is causally linked to smoking prevalence. It quoted advocates who described the new data as “really dramatic and exceptionally encouraging” and likened plain packaging to the discovery of a vaccine against lung cancer.

When the representatives of Imperial Tobacco cast doubts on this interpretation in the penultimate line, my reaction was: “Well they would say that, wouldn’t they?”

But I was troubled that the only data cited were from 2010 and 2013 and not from earlier in the series of data points. Few, I assume, went to the trouble of accessing the survey. It is a pity your report did not include this graph from the Australian Institute of Health and Welfare, which makes it more difficult to make the link between plain packaging and smoking rates.

Readers should be trusted with analysis of data ourselves, instead of having lobby groups do it for us.

Dr Eoin O’Malley, Dublin City University, Ireland

There is also a letter from the managing director of JTI...

Sir, As a director of the second largest tobacco company in the UK, I am concerned by some of the misleading statements by tobacco control lobbyists reported in your article “Australia smoking rates tumble after plain-packaging shift”, FT.com, July 17).

In fact, the recent Australian smoking prevalence data reinforce the fact that plain packaging does not work.

Daily smoking prevalence declined by 2.3 per cent between 2010 and 2013, consistent with the pre-existing trend. The decrease between the introduction of plain packaging in December 2012 and December 2013 cannot be measured because that level of detail is not available. It is wrong to suggest plain packaging has worked, let alone to report that smoking rates have tumbled as a result.

The data also show that underage smoking has increased in the same period, reversing previous declines. While this obviously undermines the claims of the tobacco control lobbyists, it doesn’t necessarily mean that plain packaging led to the increase. Pretending otherwise would be a misrepresentation of the statistics to fit an ideology. Such junk advocacy should not form part of public policy debate and is no substitute for robust evidence.

Daniel Torras, Managing Director, JTI UK

The point about underage smoking is a good one. As Dick Puddlecote mentioned recently, the same data set that shows the - cough - "huge drop" also shows a rise in underage smoking between 2010 and 2013.

It is also worth noting that ASH are also lying when they claim that "Standardised packaging is the only new policy intervention over this time period and is therefore the most likely reason for the significant fall in smoking prevalence." In fact, there was a 25 per cent tax hike on tobacco in April 2010 which the Australian health minister specifically predicted would cause 2 to 3 per cent of smokers to quit.

There has subsequently been another tax hike (of 12.5 per cent) in December 2013 which led to a fall in (legal) tobacco consumption in the first quarter of this year. As mentioned in a previous post, this tax rise spared the blushes of anti-smoking campaigners because the data clearly show tobacco consumption rising in the first year of plain packaging (2013). Naturally, they ignored the 2013 data and claimed that the decline that followed the tax rise was the result of plain packaging.

All in all, just another week of porky pies in the world of tobacco control.

Thursday, 17 July 2014

Dogs bark, cows moo, ASH lies

Even by ASH's standards, this is staggeringly dishonest...

Huge drop in Australian smoking rates attributed to standardised packs
New figures released by the Australian government have shown adult smoking rates have fallen by a massive 15%. Before the measure was introduced in December 2012, daily smoking prevalence stood at 15.1% and has now fallen to 12.8%. Standardised packaging is the only new policy intervention over this time period and is therefore the most likely reason for the significant fall in smoking prevalence.

If the smoking rate has really fallen from 15.1% to 12.8% in the year and a half since plain packaging came in, that would be good prima facie evidence that the policy is working. Smoking rates in Australia have been falling since the 1970s, but a decline of 2.3 percentage points would be two or three times greater than the annual decline.

Impressive stuff, then, and ASH's Deborah Arnott is excited:
Deborah Arnott, Chief Executive of health charity ASH said:"The UK government is currently consulting on standardised packaging before deciding whether to proceed and has asked for new and emerging evidence. Well here it is and it demonstrates a massive decline in smoking prevalence in Australia following introduction of standardised packaging. This is exactly the strong and convincing evidence the tobacco industry said was needed."

There's only one problem. She's lying. Almost incredibly, the date ASH describes as being "before the measure was introduced" was not November 2012 (the month before plain packaging came in). It is not 2012 at all. It is not even 2011. The date they are referring to is 2010, more than two years before plain packaging was introduced.

ASH even gives the reference to the Australian report in its press release so that anyone can check it. I urge you to do so. It very clearly shows a steady and gradual downward trend in smoking rates going back to 1993. There is no increase in the rate of decline in 2013 and no effect from plain packaging. The rate has not "fallen by a massive 15%" since plain packaging came in, as ASH claims, and there has not been "a massive decline in smoking prevalence in Australia following introduction of standardised packaging". 

The data show that the smoking rate has been falling by 0.4-0.9 percentage points every year for twenty years and has continued to do so since plain packaging came in. There has not been a "huge drop" in smoking rates since the policy was enacted. There has been, at best, a mundane and totally predictable continuation of the secular decline.

The report that ASH uses as its sole reference says that "daily smoking declined significantly between 2010 and 2013 (from 15.1% to 12.8%)". This is a three year period. There is no mention of a three year period in the ASH propaganda. Their trick is pathetically simple. They are taking a three year gradual decline and pretending that it is a one year "huge" decline. There is nothing more to it than that. It is a piece of transparent mischief that a child could see through.

Use whatever term you want - "spinning", "bending the facts", "twisting the truth" - but ASH are doing what they have been doing for years. They are - quite simply - lying, and they are using the crudest of tricks to do so.

Credit to the British media for doing due diligence on this trash and not reporting it. The same cannot be said for the Sydney Morning Herald which has reported it as fact and included a quote from the parasitic sociologist Simon Chapman that does the unthinkable by making ASH look almost honest. I advise you to sit down before reading it...

"It's almost like finding a vaccine that works very well against lung cancer," said Simon Chapman, a professor in public health at the University of Sydney.
These people are truly amongst the greatest and most brazen charlatans of our time.

Tuesday, 15 July 2014

Sin tax interview

I recently talked to David Pakman about sin taxes. Here's the video.

See also The Consequences of Not Mugging You.

Monday, 14 July 2014

Punishing the Majority: a reply to Will Haydock

Somewhat belatedly, I'd like to reply to a post by Will Haydock about the IEA report I wrote with John Duffy last month. Titled Punishing the Majority, the report looked at the claim that per capita consumption of alcohol is the determining factor of levels of alcohol-related harm and that governments should introduce policies to control or reduce average consumption in order to reduce problematic consumption (AKA the Total Consumption Model or Whole Population Approach). Using real world data and citing decades of research, we show that this theory does not stack up and recommend that policy be aimed at problem drinkers rather than the general population.

Will points out that you don't need to believe in the TCM in order to believe in whole-population policies such as tax rises...

There isn’t any necessary link between the Total Consumption Model and whole population approaches to alcohol policy. There are all sorts of reasons for identifying a whole population solution even if you know the problems are caused by individuals. 

If Will means that the policies that are proposed by advocates of the Total Consumption Model (TCM) can be justified on other grounds, I agree. The government could put up alcohol taxes on the basis that it would have a deterrent effect on heavy drinkers even if it did not care whether overall (per capita) consumption went up or down.

Sometimes this might be about the ease of administering a policy. For example, we place fixed age limits on alcohol consumption, even though potential drinkers mature physically and mentally at different rates, and won’t all be equally well prepared to deal with alcohol at the same age.

I agree that there are perfectly good reasons for having an age limit on alcohol purchase, but raising the limit isn't a big issue for advocates of the Total Consumption Model and the existence of a limit can clearly be justified on other grounds (eg. child protection).

Sometimes this might be about equality. There’s something attractive about the idea that all units of alcohol should be treated (and taxed) in the same way, rather than differentiating on the basis that more problems are associated with a particular drink. 

I happen to agree with that, but it's not really the issue here and, again, it's not something that fans of the TCM are particularly vocal about.

Finally, support for a whole population approach might be political (or perhaps more accurately moral). Kettil Bruun supported a population-wide approach partly because he felt it might avoid stigmatising dependent drinkers. 

He did, and we discuss his motives in the report. Bruun didn't like the stigmatisation of alcoholics in Scandinavia at the time and he tended to think that society, rather than the individual, was to blame for alcohol misuse. This drew him towards a dubious but highly influential version of the TCM—the Ledermann hypothesis—which he used like a drunk uses a lamppost: for support rather than illumination. Bruun was well-meaning and the treatment of alcoholics in post-war Scandinavia could certainly be draconian, but he went to the opposite extreme by ignoring personal responsibility and treating people like helpless pawns of industry and institutions (as socialists and 'public health' people tend to do).

That is, population-level approaches needn’t have the Total Consumption Model as their cornerstone.

I think we agree so far. However...

More importantly, though, population-wide policies aren’t the ‘cornerstone’ of the Total Consumption Model, as Chris also seems to suggest on his blog. The TCM might prop those policies up, but it would be back-to-front thinking to have the solutions explaining a problem. 

It's hard to believe that Will really thinks that raising prices and restricting advertising and availability are not the cornerstone policies of the TCM, but he must do because he says the same thing again towards the end of his blogpost:

Whole population policies might or might not be a sensible approach to alcohol, but it’s misleading to focus on the idea that ‘The 'cornerstone policies' of the Total Consumption Model involve raising taxes, restricting advertising and limiting availability’, since these policies can be justified in a number of other ways.

This is a simple fallacy. Just because these policies can be justified on other grounds does not mean that one school of thought does not place great importance on them. Of course these policies are at the cornerstones of the Total Consumption Model. They are mentioned in virtually every document produced by supporters of the model since the early 1970s and they are the cornerstone policies of the neo-temperance lobby in Britain today. 

Don't take my word for it. Here's what James Nicholls has to say in his 2009 book, The Politics of Alcohol. On pages 252-3, he lists various anti-drink campaigns seen in England over the centuries along with their 'core arguments' and 'preferred solutions'. At the bottom of the list is the most  recent breed, termed 'Public health'. Its 'core argument', he says, is 'Per capita increases in consumption lead to increases in all alcohol-related problems' and that 'Drink should be tackled at the population level'.

Quite obviously, this is the total consumption/whole population approach and the 'preferred solutions' are, he says, 'Tax increases' and 'Restrictions on alcohol through licensing controls'. I won't put words in James's mouth, but I'd be surprised if he didn't agree that restrictions on advertising are also part of their arsenal.

Who believes in this approach? Lots of people in 'public health'. On page 236, James writes: 'In 1994, a major report entitled Alcohol and the Public Good had argued that focusing on problem drinkers was less effective than tackling overall consumption across the population... These conclusions had been reiterated in another major international report compiled by public health researchers in 2003. The consensus among these researchers was that population-based approaches were the only sure way to tackle alcohol-related problems, and that the most effective way to reduce overall consumption was through raising prices via taxation and reducing access to alcohol via licensing restrictions.'

And, lest you think that this approach has since been abandoned, he notes—on page 250—that the establishment of the Alcohol Health Alliance in 2007 'marked an important moment in the development of a coordinated campaign, led by public health campaigners, for action to reduce per capita consumption through tax increases and stronger licensing restrictions' (my emphasis). He also mentions that this was the 'new consensus among alcohol campaigners'.

James's complaint about Punishing the Majority was that it overstated how influential the Total Consumption Model has been in terms of policies that have actually been implemented (as opposed to policies that the 'public health' lobby would like to see implemented). I can understand why he says that and I have responded here. He is right about licensing, which has been relaxed in the last decade, but I maintain that the UK's alcohol taxes and advertising restrictions reflect a belief in reducing per capita consumption (indeed, when writing about the large tax rises on alcohol that began in 2008, Nicholls writes that 'by framing the announcement in terms of affordability, and by effectively targeting all drinkers, the Treasury had accepted a key tenet of the population model' although he adds that this is 'something they had resisted forcefully for decades' (p. 246).)

Politicians do not need to be familiar with Kettil Bruun and bell curves in order to implement population-based policies. As Will says in his blog post, justifications for policies such as tax rises can be found without resorting to the Ledermann hypothesis. The IEA paper was intended only to assess the validity of the Total Consumption Model which, as we show, is explicitly supported by many 'public health' organisations. We wanted to test two claims: (a) that alcohol-related harm will inevitably fall when per capita consumption declines, and (b) that the policies favoured by the public health lobby are effective in reducing alcohol consumption and/or alcohol-related harm.

To test these claims, we only need to look at countries which have either seen per capita consumption decline or have introduced tax rises, ad bans and/or restricted licensing. It doesn't matter whether the politicians are ideologically committed to the Ledermann hypothesis or are persuaded by those who are—or have completely different motives (such as raising taxes to raise revenue).

Chris’ problem with the Total Consumption Model is that it (apparently) supports population-wide policies, which he says are likely to be ineffective, but we haven’t even agreed on how that potential efficacy might be judged. 

Haven't we?! I thought the aim was to reduce alcohol-related harm by reducing per capita alcohol consumption. Therefore we surely judge the efficacy by looking at the incidence of alcohol-related disease and mortality. This is what we do in the report and, in line with other studies that we cite, we find the claim that alcohol-related harm is fixed to overall consumption to be false.

I’m sticking my neck out here, because this isn’t quite the reasoning he offers on the blog, but I have a suspicion that the reason he doesn’t like population-wide policies is because they might affect people whose drinking impinges on no-one but themselves. 

No kidding. Why do you think it's called Punishing the Majority? We say on the very first page that population-wide policies 'have significant general welfare costs' which include 'the deadweight costs of taxation, the welfare cost of being unable to drink at chosen times and search costs incurred by limitations on advertising.'
However, as I’ve noted, there are lots of other arguments in favour of population-wide policies other than the TCM.

Fine. Argue for them on different grounds (although I think you'd still lose the argument). All we're saying is that the justification employed by NICE, Alcohol Focus Scotland, the European Commission and many others is bogus and has been known to be bogus by researchers for many years.

Moreover, MUP may affect the majority of drinkers, but it wouldn’t ‘target’ them (as Chris put it on his blog). All drinkers might all be somewhat affected by MUP, but there’s no doubt that people wouldn’t be equally affected by the policy. One good way of seeing this is to watch Nick Sheron’s presentation about the drinking habits of the people he sees with serious liver conditions: they drink a disproportionate amount of cheap alcohol, and would be disproportionately affected by MUP – whether that would reduce their consumption or simply lead to a financial hit. 

The report isn't about minimum pricing (MUP). I would agree that, in some ways, MUP does attempt to target problem drinkers and is therefore a more nuanced policy than traditional TCM policies. However, it is still very clumsy and would have significant financial and welfare costs on people who are not harmful drinkers. In practice, the only people who will be excluded will be a wealthy minority who do not buy cheap and medium priced alcohol, but that is a different discussion.

There’s also something misleading in Chris’ discussion of risk and health in the context of population-wide policies. It’s perfectly correct to point out that an individual won’t be much affected by a small reduction in their consumption, particularly if they’re not at the top end of the consumption spectrum. However, this is to misunderstand how population-level policies work: they don’t aim to make everyone necessarily live longer by a day or so; they aim to make an average population live longer, and affect some individuals significantly. The nature of the prevention paradox is that an individual won’t be noticeably affected by the small reduction in risk their change in consumption habits produces. These small reductions in risk, though, when aggregated across a whole population, can produce a notable reduction in overall mortality.

I don't see how any fair-minded reader of Punishing the Majority could think I don't know this. We write about Geoffrey Rose's theories (which is really what Will is alluding to here) and dismiss them with good reason. Besides, the Total Consumption Model does not merely argue that everybody drinking a little less will be a little better for everybody's health (a dubious assertion in itself). It says that a decline in consumption amongst moderate drinkers—so long as it leads to a fall in per capita consumption—would somehow make harmful drinkers consume less alcohol and suffer less alcohol-related harm. This is patently false and can be shown to be false by looking at countries, such as England in the last decade, where per capita alcohol consumption has fallen considerably.

Of course it can perfectly reasonably be argued that pushing (not quite nudging) people towards certain choices is no business of the state – and that’s fundamentally where the disagreement here lies. The IEA isn’t an expert in the effectiveness of health interventions; it’s a bit more clued up on political philosophy.

If this is meant to be an appeal to authority, I'd point Will towards the CV of my co-author John Duffy. If it is meant to be a 'why would a free market think care about any of this', I'd refer him to the welfare costs mentioned above. Yes, I am interested in the theories and excuses used by the public health lobby to enact policies that have wide-ranging costs on the public and I think people deserve to know whether they are true.

You don't need to look for hidden subtexts with the IEA. Our commitment to individual liberty and free markets could not be more explicit.

The real policy debate should be a clear discussion of what the problem is, and what an appropriate solution might be – which may not necessarily be the most effective solution, as that might not be acceptable for practical or moral reasons.
If this is a debate about liberty and fairness, let’s have it.

We can have that debate any time, but Punishing the Majority is about a specific empirical claim upon which many neo-temperance campaigners have hung their hat. Either it is true or it is not. When 'public health' campaigners hold ludicrous beliefs and tell a dozen lies before getting out of bed in the morning, the IEA would be missing an open goal if it restricted itself to a debate about philosophy. 

Saturday, 12 July 2014

Getting worried, Big Pharma?

I spotted this on the London Tube today. It's the first time I've seen the purveyors of pharmaceutical nicotine openly knocking e-cigarettes...

"Don't vape. Quit for good", it says. Quit what? If you want to quit smoking, the evidence suggests that e-cigarettes are at least as good as Big Pharma's offerings. If you want to quit nicotine, well, why would you want to do that if you like it and it's doing you little or no harm? But if you do want to quit nicotine then taking more nicotine is not the answer.

"Do something incredible", it says. Considering the efficacy of NRT as a smoking cessation aid, it would be pretty incredible if you stopped smoking, let alone stopped using nicotine, with Pharma's products.

Thursday, 10 July 2014

The consequences of not mugging you

Imagine I'm walking towards you in the street. Your wallet is in your hand and I can see that it contains three twenty pound notes. We get closer. A terrible thought suddenly crosses my mind that I could snatch your wallet and run off with £60. We draw still closer and, as we are about to pass, I abandon the criminal thought and go about my day.

As a result of not stealing from you, you are now £60 better off than you would have been. If you had a warped view of the world, you could almost say that I have saved you £60, but even a warped thinker would not would claim that I have actually given you £60.

Take another example. I am walking down the street with £20. The thought suddenly occurs to me that I could double my money by putting it on a greyhound. I spontaneously walk into a betting shop, stick my money down on Bonny Lad and watch the race. The dog comes last, I lose my money and I walk out.

I have lost £20. If you are a fan of rhetoric, you could argue that my bet has cost society £20. After all, I am a member of society. It would be a difficult argument to make and you would be wrong, but you could make it. And yet nobody would seriously claim that my losing bet has cost the taxpayer £20.

These might seem silly examples of logical failure, but they are endemic in the public health racket whenever they talk about the 'costs' of various activities. In the last few days, there have been three examples which nicely illustrate this.

Firstly, as Dick Puddlecote has mentioned, Theresa May, the British home secretary, recently asserted that "Alcohol-fuelled harm costs taxpayers £21 billion a year." This is the common or garden alcohol cost error and would almost be forgivable if it had not been May's ministerial department that came up with the figure in the first place. Her mistake is simple. She has taken an estimate that mainly consists of intangible, internal and/or private costs and pretended that they are all financial costs to the government. They're not (see The Wages of Sin Taxes for details). This happens all the time.

Secondly, Tobacco Control magazine recently published a study with the self-explanatory title 'Economic cost of smoking in people with mental disorders in the UK'. It found...

Results The estimated economic cost of smoking in people with mental disorders was £2.34 billion in 2009/10 in the UK, of which, about £719 million (31% of the total cost) was spent on treating diseases caused by smoking. Productivity losses due to smoking-related diseases were about £823 million (35%) for work-related absenteeism and £797 million (34%) was associated with premature mortality.

As is typical of these kind of studies, the authors don't look at potential savings and so all we have are the costs, not the (more relevant) net costs. Nevertheless, the authors' findings are quite clear. Treating smoking-related diseases amongst this group costs £719 million per annum and it is reasonable to assume, this being Britain, that the lion's share of that treatment is provided by the state and is therefore paid by the taxpayer.

On top of that, there are various costs to individuals and (to some extent) to private businesses, notably lost productivity and absenteeism, as well as the intangible, non-financial cost of premature mortality. These 'costs' do not involve money being spent by anyone. At best, the individual misses out on some extra income.

In short, the only part of the £2.34 billion total that affects taxpayers is the 31 per cent (£719 million) that goes on health care.

But here's how the BMJ promoted the study...

To which I responded...

You might think that the BMJ would blame a slip of the tongue for this mistake, but instead they doubled down and proved that they really don't understand the difference between taxpayers spending money on something and individuals bearing a private cost or forgoing income (you can see their next tweets here and here).

Finally, let's take an example from the third leg of the 'public health' stool—diet—starting with the tweet that led me to it:

The government is taking taxpayers' money and giving it to businesses to spend on advertising? That's outrageous! Or rather it would be outrageous if it were true. Instead, it turns out that the Centre for Science in the Public Interest has a peculiar definition of a subsidy:

Urge Congress to End Taxpayer Subsidies for Junk Food Marketing to Children

With one-third of kids overweight or obese, should U.S. taxpayers be subsidizing junk food marketing to children? Under current tax law, companies are allowed to deduct expenses for advertising and marketing unhealthy foods to children. Please help us to end that obesity-promoting tax loophole.

Marketing is a cost of doing business and is therefore a legitimate expense that comes off the bottom line. Salaries to staff are also business expenses, but would anyone claim that the taxpayer is subsidising the salary of McDonalds' CEO? Would anyone claim that the taxpayer is subsidising the photocopying at Burger King? No. These are expenses and businesses do not pay tax on expenses, only on profit.

What CSPS are really saying is that they don't like 'junk food' advertising and think that food companies should pay additional taxes for the right to advertise. But even if you are warped enough to think that advertising isn't a legitimate business expense, a tax break is not a subsidy.

It is true that the government has less money as a result of not taxing McDonalds' advertising, but it is also true that the government has less money as a result of not introducing a beard tax or a window tax. Is the taxpayer subsidising growers of beards or owners of windows? Only if you are looking down the wrong end of the telescope.

The only way in which you could consider a tax break to be a subsidy is if you believe that the government is entitled to all your money and that anything it allows you to keep is tantamount to a gift. And this brings me back to my original analogy.

I stroll past you in the street without snatching your wallet. As I walk away I begin to feel resentful. You have £60 more than you would have done had I acted on my impulse. I have £60 less than I would have done. It's not fair! I have subsidised you!

Would my reaction be reasonable? Or would I, in fact, be a confused, criminal sociopath?

Tuesday, 8 July 2014

Let's face some facts about obesity

I recently mentioned a compendium of statistics from the British Heart Foundation which includes a statement that some might find surprising:

Overall intake of calories, fat and saturated fat has decreased since the 1970s. This trend is accompanied by a decrease in sugar and salt intake, and an increase in fibre and fruit and vegetable intake.

This is so far removed from what the public is told by groups like Action on Sugar that it deserves some elaboration.

The Office for National Statistics holds detailed information on the British diet going back to 1974. The evidence is unequivocal that per capita consumption of sugar, fat and carbohydrates has fallen significantly.

Here is saturated fat consumption:

Here is carbohydrate consumption:

Here is total sugar consumption, which only goes back to 1992:

If consumption of sugar, fat and carbohydrate has fallen, what has risen? The answer is: not much. There's been a small rise in Vitamin C and protein consumption. Otherwise, nearly everything has declined or stayed static. Unsurprisingly, then, calorie consumption is also down, from 2,534 calories per person per day in 1974 to less than 2,000 in 2012 (nb. these figures include calories from alcohol).

At this point, I should add a caveat. The figures above refer only to food consumed in the home. Have we been increasingly stuffing our faces in restaurants and chippies? Well, no. Food consumed outside the home makes up about ten per cent of total energy intake and, although we only have evidence on consumption outside the home going back to 2001, there is no sign of a rise here either. On the contrary, since 2001 the number of calories consumed outside the home (including snacks) has fallen by 30 per cent, from 310 to 219 per day.

And if we include food eaten inside and outside the home we once again see a downward trend:

In 2012, the last year for which we have data, total per capita calorie consumption in the UK was 2,262 per person per day. This is considerably less than people were consuming in the home, let alone from all sources, in the mid-1970s.

The facts are clear. Britons, on average are eating about twenty per cent fewer calories than they did forty years ago and we are eating 16 per cent less sugar than we were in 1992.

So, if we're getting fatter despite eating fewer calories (and if we believe the first law of thermodynamics) there can be only one explanation—we are burning off even fewer calories than we are eating. There are a few things that might have made a difference to metabolism, such as warmer houses and the decline of tobacco smoking, but the overriding explanation is the decline in physical activity. The claim that obesity rates have risen because we are being fattened up with fizzy drinks, large helpings and 'hidden' sugar in food is bunkum. The cause of the obesity 'epidemic' has nothing to do with calories in and everything to do with calories out.

Considering how many news stories are written about obesity, you'd think that the facts above would be common knowledge. If there was a physical inactivity industry for the public health lobby to attack (Big Slob-acco), perhaps they would be. Instead, we have a food industry known by the risible moniker of 'Big Food' (the 'men who made us fat') being blamed for stuffing the population with more and more sugar and calories despite no such increase having taken place. Who needs facts when we can blame obesity on people "being bombarded every day by the food industry to consume more and more food" or when we can point the finger at a product that the British have never eaten?

In an increasingly sedentary society, those who are not prepared to do more exercise may find it easier to reduce the number of calories they consume than to live a physically active life. That is not an unreasonable response (although exercise has health benefits that go beyond obesity prevention).

It can certainly be argued that calorie consumption has not fallen fast enough to offset the decline in physical inactivity. For many people, that is obviously true, but let's not pretend that it was rising calorie consumption that caused obesity rates to go up after 1980 and let's ignore irresponsible barkers like Aseem Malhotra who want to "bust the myth of physical activity and obesity". It is not a myth. Physical inactivity, not increased calorie consumption, is behind the rise in obesity in the UK.


This was a timely post. A report in The Guardian grudgingly acknowledges the role of physical inactivity. A new study shows that calorie consumption has not risen in the USA for twenty years, whereas the number of people who never take exercise has more than doubled. This is the Guardian, however, so don't expect any change of heart:

A new study in the American Journal of Medicine says we are fat because we move so much less, not because we eat more. But that is no reason to let the food and drink industry off the hook

Heaven forfend!

It should be noted that the USA and Britain are different insofar as calorie (and sugar) consumption remains higher in the USA than it was in the 1970s whereas both are lower than they used to be in the UK.