Monday, 30 November 2009

Liverpool votes against lunacy

From the BBC (follow that link because you will never find the story if you go to the main news page at

Proposals to give automatic 18 ratings to films shown in Liverpool which feature smoking characters have been rejected by councillors.

Oh dear. With minimum pricing of alcohol being rejected in Scotland, it's been a bad few days for the puritans.

A public consultation found little support for the idea and cinema owners felt it would affect business...

73% of young people asked about the policy opposed the idea. Officials found that 65% of adults questioned also opposed the idea.

Interesting that young people are even more opposed to this hare-brained scheme than adults, particularly since Colin Eldridge claimed that it was young people who were demanding it. But then since these teenagers were effectively being asked "Shall we treat you like idiots and prevent you from seeing a whole bunch of films?" their reluctance to say 'yes' isn't so surprising.

With so little apparent public support, Liverpool's Licensing Committee will almost certainly have to abandon the idea. But don't expect to hear the last of it, as the Committee has also offered some advice to the anti-smokers:

The licensing committee advised the PCT to consider lobbying at national level, or commission further Liverpool-based research to back the idea.

An interesting choice of words, don't you think? Not "to see if the policy will be effective or popular", but "to back the idea". A pretty clear case of commissioning evidence to support a pre-ordained conclusion. 

Watch this space for that 'evidence' to appear. One thing's for sure - they won't be troubling the general public for their views again.

Political credibility vs. scientific credibility

I was reminded of the following story by Michael Siegel who mentioned it today on his blog. I was going to include it in Velvet Glove, Iron Fist but left it out for reasons of space. It is an interesting example of how the anti-smoking movement responds to criticism.

In 1998, Robert Levy and Rosalind Marimont wrote an article questioning the oft-cited estimate of 400,000 smoking-related deaths per annum in the USA. Levy and Marimont gave several reasons why they believed this to be an exaggerated figure.  

Only nine years earlier, the Surgeon General's estimate had been 335,600. The US population had increased during that period but nowhere near as sharply as the supposed number of tobacco deaths; a number which was based entirely on estimates rather than death certificates. Over the same period, it was claimed that one quarter, then one third, then one half, of all smokers died as a result of their habit.

Levy and Marimont evaluated the figures from the Surgeon General, the Centers for Disease Control and the National Centre for Health Statistics and concluded that: 

"To be blunt, there is no credible evidence that 400,000 deaths per year - or any number remotely close to 400,000 - are caused by tobacco."

This was not the kind of talk that gladdenned the hearts of anti-smoking activists, nor did Levy & Marimont's assertion that "the campaign against cigarettes is not entirely honest" make them any friends in tobacco control. 

But by the 1990s, ad hominem attacks on anyone who did not toe the anti-smoking line were the first line of defence for Americans for Nonsmokers' Rights (ANR) and, in a counter-attack, Dr Michael Siegel - a senior member of the ANR - wrote an article which included the following statement:

"Robert Levy and Rosalind Marimont released a report (issued by the CATO Institute) attacking the CDC and its estimate that smoking causes 400,000 deaths each year. All of these authors have strong connections to the tobacco industry... Robert Levy works for the Cato Institute, which receives financial support from the tobacco industry and Rosalind Marimont is with the National Smokers Alliance which also receives tobacco industry financial support. 

(Note: Americans for Nonsmokers' Rights can provide copies of tobacco industry documents which reveal the details of these authors' ties to the tobacco industry.)"

Levy did indeed worked for the Cato Institute which, like a number of libertarian organisations, had been given tobacco industry grants in the past. But neither Levy nor Marimont had ever personally received any money from the tobacco industry and Levy replied to Siegel:

Dr. Michael Siegel,

Yes, I accept your offer to "provide copies of tobacco industry documents which reveal the details of [my] ties to the tobacco industry." I'm not aware of any such document(s) but, considering the legal exposure if your allegation is without foundation, I'm sure you'll be able to substantiate what you have written and broadly disseminated over the Internet.

I look forward to your prompt response.

Robert A. Levy

Michael Siegel replied:

Dear Mr. Levy:

I did not intend to make any personal allegations about your ties to the tobacco industry, and certainly did not ask you to provide copies of any documents. (I'm not sure who made such a request - perhaps it came from Americans for Nonsmokers' Rights). The only statement that I made was that the Cato Institute has received funds from the tobacco industry. This was information that was provided to me (with what I believe is adequate documentation) by Americans for Nonsmokers' Rights.

Nevertheless, I will not disseminate inaccurate information. Please let me know if it is not true that the Cato Institute has received funds from tobacco companies, because if that statement is not correct, I will have it corrected immediately.

Michael Siegel

This response did not satisfy Levy who replied:

Dr. Siegel,

You did indeed make personal allegations about my ties to the tobacco industry. In your recent article, in the very next sentence after you mentioned me and Ms. Marimont, you noted that "Americans for Nonsmokers Rights can provide copies of tobacco industry documents which reveal the details of these authors' ties to the tobacco industry." That verbatim statement couldn't be clearer; it says, explicitly, that I have personal ties to the industry and you can prove it.

Now I insist that you forward a copy of the relevant documents. I'm afraid that your e-mail has it backwards. It is you that must provide supporting documents to me, not vice versa.

I await your documents, or a published retraction and apology.

Robert A. Levy

Siegel replied:

Dear Mr. Levy,

By stating that the authors mentioned in the article had ties to the tobacco industry, I did not mean to suggest that you had a personal affiliation with the tobacco industry. I simply meant to suggest that you have ties to the industry in the sense that the organization you work for has received funding from the tobacco industry. However, I can now see how misleading my statement was.

I realize now that the way in which I wrote the article was very misleading, and could have been misinterpreted. I therefore wish to apologize to you and to publicly retract the statement that I made that could have implied a personal tie between you and the tobacco industry in some way other than the receipt of funds from the industry by your organization.

I have therefore asked Americans for Nonsmokers' Rights to post on the internet site the following retraction and apology:

Retraction and Apology
Re: "Responding to Tobacco Industry Attacks on the Scientific Evidence Linking Secondhand Smoke to Disease and Death"
Michael Siegel, MD, MPH
August 27, 1999

In a column dated July 19 and entitled "Responding to Tobacco industry Attacks on the Scientific Evidence Linking Secondhand Smoke to Disease and Death," I unintendedly suggested that Robert Levy (who works for the Cato Institute and issued a report regarding CDC's estimate of smoking-attributable mortality) has a personal tie to the tobacco industry.  

I did not intend to imply any kind of personal tie between Mr. Levy and the tobacco industry, other than the fact that he works for the Cato Institute, which according to Americans for Nonsmokers' Rights, has received tobacco industry funds. I can see how my statement could have been misinterpreted to imply some sort of personal affiliation between Mr. Levy and the tobacco industry.

In particular, I had stated that "Americans for Nonsmokers' Rights can provide copies of tobacco industry documents which reveal the details of these authors' ties to the tobacco industry." With respect to Mr. Levy, I intended to imply only that ANR has documents showing that the Cato Institute received tobacco industry funds. However, I can see how what I actually stated may imply a personal connection. I regret this and I publicly retract the statement.

In addition to publicly retracting any suggestion of a personal tie between Mr. Levy and the tobacco industry, I also publicly apologize to Mr. Levy for making the statement. In the future, I will be more careful in my writing when making any kind of statement that could be interpreted as a personal allegation. Again, my profound apology to Mr. Levy."

In addition, I have asked Americans for Nonsmokers' Rights to remove the article from their website and to discontinue any further distribution of the article.

Again, my profound apology. I can only assure you that I will never make this type of mistake again.

Michael Siegel

Satisfied with this retraction Levy agreed to drop the matter:

Dr. Siegel:

Thank you for your prompt response.

Your "Retraction and Apology" is fair and reasonable and I accept your offer to have it published. Assuming that Americans for Nonsmokers' Rights does indeed comply with your request to, first, post the "Retraction and Apology"; second, cease distribution of the underlying article; and third, remove that article from their Website, I will consider the matter closed.

Unless I hear otherwise, I will expect your "Retraction and Apology" to be posted within a week. Meanwhile, I will leave it to Ms. Marimont, who is copied on this e-mail, to contact you if she requires additional language in order to resolve her similar and equally justified grievance.

Perhaps we can continue the tobacco debate by focusing on substantive issues -- even though you have advised your colleagues that impugning the character of their opponents is the safer and more effective course of action.

Robert A. Levy

That would have been the end of the matter were it not for the subsequent involvement of Americans for Nonsmokers' Rights, who viewed any retraction as a sign of weakness in the face of what it considered to be tobacco interests. They denied Siegel's request to have the offending article removed from their website and, powerless to do any more, Siegel sent Levy the response he had received from Pete Hanauer, who had co-founded the group with Stanton Glantz:

Mr. Levy,

Per your request, this is the email I received from ANR refusing to post my retraction and apology.

Michael Siegel

From: "Hanauer, Pete"
To: "''"
Cc: "''"
Subject: Levy, et al
Date: Tue, 31 Aug 1999 13:58:51


After further discussion with Julia and receipt of more input from other Board members, we have concluded that the possible "clarification" that you and I discussed is simply not feasible. There is a strong concensus [sic] that we do not want to post ANYTHING on our web page that can be construed as an apology or as backtracking from the position taken in the paper you wrote. 

More specifically, Julia has convinced me that, given Levy's long history of attacking ETS science, it would be a mistake to state anything that would give him credence. So, we have decided to remove your name from the paper, as you originally stated to me that you wanted to do, and we will post an addendum to the effect that an attempt was made to censor it. Julia will be sending you a copy of that. I realize that your views on the matter are heart-felt and sincere, and that mere removal of your name from the paper, without more, will not be entirely satisfactory to you. 

But at this point ANR must put its political credibility ahead of what you consider to be your scientific credibility. As I stated to you earlier, you are being much too hard on yourself and perhaps after some time passes you will feel more comfortable with the notion that the paper was accurate and that you really had nothing to apologize for. You have done far too much good on this issue to let this one incident deter you from further strong advocacy, and I hope you will continue to be a valuable asset to the movement.

Of course, if you wish to discuss this further, I would be happy to talk to you.


The attack on Levy and Marimont's work remained on the ANR's website with the following appendum:

Robert Levy, one of the authors mentioned in the article below, has attempted to censor this article by making a veiled threat of legal action against the original author. While we have acceded to the author's request to have his name removed from the article, ANR stands by the full content of this article, which remains as originally written.

We have the utmost respect for the truth and no respect for bullies, and will not stop speaking one to appease the other.

Levy then made another request to ANR, asking to see the supposed documents that linked him to the tobacco industry. ANR's executive director Julia Carol replied:

"We provide documentation as a courtesy to the public, reporters, policy makers, etc. We do not extend this courtesy to the tobacco industry or [its] allies...

If you find [what we have said about you] to be the least bit offensive then I suggest you change the work you do."


Sunday, 29 November 2009

What have the Balkans ever done for us?

Blimey, how did this slip past The Observer's editor?*

A whirl of tutus in a Zagreb cafe-bar during a break in ballet rehearsals: poise, and skin, and fabulous discs of swan-white tuile, and yet what are our eyes drawn towards? Exactly. A little paper tube, being happily smoked.

The smell will be of black Balkan tobacco, yes; but it is also the smell of rebellion and the first successful example of people-power since the idea of smoking bans began sweeping the developed world. It's only 18 years or so since the notion first captured the imaginations of thoughtful caring responsible/interfering self-righteous killjoy (insert own prejudice here) authorities. California went first: 37 US states have now followed. In Europe, smokers sneered: at the surf-dude health-fascists over there and at the more, shall we say, organised continental countries – Norway, Austria (of course) so swift to follow – and laughed that it would never happen here. [nb. Austria wasn't swift to follow at all. Even today it only has a partial smoking ban - Chris]

The surprise was not that it did happen in Britain – the idea of another ban, particularly on anything fun, was obviously very catnip to this government – but that it was accepted so meekly. In Ulster, the free spirits, all those broths of boys so full of the rebel songs, lined up to smoke in the soft, soft rain. The thrawn, torn-faced Scots embraced the ban with hacking Calvinist fervour. England and Wales made angry noises, then succumbed: smokers through all these isles, for all our fine words, gave in like meek, coughing lambs.

What have the Balkans ever done for us? Until I saw this picture, I would have said pretty bloody little. Anger, wars, vampires, evil food, poisoned rivers, dictators, distrust, revenge and fear and it still features the only part of the world – mad northern Albania – where I've been offered a handgun for protection in a hotel because they'd lost the bedroom key. But Croatia rebelled against its bar/cafe smoking ban and simply kept on smoking. The ban has now been revoked. Plucky little Balkans. There is hope.

* I'm being a little unfair. Although The Observer's editorial stance is firmly pro-ban, it is also the journalistic home of Barbara "banning smoking in pubs was a really terrible idea" Ellen and Victoria "I'd have shoved her off the platform myself" Coren. 

The piece above was written by Euan Ferguson who also has form for criticising smoking bans.

Saturday, 28 November 2009

Glorifying communism shouldn't be a crime

Having just finished reading Anne Applebaum's superb history of the Gulag, I'm inclined to welcome anything that reminds people of the horrors of Soviet communism. Still, I'm rather uncomfortable about this:

Up to two years in jail await anyone glorifying communism according to an amendment to Article 256 of the Polish criminal code — the race-hate article — which is likely to come into force next year. The ban outlaws “the production, distribution, sale or possession ... in print, recordings or other means of fascist, communist or other symbols of totalitarianism”

No, no, no. Poland, you don't need to do that censorship stuff any more. You're free. And that includes being free to glorify communism if you are stupid enough to want to do so.

“Communism was a terrible, murderous system that took millions of lives,” said the Polish historian Wojciech Roszkowski. “It was similar to National Socialism and there is no reason to treat these two systems, and their symbols, differently.”

Quite right. Poland's new law is a well-meaning attempt to show that communism was every bit as vile as fascism. This holds a certain allure for many, even for those who, like Tim Worstall, believe in free speech:

Well, actually, such limitations on free speech aren’t really desirable at all. But putting the two great murderous ideologies of the 20th century on an equal footing certainly appeals.

True, but I would argue (and I think Tim would do too) that Holocaust denial shouldn't be a crime at all. It is in Poland, of course, and in another 12 countries. It isn't in Britain but that didn't prevent British historian David Irving from getting banged up in Austria for "trivialising the Holocaust".

One of the main arguments against making Holocaust denial a crime is that the censorship won't end there. And that's exactly what's happened in Poland. There is a logical progression from banning the Swastika to banning the hammer and sickle. There is no reason to allow Gulag denial whilst Holocaust denial is a crime.

But then why not prohibit 'moon landing denial' as well? Ah, but the moon landing didn't kill millions of people. Alright then, what about climate change denial? Global warming will - according to many - kill more than Stalin and Hitler combined, and some people do indeed want to see its 'denial' made illegal.

David Irving is under arrest in Austria for Holocaust denial. Perhaps there is a case for making climate change denial an offence - it is a crime against humanity after all.

Another argument is that such laws are difficult to interpret and problematic to enforce. The banning of historic "symbols" is not as easy as it sounds, particularly in countries where such symbols were produced in their millions. What about antiques? Does a bust of Karl Marx count? Do war medals or books count? Again, the question is where does it end? As The Times reports:

The European Court of Human Rights ruled last year that a similar Hungarian ban on wearing “symbols of tyranny” was too broad and indiscriminate.

Britain faces the same problem with its ill-considered and badly written laws against "inciting religious hatred" and "glorifying terrorism". They are open to wide interpretation. Do Glaswegian football chants "incite religious hatred"? Would a biopic of Nelson Mandela's life "glorify terrorism"?

But the most compelling argument against denial laws (apart from the obvious issue of free speech) is that you can't keep track of the loonies and the cranks if you drive them underground. Historians have nothing to fear from Holocaust or Gulag deniers. As Anne Applebaum says in her book:

Our tolerance for the odd 'Gulag denier' in our universities will not destroy the moral fabric of our society.

The "deniers" are few in number and their claims can be easily refuted. David Irving is a fool and can be shown to be a fool, but I don't think he is a danger to anybody. And even if there are a million Communist "glorifiers" in Poland, their repression will only feed their anger and sense of injustice. That, in fact, is precisely what happened to Hitler and Stalin when they were imprisoned for their political views. Didn't exactly hold them back though, did it? And banning free speech and political "symbols" is exactly the kind of thing they did when they got into power.

Friday, 20 November 2009

Football nonsense and xmas gift tips

I'm going away for a few days, so I will say cheerio and leave you with spurious piece of research:

Man Utd fans 'most keen to quit smoking'

Manchester United fans have been the keenest to sign up for Smokefree United - a virtual club of quitters that supports fans to give up smoking.

New figures show that 274 Manchester United fans have signed up to the initiative, which was launched in October by the NHS.

Far be it from me to question the veracity of this research, but could this finding - just possibly - be because Manchester United have the most fans? Having the most fans is a bit different to having fans who are 'most keen to quit'. And calling the programme 'Smokefree United' is hardly going to have Man City fans rushing to sign up, is it?

Liverpool are in second place with 182 quitters, while Arsenal are third-placed with 138 members.

I rest my case.

Also, since Amazon are selling my book at a generous discount, I hope you'll forgive me for making a shameless pre-Christmas plug for Velvet Glove, Iron Fist which comes complete with a festive red cover and could just about be squeezed into a stocking. 

Why not buy one for a loved one, work colleague or family pet? Nothing says 'I love you' quite like a comprehensive history of the anti-smoking movement. Available for £11.50 on and $16.50 on, unless they've whacked the price up between me writing this and you reading it. 

Thursday, 19 November 2009

Fruit cakes

Dick Puddlecote has written a great post, inspired by efforts to demonise fruit juice. His conclusion is short and to the point, but it encapsulates the frustration of many people who - after a decade of junk science and scare stories - must be wondering what on earth they can eat or drink.

The article Dick links to is fascinating in the way it illustrates the cul de sac that debased epidemiology and food faddism have left us in. Please read it. Weeping is optional. 

At its heart is a study which found that children who drank more than 12 ounces of fruit juice were 3 and a half times (or 350%) more likely to be fat that those who didn't. The study only involved 168 children and the obvious explanation - that gluttons who eat a lot tend to drink a lot as well - is never entertained. 

Furthermore, the article admits:

The link between juice and weight gain isn't always found, however. In a 2008 review of 21 studies, six supported the connection and 15 did not.

None of which deters Kimber Stanhope of the (surprise, surprise) University of California, who says there is no difference between fruit juice and soda.

"Both are going to promote equal weight gain," she said, adding that she's perplexed by the fixation on the evils of sugar-sweetened beverages: "Why are they the only culprit?"

The thing is, she has a point. Once calories were identified as evil, there was never any reason to end the obesity crusade with less-fashionable items like burgers, pizza, soda. 

The tone is set near the beginning of the article with this statement:

There's also evidence that high consumption increases the risk of obesity, especially among kids.

This is a meaningless statement. It's like saying that "too much of x is harmful." It is self-evident. "High consumption" of anything containing calories could increase the "risk" of obesity. As ever, it is the quantity that matters. The poison is in the dose. 

We can laugh at such stories but one thing we cannot do is accuse those behind them of inconsistency. If we are to tax fizzy drinks because of their calorie content, it is perfectly logical to tax fruit juice, bread, potatoes - indeed everything except water and celery. There is a faultless internal logic at work here which can only be undermined by challenging the whole rotten edifice on which it stands. 

Is a tax on fruit juice likely? No, not for the time being. But only because the self-appointed guardians of public health dare not attack something that is so popular with so many. This is an important point. They have no ethical objections to such measures. It is doubtful whether issues of liberty even cross their mind. But they are pragmatists, as the reporter explains:

It's uncomfortable for advocates of a junk-food tax who say they can't afford to target juice and alienate its legions of fans.
Even the porky obesity zealot Kelly Brownell agrees that it is too much, too soon (Jacob Sullum has written entertainingly about Brownell here - recommended):

Brownell of Yale has waged a high-profile campaign to fight obesity with "sin" taxes on soda and other sugary drinks. It's already an uphill battle, and he said he's loath to provoke the tens of millions of Americans who consider their morning juice sacrosanct.

Dr. Frank Greer, who spent 10 years on the American Academy of Pediatrics' nutrition committee, said he "can't imagine" the group would ever downgrade juice to the status of soda.

"It's such a normal part of the American diet," Greer said. "A glass of fresh-squeezed orange juice for breakfast, my goodness!"

Fruit juice gets a stay of execution, then, only because it has not yet been denormalised. In a few years, thanks to articles like this, that may change. 

Wednesday, 18 November 2009

Wisdom of the ancients

From the BBC:

Ancients 'had heart disease too'

Hardening of the arteries has been found in Egyptian mummies - suggesting that the risk factors for heart disease may be ancient, researchers say.

Who really thought otherwise? It shows how engrained the 'Social Theory' of disease (© James Le Fanu) has become that anyone would be surprised by this finding. It's one thing to say that modern lifestyle choices are responsible for some cases of coronary heart disease, but quite another to blame them for all cases (thereby assuming that heart disease is a purely modern phenomenon).

Dr Gregory Thomas, from the University of California, said: "While we do not know whether atherosclerosis caused the demise of any of the mummies in the study, we can confirm that the disease was present in many.

"So humans in ancient times had the genetic predisposition and environment to promote the development of heart disease.

"The findings suggest that we may have to look beyond modern risk factors to fully understand the disease."

Good news, if true. However, the BBC report suggests that they're not going to be looking too far beyond them.

The researchers said that while ancient Egyptians did not smoke tobacco, eat processed food or lead sedentary lives, they were not hunter-gatherers.

So, let's see now...


Passive smoking

Processed foods

Sedentary lifestyles

That only leaves one thing...

All the mummies were of high socio-economic status and would have had a rich diet.

Agriculture was well-established and meat consumption appears to have been common among those of high social status.

Of course. Meat!

Thank you, social theory. Biology would be so much more complicated without you.

Tuesday, 17 November 2009

Beating up smokers

The folks at Freedom2Choose have been successful in getting Birmingham NHS to withdraw a particularly obnoxious anti-smoking commercial (also reported here). If you haven't seen it yet, click to play (it shouldn't be online much longer).

Freedom2Choose objected to it on the basis that it could encourage violence towards smokers. This does not seem to me to be an unreasonable objection. I've written before about the fine line between 'denormalisation' and hate-mongering. In recent years there have been too many incidents of what we might call smoking-related violence. Freedom2Choose presented a list to Birmingham NHS, including:

A non-smoker was jailed for two years yesterday for attacking a “deaf and mute” man who refused to stub out a cigarette.

Wales Online March 19 2008

A 17-year-old student was burned with a home-made flame thrower during a horrifying four-hour torture ordeal, a court heard.

Aerosol cans of air freshener and furniture polish were squirted at Katy James and the jets set alight with a naked flame. She was attacked by a gang of teenagers at the flat they shared in Burcot Lane, Bromsgrove, after her smoking was blamed for Hayley Kirby's miscarriage.

Her hair was set alight and she had to beat out the flames with her bare hands. Perfume was sprayed onto her stomach and also set on fire.

She was battered with a chair until its leg broke, punched, kicked and forced to drink a cocktail of coca-cola, cigarette ends and urine while her tormentors laughed, Worcester Crown Court was told.

Miss James, a vulnerable girl with learning problems, was lured home on March 23 where she was attacked by Kirby, her boyfriend Robert Hart, Wynette Darkes and her boyfriend James Smale. Kirby claimed that on that day she was told by a hospital that smoke in her body had caused her to lose the child, said Nicolas Cartwright, prosecuting. 

Bromgrove Advertiser 18 December 2006

A drinker has taken offence to a fellow drinker lighting up a cigarette in a pub and went to extreme measures to stop him - he shot the smoker in the head, killing him.

The dispute between the 50-year-old gunman and the 35-year-old smoker broke out at the Flash Road Bar in Kwartel Street, Birch Acres, Kempton Park, on Saturday night.

Independent Online 7 December 2004

Authorities allege an argument over smoking led a Brooklyn Center man to slash his wife's throat, severing her tongue and windpipe.

Authorities say Meg Lundeen and her husband, Randy Aaser, visited a couple bars with friends and colleagues to celebrate her 30th birthday Friday night. According to the complaint, she told a friend she wanted to buy cigarettes, but that she had quit smoking and that her husband would be mad if he found out.

Authorities say Lundeen was attacked later at the couple's house.

Associated Press June 13 2007

The case of the 17 year old girl is particularly troubling, since the doctor had no evidence to support his claim that secondhand smoke led to her assailant's miscarriage. This seems to be a case of 'if in doubt, blame tobacco'. Many white lies told about secondhand smoke are justified on the basis that anything that discourages smoking can't be a bad thing. "What harm can it do?", they say. This case shows the harm it can do.

Let's be clear. The responsibility for all of these horrific crimes lies with the people who committed them. But since tobacco control is set on 'denormalision', it must at least recognise the dangers of such state-sponsored stigmatisation and behave responsibly. That means erring on the side of caution and this particular campaign, in my view, oversteps the mark.

Yes, I understand the subtext of this advert, but ultimately it shows someone lighting a cigarette and then being beaten half to death as a result. For some disturbed people lurking in the darker reaches of the internet (I won't link to the sites I have in mind) this video represents some sort of wish-fulfillment. It should have been forseeable that certain individuals would get a frisson of excitement from it. The Department of Health should not be doing anything that might encourage denormalisation to spill over into violence.

I'm not suggesting that people in the public health movement want to personally assault smokers. I wouldn't even suggest that this advert alone could necessarily lead to smokers being assaulted. But it adds to a growing culture of aggression towards people who smoke. 

Above all, I'd like to know what was going through the head of the person who came up with the advert and ask why public money was spent producing it.

[Thanks for Dave and Brenda at F2C for the news reports]

Sunday, 15 November 2009

Soft drinks, tough laws

Sugary soft drinks should be taxed to raise money for hospitals and to tackle obesity, a leading doctor has urged.

Of course he has. Can we spell 'slippery-slope' yet?

Small charge added to fattening, sugary drinks 'could slow UK's weight gain and raise billions for NHS'

Spot the inherent contradiction here? Since nearly everyone consumes these drinks, it is important to stress that it will only be a "small charge". The neo-temperance campaigners face the same dilemma with their minimum-price-per-unit-of-alcohol ruse. On the one hand, they assure "responsible drinkers" that the price rise will be so low they won't notice it. On the other hand, they say that it will big enough to transform the nation's drinking culture.

But, as with booze, how will a "small charge" deter people from drinking fizzy drinks? How, for that matter, will a small charge raise "billions"? It could only raise billions if people keep drinking these drinks - if, in other words, the policy fails to do what it is supposed to do. And, like most neo-prohibitionist measures, it will fail to do what it is supposed to do.

[Dr] Chand said drinks that contained up to 17 teaspoons of sugar were fuelling the UK's obesity epidemic: "The amount of sugar that goes into some of these drinks is staggering and it has a double whammy, increasing obesity and rotting teeth."

Speaking of rotting teeth, I'm always intrigued by how we rarely, if ever, hear dentists calling for higher taxes and suchlike. I've never heard a dentist call for gobstoppers or pork scratchings to be banned, although I'm sure they could easily produce evidence to link them to nasty dental injuries. Perhaps they haven't developed a sufficiently effective PR machine, or maybe they just don't have the God complex that afflicts so many doctors.

Chand said he was talking about fizzy drinks such as high calorie colas and lemonades, as well as fruit squashes and energy drinks.

The clue is in the name "energy drinks", surely? It's pretty difficult to have an energy drink without calories and whilst the public health movement imagines us all to be catatonic in front of the television, there are plenty of us who play sports and do activities which require more than a diet of bread and water. 

Recently, the Scientific Advisory Committee on Nutrition seem to have (sort of) woken up to the fact that different lifestyles require different calorie intakes.

The calorie counts used as the foundation for diet plans and healthy-eating guidance for the past 18 years may be wrong, a report suggests.

The recommended daily intake of calories could be increased by up to 16%, a draft report by the Scientific Advisory Committee on Nutrition said.

This raises several points:

1. Public health frequently issues advice which turns out to be based on poor data and is wrong, sometimes even life-threateningly wrong (see the rethink on aspirin).

2. Apart from a few hypochondriacs, politicians and public health professionals, no one really pays attention to these daily limits. It is a huge vanity to believe that people will adjust their diet regardless of whether the Scientific Advisory Committee on Nutrition increases the daily limit by 16% or not.

3. There can be no one-size-fits-all approach to diet, calories or water consumption. People are different sizes, live in different climates and do different jobs. 2,500 calories and 8 glasses of water a day is not enough for a labourer working in the sun and is too much for an administrator in an office. The only sensible advice is - and has always been - don't take in more energy than you use up. 

But I suppose that kind of advice won't raise "billions" and - heaven forfend - people would be free to ignore it.

Friday, 13 November 2009

US smoking rate rises for the first time since 1994

Now that more than half of America is covered by smoking bans, could it be that the US is experiencing the curse of the smoking ban? From The Washington Times:

Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials' hopes that the U.S. smoking rate had moved permanently below 20 percent.

As with Ireland, where smoking rates have soared despite being the "world-leader" in tobacco control, advocates are putting their faith in still higher cigarette taxes.

Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. Perhaps the recession will have an impact, too.

"In general, when people have less money, they smoke less," Dr. Frieden said. "Time will tell."

So it is often said, but where is the evidence? Is it not the case that the poor smoke more than the rich? Even if it were true that people smoke less during recessions, it is not the amount people smoke that matters here, but the number of people smoking. The economic depression of the 1930s didn't see a fall in smoking prevalence. It saw quite the reverse. 

Evidence that recessions significantly affect smoking prevalence is thin on the ground, as is evidence that tax hikes make a major difference. There are examples of tax rises reducing prevalence (England in the 1940s, America in the early 1980s) but there are more examples of them making no difference or backfiring (America in the early 1990s, Ireland recently).

It's too early to say whether this (small) rise in US smoking prevalence is the start of an upward trend. It may be that the 2007 decline (from 21% to 19.8%) was a blip and that smoking rates have essentially been static in America for the last 5 years.

More interesting, I think, is how these statistics are generated. Always based on surveys, the figures very much depend on what questions are asked. The European journal Public Health has recently published a ground-breaking study which compares the Centers for Disease Control's surveys with those of the National Survey on Drug Use and Health. As co-author Brad Rodu explains on his excellent blog, there is a very significant discrepancy between the two.

In contrast to the decline reported by the CDC, we found evidence from another federal source that the number of adult smokers in the U.S. has been stable for about a decade. In 2005, for example, the CDC estimate was 45.1 million smokers; our analysis revealed that number could be as high as 54.2 million.

You would think that collating data for smoking prevalence would be fairly simple, wouldn't you? A simple yes/no question. But as Brad shows, nothing in tobacco control is ever simple and if the National Survey on Drug Use and Health is correct, the smoking rate has not fallen at all since 1998. Go read.

Tuesday, 10 November 2009

John Banzhaf's slippery slope

Further to yesterday's post on John Banzhaf, here's an article I wrote about the man earlier this year...

But he seemed so reasonable!

For many years the anti-smoking movement has been accused of creating a 'slippery slope' that will lead to a puritanical crusade against any product deemed to be unhealthy. The anti-smoking movement has always denied this. As Stanton Glantz (founder of Americans for Nonsmokers' Rights) said in 2006:

"The whole slippery slope argument is fallacious. It says that intelligent people aren't capable of making decisions."

In actual fact, Stanton Glantz is quite right in what he says. It is a logical fallacy to claim that just because A leads to B, that B will inevitably lead to C, and that C will lead to Z. Lawmakers can draw the line at any time. Circumstances can change. What is deemed appropriate remedial action in one case might be deemed inappropriate in another case.

And yet, history shows that the slippery slope is no myth. Those who warn that prohibitions in one area will lead to prohibitions in other areas are portrayed as fear-mongerers in their own time but, with hindsight, have often been shown to be right. The slippery slope may be a logical fallacy but it is also a political reality. Politics is not always logical.

The career of John Banzhaf III provides a classic illustration of the slippery slope in action. Banzhaf founded Action on Smoking and Health in 1968 as - to quote Richard Kluger - "an extension of a not inconsiderable ego" (Ashes to Ashes, p. 506) and has appeared on television and radio enough times in the last 40 years for us to see how he has slowly taken off the velvet glove to reveal the iron fist.

Back in 1968, ASH ostensibly existed as a pressure group to resist cigarette advertising on television to protect children. When the Los Angeles Times interviewed him in that year, he was insistent that he was anti-smoking, not anti-smoker, as their reporter explained:

"Banzhaf doesn't smoke but he denies his crusade is based on an antipathy for smokers and smoking. "You can smoke," he said. "That's all right. I just don't want children brainwashed into it."

Fast forward to 2009 and Banzhaf has a very different attitude. He now describes ASH as "a national organization leading the fight to protect nonsmokers from thirdhand smoke." ('Thirdhand smoke' being an ill-defined chimera based on a telephone survey which has no credibilty amongst serious scientists). For several years, he has been a leading voice in the campaign for smokers to be discriminated against in custody battles. Not only has he called for the children of divorced couples to be given to the nonsmoking parent, but he now believes that the smoking parent should be compelled by law to "change clothing and use a mouthwash before the child visits." Last year, he appeared on television to explain why it was "legal and profitable" for companies to "fire smokers and employ only nonsmokers."

It is safe to say that Banzhaf would have never been taken seriously had he proposed even one of these policies in the 1970s. Instead he has taken baby steps to win a long series of small victories, all the while calling for compromise and reasonable accommodation. This article documents a few examples of how he has achieved this.

Banzhaf on outdoor smoking bans

The first example comes from 1977, when Banzhaf debated with the Tobacco Institute's Walter Merryman on the Joel Spivak Show. In a lively debate, an audience member said she believed that any attempt to ban smoking in the street would be unreasonable and unenforceable. Banzhaf whole-heartedly agreed:

(Skip to part 3 - 5.55 minutes in)

John Banzhaf, 1977:

"Where you try to ban it entirely on a street or something like that, obviously you're going to have problems. But what we have found is if you have a law, if you provide separate smoking sections, if the restrictions are not onerous or whatever, if you don't have large fines or make it a major criminal problem it a then you have reasonable compliance."

Of course, no one was seriously suggesting that smoking be banned in the street in 1977. It was not until 2006 that an outdoor ban was mooted in Calabasas, California. When this law was debated, Banzhaf gave testimony in support of it, now claiming that "even the small amounts of tobacco smoke hovering over a sidewalk CAN be enough to trigger an asthmatic attack".

In his testimony, Banzhaf explicitly addressed the issue of enforcement, now with a very different point of view:

John Banzhaf, 2006: 

"Equally unavailing is the argument that outdoor smoking bans may be difficult to enforce. Exactly the same argument has always been made for indoor smoking bans, but time after time - from elevators to airplanes to office buildings - they have been proven to be dead wrong as they are now being proven wrong regarding other outdoor smoking bans on beaches, in parks, and around building entrances."

Banzhaf on smoking/nonsmoking sections

In another television appearance (in 1986), Banzhaf said he wanted smoking banned in hospitals "with the exception of smoking sections". When another guest - Bob Greene - complained that anti-smoking groups were trying to make it illegal for him to smoke in a private room of a hospital, Banzhaf accused him of "creating a straw man".

The ASH director was a picture of sincerity when he put forward his compromise:

Banzhaf, 1986: 

Banzhaf: Most of the anti-smoking organisations are not against Bob smoking in his private room in a hospital, smoking in his office, smoking outdoors or smoking anywhere where it's away from nonsmokers."

Bob Greene: What about a domed stadium where professional football is being played?

Banzhaf: Then you have separate smoking and nonsmoking sections. You wouldn't object to that would you?!

But seven years later, in 1993, Banzhaf gave a very different reply. Having spent 25 years campaigning for no-smoking sections, he now flatly dismissed them:

"A non-smoking section? There ain't no such thing. Tobacco smoke drifts, it is recirculated."

Banzhaf has since gone much further, saying:

"The ultimate goal is to have a smoke-free society, by which we don't mean that nobody will smoke, but it will be something like spitting which is not done politely in public. We will not be tolerating it on public places, streets, outdoors or anywhere else."

Smoking in bars

Throughout the 1970s and 1980s, John Banzhaf would accuse many other people of constructing "straw men" when they suggested that his ultimate aim was to have smoking banned in all public places and workplaces. He made this very point to Tobacco Institute spokesman Bill Dwyer when they debated on a radio show in 1979:

Banzhaf, 1979:

"Bill, this isn't prohibition. You know it and I know it. We have no objection whatsoever if you and the other folks who want to smoke want to go into smokeasies and smoke all day long. We just object that you do it around us."

But when, more recently, Washington DC discussed exempting some bars from its smoking ban because they were losing money, Banzhaf sung a very different tune:

Banzhaf, 2007:

"I don't think there should be any exemptions at all," adding that: "The idea that we have to accommodate smokers is changing." 

Smoking bans on aeroplanes

A further example of Banzhaf insisting that he only wanted to meet smokers half way comes from 1984, when he debated with the Tobacco Institute's Anne Browder on television. The subject was banning smoking on flights of two hours or less:

(8.10 minutes in)

John Banzhaf, 1984:

"What we are talking about here is not a prohibition of smoking on airplanes. Rather it is in the nature of a compromise... We are asking for a ban only on flights of two hours or less because we feel this is a reasonable compromise based upon the needs of the smoker and the requirements of the smoker and social justice."

In 1988, bowing to the request for a 'reasonable compromise', the House of Representatives voted for a bill to ban smoking on flights of up to two hours by the narrow margin of 198 votes to 193. With it ended any further talk of a 'reasonable compromise.' The anti-smoking lobby immediately complained about the inherent inconsistency of the legislation and talked about the "loophole" that exempted longer flights. In 1990, the ban was extended to all flights.

Looking back in 2003, Banzhaf admitted that the piecemeal approach had all been part of the plan:

"When we started to fight for nonsmokers, we started with airplanes. No one then thought we'd be successful at banning smoking in bars, banning smoking outdoors. We took the easier ones first. Each step builds on the one that comes before."

The slippery slope 'fallacy'

Despite such admissions, the anti-smoking movement has always resisted the slippery slope argument. Stanton Glantz, for example, has written (pdf):

"The 'slippery slope' argument is one that the tobacco industry has routinely raised to oppose policies against its interests, including smokefree policies, decisions by arts and cultural organizations not to accept tobacco money, advertising restrictions, and other policies. These predicted subsequent problems simply have not materialized"

The idea that these "subsequent problems" have "not materialized" is risible when one considers the 'sin taxes' and advertising bans currently being enacted against various drinks and food products around the world. The possibility of the anti-smoking campaign being extended to food and drink was often raised by Banzhaf's critics in the 1990s, but the notion was given short shrift by the ASH founder. In 1991, for example, he said:

"They use the 'slippery slope' argument. 'My God, if they can do this to smokers today they can do this to people who eat Haagen-Dazs ice cream or whatever.'"

Of all the hostages to fortune that Banzhaf has left in his 40 year career, this is the most ironic. Today, Banzhaf is at the forefront of the food wars. Just thirteen years after scoffing at the idea of Haagen Dazs coming under attack, he referred to ice-cream as a "coronary in a cone" and sent a letter to six ice-cream manufacturers telling them that they had been "put on legal notice that they may be sued if they don't begin disclosing just how much artery-clogging fat and calories their offerings contain."

These companies included Baskin-Robbins, Ben & Jerry's, Cold Stone Creamery, Friendly's, TCBY and - of course - Haagen-Dazs.

*Videos come courtesy of the superb and

Monday, 9 November 2009

John Banzhaf ridiculed on TV

For John Banzhaf, the founder of ASH (US), suing restaurants for making people fat is the 'next logical step' in the public health crusade. As a bonus, it also offers him the chance to become stupendously rich. 

The rotund 'legal activist' has been trying to sue McDonald's for years and, as this recent televised interview shows, he hasn't given up yet.

It's worth watching for the presenter's sarcastic and incredulous reporting of the whole sorry farce, and also to see how Banzhaf keeps resorting to fallacious arguments. He talks about cigarettes again and again, as if to drill home the idea that fast food and tobacco are as bad as each other. After comparing his McLawsuit to lawsuits that fought racial segregation, he uses this piece of specious reasoning:

"Many of our most famous lawsuits - the ones my students studied and you studied in law school - were originally called frivolous."

Maybe so, but a lot of frivolous lawsuits have been called frivolous too. I'm reminded of the conversation in the movie Bedazzled...

- You're a nutcase! You're a bleedin' nutcase!

- They said the same of Jesus Christ, Freud, and Galileo.

- They said it of a lot of nutcases too.

Predictably, Banzhaf resorts to ad hominem attacks on his opponent, calling Congressman Rick Keller "the mouthpiece for the food industry". Keller responds with this gem:

"I think we should have labelling on the people who bring these lawsuits; a T-shirt that says 25% junk science, 50% greed and 25% seeking publicity."


Thursday, 5 November 2009

Daylight robbery

Prohibition creates lawlessness. Few dispute the fact that organised criminals, smugglers and thieves are the main beneficiaries of prohibition. This is true of total prohibition, as seen in America in the 1920s, but is also true - albeit to a lesser extent - when prohibition is brought in by degrees.

Putting a 'sin tax' on a product is a prohibitionist measure. It is explicitly designed to make the product prohibitively expensive. In theory, this should reduce consumption most amongst the poorest members of society. Anti-smoking advocates refute the obvious economic argument that high cigarette taxes are regressive by saying that, actually, they benefit the poor most because they are the ones who will quit smoking. It's a nice bit of rhetoric, and clever, but it doesn't stand up to scrutiny.

Every piece of evidence collected, not just over decades but over centuries, tells us that the poor are the least responsive to tax rises on tobacco. We also know that people are quite prepared to buy smuggled or counterfeit tobacco if they feel the tax burden is too high. It happened under Jame I in 1604 and - as I mentioned yesterday - it's happening now.

An excellent article by Wat Tyler on the Burning Our Money blog shows us that as cigarette prices are rising across the whole of the European Union, there is less incentive for smokers to go day-tripping to France and Belgium for cheap cigarettes. Consequently, and predictably, organised gangs are now turning to robbery.

Just in the last few months, small shopkeepers have been hit in Croydon, Oxfordshire, Glasgow, Sussex, Devon, Gloucestershire, Liverpool, Yorkshire, and back in Sussex again. AND THAT'S JUST THE FIRST PAGE FROM HUNDREDS OF GOOGLE RESULTS.

This is a massive crime wave.

One of the most damaging effects of alcohol prohibition was that it turned normal people into criminals and undermined respect for the law. The criminals who rob the shops may be, as Wat Tyler describes them, "thieving scum" but their customers are otherwise law-abiding people. 

Yesterday, I quoted ASH Ireland's Luke Clancy, who said:

"If we are serious about becoming a nation of non-smokers, the government has to start paying attention to the data. Price increases stop people smoking and deter young people from starting."

But as Frank Davis said in the comments:

Who the hell is this Clancy anyway to decide that the Irish are to become a nation of non-smokers? I mean, really, the sheer, mind-bending arrogance of it! Why the hell should anyone pay a blind piece of attention to someone who seems to have appointed himself into an unaccountable public role as adjudicator of a nation's pastimes?

Smokers everywhere are expressing a similar sentiment, in action if not words. Just as Americans in the 1920s were never consulted about the introduction of prohibition, no one today - beyond a self-selecting elite of 'health professionals' - has been asked if they want a "smoke-free world". When the law comes to be seen as unfair, punitive and unnecessary, people feel no guilt about breaking it. To quote Wat Tyler again:

Fundamentally, with tax now accounting for three-quarters of the price of cigarettes, even normally law abiding folk like the parson and the clerk can convince themselves such taxes are onerous and unnatural, and that it's reasonable to resort to the black market. After all, it isn't as if the black market is real crime, like murder or something.

We have moved beyond the realms of workable taxation. High taxes become the excuse for criminality.

It has always been thus. I've said it before and I'll say it again: no man-made law will ever be as powerful as the law of supply and demand.

Wednesday, 4 November 2009

That didn't work, let's do it again.

On March 8 2006, an Irish anti-smoking group issued this press release:

Nearly 40,000 Irish people would quit smoking if the price of twenty cigarettes increased to €6.98. That is according to research done by the EU anti-smoking campaign, ‘HELP – For A Life Without Tobacco’, which shows that a 10% price increase in high income countries results in a 4% reduction in smoker numbers.

Professor Luke Clancy, Chairman of ASH Ireland was quoted in the release, saying:

"If we are serious about becoming a nation of non-smokers, the government has to start paying attention to the data. Price increases stop people smoking and deter young people from starting."

They got their wish, and more. Successive tax rises pushed the price of a pack of 20 well above the €6.98 they demanded. A pack now retails at €8.50. So what is the result?

A THIRD of the Irish population now smokes, a new survey reveals.

A survey of 4,082 people this summer revealed that 33pc of the Irish population had taken up or continued to smoke.

It is the highest smoking rate recorded here in the past 11 years, according to the EU's 'HELP - For A Life Without Tobacco' campaign.

Even those of us who are used to seeing tobacco control policies backfire must be astonished by how badly things are going for the anti-smoking movement in Ireland. This was supposed to be the country that would lead the world in tobacco control. It was the first country to ban smoking in public places. It has the third most expensive cigarettes in Europe. It has a tobacco display ban. And yet, in the space of five years, it has gone from being the jewel in the crown to being a failed state.

Everything that could go wrong, has gone wrong. 1,500 pubs have closed, smuggling has gone through the roof and the smoking rate has hit an eleven year high (it was at an all-time low before the ban was introduced).

So what is Luke Clancy's response?

"There is no evidence of any decline in smoking in this survey [you can say that again!], indicating a clear need for higher prices of cigarettes" 


Elsewhere, Patrick Basham and John Luik discuss whether the Irish fiasco will be repeated in Britain and Pete Robinson says that Ireland's pub crisis supports his prediction that the UK will lose 25% of its pubs by 2012.

Tuesday, 3 November 2009

Michael Kitt on the e-cigarette

Back in September, I mentioned that the e-cigarette company had offered to donate 10p from every product sold to Cancer Research UK. I said at the time:

ASH (UK) have not, so far, demanded a ban on e-cigarettes (unlike their American namesakes). Since ASH receives substantial funding from Cancer Research, these new donations from the e-cigarette industry should ensure that things stay that way. Or will pressure from American fundamentalists and Big Pharma prevail?

It seems to have been the latter, since Cancer Research turned down the donation. Shortly afterwards, I interviewed the company's owner Michael Kitt to ask him about the proposed donation, the current state of the e-cigarette industry and what he expects to happen in the future. This is a transcript of that interview:

CS: Essentially what is the difference between the pharmaceutical nicotine inhaler and the e-cigarette?

MK: Very little. I’m not 100% sure about the technical differences but the e-cigarette uses more electronics to generate the smoke and atomise the vapour into the lungs. The inhaler, as far as I’m aware, is just a direct air pull through.

CS: Almost like an asthma inhaler?

MK: Almost. It’s along those lines, but without the aerosol. Like the ones you just suck on. What it does differently to the inhaler is that it provides a psychological experience. You’re not as aware that you’ve got an electronic instrument in your hand. You’re seeing the smoke coming out, you’re feeling the throat hit. You’re experiencing everything really. That’s why I think it’s going to take off better than the nicotine replacement therapies.

CS: What do you think the chances are of regulation? Could the e-cigarette even be banned?

MK: I think they’ve got a job on their hands to ban it. The FDA has made a mistake in the way they’ve tried to clamp down and say “No, it’s bad for you” because they seem to have done it with very, very little proof and a very biased report. I think it was 19 samples and one of those samples had an ingredient in that they consider makes it unsafe. And yet they’ve approved that same ingredient in cosmetics and food and loads of other things.

CS: Would you accept there’s a need for some regulation?

MK: Definitely. There’s too many questions and inconsistencies with what we do. There’s no real regulation about what’s got to be on the box. There’s no real regulation about any warnings that need to be given and, at the end of the day, nicotine is a poison.

CS: Would you like to see it available only to people over the age of 18?

MK: I think it needs to be. I don’t think many people under that age will buy them anyway because of the cost. Not many kids get £50 pocket money.

CS: What about the issue of flavouring? Various anti-smoking groups have said they’re flavoured to appeal to young people.

MK: They have, haven’t they? I suppose it’s the same principle as why do they allow flavoured alcohol? That’s not marketed to young people. Just because I’m 30 years old doesn’t mean I don’t like the taste of chocolate. I don’t think that’s purposefully trying to target it towards children. But the other regulatory side - child-proof containers and so on - needs to be clamped down on quite heavily. There’s nothing there at all at the moment.

CS: How many players are there in the UK market?

MK: There’s five manufacturers. As for dedicated electronic retailers, I think we’re the only one really dedicated that’s doing multiple brands. There are a few others who are selling them on Amazon, some people - like Click Shop - are mixing them in with lots of other products. CigZag are just about coming online.

CS: Where are they made, mainly China?

MK: They’re made in China, yeah.

CS: Who invented them?

MK: It was a guy who patented the Ruyan Jazz disposable one who actually owned the patent for the technology and then other licenses have come off that to produce the mini ones and what have you. NicoCig actually produce the Ruyan Jazz in the UK.

CS: When was it patented?

MK: 2003, 2004.

CS: So it really is very recent.

MK: Yeah, it’s not been long at all.

CS: And what are the messages coming out from government in the UK? Are there any?

MK: Not really. It’s still very under the radar. It’s purely, from what I can gather, being aware of the product. When I take mine out of a Friday or Saturday night, the number of people who ask about it is amazing and - so far - there’s been no negative reaction towards it. It’s difficult to explain how positive most people are about it. I saw a study once that said 98% of smokers would consider an alternative if it gave the whole package - if it was healthier obviously.

CS: And are you a smoker? Were you a smoker?

MK: Yes.

CS: So you smoke tobacco and these?

MK: No, just the e-cigarette now.

CS: And you gave up using these?

MK: Yes, but we can’t promote that!

CS: No. Unfortunately not. Your name came to my attention because you offered a donation to Cancer Research. I found it very interesting that they turned you down, and it makes me think that they’ve got it in for the e-cigarette.

MK: Possibly. I didn’t think they would decline it, but they did and that’s up to them really.

CS: Why do you think they turned down money that they could have used for cancer research?

MK: I think there’s a bit of pressure coming from some anti-smoking groups there, to be honest. They do accept donations from the people who make Nicorette, I believe, and other nicotine replacement therapies. So why they wouldn’t accept donations from us is up in the air. We don’t know anything for sure but I would hedge my bets towards them getting some pressure from someone. Whether it’s the anti-smoking groups or the government, I don’t know.

CS: The anti-smoking movement as a whole has a ‘quit-or-die’ approach; an ‘all or nothing’ approach. They would never encourage people to use chewing tobacco, low yield cigarettes or any tobacco product at all, with the exception of pharmaceutical products. The pharmaceutical industry is one of the world’s most powerful industries, whereas the e-cigarette industry is very small. It’s a bit under the radar and, presumably, you’re not particularly co-ordinated - as an industry - to defend yourselves?

MK: There’s the electronic cigarette association in American. They almost act like a regulatory body, to make sure the products are promoted in the right way. They’ll only accept people in that are not promoting them as smoking-cessation devices and aren’t making false claims about the health benefits. But over here [in the UK], as of yet, we’ve got nothing along those lines.

CS: ASH (US) has been extremely critical of the e-cigarette and wants to see it banned entirely. In the last few years, the way the media have reported things like ‘third-hand smoke’ has been completely uncritical and it’s easy to imagine that ASH (UK) could come out and say “Here’s this new, unregulated device which pumps out poisonous nicotine and diethylene glycol - as used in anti-freeze!” and it needs to be banned. Do you think that’s likely?

MK: I think it depends how much influence the American ASH and the worldwide ASH have over them. If it they have to do it, I think they probably will. But that’s just another argument for some kind of regulation. If the e-cigarette is regulated and if there are details about what needs to be provided in the same way that normal cigarettes are retailed then they should be happy as far as I can see.

CS: But doesn’t regulation require the product being taken off the market for years? Eight years is what they’re saying in America but it could take much more than eight years. If you want to do a study on lung cancer, you’re talking about a wait of at least 20 years, probably more like 50 years.

MK: Yeah. And you’ve got to have people smoking for that long.

CS: So to make sure the e-cigarette is 100% safe, you’ve got to have the product off the market for up to 50 years.

MK: Potentially.

CS: Which could be a major problem for you!

MK: It could be but I don’t think it would ever get that far. If you look at mobile phones, for example, they’ve only been around for 10, 20 years now. We still don’t know what effect they have on the brain but they don’t take them off the market, otherwise they’d have no test subjects to test them on. And if the e-cigarette needs to be studied, it has to be studied while it’s out in the market. They can’t study it while no one’s using it!

CS: What about the claim that it’s a gateway to smoking?

MK: Again, it’s difficult because of the price of it. I can’t see young people spending £50 on a starter kid when they could get a pack of fags for £5. The argument they’re trying to make is that they’ll steal it from mum’s purse, but actually it’s more difficult to steal it from mum’s purse because there’s only one. Mum will notice that it’s gone missing more easily than the one cigarette missing from a packet of twenty.

CS: I’ve seen two figures online. One said that 79% of users have quit smoking successfully using the e-cigarette. The other said 72.5%. You can’t market the e-cigarette as a smoking-cessation device, I know, but is there any research underway to seriously get a figure on how effective it is for people who are trying to give up?

MK: Not that I’m aware of. There was a study done in South Africa that said 45% had quit smoking altogether within 6 months of taking up the e-cigarette.

CS: Why can’t you use these figures?

MK: Because there’s no medical backing to them. Without spending thousands or possibly millions on proper medical, clinical trials, there’s no clinical backing behind the figures. I can quote the ten or fifteen people a day who phone us up saying that they haven’t smoked for so long and that they’re very happy with it. Emotionally, that’s very nice but we can’t market those figures.

CS: Although you can’t market it as a smoking-cessation aid, from what I’ve read it seems to be a genuinely effective device. It’s all anecdotal at this stage, but they appear to be much more more effective than the pharmaceutical products, which have a failure rate of about 95%. And it makes you wonder how much power the pharmaceutical companies have over the anti-smoking groups, because I bet if 'Big Pharma' had invented the e-cigarette, it would be seen as the breakthrough of the 21st century.

MK: Absolutely. I don’t which way it will go and whether tobacco companies will start making them themselves.

CS: Could they do that? What’s the patent situation?

MK: If they get the license, there’s nothing to stop them. They’ve got the budgets to do it. They’ve got the facilities and the equipment. I can’t see why they couldn’t. It’s a question of whether they want to go down that route.

CS: What I find fascinating about the whole situation is that your competition in the nicotine market is the tobacco industry and the pharmaceutical industry.

MK: Two pretty big industries!

CS: Two very big industries but also two industries that are fighting each other. And they’re coming together...

MK: To fight this common enemy!

CS: This new, ‘rogue’ industry...

MK: ...which is a danger to their whole business model. It wasn’t that long ago that people thought nothing could ever cripple the tobacco industry, but if it’s done right there’s no reason why the e-cigarette couldn’t. I’ve tried it and have had great success with it and I know other people who’ve tried it and had great success with it. It is a great little product but it’s such a new industry and a new product that there’s so much needs to be done to get it into the mainstream.

CS: Are you allowed to advertise in the normal ways?

MK: There are some restrictions. You can’t advertise on things like Google Adwords, just as you can’t advertise tobacco products, but we could advertise on the radio.

CS: And what would you do if tomorrow the papers were full of stories about this new “terrifying” product that was “poisoning the air”?

MK: I don’t think it would damage us, to be honest. People aren’t stupid and since Google came along, people can look into a product.

CS: But in America, these scare stories have worked. Some places have banned them outright, others have banned them in public places.

MK: Yeah, but anyone who is seriously interested is going to go online and read the same stories that we’ve both read and probably come to the same conclusion - that it can’t be any worse than tobacco, and that’s all it needs.

CS: One thing I noticed when I went on one of the e-cigarette forums, is that when people start using the e-cigarettes, a lot of them very quickly become opposed to people smoking normal cigarettes. Maybe it’s the old thing about ex-smokers being the worst, but have you noticed this?

MK: I have noticed that actually.

CS: Is that something you feel yourself?

MK: I’ve noticed so much of a change in myself. I notice my clothes not smelling and I notice breathing easier and what have you. I’m not sure it doesn’t just come from pride though, and being able to say they’re a nonsmoker. It probably is the same mentality as when people give up and they become very anti-smokers.

CS: I like the term ‘analogue cigarettes’ for normal cigarettes

MK: Yeah! The digital switchover! is a UK based reseller of innovative electronic smoking products. There are more details on their website

Sunday, 1 November 2009

Nutt's sacking

Much ink has been spilt on the David Nutt saga in the last few days. For the benefit of readers outside the UK, the amusingly named Professor Nutt was the chairman of the Advisory Council on the Misuse of Drugs until the government sacked him because he said that cannabis, LSD and ecstasy are less dangerous than alcohol and tobacco.

Daniel Hannan and Tom Harris, despite being on opposite ends of the political spectrum, are united in siding with the politicians. They say that it is for the government to make the final call on the classification of drugs. I agree up to a point, but do politicians also have to sack any experts who don't give them the advice they want to hear? This looks like a dangerous precedent to me.

I don't want to go over the arguments for and against this decision, but there are a couple of points that have been largely overlooked.

The Pub Curmudgeon's take on it echoes my own thoughts, which is that we shouldn't confuse David Nutt with a liberal.

Prof. Nutt’s message is as much anti-alcohol as pro-drug.

Indeed so, and it is a message that he has been pushing since March 2007 when The Lancet first published the top 20 drugs in order of their supposed harm. This showed cannabis in 11th place and ecstasy at 18th, while tobacco was at 9th and alcohol was at 5th.

I remember this story being in the papers at the time, but there was no backlash from politicians, despite Prof. Nutt saying things like...

"The current system is not fit for purpose. Let's treat people as adults. We should have a much more considered debate how we deal with dangerous drugs."

Nutt didn't say anything this week that he hadn't said back in March 2007. So why were there no sackings then? I think Rod Liddle hits the nail on the head in today's Sunday Times.

Nutt also pointed out the simple fact that cannabis is less dangerous than tobacco or alcohol, pretty much regardless of the strength of the dope; nobody disputes this, and nobody disputed it three years ago when Nutt first made the comparison. 

But at that point the government was busy trying to push through its bill to ban the smoking of tobacco in public places and what is now an unfortunate truth was then a useful propaganda tool.

Nutt's advice could be taken in one of two ways:

(1) Cannabis is less dangerous than tobacco and alcohol so let's ease up on cannabis

(2) Tobacco and alcohol are more dangerous than cannabis so let's clamp down on tobacco and alcohol. 

In 2007, it suited the government's cause du jour to adopt the second position. Today, having since upgraded cannabis to a class B drug - the government can no longer be seen to adopt the first position. But, as the Pub Curmudgeon says, Nutt's liberal attitude towards drugs does not extend to tobacco or alcohol. He has made it clear that if he had his way, cannabis would be a class C drug, but alcohol would be a class B drug. They would both be illegal.

Whatever their differences, David Nutt and the government are united in wanting to see fewer people taking any of the substances in The Lancet's top 20. Nutt's dismissal, and several subsequent resignations, have all been caused by a dispute over whether certain drugs should be in Class B or Class C. What goes unmentioned is that once a drug is criminalised, it makes no difference what class it it put in.

By the government's logic, upgrading cannabis to class B should make fewer people smoke it. But if that is true, we should have seen more people smoking it after 2004, when the Blair government downgraded it from class B to class C. As we can see from this graph [PDF], the opposite happened.

After rising for several years, rates of cannabis use dropped by a third after it was downgraded. I would never suggest that this drop was due to the reclassification itself (I'm always reluctant to use the post hoc proptor hoc logic of the 'heart miracle' cranks) but we can surely agree that cannabis use did not rise after it was downgraded. What, then, is the point of upgrading it? 

Most public health policies are expensive failures (see Ireland for a recent example). Drug classification is only a talking point for academics and the political class. It is, quite simply, irrelevant to the people who use drugs.

I'd be prepared to bet that most cannabis users have no idea which class their drug is in and that they wouldn't alter their intake even if they knew. It is a peculiar vanity of politicians to believe that the public will alter its behaviour as a result of them reclassifying drugs, creating new targets or changing recommended daily limits. 

David Nutt and Alan Johnson are like two bald men fighting over a comb. Resign on principle, by all means, but don't imagine that moving a drug from one class to another is going to make any difference to how many people take it.