Thursday, 28 February 2013

Ban everything

Smoking in cars is back in the news thanks to the tireless efforts of state-funded prohibitionists. One such is Mr Martin Dockrell of fake charity ASH...

Martin Dockrell, director of policy and research at the campaign group Action on Smoking and Health, said: "The minister can count on our support and the majority of the public. A ban on smoking in cars is the right thing to do."

This is all to be done on the basis that we must THINK OF THE CHILDREN—because the government cares more about people's children than their parents do.

There are some who suspect that banning smoking in cars when children are present is the thin of the wedge and will lead to a ban on smoking in cars when grown adults have made the conscious decision to hitch a lift with a smoker.

Of course that would be fallacious slippery-slope rhetoric and would never happen, would it Martin?

"We need to think about whether this should just be aimed at children. Older adults are vulnerable too."

These salami slice tactics are so tiresome, predictable and irrational. The idea seems to be that people have a right to smoke, but that nonsmokers do not have a right to be around smokers even if they want to. Nanny knows best.

You will fondly recall the BMA's arch-propagandist Vivienne Nathanson lying through her teeth about secondhand smoke in cars being 23 times being more concentrated than secondhand smoke in bars (listen to the clip at Dick's place). She was back to her old tricks today on Radio 4 calling for the prohibition of e-cigarettes. You can listen to her at 48 minutes in here (the item starts five minutes earlier if you want to listen to the whole thing.)

Nathanson admits there is no evidence of harm, but claims that people using them on aeroplanes encourages smokers to light up real cigarettes. I would be amazed if this is not a bald-faced lie. She is a disgrace to the medical profession.

And finally, there's this from the Daily Mail.

Caffeine is so dangerous that it should be regulated like alcohol and cigarettes, warns leading expert

The Mail has a pretty broad definition of what a 'leading expert' is, but this particular guy is the editor of the peer-reviewed Journal of Caffeine Research so he couldn't possibly be a crank with a  axe to grind (cough). I recommend reading the whole article as it is a textbook example of a tabloid moral panic.

Even more worrying, he says that caffeine is also frequently used as a diluent (cutting agent) in illicit drugs.

You wouldn't want a bit of caffeine in your illicit drugs now, would you? It might very slightly raise the heart beat.

There is also evidence that children who drink caffeine are more likely to use alcohol, drugs and smoke in the future.

Ah, the old gateway theory. And so it continues, forever and ever without end.

Wednesday, 27 February 2013

Over-reported studies

As reported by the Express, the Guardian and the BBC, a study has been published which looks at the gap between self-reported alcohol consumption and recorded alcohol sales. According to the BBC, which never knowingly under-reports any news about alcohol...

The amount of alcohol consumed in England could be much higher than previously thought, a study suggests.

This is very much in line with the study's press release...

Alcohol consumption could be much higher than previously thought, with more than three quarters of people in England drinking in excess of the recommended daily alcohol limit

Or, as the Express puts it in its irrepressible style...

Booze-fuelled Britain: Now 80% of women are ‘binge drinking’

Anybody who is familiar with these sorts of statistics is well aware that self-reported consumption figures for alcohol (and drugs) significantly under-estimate the true level of consumption. If people only drank what they said they do it would mean that up to half of all the alcohol sold is poured down the drain. This seems rather unlikely. (UPDATE: Did I speak too soon?... Thousands of litres of whisky flushed down drain in Dumbarton.)

The amount that is under-reported can be easily worked out by comparing the total self-reported estimates with the total sales recorded by HMRC. There are a few other factors to confuse things, such as alcohol consumed by those under the age of 15 (a very small amount) and unrecorded booze sold on the black market (not such a small amount), but this basic piece of maths gives us a working estimate.

This particular study assumes that 40 per cent of all alcohol sold goes unreported by drinkers in surveys. This is not a new finding. As the authors of the study note: "International studies have shown that self-reported alcohol consumption only accounts for between 40 and 60 per cent of alcohol sales."

The basic premise of the press release—and the BBC's story—is therefore misleading. It is not true that alcohol consumption "could be much higher than previously thought". The Office for National Statistics, HMRC, the General Lifestyle Survey, the drinks industry and everyone working in the field of alcohol did not 'previously think' that self-reported consumption figures were reliable.

It is precisely because we know they're not reliable that we prefer to look at per capita consumption of 100% alcohol by people aged 15+ based on sales. Regular readers will know that these figures show a large decline in consumption in recent years—from 11.5 litres in 2004 to 10.0 litres in 2011.

So why do we bother asking people about their consumption if they're just going to lie? Partly it's because it gives us a rough idea of drinking habits. If we factor in the under-reporting we can still get an idea of who's a heavy drinker, moderate drinker or light drinking. And partly it helps us to see trends over time. People might lie (or forget) about how much they drink, but the level of inaccuracy should stay fairly constant, and so we can see how things change over the years—as in the graph below.

You'll note the change of methodology that the Office for National Statistics introduced in 2006. This was a further attempt to improve estimates based on self-reported consumption. In this instance, the ONS assumed larger glass sizes and stronger beer and wine. Despite this, the trend is still downward.

In short, there is nothing new or exciting about saying that sales figures are more reliable than self-reported estimates. Nor is there anything insightful about this new study which employs such a crude, back-of-a-fag-packet methodology that the authors should be commended for managing to stretch it out over six pages.

In short, they take the 40 per cent of alcohol that is missing from the self-reported data and spread it evenly across the drinking population. Or, to put it still more simply, they assume that everybody drinks 40 per cent more than they say they do.

Because the infamous 'guidelines' are set so low (3 units a day for a woman and 4 units for a man), adding 40 per cent immediately throws millions of people into the 'unhealthy drinking' category. And so, voila!, Britain's binge-drinking crisis is even worse than was previously thought.

Er, not quite. First of all, drinking more than the 'guideline' in a day is not 'binge-drinking', even by the debased definition of that term. Aside from the fact that the guidelines are notoriously evidence-free, they apply to weekly drinking of 14/21 units. The splitting into daily 'limits' was a later amendment by government and, even then, the advice is to not regularly drink more than 3 or 4 units in a day. The definition of 'binge-drinking', on the other hand, is more than 8 units in a single session for a man or more than 6 units for a woman.

The headline in the Express is therefore simply wrong, but what about the study itself? The authors concede that the UK government advice is "not to regularly exceed daily limits of 3-4 alcohol units" (my emphasis), but they nevertheless focus on the heaviest drinking day as if exceeding these limits on an irregular basis was a health concern.

But the big problem with the study is the assumption that everyone under-estimates their alcohol consumption equally. Based on this assumption, the authors conclude that "the daily limits effectively become 2.4 units for men and 1.8 units for women." This doesn't give an honest women much of a chance or not being a 'hazardous drinker' (if, by that term, we mean someone who drinks more than the risible guidelines dictate). Since there are two units in a pint of lager or a reasonable sized glass of wine, having just one drink once a week puts them into the hazardous category once their supposed lying or forgetfulness is factored in.

It is, however, unrealistic to assume that someone who drinks two or three units a day is as likely to misreport their consumption as someone who drinks twenty units a day. Even in these puritanical times, light drinkers have no reason to be ashamed of their alcohol consumption and therefore have little incentive to lie. Moreover, those kind of quantities are not enough to affect the memory. Someone who gets smashed every night is obviously more likely to forget how much they've consumed than someone who has one pint after work or a glass of sherry before dinner.

These observations fall under the banner of "common sense" and therefore have little appeal to policy-oriented epidemiologists. In fairness, the authors say that they made an alternative calculation in which heavy drinkers under-report more than light drinkers, but they do not bother to show the results of this, nor do they discuss it in any detail. Instead they focus on an unrealistic scenario in which everybody lies and forgets to the same extent.

Another feature of the study is that it looks at data from 2008 when per capita alcohol consumption was 8 per cent higher than it is today. The ironic result is that a study which wants to draw attention to under-reporting of alcohol consumption ends up over-reporting it.

Ultimately, the most reliable way to measure alcohol consumption remains per capita figures based on sales. By this measure, the UK consumed 10.0 litres per adult in 2011. In 1979 it was 9.8 litres. In 1997 it was 10.0 litres. So, please, would everybody just calm down?


Tim Worstall makes a good point about what the misreporting of alcohol consumption means for assumed rates of harm. He also leads me to the woeful Telegraph report which adds a whole new layer of wrong to the story... 

In addition, the research suggests the ‘average’ drinker is actually knocking back at least the weekly limit, week-in week-out, and probably more.

Really? Is that what it says?

Oh no, it doesn't say that at all...

Sir Richard Thompson, president of the Royal College of Physicians, said the study estimated 44 per cent of men and 31 per cent of women were exceeding weekly alcohol consumption guidelines.

Interesting definition of 'average' they have at the Telegraph.

Tuesday, 26 February 2013

The poverty fetishists of public health

From New Scientist...

If you want to stem rising obesity levels, sugary drinks should be taxed like cigarettes. So urges the UK Academy of Medical Royal Colleges, which is calling for pilots of taxes that hike prices by 20 per cent. The idea is to lower consumption by making sugary drinks dearer, a strategy known to cut sales of cigarettes and alcohol.

These medical busybodies seem to be in permanent awe of the law of demand, as if it was some fantastic new discovery. And this is their idea of progress...

Potential health benefits of reducing calorie intake were demonstrated after the Cuban economy collapsed in the late 1980s, says Simon Capewell, on the steering committee for the academy's report. Hard-up citizens ate an average of 1000 calories a day less. Within a decade or so, the incidence of obesity halved, with falls of 51 and 35 per cent respectively in diabetes and heart attacks (American Journal of Epidemiology,

The study in question found the following:

Cuba's economic crisis of 1989–2000 resulted in reduced energy intake, increased physical activity, and sustained population-wide weight loss.

...The crisis reduced per capita daily energy intake from 2,899 calories to 1,863 calories. During the crisis period, the proportion of physically active adults increased from 30% to 67%, and a 1.5-unit shift in the body mass index distribution was observed, along with a change in the distribution of body mass index categories.

Considering that the average man needs 2,500 calories a day, Cuban citizens were effectively put on a starvation diet in this period while  being forced to work harder for less money (ie. advanced socialism). It is scarcely surprising that rates of obesity fell amongst a hungry population. (The obesity rate fell from 14% to 7%—the 7% were presumably Communist Party apparatchiks.) Nor is it surprising that the poverty fetishists of the medical establishment would cite such a precedent approvingly.

Sunday, 24 February 2013

Kangaroo court

Monday sees the one and only public hearing about the EU Tobacco Products Directive. I'll be live tweeting the event as it happens (you can also watch it live here).

The presentations have already been posted online here. As I suspected, two of the speakers will be talking almost exclusively about plain packaging, which is not part of the Directive. Clearly the neo-prohibitionists hope to create a false narrative in which the EU is not going far enough, is being soft on the tobacco industry, blah, blah, blah. It doesn't look like any of them will so much as mention the fact that the Directive will maintain the ban on snus and will introduce a de facto ban on e-cigarettes.

The pharmaceutical industry will be delighted that their years of lobbying and donations to EU institutions such as the Smokefree Partnership have paid off. Not that the anti-tobacco zealots need much encouragement from corporate interests. They are far more interested in annoying the tobacco industry with petty policies like plain packaging than they are in the health of Europeans. These people are so far down the rabbit hole that it probably never occurs to them that banning e-cigarettes and snus plays straight into the hands of cigarette companies.

They simply do not care.

As ever, Clive Bates has some wise words to say about all of this.

Saturday, 23 February 2013

Carl Phillips on addiction

Carl Phillips has recently written a series of essential posts at Anti-THR Lies (THR= Tobacco Harm Reduction) about the ANTZ (anti-nicotine and tobacco zealots). Carl's writing has something that many academics lack: clarity and insight. I recommend you read them all...

“…but they are still addicted!”

“…but they are still addicted!” (part two)

What is addiction?

What is addiction? (part two)

The mirror-image delusion

Some highlights...

On anti-smoking ideologues who suspect everyone is a paid shill, including e-cigarette and snus users who say that reduced harms products helped them quit (from ANTZ and the mirror-image delusion).

Most of the ANTZ would never take the time to do anything they were not being paid for, and are themselves often doing the bidding of their paymasters. For many, their delusions make them incapable of understanding that consumers and the rest of us who are genuinely concerned with public health do not behave that way.

Similarly, on the subject of their apparently sincere (?) belief that all the evidence that displeases them must be corrupt...

ANTZ do not hesitate to corrupt scientific inquiry, lie about scientific results, and otherwise produce stinking pools of junk- and pseudo-science, and so they assume that their opponents have the same lack of concern about good science and ethics.

I was particularly impressed by Carl's discussion of the claim that most smokers want to quit which nicely expresses my own thoughts on the matter...

It is commonly claimed that most smokers want to quit. The surveys that support this are actually quite suspect, since smokers know that they are supposed to say that, and thus often just give that answer as cheap talk. But while this explains a large portion of the responses, there are definitely some people who sincerely assert that they want to not smoke, even as their actions show that they are choosing to smoke. But what can this obvious contradiction possibly mean? It almost certainly means, in most cases, that their second-order preference is to be someone who wants to not smoke, even though the reality is that they are someone who really wants to smoke.

This is an important point. It is often said that 70 per cent (or more) of smokers want to quit. As Carl says, the surveys are questionable and there is a big difference between stated preferences and revealed preferences.

Aside from the fact that only a small fraction of smokers actually quit smoking each year, only around 30 per cent of them even attempt to quit smoking each year. The high failure rate of those who attempt to quit can plausibly be cited as proof of "addiction", but the fact that at least half of the smokers who claim to want to quit don't make even one attempt to do so suggests that their stated preference is not their true preference.

As Carl points out, what these smokers are really saying is they wish they enjoyed not smoking as much as they enjoyed smoking. This does not preclude the possibility of genuine physiological addiction, but the fact that many smokers resume smoking after a long period of absence, when physical cravings are a distant memory, strongly suggests that people smoke because (whisper it) they enjoy it.

There is nothing horrible, or even the slightest bit unusual, about this second-order preference pattern. We all have countless preferences for different preferences. I would prefer to like going to the gym as much as I like playing computer games, and I would prefer to like unsweetened iced tea as much as I like Coke.

Public health campaigners assume that it is their job to force people away from their revealed, first-order preferences towards their stated, second-order preferences. If people say they want to eat more healthily or quit smoking but fail to do so, the campaigners blame the retail environment, or the industry, or the government for failing to "make healthy choices easier".

But the campaigners cannot make the second-order preferences more appealing or more enjoyable. They can only make the first-order preference more expensive, or less attractive or—the nuclear option—illegal.

Notice that I do not want diminish my enjoyment of computer games to the point that I prefer the gym; I want to raise my enjoyment of gym-going to that of computer games. If there were an action that accomplished that, making gym attendance better without diminishing the value of any alternative, there would be no question that this was an improvement in the world. But, of course, for most actions, particularly those where there is profit to be had by improving quality, there is no such magical cost-free improvement that no one has bothered to implement. You can sweeten and flavor the iced tea, but only at the cost of making it nutritionally about the same as Coke. My gym options are much nicer than the university weight rooms I frequented for a few decades, thanks to the wonders of the free market, but those wonders are still not enough to change the fact that staying home is nicer still, and there is no reason to expect magical further improvement.

Many anti-smoking efforts can be characterized as attempts to cause people’s preferences to align with their second-order preferences. But this is done by lowering the net benefits of smoking until quitting is the preferred option. That is ethically justified if (and those of us who believe in individual liberty would argue, only if) those who are affected genuinely want an external actor to do that to them, and they understand that the action is not going to make being abstinent as good as smoking, but is going to make smoking as bad as being abstinent. So, a drug like Chantix that makes someone not want to smoke is fine (ignoring, in this analysis, the side effects), so long as someone understands that it probably will not make the experience during long-term abstinence as enjoyable/productive/etc. as life when they smoked, but is merely going to lower the benefits of smoking in the short run to help achieve a new habit of abstinence that is in line with the second-order preference that the individual cannot bring herself to act upon.

...When the ANTZ defend policies that make smoking more costly and less pleasant with language like “helping smokers quit”, a standard response is that this is utter crap: Intentionally inflicting pain on someone to try to modify their behavior is called “torture”, not “help”, and it violates all accepted modern Western rules of ethical behavior.

...When the ANTZ claim that torture is help, they are invoking the implicit (and clearly false) claim that everyone affected by the torture has second-order preferences for quitting, and also invoking the implicit (and clearly false) claim that they want someone to use force to align their preferences with their second-order preferences by inflicting torture until quitting is preferable to smoking. In addition, the ANTZ are making the implicit (and clearly false) claim that all of these smokers who want to be forced really understand that when they are abstinent they are likely to be less happy/productive/etc. compared to when they were smoking.

Do go read all the rest.

Friday, 22 February 2013

Wages of Sin Taxes USA

My paper—a small book, really—The Wages of Sin Taxes has been reissued by the Competitive Enterprise Institute with a new foreword and some extra US-based stuff.

Sin taxes breed criminality and contempt for the law. They give governments a financial incentive to foster the vice they profess to despise. They are tools of disingenuous paternalists and would-be prohibitionists. They are favored by political cowards who dare not raise taxes openly and honestly. Their enduring popularity amongst the political class is summed up in the maxim of the late Senator Russell B.Long (D-La.): “Don’t tax me. Don’t tax thee. Tax that fellow behind the tree.”

It's free and it's a piece of work that I'm particularly proud of so download it here.

Thursday, 21 February 2013

New Zealand's path of least resistance

You may have heard that New Zealand has approved plain packaging in principle. In truth, it's a little more complicated than that. The NZ government has said it will go ahead with the policy if the Australian government wins all of the necessary court cases and gets approval from the World Trade Organisation.

In contrast to the giddy triumphalism of the Australians, the NZ prime minister has been notably circumspect about a policy which, at heart, is only designed to irk the tobacco industry. He says it is “one way of reducing smoking, in my view not the most important” and that “if we can take it we will but ultimately if we can't, we won't.” As 3 News noted, "the man who hits the go button couldn't muster up any fighting talk."

Perhaps this half-hearted decision to follow the Aussies if the Aussies win their battles is, as Angela Harbutt reports, due to the fact that the government only had three options and two of them conflict with New Zealand's trade obligations with Australia under the Trans-Tasman Mutual Recognition Arrangement.

Under option 1: “no change”, the Ministry openly admits that it can’t maintain the status quo:
Option 1 – Impact of maintaining status quo

[17] Maintaining New Zealand’s current tobacco product labelling and health warning regime while Australia introduces plain packaging would create difficulties for Australia under the Trans-Tasman Mutual Recognition Arrangement (TTMRA…In time, Australia would need to seek a permanent exemption from the TTMRA for tobacco products. It would be preferable to align the regulatory regimes to support the principles of a single economic market.

Option 2 (an “upgrade” on current warnings but without going the whole hog on plain packaging) was also is a non-starter for the same reason:

Option 2 - Impact of increased and refreshed health warnings [20] There would still be difficulties under the TTMRA (as for Option 1)

So once you take into account the TTMRA, ruling out option 1 and 2, what is left is option 3, Australia-style plain packaging.

In short, New Zealand has decided to let Australia try to wriggle out of its trade obligations with the rest of the world rather than wriggle out of its own trade obligations with Australia. For the Kiwis, this is the path of least resistance. It's certainly the cheapest path for the time being.

Australia doesn't ban something!

OK, it's only a little thing, and it's only in one part of the country, but still: a ban has been lifted in the Australian supernanny state!

Decade-old ban lifted on poker machine signs

The state government has watered down a decade-old signage ban by allowing hundreds of venues to display prominent "pokies" signs.

But... but... that means the people of Victoria will know where the fruit machines are! Will civilisation survive? It's too early to say, but the signs will still have to respect the fashion for plain packaging:

Now the government has allowed the use of "pokies" signs measuring two square metres on the facade of pubs and clubs. The signs must be in white lettering on a single colour background with no "decorative ridges or illumination".

These signs sound bland and drab, but you can always rely on an Aussie wowser to resort to laughable hyperbole and cite a well-worn urban myth about the Great Wall of China...

Opposition gaming spokesman Martin Pakula said "the effect of [Gaming Minister] Michael O'Brien's 'reforms' is that the only man-made structures visible from space will be the Great Wall of China and pokies signs".

And just in case that line doesn't sway the floating voter, another wowser has the killer argument—the piece of rhetoric that consistently trumps all intelligent debate in this foul year 2013...

Anti-pokies campaigner Tim Costello said allowing the signs was a retrograde step. "They don't allow smoking signs at all, which is funded from addiction. Pokies fall into exactly the same category and it's a public health disaster to allow pokies to be advertised," he said.

When in doubt, make a reference to smoking and pretend you're concerned about "public health". It works for the temperance lobby, it works for the food faddists, and there's no reason why it won't work for the anti-gambers.


Tuesday, 19 February 2013

The Department of Health has gone rogue

Dick Puddlecote has uncovered yet more evidence of foul play in the plain packaging consultation, including secret meetings between ministers and lobbyists which were hidden from the public record until exposed by journalists (see more here and here).

Almost every aspect of this public consultation to date has been an insult to democracy. To take a few examples off the top of my head...

The DoH invited two zealous supporters of plain packaging to review the evidence, including a far-left fruitcake who sees himself as being at war with marketing in all its forms. It then produced an impact assessment document which the Regulatory Policy Committee rightly considered shoddy.

The DoH gave the pro-plain pack campaigners millions of pounds to put up billboards and set up websites to encourage the public to support the policy (as it did in the previous tobacco consultation). In addition to making demonstrably false claims, these groups have encouraged fraudulent signatures to various petitions.

The DoH extended the consultation period after a foreign government asked it to do so. Throughout the process the DoH has been sharing private information with Australia's premier anti-smoking nut.

Now we find out that the DoH has been doctoring its own website to conceal 'inappropriate' meetings between ASH and the health minister. And the consultation document still hasn't been published. Considering the flagrant bias of the DoH staff who are compiling it, we can expect it to be a masterpiece of whitewashing.

Are all government departments as corrupt as the Department of Health? They can't be, can they? The problem stems, I think, from the fact that so many people working in the field of health today see themselves as campaigners and policy-makers—yesterday's call-to-arms from the Academy of Medical Royal Colleges being only the most recent manifestation of this. This undoubtedly extends to bureaucrats working in the Department of Health (what better job could an activist hope to get?). It is telling that the DoH is the only government department to openly admit to funding pressure groups.

This merging of bureaucracy and activism is extremely problematic for democracy. The primary goal of activists is not truth, but action. Once they have set themselves a goal, they will go to any lengths to achieve it. That is tolerable when they are outsider groups competing with others in the battle of ideas, but it is much more troubling when they are inside the system with their hands on the purse-strings and the levers of power at their fingertips.

Friday, 15 February 2013

The EU's amen corner

The first and only public hearing for the EU's Tobacco Products Directive is being held in Brussels on February 25th. Incredibly, there appears to be nobody representing the interests of the millions of European e-cigarette users who will have their product effectively banned by this legislation. Indeed, the whole line-up is filled with the EU's yes men (and women). Only one speaker is not a card-carrying anti-tobacco extremist and she's from the tobacco industry.

Public Hearing on "Tobacco Products" organised by the Committee on the Environment, Public Health and Food Safety (ENVI)

Monday, 25 February 2013 from 15:00 to 18:30

European Parliament, Room JAN 4Q2, Brussels


Institutional Representatives

15.00 - 15.05 Welcome and opening by the Chair Matthias Groote

15.05 - 15.15 Mr James Reilly, Irish Minister for Health

15.15 - 15.25 Mr Tonio Borg, EU Commissioner for Health and Consumer Policy

15.25 - 16.00 Questions by MEPs

Position of the Main Stakeholders

16.00 - 16.10 Ms Florence Berteletti Kemp Director, Smoke Free Partnership: The economic and heath burden of tobacco in the EU: The need to protect children and young people

16.10 - 16.20 Antonella Pederiva Secretary General, Confederation of European Community Cigarette Manufacturers (CECCM)

Proposal for a revision of the Tobacco Product Directive: assessment and impacts

16.20 - 16.50 Questions by MEPs

Specific Aspects of the Proposal: ingredients, labelling and marketing

16.50 - 17.00 Dr Martina Pötschke-Langer Head of the Unit Cancer Prevention in the German Cancer Research Center: Tobacco additives – the increased health risk

17.00 - 17.10 Luk Joossens Advocacy Officer, Association of European Cancer Leagues (ECL): Traceability, plain packaging and illicit tobacco trade

17.10 - 17.20 Dr David Hammond Associate Professor in the School of Public Health & Health Systems at the University of Waterloo - Canada: Health warnings and plain packaging

17.20 - 17.30 Dr Jean King Director of Tobacco Control: Interference by the tobacco industry in tobacco control policy and the need for transparency in official interactions with industry and in lobbying

17.30 - 18.15 Debate with MEPs

18.15 - 18.25 Concluding remarks by the Rapporteur

18.25 - 18.30 Closing statement by the Chairman

Two of the putative experts are best known for advocating plain packaging despite plain packaging not being part of the directive. It looks very much as if this hearing will be dominated by professional prohibitionists complaining that the directive does not go far enough.

Don't let them get away with it. The de jure ban on snus and the de facto ban on e-cigarettes are outrageous infringements of liberty that will be a disaster for the health of millions of Europeans. Most of the other provisions, such as the ban on menthol cigarettes, are petty, pointless and lacking in any scientific justification.

This session will be available to watch on the European Parliament TV website. If you are concerned about the EU's casual disregard for harm reduction, science and liberty, I urge you to read Clive Bates' post on the issue here and then write to your MEP. MEPs can ask questions at this event. Time is running out.

The Ashtray blog is updating its list of MEPs who support or oppose harm reduction here.

Thursday, 14 February 2013

Facts versus theory

In an article for Spiked last year I mentioned that the Sheffield Alcohol Pricing Model has already been debunked by evidence in the real world.The Sheffield model predicts a large decline in alcohol-related health problems from relatively small reductions in alcohol consumption, but their data comes from 2006. Since 2006, there has been a remarkable decline in alcohol consumption but no commensurate fall in alcohol-related hospitalisations and deaths. As I said at Spiked...

If you want a realistic idea of how much difference a 50 pence-per-unit price will make to drinking and alcohol-related harm, consider the difference in the health and safety of the nation between 2005 and today. And then halve it. If that doesn’t seem a very impressive outcome, prepare to be underwhelmed and overcharged by minimum pricing.

This week, the Centre for Economics and Business Research published research that puts a good deal of meat onto the bones of that observation by comparing the Sheffield model to what has actually happened in England.

Actual mean alcohol consumption per person in England has fallen by 12.6 per cent in the period 2006-2010. This is almost twice the reduction in consumption predicted by Sheffield University under a 50p MUP policy and nearly five times as much as what was predicted under a 40p MUP...

Sheffield’s prediction was that every 1 per cent reduction in consumption would deliver a 1.7 per cent reduction in alcohol-attributable deaths... in actuality, for every 1 per cent reduction in consumption, a less than 0.1 per cent reduction in alcohol-attributable deaths has been reported.

Cebr’s research reveals an annual increase in alcohol-related admissions of 7.7 per cent in 2007 and of a further 35.3 per cent in the three years between then and 2010. The implied annual average increase for the period 2006-2010 of 11.4 per cent means that, in actuality, for every 1 per cent reduction in consumption, there has been a 0.9 per cent increase in alcohol-related hospital admissions.

You can read the full report here (PDF).

Tuesday, 12 February 2013

Those non-communicable diseases

The Guardian has caught onto the Lancet non-communicable disease thing...

...cancer, heart disease and stroke, diabetes and respiratory diseases. All are caused partly by our lifestyles - smoking, eating processed food, drinking and taking less exercise - in response to a world where energy-dense food, sugary drinks and alcohol is cheap and heavily marketed.

I've written before about the (fairly obvious) reason for the non-communicable disease 'epidemic', but one graph should suffice:

Notice the way communicable diseases have virtually disappeared (the graph uses data from the USA). Notice also that the total mortality rate has halved since 1900. You almost have to applaud the way the public health industry has managed to turn a giant leap forward in disease prevention into a new "epidemic" that requires urgent government action.

In 2010, 34.5 million people around the world died from these diseases, which were 65% of all deaths that year.

Good. Let's try to get it up to 100%.

That is expected to rise to 50 million deaths a year by 2030 as the NCD epidemic spreads.

The "epidemic" is "spreading" because of massive population growth and massive increases in longevity.

The World Health Organisation has set a target to reduce these deaths by 25% by 2025.

This is the so-called "25% by 25" campaign. Leaving aside the absurdity of campaigning against dying of old age, this target seems to have been picked purely because it rhymes. That really is not good enough. The 'emerging NCD movement', as the Lancet calls it, expects to be given carte blanche to dictate every aspect of our diet and social lives on the back of this arbitrary target. It should be based on something more than alliteration.

Even to the megalomaniacs in public health, this target must seem absurd. NCD deaths are expected to rise by nearly 50% by 2030 and yet the World Health Organisation thinks it can turn this around in just twelve years and make them fall by 25% instead? It is an impossible target and that's just the way they like it, because it means they can keep banning and bullying forever.

The usual

I can barely be bothered to comment on today's outpouring of statist garbage. More slippery slope. More of the same. Expect much more of it forever.

From Reuters...

Multinational food, drink and alcohol companies are using strategies similar to those employed by the tobacco industry to undermine public health policies, health experts said on Tuesday.

In an international analysis of involvement by so-called "unhealthy commodity" companies in health policy-making, researchers from Australia, Britain, Brazil and elsewhere said self-regulation was failing and it was time the industry was regulated more stringently from outside.

Food isn't an "unhealthy commodity" and if you think any of these industries are "self-regulating" you haven't kept up with legislation in the last hundred years.

The researchers said that through the aggressive marketing of ultra-processed food and drink, multinational companies were now major drivers of the world's growing epidemic of chronic diseases such as heart disease, cancer and diabetes.

Funny how marketing is always "aggressive" when it's for things the bullies don't like. I suspect that their problem is with the existence of "multinational companies" more than anything else.

Writing in The Lancet medical journal...

Let me stop you there. At one time The Lancet may have been worth reading, but I advise you to follow its editor—the mind-blowingly self-important, overgrown, pseudo-intellectual teenager Richard Horton—on Twitter before you take anything it publishes seriously. It is now a glorified student rag."Welcome to a permanent attack on the present" indeed. Words fail me.


This is from New Zealand...

Public health specialists say alcohol industry has no place in making policy and should stop.

Yeah, I'd prefer it if people who disagreed with me were silenced too, but down here in the land we laughingly call 'liberal democracy' that ain't how it works.

The liquor industry must be shut out of alcohol policy-making and implementation, to prevent manufacturers from undermining efforts to reduce the harms of alcohol, says an international grouping of public health specialists.

Do you? Is that what you think? Well I think they should have a say, what with it being their business and all. So why does your view trump mine?

One of the 16 authors of the statement, Professor Sally Casswell of Massey University at Auckland, said the thrust was that the global industry commitments were "all whitewash".

And who the hell might Sally Casswell be?

Sally Casswell is a social scientist...

I had a feeling she might be. I must be psychic. Go away Sally, and mind your own business.

Suggestions include reducing the alcohol content of products, refraining from lobbying against effective public health measures and giving up political activities designed to reduce or eliminate evidence-based alcohol-control policies.

Splendid. Everything in the state, nothing outside the state and nothing against the state, as Mussolini would say. But has it occurred to you that we can only decide what are "effective public health measures" by debating the issues from all sides? And has it occurred to you—I doubt it has—that even if something is an "effective public health measure", the demos might still reject it because normal people think in terms of trade-offs and are not that interested in "alcohol-control"? Next.

From The Conversation—always a trusty font of health fascism...

Most health problems in Australia are now attributable to a poor diet, insufficient physical activity, tobacco or alcohol.

Liar, liar, pants on fire.

This means we have to move on processed and fast foods in the same way that we have on tobacco.

You will move onto them because you're an Australian public health statist ratbag. I won't be moving anywhere because I'm not an authoritarian busybody, what people eat is up to them, and people are living longer than at any time in human history so your whole thesis is bunk.

Foods high in salt, fat, sugar and calories are unfortunately a great way for the industry to make profit...

I guarantee that the profit margin is higher on the type of "sustainable", "locally sourced", "organic" sucker-bait that you eat, sunshine. The reason the food industry sells the enormous range of foods it does is because people like different things. Never before have people had such choice in what they eat, nor have they had more money with which to choose, and no matter how much you rant about industry, your little crusade—like every puritanical crusade—is a snooty, regressive war on people.

Clearly, we need to find a way to put health ahead of profit. The UK Food Standards Agency, which was launched in the aftermath of the mad cow or bovine spongiform encephalopathy (BSE) outbreak in the United Kingdom, is one example of a good solution.

Ha ha! I'll pass on your regards to the Food Standards Agency as soon as they've worked out how half the meat supply came to be made up of bits of French horses and Romanian donkeys. And rates of obesity are higher in the UK than they are in Australia, but never mind...


Monday, 11 February 2013

Life saving liquor

In the nineteenth century, the shift from the doctrine of moderation to total abstinence was crucial to the development of the prohibitionist cause. To make this leap, it was necessary for so-called Scientific Temperance to ignore and deny the medicinal benefits of alcohol.

Those health benefits have since been shown in numerous epidemiological studies which show a U- or J-shaped curve for alcohol consumption and mortality, with a very clear protective effect for cardiovascular disease in particular. These findings cannot be explained by the "sick quitter" hypothesis.

Today, as in the nineteenth century, those who ignore or dispute the medicinal benefits of moderate alcohol consumption usually have a temperance axe to grind. As Eric Crampton and Dick Puddlecote have both noticed, one such fellow is Tim Stockwell of the University of Victoria's Centre for Addictions Research. This is the man who led the media to believe that a 10% increase in British Columbia's minimum alcohol price led to a 32% reduction in alcohol-related deaths, despite the fact that there has been no 10% increase in price and there was no reduction at all in alcohol-related deaths.

Stockwell wrote to the journal Addiction after yet another study showed the cardiovascular health benefits of alcohol consumption. His argument was basically "confounding factors, confounding factors, confounding factors" even though the confounding factors he mentions have been repeatedly examined and discounted as explanations. He then calls for randomised control trials, though he must know that such experiments can never be conducted since they would require thousands of people to be force fed different quantities of alcohol for decades.

The authors of the study have replied with what Crampton calls "a beautiful glove slap", noting the tendency of neo-temperance folk to accept any old epidemiological association if it indicts alcohol while setting the bar impossibly high when it comes to benefits.

Epidemiology is only one of several pillars of evidence. Basic research on pathways in animals and humans constitute the other pillars. Together, the meta-analyses of both the epidemiology and the two most important biological causal pathways, which can be examined using randomized controlled trials (more rigorous evidence), coincide with the conclusions that regular and moderate alcohol consumption is associated with a lower risk of ischaemic disease.

Given the above points and further points made in [1], it seems that some researchers in the field may be using different standards in assessing the cardioprotective effect of alcohol vs. its detrimental effect. Consider two examples. One is the effects of alcohol on colon cancer. Would the same arguments used to judge the relationship between alcohol and ischaemic heart disease not hold for this relation as well? The other example is the more than 200 other risk relations between alcohol and disease and injury outcomes.

Of course, this is not a good argument against scrutinizing the cardioprotective effect of alcohol, but we sense a desire by some in the field to apply tough standards on protective effects and more lenient standards on other effects, where sometimes the responses to very simple survey questions such as ‘Did your partner’s alcohol consumption contribute to your marriage problems?’ are accepted as causal evidence.

Touché. Alas, this lesson in epidemiology may be wasted on the psychologist Stockwell, who neglects to include such basics as control groups in his own studies and whose own data are at odds with those of his own institute.

Speaking of which, it is worth noting that Stockwell's stomping ground, the University of Victoria's Centre for Addiction Research, mentions that it does not include several major diseases in its estimates of alcohol-related mortality...

Alcohol-attributed numbers do not include the following conditions: diabetes, ischemic heart disease, cerebrovascular disease, ischemic stroke, and haemorrhagic stroke (female only)

And why is that?

Alcohol has a net protective effect on these conditions and it is not possible to separate the number of alcohol-attributed and prevented deaths and hospitalizations


Friday, 8 February 2013

Aseem Malhotra on the telly again

I could tell Aseem Malhotra was a wrong 'un from his very first Guardian article. As I have said in previous posts, he has all the characteristics of a say-anything, do-anything prohibitionist on the make.

Malhotra's rise to semi-notoriety can be put down the fact that if he didn't exist, the public health lobby would have to invent him—a man who plays fast and loose with the evidence, who treats unproven theories and outright quackery as facts and who has a Johann Hari-esque ability to quote from unverified conversations with people who happen to prove his points. Few are prepared to use the term 'Big Food' without a hint of self-consciousness, let alone explicitly equate the food industry with 'Big Tobacco'. Malhotra does it all the time and he ramps up the hyperbole every time he appears in the media.

His latest appearance was on Irish television. You will seldom see such a blatant example of slippery-slopery as in his open remarks here, as he tries to flatter the Irish government into taking unspecified legislative action to change people's diets.

He congratulates the Irish on being the first country to bring in a smoking ban and then says:

"It took fifty years from when the links between smoking and lung cancer were raised to actual regulation that had an impact. Think about how many millions of lives could have potentially been saved if this had happened earlier. And what's quite sad is we see the food industry adopting the same dirty tactics as the tobacco industry to avoid regulation, planting doubt about their products being particularly harmful, confusing the public and even denial."

This argument is entirely bogus. It is not even an argument in any recognised sense.

Leaving aside the obvious differences between food and tobacco, which are colossal  there is no reason whatsoever why the link between smoking and lung cancer should have led to a ban on smoking in 'public' places fifty years earlier. The justification for the smoking ban came from the (admittedly flimsy) evidence about passive smoking that was published several decades later. Granted, there was an unspoken goal of making smoking so inconvenient for people that they would quit, but that was not the given reason. In any case, the ban did not lead to smokers quitting. In Ireland, the smoking rate increased while in the UK the smoking rate flat-lined. Some "impact".

There is simply no parallel between the smoking ban and Malhotra's plans for 'obesity control'. The only reason he cites it—as he has before—is that it is the prime example of a government acting in an illiberal and draconian manner on the basis of feeble evidence as a result of lobbying from monomaniacs like himself. His justification for using the force of the state to change eating habits is that the state already uses force to change smoking habits. This is the 'domino effect' logic in a nutshell.

The food industry should let people like this starve.

Thursday, 7 February 2013

Minimum pricing: lying with statistics

Praise be, it's another miracle. This time in the Canadian province of British Columbia and this time involving minimum pricing. From the Addiction press release:

Drop in alcohol-related deaths by nearly a third follows minimum alcohol price increase of 10%

A new study made available online today in 'Addiction' shows that, between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia, Canada dropped more than expected when minimum alcohol price was increased...

Those of you familiar with the English heart attack miracle and the English asthma miracle will have your suspicions raised by the words "more than expected". More than who expected? The answer, once again, is partisan researchers who pretend to have expected a worse outcome once all the data are in and their favoured policy has manifestly disappointed them by having no obvious impact. It's becoming the junk scientist's favourite way of rewriting history.

The partisan researchers in this instance mostly hail from the University of Victoria's Centre for Addiction Research (and they work hand in glove with our own Sheffield-based minimum price propagandists). They claim that a 10% increase in the minimum price of alcohol led to a 32% reduction in alcohol-related deaths in British Columbia.

British Columbia has had minimum pricing for many years and its minimum price for beer and spirits rose in 2004, 2006 and/or 2008. None of the rises exceeded 5%, so the estimate for a 10% rise is pure extrapolation. The 32% fall, meanwhile, is pure fantasy.

We need go no further than the website of their own esteemed institution to get the real facts. Here are the number of alcohol-related deaths in British Columbia between 2002 and 2009 (click to enlarge). The numbers rose in most years and no year saw a lower total than in 2002.

From the same website, here is the alcohol-related mortality rate per 100,000 (red line). It has remained essentially flat throughout the period 2002-2009.

And what about hospitalisations that were attributable to alcohol? British Columbia is shown by the orange line. Nice steady rise there.

It's also worth noting that the alcohol-related mortality rate in British Columbia—where they've had minimum pricing and a state run off licence monopoly for years—is 24 per 100,000, whereas in the UK—where we supposedly have a boozing epidemic—it is barely half of that: 13 per 100,000. Cheers!

There is much more that could be said about this thinly veiled piece of lobbying. The inexplicable lack of a control group, for example, or the mystery of why official hospital records were not enough for the authors—instead they created their own "estimates" of how many people died. But the bottom line is that these people are lying with statistics. The result—and almost certainly the intention—of their study is to make people believe that fewer people died of alcohol-related diseases in British Columbia between 2002-09 as a result of minimum pricing. "Nearly a third" fewer in fact.

The wider aim is to convince countries like Britain to join this province in its statist price-fixing which, like its government alcohol monopoly, is a hangover from prohibition. Tim Stockwell, the study's lead author, has been banging the temperance drum for over twenty years. He has this to say in the press release...

"This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia."

It is a bald-faced lie to say that there have been any "significant changes in alcohol-related deaths observed in British Columbia". The media will magnify this lie, usually unwittingly but never blamelessly. One wonders whether newspaper editors who publicise arrant nonsense of this sort on the basis that it has been peer-reviewed realise that they are abrogating their own responsibility in favour of an editorial system over which they have no control and of which they know nothing.

Feel free to check the stats here.


I see that the Scotsman, Reuters and—of course—the BBC have embraced the story. But so far the undisputed champion in piling a lie upon a lie is the Metro with this stunning headline...

The Metro: free and yet still over-priced.


An interesting graph here shows the rate of hospitalisations for alcohol overdose in British Columbia. If these aren't "wholly attributable" alcohol cases, nothing is. You can see a modest rise over the period 2002-09 amounting to 16 per cent.

This graph is taken from a 2012 report produced by—you guessed it—the University of Victoria's Centre for Addiction Research. Tim Stockwell is one of its authors. They conclude:
There is evidence of increasing trends of both alcohol and illicit drug overdose events in BC.

Monday, 4 February 2013

Really learning

Quote of the day is from Doug Weir of the Ontario Medical Association talking about his organisation's plans for food regulation...

"We’re really learning from our experience in the fight against tobacco, and two of the things that were most effective in terms of getting people to stop smoking was a tax on cigarettes, so what we’re calling for is a tax on high-calorie foods really..."

Could this be the mythical slippery slope?

"...and then the other thing we’re calling for are graphic warning labels."

Why yes. Yes it is.