Monday, 22 November 2010

Undone by the facts once more

In yesterday's post I quoted the say-anything anti-tobacco shill Martin Dockrell (of ASH, natch) saying:

"By helping smokers who want to quit and protecting our children from the tobacco ad men this will be an enormous leap forward for public health, perhaps even bigger than the smoking ban," he said.

He was talking about the crazy plain-packaging ruse, but he would have said the same thing whatever the policy was. Fair enough, that's his job. If he weighed up the pro's and con's of each policy and then gave a reasoned and intelligent assessment, he'd soon find himself in a smokefree Jobcentre.

But by saying that plain-packaging could be an "even bigger" leap forward for public health than the smoking ban, he is clearly suggesting that the smoking ban was itself a leap forward. This is frequently stated by all sorts of people, and it is often assumed that the smoking ban led to a surge in people giving up smoking. But has it?

"Encouraging" smokers to give up was, of course, the true (and barely concealed) motive for bringing in the ban in the first place and woe betide anyone who cast doubt on whether this would really happen back in July 2007. In ASH's hilariously premature and ill-founded Myths and Realities of a Smokefree England document (which I wrote about at t'old place) they said that the idea that mass abstinence wouldn't happen was a "myth".

We haven't heard much about smoking prevalence since (the statistics for such thing are always slow in coming forth), so I'm grateful to regular reader Dave Atherton for sending me the Office of National Statistics' Life Style Survey 2008 (published 2010), which concludes:

The overall prevalence of smoking among the adult population was the same in 2008 as it was in 2007 at 21 per cent.


A similar phenomenon was found by the EU's Eurobarometer which found the UK's total proportion of smokers (all forms of tobacco) to be 28% in 2009, which is—again—exactly the same as it was in 2008.

And all after the biggest, most controversial, most costly and most socially divisive piece of tobacco regulation in British history. Good work guys. Have the rest of the day off.

The other thing the ONS's report shows is something that Dick Puddlecote and I often point out—drinking is not on the increase in the UK:

Following an increase between 1998 and 2000, there has been a decline since 2002 in the proportion of men drinking more than 21 units a week, on average, and in the proportion of women drinking more than 14 units 



That's yer "hazardous" consumption. This is overall consumption:

The average number of units of alcohol consumed in a week rose steadily in the 1990s and achieved a peak of around 17 units for men and 7.5 units for women in the period 2000 to 2002. These levels fell to 14.8 units for men and 6.2 units for women in 2006. The revised methodology shows that the average number of units consumed is continuing to fall from 18.7 for men and 9.0 for women in 2006 to 16.7 and 8.4 respectively in 2008.

So, to summarise:


  • Rates of drinking are falling and have been for years
  • The smoking ban had no impact on the number of people who smoked, unless by "impact" you mean "put an end to a ten-year decline"


I mention this just in case any journalists or single-issue activists accidentally give you completely the opposite impression.


(Coming up in your soaraway British Medical Journal next week: '"The smoking rate plummetted after the smoking ban and our computer can prove it", says Professor Anna Gilmore and Professor Jill Pell'.)

10 comments:

Gary K said...

Let's see, smoking rate about the same and the population increasing by a greater % than smoking rate decreases = actual number of smokers is increasing.

Then there are the smokers that smoke contraband cigarettes and do not contribute to the official numbers.

ChrisB said...

Surely this cannot be true - the 'experts' keep banging on about a 'Smoking epidemic'.
-The NHS Health Development Agency published "The smoking epidemic in England" in 2004. http://www.ealingpct.nhs.uk/Library/JSNA/JSNA_June_2008_Data/023_Smoking_epidemic_HDA_2004.pdf
- Then I find - http://www.quitsmokingsource.org/2010/10/what-is-the-solution-of-the-smoking-epidemic-in-england/
- The Smoking Epidemic in Warwickshire (circa 2009/10} http://www.warwickshire.nhs.uk/CmsDocuments/John%20Linnane%2025%20March%20presentation.pdf
- Even that nice Mr Donaldson had something to say "England's Chief Medical Officer Sir Liam Donaldson said the country was in "the grip of a smoking epidemic".
- http://www.dailymail.co.uk/health/article-325842/Almost-half-adult-deaths-smoking.html#ixzz163HzRrcF

Obviously an epidemic is defined as a situation that is decreasing in prevalence and is unlike a pandemic in that the latter haemorrhages public finances to pharmaceutical companies in a single massive panic payment whereas an epidemic simply ensures a constant income for them based on political naivety, a fear of party 'boat rocking' and sheer bloody stupidity.
Just a thought - how much would it cost the Alan Carr publishers to buy a recommendation from ASH?

Chris Oakley said...

Nice work as usual Chris. Clearly the smoking ban has been a raging success. With respect to Ms Pell and Ms Gilmore , I refuse to refer to either of these unprincipled women as professors but it seems that they do have supporters amongst the far extremes of the not particularly attractive sample of humanity that currently infests the House of Commons. Namely one Kevin Barron who (mis)quoted both on 15th October in defence of the 2006 Health Act.
I have written to Mr Barron seeking clarification of his speech and I include the text below:
“Dear Mr. Barron
I feel obliged to write to you following your speech in the house opposing David Nutall's bill on October 15th. I say obliged because I happen to believe that it is unreasonable to criticize a person without giving them the opportunity to correct their mistakes and atone for misleading others. I have waited until now because I had hoped that a person in your position would have realized that his speech contained errors and falsehoods and that it could therefore be considered an abuse of the privilege of speaking to the house not to correct them.

I can completely understand that nobody can be expected to remember all of the facts accurately at the point at which they get up to speak but in your case I have noticed that time and time again, the errors are all unidirectional so I am concerned that they may not be simple mistakes.

For example, in your speech of October 15th you stated "The most notable health gain for members of the public is the fall in the number of admissions for acute myocardial infarction. Researchers at the university of Bath have calculated that there has been a 5% drop in the number of heart attacks in England, attributable to smoke-free legislation".

If for a few seconds we suspend scientific and mathematical belief and assume that a study directly funded by DH and performed by an unqualified anti-tobacco zealot who makes a tidy living out being just that could possibly come up with any kind of objective facts, then your words to the house would still be untrue.

The facts are that MI admissions fell by 4.3% in total in the year following the ban and even the mendacious Ms Gilmore of Bath only tried to claim 2.4% as a result of the 2006 Health Act. It is worth pointing out that MI admissions did fall by over 5% in 2005, 2 years before the act came into force as this highlights the extremely dubious nature of the Bath "study". I am sure that you would be at pains not to admit such facts to the house judging by way that you managed to avoid mentioning MI admission levels in the second year following the Scottish smoking ban while having the gall to refer to the thoroughly discredited Pell study covering admissions in its first year.

Rather than attacking the other instances of untruths half truths and apparent attempts to mislead contained within your speech I would like to give you the opportunity to correct the section on public health benefits in order to demonstrate that you are an honest politician making a genuine error, rather than a dishonest man attempting to mislead parliament.

I am aware that you may not be able to answer me directly so have taken the liberty of copying local political groups and my own MP. Like many people I am largely supportive of the 2006 Health Act but feel it failed to reasonably provide for the 12 million or so British people who choose to smoke and that some of the restrictions it imposes are not justified by the facts. I in no way oppose your right to campaign on this issue but I do oppose the use of dubious methods in order to secure parliamentary support.”

I have received no response from Mr Barron after over a week so I think it entirely reasonable to call him a liar from hereto forward.
Best

Chris

Joe Jackson said...

Good point about ''how do we know how many people are smoking contraband fags' - but I would like to know, how does the smoking rate get calculated anyway? The only way I can think of is to base it on the number of packs sold, but then you have to make a guess about how much each person smokes. If someone buys 2 packs of 20, how do you know whether they're going to smoke both of them that day, make them last a week, or give one of them to someone else? You could assume that every smoker smokes a pack a day, but if you then decided to assume they only smoked half a pack, wouldn't the smoking rate immediately double? I don't see how you can confidently say that 21% or 28% of the population smokes - am I missing something?

Snowdon said...

Joe,

All the smoking prevalence figures are based on surveys, which means figures are likely to be under-reported (the shame!) rather than under-reported. There were reports of total cigarette consumption falling after the ban (but also reports of it rising). Either way, the smuggling/duty free aspect muddies the picture considerably.

It's interesting that the EU figure is so much higher - it's unclear if they're including smokeless or not. The link I provided says just smoked products but elsewhere it says 'tobacco users' and the high figure for Sweden suggests that they're including snus use. This masks the fact that Sweden has the EU's lowest smoking rate thanks to its exclusion from the EU's crazy snus ban.

Anonymous said...

The figures are based on surveys. Some claim to do follow up tests on a smaller sample, but these are unreliable because of the high rates of refusals. There have been several attempts to quantify the under reporting. One I remember was from New Zealand. I would imagine the USA has the highest under reporting as you can get fired from many jobs if found to be a smoker, or made to pay more for medical insurance. People just get into the habit of saying they don't smoke, no matter what assurances they are given that surveys are confidential. Sweden has a male smoking prevalence of only 15%, so a high figure (eg 35% male for cig and snus) would indicate total tobacco use. However, this wouldn't explain a high figure for the UK as smokeless tobacco use is neglgible.

Gary K said...

Surveys and Studies?

Let's suppose a survey was based on questioning 10,000 adults.

In the USA there are about 230 million adults and there are about 23,000 such groups of 10,000.

To base a policy on a group that is 1/23,000 of the possible groups is INSANE!!!

A study that examined 10,000 adults would have the same limitations.

A meta-analysis of 10 such studies would only be a report on 1/2,300 of such possible groups!

These things are very likely to not be representative of the whole of society.

The studiers say that they control for possible confounders; but, just how accurate can they be??

Anonymous said...

This is from today's ASH UK News. If it is to be believed, a reduction in contraband cigarettes has resulted in at least a 4% increase in sales (cigs are highest growth area, see below - my comment). If there has been a reduction in smuggling, it can't be as much as 4% of the UK market (assuming that this cash and carry is representative of UK sales). Remember, this is just the reduction. From my experience the reduction hasn't made much difference to the cost of foreign tobacco, which seems to follow very closely the retail price- about double. The alternative is that total cigarette sales are on the increase.

"Tobacco duty fraud cuts benefit Parfett’s
HMRC's renewed clampdown on tobacco duty fraud has contributed to a 4% sales boost at the cash and carry chain AG Parfett & Sons.

Cigarettes and tobacco have grown faster than any other area, said company secretary David Grimes. "To some extent this is only the return of legitimate business that has been diverted to criminal activity and duty free," he said.

Accounts filed at Companies House for the year to June 2010 revealed pre-tax profits up 21% to £2.8m on turnover up 4% to £289.1m."

Source: The Grocer - 20 November 2010
Link: http://bit.ly/eWsgYl

Gary K said...

Ahhh yes, and the antis claim that 50% of smokers will die from diseases caused by their smoking.

Welll, here in the USA, heart disease causes 26% of the yearly deaths and cancer causes 23% of the yearly deaths.

Sooo, never-smokers will also have about 50% of their yearly deaths caused by these smoking related diseases.

Anti-smokers and other Public Health types claim that smoking causes 400,000 smokers deaths per year.

Since everyone dies, if there were NO smokers, those 400,000 deaths would still occur.

The disease percentages might be slightly different and the ages of death a little different; but, those 400,000 deaths would still occur.

Also, since if you do not die, you will live longer, everyone's death is pre-mature.

Claims of 'preventable, pre-mature deaths' is a bunch of CRAP!!!

PJA said...

Chris,

I came across a paper (in pharmacology) that tested surveys against mouth swabs for cotinine. IIRC, the result was that there was 5% under-reporting from survey in the UK. (In Poland where the issue is not so moralised, the gap was smaller).

So take that as 21.5% survey = 26.5% actual as a general position.

The other thing is that Eurobarometer consistently puts prevalence 7% higher than UK. I don't know precisely why, but I suspect that people are less inclined to lie, although it also reports a 5% fall post smoking ban which doesn't seem at all credible, except under the 'lying through one's teeth' hypothesis.