Saturday, 31 May 2014

Burning Desire: A viewer's guide

 "We must not campaign, or allow ourselves to be used to campaign."
—BBC Charter, Section 10.2.3


I don't think I've ever seen the BBC make such a blatant attempt to influence government policy as Peter Taylor's Burning Desire documentary did on Thursday. You can watch it here. For most of its one hour running time, it was an overt campaign video for plain packaging, with the assistance of the campaign group Tobacco Free Futures and a host of plain pack advocates including Linda Bauld, Melanie Wakefield, John Britton, James Reilly and Mike Daube. Insofar as there was any pretense of balance, it came from carefully edited quotes from a few employees of British American Tobacco.

Peter Taylor has been making occasional documentaries about tobacco for forty years. I suspect that his formal pitch to the BBC was that this new programme would look back over that period and see how things have changed. The first third of Burning Desire did that to some extent, but only as an hors d'oeuvre before the main course of political activism.

The hazards of smoking are now universally recognised. There are some who see cigarettes as a defective product and believe that the tobacco industry should stop selling them. There are others who think that so long as people are appropriately informed about the hazards, they should be able to buy them without being over-charged, harassed or demonised. Taylor clearly falls into the former camp and I fall into the latter. There is a legitimate debate to be had and a decent documentary could be made from it. This, however, was not it. It was barely even a documentary.

The Daily Mail review

The first part of Burning Desire made the observation that, after forty years, lots of people are still smoking and the tobacco industry is still making a lot of money. We are told about Britain's numerous anti-smoking laws and are then told that smoking rates are rising amongst 25-34 year olds. Taylor does not display any curiosity as to why people are taking up smoking at such an age, nor does he ask why the overall smoking rate has flat-lined since the UK started binge legislating in 2007. On the contrary, we are told that nearly everybody starts smoking as children and that the latest anti-smoking ruse—plain packaging—is the "decisive battle". Implement plain packaging and all will be well.



This section of the documentary featured smokers of various ages who, rather awkwardly for Taylor, failed to blame packaging, advertising or the industry for their habit. A group of young college students said they started smoking because "everybody else did", or because it was "cool", or—brace yourself—because they "really enjoyed it".

Taylor may have been hoping to get more supportive quotes from an elderly couple who have been smoking for fifty years and who both have smoking-related diseases. Alas, no. "Who do you blame?" he asks Diane, who started smoking at the inconveniently mature age of 19. "Myself. I can only blame myself." Meanwhile her husband John, who claimed to have smoked 100 cigarettes a day, said he did so because he "really enjoyed it".



The lack of relevance of these testimonies to the plain packaging campaign is not dwelt upon. Instead, we are shown some old television advertisements for cigarettes, mostly from before the smoking-lung cancer link was identified and all from the USA. We are then told that packaging represents the 'last vestige of marketing'.

At this point, the documentary focuses on its real target and sticks with it for the next 35 minutes. We are transported to sunny Bondi Beach. Swimmers swim. Surfers surf. Children smile. All is joyous and thriving. And no wonder, because—as Taylor—explains...

"Smokers in Australia are now an ostracised minority. A year and a half ago glossy packages were consigned to the dustbin history."

It is not explained why ostracising minorities is a good thing, but Taylor clearly thinks that the second sentence is strongly connected to the first. There is no mention of the fact that both cigarette sales and smoking rates have risen (or, at best, stayed flat) since plain packaging was introduced. How does Taylor know that hardly anybody smokes since plain packaging came in? Because the tutor of a group of trainee lifeguards doesn't think any of them smoke. What more proof can anyone ask for?

Bondi Beach: A paternalist's paradise
We are then shown an Australian anti-smoking advertisement (in full) and get some blatant campaigning from Melanie Wakefield and Mike Daube. We are told that the tobacco industry ran a vicious campaign of character assassination against former health minister Nicola Roxon, although Roxon herself says that the worst that was said of her was that she was a 'nanny'.

We then cut back to London where Taylor claims that the Westminister government did a 'U-turn' by rejecting plain packaging. This is doubly untrue. There was never a commitment to bring in plain packaging and it was never rejected, only put on the back burner while the situation was monitored in Australia. Inevitably, this is followed by a few minutes of the Lynton Crosby conspiracy theory, despite Taylor acknowledging that both Crosby and Cameron explicitly denied ever discussing the policy.



While in London, Cyril Chantler is interviewed. His claim that smoking places a "huge burden" on the NHS ("which we all pay for") goes unchallenged despite Taylor having earlier acknowledged that tobacco tax receipts pay for the cost of smoking-related diseases twice over (in fact, they pay for it three times over). Chantler then starts talking about the benefits of reducing the smoking rate by two percentage points. The clear implication is that this would be the effect of plain packaging, despite there being no evidence for it and despite nobody—including Chantler—having ever having made such a claim.



Having failed to get adult smokers to indict tobacco packaging, Taylor resorts to a focus group of 11 and 12 year olds that has been assembled—and, one suspects, trained—by the state-funded lobby group Tobacco Free Futures (which was "working alongside the BBC in creating the documentary"). The kids are shown Sobranie Cocktails and other obscure but elaborate cigarette brands (which children don't buy) and they eventually provide enough supportive quotes for Taylor to edit together to make his case.

For the next quarter of an hour, Taylor makes a rather muddled attempt to show that plain packaging will not increase the illicit trade in tobacco. The viewer is taken to a customs warehouse in Australia where a massive seizure of cigarettes from China has recently been carried out. In Melbourne, he goes on a sting operation to see how easy it is to buy illegal cigarettes from shops. Back in the UK, he joins Trading Standards where a newsagent is busted for selling counterfeit cigarettes.

This all suggests that the sale of illicit tobacco is widespread and that the anti-smoking lobby's favourite policy of high taxes is the main driver (as Chantler accepted in his review). Instead, Taylor makes a half-hearted attempt to blame Big Tobacco for selling too many cigarettes to countries that illegally export tobacco, despite the fact that the products he finds on his travels are not legitimate Western brands.



He then turns to the question of how to measure the illicit market. HMRC figures suggest that the black market, while large, is smaller than industry-funded research suggests. HMRC uses survey data, asking people if they have bought illegal tobacco in the last year, while the industry collects discarded cigarette packs to see what proportion is illicit. Neither approach is perfect, but Taylor dismisses the latter as being "hardly scientific" and puts his faith in the self-reported survey data instead. In fact, empty pack surveys have been used by governments around the world for decades to estimate the size of the illicit trade and have a big advantage over asking people to effectively confess to a crime.

A spokesman for BAT Australia tries to explain this but is cut off mid-sentence. Instead, we hear from Melanie Wakefield who asserts her scientific credentials (she's a psychologist) and says that the industry-funded research is "rubbish". Why so? Because it uses "leading questions". This is an odd criticism since the empty pack surveys don't involve any questions at all. It is a particularly odd criticism coming from Melanie Wakefield, whose research into plain packaging involves showing cigarette packets to teenagers and asking them, er, leading questions.

Blithe dismissal of industry-funded research allows Taylor to ignore the evidence of increased smuggling and the growth of counterfeit brands in Australia since plain packaging was introduced. He also ignores official data showing a rise in illicit tobacco seizures, as well as the biggest seizure of illegally grown tobacco in Australian history.

For "balance", he interviews Northern Ireland's former chief constable, now working at BAT, who says that plain packaging will exacerbate the black market. This interview, however, is preceded with a voice over saying that "it is a measure of the importance of the smuggling argument to BAT that it's signed up Northern Ireland's former chief constable as a consultant." It could, of course, be a measure of the threat of smuggling to BAT's business rather than the importance of the smuggling argument, but Taylor does not consider that possibility.


Taylor's coup de grace to the smuggling 'argument' comes from Kate Pike, an employee of Trading Standards, who is unusually forthright in her support of plain packaging. Not only does she reject the idea that plain packs will drive the black market, she even—contrary to all the evidence—rejects the idea that tax rises drive the black market. Taylor dismisses industry initiatives to help retailers enforce the ban on selling cigarettes to minors (weirdly, he calls these efforts "lobbying by another name"). Pike agrees. She says that the only thing that will reduce underage smoking is the removal of brands from cigarette packs. Back of the net!

But Kate Pike is not just any employee of Trading Standards. Taylor doesn't mention it, but she also happens to be an employee of the aforementioned Tobacco Free Futures. What a small world!

The programme ends with Mike Daube calling for yet another raft of measures to follow in the wake of plain packaging so long as they pass his ridiculous 'scream test'. John Britton calls for outdoor smoking bans and—despite expressing concern earlier in the documentary about smoking being concentrated amongst the 'most disadvantaged and marginalised'—recommends making cigarettes £20 a pack. They're all heart, aren't they?

In the next episode, we are promised a discussion of "what BAT calls harm reduction". Taylor will be looking at e-cigarettes which, he eagerly points out, "critics say are a smokescreen". I think we can guess how that's going to go.



If you'd like to complain to the BBC about this shameless piece of propaganda being shown the week before the Queen's speech, you can do so here.

Friday, 30 May 2014

Cigarette-style warnings on soft drinks

And so the second front against sugar begins in earnest. As so often happens, the lunacy has started in California.

Similar to warnings on cigarettes or alcoholic beverages, sugary drinks in California could soon see labels advising consumers about health risk as well.

A bill that would require such warning labels on sodas and other drinks with added sugar passed in the California Senate Thursday and will move on to the state Assembly and later to Gov. Jerry Brown’s desk.

“Liquid sugar is a significant and unique driver of obesity, preventable diabetes, and tooth decay,” Democratic state senator and author of the bill Bill Monning said, according to Reuters. “Some people accuse this [bill] of nanny governing and yet it is the government that’s responsible to protect the public health and safety of its people.”

"Liquid sugar", for God's sake. These people sure have the knack of coining a phrase. By the way, Mr Manning, the government doesn't have its people. The people have their government.

The proposed warning label with read: "Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay". Sugar can certainly lead to tooth decay if you don't brush your teeth, but 'added sugar' in beverages is no different to other sugar in that respect. Excess calories can lead to obesity which can, in turn, lead to diabetes, but, again, there is nothing special or unique about fizzy drinks.

How long will it take for other food faddists with an axe to grind to point out these facts and to demand that other food and drink products should be similarly labelled? Logically, everything that contains calories should have a warning label saying "Eating this product can contribute to obesity, diabetes and cancer."  How long will it take for people to say—as this rather inarticulate anti-soda campaigner says—that “there should be labels on everything on what’s everything”?

But that's the slippery slope argument, right? And we all know that the slippery slope is a fallacy because none other than Simon Chapman explained it in a pal peer-reviewed 'study' in 2003:


"Slippery slope"

In pre-warning days, when arguments could be couched in incredulity that tobacco should be singled out from other consumer products, the industry used "slippery slope" or "thin edge of the wedge" rhetoric, arguing that the policy would inexorably bleed into other product areas."

'The precedent is one which could easily come to affect other industries. For instance, a number of medical scientists claim that butter and milk are dangerous to the health of some people. It is recognised that drinking too much liquor or reckless driving are hazards to life... can we expect all these products to carry a ‘danger’ label ...?'

This argument appears to have quickly lost momentum when the dire predictions of rampant warnings never materialised.

They've materialised now, slaphead.

(Chapman has spent the last few years insisting that plain packaging for tobacco will not be the start of another slippery slope. You can be the judge of his powers of prediction here, here and here.) 

Once more into the breach

Another chance to tell David Cameron to get a grip and drop nanny statism for good.

It takes less than a minute so please join me in signing this letter saying 'No, Prime Minister' to plain packaging. The public health racket is desperate to get this stupid proposal out of the way so they can concentrate on making cigarettes brown (like, er, cigars) and putting health warnings on cans of pop. This lunatic crusade needs stopping in its tracks. 

Sign here.

Thursday, 29 May 2014

Oh, sugar

Simon Capewell, a health demagogue who says that "sugar is the new tobacco" and thinks that people should eat ten vegetables a day, has written an opinion piece for the BMJ. Capwell is a member of the newly formed Action on Sugar (formerly Action on Salt), a pressure group that obviously models itself on Action on Smoking and Health and has exactly the same policies. Like the anti-smokers, they are starting with health warnings and sin taxes...


Sugar sweetened drinks should carry obesity warnings

Should they, by George. Why?

Many other potentially harmful products already carry effective health warnings. For example, insecticides and other toxic products have long carried labels warning users to take extreme care.

Insecticides are toxic products that should not be eaten. Sugar is a naturally occurring, non-toxic food that is intrinsic to fruit and vegetables. See the difference? Capewell doesn't.

Similarly, cigarettes have gone from being socially acceptable to quite unacceptable after warning labels were implemented. 

Firstly, smoking is only 'socially unacceptable' in medical circles and amongst sections of the ruling class. Amongst normal people, smoking remains common and unexceptional. Amongst some groups, it is almost compulsory.

Secondly, policy should not be aimed at making sugar 'socially unacceptable'.

The effectiveness of tobacco warnings and plain packaging is now accepted by almost everyone not linked to the industry. 

I'm not sure how plain packaging slipped into this article, but there is no evidence of its effectiveness and growing evidence of its ineffectiveness. Surveys show that millions of people are opposed to plain packaging and hundreds of thousands registered their opposition in the public consultation. It seems unlikely that all these people are 'linked to the tobacco industry'.

These successes in tobacco control highlight the importance of targeting the “three As”—affordability, availability, and acceptability. Warning labels clearly target acceptability.

Warnings are supposed to target ignorance. The purpose of a warning label is to provide accurate information. Its purpose is not, in itself, to deter purchase, but to inform. Graphic warnings arguably target acceptability, and that is why they are not warnings in any meaningful sense (hence they have been blocked by a judge in the US.)

Doubtless the kind of warnings that Capewell would put on sugary products would have no informational value and would be designed only to deter purchase, but that is because he is a zealot who can't tell the difference between insecticide and chocolate.

Sugar is being progressively demonised: in the UK, a recent Populus public opinion poll commissioned by the BBC found that about 60% of 1000 adults would support health warnings on food packaging similar to those on cigarette packets.


It's being demonised by Action on Sugar, a say-anything, do-anything pressure group that has gained favour with the tabloid press, but which is heading for an embarrassing implosion if it continues to thumb its nose at science. If 60% of Britons have fallen for their nonsense, that is unfortunate but hardly decisive.

The global obesity epidemic already affects more than two billion adults and children. In the UK one third of children and two thirds of adults are now overweight or obese.


Note how Capewell does the old bait and switch by conflating obesity with overweight. It is a common trick amongst these people. The obesity 'epidemic' does not affect two billion people. The majority of those people are overweight, not obese, and the health implications of being overweight are trivial.

In Europe the food and beverage industry recently spent more than €1bn (£813m; $1.37bn) in vociferous attempts to delay, dilute, and demolish food labelling. The industry would not do this unless its future profits were threatened (what the pressure group Action on Smoking and Health calls the “squeal factor”).


Actually, they call it the "scream test" and food is already labelled. What they object to is the ridiculous and arbitrary traffic light system of labelling which will simplistically mark some foods and good and some as evil without any regard to the overall diet. And that is exactly what warnings on sugary products would do, implying that low sugar/high calorie products are somehow healthier.

We might expect the industry to oppose warning labels on sugary drinks with a barrage of opposing arguments, reminiscent of previous opposition to standardised tobacco packaging.


Is this an article about sugar or about plain packaging? Is there some rule that says 'public health' activists must mention plain packaging in all contexts?

Warning labels for refined sugars hidden in sweetened drinks and processed foods represent an interesting natural experiment.


Experiment in the laboratory, Capewell. The world is not your toy.

Monday, 26 May 2014

Policy-based broadcasting

Earlier this month, I mentioned the forthcoming BBC documentary about the tobacco industry. Titled 'Burning Desire', the first of two episodes airs this Thursday and, as suspected, it looks like a one hour campaign video for plain packs...

Peter travels to Australia to look at the industry’s last-ditch battle to prevent plain packaging in which glossy images are replaced with gruesome health warnings. And now, other countries are poised to follow suit, including England and Wales, after fierce lobbying and two controversial U-turns.

I said in the previous post that it is a bit rum for the Beeb to broadcast this politically sensitive programme when a consultation on plain packaging is due any day now. I had forgotten the importance of one particular date. Next Wednesday, June 4th, is the Queen's Speech, which anti-smoking campaigners hope will contain a pledge to bring in this ridiculous policy. Burning Desire looks designed to serve as a little nudge from the state broadcaster a few days beforehand.

Vapers don't get off lightly either. It looks like the second episode will be promoting the (utterly dishonest) Hastings/McKee view of e-cigarettes as being part of a tobacco industry plot.

Peter Taylor has spent 40 years investigating how, in the past, the industry has dissembled and lied – which makes it all the more remarkable he was given rare access to the second-largest tobacco company in the world, British American Tobacco. He talks to their executives and learns how BAT, now openly recognising that smoking kills, has set itself a new core strategy of 'harm reduction', developing a range of less harmful alternatives to conventional cigarettes.

I've been writing about tobacco and the anti-smoking movement for the best part of ten years now. It's a niche subject, but I find it fascinating, and there's more than enough material for a good two hour documentary. I'm hoping against hope that Burning Desire will be a worthy successor to The Smoking Years and Addicted to Pleasure, but I fear it may be more like the Beeb's policy-based hack jobs on minimum pricing and gambling machines.



Friday, 23 May 2014

Fighting state-funded activism

More news from the southern hemisphere, this time New Zealand. A state-funded pressure group has lost its funding and is suing the government with the government's money.

Problem Gambling Foundation will this week take legal action to stop the Ministry of Health dumping it in favour of the Salvation Army.

The move comes as papers released under the Official Information Act show the PGF and the ministry embroiled in a long-running argument over the foundation’s right to speak out on gambling issues. It includes the ministry threatening to terminate the foundation’s contract if PGF didn’t halt a campaign called “pokie free and proud of it” promoting pokie-free pubs.

Commenting at the Kiwi blog, David Farrar says...

So the PGF will use its existing taxpayer funding to try and force the Government to keep funding it – rather than the Salvation Army (which was judged better by an independent panel of public servants and experts).

The Sally Army explicitly and literally believes that gambling is a sin and that nobody should partake in it. How zealous do you have to be for them to be considered a more reasonable and moderate voice?!

PGF's extremism has created some unlikely bedfellows...

A gambling industry leader was among the first people knocking on the Salvation Army's door this week after news broke that the army had displaced the country's main help agency for gambling addicts, the Problem Gambling Foundation.

"We will be moving very quickly to establish a relationship with the Salvation Army," explains Brian Corbett, who chairs the Community Gaming Association.

"We at the CGA have tried to take a collaborative approach to the problem, but that didn't seem to be the way with the Problem Gambling Foundation. They seemed to take a fairly antagonistic approach to everything."

The Problem Gaming Foundation have been using a familiar excuse to wriggle out of the 'taxpayer-funded lobbyist' tag:

The PGF has always been a vocal critic of pokie machine rorts and gambling harm. It believes, as an independent body with other income streams, it has the right to speak out. The ministry argues there should be no perception government money is being spent on campaigns.

State-funded troughers always say that they don't lobby with taxpayers' money. ASH says the same thing. This is hard to swallow when you all you do is campaign, as ASH does, or if you are overwhelmingly funded by the government, as the PGF is. These people were getting $4.7 million a year from the state and just $0.5 million from other sources. If they were speaking out with their own money, how could they be "silenced" by losing their public funding?

There seems to have been a view that PGF was using industry levy money on "political" activities, rather than the intended counselling and health promotion.


PGF has always been highly political. Stansfield's partner is Green MP Denise Roche and his media adviser was ex-Green MP Sue Bradford's husband, Bill Bradford. Ramsey, the current chief executive, is a Northland regional councillor. The board is chaired by former Labour MP Richard Northey.

The agency's public health director Tony Milne is Labour's candidate for Christchurch Central.

This is also a familiar story—a state-funded pressure group being staffed with left-wing activists in a revolving door between the quango sector and the Labour party (and, in NZ, the Green party), all of whom lobby against the free market.

The PGF's website leaves little doubt that they are indeed "highly political". They're oppose to lottery tickets being sold in supermarkets, they call pokies the ‘crack cocaine of gambling' (sound familiar?), they're very friendly with the Green party and they run a 'no more pokies' campaign nationwide. They opposed the building of a convention centre at the (excellent) SkyCity casino. They even launched a successful High Court challenge against a smoking lounge at the same casino. In short, PGF is a straightforward anti-gambling organisation that opposes all liberalisation and supports all prohibitions.

The ministry fielded a series of complaints between 2010 and 2012 from Martin Cheer, chief executive of pokie trusts, Pub Charity, that PGF was "abusing the funding stream" and was not politically neutral. Cheer wrote to Dunne saying: "We would welcome any attention you could bring to bear on this matter." Cheer was unable to comment. But an industry source said PGF had "not just shot themselves in the foot but blown it off" by not concentrating on their core work.

That led a lawyer for PGF, Duncan Webb, to write to the ministry in late 2010 to restate PGF's right to an opinion and as a non-governmental body it was not bound by civil service rules.


And therein lies the problem. Organisations that are principally funded by the government are essentially arms of the state and should damn well abide by civil service rules. That means no political activism, no lobbying, and accountability under the Freedom of Information Act. Taxpayers should never be forced to pay for special interest groups to lobby.

In Australia, Tony Abbott is leading the way by axing a whole bunch of whining, leftist so-called 'public health' quangos, saving millions of dollars and freeing up money for legitimate medical research in the bargain. If politicians don't have the cojones to get rid of these agencies entirely, they should at least make them abide by the rules that apply to other wings of the state.

Thursday, 22 May 2014

More failure in Australia

Further to yesterday's post about the smoking rate rising in South Australia, here's what's happening in New South Wales where a third of the entire Australian population lives...

The 2013 NSW Population Health Survey shows that 16.4% of all adults in NSW smoke. While this is higher than the 14.7% rate in 2011, the difference is not statistically significant and most likely reflects the change in survey methodology. In 2012, NSW Health implemented a new survey design that included mobile phones for the first time.

A smoking prevalence survey that can't statistically distinguish between 14.7% and 16.4% isn't much use, but the figures certainly doesn't imply that plain packaging has been a roaring success, to put it mildly.

Then again, are any neo-prohibitionist anti-smoking policies successful? Regular readers will know that the UK's long-term decline in smoking pretty much came to a halt in 2007 when the smoking ban ushered in an era of binge legislation against smokers. It was 21% then. It's 20.5% now.

Judging by the data in New South Wales, which starts from a lower base, the same bottoming out has occurred in Australia.


This graph shows seven years of essentially static smoking rates from 2006 to 2013, at a time when graphic health warnings, display bans, plain packaging and banning smoking in pubs, in cars and outdoors were all introduced with great fanfare. Lots of activity and plenty of promises, but no results to show for it.

We see the same abject failure if we look at the other poster boy for tobacco control, Ireland. And, as I showed last month, there is no correlation between the implementation of neo-prohibitionist anti-smoking policies and lower smoking rates in Europe. None whatsoever. Tobacco control, as practised by zealots today, simply does not work. It is frankly astonishing that this is only rarely commented upon by academics and is never noticed by politicians.


UPDATE

Brian Monteith has more on this subject at the Free Society. 

Wednesday, 21 May 2014

Plain packs not working in Australia

More smoking bans Down Under...

Outdoor dining areas will be smoke free by July 2016 in an effort to reduce the number of South Australian smokers.

There is not a scintilla of evidence that 'exposure' to smoke outdoors causes any harm to bystanders, so the South Australian government has resorted to the tyranny of the majority, as seen through the prism of a public sector consultation.

“The majority of people who responded to our public consultation last year indicated that they supported the introduction of smoke-free outdoor dining areas,” Mr Snelling said

More interesting than this routine illiberalism is the following admission...

Health Minister Jack Snelling said the new measures would help to tackle an increase in the State’s smoking rates which have increased from 16.7 per cent to 19.4 percent over the past 12 months.

Hang on, didn't Australia become a world leader a little over a year ago by introducing a fantastic new policy that would reduce the appeal of smoking and signal the end of tobacco use in Australia?

The Minister doesn't mention plain packaging in his press release. Instead, he blames the rise in smoking on budget cuts...

As a result of the smoking rate increase, the State Government will re-instate $1.1 million a year in anti-tobacco mass media campaigns.

“We can’t afford another year of smoking increases so that advertising funding will be re-instated,” Mr Snelling said. “The recent rise in smoking rates has demonstrated the importance that anti-smoking advertising has in preventing people taking up the habit, and supporting those wanting to quit.”

This may an excuse to save the state's blushes or it may not. At best, the message seems to be that educational campaigns work and plain packaging doesn't.

Tuesday, 20 May 2014

Yes, e-cigarettes work

This news, from the BBC, confirms what those of us who have switched to e-cigarettes already know...

E-cigarettes 'help smokers to quit'

Smokers who use e-cigarettes to quit are more likely to succeed than those who use willpower alone or buy nicotine replacement therapies, such as patches or gum, a study suggests.

The survey of nearly 6,000 smokers found a fifth had quit with the aid of e-cigarettes.

That was 60% higher than those who did not use the devices, the study said.

This is not the first study to come to this conclusion—see, for example, here and here—so it would be nice if 'health experts' would stop claiming that there is no evidence that e-cigarettes 'work'.

I am very confident that we will see further evidence mount up in the next year or two, especially when researchers study people who use second and third generation e-cigarettes, ie. the ones that really work (which also happen to be the ones the EU is keenest to ban).

Meanwhile, the "knowingly dishonest" Stanton Glantz and his cronies at UCSF will continue to make fools of themselves by claiming that black is white thereby speeding up the process by which they are exposed and disgraced.


UPDATE

Robert West hits the nail on the head in the Guardian:

Pharmaceutical companies such as GSK and Pfizer, which make smoking cessation drugs, are among the opponents of e-cigarettes. "They are losing sales hand over fist to e-cigarettes and are incentivised to make it appear they are not effective," said West.

A section of the public health community is also hostile. "It is related to a broad distaste for large corporations making large amounts of money out of psychoactive drugs," he said.

"You might see some of it as a puritanical ethic, which is a strong driver."

As if to prove West's point, Gerard Hastings is wibbling on about Evil Corporations in the BMJ:

“The tobacco multinationals have leapt enthusiastically into this market; all now have major e-cigarette interests. This is not a consumer movement but the full onslaught of corporate capital in hot pursuit of a profitable opportunity.”


Pathetic.

Monday, 19 May 2014

We're all smokers now

Image from here and, yes, they are serious.

From the Herald...

Plain packaging of cigarettes could lead to a domino effect

... At this stage, tobacco is the first product which the Scottish Government has chosen to regulate in this way. However, experience suggests regulation of other products almost always follows. How far are we prepared to accept the application of plain packaging to products which we may enjoy but know that they are unhealthy?

Ah, the old slippery slope argument. It'll never happen, right?

No, wait...

From the BBC...

Food should be regulated like tobacco, say campaigners

The food industry should be regulated like the tobacco industry as obesity poses a greater global health risk than cigarettes, say international groups.

Consumers International and the World Obesity Federation are calling for the adoption of more stringent rules.

These could include pictures on food packaging of damage caused by obesity, similar to those on cigarette packets.

The new rules could include reducing the levels of salt, saturated fat and sugar in food, improving food served in hospitals and schools, imposing stricter advertising controls, and educating the public about healthy eating.


Advertising to children, during television programmes such as the X-Factor, must be restricted, said the organisations.

Governments could review food prices, introduce taxes, change licensing controls and start new research to make this happen, the report said.

Luke Upchurch at Consumers International said they were asking for the "same level of global treaty" as the tobacco industry faced.

This all comes from a report which, say its authors, "has been modelled on the WHO Framework Convention on Tobacco Control". It calls for bans on advertising and sponsorship, tight regulation on where food can be sold, graphic warnings, bans on point-of-sale promotions, sin taxes and various other "economic, planning and licensing measures to address the availability, accessibility and affordability of food".

Elsewhere, campaigners want - and will probably get - a Framework Convention on Alcohol. This is the future that the anti-smoking lobby has created the blueprint for—an unelected, unaccountable world organisation dictating your eating, drinking and smoking habits.

Any questions?


UPDATE

I'm quoted in City AM on this...

Christopher Snowdon, director of lifestyle economics at the Institute of Economic Affairs, said "there can no longer be any doubt that lifestyle regulation is a slippery slope. Graphic warnings, sin taxes and plain packaging will be rolled out to food and drink sooner or later if the public health lobby gets its way".


 

Sunday, 18 May 2014

Irish politician wants to ban sweets

From Ireland...

Fine Gael Senator for Dublin, Catherine Noone, has today (Thursday) called for sugar levels in treats and fizzy drinks to be capped at 20%. Senator Noone proposed the measure following a World Health Organisation recommendation that no more than 6 teaspoons of sugar should be consumed in 24 hours.

WHO actually recommends that no more than 10 per cent of calories come from sugar. This works out as 12 teaspoons a day for women. They have opened a consultation about whether this should be lowered, but the idea that the recommendation should be halved (ie. to six teaspoons for women) is supported by "poor quality evidence" and relates only to tooth decay, not obesity.

“The vast majority of people are totally unaware of how much sugar they are actually consuming,” said Senator Noone. “For example, there are an incredible 9 teaspoons of sugar in a can of cola and 11 in a caramel Frappuccino.

“Even among those who are making a conscious effort to be healthy, many people don’t realise that the low fat options like yogurts, cereal bars, juice boxes etc. are often full of sugar to improve the taste.

“New research published in the American Journal of Clinical Nutrition, has concluded that sugar is more nefarious health-wise than fat.

That study actually shows that people enjoy eating sugar more than they enjoy eating fat. Unless enjoyment per se is viewed as nefarious by politicians—a possibility that certainly cannot be discounted—Noone has misrepresented the findings.

Meanwhile, other experts in the field have said sugar is as threatening to our health as tobacco.

A few quacks have made this claim, it is true. Experts, on the other hand, have said that such a comparison is "alarmist and misleading".

“Almost all chocolate bars contain between 30% and 60% sugar. The taste buds then adapt to this level of sugar, which in turn cause cravings and sugar addictions. In fact, the American Journal of Clinical Nutrition has compared sugar addiction to drug addiction.

“The most terrifying part of the sugar crisis is that the majority of people simply don’t know that it’s happening. Who among us would eat a chocolate bar knowing it contains 60% sugar, never mind give it to our children?"

I know chocolate contains a lot of sugar because (a) it says so on the wrapper, and (b) I am not a moron. And yes, I would (a) eat a chocolate bar, and (b) give a chocolate bar to a child. As far as I am concerned, chocolate is primarily for children. Children eat sweets. Adults drink beer. That's how it works.

"The public expect a certain amount of sugar in treats but not over 50%."

Really? Why do you think they are called 'sweets'? What do you suppose makes them sweet? When you see sherbert or candy floss, what do you think the primary ingredient is? Lobster? Long grain rice?

I can't speak for the Irish public, but I suspect that they know that there is a lot of sugar in sugary treats.

Pressure must now be put on the Food manufacturers to assume a duty of care to their customers; they should cap the levels of sugar and sweetners for chocolate and other such treats at 20%.

What does that even mean? In what sense is a chocolate bar 50 or 60 per cent sugar? Are you measuring it by weight? By size? Neither of those make any sense. Or perhaps you mean as a proportion of total calorie content? If so, then it is mere tautology to say that a high proportion of calories in sweet products are made up of sugar. Your ridiculous idea would ban sweets almost by definition.

“In addition the issue of misleadingly labelling food as a 'low fat’ option when it is full of sugar, must also be addressed as a matter of urgency."

How should products that are low in fat be labelled? As 'high fat'? With a skull and crossbones?

Let's not forget why there are so many low fat products with added sugar in the first place. It is because of the 'scientific consensus' about killer saturated fat convinced governments around the world to bully food producers into reducing fat in food products, to which they added sugar to make them palatable. It has since been shown that saturated fat is not as 'nefarious' as the denizens of public health claimed at the time and we now seem destined to go through the whole panic again with sugar taking the place of fat as public enemy number one. And when the unintended consequences of this panic become clear in twenty years time we will have cretins like Senator Noone to thank.

Friday, 16 May 2014

Death

This week it was announced that 3.3 million people are 'killed by alcohol' around the world every year. Or, if you prefer, alcohol kills 1 in 20 people to go alongside the 1 in 10 who are said to be killed by tobacco.

Like most figures related to alcohol these days, I suspect this to be an exaggeration, but it got me thinking about the causes of premature death in the world. For those people who are unfortunate enough to die before their time, what kills them?

Let's start with some uncontroversial statistics for serious diseases...

HIV/AIDS kills 1.6 million.

TB kills 1.0 million.

Diarrhoeal diseases kill 1.9 million. 

Influenza kills at least 250,000.

Malaria kills 1.2 million. 


And then let's take the various preventable lifestyle/environmental causes...

Injuries kill 5 million.

Tobacco kills 6 million.

Air pollution kills 7 million.

Suicide kills 800,000.

Hunger kills 10 million.

Obesity kills "at least" 2.8 million.

Illegal drugs kill 200,000.

Counterfeit medicines kill 1 million.

Alcohol kills 3.3 million.

Physical inactivity kills 3.2 million.

Pregnancy kills 1.0 million.

Climate change kills 5 million.

Salt kills 2.3 million.

High blood sugar kills 3 million.

Fizzy drinks kill 180,000.

Medical error kills 500,000.



There's bound to be a bit of double counting here (eg. part of the alcohol figure includes death by injury), but I've avoided most of it by excluding direct causes of death like heart disease (7 million), stroke (6.2 million) or cancer (7.6 million). I haven't even included infant mortality (6.6 million).

In other words, this is far from being an exhaustive death toll and it doesn't even attempt to include the vast and growing number of people who die peacefully in old age. Nevertheless, the list of "preventable" deaths above totals 57.23 million deaths a year. That is a pretty amazing statistic when you consider that only 55 million people actually die every year. Are we to assume that all deaths are preventable and some people are dying twice?

Thursday, 15 May 2014

Aseem Malhotra's comeuppance

Well, well, well. Look who's in trouble...

Articles published by the British Medical Journal suggesting that statins may be harmful are to be investigated.

The journal will set up an expert panel to decide if it should retract two articles saying the cholesterol-reducing drugs had harmful side-effects.

The papers were criticised when they were published in October.

Statins are offered to seven million people in the UK who have a 20% chance of heart disease in the next decade.

The BMJ said Dr John Abramson from Harvard Medical School and UK cardiologist Dr Aseem Malhotra had already withdrawn statements from the articles after some figures proved to be incorrect.

The use of incorrect figures is Malhotra's calling card and the chickens are coming home to roost for Action on Sugar's scientific director. Longtime readers of this blog will fondly recall him from such posts as Aseem Malhotra doesn't know what he's talking about, Aseem Malhotra: Still clueless and Aseem Malhotra: quackery's buddy.

Errors were not picked up at the time by the journal's editors or the experts who peer-reviewed the work, the BMJ said.

Gosh, there's a shock.

The journal said Dr Abramson's paper cited data from an "uncontrolled observational study" and "incorrectly concluded" that statin side-effects occur in 18-20% of patients.

The same mistake was made by Dr Malhotra in the same edition of the BMJ and it is these statements that have been withdrawn, the journal said.

Malhotra has not only made this claim in the BMJ, he has said the same in the more widely read Daily Mail. And, as a practising cardiologist, he is in a position to practice what he preaches...

I often stop patients taking statins when I believe they are causing distressing side effects, which happens in about one in five of those I see... Last month the Annals Of Internal Medicine reported that 20 per cent of those on statins suffered a significant side effect

As I tweeted at the the time...



It remains to be seen whether the BMJ settles for withdrawing the specific errors or retracting the whole articles. The complaint about the journal's articles was made by Prof Rory Collins who said in March...

“It is a serious disservice to British and international medicine," he said, claiming that it was probably killing more people than had been harmed as a result of the paper on the MMR vaccine by Andrew Wakefield. “I would think the papers on statins are far worse in terms of the harm they have done.”

It's good to see Malhotra in the news for the right reasons at last.



Politician accidentally tells the truth

I'd like to introduce you to Luke Pollard, the Labour candidate for Plymouth Sutton and Devonport...

"Not a single person on the doorstep has raised the licensing of e-cigarettes with me, what they are talking about is their household bills, whether they can get full time hours from week to week, worries about changes to their local NHS services. No-one is wondering whether e-cigarettes are medicinal."

Well said. How nice to hear some common sense from the Labour party. Nobody wants medicinal regulation for e-cigarettes except for a handful of zealots and the pharmaceutical industry.

Oh, and a whole bunch of Labour politicians, led by Linda McAvan and Glenis Willmott, who poured blood, sweat and tears into getting medical regulation for e-cigarettes at the EU level.

So why is Mr Pollard so keen to scoff at the unofficial policy of his own party? Brave iconoclast? Free spirit? Sadly not. He is merely taking an opportunistic pop at the Tory incumbent, Oliver Colville, who is the target of one of Britain's periodic flower-based storms in a teacup.

A Conservative MP said he was not trying to mislead anyone by not declaring he received Chelsea Flower Show tickets from a tobacco company when submitting questions on e-cigarettes.

Oliver Colvile told the Commons he had previously recorded on the MPs’ register of interests that he was given two tickets to the 2013 event, valued at £1,260, by Japan Tobacco International (JTI).

As scandals go, it's so weak that even the Observer would think twice before putting it on the front page.

There are a couple of problems with it. The first is that Japan Tobacco don't actually make e-cigarettes so there wouldn't be any conflict of interest even if this MP was cheap enough to be bought off with tickets to see some flowers.

The second is that his questions (about advertising to minors and medical regs) were so bland that no one could realistically benefit from them. It is impossible to work out if he is pro, anti or agnostic about e-cigarettes. For all we can tell, he may be stridently opposed to them. Then again, so might JTI, so perhaps he should have declared the interest to be on the safe side. But if so, any MPs that have received hospitality from the pharmaceutical industry should also declare an interest when talking about e-cigarettes.

None of this is of interest to Luke Pollard who was just trying to make a bit of political capital out of some local news coverage. But in doing so, he let slip an important truth about his colleagues' crusade.

Wednesday, 14 May 2014

Sober Britain

I've got a post up at the IEA Lifestyle Blog about the latest alcohol consumption figures.

Please have a read.

Vapers wanted: must have cancer

This is morally disgusting and scientifically absurd. The ad below is designed to recruit cancer sufferers to appear in anti-smoking commercials (click to enlarge).


Except they don't just want to make anti-smoking commercials. I've highlighted the relevant section:

We are also looking for ex-smokers (age 20–60) who:
  • Used cigars with cigarettes, or used cigarillos or little cigars alone or with cigarettes because you thought cigars, cigarillos and little cigars were healthier, and were diagnosed with a serious health condition while smoking.
  • For at least a year, used e-cigarettes or smokeless tobacco while continuing to smoke some cigarettes; and 
  • Thought using e-cigarettes or smokeless tobacco to cut back on some cigarettes would be good for your health; and
  • Despite cutting back, you were later diagnosed with a serious health condition.

We can write the script for this propaganda right now, can't we? "Hi, I'm John and I thought e-cigarettes were safer than smoking, but I used them for 18 months and last year was diagnosed with cancer. E-cigarettes are deadly - don't let them fool ya."

"You can be a hero. All you have to do is eat the cupcake."


This is being paid for by the US Centers for Disease Control. 'Public health' never fails to lower the bar.

Hat tip: E-cigarette Forum


UPDATE

I see that Carl Philips has already blogged about this.

Tuesday, 13 May 2014

Public Health live and unleashed

Sometimes you just have to let your opponents talk and they do your work for you. That is certainly the case with Gerard Hastings.

Hastings is a comic figure in many respects - almost a caricature of the public health racket's misanthropic statism - but his influence is too far reaching to ignore. This is a guy with a finger in every nanny state pie. He put together the Department of Health's assessment of the plain packaging evidence (conclusion: it's great, let's do it). He was commissioned by the World Health Organisation to evaluate the effect of food marketing on children (conclusion: it's evil, let's ban it). And he has written widely about alcohol advertising (conclusion: it's evil as well, let's ban it).    

Hastings instinctively believes that people only do things he dislikes because of clever marketing, and he completely disregards the enormous amount of evidence to the contrary. At the most fundamental level, he misunderstands the purpose and effect of advertising, which is a problem when marketing is your ostensible area of expertise. Instead, he prefers to see the public as "hapless flies" who are caught in the "profit-driven webs" of Big Business (as he says in his extraordinary and overpriced book.)

The poem Hastings wrote about The Man tells you everything you need to know about his undergraduate mentality. It is sad that such a person is working in academia at all, let alone being put in positions where his peculiar opinions can be presented as facts. If you think I exaggerate, I urge you to watch this recent video of Hastings in action. It comes from a conference called 'Big Alcohol, Big Tobacco, Big Influence' (how's that for a slippery slope?) which let several public health zealots off the leash, including Linda Bauld, Ian Gilmore, Nick Sheron and Geof Rayner (the latter's massively left-wing speech was called 'Nudge, responsibility deals and other neoliberal guff').

The whole conference video can be seen here but if you are pushed for time at least try to watch Hastings' contribution, both his own presentation and the Q & A. He barely mentions health issues at all. It is quite obvious that 'public health' is a political vehicle for him and his colleagues. It's all about the evils of capitalism and 'consumerism'.



Amongst the highlights to look out for are...

0:30 - "This is not an argument against business, it is against big business." That's okay then.

2:17 - He says that supermarkets have 40,000 different products and therefore consumers cannot make informed decisions (?!) "unless you go in with a list". A radical idea. Perhaps they could be called  - I dunno - 'shopping lists'?

5:00 - Complains that attractive women are used to sell things in advertising, particularly e-cigarettes. The horror! He says that this "massively increases inequalities".

7:30 - Freedom is the new tobacco...




8:10 - Equates the free market with totalitarianism, saying that we (ie. people who buy things) are "slaves" who "love our servitude". By this point, his voice is starting to break with emotion.

9:44 - Polar bear klaxon.

10:00 - The sermon begins in earnest. Stuff about being born alone and dying alone. There is nothing about health beyond this point.

13:00 - Quasi-religious stuff about "self-transcendence".

14:00 - Calls for a "bigger, broader - dare I say - revolutionary form of public health" to get away from the "neoliberal consensus". This, of course, requires a new "political system" ie. socialism.

15:30 - Says public health lobbyists should demand "political leverage" and demand a seat at the table, even - or especially - in finance (!). As I have said before, what he wants is a dictatorship of public health.

16:40 - Concludes by saying that he saw a beggar on the street "just yesterday" with a sign that said 'Keep your coins. I want change.' Perhaps he did, but it's a remarkable coincidence that this also happens to be a lefty slogan from a well known piece of street art.


The Q & A isn't on Youtube but you can find it here at and it's well worth watching because things get even more bizarre when Hastings and his friends are unscipted.

For example, at 2:18, Hastings answers a question about how minimum pricing can be won by wibbling on about climate change. At 2:19.40, he is asked about how 'public health' professionals can change how the media reports things and says that the media are in the pay of Big Oil. And, saving the best for last at 2:21.10, he talks about how there is "always a military presence" at conferences because "the military know that this is where the next war is going to start".


In any other context, Hastings' performance would be considered an embarrassing meltdown, but the lack of reaction from the audience suggests that this is par for the course in the wacky world of 'public health'. This really is how they talk amongst themselves. Things are much worse than we thought.

I cannot be said too many times that 'public health' is not about health. It is a political movement aimed at state control of individuals and markets. Look at the Lancet's manifesto for 'planetary health'. Look at the European Public Health Alliance's manifesto. Follow people like Richard Horton, Martin McKee and John Ashton on Twitter. If you can bear and afford it, read Gerard Hastings' book. It is not about health, it is about pushing an unelectable, economically illiterate political agenda through the backdoor.

Monday, 12 May 2014

Plain packaging for wine

Indonesia is pushing for plain packaging for wine...

The idea has received another kick along, this time from Iman Pambagyo, one of the head honchos at Indonesia’s ministry of trade. “We can do that,” he said of wine plain packaging. “Moral considerations apply to this commodity …”

The Indonesian government is, of course, Muslim, but it has also intimated that this is "retaliation" for Australia bringing in plain packaging for tobacco. Indeed, the policy will only apply to booze from Australia and any other country that is daft enough to follow the Aussies in their vanity project.


Scotch whisky could be dragged into a tit-for-tat trade war because of plans to ­introduce plain packaging for cigarettes in Scotland and the rest of the UK, MPs fear. 
The Indonesian government has proposed forcing Australian wine to be sold in plain packaging in retaliation for Australia introducing plain packs for cigarettes in December 2012. 
Indonesia is expected to impose the same restrictions on New Zealand when that country introduces plain packs for tobacco products shortly. The south-east Asian nation has called on other major tobacco-producing countries to follow its lead. Indonesia is one of the world’s largest producers and has a high rate of domestic cigarette consumption.

This is exactly the kind of tit-for-tat war that trade agreements are designed to prevent. Public health campaigners fear and despise free trade. They are keen to get exemptions from trade agreements for their pet projects and they have shrugged off the numerous complaints made to the World Trade Organisation about plain packaging. Some of them may even be licking their lips at the idea of plain packaging for alcohol. But the predicted consequences of their plain packaging ruse - the slippery slopes and the trade disputes - are drawing ever nearer.

Sunday, 11 May 2014

When puritans collide

The people who brought you An Inconvenient Truth have made a film about sugar which boats Robert Lustig as its scientific consultant. That should be fun.

Quite wonderfully, children won't be able to see Fed Up - for that is what it's called - unless accompanied by an adult. This is because the anti-sugar puritans have been undermined by the anti-smoking puritans...

“Fed Up” is rated PG (Parental guidance suggested). This is a ridiculous rating, one that was partly given to the movie because it contains images of cigarette smoking that are used to compare Big Tobacco with Big Food.

If the Smokefree Movies crusaders had their way, kids wouldn't be able to see it at all. Oh, what a tangled web we weave.






Friday, 9 May 2014

Yet more obesity babble

"The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary."
- H. L. Mencken 


Here we go again. From the Telegraph...

Three quarters of British men will be overweight or obese by 2030

Three quarters of British men will be overweight or obese by 2030 due to increasingly unhealthy diets and lack of exercise, a major study has warned.

This "major study" is unpublished and is only available as an abstract for a conference.

Currently around 66 per cent of men are overweight or obese and 57 per cent of women. However 74 per cent of men will be overweight or obese by 2030 and 64 per cent of women.

Evidence? There is none. It is a prediction based on the same pitiful methodology as other failed obesity predictions, ie. extrapolating the trend from the 1980s and 1990s - when obesity undoubtedly rose sharply - while ignoring the subsequent trend which is much less impressive.

And who are these impartial soothsayers?

Report author Dr Laura Webber, of the UK Health Forum, said although there was no ‘silver bullet’ for tackling the epidemic, the government must do more to restrict unhealthy food marketing and make healthy food more affordable.

Of course she does.

She is calling for a tax on sugary drinks and subsidies for fruit and vegetables.

Of course she does. Not that she's a health socialist who hates the free market, of course.

No, wait...

“The UK and Ireland, where obesity prevalence is among the highest, possess unregulated liberal market economies similar to the US, where the collective actions of big multinational food companies to maximise profit encourages over-consumption."

The UK is an unregulated liberal market economy?! My aching sides.

And the study found there was little evidence to suggest the rising rates will plateau in the near future.

This is true. They won't plateau in the near future. They plateaued in the recent past. In 2001 to be exact...




But what about that childhood obesity epidemic that will become an adult obesity epidemic in short order? That's, erm, really taking off...




These people really are shameless in the face of the facts.

Tam Fry, chairman of the Child Growth Foundation and spokesman for the National Obesity Forum, said the alarming projections "look inevitable."

Inevitable? They're projections, Tam, and - like every obesity projection that preceded it - they can most charitably be described as highly dubious. Damn it, you'd have thought Tam "we have no statistics, we have no evidence" Fry would have learned his lesson after the BBC's More or Less show handed his arse to him in a top hat after he tricked the media into buying his latest hysteria at the start of the year.

Campaigners have a habit of bringing the overweight and the obese together as if they were only marginally different. Aside from the fact that Body Mass Index is a terrible measure of obesity, there is nothing particularly unhealthy about being overweight and you have to be really quite obese before your mortality risk increases (although you will be burnt as a witch if you say this in public health circles). So what's the prediction for obesity?

Dr Madina Kara, Neuroscientist at the Stroke Association, said: “These shocking findings predict that a third of British men will be obese by 2030, and a similar projection is suggested for the number of obese women.

This is a bit of a climbdown from the estimate that was made in the Lancet in 2011 which claimed that...


Half of UK men could be obese by 2030


A third is very different to a half, and both are very different to a quarter, which is what the male obesity rate has actually been for the last thirteen years. In fact, it's been slightly less than a quarter and may well continue to be less than a quarter. Or it could rise or fall. There's no way of knowing, least of all from a computer model designed by people who think that obesity is caused by the "liberal market economy".

One thing is for sure: it would take a hell of a surge for the obesity rate to reach 33 per cent, let alone 50 per cent, in the next 16 years. I'd love to know if any of the people who pump out these ridiculous predictions would be prepared to put their money where their mouths are. Are they prepared to bet on these "inevitable" outcomes? If so, I've got cash waiting.

Well said

From Brian Monteith at ConHome...

Standardised packaging of tobacco is an idea that was neither conceived in Conservative Party gatherings nor demanded by ordinary Conservative voters. It’s a classic example of a government – or, more accurately, a section of government – that has been captured by its officials, agencies and quangos, not to mention the campaign groups that it funds to lobby it to introduce more legislation. That this has happened should come as no surprise because the Department of Health has been funding groups to campaign for more government intervention since the Blair years. It is exactly the sort of abomination Conservatives should be dismantling rather than falling victim to.

I have to pinch myself to remind myself that this absurd policy is being seriously proposed by a party that claims to be against the nanny state.

Go read the whole thing.




Tuesday, 6 May 2014

Two hours of plain pack promotion on the BBC

When I attended the press conference for Cyril Chantler's plain packaging report, one of the journalists who asked a question seemed positively gleeful that Chantler was supporting the proposal. He congratulated Sir Cyril on "demolishing" the arguments against plain packs and expressed his hope that there would be no further delay in bringing the policy in. The journalist was Peter Taylor from the BBC and he mentioned that he was making a documentary about the tobacco industry.

Although I didn't realise it at the time, Peter Taylor has presented such documentaries before. His 1976 British documentary Death in the West is mentioned in many books about smoking (I quoted from it in Velvet Glove, Iron Fist (p. 183)) because it was never legally shown in the USA as a result of a lawsuit from Philip Morris. This, of course, was at a time when the industry did not publicly accept that cigarettes were dangerous or addictive. The lawsuit gave the programme a measure of notoriety and it was subsequently imported into the US on VHS and used by anti-smoking groups. Other Taylor documentaries about tobacco include Dying for a Fag and License to Kill.

The new documentary is two hours long and, according to the BBC, will be broadcast in two parts at some point this month. It appears to be entirely dedicated to the plain packaging agenda, of which Taylor is clearly a keen supporter. Moreover, it is being made with the active support of state-funded plain packaging campaigners...

Students Star in BBC Anti-Smoking Documentary

Media students from Salford City College’s Walkden Sixth Form Centre will make their small-screen debut in May as part of a BBC2 documentary focused on exposing the UK's tobacco industry.

...The opportunity was organised in conjunction with Tobacco Free Futures, who are working alongside the BBC in creating the documentary.

Even by the standards of partisan broadcasting, this is pretty blatant stuff. How can the BBC possibly square this its duty to "not campaign, or allow ourselves to be used to campaign'?

The timing is particularly suspect since the government is expected to launch a final consultation any day now. There is also the question of the EU elections, in which UKIP is the only significant party to be firmly against plain packaging. It is very likely that these programmes will go out just as both the plain packaging consultation and the EU election campaign are coming to a head.

Coincidence? I doubt it.

Saturday, 3 May 2014

Infant mortality and income inequality

Yesterday, the Lancet published infant mortality rates for every major country in the world. In line with previous estimates, they showed that Britain did much better than the global average but slightly worse than most EU countries. The death rate for under-5s in the UK is 4.9 per 1,000 live births. Globally, the average is 44.0 per 1,000 live births and the Western European average is 3.9 per 1,000 live births.

This was initially reported in a matter-of-fact way by the BBC, but when I looked at the report again in the afternoon it had changed substantially. I am quite sure of this because when I first saw the headline I vaguely wondered if the Beeb would do its usual thing of trying to blame everything on smoking, drinking and/or obesity, and I noticed that it hadn't. By the afternoon, however, it had. It had even put up a photo of a pregnant woman holding a pack of cigarettes (a plain pack, naturally). Furthermore, it had also introduced the fringe theory that inequality 'causes' infant mortality.

All of these additions arrived in the form of quotes from Dr Ingrid Wolfe of the Royal College of Paediatrics and Child Health, and the BBC has now given her an entire op-ed in which she expands on her opinions ('Why the UK has a high child death rate').

In reality, it's a combination of factors; but just because the causes are complex that shouldn't stop us looking for solutions.

This week the Royal College of Paediatrics and Child Health launched a report - Why Children Die - that dug deeper into what it is children die from and which of these deaths can be prevented.

Our overarching conclusion was that risk of child death disproportionally affects poorer families.

When you compare Britain to the rest of Europe, we are one of the most unequal societies, with a growing gap between rich and poor.

It is no coincidence that our child mortality rates are also the worst.

Our analysis of the causes of child deaths shows many deaths in under-fives are due to risky behaviours (such as smoking) during pregnancy, which is more common among women who are socially disadvantaged.

Drinking during pregnancy is another risk factor, as is children being around second-hand smoke and unsafe sleeping - all of which can contribute to premature death.

So what do we want to see?

The focus has to be on reducing the growing gap between rich and poor - put simply, countries that spend more on social protection have lower child mortality rates.

... The messages are stark; living in an unequal society raises the risk of children dying.

You will notice that Wolfe, having correctly noted that the "causes are complex", provides some very simple and predictable solutions: don't smoke, don't drink and let's reduce inequality.

On the first point, it seems clear that smoking and excessive drinking during pregnancy increase the risk of infant mortality. However, Wolfe offers no evidence to indicate that either behaviour is especially common in the UK, and smoking in general is less common in the UK than in most EU countries. So whilst these are two (of many) risk factors, they apply to all countries and are not decisive in answering the question of why infant mortality in this country exceeds the Western European average.

On the second point, Wolfe makes a basic, but very common, error in conflating income inequality with material deprivation. It is undeniable that rates of infant mortality are highest amongst low income groups. This, again, is true in all countries. But the level of inequality (which, contrary to her claim, is falling, not rising, in the UK) tells us nothing about how many people are materially deprived, nor does it tells us about their level of material deprivation. Nor, indeed, does the level of inequality tell us anything about how much money is spent on 'social protection'.

She puts it like this...

Our overarching conclusion was that risk of child death disproportionally affects poorer families.

When you compare Britain to the rest of Europe, we are one of the most unequal societies, with a growing gap [sic] between rich and poor.

It is no coincidence that our child mortality rates are also the worst.

This is a non sequitur. The prevalence and income of 'poorer families' is not related to the level of inequality. Income inequality is very low in a country like Namibia and very high in a country like Luxembourg. Neither statistic tells anything about poverty in those countries.

Wolfe may have made an honest category error in confusing the two measures. Lots of people do. Or she may genuinely believe that the economic variable of income inequality is causally linked to rates of infant mortality; that certainly seems to be what the reader is supposed to conclude. If so, she may have been influenced by The Spirit Level, which blames income inequality for almost everything. The authors of that book do not provide a single reference to support their claim that inequality 'causes' infant mortality and I have yet to meet anyone who can offer a plausible explanation for how it could cause a rare biological problem. Robert Waldmann suggested there might be a link in 1992, but his research has since concluded that the statistical association is actually the result of a third variable—healthcare spending (he explains it here).

When I give talks about The Spirit Level, I often say that the inequality hypothesis offers policy-makers a panacea. The Spirit Level suggests that almost every problem can be alleviated by reducing the income gap. This seems to good to be true and, like all panaceas, it is. I suggest that one of the dangers of swallowing The Spirit Level theory is that the real causes of health and social problems could be overlooked in the rush to adjust a single economic variable.

This is particularly true in the case of issues like infant mortality. Its causes are indeed complex (there is a whole chapter about it in The Spirit Level Delusion). Rates of infant mortality tend to be higher in the English speaking nations, lower in Europe and even lower in the richer Asian countries (including Singapore, which has a very unequal income distribution). Within the English speaking countries, rates are particularly high amongst certain ethnic groups (eg. Maoris, Aboriginals, African Americans, Pakistanis). And, as Wolfe correctly notes, rates are consistently highest amongst poorer groups.

I am convinced that much of the success of The Spirit Level results from people making the simple category error described above. If one wrongly assumes that rates of material deprivation are fixed to rates of income inequality, it is easy to conclude that reducing inequality will materially benefit the poor. This is simply incorrect. The two measures can easily go in different directions. Indeed, they have been going in different directions in Britain since 2008. Conversely, the living standards of the poor typically improve when income inequality grows. There is no correlation between income inequality and infant mortality over time.

Finally, it should be noted that the Lancet study itself does not mention smoking, drinking or inequality at any point. The points raised above are pure editorialising on the part of Wolfe and the BBC to make a political point from a non-political piece of research.