Velvet Glove, Iron Fist

A work of art

2012-01-28T14:29:00.001Z

The Guardian recently kicked off the campaign for plain packaging this week with an interview with that sad old sociologist Simon Chapman who seems to think that the tobacco industry finds him fascinating:

"They dislike me intensely because of my prominence and persistence. But I also confuse them because I'm very against the censorship and rating of films because of their tobacco content."

"Hey, look at me—I'm only half-mad!"

Expect much more about plain packaging in the next few months. The Department of Health has lined up its usual NGOs and fake charities to persuade the public that a policy that is so preposterous that even the most deranged anti-smoking headbangers have only recently endorsed it, should be a priority as we slide back into recession and the EU goes bust.

It won't surprise you to hear that I see plain packaging as a gross infringement of intellectual property, private property and the free market. That it will be extended to other products in due course I consider to be a near-certainty. It is a lunatic idea dreamt up by people who have long since run out of ideas. The entire self-serving and deceitful cabal of 'tobacco control professionals' should be put out to grass. They have done enough damage. Chapman is very proud that the Australian supernanny state has banned e-cigarettes and snus, for example—these people should be in a smokefree prison cell.

David Hockney has better things to do that smack down pointless wowsers like Chapman, but he has done so all the same in today's letters section and it is quite glorious...

Why doesn't Mr Chapman debate with a good and satisfied customer of the tobacco companies (Plain packs will make smoking history, 25 January)? Someone who has seen what will replace it as a smoothing, calming contemplative helper. Someone whose friends died of alcohol consumption, not tobacco. Someone who has smoked for nearly as long as he has lived. Someone who knows about the fanatical attitude of haters of tobacco. Someone who is not so naive about advertising and packaging.

Someone who has almost outlived a fanatical anti-smoking father. Someone who is fed up to the teeth with people who think they really know what health is. Someone who is not afraid of the cowardly, crooked politicians who stifle the debate about pleasure in the now. Someone who knows that time is elastic. Someone who knows how easy it is to lie with statistics. Someone who is not a professional agitator, who knows there is no such thing as a professional smoker but knows there are hundreds of dreary, professional, highly paid anti-smokers.

Someone who thinks laughter is good for you as it drains fear from the body. Someone who has something better to do than to try and control the quiet lives of others. Someone who knows we are all a bit different and is fed up with the growing regimentation of people. Someone who knows that smokers can live perfectly average-length lives but heavy drinkers rarely. Someone who is shocked by the growing conformity among people, and what that might mean for a reasonable free society. Someone who prefers the centre of Bohemia to Australian suburbia. Someone who knows we have to die.

David Hockney
Bridlington, East Yorkshire

Taxi for Chapman...

David Hockney's contribution to culture

Simon Chapman's contribution to culture

The Smoking Years

2012-01-28T02:11:00.000Z

For those who didn't, or couldn't, watch it when it was on the telly earlier this month...

Sheer heart attacks

2012-01-26T22:43:00.000Z

Long time readers will have seen quite a few graphs like the one below over the years (for example here and here). They show the number of people admitted to hospital with heart attacks in a country. In this case, the country in England. I have previously used NHS hospital data to show that the English smoking ban had no effect on England's heart attack rate, contrary to a claim made by Anna "pants on fire" Gilmore. (In fact, the data in that graph came from her study; she just chose not to show it in a chart.)

You can see the non-effect of the ban (started July 2007) in the graph below. Clearly, there is a consistent, gradual downward trend, but no big dips. There are slight increases in the downward trend in 2005 and 2010, but these can hardly be attributed to a ban that started in 2007.

You knew this already, right? I only mention it again because this graph comes from a new study in the British Medical Journal which looks at the the heart attack rate in England between 2002 and 2010. So, just in case you think I've been making up the data these past two years, let this assure you that I have not.

The six page study does not mention the smoking ban at all and its data clearly do not support the notion that the ban had any observable effect on heart attack admissions. The big story is that deaths from heart attack have halved since the turn of the century. This is great news, but it has obviously been a steady process which has come about for a multitude of reasons.

If someone tells you that the heart attack rate fell after the smoking ban, they are not lying, but they are not being entirely truthful either. Pick any event of the last decade and the heart attack rate fell afterwards. Pathetic as this post hoc logic is, it has been the basis of one of the biggest scientific scams of recent years.

The hubris of CAMRA

2012-01-26T12:08:00.006Z

Dick Puddlecote has the story of the Campaign for Real Ale's latest head-in-the-sand efforts to save the great "community pub". You know a place is in trouble when people start putting the word "community" in front of it (see also "community Post Office"). Pub closures peaked at 52 a week in the second year of the smoking ban and the rate is now a still-worrying 16 a week.

In an expensive-looking report, the Real Ale Twats have found a correlation between smoking rates and pub closures, but choose not to draw any policy conclusions from this. Instead, they play their usual game of blaming supermarkets for selling cheap alcohol (which was being sold cheaply before the smoking ban) and pleading for tax cuts and special favours (which they didn't need before the smoking ban). The one piece of government action that could make people actually want to go to pubs again does not get a look in (the Morning Advertiser—trade mag to the pub trade—doesn't even mention the ban in its report).

Perhaps CAMRA still believes in its own self-deluding pre-ban propaganda, of which Dick has unearthed a beautiful example...

REAL ALE INVASION OF SMOKE-FREE PUBS

CAMRA is urging publicans to prepare for a boost in demand for real ales following the banning of smoking in all pubs in England from 1 July this year.

And pub goers will now be able to savour the flavour of real cask ales as the fog of tobacco smoke is finally blown out of pubs and bars throughout the UK.

In Wales, CAMRA reported a boost in demand for real ale after the earlier ban of smoking there from 1 April.

...The research also indicated that after the smoking ban over 6 million pub goers in England and Wales expect to visit pubs more often and 840000 people who never go to pubs said they will do after the ban. And 68% of smokers said the ban will not affect their pub going habits, with only 3% of adults saying that they would not visit pubs as a result of the ban.

Paul Moorhouse continued: ‘We expect a minority of smokers to be put off going to the pub. But this will be offset by more use of pubs by others who will welcome the smoke-free environment. And with over two thirds of real ale drinkers being non-smokers, we expect it to be real ale that will benefit the most from this new trade. Any pubs that do not offer real ale are encouraged to stock one to attract this new clientele.’

Peace in our time, CAMRA?

The Pub Curmudgeon and The View from Cullingworth have more to say about CAMRA's uselessness.

ASH: The government in drag

2012-01-24T22:30:00.005Z

I recently mentioned the possibility that ASH (England) may have lost its government funding. Maybe they have, maybe they haven't, but the anti-smoking pressure group was certainly sucking on the teat of the state in 2010/11, as its latest accounts show.

Department of Health: £220,500

ASH International: £152,657

Supporting charities: £393,833

Donations: £15,365

Total: £782,355

ASH International is funded by Pfizer, which perhaps explains ASH's eagerness to promote Pfizer's psychotic stop-smoking drug Chantix/Champix.

The supporting charities are the British Heart Foundation and Cancer Research UK, so if you don't like indirectly funding neo-prohibitionist pressure groups, you might want to avoid them in the future and donate to other charities.

The Department of Health grant is for a project called 'Capitalising on Smokefree'. This is the third year in a row that taxpayers' money has been diverted to this mystery project. Although we pay for it, no details have ever been made public. If I was a cynic, I would say that it involves ASH being given money to manufacture support for Department of Health policies.

And that leaves £15,365 of donations from the public, meaning that one of the country's most powerful and influential "charities" gets less than 2% of its income from the general public's voluntary donations. However, it gets 28% from involuntarily donations through the tax system and a further 50% from donations given to different charities which are then diverted to ASH.

I do believe that means that ASH continues to be what it has always been: a fake charity. They are the government in drag; they are the Department of Health's sockpuppets; they are the state lobbying the state. Why are smokers being forced to pay for their own vilification?

UPDATE:

Number 11 in ASH's list of 'objectives' for 2010/11 is:

To be sensitive to the concerns of the smoker.

Wow. Just wow.

They said it couldn't happen

2012-01-24T10:30:00.002Z

Can something be banned just because some people don't like the smell of it? Of course it can. It's happened all over the world and now—thanks to that non-existent slippery slope—it's happening with perfume and aftershave.

New Hampshire May Ban Perfume for State Employees

State employees in New Hampshire who douse themselves in Chanel before heading into the office may be in for a shock. If New Hampshire’s House Bill 1444 passes, state employees would be banned from spritzing their favorite perfumes during the work week, the Union Leader reports.

This seems rather silly. After all, getting a whiff of perfume isn't a health issue.

“It may seem silly, but it’s a health issue,” Michele Peckham, the state representative sponsoring the bill, told the Union Leader.

I stand corrected. It's just that Multiple Chemical Sensitivity (for that is the 'health issue') is a load of old cobblers (more details at Quackwatch).

“Many people have violent reactions to strong scents.”

Maybe they do, maybe they don't. Maybe they associate fragrances with 'man-made chemicals' and maybe they have a psychological problem. Whatever the source of the problem, it is not one that has any grounding in science.

Susan McBride, a constituent with a sensitive nose, started the conversation about banning offensive scents in the workplace back in 2008 when she sued the city of Detroit, claiming that the scent made it tough to breathe, thus keeping her from doing her job, Yahoo! Shine reports.

Readers of Velvet Glove, Iron Fist might remember this lady. She's nuts.

The city awarded McBride $100,000 and a city ordinance against scented body products.

More fool them. Now they've opened the floodgates to every hypochondriac, tree-hugger and chemophobe in the USA.

Expect this one to run and run. After all, it's new secondhand smoke...

'Quit-or-die approach not working' shocker

2012-01-23T20:38:00.003Z

Surprise, surprise...

Despite recent ecstasy-related deaths, Vancouver dealer says business is booming

Sam's workday usually starts late in the afternoon as Vancouver's aggressive partiers begin looking for a way to chemically enhance their fun.

Most nights of the week, a host of twenty- and thirtysomethings call Sam's work phone throughout the evening and into the early morning looking for ecstasy and cocaine. Despite recent headlines about the deadly PMMA-laced ecstasy pills, Sam's phone still rings with clients searching for a good time.

Backstory here.

The cowardice of public health

2012-01-22T23:25:00.002Z

The Lancet is unhappy about a recommendation from the NHS Future Forum that doctors "make every contact [between doctors and patients] count", ie. they pester us about our diet, drinking and smoking every time they see us. I share The Lancet's unhappiness. It's an awful idea and doctors won't do it anyway (I've said it before, but since I criticise public health so much, it bears repeating: every GP I've ever met has been likable, sensible and not at all like their evil twins in public health. Never mistake 'public health professionals' for real medics).

Lecturing the patient on their lifestyle choices during this time is likely to appear rushed and inappropriate, especially if doctors see the task as a box-ticking exercise. There is a high risk that such an approach will leave the patient feeling frustrated, resentful, and reluctant to return.

Indeed so. Mandatory hectoring would be a terrible idea. It's not that I think that health advice is a bad thing, it's just that it should be relevant and timely.

Having said that, if I'm going to receive health advice I'd rather it came from a qualified GP who has actually met me, not some distant bureaucrat with an advertising account and an axe to grind. This is where I part company with The Lancet, which doesn't seem to approve of the concept of advice at all.

Effective, evidenced-based public health measures do not include nudging people into healthy behaviours or getting NHS staff to lecture patients on healthy lifestyles. They include measures such as raising taxes on cigarettes, alcohol, fatty foods, and sugary drinks, reducing junk food and drink advertising to children, and restricting hours on sale of alcoholic drinks.

Quelle surprise. This is, after all, The Lancet, where whatever the question is, bans and taxes are the answer.

Here we see the true moral cowardice of public health. They know that any doctor who harasses his patients in the same way that 'public health professionals' harass the population will be assaulted on a daily basis, so they hide behind the government, goading it on to ever greater illiberalism. The public will still feel "frustrated" and "resentful" at having their money and liberties stolen, but they will vent their frustration on politicians, not GPs. Like all bullies, 'public health professionals' are cowards at heart.

The government should show true leadership and make effective legislation the cornerstone of their public health strategy. Focusing on other approaches is foolish. The nudge and nag approaches need one thing: the firm elbow.

The firm elbow, indeed—for when nudging and nagging is no longer enough! You can't say you haven't been warned. Does anyone else find it perverse that politicians want people to get health advice and doctors want to make laws? When exactly did this job swap happen? And would The Lancet care to set up a Doctors' Party and run for office so we can see just how much popular support there is for the firm elbow?

Etta James RIP

2012-01-21T01:49:00.000Z

High prices and smuggling: nothing to see here, says BHF

2012-01-20T15:06:00.001Z

Last week, the Economist produced an article about sin taxes which made the fairly obvious statement that...

...when duties rise so do the incentives to get around them, by buying abroad or on the black market. This is particularly common with cigarettes, which are easy for individual smokers to import. In 2000 non-duty consumption reached a peak of 78%, according to the Tobacco Manufacturers’ Association—a consequence of the weak euro as well as a sudden increase in taxes of inflation plus 5%.

Pretty uncontroversial, but not to the British Heart Foundation, who have a letter published today:

SIR – Your article on sin taxes in Britain (“The high cost of virtue”, December 31st) took at face value claims by the Tobacco Manufacturers’ Association that cigarette smuggling in Britain peaked in 2000 as a result of high taxes and a weak euro. In fact, the affordability of tobacco has not changed greatly in the past ten years, while cigarette smuggling has halved. Tobacco smuggling is weakly affected by price.

If smuggling is only "weakly affected by price", it would be interesting to know what the real reason is for people buying and selling contraband tobacco. Maybe they just do it for a laugh. Why does Ireland, Britain and Canada have the worst smuggling problems if not for the fact that they have the highest prices? How much tobacco is smuggled from high tax countries to low tax countries? None at all because the whole point is get a cheaper price.

Contrary to the BHF's glib assertion, cigarettes have, in fact, become both more expensive and less affordable—the price has risen by about 90% since 2000. Inflation has risen by 30-40% in that time and although I cannot get precise figures on average wages, I am confident they have not risen by 90%. It should also be remembered that smokers are more likely to be on lower incomes, and the people who buy smuggled tobacco are likely to be on still lower incomes. Affordability measures based on median wages do not tell the whole story, despite both the heavy emphasis placed on them by both the anti-tobacconists and the temperance lobby.

Secondly, notice that the BHF uses the peak of tobacco smuggling (2000) as their baseline. According to HM Revenue and Customs, the illicit cigarettes made up 11% of the market in 2009/10. This is a decline since the 21% peak of 2000, but BHF make no mention of the illicit rolling market, which continues to make up half of the entire rolling tobacco market. Nor do they mention counterfeit cigarettes which were hardly ever seen in 2000, but which are a major problem today.

As I wrote at the ASI recently, the connection between price and tobacco smuggling has not gone unnoticed by customs officials in Ireland who have spotted the Laffer curve that has taken shape as prices have risen.

Initially, tax rate rises do increase tax revenue, however beyond a certain point tax rate rises may actually start to decrease revenue. The main causes for such decreases are that high levels of taxation either cause economic activity to reduce (the disincentive effect of higher taxation) or economic activity to switch to the shadow economy.

This is all pretty obvious stuff unless you happen to be an anti-smoking campaigner, in which case the laws of economics that apply to ever other product can be rejected as tobacco industry propaganda.

Campus smoking bans

2012-01-18T16:32:00.003Z

Who would say something as stupid as this?

"We don't want your car to be a safe haven"

Read my blog post at the Adam Smith Institute to find out...

The murderous insanity of the War on Drugs

2012-01-17T16:55:00.001Z

A batch of Ecstasy pills in British Columbia has been contaminated with a dangerous substance called PMMA which is similar to PMA, also known as Death, Dr Death and Chicken Powder, and is five times more toxic than MDMA.

You might infer from their names that Death is not such a nice drug as Ecstasy. You would be right. PMA has been linked to a number of fatalities in the past and PMMA appears to be causing similar carnage.

A batch of ecstasy believed to be behind a spate of recent deaths in Calgary may have been tainted with a lethal chemical never before found in the street drug, according Alberta’s chief medical examiner.

Five people have recently been found dead with PMMA in their systems. All had taken tainted Ecstasy. The police know what batch is contaminated and they know what it looks like. They know what colour the pills are and they know what the stamp is. So what are they doing to prevent more fatalities?

Absolutely nothing.

Police in British Columbia are reluctant to tell the public what unique, colourful markings are on ecstasy pills suspected to be packed with a lethal additive linked to five deaths in the province over concerns users will believe they're sanctioning the rest.

Lisa Lapointe said while some police agencies have been voluntarily handed samples of the suspect pills, they've decided against putting photos online.

"We don't want to give the impression that these are the tablets that are risky, and other tablets are safe," she told reporters.

"At any time, any tablet can be contaminated with anything."

RCMP and police in Vancouver and Abbotsford have all promoted the message that no drugs are safe, while shying away from providing specific details around tracking the substance's source or revealing what stamps the pills bare [sic].

This is just appalling. In their desire to 'send a message' that all drugs are bad, these negligent imbeciles are prepared to conceal information from people that might save their lives. Why is there PMMA in the Ecstasy supply in the first place? Because of the War on Drugs. Why won't they give users health information that will drastically reduce their risk? Because of the War on Drugs.

This is, of course, the same quit-or-die mentality that allows snus and e-cigarettes to be banned because they may or may not be a 100% safer alternative to cigarettes. It is harm maximisation in action and it is utter madness.

Happiness

2012-01-16T13:05:00.000Z

Today sees the release of a new book from the Institute of Economic Affairs called ...And the Pursuit of Happiness. It was inspired by David Cameron's idea of basing policy on Gross National Well-being rather than Gross National Product. In my view, this is a fatuous distraction from real policy and is likely to be hi-jacked by various special interest groups.

We have a fairly good idea of what makes people happy—a lasting marriage, friends, a good income, community spirit, nice weather, religious belief, children—but the government is unable to provide any of these. There are basic services the state can offer which alleviate misery, but generally the nation's happiness can be best secured by politicians getting out of the way and allowing us to pursue it.

I warmly recommend the IEA's book to you and not just because it contains a chapter written by myself. It's available to buy or as a free download here. There is also an event to mark its release at the IEA next Wednesday—details here.

An evening with the New Economics Foundation

2012-01-13T12:30:00.002Z

Over at the IEA blog...

Has ASH lost its funding?

2012-01-13T09:55:00.000Z

I have just come across a question asked in Parliament last year concerning ASH's Department of Health funding. As you may know, Alcohol Concern recently lost its DoH grant and has been forced to behave like a charity by relying on donations from the public, rather than money taken from people who profoundly disagree with their neo-prohibitionist agenda. This exchange implies that ASH might have suffered the same fate.

Asked by Lord Naseby: To ask Her Majesty’s Government how much public money was given to Action on Smoking and Health in 2009–10; how much was budgeted for 2010–11; and whether this will be cut in 2011–12. [HL8180]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): Action on Smoking and Health (ASH) received funding of £210,000 in 2009-10 and £220,000 in 2010-11 through the department's Section 64 General Scheme of Grants to Voluntary and Community Organisations. ASH received these grants specifically to carry out a defined project entitled Capitalising on Smokefree: the way forward.

ASH did not make a grant application to the department's Third Sector Investment Programme: Innovation, Excellence and Service Development Fund for 2011-12. The department currently has no other plans to provide ASH with funding in the next financial year.

This statement is not unequivocal so don't uncork the champagne just yet, but ASH have been a bit quiet recently. What do you think?

Bad news for Big Pharma

2012-01-10T10:23:00.000Z

From The Guardian:

Nicotine replacement has no long-term benefit when quitting smoking

Chewing nicotine gum or using nicotine-replacement patches offers no advantage in keeping smokers off cigarettes in the long term, according to scientists. They say that while nicotine-replacement therapies (NRTs) could be useful in the early stages of combatting withdrawal, public health bodies should reconsider their reliance on these techniques as a way to reduce the number of people who smoke.

Ouch. Looks like taking nicotine isn't a good way of giving up nicotine after all. Who'd have thought?

John Britton and Deborah Arnott pop up in the article to defend their friends in the pharmaceutical industry.

Carrying an e-cigarette is forbidden at UCSF

2012-01-07T17:03:00.002Z

The University of California, San Francisco—the home of anti-smoking über-zealot Stanton Glantz—has banned students from using and carrying e-cigarettes across campus, inside and out.

To provide a smoke-free environment for its faculty, staff, students, patients, and visitors, UCSF shall be a smoke-free campus.

The policy, which has been flagged up by Glantz on his blog, applies to all "University-owned or leased property, buildings, space, and University-owned passenger vehicles and moving equipment" and includes all "smoking tobacco products".

To the scientifically illiterate goons at UCSF, "smoking tobacco products" includes products which are not smoked and do not contain tobacco.

Smoking tobacco products means inhaling, exhaling, burning or carrying any lighted or heated cigar, pipe or cigarette (traditional or e-cigarette).

Just unbelievable.

Today's blog post...

2012-01-06T17:17:00.000Z

... is about The Spirit Level and is at the Adam Smith Institute blog.

Lennox Johnston in his own words

2012-01-05T03:02:00.000Z

BBC Timeshift: This is not Lennox Johnston

Some of you may have watched the BBC 4's Timeshift programme last night (The Smoking Years, available on the iPlayer and to be repeated several times in the next week). Aside from the last ten minutes, I thought it was a very good piece of television with some excellent archive footage and some fine guests, ahem.

If I had a quibble—and of course I do—I would say that it greatly exaggerated the impact of the anti-smoking group GASP, which was fairly inconsequential, while downplaying the influence of ASH, the BMA, and the government in changing behaviour.

I was pleased to see a bit of coverage about Dr Lennox Johnston for what I believe to be his first television appearance. Readers of Velvet Glove, Iron Fist will be familiar with him and I'd like to add some more flesh to the story by reproducing some of his correspondence in the British Medical Journal. These letters are fascinating for what they tell us about a zealous anti-smoker born before his time as well as what they show us about the medical establishment in the mid-twentieth century.

The first letter is a reply to Johnston from another doctor. By 1950, Johnston felt vindicated by the work of Austin Bradford Hill, Richard Doll and Ernest Wynder showing a clear association between smoking and lung cancer. Many rank-and-file GPs remained largely unmoved, however, and this letter is typical in its focus on moderation (no talk of "no safe level" in those days!). He goes on to make light of the issue by comparing smoking with tea-drinking and kissing.

October 7 1950

Dr. A. LEWIS (London, W.9) writes:

Your correspondents, Drs. Lennox Johnston and F. C. Morgan (September 9, p. 630) would be far less likely to find themselves in a minority crusade if they were a little less sweeping in their assertions. Few doctors could fail to join them in a campaign against excessive smoking, nor could many fail to agree that the inhalation of tobacco smoke is unlikely to do good to any kind of cough whatever its aetiology.

But how far are Drs. Johnston and Morgan justified in announcing that failure to get rid of tobacco is probably the main cause of failure to get rid of tuberculosis ? The pathogenicity, infectivity, and chronicity of tuberculosis depend on several factors, and the extent to which these may be affected by smoking may not be so great as they would have us believe...

Not satisfied with this, Drs. Johnston and Morgan go on to argue that, because of its bad effect on tuberculosis (which most of us admit) and because of other ill effects of excessive smoking, all tobacco smoking could (and should) be abolished to the advantage of the community. Perhaps it could. But it is only one of the so-called " evils " with which a civilized community indulges itself. I feel, for instance, that a strong case could be made against tea...

I have no doubt that Drs. Johnston and Morgan could if they tried bring a good case on a sound scientific basis for the abolition of kissing. But if they charged all who failed to join them with promiscuous lasciviousness they could hardly be surprised if their accusations were met with ribald cries of " Whack ho ! "...

Until Drs. Johnston and Morgan can show that a little of what I fancy does me harm I hope the world will still find me willing to appreciate anything from a pipe and a glass of beer to a Havana cigar and a vintage brandy.

Johnston was more than a GP and amateur scientist. He was, above all, an anti-smoking campaigner. He was the president of the National Society of Non-Smokers for many years and bitterly resented the failure of epidemiologists to grasp the nettle and campaign for legislation (how times change). He hated Doll and Hill for stealing his thunder, but also for not taking what he saw as the obvious next step of demanding the abolition of smoking.

Johnston was overly optimistic about the chances of turing Britain smokefree. Despite being acutely aware of nicotine's addictive potential, he felt that if he was put in charge of a national stop-smoking campaign, he could get most smokers to quit at a stroke.

In this letter, he applauds Ernest Wynder's epidemiological research while taking a side-swipe at both him and Doll & Hill. He then outlines his own plan of action which will culminate in prohibition. Unlike modern anti-smoking campaigners, he does not pretend that smokers are a net burden on the health service. He accepts that smoking cessation will require nonsmokers to pay more in tax.

January 26 1957

Sir,
Dr. E. L. Wynder's masterly deployment of the evidence in support of the carcinogenicity of smoking (Journal, January 5, p. 1) contrasts with the timidity of his "practical aspects of solving the tobacco-cancer problem." There is, of course, but one "practical aspect," one solution, as he must know, but, like Doll and Bradford Hill, he has avoided—very wrongly, in my view—stating plainly that tobacco-smoking should be stopped and that it is our duty to stop it, quickly. Instead, we continue to fiddle while Rome bums.

"All a physician can do," says Wynder, "is to present the facts to the public." He can do much more. He can state plainly what action should be taken and crusade his utmost for that action. Moreover, the mode and frequency of the presentation of the facts are important. Because of the inaccessibility of smokers to the facts against smoking, nothing less than their very frequent and blunt presentation by a non-smoker over a long period using every modern publicity device would be effective in eliminating tobacco-smoking, and in the end there would have to be compulsory prevention of smoking to cure a considerable hard core of addicts...

Taxation would have to be equitably redistributed, present-day smokers paying much less, and non-smokers much more, than in the past; and the tobacco labour force, buildings, and equipment would have to be redeployed and put to socially valuable work. Individuals can stop smoking, so also therefore can nations. Notwithstanding my criticisms, I recognize fully and gratefully Dr. Wynder's pre-eminent contributions to the cause of non-smoking.
I am, etc.,

Wallasey, Cheshire. LENNOX JOHNSTON.

By 1958, the Medical Research Council (MRC) had accepted a causal link between smoking and lung cancer, but, much to Johnston's chagrin, had called for little in the way of remedial action.

Johnston had form with the MRC. After being refused funding, he accused them all of being nicotine addicts, an allegation he repeats in this letter. Once again, he criticises Doll and Hill—who he continued to view as moral cowards—and repeats his belief that, "The nation's smoking could be cured almost overnight" if only the government were committed to abolishing tobacco as it had opium.

June 21 1958

SIR,-Tobacco consumption in England and Wales last year went up 4.8 million lb. (2.18 million kg.) and reached the record figure of 304.3 million lb. (138 million kg.).'

In its statement on "Tobacco Smoking and Cancer of the Lung" the Medical Research Council accepted the evidence associating smoking with a major part of the increase in lung cancer. This was tantamount to accepting the view that a major part of the epidemic of lung cancer now upon us is readily preventable because tobacco-smoking is readily preventable—it is no more difficult to prevent than opium- or hashish- smoking (which we now prevent), and large numbers of smokers stop smoking voluntarily. Yet the M.R.C. made no recommendations in this statement for preventing lung cancer by stopping people smoking. They were thus guilty, it seems to me, of a grave act of omission.

They followed the precedent established by their chief investigators on this subject, Dr. R. Doll and Professor A. Bradford Hill, of merely setting out the evidence and their conclusions, which carried an implied warning for smokers. But tobacco is far too powerful a drug of addiction to be abandoned, except by a small minority of smokers, in response to mere implied warnings about a remote risk—as the tobacco consumption figures testify. Such warnings have often, indeed, an immunizing effect. Many smokers have acquired such a degree of immunity to fear of lung cancer, as a result of repeated inadequate warnings over the past seven years, that they are quite unscarable: their protective emotion, fear, no longer fulfills its normal function where lung cancer is concerned.

In the absence of any recommendations from the M.R.C., the Government, a lay body which consists mainly of smokers, put in hand measures of its own devising for ending the epidemic of lung cancer. These are a complete farce: the Government merely passed the buck to the local authorities. Cancer of the lung is not, of course, a local but a national problem, and only the national Government has the power to deal with it effectively.

The nation's smoking could be cured almost overnight and the great bulk of lung cancer prevented by a national anti-smoking campaign followed by legislation aimed at doing away with tobacco-smoking within a matter of months. The campaign would consist of educational talks at peak listening times on T.V. and sound radio on the effects of tobacco smoking on the human organism. Blunt warnings about the damage smoking does, coupled with firm injunctions to smokers to stop smoking, could be interposed from time to time between programmes. Everything connected with the campaign should be in the hands of non-smokers, since smokers are obviously pro-smoking, and anti-smoking words on their lips must be hypocritical, however much smokers may protest their sincerity. There is no objection to frightening smokers about the effects of smoking just as there is none to frightening children about the effects of fire.

The economic effects of the nation's stopping smoking would be a problem primarily for the Chancellor of the Exchequer. For too long have successive Chancellors shamelessly exploited the smoker's craving for tobacco to extort from him enormous sums in the form of taxation.
-I am, etc.,
Wallasey. LENNOX JOHNSTON,
President. National Society of Non-smokers

Three months after the previous letter, Johnston writes again. This time, he is responding to a doctor who has said that Johnston's anti-smoking campaign is unrealistically ambitious. He refutes this and calls for smokers to be scared and coerced out of their habit. Again, he cites the precedent of drug legislation.

September 6 1958

SIR,-The suggestion by Dr. B. J. Bouchd (Journal, July 12, p. 106) to the effect that a recommendation to prevent the major part of the present epidemic of lung cancer by stopping the smoking of tobacco would be outside the scope of the Medical Research Council is unfounded. " The [Medical Research] Council, by its constitution, has full liberty to pursue an independent scientific policy.... The programme [of research work undertaken by the Council] . . .includes . . . clinical, and laboratory studies of disease; its nature and causes, and methods for its prevention..."

I assure Dr. A. C. Woodmansey (Journal, July 5, p. 46) that my scheme for curing the nation's smoking in months was put forward seriously. He describes it as unrealistic. But what is there unrealistic about urging on the Government a (real) anti-smoking campaign followed by legislation aimed at, doing away with tobacco-smoking? We prevent the smoking of other drugs, notably opium and hashish, so why not tobacco? Dr. Woodmansey does not believe in deliberately frightening people. Nor do I, unnecessarily. But many smokers are so inaccessible to reason where their drug is concerned that the only hope of cure lies in scaring them (if you can!) sufficiently to break down their inaccessibility.

I am, etc.,
LENNOX JOHNSTON,
President, National Society of Non-Smokers

In this letter from 1971, Johnston is rightly keen to take credit for setting up the UK's first stop-smoking clinic. He admits that it was short-lived due to his belief that he could "turn the whole country for a time into a vast anti-smoking clinic." Although he begins by talking about nicotine addiction as a clinical addiction, he soon slides towards more emotive language.

Incidentally, it should be noted that Johnston uses the term "anti-smoker" in this letter and "anti-smoking" in many of his letters. It is occasionally claimed today that these terms were invented by the tobacco industry as more negative-sounding alternatives to 'tobacco control advocates' or 'smokefree campaigners'. As these letter show, that is not true.

4 September 1971

DR. LENNOX JOHNSTON (Wallasey, Cheshire) writes: It is perhaps worth recording that the first anti-smoking clinic in the world was started in Britain by me in November 1957. The application of the word "clinic" to a centre for the treatment of tobacco-smoking was crucial. It helped to respectabilize such treatment by bringing it into the orbit of clinical medicine. Previously, smoking had been generally regarded as merely or, at any rate, primarily a vice, and getting rid of smoking as a matter of "conversion"; and this, regrettably, was often sneered at as the province of goody-goodies.

My book firmly taught that smoking was a disease, a drug addiction; like most diseases, an intoxication by (in this case) nicotine, carbon monoxide, tar particles, and the other volatile toxic products of tobacco combusion.

Smoking is also, however, a vice. It is antisocial (or vicious) to pollute the air-space of a fellow man. I ran the clinic for over six months, then gave it up. My reasons were lack of medical and financial support, and increasing realization that it was not too much use curing a few smokers, then turning them loose in our tobacco-addicted society where many would be sure to be psychologically reinfected. I felt that the way to deal with tobacco addiction was to turn the whole country for a time into a vast anti-smoking clinic: give anti-smokers carte blanche on T.V. and on the radio, and stop all tobacco advertisements at a stroke...

When I was researching Velvet Glove, Iron Fist (2005-2008), I was unable to find out when Lennox Johnston died. Since then, I have been able to locate his BMJ obituary. He died in 1986 at the age of 86.

29 March 1986

Obituary:

Dr. L. Johnston, a retired general practitioner and antismoking pioneer, died on 18 January aged 86.

Lennox Johnston was born in 1899 and was educated at Ayr Academy and Glasgow University. He graduated MB, ChB in 1921, having served as a medical student in Royal Navy minesweepers in the North Sea during the first world war. He started to smoke at the age of 16 and continued for 12 years. Having thought about his compulsion to continue, he "wondered what would be the effect of stopping." It proved easier than expected, and what surprised him most was how much better he felt. A year or so later he relapsed, and on that occasion it took him "two agonising years" to give up. The salutary experience of the addictive nature of nicotine led him to carry out experiments on himself. In the days when well over half the adult population smoked, and before the mass of technical writings on the subject appeared, he published a book in 1958 entitled The Disease of Tobacco Smoking and Its Cure. In it there is a startling description of the systemic effects of acute nicotine poisoning when he accidentally sprayed a few drops of 40% nicotine solution on his hand, with almost fatal consequences.

After various experiments with nicotine to prove its addictive nature he did everything he could to promote non-smoking, his researches having left him in no doubt that tobacco smoking was "the biggest killer in the world." He carried on a singlehanded fight against the BMA initiated at the annual representative meeting at Brighton in 1956 and continued at the special representative meeting in May 1957, when he spoke against the suspension of a standing order that prohibited smoking at BMA meetings. He became a positive thorn in the side of the Medical Research Council as he conducted his active campaign: it is alleged that as a result of his persistence the council was stimulated to research the effects of smoking on health. Nowadays we realise how courageous his efforts were, but in those times he must have seemed to the uninspired like a latter day Don Quixote tilting at windmills. Only he could see the reality of his cause, and his dedication proved that he was fully justified.

It was fitting that Lennox and his wife were guests of the Royal College of Physicians in 1976 in honour of his pioneering work on smoking. In his address Sir Cyril Clarke likened Dr Johnston to Semelweis, whose discovery of the cause of a big epidemic of puerperal fever that resulted in many deaths in Budapest was not accepted or acted on by his colleagues until after his death. Fortunately, Lennox survived long enough to see his pioneering efforts bear fruit. As past president of the National Society of Non-Smokers he always took an active interest in its work even after his retirement.

In his home life Lennox was devoted to his wife, Frieda, and family. They enjoyed 55 years together. Besides his wife and son, Ivor, he is survived by two daughters, Heather and Sandra, and 10 grandchildren and one great grandchild.

Stagnation

2012-01-04T14:10:00.000Z

Three anti-smoking organisations have commissioned a group of academics to write a report which amounts to a begging letter for continued state funding. It talks about tobacco control "investment" (a word it uses fifteen times) and tries to persuade our impecunious political masters that spending taxpayer's cash on wowserism and junk science will save the country money.

To this end, they lean heavily on the much-mocked Policy Exchange report of 2010 which attempted to show that smokers were a burden on the economy. Unfortunately, all it really showed was that the Policy Exchange can't distinguish between private costs and public costs, financial costs and intangible costs, and externalities and internalities. Nor does it understand that savings need to be weighted against costs in cost-benefit analyses. And, for good measure, it is ignorant of the body of research showing that smokers more than pay their weigh in economic terms.

Never mind though, eh? All policy-makers really need to know when considering whether to throw more taxpayers' money at Tobacco Free Futures, Smokefree South West and Smokefree North East (for it is they) is on page 5:

Furthermore, whilst there has been a downward trend in smoking prevalence over several decades, this appears to have stagnated since 2007.

What happened prior to 2007 to bring down the smoking rate? Not a great deal by the standards of the anti-tobacco extremists—education, awareness, taxation and a ban on tobacco advertising.

What happened from 2007 onwards? One of the world's most draconian smoking bans (2007). Graphic health warnings (2008). Adverts showing fish hooks severing the faces of smokers (2007, below). Massive tax rises (20% increase since January 2010). Counterfeit cigarettes openly sold in the street (2010). Nutters demanding outdoor smoking bans (2011).

Since 2007, the UK has sat proudly atop of the 'Tobacco Control Scale' league table. Like Ireland, Britain did everything the anti-smoking 'experts' said we should. What has been the reward? Stagnation.

Denormalisation, division and extremism is not working. The primary goal of reducing smoking prevalence is not being achieved. The unintended consequences have been socially and economically disastrous. The neurotics and fanatics have been running the show for too long. The coalition should hold tobacco control accountable for this dismal record of failure and return to sensible smoking cessation programmes, believable educational campaigns and treating people like grown ups.

Slip of the tongue?

2012-01-04T12:28:00.003Z

Last week, a new report was published by the Royal College of Physicians on the subject of drinking and sexually transmitted diseases. The conclusions weren't very interesting (there's a link between the two, would you believe?!), but one sentence stood out...

As already noted, there is good evidence that health promotion interventions at a societal level (such as increasing the unit price of alcohol) are more effective than health education messages directed at adolescents.

An interesting choice of words in the parentheses there, as we don't currently price alcohol by the unit. (No country does, so from whence does this "good evidence" come?) We can hardly increase the unit price when we don't charge by the unit.

Slip of the tongue? Perhaps the RCP expected minimum pricing to be law by the time their report came out. Or perhaps they were just getting ahead of themselves.

Either way, if those moral imbeciles in Westminster do give minimum pricing the green light, you can expect to see the words "increasing the unit price of alcohol" in every document from Alcohol Concern, the RCP and the BMA for years to come. Once that Pandora's Box is open, the demands for the unit price to rise will be endless and unforgiving.

Wowsers foiled again

2012-01-03T15:22:00.000Z

Shock news from the nanny state island continent of Australia:

Young binge drinkers have simply switched to cheaper booze to beat the Federal Government's controversial "alcopop" tax.

New research shows 15 to 29-year-olds have dodged the 70 per cent tax on popular pre-mixed drinks by changing their drink of choice.

The University of Queensland study found no significant reduction in binge drinking-related hospital admissions since the tax was introduced in 2008.

Well, well, well. Who could have possibly seen this coming? Those feisty Australian youngsters worked out that if they mix their own drinks, they could avoid paying tax on ready-mixed drinks. Those cheeky little larrikins.

Australians are the biggest consumers of alcohol in the Western world...

What?!?

...ahead of the United Kingdom, the US and France.

What?!?

OK, I'll give you the US, but aside from those lightweights...

Total alcohol consumption (litres, per capita) - World Health Organisation

Australia: 10.02

France: 13.66

UK: 13.37

USA: 9.44

Going from A-Z until I get bored, here are the countries that have a higher per capita alcohol consumption than Australia:

Andorra: 15.48

Armenia: 11.35

Austria: 13.24

Azerbaijan: 10.60

Belarus: 15.13

Belgium: 10.77

Bulgaria: 12.44

Croatia: 15.11

Czech Republic: 16.45

Denmark: 13.37

Bored now, but I think you get the picture. Do Australians really believe they are the "biggest consumers of alcohol in the Western world"? Perhaps they do. I dare say a lot of people in British think they are the biggest consumers of alcohol as well. Certainly, our 'alcohol charities' have no incentive to put the record straight and the media love the fantasy of 'Booze Britain'. Without the myth of exceptionally high drinking levels, who would support the temperance lobby's draconian policies?

And do you think that the abject failure of the alcopop tax has led to apologies and resignations within the 'public health' movement? Do you imagine that politicians have become weary of their broken promises? Or do you think that one failed policy is being used as justification for another?

I think you know the answer by now...

It has prompted fresh calls for a minimum price on alcohol.

Of course it has. And what kind of people are making these calls?

"The price is the most important single determinant of alcohol use and misuse," said co-chair Professor Mike Daube from Curtin University.

Remember Mike Daube? He's the guy who wants graphic warnings on bottles of booze. He is also Mr. Slippery Slope, as I have mentioned before.

Mike Daube was the president of ASH (UK) in the late 1970s when he put that organisation firmly on the path to prohibition. If drinkers have any doubt that they're on the same trajectory as smokers they might take note that they're not just faced with the same rhetoric, but with the same personnel.

And it's no surprise to see the recently formed National Alliance for Action on Alcohol getting in on the action. These science-denying, "one drink can cause cancer" cranks are everywhere in Australia these days.

The National Alliance for Action on Alcohol says 40 per cent of 16 to 17-year-olds admitted drinking to get drunk, so any moves to raise prices would be supported.

Apart from this being a complete non-sequitur, I am so very tired of neo-prohibitionists punishing legal consumers for the perceived crimes of illegal consumers. If you want to stop 16 and 17 years "drinking to get drunk", may I suggest you enforce the laws that already exist rather than soaking the rest of us for taxes?

Any more lies you'd like to tell?

Cask wine is cheaper than bottled water, retailing for about $7.50 for four litres.

[sigh]

Peter Lavac - the whole story

2012-01-01T14:37:00.004Z

I recently mentioned the bizarre case of Peter Lavac, who blames two people who lived in a flat below him for 18 months for giving him lung cancer and now plans to sue. The whole affair is as fishy as a barrel of haddock, not least because Lavac is a well-known nonsmokers' rights activist and the doctor who claims that his illness was probably caused by secondhand smoke "permeating" his apartment happens to be the chairman of ASH Australia.

My thanks to commenters on the previous post for pointing me to Lavac's testimony to a parliamentary committee on tobacco policy which is dated 1st May 2006. Despite being a member of the Non-Smokers Movement of Australia, Lavac describes himself in this document as a "private citizen". His testimony is filled with anti-smoking clichés and an obvious hatred of smokers.

We have laws to protect us from home invasion by thugs and criminals, yet inadequate laws to protect us from home invasion by toxic carcinogens transmitted by selfish ignorant idiots who do not give a dam [sic] about anyone else ... From the moment these people start sucking on their cancer sticks there is no escape ... Invisible smoking and non-smoking lines make about as much sense as having a non-urinating area in a swimming pool.

His testimony provides some crucial facts that did not appear in the recent news reports, which make a mockery of ASH's claim that his lung cancer (from which he has now recovered) was caused by second, third or fourth-hand smoke. Bear in mind that this testimony was given two years before the cancer was detected, but while he was still living in the apartment.

Not long ago I was diagnosed with a very serious life-threatening illness. One of the first things I did was to purchase a small apartment right on the headland on the edge of a cliff overlooking the ocean to take advantage of the fresh clean air coming off the sea. This, I felt, would be conducive to my recovery and treatment, and give me the best possible chance of beating my illness. The location is idyllic, the view spectacular, the atmosphere tranquil, but, most important of all, the ocean air is pure and pristine.

He does not specify what this life-threatening illness was, but judging by the importance of "fresh clean air", it is reasonable to assume it was some sort of respiratory disorder. Furthermore...

My current health problems are further aggravated and compensated by the fact that I am asthmatic, and have permanent scarring of my lungs from a bout of pneumonia several years ago.

It was at this cliff-side getaway that Lavac encountered two hated smokers who lived in a flat below. According to Lavac, "second-hand smoke constantly permeates my apartment" and according to the Sydney Morning Herald:

Professor Peters told Mr Lavac and his wife to reduce their exposure. After living in their flat for 18 months in 2005-06, they changed address.

And so, within months of giving his testimony to parliament, Lavac had moved house. He had only been there for a year and a half, and it was another 18 months before he fell ill again.

In March 2008, Mr Lavac was in a criminal trial in the Downing Centre, which happened to be filmed for an ABC documentary, On Trial.

"I got pretty sick but at the time I didn't realise just how sick," he said. "I had a bad flu that didn't seem to go away. After the jury verdict I got an X-ray done. I thought I had pneumonia."

A CAT scan detected a small dark shadow at the top of his right lung, and a biopsy confirmed it was cancer.

Here we have a guy with a history of pneumonia, respiratory illness and asthma. A man who had scarred lung tissue long before he moved to his mountain retreat and who had only moved there in the first place because he had a "very serious life-threatening illness".

Both scarred lungs and pneumonia are risk factors for lung cancer:

Tuberculosis and pneumonia can leave scarring on the lungs. The scarring is a risk factor for lung cancer development, specifically adenocarcinoma.

Asthma is also an independent risk factor for lung cancer:

The combined results from five case-control studies--that presented data limited to individuals who had never smoked--showed a 1.8-fold increase in lung cancer risk among asthmatics (95% confidence interval (CI) = 1.3-2.3).

Attributing a case of lung cancer to any single cause is a fool's game—which is why his case will fail if it ever gets to court—but Lavac had at least three identifiable risk factors for the disease which had nothing to do with tobacco. It is plainly nonsense for ASH's chairman to claim that "on the balance of probabilities" Lavac's lung cancer was caused by living for 18 months by the ocean near some people who smoked on the balcony below him. This would be a ludicrous thing to say at any time, but it it is still more absurd when the patient had at least three known risk factors.

You be the judge, because I seriously doubt that a real judge will ever be asked to decide. This is a publicity stunt to launch ASH's campaign against smoking at home. Nothing more, nothing less.

2011: The ten best bits

2011-12-31T02:11:00.000Z

Like all years, 2011 was mostly awful for those of us who have a fondness for liberty. However, I have managed to find ten highlights to bring you cheer as the year comes to an end.

10. EU consultation backfires

It all seemed so easy for the European Commission: quietly launch a public consultation on tobacco regulation, pack it full of responses from NGOs and fake charities and, voila!, the EU can declare huge support for plain packaging and huge opposition to lifting the ban on snus. Alas, for our penniless European masters, the NGOs barely turned up, but the public did. Result: very little support for more bans and lots of support for harm reduction policies.

Naturally, the EU disregarded the consultation and claimed to have suddenly found a bundle of supportive responses which they won't let anyone see. Ah, sweet democracy.

9. Junk scientist caught and sacked

All he wanted to do was come up with evidence to show that meat-eaters are anti-social louts, but things unravelled for "social psychologist" Diederik Stapel in October when an investigating committee found that he had "made up or manipulated data in dozens of papers over nearly a decade". The academic fraudster was finally exposed after his students noticed that his data fitted Stapel's pre-existing beliefs a little too perfectly. Sacked in disgrace, one hopes in vain that his example will act as a warning to other politically-motivated social scientists.

8. Malta gets mugged by reality

Having heard about the miraculous effect of smoking bans on heart attacks—arguably the most egregious case of systematic scientific fraud of the last ten years—the people of Malta were expecting great things when they conducted a review of hospital admissions. Alas, the country's heart attack rate had risen since the ban and they had neglected to employ a junk scientist to manipulate the figures to show otherwise.

Failing to twig that they had been tricked by the likes of Jill "let me smooth that our for you" Pell and Anna "pants on fire" Gilmore, the hapless Maltese issued the figures in a report with the unintentionally hilarious title "The Smoking Ban: The Malta Paradox".

7. BBC finally admits that drinking has been declining for years

In which the BBC admitted the truth it had been so carefully obscuring throughout the noughties.

It's difficult to open a newspaper without reading about the alcohol problems that exist in the UK. Recent headlines include "Binge drinking costs NHS billions", "Hospitals reel as drink cases soar" and "Alcohol abuse to cost NHS an extra billion"

And this week, figures from Alcohol Concern suggest the number of people being treated in hospital for alcohol misuse has more than doubled in eight years.

But behind these stories is an unexpected truth - Britons have been drinking less and less every year since 2002.

They didn't make a big deal of this admission—it featured in a little magazine article—and they made it up to their friends at the BMA by producing the most outrageously biased pro-temperance television programme of the year, but at least it was there. If we're lucky, maybe in 2012 they'll acknowledge that obesity hasn't risen since 2002 as well?

6. BMA caught pulling numbers out of the air

Of all the junk statistics that are used to justify a smoking ban in cars, the one you really don't want to cite if you're an "evidence-based" anti-smoking campaigner is the one that was debunked in a prestigious peer-reviewed journal in 2010. But when the British Medical Association earnestly informed the media that smoking in a car creates 23 times more smoke than would be found in a smoky bar, it apparently forgot that the Candian Medical Association Journal had told advocates to "stop using the 23 times more toxic factoid because there appears to be no evidence for it in the scientific literature".

The open and shut nature of the case forced the BMA to retract the silly claim. Having insisted that a single cigarette smoked in a moving vehicle with all the windows open creates 23 times more secondhand smoke than a pub full of smokers, they replaced it with the claim that ten cigarettes smoked in a stationary car with all the windows up and the ventilation off creates 11 times more smoke. Not quite the same thing, that, but it mattered not because the media had moved on and virtually no news outlets let their readers in on the cock-up.

5. Stanton Glantz roundly mocked for Smokefree Movies madness

It's always amusing when normal people suddenly become aware of deranged characters like California's mad professor Stanton A. Glantz (I can't say what the A stands for, but its an anagram of 'earholes'). In March, the paranoid mechanical engineer got himself in the news when he attacked an animated film called Rango which depicted people doing the worst thing in the world. It was true, said Glantz: "A lot of kids are going to start smoking because of this movie." Cue hilarity from across the media and blogosphere, of which the best came from the website Filmdrunk:

Let me be very clear about something: Stanton Glantz is not a real person. He can’t be. An anti-smoking advocate named Stanton Glantz who lives in San Francisco and makes conclusory doomsday statements like “A lot of kids are going to start smoking because of this movie” sounds like something even Michael Bay would dismiss as being too on-the -nose. No, I’ll not be fooled by this.

Look, I don’t want kids smoking any more than the next guy (provided the next guy isn’t Joe Camel). But these morons who take it upon themselves to try to eradicate tobacco use from the planet one city ordinance and petition at a time need to be stopped. I’m sorry if your enjoyment of the park is lessened because Johnny Motorcycle lit up a Marlboro Light and the smell of smoke just drives you batty. But tough sh*t. I don’t like country music, but I’m not going to go out and picket every Keith Urban concert. As I said up top, I can understand banning smoking in tight, confined spaces like bars or airplanes for the health of consumers and employees. But when your argument devolves into “ALL MOVIES WITH SMOKING SHOULD BE RATED-R REGARDLESS OF CONTEXT,” then you’re no longer doing a service to your cause.

And you’re an asshole.

And I hate you.

Quite.

Gobshite

4. Dutch government decides to treat electorate like grown ups

Wailing and gnashing of teeth were inevitable when the Dutch government decided to relax the smoking ban and slash funding of the neo-prohibitionist tobacco control outfit STIVORO.

A bunch of concerned advocates (ie. people who would be out of work if their governments also slashed tobacco control spending) wrote a tear-stained letter to The Lancet with the wonderful title 'Can the Dutch government really be abandoning smokers to their fate?' If stopping harassment and vilification is leaving people to their fate, then yes, they were.

The Dutch health minister, Edith Schippers, has said that "the state is not a nanny" and that she wants to allow "adults to decide for themselves over lifestyle decisions." Public health professionals across Europe looked at each other in bewilderment.

3. McDonalds outwits San Francisco food fascists

Bone-headed Californians decided that Happy Meals were the cause of obesity and so banned the practice of giving toys away with fast food. McDonalds duly obeyed and started selling toys separarely for ten cents while giving the proceeds to charity. The result?

Happy Meal sales haven’t slowed down, McDonald’s is making even more money, and parents are now spending an extra 10 cents per kid every time they stop by the golden arches.

Tee, and furthermore, hee.

2. Bigot crushed in Stony Stratford

Risible neurotic local councillor decides that there will be no more smoking on his watch and moves to ban people lighting up in the streets of Stony Stratford. ASH gives him their support but hundreds of more liberal-minded people flock to the town to register their disgust. Local residents disown him, the motion is rejected by 148 votes to 2 and Councillor Paul Bartlett - for it is he - may not be a councillor for much longer.

1. Alcohol Concern loses government funding

In October, there was terrible news for the nation's second least popular fake charity when the government decided that there was no need to keep shovelling hundreds of thousands of pounds at a temperance group which did nothing but slag them off. Having bit the hand that fed it once too often, Alcohol Concern was left without state-funding. Faced with the prospect of having to collect donations from the public like charities are supposed to do, its CEO, Don Shenker, immediately jumped ship. Shenker is now desperately hoping that any future employees don't Google his name.

Happy New Year.

March of the morons

2011-12-30T14:43:00.002Z

Some pitiful news from Australia:

Cancer sparks legal action over smoking fumes

Peter Lavac, a Sydney lawyer, fitness fanatic and champion surf skier, thought something was wrong when he was not breathing as freely.

Knowing smoke was getting into his air from a flat below where a chain-smoking couple lived, he tried to get them to stop. Unsuccessful, he then approached the body corporate, strata title management and the tenancy tribunal, but to no avail.

He consulted a respiratory specialist, Professor Matthew Peters, who told him to monitor his condition. "From this data and my symptoms, Professor Peters concluded on the balance of probabilities that my symptoms and decrease in lung function were caused by the second-hand cigarette smoke," he said.

No responsible physician would make such a statement. 15% of lung cancers occur in nonsmokers and there are 40 different risk factors for the disease—there is no evidence that being in a flat near another flat where people smoke is one of them. On the contrary, such a hypothesis flies in the face of both science and common sense. What kind of an idiot is this Professor Peters?

Professor Peters, chairman of Action on Smoking and Health, said there was no lower limit for exposure to smoking. "If you can smell smoke, it is hurting you," he said.

Aha! Not just any old doctor, then. This is a guy who has argued for smokers to be denied surgery, who shills for GlaxoSmithKline and who has taken pleasure from hounding smokers out of every conceivable 'public' place in the über-nanny state of Australia. Now, having lied to his patient, he intends to persecute two innocent people who have retreated into their own home—the only place left for them to smoke. Let's not beat around the bush here, friends, this guy is the lowest of the low.

Professor Peters told Mr Lavac, 65, and his wife to reduce their exposure. After living in their flat for 18 months in 2005-06, they moved. In March, 2008, Mr Lavac felt unwell. A CT scan detected a shadow at the top of his right lung, and a biopsy confirmed cancer...

Mr Lavac, who had never smoked, lost a third of his right lung. His surgeon and Professor Peters told him that, on the balance of probabilities, the lesion had been caused by passive smoking.

Yes folks. We live in a world in which professors of medicine tell people that they have developed lung disorders because they lived in a flat for 18 months above people who smoked. This is the state of hypochondria and intellectual retardation we have reached in the last days of 2011.

You can watch this cretin below, if you can stomach it. He mentions that his patient had never smoked and reported no secondhand smoke exposure and so, in his weird little world, it must have been tobacco smoke magically seeping in from a neighbouring building wot done it. At this rate, Australians will be burning wickermen and ducking witches before the end of the decade.

UPDATE:

I didn't want to say too much about Peter Lavac in this post as he has clearly suffered a brush with death. His disbelief at contracting lung cancer is sadly typical of people who think they don't "deserve" to suffer ill health because they have followed all the rules of public health

“How could this possibly happen to me?” asks Peter. “I was at the peak of my physical strength and power. I’d never smoked, I never drank alcohol, I never did drugs, I was an athlete."

However, as Mag points out in the comments, Mr Lavac has a back story himself. He is a member of the Non-Smokers Movement of Australia and lobbied parliament for a draconian smoking ban in 2006.

The coincidences are coming thick and fast, are they not? ASH and the NSMA are both small organisations with limited memberships and yet it just so happens that the "victim" of fourth-hand smoke (or whatever it is) is a prominent lobbyist for NSMA and the doctor who says his story checks out just so happens to be the chairman of ASH.

Gee, what a small world.

Absurd logic

2011-12-29T15:39:00.003Z

Earlier this month, the Department of Health announced that it would be launching a public consultation on plain packaging before the end of the year. They have since delayed it until the spring, but the British Heart Foundation was clearly all geared up for the earlier deadline. How else to explain this spurious propaganda appearing three days before new year?

Branded cigarettes safer, say 25%

More than a quarter of young smokers believe cigarettes in "glitzy" and branded packaging are less harmful than those in packets with a plain design, a charity has warned.

A report by the British Heart Foundation (BHF) found that just over 25% of regular smokers aged 16 to 25 thought a branded cigarette pack was less harmful than another based on the packet design alone.

This refers to the fact that people can still remember when (low-tar) Marlboro Gold were called Marlboro Lights. That was not so very long ago so it is hardly surprising. The BHF do not consider the fact that Marlboro Gold will still be called Marlboro Gold even if plain packaging is introduced and, therefore, a minority of people will consider them to be less harmful—or, to put it another way, that Marlboro are more harmful. Being prohibitionists, they never contemplate the consequences of their actions. Action is all that counts. But unless they plan mass brainwashing of the population, the plain packaging ruse will have no effect on the misconception they profess to be concerned about.

Betty McBride, director of policy and communications at the British Heart Foundation, said: "As informed adults, we know that smoking is a deadly addiction that kills half of all smokers.

Why does the British Heart Foundation—a charity—have a "director of policy"? Is this really what people donate their money for?

"But young people are not always fully aware of the risks, and the power of branding holds more sway."

Firstly, it is highly unlikely that young people are not fully aware of the risks considering the multi-million pound anti-smoking campaigns in every media, as well as at school. Secondly, in case you hadn't noticed, "young people" are not allowed to buy cigarettes and by the time they are able to buy them they are "informed adults". Even if they obtain them illicitly in the mean time, they will find extensive, graphic health warnings on every pack. If these do not make them "fully aware of the risks", the fault lies with the anti-tobacco policy-makers who created them.

But for do-anything, say-anything campaigners like the BHF's director of policy, nothing is ever enough...

"Tobacco advertising is rightly banned in the UK. Yet current glitzy packaging clearly still advertises tobacco on the cigarette box."

Tobacco advertising is indeed banned. I vividly recall organisations like the BHF celebrating all those years ago when the UK introduced a total and utter ban on tobacco advertising and sponsorship. They celebrated because the ban was so "comprehensive". There was not a word from them about any "loophole" which allowed cigarette packaging because, as everyone understood, packaging is not advertising. Only very recently, as the anti-smoking movement searched for new barrels to scrape, have they attempted to redefine advertising to include colours and logos.

She added: "It's an absurd loophole the tobacco industry takes full advantage of to lure in new young smokers."

This is abject nonsense, but expect to hear much more of it next year. The alcohol, food and pharmaceutical industries should take note. 'Junk food' and alcohol are not allowed to be advertised before 9pm. Most drugs cannot be advertised at all. Alcohol may also soon be subject to a total ban. Why, then, should children have to be "exposed" to the "advertising" of "glitzy packaging" every time they step foot in a shop or walk past a window? Won't somebody think of the children? Something must be done, etc. etc.

Either packaging is advertising, in which case products which cannot be advertised on television should be sold in plain packaging from covered shelves, or it is not, in which case some semblance of a free market should remain.

It is not, of course. Never in history has a logo on a product been considered advertising. Even the fruitiest loops of the anti-smoking fraternity never viewed it as such until necessity became the mother of invention. They will resort to anything to get their way, but their corruption of the English language must be resisted by every industry before the neo-prohibitionists take the "next logical step."

The hyper-inflation of beer

2011-12-29T09:58:00.000Z

Amongst my stocking fillers this year was a book titled The Book of Beer Knowledge from which I give you these statistics:

Pint of milk

1971: 5p

2007: 32p

= 640% increase

Pound of steak

1971: 60p

2007: 408p

= 680% increase

Sliced loaf

1971: 9.5p

2007: 88p

= 926% increase

Pint of beer

1971: 12p

2007: 224p

= 1867% increase

Aside from the enormous, above-inflation rise in the price of beer—despite the temperance lobby's disingenuous assertion that alcohol has become more "affordable"—I'm struck by how much the price of a pint has increased even since 2007.

The book was published by CAMRA so £2.24 pint was presumably the average cost of real ale, but anecdotal evidence tells me that the price must have risen to around £3 in the four years since, no? Does anybody have some 2011 prices to complete the picture?

Everyone needs sugar - let's tax it!

2011-12-28T13:15:00.000Z

An op-ed in the New Zealand Herald calls for a tax on sugar. Nothing special about that, but the article—written by one Tony Falkenstein—uses so many of the neo-prohibitionist's rhetorical tricks that it should be regarded as a classic of the oeuvre.

It starts with the inevitable argumentum ad tobacco:

Remember the Marlboro man who rode across billboards, cigarette hanging from his lips? Remember Benson & Hedges, which sponsored the tennis, Rothmans which sponsored the cricket? - all brands promoting healthy living when the exact opposite was the truth.

Ignoring the fact that tobacco isn't essential to human life but sugar is, Falkenstein then draws a spurious comparison:

It took a tax to dramatically slow smoking addiction; a tax on sugar and fat products would do the same.

And let's have that parallel with tobacco again...

Thirty years ago nobody would have imagined that cigarette advertising would be banned, workplaces would be smoke free, and that cigarettes would attract an excise tax of 24c a cigarette.

Perhaps not, but thirty years ago there were people who warned that the anti-smoking campaign would set a template for food faddists, teetotallers and other puritans and cranks. This was always strongly denied, but it is now glaringly obvious that they were right.

We now have two newer addictions - sugar and fat.

These are not addictions, let alone "new" ones. Fat and sugar are essential to sustain life, hence the body naturally desires them.

These are the major cause of Diabetes 2

Hardly the "major cause". According to Diabetes UK, the causes of diabetes are many and varied:

You should ask your GP for a test for diabetes, if you:
are white and over 40 years old
are black, Asian or from a minority ethnic group and over 25 years old
have one or more of the following risk factors.

The risk factors

A close member of your family has Type 2 diabetes (parent or brother or sister).
You're overweight or if your waist is 31.5 inches or over for women; 35 inches or over for Asian men and 37 inches or over for white and black men.
You have high blood pressure or you've had a heart attack or a stroke.
You're a woman with polycystic ovary syndrome and you are overweight.
You've been told you have impaired glucose tolerance or impaired fasting glycaemia.
If you're a woman and you've had gestational diabetes.
You have severe mental health problems.

He continues:

Sugar is an addiction...

No. No, it isn't.

...so a gentle weaning off the addiction will make it more manageable for consumers as well as giving manufacturers time to adjust the composition of their products.

The excise tax I propose would be 20 per cent on all products with more than 10 per cent sugar content.

Apples and mangos are 15% sugar. Bananas are more than 50% sugar. Are you sure you've though this through?

Each year the sugar content bar would reduce by 1 per cent , so that in seven years the 20 per cent tax would apply to all products with more than 4 per cent sugar,which is considered an acceptable level.

This would mean a sin tax on all fizzy drinks, of course. But it would also mean a sin tax on most fruits, all smoothies, all desserts and a good proportion of yoghurts. From taxing Marlboros to taxing grapes in thirty years. If this is not a slippery slope, what is?

Of course, the food industry is equated with Big Bad Tobacco.

The food and beverage industry, like the tobacco industry before it, can afford to outgun health spending for its own benefit.

And there is the usual appeal to the economy:

The country cannot afford the cost of diabetes, and a sugar tax will force the industry to adopt better standards, and consumers to reduce their addiction.

If the country cannot afford diabetes, how can it afford a Pigouvian tax levied to pay for diabetes? The idea, surely, is to be Pareto efficient?

And finally, the massive conflict of interest. Who is this Tony Falkenstein who wants a 20% tax on all sugary drinks?

Tony Falkenstein, ONZM, is chief executive of Just Water International.

Just Water International makes its money from selling water coolers. Fancy that!

Tony Falkenstein: Rent-seeking shill

(Thanks to Ross for bringing this article to my attention.)

What effect will a fat tax have?

2011-12-27T15:58:00.003Z

From The Guardian:

Imposing a 10% "fat tax" on sugary drinks would help tackle soaring rates of obesity, according to new research by international experts.

Would it, by God? And your evidence?

"In testing taxation as an option for shifting beverage purchase patterns, we calculate that a 10% increase in the price of SSBs could potentially result in a decrease of 7.5ml per capita per day." A similar 10% hike in the cost of full-fat milk would also reduce consumption of it by 5ml per person per day and increased intake of reduced fat milk by 7ml per head every day, it adds.

Okay. So a 10% tax—essentially a tithe to be given to the Gods of public health—would reduce full-fat milk intake by 5ml a day, or 1,825 ml a year. That works out at 3.2 pints a year.

Doesn't sound like very much, does it? And indeed it's not. There are 380 calories in a pint of full-fat milk and 265 calories in a pint of semi-skimmed. If a 10% tax on full-fat milk makes people replace 3.2 pints of full-fat with 3.2 pints of semi-skimmed, they would reduce their calorie intake by 368 per year ((380-265 = 115) x 3.2 = 368). This works out at one calorie per day which is, to all intents and purposes, nothing.

But there is more. The fat-taxers seem to think that consumption of reduced fat milk will increase by 7ml a day—more than offsetting the 5ml fall in full-fat milk consumption. Why they believe this, I know not, but let's roll with it for a moment.

A 7ml increase is 2,555ml a year, ie. four and a half pints a year. If this is semi-skimmed, this is an extra 1,166 calories.

If it is skimmed milk (195 calories per pint), it would be an extra 858 calories.

Remember that people will supposedly lose 1,216 calories because the fat tax makes them reduce their full-fat milk consumption by 3.2 pints.

So if they switch from full-fat to semi-skimmed milk, they will lose fifty calories per year—a whopping 0.1 calorie per day! (1166 - 1216 = -50). Just watch that flab fly off!

Even if they switch to skimmed milk, they will lose only 358 calories per year, ie. one calorie a day (858 - 1216 = -358).

As for reducing consumption of "sugar-sweetened beverages" by 7.5ml a day, there are 400 calories in a litre of Coca-Cola, so a reduction of 7.5ml works out at 3 fewer calories per day. This, of course, assumes that people would replace their Coke with water or nothing at all. If they substituted something "healthy", like an Innocent Smoothie, they would wind up consuming more calories because a typical litre of smoothie contains more than 500 calories. (But we don't mention that because middle-class people like them.)

Since the average adult male needs 2,500 calories per day to maintain a healthy weight, the idea that a reduction of 0.1 to 3 calories would "help tackle soaring rates of obesity" must be described as extremely fanciful. It would, however, be an effective way of clawing more money out of the hands of the hapless electorate on the pretext of health. And that, dare I say, is the real appeal.

Vested interests

2011-12-27T00:05:00.002Z

Dr. Theodore Dalrymple has written a typically incisive article about the Dutch government's decision to reduce the amount of taxpayers' money spent on anti-smoking groups. You might recall the squeals of discontent from various tobacco control employees in a recent letter to the Lancet. That the authors of that letter depend on draconian anti-smoking policies for their livelihoods has not gone unnoticed by Dalrymple.

It seems to be beyond the imagination of anti-smoking campaigners that someone might support the right to smoke on grounds of principle and not of narrow personal interest. The item, brief as it is, gives a flavor of the often bile-filled writing of anti-smoking campaigners:

It would be a matter of no little shame to a country that prides itself on a compassionate and inclusive ethos if its government were to abandon smokers to their fate. Every death that ensued would not just be the responsibility of the tobacco industry, which continues to promote its lethal product, but also of every politician in the Dutch Government who chose to look the other way and allow it to happen.

What of the responsibility of the smokers themselves?

Of this, not a word: they are putty in the hands of the tobacco companies and their government, scarcely human in fact. Apparently, Dutch smokers would stop if they knew about the effects of secondhand smoke, which are harmful additionally to first-hand smoke. A strange psychology indeed!

What if someone wrote a theoretical defense of the right to smoke, but put at the end that he had received money from the tobacco companies and indeed was employed by them? A cry of “vested interest!” would deafen.

Do go read the rest.

Kicking Edgar Allan Poe

2011-12-26T11:26:00.001Z

"Quiantest thoughts, queerest fancies come to life and fade away.

What care I how time advances?

I am drinking ale today."

- Edgar Allan Poe

Happy boxing day.

The magic 25%

2011-12-23T16:55:00.003Z

A handful of anti-smoking extremists have long hoped that smoking is linked to breast cancer. The pink ribbon breast cancer campaign is arguably the best-publicised and best-funded initiative in pubic health. Because breast cancer is the most common form of cancer amongst women, even a small association with smoking would allow tobacco control advocates to claim that millions of cases could be prevented by stamping out tobacco.

The problem is that there really isn't any reason to think the two are related. Sixty years of epidemiological research has failed to find a link and, unlike with diseases of the lung and airways, there is no obvious causal mechanism. As recounted in Velvet Glove, Iron Fist (pp. 236-38), neither the International Agency for Research on Cancer (IARC) nor the American Cancer Society believe there is a link and even the otherwise outré Surgeon General's report of 2006 didn't claim smoking to be a cause of breast cancer.

Outside of California, it is generally accepted that breast cancer is not a smoking-related disease. Inside California, things are always a little different. From his pulpit at UCSF, Stanton Glantz has been insisting on a connection for years, and the California Environmental Protection Agency (Cal-EPA) conducted a meta-analysis in 2004 which found an association between breast cancer and passive smoking. When the American Cancer Society expressed reservations about this meta-analysis (amongst other flaws, it excluded a notable cohort study which would have wiped out the association), Glantz went berserk and referred to doubters as "religious fanatics", thus displaying an extraordinary lack of self-awareness.

Glantz has been at it again this month following a review of breast cancer risks conducted by the Institute of Medicine. Getting rather excited at the prospect at linking arms with the pink-ribbon campaign, he overstated the conclusions of the IOM report and announced:

It's time for the large breast cancer advocacy groups to join the tobacco control community.

Glantz seems to think that the IoM report implicated smoking (and passive smoking) as a cause of breast cancer. That is not how I read it, nor is it how the New York Times read it. What the IoM actually found was this:

The evidence also indicates a possible, though currently less clear, link to increased risk for breast cancer from exposure to benzene, 1,3-butadiene, and ethylene oxide, which are chemicals found in some workplace settings and in gasoline fumes, vehicle exhaust, and tobacco smoke.

This was the only reference to tobacco in a 700 word press release. In the report itself, the IoM say that they cannot rule out a link, but that the evidence is equivocal. Tobacco remains a "possible" cause in the same way that mobile phones were found to be a possible cause of brain cancer in a recent IARC report. In other words, the collated evidence does not suggest a causal link, but some studies have found an association.

There are two interesting aspects of the breast cancer/smoking hypothesis. The first is that there was barely a hint of a link for the first 40 years of epidemiological research, as the IoM acknowledge:

Before 1993, more than 50 epidemiologic studies examined the relationship between breast cancer and exposure to tobacco smoke. Although the quality of studies was highly variable, the better conducted studies did not suggest a causal relationship (Palmer and Rosenberg, 1993). An IARC review published in 2004 included studies conducted before 2002, and it relied heavily on a pooled analysis of 53 case–control and cohort studies by the Collaborative Group on Hormonal Factors in Breast Cancer Study (2002) that contended that apparent associations with smoking were confounded by alcohol consumption. The IARC (2004) conclusions were that neither active nor passive smoking was associated with increased risk of breast cancer.

In any other field of research this would be enough to put the matter to bed, but tobacco control was flooded with money in the 1990s and so it continued. This coincided with the rise of ultra-low risk epidemiology and cherry-picked meta-analyses which, in turn, was accompanied by the burden of proof being relaxed in the science to the point where statistically insignificant findings were taken seriously.

Breast cancer is a very common disease and smoking is a very common behaviour. Given these facts, any association between the two should have been evident very early on (by the 1950s, if not even earlier). That no one found an association despite smoking being the most studied risk factor of the twentieth century strongly suggests that none exists. "If smoking was a major cause of breast cancer, we would have found it by now," says Dale Sandler, chief of the NIEHS Epidemiology Branch.

Those who say that smoking (active or passive) causes breast cancer are making an extraordinary claim and, despite efforts being redoubled in the last fifteen years, there is no extraordinary evidence and very little ordinary evidence.

From the IoM report:

Active smoking

The summary risk ratio was 1.10 (95% CI, 1.07–1.14), indicating a weak association with increased risk for early initiation of smoking. For women who smoked only after a first pregnancy, the summary risk ratio was 1.07, but it was not a statistically significant increase in risk (95% CI, 0.99–1.15). A subsequent report from the NHS found a statistically significant increase in risk associated with greater smoking intensity (i.e., pack-years of smoking) from menarche to a first birth (p for trend <0.001) (Xue et al., 2011). At 1–5 pack-years of smoking before a first birth the hazard ratio (HR) is 1.11 (95% CI, 1.04–1.20); for 16 or more pack-years, the HR is 1.25 (95% CI, 1.11–1.40).

No increase in risk was evident for pack-years smoked from after a first pregnancy to menopause. For 31 or more pack-years, the HR was 1.05 (95% CI, 0.92–1.19). However, pack-years of smoking after menopause may be associated with a slight reduction in risk (p for trend = .02) (Xue et al., 2011). For 16 or more pack-years of postmenopausal smoking, the HR was 0.88 (95% CI, 0.79–0.99).

... For women who started smoking between ages 15 and 19, the HR was 1.21 (95% CI, 1.01–1.44); whereas those who initiated smoking after age 30, the HR was 1.00 (95% CI, 0.76–1.32).

Brown et al. (2010) concluded that their data did not show a consistent association between smoking and significant increases in breast cancer risk among U.S.- or foreign-born Asian women. For example, the results for current smokers showed an OR of 0.9 (95% CI, 0.6–1.3) while ex-smokers had an OR of 1.6 (95% CI, 1.1–2.2).

A study that examined risk for triple-negative breast cancer found no statistically significant increase in risk over nonsmokers based on smoking status, age at initiation, or duration of smoking (Kabat et al., 2011). By comparison, women with estrogen-receptor- positive cancers (ER+) were at significantly increased risk with earlier initiation (< age 20: HR = 1.16, 95% CI, 1.05–1.28) and longer duration of smoking (≥30 years: HR = 1.14, 95% CI, 1.01–1.28).

These relative risks are low or non-existent and even the positive findings are often not statistically significant. The most interesting thing about these associations is that they are actually lower than the associations claimed for passive smoking.

Passive Smoking

A 2005 review by the California Environmental Protection Agency of various health hazards associated with exposure to secondhand smoke included a meta-analysis of 19 epidemiologic studies of breast cancer ... The meta-analysis produced an overall estimate for exposed women of RR = 1.25 (95% CI, 1.08–1.44) (CalEPA, 2005; also reported in Miller et al., 2007). When the analysis was restricted to five studies with more comprehensive exposure assessment, the overall estimate was RR = 1.91 (95% CI, 1.53–2.39).

In 2006, the U.S. Surgeon General’s report The Health Consequences of Involuntary Exposure to Tobacco Smoke, which included consideration of many of the same studies as the California review, concluded, “The evidence is suggestive but not sufficient to infer a causal relationship between secondhand smoke and breast cancer” (HHS, 2006, p. 13). The conclusion was based on a review of the findings from seven prospective cohort studies, 14 case–control studies, and a meta-analysis of all of these studies. The meta-analysis found that women who had ever been exposed to secondhand smoke (10 studies) were at increased risk of breast cancer (RR = 1.40, 95% CI, 1.12–1.76).

The idea that passive smoking is more dangerous than active smoking is patently absurd, but that didn't stop ASH (USA) hyping Cal-EPA's meta-analysis with this headline in 2005:

Secondhand Tobacco Smoke More Dangerous Than Smoking Itself

It is fitting that an organisation that endorses so much flim-flam should wind up embracing the principles of homeopathy, but any reasonable person understands that the dose makes the poison. In its understated way, the IoM acknowledges that it is a tad unlikely that people who inhale less than 1% of the dose inhaled by smokers would be at greater risk.

For most other smoking-related diseases, the relative risks are much stronger for active smoking than passive smoking. Thus findings of equivalent or stronger relative risks for breast cancer with passive smoking than with active smoking are difficult to explain mechanistically.

And yet these perverse findings exist and they require explanation. At first glance, it seems that the epidemiological research into breast cancer and tobacco don't tell us very much at all. Certainly, they don't tell us very much about the environmental causes of breast cancer, but I think they tell us quite a bit about the state of epidemiology. They show how easy it is to find a relative risk of around 1.25 (ie. a 25% increase) in an observational study. It takes only moderate recall bias or deficiencies in a study's design to come up with such associations. In the case of secondhand smoke and breast cancer we can surmise that the associations are false because there is no link with active smoking, but it is curious that the claimed associations with other diseases also fall in the same ultra-low bracket, regardless of the magnitude of the risk from active smoking.

Smokers are around 1,000 to 2,000% more likely to develop lung cancer. The passive smoker's excess risk is said to be around 25%.

Smokers are around 70% to 100% more likely to develop coronary heart disease. The passive smoker's excess risk is, again, around 25%.

Smokers are not any more likely to develop breast cancer, but the passive smoker's excess risk is said to be—you guessed it—25%.

Despite huge variations in the effects of smoking, the effects of secondhand smoke—if we are to take the epidemiological studies at face value—are remarkably consistent. Consistent with each other, that is. Not consistent with the rest of science.

Reason reviews The Art of Suppression

2011-12-21T15:57:00.001Z

I'm delighted to see that Reason magazine has reviewed The Art of Suppression and compares it favourably with the recent PBS documentary about Prohibition...

The new Ken Burns and Lynn Novick documentary Prohibition is a five-and-a-half-hour missed opportunity to demonstrate why bans on substances are doomed from the start. Fortunately, for those who want to understand the irresistible lure of all types of prohibitions, there is Christopher Snowdon’s The Art of Suppression: Pleasure, Panic and Prohibition Since 1800. Although Snowdon’s comprehensive history will never reach as many people as the PBS series, The Art of Suppression makes the case that Burns seems to go out of his way to avoid: that prohibition of products that people desire, whether alcohol a century ago or Ecstasy today, is bound to fail miserably.

Deploying a colorful cast of characters, Snowdon, a British journalist whose first book, Velvet Glove, Iron Fist (2009), documented the history of anti-tobacco campaigns, tells the story of prohibition’s broader context. He brings to the task the stinging humor reminiscent of H.L. Mencken, whom he quotes in describing one of the book’s central villains, the Anti-Saloon League lawyer Wayne Bidwell Wheeler: “He was born with a roaring voice, and it had the trick of inflaming half-wits.”

Please go read the whole thing.

You can buy the book here (UK) and here (rest of the world).

The limits of cigarette taxation

2011-12-20T12:46:00.000Z

Today's blog post is at the Adam Smith Institute. While ASH deny that higher prices cause smuggling, the Irish have realised that further cigarette taxes will make them less money.

Laffer curve spotted in Ireland

Strange unintended consequences

2011-12-19T14:38:00.001Z

Some saucy news from Manitoba, Canada...

After smoking in public places was banned in 2004, happy hour crowds dwindled in bars across the province.

Lies, all lies! Stanton "black is white" Glantz has conducted studies into this and has proved that smoking bans are good for business. Why do bar-owners around the world continue to deny this? The fools!

In a bid to woo customers back to his lounge, Ron Petryna, the owner of the Headingley Hotel, began running conventional Friday night bingo games.

And why not?

"We started off giving away pretty tame stuff -- cases of pop or boxes of candy," Petryna says. Then he recalled a Ladies' Night promotion he`d witnessed south of the border -- one that climaxed with a few rounds of "naughty bingo" where female participants went home with vibrators and such.

"So we began to introduce adult toys into our own bingo games," says Petryna. "Next we added special martinis and cocktails named after the games. This all evolved from there."

Oh, I say.

"This all" refers to the fact that Manitoba has quietly become the undisputed erotic bingo capital of the world. Sure, you can find comparable goings-on in places like Toronto, Ont., Portland, Ore. and Orlando, Fla. But "dirty bingo" or "X-rated bingo" or however it's billed in those burgs isn't a standard occurrence. Not like it is at Dick's Dylan's, the Stock Exchange Hotel and the Riverside Inn, to name a few local nightspots that now host erotic bingo on a weekly basis.

Tis a frenzy of x-rated bingo in Manitoba.

"Last weekend was the busiest it's ever been, in fact; we had a 28-girl bachelorette party and a soccer team from the U of M. We ended up having to seat people at the pool tables so that everybody could play."

A full house, if you will.

"My first reaction was that it sounded kind of skanky," says Kaisaris. "We don't do strippers here -- we're not that kind of place -- but I quickly discovered that erotic bingo isn't like that at all. It's good clean fun." (Good, clean and free: none of the bars we visited charges people to take part.)

Nowadays, erotic bingo at "The Nob" is definitely a family affair...

Steady on. You're just being silly now.

You can read more of this smut here.

A true sports personality

2011-12-18T10:42:00.001Z

I'm not usually very interested in BBC Sports Personality of the Year, but I notice that Darren Clarke has been nominated this year. Clarke has been described as a "walking, smoking, Guinness-drinking counterblast to the notion that the modern professional golfer has to be a finely-tuned athlete with a six-pack." He smoked his way to victory at this year's British Open and then stayed up all night on a nineteen hour bender. His manager, Chubby Chandler, says he plays better when he's fat. Clarke does not disagree.

"I'm not going to change anything that I do. I think it would be very poor of me if I was to change the way I am because of a few people's opinions. That's not going to happen.

"I drink a little too much, smoke a little bit too much and enjoy myself a little bit too much at times. But when it comes down to it, I'll put my head down and work whenever I really have to."

I can think of no better way of driving the Righteous to distraction this Christmas than by having this fine athlete win Sports Personality of the Year. Please vote and vote often. You know it makes sense.

The Hitch on snitches

2011-12-16T20:55:00.002Z

Christopher Hitchens (1949-2011)

The death of Christopher Hitchens earlier today robbed the world of one of journalism's most eloquent and articulate voices. Here he is speaking about the nanny state in 2004...

When the complete ban on smoking in all public places was enacted in California, I called up the assemblyman who wrote the legislation and I said: “I’ve just discovered that bars are not going to be able to turn themselves into a club for the evening and charge a buck for admission for people who want to have a cigarette. You won’t be able to have a private club. You won’t even be able to have a smoke-easy, if you will, in California.”

And he said, “That’s right.”

I said, “Well, how can you possibly justify that?”

And he said, “Well, it’s to protect the staff. It’s labor protection legislation. We don’t want someone who doesn’t want to smoke, who doesn’t like it, having to work in a smoky bar.”

And I said, “You don’t think that if there were bars that allowed it and bars that forbade it, that, sooner or later people would apply for the jobs they preferred, and it would sort of shake out?”

He replied, “No. We could not make that assumption.”

So we have to postulate the existence, if you will, of a nonexistent person in a nonexistent dilemma: the person who can find only one job, and that job is as barkeep in a smoking bar. This person must be held to exist, though he or she is notional. But everyone who actually does exist must act as if this person is real.

...The worst part is that the staff has to become the enforcers. The waitresses have to become the enforcers. The maitre d’ has to become the enforcer. He has to act as the mayor’s representative. Because it’s he who is going to be fined, not you. If you break the law in his bar, he is going to have to pay.

So everyone is made into a snitch. Everyone is made into an enforcer. And everyone is working for the government. And all of this in the name of our health.

Now, I was very depressed by the way that this argument was conducted. There were people who stuck up for the idea that maybe there should be a bit of smoking allowed here and there. But they all said it was a matter of the revenue of the bars and the restaurants. That was the way the New York Times phrased it.

In no forum did I read: “Well, is there a question of liberty involved here at all? Is there a matter of freedom? Is there a matter of taste? Is there a matter of the relationship of citizens to one another?”

And something about it made me worry and makes me worry still. The old slogan of the anarchist left used to be that the problem is not those who have the will to command. They will always be there, and we feel we understand where the authoritarians come from. The problem is the will to obey. The problem is the people who want to be pushed around, the people who want to be taken care of, the people who want to be a part of it all, the people who want to be working for a big protective brother.

Read the full article here.

Anna Gilmore returns

2011-12-15T12:24:00.000Z

Anna Gilmore's new study doesn't seemed to have generated much media attention, perhaps because any editor looking at the headline of the press release is likely to think "well, duh":

Smoke free legislation linked to drop in second-hand smoke exposure among adults

Levels of second-hand smoke exposure among non-smoking adults fell by almost 30 per cent after smoke free legislation was introduced in England in 2007, researchers in the Department for Health have found.

...Professor Anna Gilmore, who directed the study, said: “The importance of this study is that it examines the impacts of smoke free policies on adults’ exposure using a specific biological-marker of smoke exposure (rather than self-reported exposure) while simultaneously controlling for underlying declines in exposure.

“To our knowledge it is the first study to do this. The fact it shows marked declines in adult exposure provides further evidence of the important public health benefits of smoke-free policies.”

What, if any, are these "public health benefits"? The study looked at cotinine readings in nonsmokers before and after the English smoking ban and found that they fell by 27%. Cotinine itself is perfectly harmless, but it is a bio-marker for nicotine which is, in turn, is a proxy for "secondhand smoke exposure". Nothing wrong with that, nor is there anything surprising about cotinine readings falling as a result of a total smoking ban in 'public' places.*

The graph below (which comes from the study) shows saliva cotinine levels in nonsmokers before and after the ban (click, as ever, to enlarge).

'SFL' indicates the start of the 'SmokeFree Legislation'. What is most striking about this graph is how much cotinine and, it must be assumed, secondhand smoke exposure declined before the smoking ban. After the ban, cotinine levels did not change for people living in smoking households and Gilmore found that people in social classes IV and V experienced no reduction in secondhand smoke exposure at all (inevitably, this leads to her calling for "further efforts to reduce SHS exposure to benefit those who remain most exposed.")

Only nonsmokers from social classes I to III who live in nonsmoking households saw a decline in their saliva cotinine levels. Gilmore claims that this decline was greater than would be expected from the long-term trend, although none of her graphs appear to support this.

Gilmore's track record gives us no particular reason to trust her assertion that the smoking ban accelerated the existing trend towards less secondhand smoke exposure. However, it is obviously very plausible that a smoking ban would have this effect so, for the sake of argument, let us agree that there was a 27% drop in saliva cotinine readings as a result of the ban.

Her data show that before the ban (1998 to 2007), average cotinine levels in nonsmokers' saliva fell from 0.36 ng/ml to 0.14 ng/ml. After the ban, this declined continued and, by the end of 2008, cotinine levels were at 0.071 ng/ml.

The question is: so what? Is this decline—which sounds impressive when described as a 30% fall in secondhand smoke exposure—of any practical significance? How do these levels compare with actually smoking?

A systematic review of cotinine readings found that the average smoker has a saliva cotinine reading of 318 ng/ml. This is more than 2,250 times greater than levels found in nonsmokers before the ban.

This difference is so vast that it is difficult to show it visually. The graph below shows cotinine levels of nonsmokers in 1998, 2007 (pre-ban) and 2008 (post-ban) compared with a typical cotinine reading from a smoker. If you click to enlarge, you may just be able to see the nonsmokers' data.

While smokers have average cotinine readings of 318 ng/ml, the smoking ban reduced the average nonsmokers' levels by 0.0019 ng/ml. This is beyond negligible. Whether before or after the ban, we are talking about truly homeopathic levels of exposure. It takes a leap of faith to believe that reducing 'exposure' levels from 0.03% of a smoker's level to 0.02% of a smoker's level really constitutes "the most significant and beneficial public health intervention for a generation". Far from showing us how effective the smokefree legislation has been in tackling the passive smoking peril, this study reminds us how overhyped the peril was in the first place.

* However, it is wrong of the press release to describe a 27% fall in nonsmokers' cotinine levels as meaning that "second-hand smoke exposure among non-smoking adults fell by almost 30 per cent". This suggests that if all secondhand smoke was eliminated, cotinine levels would fall to zero. This would never happen because nicotine, and therefore cotinine, exists at low levels in various nightshade vegetables.

Yes, it's all about prohibition

2011-12-14T22:02:00.002Z

An anti-smoking group calling themselves Tobacco-Free Washington have taken their crusade to its logical conclusion by demanding the prohibition of tobacco. Under their proposed law, possession would be a class C felony. Sale would be a class B felony.

Yes, I am serious and so are they. Initiative 512 reads...

(1) It is unlawful to sell, manufacture, or possess any tobacco products including, but not limited to, cigarettes, cigars, and smokeless tobacco.

(2) A person who:

(a) Sells or manufactures any tobacco product is guilty of a class B felony punishable according to chapter 9A.20 RCW; or

(b) Possesses any tobacco product is guilty of a class C felony punishable according to chapter 9A.20 RCW.

(3) For the purposes of this section, “tobacco product” includes any product containing tobacco or nicotine that is expected or intended for human consumption.

The prohibitionists are now looking for 300,00 signatures to move Initiative 512 forward. The good news is that they have used a clumsy definition of tobacco products which includes pharmaceutical nicotine 'therapies', so the bill will meet strong opposition from Big Pharma and the various anti-smoking groups they fund.

You have to laugh at the guy who is behind this law. Dr Ed Dolan is a dentist who doesn't sound too bright (you can listen to the half-wit here). Whenever prohibitionists are looking for a handy precedent to seem less nuts, it's only a matter of time before they point to seat-belts laws. They are, after all, one of the few laws which are imposed on people for their own good.

Such a law, if it came in to existence, would likely illicit a lot of resistance from those who believe taking away their right to smoke is a violation of their civil liberties. So Dolan compares it to the seat belt law - a law that yes, infringes on civil liberties, but significantly increases the average life expectancy of someone living in Washington.

One of the main objections to seat-belt laws in the 1980s was that they would be the start of a slippery slope to banning smoking, drinking and Lord knows what else. "Nonsense!", said the campaigners, but here we are 30 years later doing just that.

Dolan does acknowledge that it treads on a slippery slope.

Dude, you're calling for the possession of tobacco to be a felony. Possession of alcohol wasn't even a felony under Prohibition. You don't need to worry about treading on the slippery slope. You hurtled down that a while ago.

When [it was] suggested that if cigarettes are outlawed, then red meat and alcohol could be next, Dolan said he's not sure about what could happen regarding health concerns and laws.

At least this numpty doesn't try to deny it. It's the next logical step, innit?

Repetition, repetition, repetition

2011-12-14T10:51:00.005Z

Knock, knock, knock at the door they go—the incessant whining designed to make the government sigh and give in, with the forlorn hope that maybe they'll finally shut up and go away. We saw it with the smoking ban. We saw it with banning below-cost alcohol.

And do they ever shut up and go away?

They do not.

Ban cut-price alcohol to save lives, leading doctors warn

In a letter to The Daily Telegraph, medical experts urge the Government to take “bold action” and follow the lead of Scotland by bringing in minimum prices for drinks.

Firstly, writing a letter to the Telegraph shouldn't be considered front page news, even in the Telegraph.

Secondly, quit it with this "bold action" stuff will you? You tried it last month...

The British Medical Association (BMA) is calling on ministers to bring in the "bold and courageous" ban for reasons of health rather than road safety.

There's nothing bold about putting up tax and banning things. It's cowardly and self-serving. Your attempts at flattery are nauseating and your cynicism is transparent.

Sir Ian [Gilmore—for it is he] is calling for a return to the higher prices of 20 years ago, when alcohol was about 50 per cent more expensive in real terms.

Does anybody understand what 'real terms' means any more? It means 'after adjustment for inflation', not 'compared with average wages'. As I never tire of pointing out, the Office for National Statistics has looked into this and concluded:

Between 1980 and 2008, the price of alcohol increased by 283.3%. After considering inflation (at 21.3%), alcohol prices increased by 19.3% over the period.

Actually, I do tire of pointing this out, so please stop it.

New figures were made public last week showing that twice as many people were being treated in hospital because of alcohol compared with 10 years ago.

New figures?! You must be kidding. The "twice as many people being treated in hospital because of alcohol" story appears more often than the crossword. It's done the rounds three times this year alone (in February, May and December).

In addition to reporting this "news" last week, the Telegraph reported it in May and August—using the same photo to illustrate it on each occasion. It was first reported back in 2008 and has appeared with unfathomable regularity ever since.

The repetition of the 'hospital admissions double' canard (and it is a canard) epitomises the campaign for minimum pricing, which is based on nothing more than a relentless, circling PR exercise by the UK Alcohol Health Alliance modelled on the smoking ban campaign. There is nothing in the article or the accompanying letter of any interest. None of it is new. It is the same hysterical half-truths masquerading as news.

And so, in the absence of anything interesting to write about, I will use the occasion to launch my new leisurewear collection. The Snowdon Winter 2011 collection includes two high quality white t-shirts (other colours are available) featuring simple but lovingly designed motifs which will give the wearer years of satisfaction.

Order now to avoid disappointment.

Nicotine wars: Latest

2011-12-13T11:44:00.001Z

There can now be little doubt that the EU's ban on snus is being maintained at the behest of the pharmaceutical industry. It is not about health. It is not about science. As the Swedish press recently reported, the battle lines are drawn:

In the battle over snus the world's largest pharmaceutical company is in one corner of the ring and the world's largest tobacco company in the other. The battle is about the hundreds of millions of smokers who are trying to quit. Big time lobbying is clearly visible in the EU snus debate. The tobacco industry was most successful in mobilising support for petitions via YouTube and the Internet, while the pharmaceutical industry has achieved success by more selective actions.

“There is clear competition between us and the pharmaceutical industry,” says Swedish Match's Public Affairs Director Patrick Hildingsson. “In the EU there are 107 million smoking consumers both our industries want to reach. The pharmaceutical industry does not want see the success snus has had in helping people stop smoking to spread outside Sweden.”

But Pfizer's Medical Director John Brun does not see snus as competition: “Absolutely not. Tobacco is a major health risk regardless of how it is consumed, which is why we have committed ourselves to reaching out from a health perspective in public debate.”

Pfizer—maker of Nicorette and Champix—does not see snus as competition?! How strange that they should waste so much their time and money lobbying for it to remain illegal (almost as strange as them funding studies into the economic impact of smoking bans). You'd think they'd have better things to do that worry about a niche smokeless tobacco product, unless of course they're worried that it's a more effective smoking cessation aid than their own products.

Instead, they're keen to rush the European Commission into producing its new Tobacco Product Directive, which will address the question of whether the snus ban is justifiable. The following is a letter Pfizer put its name to (along with Anna Gilmore, Luke Clancy and other useful idiots):

Dear President Barroso,

We are writing to you as a group of NGOs, charities, researchers, industry representatives and MEPs representing a majority of Member States and every major major political group, to urge you to bring forward the proposal for a revision of the Tobacco Products Directive at the beginning of 2012, as promised.

... As a signatory of the Framework Convention on Tobacco Control the European Union has a responsibility to implement measures which reduce tobacco use across Europe, and the revision of the Tobacco Products Directive is central to that. As this report will be so important, and undoubtedly controversial, the Council and Parliament will need time to thoroughly scrutinise and negotiate an effective revision. If we do not begin work at the beginning of 2012 we could be in real danger of having to restart the whole process after the 2014 elections. Given our commitment to the Framework Convention on Tobacco Control this is simply not an option.

We are of the view that further delays are not acceptable, and would appreciate if the Commission could inform us of a definitive timetable for the revision of the Tobacco Directive.

The only problem is that the EU's public consultation didn't exactly go Big Pharma's way...

Of the citizens who submitted their opinions, more than eight out of ten, 84 percent, support lifting the export ban on snus. 86 percent of government representatives and 74 percent of industry representatives wish to lift the ban. Only among lobbyists and NGOs is there a slim majority, 56 percent, who want to keep the ban on snus.

The consultation was a disaster for Pfizer because the anti-tobacco extremists neglected to get their NGOs and fake charities to respond en masse. Worse still, tobacco retailers in two countries organised petitions which generated 82,000 responses.

Mind you, those 82,000 people were probably tobacco users so the EU won't be counting them...

The EU Commission, however, dismisses a significant portion of the responses from the 82,000 citizens on the grounds that two-thirds are from Italy and Poland, where tobacco merchants organised petitions.

Some people say the EU is anti-democratic, y'know.

But even if we exclude these two countries, the majority is still for lifting the export ban on snus, 10-6, when respondents are broken down by country.

Bit of a bugger. What if we exclude the public altogether?

DN's review of the 400 responses in this group shows that even among the responses from parliamentarians, municipalities, government agencies and ministries a large majority, 71 percent, support lifting the export ban.

Ouch! Surely there must be some way to fiddle the figures?

Even when only EU governments and ministries are included, there is still no majority against snus, but rather 3-3.

Damn it! How is the EU supposed to justify its arbitrary, scientifically indefensible prohibition when even politicians won't lend their support?

Oh well, there's only one thing for it...

The European Commission's health directorate claims to have received responses from governments who in other ways support the ban on snus, but refuses to show them.

Bingo!

"You know that public consultation that went against us? You won't believe this, but I've just found a bunch of responses down the back of the sofa. Thousands of them, and all of them support the ban!

Sorry, you want to what? Oh, you want to see them? Er, yes...erm...ah... Good Lord is that the time? I really must be going..."

Some people say the EU is corrupt as well, y'know.

However, there may yet be a glimmer of hope...

The European Commission has promised Sweden it will take another look at its ban of the tobacco product snus, which is allowed in Sweden but banned elsewhere in the European Union, the Swedish trade minister said on Wednesday.

Trade minister Ewa Bjorling said she had met EU Health Commissioner John Dalli and discussed the results of a survey of EU states about current tobacco laws.

“What I believe is most important is that you base your reasoning on scientific facts. That is what I try to tell Dalli, and I ask the question: Why do you still want to have a ban on Swedish wet snuff when there are other snuff products on the market in the EU, for example Pakistani snuff?,” Bjorling told Reuters.

This was the second time she raised the snus issue with Dalli.

“I think he was listening in a different way this time. The first time he dismissed it simply saying their goal is to get everything away for health reasons,” Bjorling said.

I suppose not dismissing the idea out of hand is some sort of step forward. Interesting to note that the real goal is total prohibition of all tobacco products, but I think we'd worked that out already.

Over yonder

2011-12-13T00:18:00.003Z

A couple of blog posts are knocking around with my byline at the moment. In case you haven't seen them...

One is on the subject of the Dutch government finally giving smokers smoke respite.

The other is about the OECD apparently swallowing The Spirit Level's quack science. (And there's more on The Spirit Level authors' silly claims here.)

We warned you about people like this

2011-12-11T03:28:00.000Z

"Bring on the nanny state"

Is it Hate Week or something? Just two days after Jonathan Waxman's demand for diet policing, The Independent on Sunday publishes an opinion piece by Joan Smith entitled...

Filling your face with popcorn is not a human right

Funny that, because I'm a human and I thought I had the right to fill my face with popcorn. It's my popcorn, my money and my body, and, in any case, popcorn can be a nutritious, low-fat, low-calorie food.

What are these human rights of which you speak? Is filling your face with celery a human right? Is reading a book a human right? Is going for a walk a human right? For that matter, is writing ignorant, bigoted columns for loss-making Sunday newspapers a human right? If not, according to the logic of the bilge that follows, the state should put a stop to it.

As a breed, Conservative politicians hate the nanny state. So do right-wing columnists, some of whom are still whining about the fact that they can't smoke in public places.

Any suggestion that the principles behind the smoking ban be extended to junk food prompts near-apoplexy, as though we have an inalienable right to consume as much high-fat, sugary rubbish as we wish.

At least Jonathan Waxman had the good grace to wait a few paragraphs before throwing in the 'we did it to smokers, now let's do it to them?' argument. Smith, on the other hand, dives straight in there. I'm sure you can guess where this is heading.

I've never been convinced that eating popcorn is a human right...

As in the UN Declaration of Human Rights, you mean? What straw man is this? Nobody has ever said that eating popcorn, or anything else, is a right enshrined in international law, but in civilised countries we have this convention that says that people have a right to do something unless it is specifically proscribed by law. Perhaps Smith would prefer to live in a society in which everything is proscribed by law unless specifically permitted. If so, I will happily pay for a one-way flight for her to emigrate to such a nation on the condition that she promises to never return.

...and the argument that governments shouldn't intervene in the nation's eating habits looks shakier than ever. According to an analysis carried out at the Wolfson Institute of Preventive Medicine and published last week, around 40 per cent of cancers could be avoided by a change in lifestyle blah, blah, blah...

This is the same study that Waxman was citing on Friday as his excuse for having the state decide what people eat and drink. Amongst other problems, this study assumes that someone who gets lung cancer, for example, would otherwise not have got any form of cancer had they not smoked. Since the biggest risk factor for cancer is age, this is quite a major flaw. I refer you to Nigel Hawkes' analysis of it over at Straight Statistics. Hawkes points out that more than 60% of the 'lifestyle-related' cancers are due to smoking—a risk factor which has hardly been under-publicised in recent years—but that for nonsmokers, "adopting a perfect diet, drinking no alcohol, eating no red or processed meat, and maintaining a body mass index of less than 25 would actually reduce total cancer incidence by 13.3 per cent. Many people might think the sacrifice scarcely worth the reward."

Indeed. Particularly since, as he also notes, the majority of cancer deaths registered in England and Wales last year involved people over the age of 75. Unless Joan Smith believes that the alternative to cancer is eternal life, what is it that she thinks people should die of?

That figure is bound to rise as more people exceed sensible weight limits, with one study published in The Lancet predicting that half the population could be obese by 2030.

That study, frankly, is bullshit in a ball gown. A glance at recent trends in obesity indicate that it is highly unlikely that half the population will be obese in 19 years time. On the contrary, the rate seems to be flattening out. Actual figures are shown on the left of the graph below. The Lancet's projection is on the right. As with the '40% of cancers' study, The Lancet's fanciful prediction was designed purely to inspire half-witted busy-bodies to write half-witted opinion pieces in which they demand authoritarian policies from half-witted politicians. Joan Smith has not disappointed.

The cost in extra health care alone would be about £2bn a year...

No it wouldn't.

Last week, cancer charities were keen not to blame individuals for habits that raise their risk...

Of course they were, you fool. The whole idea is to place the blame on the government because what these campaigners want is 'tough action' from the government. Everybody knows that the individual is responsible for what he eats, drinks and smokes, but the lobbyists are hardly like to say that, are they now? Do try to keep up.

...it's clear that many people find it hard to resist fatty food and cheap alcohol, which leaves government intervention the only serious option.

Well, let's not be so hasty. Are we sure that all the other possibilities have been exhausted? Have you, for example, considered the option of fucking off and leaving us alone?

It's worked with smoking, which used to be enjoyed by more than half the male population and has now dropped to a fifth. The success of campaigns against tobacco, from graphic health warnings on cigarette packets to high rates of tax and an advertising ban, provides an optimistic model of how self-destructive behaviour can be altered.

Ah yes, the "model". The anti-tobacco blueprint. The tobacco control template. The start of that slippery slope which we were told for years was a figment of our imagination.

How the drinkers scoffed when we told them that they were next. How the nonsmokers chuckled when they were warned that pizza would one day be equated with cigarettes.

Seems like only yesterday, does it not? These complacent souls now find themselves with no leg to stand on. How can they argue with Smith's prescription—graphic warnings, high taxes, advertising bans? Presumably she agrees with plain packaging, retail display bans and denormalisation as well.

And why not? The provide an "optimistic model".

Where do we draw the line between smoking and drinking? Where do we draw the line between drinking alcohol and drinking Pepsi? We cannot. Once we have accepted the healthist world view, no principled and logically consistent objection can be made against photos of rotten teeth on soft drinks. Those who welcomed the 85% sales tax on cigarettes are in no position to oppose an 85% sales tax on bacon. They can only wriggle and squirm and hope the puritans tackle their pleasures last.

And so, in a sense, I welcome the likes of Joan Smith and Jonathan Waxman for finally coming clean and alerting us all about what is afoot.

Unless it wants to look criminally irresponsible, the Government should tackle weight and alcohol problems with the same ferocity. Bring on the nanny state, and ignore the predictable protests.

The lines are drawn. We tried to warn you, we really did. Now whose side are you on?

A nasty piece of work

2011-12-09T16:12:00.003Z

This man must be denormalised

The endless slurry of stupidity in modern life makes it easy to become numbed to even the vilest viewpoints, but every now and again you encounter somebody whose worldview is so revolting that you wonder whether you can be of the same species. Such an individual is one Dr Jonathan Waxman who has an article in The Times (£) today under the headline...

To avoid cancer, let the State dictate your diet

Oh dearie, dearie me. Not a good start at all. However, writers don't get to pick their own headline, so let's give him a chance to explain himself.

This week, a Cancer Research UK study revealed that about 40 per cent of cancers could be prevented by changing the way we live. This caused a lot of headlines, but we have known for centuries that cancer is related to lifestyle. In the 16th century, Italian barber-surgeons observed that breast cancer occurred at an increased rate in nuns and concluded that the increased risk might be due to the nuns’ apparent virginity — or rather that they had no children.

An interesting example to give, because breast cancer is indeed very strongly associated with childlessness. If doctors were to suggest that women who wanted to avoid breast cancer have as many children as possible as young as possible, that would be very sound advice. Strangely, I didn't see any mention of this in the Cancer Research report, but I did see a great deal about the much weaker association with drinking alcohol, which makes me wonder if there is a tendency to focus on certain 'lifestyles' while sweeping over 'lifestyles' under the carpet.

Inevitably, it is not long before we get to the anti-smoking blueprint...

The fight against tobacco shows that public health cannot be left to the individual...

No, it shows that it has not been left to the individual. It easily could be. And, by the way, there is no such thing as public health. There is my health and your health and their health. There is no communal pot of health.

Twenty-five years ago, about half the population smoked. Now that figure is 20 per cent.

Twenty-five years ago it was 1986, if I'm not much mistaken. In 1986, 33% of the population smoked. Maybe "about half" and "about a third" count as the same thing in the 'evidence-based' world of public health.

That shift would not have happened without powerful government intervention that took on the tobacco companies (and ignored the lamentations of the pension funds). Changing lifestyles not only needed information campaigns; it required mandatory and gory warnings on packets, an ever-increasing vice tax on cigarettes, advertising bans and forcing smokers out of pubs and offices and on to the streets with their habit.

Hang on, I thought the smoking ban was about 'protecting' all those poor bar-workers from being 'exposed' to secondhand smoke? That was the line in 2005-06 when ASH were campaigning for it. We were explicitly told that it wasn't a witch-hunt against smokers.

But now the truth can be revealed, as if we hadn't already guessed. It was about "changing lifestyles" by "forcing smokers out of pubs and offices and on to the streets with their habit."

Only with this “nannying” did the message begin to stick and the mindset and individual choices of the population begin to change.

Cobblers. The smoking rate began falling in the early 1950s and has been gradually declining ever since. The smoking ban, the graphic warnings and the denormalisation began in 2007 and the rate of decline has slowed or—by some estimates—halted in the years since.

We need the same strength of public campaigning to prevent the coming cancer epidemic caused by obesity. Already a quarter of Britons are overweight — and the figure is rising.

You mean 'obese', not 'overweight', right? They are two very different things, as a doctor might be expected to know. The obesity rate is close to a quarter, yes. But whether one looks at the number of people who are overweight or obese, it is straining the truth to say that that figure is "rising". It is too early to say that the rate is declining after the large rise of the late twentieth century, but certainly "flat-lining" would be the only honest assessment of the recent trend.

I'll warn you now, dear reader, that you may need a stiff drink for this next bit...

So should the State dictate how many sausage butties I have for breakfast? Should the Health Minister be e-mailing me about my five-a-day broccoli and bananas? Yes and yes.

Sorry, but is this a wind up? "The State" should dictate how many sausage butties I have for breakfast?

Because my “freedom” has repercussions, not just on my health but on the rest of us. Private lifestyle choices have a tremendous effect on the public purse.

It's interesting that Waxman capitalises the word 'State', but puts the word 'freedom' in scare quotes, is it not? Gives you an idea of the value he places on the two.

As for smokers and the obese having a "tremendous effect on the public purse", not according to the vast majority of economic studies of the subject, it doesn't. Unless by "tremendous effect on the public purse" you mean saving money in pensions, benefits and healthcare costs. The table below shows the net lifetime healthcare costs of smokers, the obese and the 'healthy-living'. The smokers cost 220,000 euros, the obese cost 250,000 euros and the 'healthy-living' cohort cost 281,000 euros. Make your case on the basis on naked paternalism, by all means, but do not make it on economic grounds.

Some will argue that this is an affront to personal freedom.

Jeez, d'ya think?

But the people with the least ability to make informed choices are the poor, who happen also to be more likely to smoke or be fat.

Because the poor are so stupid and uninformed that they need the übermenchen of the public health establishment to force them to do what's right for them, is that it? They couldn't possible be rational actors like everybody else, could they? Here's an idea—since the poor are irrational and ignorant, why don't we stop them voting and form a coalition of doctors to preside over us? Then you lot could send us food parcels and 14 units of alcohol a week. Would that be enough control for you? Probably not.

Y'know, back in 1994, the tobacco company RJ Reynolds published an advertisement titled 'Today it's cigarettes. Tomorrow?' accompanied with photos of people eating burgers and drinking alcohol and coffee.

The text reads, in part:

Let's understand exactly what they're trying to do. They're pursuing a new era of prohibition, and in the process are ignoring the individual rights of not just the 45 million Americans who smoke but non-smokers as well. But the most threatening aspect of their program is their intention to force their views on the whole country. If they are successful in their bid to abolish cigarettes will they pursue other targets? Will alcohol be next? Will caffeine and cholesterol "addicts' need to be protected from themselves? Will books, movies and music get the treatment?

Not many people took this warning seriously, partly because it came from an industry which had an obvious vested interest and partly because the scenario seemed so outlandish. Who in 1994 could seriously envisage a campaign to ban smoking in the movies?! Who could imagine that people who eat high fat foods would ever be classed as addicts?! In all likelihood, RJ Reynolds never fully believed it themselves.

Three years later, ASH published a paper that addressed the slippery slope issue in relation to the ban on tobacco advertising. It read, in part:

Not a precedent for wider restriction

A ban on the promotion of tobacco is occasionally portrayed as the harbinger of wider restrictions and an authoritarian 'nanny state'.

Often this is made into a reductio ad absurdem [sic] argument in which the government is portrayed as regulating everything. This is false: the case for action against tobacco is based on its unique characteristics and enormous toll of death and disease even when used as intended. No other product comes close to matching this.

Contrast that with Waxman's article today, riddled with factual errors though it is...

Not only do we need to ramp up the public health campaigns that encourage us to ditch the doughnuts. But we will have to go further and ban adverts for high-fat foods.

Sure we do, and the rest. A reductio ad absurdum argument, huh? Who looks absurd now?

Stanton Glantz: How to deceive without actually lying

2011-12-07T02:29:00.001Z

Last year, the Netherlands relaxed its smoking ban after a campaign by small bar owners and their customers. It came after a battle between the Dutch and EU governments' lavishly-funded NGOs and fake charities who masqueraded as nonsmokers' rights groups against Wiel Maessan and others gave their time for free to undo the worst of the ban's damage to small bars.

This is how things work these days. State funded astro-turf groups create the illusion of support for draconian laws. Ordinary people fight against them. Usually the astro-turf groups win. Sometimes, as in the Netherlands, ordinary people claim a scalp.

Anti-smoking dinosaurs like Simon Chapman and Stanton Glantz (pictured left) try to maintain the facade of it being a battle between the whole of humanity—made up of people who don't smoke and people who do smoke but want tobacco control to save them—versus the big, bad, evil, all-controlling tobacco industry.

Stanton Glantz knows that the tobacco industry weren't involved in the campaign to relax the smoking ban in the Netherlands. He knows because he interviewed Wiel Maessan personally several months ago and got it from the horse's mouth. If that weren't enough, he's failed to uncover a scintilla of evidence of industry involvement with the campaign despite looking under every stone. It was a grass-roots campaign by people who believed in property rights, individual freedom and—in the case of bar-owners—self-interest. End of story.

This is mind-blowing information to someone like Glantz who is so far down the rabbit hole of delusional self-righteousness that he probably believes his own studies. So when he writes up his account of what happened in the Netherlands, he can't bring himself to tell the truth, but he can't lie either. Instead, he uses innuendo and suggestion to give the reader the impression that Big Tobacco was at work, while never risking libel by stating it up front.

The introduction of his latest article (from the European Journal of Public Health) gives the flavour of what is to come...

Introduction

The tobacco industry has made maintaining smoking in hospitality venues a priority worldwide by organizing and sometimes financing hospitality and ‘smokers’ rights’ groups to oppose smoking restrictions. Bars are particularly important to the tobacco industry because they are adult only venues where young adults can be targeted [what on earth does this mean? - CJS]. As claims of adverse economic effects on restaurants have lost credibility, the tobacco industry has focused on bars as a wedge to undermine 100% smoke-free laws, including in the Netherlands.

Get the picture? It's the tobacco industry who want people to smoke in bars, not smokers or the people who own the bars.

It carries on in much the same vein, with Stan always talking about the kind of things the tobacco industry might do, while being careful to never say that they actually did them.

Echoing tobacco industry messaging, opponents accused the government of violating individual freedom, and called Minister Klink a ‘nanny’.

Perhaps, because of the dominance of the pro-industry messaging in the media, the health groups did not gain much traction.

And then finally, on page 5 of this 7 page article, we get a glimpse of the truth.

While the tobacco companies did not play an open public role in these events...

They didn't play any role in these events—open or covert, public or private—and Glantz knows it. If he had any evidence to the contrary he would present it. Instead, he continues with the same innuendo.

...the strategies and rhetoric deployed to oppose the smoking restrictions parallels tobacco industry global strategies, including arguing that smoke-free laws represent a form of intolerance and extremism [they do—CJS], and that, despite consistent evidence to the contrary, smoke-free laws harm bars [they do; it's basic economics—CJS]. Other industry tactics are to encourage and publicize venues flouting the law to create the perception of widespread noncompliance [I went to Amsterdam when the ban was in force and there was widespread noncompliance—CJS], to encourage (and fund) hospitality venues to challenge the law in court, and to promote ventilation.

And just in case you haven't taken the nudge and the wink, he finishes with this...

Conclusion

Owner-run bars in the Netherlands have been used by tobacco industry allies as a wedge to undermine public perception of and encourage noncompliance with smoke-free regulations. (Compliance remained high in other hospitality venues). The reversal in the Netherlands was the result of a failure to present and defend the law as a way to protect non-smokers, together with continuing to allow smoking rooms. There is a danger that the Netherlands may be cited by the tobacco industry and its allies as evidence that 100% smoke-free bar laws are unpopular and unenforceable and that tobacco control best practices embodied in the FCTC do not work.

"Allies", "parallels", "tactics", "pro-tobacco messaging". What weasel words these are. Misleading but never quite libellous; untrue but never quite lies. Using the same techniques, I will say this about the great mechanical engineer...

There is no direct evidence that Stanton Glantz is a criminally insane fraudster. That said, his refusal to acknowledge facts which clash with his delusions is a common phenomenon often observed in psychiatric patients. Although never officially certified with a mental illness, Glantz's constant references to dark conspiracies for which there is no evidence is a classic symptom of paranoid schizophrenia, as is the belief that ordinary people are working for sinister organisations. Asylums are filled with people with delusions of grandeur who obsessively repeat the same words over and over as if they had a profound meaning.

Glantz has recently written an article that was published in The Lancet, the same journal that published the notorious study on autism and MMR which has been described as "deliberate fraud" involving "clear evidence of falsification of data." Glantz has also worked with Prof. Anna Gilmore.

Glantz has written a book in which he explains his beliefs, thereby mirroring the strategies and rhetoric deployed by the suspected murderer O. J. Simpson, the disgraced politician Jeffrey Archer and the genocidal dictator Adolf Hitler whose book, Mein Kampf, was written whilst in prison in Germany. Like many of the most evil men in history, Glantz uses the Latin alphabet and owns a pen.

On the ninth of September 2001, two passenger aircraft were flown into the twin towers of the World Trade Centre. Glantz did not play an open public role in these events, although he has never publicly denied involvement. Nor has he denied involvement in the disappearance of Madeleine McCann, the schoolgirl who went missing in Portugal six years later. Some eye-witness reports suggested that the kidnapper was a white male.

Stanton Glantz, a white male, has never been formally charged with racially motivated violence. He lives in the United States of America, where lynchings of ethnic minorities were common until quite recently. His home state of California endorsed eugenics and carried out an extensive sterilisation programme which did not end until 1979, at which point Glantz was working at the University of California, San Francisco.

You see how easy it is? Glantz has long since scraped through the barrel and at this rate will each the core of the Earth by 2019. It's garbage. The truth is—as his study tells you if you can cut through the guff—that the tobacco industry only appears twice in this story. On the first occasion, they were invited by the government to attend a meeting as a stakeholder. The industry's lobbying at this meeting was ignored and a total ban was introduced. On the second occasion, a law firm working on behalf of the hospitality industry allegedly approached the Dutch Cigarette Manufacturers Association to ask for funding so that bar-owners could sue the government. The Dutch Cigarette Manufacturers Association turned them down.

That's yer conspiracy, right there. Scary, huh? If you want to hear what really went on, I suggest you listen to the conversation between Wiel Maessan and Stanton Glantz (listen here).

Warped minds

2011-12-07T02:19:00.006Z

"WTF is this?" you may well ask. Pop over to Carl Philips' place and find out.

McDonalds 1 - Food Fascists 0

2011-12-04T12:21:00.000Z

Ronald McDonald: He's lovin' it

The story of San Francisco's ban on Happy Meals has come to an amusing conclusion. The city of killjoys has just enforced a prohibition on restaurants giving away toys with "unhealthy" food—a law that has only one intended target (the red-nosed fellow above). Needless to say, the law was passed for the chiiildren.

The politicians bragged that they had instituted a de facto ban on the Happy Meal when they passed the law. Their assumption was that the crafty corporate types had programmed kids to incessantly nag their parents to buy meals that the nanny state had decreed unhealthy by dangling a plastic toy in front of impressionable youngsters.

McDonalds' response has been beautiful in its simplicity: sell the food and the toys separately, charging 10 cents for the toy. Unlike the bone-headed prohibitionists, McDonalds understands that the toys have a value in themselves and parents are continuing to buy them—and the Happy Meals—in abundance.

A shrewd move by McDonalds, then, but these are Californian politicians we're talking about here; they could be outwitted by a bag of sand. The really smart part of Maccy D's counter-offensive is to give the 10 cents to charity. Not just any charity, mind, but the Ronald McDonald House charity which supports seriously ill and injured children.

So, think of the chiiiildren and buy a McDonalds toy. And while you're here, why not enjoy a Happy Meal?

Happy Meal sales haven’t slowed down, McDonald’s is making even more money, and parents are now spending an extra 10 cents per kid every time they stop by the golden arches.

Touché.

The Points interview

2011-12-01T12:38:00.001Z

Some readers may be familiar with Points —the blog of the Alcohol and Drugs History Society — which has been on my blog roll for most of the year. As you might imagine, it is right up my street and so I was more than happy to participate in the Points interview to discuss my latest book The Art of Suppression.

Read the interview here.

A little taste of prohibition

2011-11-30T10:17:00.000Z

Dec. 1920: Prohibition agents show off 89 confiscated stills.
(From here)

From The Morning Advertiser:

Five men who masterminded a major counterfeit vodka manufacturing and bottling plant in Leicestershire, were sentenced to a total of 17 years and ten months on Friday at Hull Crown Court.

The plot was uncovered in an industrial unit by HM Revenue & Customs (HMRC) when they carried out raids in September 2009. They seized 9,000 bottles of fake vodka, branded as Glen’s, manufacturing equipment, bottles and counterfeit packaging – labels and cardboard boxes, at the remote industrial unit at Moscow Farm near Great Dalby, Leicestershire.

The court heard there was a complete lack of any fire safety measures which posed a serious and life threatening hazard. The alcohol vapour alone could have triggered a major explosion if the lights had been switched on or a naked flame or cigarette had been lit.

It certainly could. You may recall what happened back in July...

Boston fire blast unit producing illegal vodka

An industrial unit in Lincolnshire, where five men were killed in an explosion, was being used to produce illegal vodka, police have confirmed.

This happened in Boston, England in 2011, by the way, not Boston, Massachusetts in 1921. Easy mistake to make.

This is part of a growing trend, as the UK's sky-high alcohol taxes combine with economic hardship to fuel demand for the black market. Half of all rolling tobacco is smuggled into the country. Counterfeit cigarettes are openly sold in the streets. We've got the smoke-easies (last week I was in a pub in central London where the landlord told people to light up and leave their cigarette stubs on the floor). Now we have criminal gangs producing poisonous moonshine and blowing themselves up with illegal stills. All we need now is Elliott Ness dancing the Charleston and we can have a full-blown 1920s revival.

The neo-prohibitionist fools believe they can avoid the consequences of prohibition so long as society falls short of a total ban. That's now how it works. It's a sliding scale. In The Art of Suppression I write about 'little prohibitions'—bans, price hikes, excessive regulations—which cause the same problems, only on a smaller scale. After all, as John Stuart Mill said: "Every increase of cost is a prohibition, to those whose means do not come up to the augmented price."

Still, at least people aren't getting literally blinded by moonshine like they did during Prohibition.

No, wait. They are.

25p vodka made me go blind

Christmas partygoers have been warned off bargain booze that can leave you blind. Eastern European gangs are flooding corner stores and even going door to door selling illicit drink in a £1billion- a-year trade.

Last night trainee accountant Dale Shaw, 27, told how he nearly lost his sight drinking the dodgy liquor. After being invited to a family party, Dale bought a bottle of Drop Vodka from an off-licence in Bradford, West Yorkshire.

He said: “I’d never heard of the brand before but it was £4 cheaper than the others. After downing a quarter of the bottle, Dale began to feel more drunk than usual and his vision began to blur.

But by the next morning he could not see at all and was suffering excruciating pains in the lower half of his body. “As soon as I woke I knew there was something wrong,” he said. “I was in agony and my sight was almost completely gone.”

Dale was taken by a relative to Bradford Royal Infirmary where a doctor immediately recognised he was being poisoned by the bootleg spirits. The cut-price vodka contained methanol – alcohol used in explosives, anti-freeze and racing car fuel – and not the safe ethanol found in legal booze.

Expect much more of this if Alcohol Concern and the BMA get their way.

Velvet Glove, Iron Fist review

2011-11-29T12:41:00.006Z

The journal Social History of Medicine has recently (well, two months ago) reviewed my first book Velvet Glove, Iron Fist: A History of Anti-Smoking. The review is behind a pay-wall, but as it is fairly short I trust they won't mind me reproducing it here.

Velvet Glove, Iron Fist is a fast-paced critique of the late twentieth- and early twenty-first-century public health focus on lifestyle behaviours. The book centres on smoking, which Snowdon, in common with anti-smoking activists, sees as the blueprint for increased regulation of individual health behaviour for the common good. Snowdon traces the history of anti-smoking campaigns from the early seventeenth century through to the present day, via campaigners such as Lucy Page Gaston in early twentieth-century USA and the National Socialist regime in 1930s and early 1940s Germany. Rather than making the simplistic argument that current regulations on smoking exceed anything the Nazis hoped to implement (although he makes this point), Snowdon's aim is to unveil the financial interests which have grown around the tobacco control movement and the spurious epidemiology used to back up some of its claims, particularly in relation to passive smoking and ‘third-hand smoke’ (that is, the residual nicotine that remains on surfaces after a cigarette has been smoked).

Much of the material in Snowdon's early chapters is re-worked from existing historical accounts of smoking, but he presents the material in an interesting and accessible manner. The more substantive part of Snowdon's argument comes in the later chapters, where he follows the development of the tobacco control movement from local initiatives to its global position today, a development which has gathered pace in the last decade and a half. In 1994, leaked documents acknowledging that the tobacco industry had been aware of the addictive nature of cigarettes and ‘had deliberately misled the public for decades’ (p. 191) undermined the notion of the smoker's right to choose. At the same time, concerns about passive smoking legitimated moving the debate beyond individual rights towards a raft of measures justified as within the public interest, such as increased taxation and restrictions on smoking in public places. These measures went beyond previous approaches, such as educating and informing the public about the dangers of smoking, to health and offering advice on how to quit.

This shift in the direction of anti-smoking campaigns has been chronicled elsewhere, most notably by historian Virginia Berridge (Marketing Health, Oxford University Press, 2007). However, Snowdon argues that the case against passive smoking was (and crucially for his argument, remains) scientifically unfounded, epidemiologically dubious and manifestly overstated. He seeks to call the tobacco control movement to account for unsubstantiated statements such as ‘[j]ust thirty seconds of exposure [to smoke] can make coronary heart function indistinguishable from smokers’ (Snowdon's emphasis; p. 332). He cites comments from Sir Richard Doll, one of the epidemiologists who established the causal connection between smoking and lung cancer, that ‘the effects of other people smoking in my presence is [sic] so small it doesn't worry me’. But such views went against the tide: Doll was obliged to later state he had been speaking in a personal capacity (p. 248).

While Snowdon is correct to highlight questionable tactics which go beyond sound public health, and to highlight the dangers to individual liberties which arise from those tactics being applied to other lifestyle behaviours, he undermines his case by downplaying the risks of smoking to individual health. He states that ‘some people might become addicted and some of those might then become ill and die’ (emphasis in original, p. 323), a statement which flies in the face of medical evidence.* ‘Will’ would surely be more appropriate. Similarly, to dismiss concerns about excessive alcohol consumption as ‘panic’ fails to take into account the very real social, as well as medical, harm caused by alcoholism.** Snowdon's attack on the health inequalities agenda (pp. 296–300) ignores the differences in longevity and mortality experienced in different social groups within the developed world. Further, although there is a detailed summary of the epidemiological evidence relating to passive smoking, there is a frustrating lack of referencing in other parts of the book. Regarding passive smoking, Snowdon by-passes the influence of Roy Castle in the UK context, a popular musician and television personality who died of lung cancer in the early 1990s despite being a non-smoker, and did much to bring the subject to public attention.

These criticisms notwithstanding, Velvet Fist, Iron Glove is an enjoyable read which surely proves that smoking has not lost its ability to provoke debate and reaction in over four centuries. It remains to be seen whether the pendulum will continue to swing towards prohibition, or whether smokers will enjoy a renaissance.

* 'Will' would probably have been a better choice of word, although in the context of the paragraph (which is about degrees of risk from cholera to gambling), it makes more sense. On the whole, I don't think the book downplays the risks of smoking at all.

** Alcoholism is always with us. Panics aren't. The hysteria about 24 hour drinking and 'binge-drinking' can fairly be described as a moral panic - see, for example, this study.

Almost half

2011-11-29T12:13:00.001Z

I nearly missed this little story in the Daily Mail...

Tobacco firm gave thousands of pounds worth of hospitality to nine MPs who opposed smoking bill

MPs who received thousands of pounds worth of hospitality from one of the world’s largest tobacco companies opposed a new law banning smoking in cars.

The parliamentary register of members’ interests shows Japan Tobacco International, which produces Benson & Hedges, Silk Cut and Camel cigarettes, spent £23,000 entertaining 20 MPs in the past six months.

Almost half of them voted against a Private Member’s Bill banning smoking in cars carrying children.

"Almost half of them" means "less than half of them" — which doesn't sound like much of a return for sending 20 fat cat MPs to the Chelsea Flower Show (for that is what happened). So how does that compare to the MPs who were not treated to corporate hospitality?

The vote went in favour of the bill by 78 votes to 66. If we exclude the 20 votes of the MPs above, it leaves a vote of 67 to 57. Therefore 46% voted against the bill—or, if you are the Daily Mail, "almost half of them".

Amongst the MPs who accepted tickets to the flower show, 11 voted for and 9 voted against. Therefore 45% of them voted against the bill.

Behold the power of Big Tobacco!

Malta gets mugged by reality

2011-11-28T18:20:00.002Z

And so it comes full circle. Junk study after junk study claims a dramatic decline in the heart attack rate following a smoking ban. Each and every one of them is fatally, often comically, flawed. Whenever routine hospital data is available, it is obvious that smoking bans have no discernible effect on the number of people having heart attacks.

And yet the myth persists thanks to well-publicised, cherry-picked scam studies. So persistent is the myth than when a country makes an honest endeavour to replicate these fantastic results, they are genuinely baffled when the data show no change.

Malta bought the snake-oil in good faith and—guess what?—it didn't work. Alas, the Maltese health establishment is so far down the rabbit hole that this entirely predictable non-event is considered bizarre and mysterious.

Malta smoking ban fails to stub out heart disease
We are shocked over smoking ban results

The smoking ban may have led to a decrease in the heart disease death rate and hospital admissions in every country where it was introduced, but it has had absolutely no impact in Malta, a medical study has revealed [actually, the rate increased - CJS].

From Italy, where heart attacks dropped by 11 per cent after it banned smoking in public places, to Montana where the decline was a whopping 40 per cent, every country registered an improvement.

OK, one more time for the world...

'Italy' was in fact one region of Italy (Piedmont) and it didn't see an 11% decline in heart attacks. It saw a 2% increase.

'Montana' was one small town in Montana called Helena, hence the 'Helena miracle', and what more is there to be said about this piece of effluent?

“We were shocked and disappointed with Malta’s results, especially since the island was the second country in Europe to introduce the smoking ban,”cardiologist Robert Xuereb told The Sunday Times.

“Seeing that international studies all showed a reduction in heart attacks and smoking-related deaths, we assumed we’d find a drop in Malta too – to our surprise there was absolutely no change in the figures,” he added.

You don't say! I guess the Maltese forgot to employ a tobacco control charlatan to massage the figures, ignore inconvenient data and invent a phony computer model. How very remiss of them.

The findings were recently presented to the European Society of Cardiology Congress, which was held in Paris and attended by a record 32,946 participants from across the globe.

The paper, titled ‘The Smoking Ban: The Malta Paradox’...

Oh, for God's sake.

...looked at figures for cardiovascular deaths and hospital admissions due to a heart attack five years before Malta introduced the ban in April 2004, and compared these with five years later – there was no change in either the admission or mortality rates.

The inevitable excuses about the ban not being enforced properly follow. And then, in keeping with the conclusion of yesterday's post, there is the usual cry of "that didn't work, let's do more of it!"

“Maltese authorities were among the first to introduce the ban in Europe and they deserve a pat on the back for this, but unfortunately, we didn’t get the results,” Dr Xuereb said.

He is urging authorities to take bolder decisions that restrict smoking in places such as cars, in stadiums, public gardens and on beaches.

Of course he is. What else can a bone-headed prohibitionist do but call for more prohibitions?

People of Malta, please don't blame yourselves. You sound like the cripple who visits the faith healer and blames himself for his lack of belief when other people get cured but not him. Those other people didn't get cured, Malta, they were stooges. It was fixed.

If you insist on believing in miracles, you'd better brace yourself for disappointment. You were never going to see a dramatic fall in heart attacks. England didn't. Australia didn't. Denmark didn't. The USA didn't. Scotland didn't. Wales didn't. New Zealand didn't. Because they are impossible. Trust your own data, not the con artists of tobacco control.

Nothing to see here (part 94)
Heart attacks in Malta before and after the smoking ban

The failure of the Scottish smoking ban

2011-11-27T19:35:00.000Z

A new study in PloS has found that Scotland's smoking ban had no effect on the country's smoking rate in the long term. Authored by the notorious Jill Pell and colleagues from Glasgow University, the study shows that there was an upswing in quit attempts in the months before and after the implementation of the ban (March 2006), but that these attempts had no lasting effect on smoking prevalence.

The graph below, which comes from the PloS study, shows 12 years of smoking prevalence data. The dotted line shows the predicted rate based on past performance. The vertical line shows the smoking ban.

If you look closely, you can see that smoking prevalence dropped below the anticipated level for a while around the time of the ban, but then rose back to the normal level where it has remained ever since.

... in October–December 2005 immediately prior to the introduction of the ban prevalence fell by 1.70% more than expected from the underlying trend. The magnitude of the decay parameter, −0.08, (95% CI −0.38, 0.22) indicates that this effect was short lived with prevalence returning to its long term trend by the last quarter of 2006.

The graph below shows the quantities of nicotine replacement therapy (NRT) being handed out by the Scottish NHS between 2003 and 2009. Again, the dotted line shows the predicted figures.

Assuming that NRT prescriptions are a marker for total quit attempts (a reasonable assumption), there was a rise in people trying to give up around the time of the ban. Quit attempts then fell below the average for the next two years. This suggests that many of the people who would have made a quit attempt in 2007 or 2008 brought their attempt forward to late 2005/early 2006. Having failed to quit at the time of the ban, these people did not try again in the next couple of years. Over the whole period, there was no increase in the number of people who tried to quit.

The rise in quit attempts was no doubt bolstered by the publicity about the ban and the expensive smoking cessation campaigns that accompanied the legislation. As the study's authors note:

In the six months leading up to implementation of the legislation there were two high profile television campaigns.

It was not the ban, but the fear of the ban, combined with increased advertising for smoking cessation services, that led to the increase in quit attempts—this is evident from the fact that the 1.7% drop in smoking prevalence pre-dated the ban by several months. Contrary to the expectations of anti-smoking lobbyists, the ban itself did not help people sustain their quit attempts, nor did it have any independent effect on the smoking rate. Given the choice of giving up smoking or giving up the pub, many of them gave up the pub.

Despite a large surge in the amount of NRT being distributed, there was no lasting effect on smoking prevalence. The short term blip was not sustained in the medium- or long-term. Ultimately, the ban failed to achieve what its advocates hoped and predicted. It also suggests that NRT products are not very good at helping people quit for more than a few weeks or months.

This should all be contrasted with the claims put forward before the ban. In 2005, NHS Scotland's 'evidence-based' review of the literature found that:

Prospective cohort studies reported reductions in smoking prevalence of 7–20% and population-based studies comparing workplaces with and without restrictions showed 15–20% lower prevalence. Partial restrictions had little or no effect. A recent meta-analysis reported a 3.8% reduction in absolute prevalence (pooled effect) associated with smoke-free workplaces.

Given the uncertainty around the precise estimate, the beneﬁt of reduced smoking prevalence has been estimated using conservative estimates of the effect, with a range of 1–3%.

A more conservative estimate would have been 0%. It would have been right.

And let us cast our minds back to 2006 when the BBC reported this breathless forecast from Scotland's Chief Medical Officer...

Ban will 'eradicate lung cancer'

Lung cancer could be virtually wiped out in Scotland as a result of the smoking ban in public places, according to the chief medical officer.

Dr Harry Burns said lung cancer rates would be reduced to just a few hundred cases a year in the future.

Dr Burns said: "Imagining Scotland with no lung cancer is not trivial speculation. In the 1960s, one in 100 men died of lung cancer. Today, rates are falling all the time and thanks to the smoking ban, I expect the reduction in deaths to accelerate until dying from the disease becomes a rare occurrence.

"Anecdotal evidence shows that since the smoking ban, there has been a surge in the numbers of smokers seeking help to give up."

We now know that this "surge" was a temporary blip which was followed by two years of fewer people "seeking help to give up." It turns out that Imperial Tobacco was better at predicting the future than Harry Burns. This, also from 2006...

Imperial not worried by smoke ban

The world's fourth-largest tobacco group, Imperial Tobacco, has said it does not expect UK smoking bans to have a significant impact on business.

"We believe [UK] smokers will continue to choose to smoke regardless of regulations and our view is supported by experiences in other markets," said Imperial.

Can we expect a mea culpa from the anti-smoking campaigners who predicted a huge drop in the number of smokers, if not the elimination of lung cancer? Can we expect them to reassess their strategy in the light of yet another broken promise?

We cannot. As I have said many times, tobacco control is not a results-driven business. As in Ireland, where the smoking rate is now higher than before the ban, the anti-tobacco industry has only one response to failure—more of the same. Pell et al's conclusion epitomises this mindset.

Quit attempts increased in the three months leading up to Scotland's smoke-free legislation, resulting in a fall in smoking prevalence. However, neither has been sustained suggesting the need for additional tobacco control measures and ongoing support.

Heads, we win. Tails, you lose.

Snus prohibition

2011-11-26T13:50:00.004Z

This week I wrote an article for the Swedish newspaper Espressen about the EU prohibition on snus—which most Swedes find baffling (and with good reason). The whole story is recounted in my book The Art of Suppression. This is a very brief overview. Prohibition still kills. Won't someone tell the FDA?

Here is the unedited article in English...

For most of us, the word ‘prohibition’ brings to mind images of Al Capone, Elliot Ness, speakeasies and moonshine gin being distilled in bath tubs. It is widely acknowledged that America’s attempt to use manmade laws to defeat the laws of fermentation was a fiasco. Russia, Finland and Iceland also experimented with bans on alcohol in the 1920s with equally dismal results. Sweden narrowly escaped the same fate in 1922 when a referendum for national prohibition was defeated by the tightest of margins - 49% voted for and 51% voted against.

The violence, crime, ill health and drunkenness that invariably accompanied alcohol prohibition meant that it was repealed in every country that tried it. Finland’s ban was so unsuccessful that by the time it ended in 1934, the Swedish government was complaining about the amount of drink being smuggled in from its supposedly dry-as-dust neighbour.

Bootlegging, gangsterism and poisonings were unintended consequences of prohibition that no government could ignore, but the harmful consequences of criminalising products are not always so obvious. In the case of the European Union’s ban on Swedish snus, the damage remains unseen precisely because the prohibition has ‘worked’. It has ‘worked’ in the sense that few people outside Scandinavia use – or are even aware of – the product. As a means of limiting snus use in Europe, the ban has been a roaring success, but as a public health measure it has failed as grievously as any prohibition in the last two hundred years.

My country, the United Kingdom, must take some of the blame. In the 1980s, a smokeless tobacco company set up a headquarters in Scotland where they produced an oral tobacco product similar to snus called Skoal Bandits. Low in nicotine, sweetly ﬂavoured and with a masked cowboy emblazoned on each container, Skoal Bandits were accused of being aimed at teenagers. The British have no history of using snus and, as a result, there was a loophole in the law that allowed its sale to children. Alarmed by this news, anti-smoking groups and the tabloid press led a brief moral panic which resulted in oral tobacco being banned outright in the UK and Ireland. In 1992, the European Commission complained that unilateral bans by member states undermined market harmonization and so decided to enforce a total ban on “new tobacco products for oral use.”

Few noticed and fewer cared about this legislation because hardly anybody in the EEC used these products. It was not until Sweden prepared to join what had become the EU in 1995 that it became a live issue. Aware that Sweden was a nation of snus-users, the European Commission temporarily abandoned its insistence on market harmonization and allowed it an exemption from the ban. The rest of Europe remained indifferent to this little piece of diplomacy, but that was about to change.

The public health basis for the EU’s ban was based on the twin assumptions that snus increased the risk of oral cancer and was a gateway to smoking. The first of these beliefs was plausible since it was well known that some smokeless tobacco products, especially those used in Africa and Asia, contain high levels of carcinogens. What was less well understood, however, was that Swedish snus is a fundamentally different product. Whereas the hazardous ‘tobacco-speciﬁc nitrosamines’ can be found in excess of 1,000 parts per million in some chewing tobaccos, levels in Swedish snus are as low as 2 parts per million. Very little was known about the effect of snus use on health when the EU introduced its ban, but when scientists conducted studies in the 1990s, they found no difference in cancer rates between users and non-users. This evidence was so compelling that, in 1999, the EU went to the unprecedented step of removing the ‘Causes Cancer’ warning on snus packaging.

As for the ‘gateway to smoking’ hypothesis, it has become clear in the last twenty years that snus is a gateway from smoking. The revival of snus use in Sweden since the 1970s has been accompanied by an exceptional decline in smoking prevalence. Today, Sweden has the lowest male smoking rate and the lowest lung cancer rate of any developed country. In the North of the country, where snus consumption is at its highest, the smoking rate is lower still. Any lingering fears that snus causes cancer are dispelled by the fact that Sweden also has the third lowest rate of oral cancer (and the fourth lowest rate of pancreatic cancer) of any EU nation.

As public health researchers pieced this picture together, it became clear that European smokers had been deprived of a product that could help them quit cigarettes. One study estimated that 200,000 lives could be saved if the whole EU emulated the ‘Swedish experience’. Britain’s Royal College of Physicians, Action on Smoking and Health, the American Association of Public Health Physicians, the European Respiratory Society, the Norwegian Directorate of Health and the Swedish government have all called for the EU ban to be overturned, but they face resistance from hard-liners in the anti-smoking movement who are anxious to maintain one of the world’s few prohibitions of a tobacco product. The manufacturers of nicotine gums and patches are also keen to maintain their monopoly on the smoking cessation market and have lobbied hard for the ban to remain in place.

This leaves snus in a peculiar position. Despite being a near-harmless substitute for smoking, it is treated like an illegal drug in the EU while cigarettes remain freely available to any adult who wants to buy them. Few Swedes appreciate the role that snus has played in improving the nation’s health and few people outside Scandinavia have even heard of it.

There are no Al Capones or Pablo Escobars smuggling snus into other member states. No one is making counterfeit General in their basements or running illicit bars for snus users. The curious ban on snus has created no mayhem in the streets and yet, by helping to keep nicotine users consuming the most deadly tobacco products, this little known prohibition may be costing more lives than all the poisoned moonshine drunk in 1920s America.

Other recent articles related to The Art of Suppression:

'We should stop panicking about Boozy Britain' (Independent)

'Prohibition fuels firestorm of new dangerous drugs' (City AM)

Patrick Hayes' review of The Art of Suppression (Spiked)

Tom Miers' review of The Art of Suppression (The Free Society)

Big Alcohol = Big Tobacco

2011-11-19T13:58:00.008Z

A bit more schadenfreude for the nonsmoking drinkers who applaud the anti-smoking campaign while expecting their own vice to be left alone. As I said yesterday in relation to quisling pub supremo Ted Tuppen...

Do you really think it is wise, as the head of a pub company, to equate alcohol with cigarettes? There are enough temperance nuts doing that already without you helping them out.

Five years ago this would have been outrageous hyperbole, but things move pretty quickly in 'public' health. Five years ago I don't recall anyone ever seriously using the term 'Big Alcohol'. Big Tobacco, sure. Big Oil, sometimes. But 'Big Alcohol'—not so much.

That's all changing.

How's that for guilt by association? Alcohol Concern Wales—for it is they—have created a document which contrasts statements from the tobacco industry with statements from the alcohol industry. They're both the same, doncha see?

The logic here is lame even by temperance standards. They take no account of whether the statements might be true, for a start. They have dredged the internet and found comments that are roughly similar and that is enough for them.

And when I say roughly similar, I mean similar as in they're both spoken in English and involve words. Take this, for example....

“The Lorillard Tobacco Company today announced the launch of a nationwide youth smoking prevention programme. This...is in addition to the funds Lorillard and other companies have committed to the...youth smoking prevention and education programme.”
Lorillard Tobacco Company Press Release (1999)

“It is only through education, coupled with targeted interventions against misusers, that we can ultimately change the drinking culture...”
David Poley, Chief Executive of the Portman Group (2010)

Uncanny, eh? A tobacco company announces the launch of a youth smoking prevention programme (as it was required to do under the Master Settlement Agreement) and the Portman Group announces that, er, education and targeted interventions are essential to change the drinking culture. Both statements include the words "education" and "the". It's really quite spooky.

Or take this...

“[Increasing the price of cigarettes] discriminates against those who can least afford it. Increasing tobacco duty could cost the government billions of pounds...The Chancellor said the government’s policy on tobacco will reduce smoking. It’s not the government’s role to force people to quit.”
Simon Clark, Director of smokers’ lobby group Forest (2011)

“It is worrying that in the midst of a recession, when sales and consumption of alcohol are falling, that the Government should be talking about raising prices for all consumers, at a time when many are already struggling to make ends meet.”
Jeremy Beadles, Chief Exec. of the Wine and Spirit Trade Association (2009)

Let's take the first quote. Clark is saying that cigarette taxes are regressive (clearly true), that very high prices increase smuggling (also true) and that it is not the government's job to force people to stop smoking (a moral question, but a valid opinion).

Beadles, however, is simply saying that increasing the price of a product used by 90% of the population during a recession will make people worse off. He is not referring to the poor, to smuggling, nor to whether the government should be trying to stop people drinking.

These comments have very little in common except they refer to taxes. In the minds of Alcohol Concern, however, any industry that opposes tax hikes on its products is following the Big Tobacco template. As they say on their 'glancesheet' ('Glantz sheet'?):

This glancesheet shows how arguments previously put forward by tobacco companies and lobbyists, to delay or prevent tighter regulation of the industry, have now been adopted by the alcohol industry to protect its own interests.

There should be a version of Godwin's Law for anyone who resorts to comparing an industry with the tobacco industry for rhetorical purposes, with extra marks for using the word 'Big' (capitalised, natch). To the neo-prohibitionists, any industry that dares to challenge them is "recycling Big Tobacco arguments" and, therefore, can be ignored.

The irony is that there is a template being copied here and it is being copied very precisely. The temperance lobby is demonising industry, demanding higher taxes, calling for a total ban on advertising, playing the 'think of the children' card, using junk statistics and talking about 'passive drinking'.

Now who did they get from, I wonder?

Unfree Enterprise

2011-11-18T14:48:00.000Z

Ted Tuppen:
Plenty to look miserable about

Few things are less edifying than an industry conspiring with the government to screw over its competition. The Coca-Cola company's support for Prohibition was driven by a transparent pursuit of profit. The makers of Nicorette and Champix not only support the EU's snus ban but are lobbying for the prohibition to be extended to all smokeless tobacco products. It's cynical and it's opportunistic. It's rent-seeking.

Britain's pub industry is going down the same dismal road. Yes, the pubs have been victims of punitive legislation themselves. Yes, they could have done more to oppose the smoking ban. And yes, we have some of the highest alcohol taxes in the world, but that it is no excuse for this...

Tuppen: Supermarkets may need to be "bullied"

Supermarkets may need to be “bullied” into adopting a responsible pricing strategy on alcohol according to Enterprise Inns chief executive Ted Tuppen.

First the Scottish Licensed Trade Association, then Greene King, and now Enterprise Inns. All lining up to demand a new bad law to make up for another bad law. They all share the delusion that minimum pricing will drag back the customers that the smoking ban drove away. Ted Tuppen is the guy who, in 2007, predicted that "the ban will lead to a number of pub closures across the industry, particularly amongst lower quality wet-led outlets." But, he said, Enterprise Inns would be just dandy:

"However, we are confident of a positive outcome as the smoking ban becomes an accepted part of pub-going and licensees and customers alike enjoy the benefits of the more pleasant, healthier, smoke free regime."

Since then, Enterprise has sold hundreds of its pubs and its share price has collapsed from £7.00 in July 2007 to 29p today. Winning!

The Enterprise boss also launched an attack on the government’s “punitive” beer duty escalator, saying it is time to “level the duty playing field so cynically distorted” by George Osborne and “put right the duty wrong perpetrated by Gordon Brown”.

Ah, the fabled "level playing field", destroyer of jobs, killer of businesses. Funny how the playing field is always levelled down but never up, isn't it? I recall Enterprise Inns pleading for a level playing field back in 2006...

Hubert Reid, Enterprise chairman, said: "If a total ban is inevitable, then it should be imposed across the board, including 20,000 private members clubs, in order to create a level playing field for all those employed or operating within the hospitality and leisure industry."

To be clear, the exemption for private members' clubs would have distorted the market and been unfair to public houses. It would have been better for the consumer, but it was still a rotten law.

Back in 2006, it may have seemed good business to demand the government shaft all licensed premise with equal vigour. With hindsight, a united front against the whole illiberal law would have been better. The pubco's must now regret getting into bed with the anti-smoking lobby in 2006, just as they will live to regret getting into bed with the temperance lobby on the minimum pricing issue.

“Pubs don’t want to be treated as a special case but we do need to see an end to the discrimination which will lead to more pub closures and more job losses,” said Tuppen.

No, Mr Tuppen. Being treated as a special case is exactly what you want. The on-license and off-license trade are completely different industries selling completely different services. Off-licenses sell alcohol. Pubs sell an experience. There can be no level playing field. The pub experience is necessarily more expensive. It involves washing glasses, larger premises and—above all—extortionate rents to greedy pubcos so that their CEOs can pocket £1.2 million a year.

“I am uncomfortable with the imposition of minimum pricing, no matter how attractive it might seem. I believe that we need a society which suffers from less regulation and not more.

Well, that's more like it, sir. So, no more silly talk of minimum pricing then?

“However, a minimum pricing level may well be necessary if we are to have a ban on below-cost selling."

D'oh!

It is plainly nonsense to say that minimum pricing is needed to ban below-cost selling. However, if Mr Tuppen thinks that selling alcohol below is such a great way to get ahead in the licensed trade, why doesn't he try doing it for a few weeks and see how it goes? He will soon find out why—as even the temperance lobby now admits—below-cost selling is as rare as hen's-teeth.

"Can we ask the supermarkets to be responsible? This is really where the industry, the Association of Licensed Multiple Retailers, the British Beer & Pub Association are all in loud agreement."

The pub industry are united in wanting the state to shaft their competitors? Well, stone me.

"Like cigarettes, why shouldn’t alcohol be sold behind the counter rather than picked up by anyone from the shelves?"

Because cigarettes are small, high value items which makes them a perfect target for shop-lifters. Are you seriously suggesting that people would go to pubs more if they had to buy alcohol from a supermarket counter? And do you really think it is wise, as the head of a pub company, to equate alcohol with cigarettes? There are enough temperance nuts doing that already without you helping them out.

"There should be a clear restriction on irresponsible advertising and multipack sizes could be reduced to say a pack size of four, rather than 20."

What on earth is this fellow babbling about? Is this meant to be "nudging"? Give me gospel temperance over the doctrine of piddling inconvenience.

"There should be a ban on external advertising of price, something I think which would equally apply to pubs."

Does the phrase "cutting off your nose to spite your face" mean anything to you, Ted?

"These are simple solutions which the supermarkets should be encouraged, or perhaps bullied to follow, perhaps through a voluntary code of practice."

There's nothing like bullying people to make them do things voluntarily, is there? And that's what this is all about: bullying. Ted Tuppen is the mouthy little oik standing behind the big kid, goading him on. Too stupid and cowardly to do anything himself, he relies on the bully to beat up his enemies. Utterly pathetic. Boycott Enterprise Inns while you still can. There aren't many left.

BMA retracts claim about smoking in cars

2011-11-17T17:52:00.002Z

The British Medical Association has now retracted its claim that secondhand smoke is 23 times more concentrated in a car with all the windows open than in a smoky bar.

The original claim—press released around the world this week—stated that:

There is evidence to suggest that the levels of SHS present in vehicles can contribute to a serious health hazard for adults and children. Further studies demonstrate that the concentration of toxins in a smoke-filled vehicle is 23 times greater than that of a smoky bar, even under realistic ventilation conditions.

In the studies a number of ventilation conditions were assessed, where airflow parameters included average driving speed, presence of air conditioning and open windows. Realistic ventilation is described as driving at average roads speeds with all four windows completely open.

The BMA has now rewritten their briefing paper (the previous version has now disappeared) so that it now reads:

There is evidence to suggest that the levels of SHS present in vehicles can contribute to a serious health hazard for adults and children. Further studies demonstrate that the concentration of toxins in a smoke-filled vehicle could be up to 11 times greater than that of a smoky bar.

In the studies a number of ventilation conditions were assessed, where airflow parameters included average driving speed, presence of air conditioning and open windows.

Aside from removing the now-notoriously fictitious "23 times" claim, it is significant that the BMA has removed all reference to "realistic conditions". As I have said before, when experiments have been conducted in realistic conditions (ie. with one or more windows at least partially open), the amount of secondhand smoke in a moving vehicle is much lower than in a smoky bar. When all windows are closed and the ventilation is turned off, however, concentrations are higher than in a smoky bar. Of course they are. Cars are smaller than bars. That's why people who smoke in a car open the window.

The BMA's half-correction is welcome. I wonder if they will use their formidable PR machine to make sure the media get the message? (Rhetorical question). The fact remains that millions of people have now been informed that secondhand smoke in a car under realistic conditions "is 23 times" more concentrated than secondhand smoke in a bar.

Now, with the world's media having moved on, the BMA has little to lose by quietly announcing that what they meant to say was that secondhand smoke in a car under unrealistic conditions "could be up to 11 times" more concentrated than secondhand smoke in a smoky bar.

Perhaps the BMA should launch a campaign to make people smoke under realistic conditions?

UPDATE:

I'm grateful to Ivan who has left a comment leading me to this interview from the Today programme with Dr Vivienne Nathanson, the head of science and ethics at the BMA. The fact that she wants it to be illegal for people to smoke in their own car demonstrates her weak grasp of ethics. This interview demonstrates her weak grasp of science.

Bear in mind that this immediately followed an interview with Simon Clark who mentioned the debunking of the "23 times" claim in the Canadian Medical Association Journal.

Interviewer: What is the evidence?

Nathanson: Well, the evidence is, in fact, that the levels of toxins that can build up in a car do reach 23 times the levels in a smoky bar...

Interviewer: And that is—sorry to interrupt you—but that is peer-reviewed?

Nathanson: Yes, absolutely.

Interviewer: Everyone in the scientific community accepts that it's true?

Nathanson: Absolutely.

Pretty emphatic stuff, there. Of course, what the peer-reviewed study actually says is...

We recommend that researchers and organizations stop using the 23 times more toxic factoid because there appears to be no evidence for it in the scientific literature.

It's also worth reading this blog post which casts a critical eye on some of the other claims in the BMA's latest report.

The BMA's tactical victory

2011-11-17T15:37:00.002Z

The BMA appeared to put their foot in it yesterday with their 'ban smoking in cars' media blitz. Firstly, they used a thoroughly discredited junk statistic. Secondly, they demanded that it be illegal for a person to smoke in a car by his or herself—a policy that most people rightly regard as the nanny state gone berserk.

All of this made it easier for those of us who discussed the proposed ban on television and radio. At the very least, we were able to make the public aware that the BMA's grasp of the science is weaker than is generally assumed. Readers of the Telegraph, the Independent, Spiked and Full Fact can consider themselves better informed than most.

But if relying on the absurd "23 times more toxic" canard was a blunder, I'm not so sure than calling for a total ban was also a cock-up. I tend to share the view of Simon Clark that it was a deliberate strategy.

My view, for what it’s worth, is that it’s tactical. The BMA’s declaration coincides with the second reading of Labour MP Alex Cunningham’s Private Members’ Bill which calls for a ban on smoking in private vehicles when children are present. It’s listed to be debated on Friday 25 November.

The BMA has possibly worked out that by calling for more extreme action, the coalition government may see a ban on smoking in cars with children as a reasonable compromise.

I may be right because, unknown to me (I have only just read it), the Huffington Post this morning published a piece by Dame Helena Shovelton, chief executive of the British Lung Foundation, entitled Calls for a Ban on Smoking in Cars Are Welcome, but Action on Children Is Needed Now. (I assume that my article is intended to be a companion piece.)

As we know (and I respect them for it), the tobacco control industry is very well coordinated. Alex Cunningham, the BMA and the BLF are not working in splendid isolation. They will be working together, I'm sure, and privately they will all be singing from the same hymnsheet. First, a ban on smoking in cars with children, then a ban on smoking in all private vehicles.

By calling for the latter now the BMA is trying to make a ban on smoking in cars with children appear more liberal. They will be delighted with that, believe me, because they know that, after that, a ban on smoking in all vehicles is only a matter of time.

There are two routes to prohibition. One is to move incrementally—the salami slice approach—as is happening with alcohol advertising. The other is to appeal to the public's sense of compromise by making extreme demands. Back in 2003, The Lancet called on the government to ban the sale of tobacco completely in an editorial titled 'How do you sleep at night Mr Blair?' Although widely derided, this editorial opened an Overton window which made a total ban on smoking in 'public' places—which had previously been seen as the most extreme measure available—seem almost moderate.

Let there be no doubt. The BMA believes it is perfectly appropriate for the police to stop and fine adults for smoking a cigarette in their own car, even when no one else is in it. They have the ethics of a rattlesnake and will undoubtedly campaign for a total ban in the future, just as The Lancet will one day renew its call for tobacco prohibition. Compromise in anathema to them, but expect them to suddenly present themselves as compromisers in the next days and weeks.

The British Medical Association spices up an old myth with a new lie

2011-11-16T11:25:00.002Z

I predicted last night that...

The chances are [the British Medical Association] will claim that a cigarette smoked in a car exposes passengers to either 23 or 27 times more secondhand smoke than they would get from a whole night in a smoky bar. Both of these statistics are obviously absurd.

In the end they plumped for the "23 times" figure despite it being thoroughly debunked in the Canadian Medical Association Journal, which offered this advice to advocates:

We recommend that researchers and organizations stop using the 23 times more toxic factoid because there appears to be no evidence for it in the scientific literature.

Did that stop the BMA resurrecting this zombie statistic?

It did not. Not only are the BMA bandying around a figure for which there is "no evidence in the scientific literature", but they have added a fresh layer of nonsense to it.

There is evidence to suggest that the levels of SHS present in vehicles can contribute to a serious health hazard for adults and children.

Further studies demonstrate that the concentration of toxins in a smoke-filled vehicle is 23 times greater than that of a smoky bar, even under realistic ventilation conditions.

In the studies a number of ventilation conditions were assessed, where airflow parameters included average driving speed, presence of air conditioning and open windows. Realistic ventilation is described as driving at average roads speeds with all four windows completely open.

The BMA seem to be suffering from undiagnosed pseudologia fantastica. Their new briefing paper supplies three references for their bizarre claim about "realistic ventilation". Only one of the named studies experimented with a scenario in which all the windows were open. The researchers called it 'Condition 3' (PM is particulate matter)...

At the other extreme, in Condition 3 (all windows open all the way while driving), the PM2.5 level was the lowest (M = 60.4 μg/m3, range = 15.7 to 220.5 μg/m3).

And how does that compare to a "smoky pub"?

To provide some context about the PM2.5 levels recorded in this study, in a recent report of PM2.5 levels in Irish pubs throughout the world, the average level of PM2.5 in 48 Irish pubs that allowed smoking was 340 μg/m3.

Pedants and sceptics would say that there is a bit of a difference between "23 times higher" and "82% lower" but what the hell, eh? If the BMA says it, it must be true.

Smoking in cars: groundhog day

2011-11-15T22:47:00.001Z

Word has it that the British Medical Association is going to have another stab at campaigning for a smoking ban in cars today. This is turning into an biannual crusade and I don't have any more to say about it than I did in all these previous posts.

The chances are they will claim that a cigarette smoked in a car exposes passengers to either 23 or 27 times more secondhand smoke than they would get from a whole night in a smoky bar. Both of these statistics are obviously absurd. The "27 times" canard comes from an unpublished, non-peer-reviewed study presented at a conference nine years ago. It was heavily rigged towards getting the "right" result and finally concluded...

The calculated exposure for a five hour automobile trip with the windows closed/ventilation off and with a smoking rate of 2 cigarettes per hour is 25 times higher than the same exposure scenario in a residence.

"Residence" is not quite a "smoky bar" and "windows closed/ventilation off" is not exactly a realistic scenario for a smoker on a five hour car journey, but nevermind. And no, I don't know why 25 got changed to 27, but this is the reference ASH use for the claim.

The "23 times" claim is even more fun, because it involves a rare mea culpa from tobacco control. In a study in the Canadian Medical Association Journal entitled 'Second-hand smoke in cars: How did the “23 times more toxic” myth turn into fact?', MacKenzie and Freeman showed that the "fact" was entirely without scientific evidence and stemmed from a, obscure quote in a local newspaper in 1998 (as I had revealed on this blog two months earlier).

They concluded with the following unheeded recommendation:

We recommend that researchers and organizations stop using the 23 times more toxic factoid because there appears to be no evidence for it in the scientific literature.

I'll be talking about this on BBC Sussex at around 9.40 am.

Don't panic

2011-11-15T20:38:00.003Z

I've got an article over at The Independent today covering many of the facts about alcohol of which readers of this blog will be familiar, but politicians seemingly are not.

Yes, we are drinking more than we did in the immediate post-war years. An economic depression sandwiched by two world wars reduced alcohol consumption to the lowest in our history, but austerity Britain can hardly be considered a typical reference point. Using more relevant benchmarks, we are drinking less than we did in 1914 and very much less than we did in previous centuries. We are drinking only marginally more than we did thirty years ago and—here is a seldom spoken truth—we are drinking less than we did in 2002.

Yes, there are millions of us who exceed our ‘daily limits’ (they’re actually weekly guidelines). How could we not? These guidelines were not based on any real evidence when they were set in 1987 and methodological changes have since dragged several million more of us over the line of ‘hazardous drinking’. Limits that do not allow for tipsiness, let alone drunkenness, deserve to be ignored and yet the percentage of men and women drinking above the ‘limits’ has still been falling for a decade, with the largest decline seen amongst young men.

By comparison with our European neighbours, we are firmly mid-table in the alcohol consumption stakes, behind France, Germany and Spain and far behind the Czech Republic and Luxembourg. In terms of alcohol taxation, however, we are Champions League contenders. The UK has the second highest excise duty on wine, the third highest excise duty on beer and the fourth highest excise duty on spirits. ‘Rip-off Britain’, perhaps, but hardly ‘Boozy Britain’.

The comments are generally positive. Do go have a read.

Heart miracles are impossible

2011-11-15T00:21:00.001Z

King-size cigarette,
pint-size intellect

It's good to see Dr. Carl V. Philips back and blogging over at Ep-ology. In his last two posts he has been discussing the North Carolina heart miracle 'study', which is as bad a piece of advocacy-driven junk science as you will ever see.

In particular, he makes a point which I have tried to made before, which is absolutely fundamental to all the heart miracle studies. The results they report—of heart attacks falling by 17%, 21%, 40% or whatever—are simply impossible.

Let's go along with the "consensus" view that long-term secondhand smoke exposure increases the lifetime risk of heart disease by around 20-30%. Nevermind whether that is a realistic estimate. For good or ill, it is the figure used by the Surgeon General and other authorities, and it is accepted by those who conduct the heart miracle studies.

That being the case, is it plausible that the elimination of secondhand smoke from restaurants, offices and bars could reduce the heart attack rate by 21% (as reported in North Carolina) or 40% (as reported in Helena, Montana)?

It is not.

For one thing, most restaurants, some bars and nearly all offices were non-smoking before the ban. In addition, many non-smokers avoided the few remaining smoky venues before the ban. The vast majority of heart attack cases are elderly and not the kind of people to be out partying in bars, nor indeed working in pubs or waiting tables in restaurants. Furthermore, the amount of secondhand smoke inhaled by this subsection of non-smokers before the ban is minimal compared to the long-term exposure that the 20-30% figure is based on.

As Carl explains...

How many people go from being exposed to restaurant/bar smoke to unexposed as a result of the ban? It is a bit fuzzy to define this since there will be a lot of people whose exposure is reduced, and a spectrum of how much it is reduced. But we can start with the observation that roughly half of everyone had approximately zero such exposure before the ban, never or almost never going out to eat and drink, or avoiding smoking-allowed venues when they did...

Thus, even if you believed that exposure at the level of visiting restaurants and bars causes somewhat more than 20% increase in risk, which is an absurd belief in itself, there is no possible way the effect of the smoking ban could be more than about half of the claimed 21%.

Even if we assume that secondhand smoke does cause heart attacks, smoking bans have so little effect on so few non-smokers (and have no effect at all on the smokers, unless it compels them to quit), that the kind of reductions in the heart attack rate reported by these studies defy both science and common sense. If there is an effect, it is too small to measure and would never show up in population-level statistics. Once that is understood, it is obvious that any studies which claim a dramatic effect on the heart attack rate must be flawed, cherry-picked or distorted. Sure enough, when such studies are examined, they prove to be flawed, cherry-picked and distorted.

We can figure that half of the population was not exposed in the first place, that easily a third of those exposed were smokers, that many of those exposed had very minor and occasional exposure, and that many others that were exposed had only a minor reduction in exposure since most of their exposure was elsewhere. So it seems unlikely that even one-fifth of the population experienced a substantial reduction in exposure, getting the effect down below 1% of the total.

If, to take North Carolina as an example, the smoking ban caused the heart attack rate to drop by 21%—which it unequivocally did not—it follows that smoking in bars, restaurants and offices must have been responsible for a fifth of all heart attacks before the ban.

It is quite possible that thirty years of induced panic about passive smoking has persuaded many people that such diluted tobacco smoke is capable of wreaking such havoc, but the empirical evidence shows that it cannot be so. If it were, the relative risk from secondhand smoke exposure would be far higher than 20-30%. Indeed, secondhand smoke would be responsible for more heart attacks than smoking. It would mean that passive smoking (at work and at home) was the single biggest risk factor for heart attacks. Even the most tobaccophobic hypochondriac surely cannot believe such a thing.

In the case of Stanton Glantz's bar-lowering Helena study (2004), the smoking ban effect was even greater—an astonishing 40%. Again, this implies that smoking in a subsection of private venues was responsible for two-fifths of all heart attacks before the ban—a manifestly risible idea.

Interestingly, Glantz must have known that his findings were inherently implausible because he addressed them in the text of the study itself. His comments tell you much about the man's mathematical illiteracy and, sadly, tell us much about the decline of the peer-review process (the study was published in the prestigious British Medical Journal). He wrote:

The effect associated with the smoke-free law may seem large but is consistent with the observed effects of secondhand smoke on cardiac disease. Secondhand smoke increases the risk of a myocardial infarction by about 30%; if all this effect were to occur immediately, we would expect a fall of - 0.30 x 40.5 = - 12.2 in admissions during the six months the law was in effect, which is within the 95% confidence interval for the estimate of the effect (a drop of - 32.2 to - 0.8 admissions).

His argument here is that secondhand smoke exposure increases the risk of heart disease by 30% and so, "if all this effect were to occur immediately", a smoking ban should reduce the heart attack rate by around 30%. 40% is, he concedes, a little higher than might be expected but it is within the margin of error.

This piece of reasoning is so patently flawed that I still cannot believe it was allowed to be published. Let's leave aside the fanciful idea that the effect of a lifetime's exposure would suddenly be nullified by a smoking ban in non-domestic settings. The key point is that Glantz ignores the fact that secondhand smoke is one of dozens, if not hundreds, of risk factors for heart attacks (or heart disease—he treats them as if they were the same thing). He seems not to comprehend the difference between relative risk and absolute risk. He does not acknowledge that a relative risk which affects a subsample of the nonsmoking population is not going to have a commensurate effect on the entire population. And he implicitly treats secondhand smoke as if it were the sole cause of heart disease. These are staggering schoolboy errors for a man with pretensions of being an epidemiologist (which just goes to show that a degree in mechanical engineering is not always the best grounding for a career in cardiology).

Look at it this way. If using a mobile phone while driving increases your risk of having an accident by 90%, what will be the effect on the number of car crashes in a country that bans the practice?

The answer is that we do not know. There are countless other risk factors for car crashes and so, even if using a mobile phone has a substantial effect on individual risk, the effect at the population level will be too small to measure.

By Glantz's logic, however, the effect of a mobile phone ban will be to reduce the number of car crashes by 90%—because he doesn't understand the basic difference between individual relative risk and absolute risk to the population. How can he be so ignorant? There are, as Carl says, only two possibilities.

Interestingly, it is not entirely clear whether he spouts junk because he has not acquired a modicum of understanding about the science in the field where he has worked for decades, or because he is a sociopath-level liar; I am not entirely sure which is the more charitable interpretation.

Do go read both of Carl's pieces about the North Carolina nonsense:

Unhealthful News 189 - Absurd claims about the effects of smoking place restrictions, North Carolina edition (Part 1)

Unhealthful News 190 - Absurd claims about the effects of smoking place restrictions, North Carolina edition (Part 2)

Better the devil you know

2011-11-11T14:45:00.000Z

The Guardian has some unsurprising news about mephedrone (AKA meow meow, m-cat, bubble, etc.)

Mephedrone was classified in the UK as a Class B substance in April last year. Prior to the ban it was a "legal high", with users buying it primarily from websites that advertised it as "plant food". Since then prices have approximately doubled to £20 per gram and the trade has been taken over by street dealers.

UK Home Office figures published in July found mephedrone ranks joint second with cocaine behind cannabis in popularity among 16- to 24-year-olds, with 4.4% having taken it in the previous 12 months.

Yes, it's another triumph for prohibition. Mephedrone is one of dozens of drugs to have surfaced as legal highs in recent years. Most legal highs have little going for them apart from their legality. Mephedrone's staying power suggests that it has qualities which allow it to compete as a controlled substance. Whether it is truly dangerous—let alone addictive, as The Guardian's report claims—remains to be seen. All the mephedrone-related deaths reported in the media before it was banned turned out not to be mephedrone-related at all (as readers of The Art of Suppression will know). Since it was banned, there has been talk of 200 deaths, but, if so, specific incidents have been uncharacteristically absent from the newspapers.

All of which leads me to mention the article I wrote for City AM yesterday, the theme of which is the futility of this war on chemistry.

Despite immense efforts by police, customs officers and legislators, there has been no decline in the nation’s consumption of illicit chemicals since the ecstasy panic peaked fifteen years ago. What we have instead is an ever-widening menu of narcotics about which users and authorities know little.

One proposed solution is to introduce a law similar to the USA’s Analog Act which automatically bans drugs which are “substantially similar” to banned substances. The idea is tempting in its simplicity, but this Nixon-era legislation is too vague to be legally useful and has rarely been invoked. The grey market continues to be one step ahead of legislation.

An alternative solution was proposed last week by Dr James Bell, of the South London and Maudsley NHS Foundation Trust, who suggested abandoning the unwinnable war against chemistry in favour of legalisation. All calls for drug liberalisation fall on stony political ground and Bell’s was no different, but there would be no better way of stopping the flood of dubious chemicals than a regulated free market. These drugs are nobody’s first choice. BZP was originally a worming tablet for cattle. Ketamine was a veterinary anaesthetic. GBL was a superglue remover. In all likelihood, that is what they would have remained had ecstasy not been banned.

Nobody made 80 per cent proof gin in their bathtubs after prohibition was repealed in 1933. Instead, Americans turned from distilled spirits to beer, the number of alcohol poisonings fell and the murder rate subsided. There is a lesson there for those fighting against narcotic moonshine today.

Do go read it all.

The gathering storm of prohibitionism

2011-11-10T17:46:00.001Z

Reason magazine's Nick Gillepsie interviews the great Joe Jackson about music, smoking and the "gathering storm of prohibitionism."

Jackson's antipathy for the creeping nanny state in his native England and his longtime home of New York City led him to write a meticulously researched essay called "Smoking, Lies and The Nanny State." It also led him to finally flee New York and London, setting up residence in Berlin because there he at least feels like he is relatively "free" and "treated like an adult."

Well worth watching.

The North Carolina smoking ban/heart attack hoax

2011-11-09T22:05:00.001Z

Stop me if you think you've heard this one before.

From the University of San Francisco (note the byline)...

Heart attacks down 21 percent in the first year after the North Carolina smokefree restuarant and bar law took effect

Submitted by sglantz on Wed, 2011-11-09 11:54

The evidence that strong smokefree laws provide large and immediate health benefits just keeps piling up.

The latest study, released today, found a 21 percent drop in emergency room admission for heart attacks during the first year of the law, saving an estimated $3.4 to $4.3 million in heath care costs. This is serious money, particularly as both government and the private sector struggle to keep health costs down.

These real documented and rapid benefits not just in terms of health, but the economy, show that the economic argument on smokefree policies has clearly shifted away from the tobacco industry and its allies to the health side.

Real and documented, you say? So we can assume, at the very least, that there were 21% fewer heart attacks after the smoking ban?

Not even that, I'm afraid. Not even close. As the study shows, there were 9,066 heart attacks in 2008. This fell by 10.5% to 8,113 in 2009. The smoking ban came in at the start of 2010. In that year, there were 7,669 heart attacks—a decline of 5.5%.

The researchers have even helpfully included a graph in which you can clearly see the heart attack rate falling before the ban and then leveling off somewhat after the ban.

As if to rub our noses in it, the researchers spell out exactly what the trend was.

Interestingly, the rates appear to have consistently declined between the year 2008 and 2009; after that period the rates leveled off at a consistently lower level in the year 2010.

Er, yeah. So where on earth does this claim that there was "a 21 percent drop in emergency room admission for heart attacks during the first year of the law" come from?

The answer is that they did a Gilmore. They made a computer model. You may recall Anna Gilmore and her band of merry women reinterpreting the no-change-there-then English heart attack data and declaring that 2.4% of the 4.2% drop was attributable to the smoking ban. Unprovable (she made no attempt to prove it) but also unfalsifiable.

This new study takes that approach to absurd new depths. Whereas Gilmore claimed that a portion of the drop in heart attacks was due to the smoking ban, this model says that the smoking ban reduced the heart attack rate by 21%, despite the actual heart attack rate only falling by 5.5%.

You almost have to admire the sheer audacity of these people. Every time I think there is no way they can keep flogging this dead horse, they come up with another ruse.

Here is a study which unequivocally shows that the smoking ban had absolutely no effect on the heart attack rate. If anything, the year after the smoking ban saw rather more heart attacks that would be predicted based on the preceding years. The study provides all the data you need to see that the heart attack rate fell by 5.5% after the smoking ban and yet it concludes—based on a demonstrably ludicrous computer model—that the smoking ban reduced the heart attack rate by 21%. When your computer gives you information like that it's time to turn it off and turn it on again.

And yet you can be sure that when this study is inevitably reported, the facts will not be allowed to stand in the way. The number of people who actually went to hospital with a heart attack will become irrelevant (although it's fitting that bans based on imaginary deaths are saving imaginary lives). The fiction has become the reality. The model has spoken. "There were 21% fewer heart attacks after the smoking ban. Here's Tom with the weather..."

Review time again

2011-11-08T11:39:00.000Z

Patrick Hayes has written a thorough and generous review of The Art of Suppression for Spiked.

In masterfully charting the history of the prohibitionists’ war on pleasurable substances, in highlighting their endless failures to impose restrictions on the public, in exposing their dodgy use of statistics and ‘evidence bases’ to disguise moral arguments, and in emphasising the ability of us as individuals to exercise our capacity for self-restraint and personal responsibility, Snowdon does all of us determined to challenge the contemporary prohibitionist movement a great service.

Do read the whole thing.

The Art of Suppression is available from Amazon UK, Amazon.com or direct from me. Why not treat a loved one to a dozen copies this yuletide?

Season of hate

2011-11-04T02:43:00.001Z

I generally have zero interest in what random people choose to type beneath the line of news stories on the internet, but a couple of articles this week made me think that the intellectual climate is darkening at a worrying rate.

Take this item from the Winnipeg Free Press about an unfortunate woman who nearly froze to death after being locked outside a hospital.

It was a bitter winter night, -30 C, in December 2000, when a 54-year-old hospital patient slipped outside Seven Oaks Hospital in her hospital gown, pulling her intravenous pole behind her.

She wanted a smoke.

An hour later, she was found comatose in a snowbank. The woman had suffered hypothermia and frostbite to her hands and feet. Four fingers on her right hand had to be amputated. She was left with limited mobility in her left hand.

The door had locked automatically behind the patient and she couldn't find a way back in.

It's hard not to feel sorry for a lady who had a near-death experience and suffered multiple amputations.

Or so you might think. In fact, the mental image of a woman having a cigarette alone in arctic temperatures unleashed a river of bile in the comments section.

Shouldn't be smoking in the first place. Maybe a little cold made the lady realize that smoking is not healthy for you and neither is hanging out in the cold in a hospital gown.

This is a disgusting, filthy habit, and for people who are already in the hospital for a smoking-related illness wanting to go outside and smoke some more is just sickening. It's one thing not to be concerned for your own health - that's your perogative, but don't put the other patients & children with weakened immune systems in the way of second hand smoke. There are hundreds of other places to smoke, and a hospital or the hospital grounds definetely should not be one. Take a walk down the street, across from the hospital to inhale your death stick. If you can drag yourself out of bed, with your IV pole and grown, down the elevators outside, then you can take a few extra steps to move away from the building. Yes, even if it's -40. It won't kill you. Or maybe it will.

It's a dirty blue collar habit. And as for the stereotype - it need only be confirmed by the appearance of them in mass aroud the door of a building in the winter.

Absolutely zero sympathy for anyone who defies a doctor's caution to stop smoking and gets lung cancer. In fact, they should be refused any treatment whatsoever.

Nice.

And how about this light-hearted little item in The Economist, in which a journalist notices that many airports around the world manage to accommodate smokers in some small way without inconveniencing other passengers.

Yes, smoking is bad for you. But if you are a smoker, a civilised cigarette makes all the difference between being an irritable passenger itching to burst out of the terminal doors and a calm, considerate sort who makes room for his fellow travellers.

... Smokers don’t ask much. Put a designated smoking zone in the shoddiest corner of the terminal and they will trek to it, thanking the authorities with every carcinogenic breath. It would make economic sense too: Heathrow worries about losing its place as Europe’s foremost hub for international air traffic now that plans for the airport’s expansion have been shelved. But why waste money on a third runway when you can build a little smoking room and watch travellers flood in?

This is very moderate and unassuming stuff. The risks of smoking are acknowledged and all that is being asked for is "the shoddiest corner". Will the readers of this article respond with similar bonhomie and tolerance? They will not.

Smoking is a filthy habit that should be discouraged, not encouraged. "Kissing a smoker is like licking a full ashtray". I don't want to sit next to a passenger who has been chain smoking, whose head and arm hair and clothes stink of stale smoke, whose yellowed teeth exhale nicotine air in my ambiance as s/he coughs his lungs up. Not to mention the cost to clean up smoking lounge draperies, fabric chairs, carpet. Because smoking kills the olfactories, smokers have no idea how badly they smell and they cannot taste food. Get a life, save money, and quit!

Having someone who has recently been smoking sit next to you on a flight is almost as bad as having them smoking there. The stench of cigarette smoke hangs in that persons hair, clothing and (if you are close enough) breath for a very long time. Let's keep it as far away as possible. Those demeaning goldfish-bowl smoking rooms are one of the saddest sights I've ever seen at an airport. Do these people know just how ridiculous they look?

If I am going to sit next to someone on a nine hour flight I don't want them stinking of fag ash. I don't mind if people smoke in special smoking rooms as long as they are required to shower and change into fresh clothes immediately afterwards.

Why not facilities for other drug addicts whilst one is about it? Of course the rest of us do not wish to be in the plane with smelly smokers, let alone drug-addicted pilots, so we are looking at complete segregation here....

Remember how in the very recent past, tobaccophobes insisted that they were not against people smoking per se, they just didn't want people to do it around them. Now, it seems, their sensitive noses need protecting to such an extent that the mere presence of someone who smoked several hours ago is enough to stir their righteous indignation. In the first story, we see a woman who has done everything that is demanded of her by braving sub-zero temperatures so that not a wisp of smoke goes up the delicate nostrils of fellow Canadians and yet all that can be said of her is that it is a shame she survived.

Finding anonymous half-mad obsessives spouting drivel on the internet is the easiest task in the galaxy, of course. It is always possible that a handful of loons scour the search engines for any mention of their bête noire to make sure their peculiar voices are heard. And yet, there is something in the sheer hatefulness—and quantity—of these comments that suggests that the policy of 'denormalisation' is producing fruit.

This is the inevitable result of the state-sanctioned stigmatisation that the anti-smoking movement has been working towards for twenty years. The public health establishment might distance itself from such sentiments but when even the NHS produces adverts like the one below, they must take some responsibility for lighting the blue touch paper.

Governments have a responsibility to quell tensions and defuse conflict in society. In no other area of life does government deliberately create and inflame hostility. Like so many other failed tobacco control policies, the doctrine of denormalisation is counter-productive and damaging because it is the brain-child of a small group of emotional zealots, some of whom are operating at a sub-optimal level of mental health themselves. It's time for the government to put the tobacco control freaks behind them and chart a new course before things get really nasty.

No miracle in Oregon

2011-11-03T14:44:00.001Z

Jacob Grier has written an article in The Oregonian looking at the state's heart attack rate following its smoking ban of 2009. It will no come as no surprise to regular readers that the dramatic fall in heart attacks predicted by ban supporters has failed to materialise.

Two years ago, Ty Gluckman cited research from Americans for Nonsmokers' Rights founder Stanton Glantz showing that smoking bans led to a 17% fall in hospital admissions for acute myocardial infarction and concluded that "it's highly likely that Oregon's heart attack rates are already dropping as we near the law's one-year anniversary." He said:

If we reduce the number of acute heart attacks by 17 percent, there will be at least 1,100 fewer hospital admissions in Oregon in just one year. At a cost of more than $35,500 per admission, the savings will be substantial: $40 million.

"Highly likely" is right. Oregon's heart attack rate has been dropping for years. In the year before the ban, it fell by 6.67%. As Grier shows in his article, in the years since the ban, it has fallen by 7.21% and 3.11%—very much in line with the long-term trend.

Taken from http://www.jacobgrier.com/blog/archives/4887.html

Once again, routine hospital admissions data provide no evidence of a heart miracle. This is not surprising since the 17% figure comes from a meta-analysis of studies which are riddled with data-dredging, retrospective cherry-picking and blatant researcher bias. That the myth of the smoking ban heart miracle has travelled the world and informed policy for the best part of a decade is a scandal that would be front page news in any other field of science.

As Grier notes, the Oregon non-event adds to the weight of evidence taken from countries around the world—including three peer-reviewed studies focusing on the USA—showing no positive effect from smoking bans on the heart attack rate.

Critics have dubbed these fantastical results "heart miracles," and, like most miracles, they proved too good to be true. When larger populations are examined, the effect diminishes or disappears entirely. The most extensive study to date was recently conducted by the RAND Corp., with a data set of more than 670,000 heart attack admissions from 26 states over a period of 11 years. It concludes that "smoking bans are not associated with statistically significant short-term declines in mortality or hospital admissions" for heart attacks.

The RAND study also explains how publication bias in favor of results and the large variations in smaller samples have combined to produce the illusion that bans are effective.

Gluckman has responded in the same newspaper, acknowledging that the figures Grier presents are correct while downplaying their significance. His defence is that many venues were smoke-free before the 2009 ban and so the effect of the state-wide legislation was less pronounced that it might have been. (This is the same excuse given by Anna Gilmore and colleagues (without evidence) when they failed to replicate the 17% drop claimed in the notorious Scotland heart miracle study.) It is strange that Gluckman did not mention this limitation when he was raving about the $40 million saving the state would make when it reduced heart attacks by 17%.

Now, at the eleventh hour, Gluckman concedes that heart disease is multi-factorial. He notes that major causes such as obesity may cloud the results. Indeed they could. It was always massively implausible that one minor variable—secondhand smoke exposure in bars—could have a large enough effect to show up in aggregate data, but this is the lemon that has been sold to the public around the world. We were told unequivocally that smoking bans produced declines in the heart attack rate of 17%, 40%, 50% and higher. Hospital admissions data have consistently shown this to be a fantasy.

Smoking ban campaigners have little choice but to back-track and make excuses in the face of reality, but there are two important things to remember.

The first is that this scam has only been exposed because it relied on data that are accessible to the public. The public will never be allowed to see the raw data behind the vast majority of what passes for science in journals like Tobacco Control. Light is the best disinfectant, but the bulk of the anti-smoking movement's policy-based evidence remains hidden in dark corners.

The second is that, although the fiction of the heart miracle is now virtually impossible to maintain, studies making impossible claims were published in peer-reviewed journals, including respected organs such as the NEJM and the BMJ for several years. Several meta-analyses (including two written by Stanton Glantz) have uncritically perpetuated the myth. And yet, whenever hospital admissions data are publicly available, they strongly indicate absolutely no impact on heart attacks from smoking bans.

There are lessons here about the perils of publication bias, advocacy-led science and the limitations of ecological studies. But in the end, it comes down to one simple fact — we have been lied to.

A good news story

2011-11-02T00:04:00.002Z

This piece of junk research came out a couple of months ago...

Meat eaters are selfish and less social

"Meat brings out the worst in people. This is what psychologists of the Radboud University Nijmegen and Tilburg University concluded from various studies on the psychological significance of meat.

Thinking of meat makes people less socially [sic] and in many respects more "loutish". It also appears that people are more likely to choose meat when they feel insecure, perhaps because it is a feeling of superiority or status displays, the researchers suggest.

Marcel Zeelenberg Tilburg professors (Economic psychology) and Diederik Stapel (consumer sciences and dean of Tilburg School of Social and Behavioral Sciences) and the Nijmegen Professor Roos Vonk (social psychology) examined the psychological significance of meat.

The conclusion was that eating meat is symptomatic of some sort of psychological disorder. This, of course, was just what militant vegetarians wanted to hear and it was eye-catching enough to make it into the newspapers.

Roos Vonk, known for her columns and books about how our ego gets in our way, doesn’t feel shocked. "Previous research had already shown that meat eaters think more in terms of dominance and hierarchy (who is the boss?) than vegetarians. Eating meat is also traditionally associated with status, meat used to be much more expensive and scarcer than now. Eating meat is a way to elevate yourself above others. But by uplifting yourself, you lose connection with others. That explains why there are more insecure people in need. It also makes people loutish when they think about meat and also feel lonely. "

Diederik Stapel adds to it: "It seems that vegetarians and flexitarians are happier and feel better, and they are also more sociable and less lonely."

Diederik Stapel is a social psychologist with a string of peer-reviewed studies to his name, including this one - just another junk scientist forcing his beliefs onto others with the veneer of social science. Nothing special about that, except that this story has a happy ending.

Dutch 'Lord of the Data' Forged Dozens of Studies

One of the Netherlands' leading social psychologists made up or manipulated data in dozens of papers over nearly a decade, an investigating committee has concluded.

Diederik Stapel was suspended from his position at Tilburg University in the Netherlands in September after three junior researchers reported that they suspected scientific misconduct in a study that claimed eating meat made people more aggressive.

Stapel's work encompassed a broad range of attention-catching topics, including the influence of power on moral thinking and the reaction of psychologists to a plagiarism scandal. The committee, which interviewed dozens of Stapel's former students, postdoctoral researchers, co-authors, and colleagues, found that Stapel alone was responsible for the fraud. The panel reported that he would discuss in detail experimental designs, including drafting questionnaires, and would then claim to conduct the experiments at high schools and universities with which he had special arrangements.

The experiments, however, never took place, the universities concluded. Stapel made up the data sets, which he then gave the student or collaborator for analysis, investigators allege. In other instances, the report says, he told colleagues that he had an old data set lying around that he hadn't yet had a chance to analyze. When Stapel did conduct actual experiments, the committee found evidence that he manipulated the results.

This is the kind of thing that the public expects peer-review to be able to weed out. In practice, alas, peer-reviewers do not verify raw data nor do they obtain proof that experiments have been carried out. Most of the time, they wouldn't be able to perform these checks even if they wanted to.

Not that I'm suggesting that peer-review is massively over-rated - sometimes reviewers will correct spelling mistakes.

The data were also suspicious, the report says: effects were large; missing data and outliers were rare; and hypotheses were rarely refuted. Journals publishing Stapel's papers did not question the omission of details about where the data came from. "We see that the scientific checks and balances process has failed at several levels," Levelt says.

The case of Mr Stapel is highly unusual. He got caught.

One down, hundreds to go.

No, no, no

2011-11-01T13:44:00.001Z

A quick review of some of the weekend's idiots...

From the BBC, where if the press release mentions 'alcohol', it's a news story, no matter how implausible the findings or how shaky the research.

A small number of children as young as 12 claimed they drank the equivalent of 19 glasses of wine a week when questioned for a health survey.

Research by the independent Schools Health Education Unit suggested that 4% of those questioned aged 12 or 13 claimed they drank 28 units or more.

It's strange that no one involved in this study, let alone the Beeb, considered the possibility that 4% of 12 and 13 year olds might amuse themselves by making stuff up when confronted with earnest surveys about their drinking habits. Frankly, I'm a little disappointed the figure was so low. What's the matter with kids today?

Elsewhere, an epidemiological study has arrived with some mildly heroic conclusions:

Heavy alcohol consumption linked to lung cancer

Smokers are more likely to be heavy drinkers. That much is true. I humbly suggest, therefore, that this study failed to control adequately for smoking or misclassified some smokers as nonsmokers. I cannot prove this, but the other findings suggest that this was not the best conducted study ever produced...

Although researchers found several factors that increased lung cancer risk, other factors were found to be related to reduced risk of the disease. Dr. Siu and team found an inverse relationship between BMI and lung cancer risk, where higher BMI levels were associated with a lower risk for lung cancer. A similar relationship was seen in those who graduated from college.

Er, yeah. Nonsmokers are more likely to be overweight and obese than smokers, therefore there would be an indirect association between low BMI and lung cancer. As for the 'link' with high school graduation, that only demonstrates that associations can be found anywhere if you do not control for confounding factors. I would be interested to see the study in full (so far it's only been presented at a public health conference - surprise, surprise), but in the meantime I think it's safer to call bullshit on this one rather than rip up the textbooks.

Meanwhile, as Scotland brings its illegal pricing scheme before parliament, the suicidal pub industry cannot see beyond its short-term self-interest.

Greene King brewery boss backs minimum alcohol pricing

Plans to introduce minimum pricing for alcohol would "go to the very heart" of Scotland's drink problems, a brewery boss has claimed.

This is the same Greene King that was "optimistic about the smoking ban" in July 2007 before the reality of the smoking ban helped its shares to collapse by 60%. Maybe they were right to be optimistic, compared to some other pub chains, a post-ban plummet of 60% isn't that bad.

That experience hasn't dented their faith in alleged public health policies and they see minimum pricing as a way to lure back the customers that the smoking ban drove away. Like the Scottish Licensed Trade Association, who made the jaw-dropping demand that alcohol units be priced at £1.00, they think that if they help the temperance lobby batter the off license trade, the beast will kill them last. The short-sightedness of these cretins beggars belief.

Greene King runs 2,000 pubs and makes Ruddles, IPA and Old Speckled Hen. Bear that in mind next time you're out and about.

The Battle of Ideas

2011-10-28T13:35:00.000+01:00

Tomorrow I'll be at the Battle of Ideas at the Royal College of Art, London, to take part in a session titled 'Seduced by stats?'

From Hans Rosling’s surprise hit TV show The Joy of Stats to visual snapshots of the numbers in the news, there seems to be a new love affair with statistics, especially when they come in a graphic form that can be grasped intuitively. It doesn’t take a maths degree to see that a straight line sloping upwards suggests a relationship between the height and age of schoolchildren, for example, or that a large blob represents more murders than a smaller blob. We are ready, perhaps too ready, to give credence to statistics, which appear to manifest the mysterious labours of the mathematically literate in transparent, self-explanatory form. We too rarely question the assumptions that underlie the figures, and too often forget that an evident correlation between two things – US oil production and the quality of rock ‘n’ roll, for example – does not necessarily mean there’s a causal relationship. And we are often beguiled into believing that the past automatically predicts the future – a graph which shows anything increasing exponentially in the past can only spell doom for the future.

We need statistics. By collecting lots of simple information in numerical form we can see patterns that may help us understand problems and spot underlying causes. But this is where things get tricky. If the number of Elvis Presley impersonators continues to increase as it did from 1957 (170 worldwide) to 2007 (over 85,000 worldwide) one in three of us will be Elvis impersonators by 2019. Is this likely? Public health and economics, among other disciplines, rely on modelling human behaviour the same way animal behaviour, or the behaviour of water molecules, can be modelled: by looking at what they’ve done so far. Not surprisingly, this leaves the predicted future looking very much like the past. But people are not data points, and both individuals and societies can behave in unpredictable ways. You can calculate your probability of living to be 100 (one in six of the current UK population) but that’s an educated estimate of the odds, not a guarantee. Are we in danger of turning statistical modelling from a useful analytical tool to the new astrology?

Speakers

Timandra Harkness
journalist and writer; co-writer and performer, Edinburgh Festival Fringe smash hit Your Days Are Numbered: the maths of death

Bryan Joseph
actuarial partner, London, PwC

Chris Snowdon
author, Velvet Glove, Iron Fist and The Spirit Level Delusion: fact-checking the Left's new theory of everything

Chair: Hilary Salt
founder, First Actuarial plc; chair, Manchester Salon

Saturday 29 October, 12.15pm until 1.15pm, Lecture Theatre 2

The Battle of Ideas festival has a huge range of intriguing debates on tomorrow and Sunday. Readers of this blog might be particularly interested in the following...

Drinking by numbers: should we count our alcohol units?

Saturday 29 October, 10.30am until 12.00pm, Henry Moore Gallery Society Wars

Dolan Cummings
associate fellow, Institute of Ideas; editor, Culture Wars; editor, Debating Humanism; co-founder, Manifesto Club

Dr Richard Smith
board member, Public Library of Science; former editor, British Medical Journal; author, The Trouble with Medical Journals

Christine Thompson
policy manager, SABMiller

Chair: Josie Appleton
director, civil liberties group, Manifesto Club

Doing it for charity?

Saturday 29 October, 12.15pm until 1.15pm, Henry Moore Gallery Society Wars

Dave Clements
social policy writer; convenor, IoI Social Policy Forum; co-editor, The Future of Community

Simon Blake
chief executive, Brook; chair, Compact Voice, the voluntary sector network

Ed West
features editor, Catholic Herald; features writer, Daily Telegraph

Chair: Sheila Lewis
director, Volanti Consulting

Your mind, your high: is recreational drug use morally wrong?

Saturday 29 October, 1.30pm until 3.00pm, Courtyard Gallery Battle for Morality

Dr Michael Fitzpatrick
GP; author, The Tyranny of Health: doctors and the regulation of lifestyle and Defeating Austism: a damaging delusion

Roger Howard
chief executive, UK Drug Policy Commission

Professor Neil McKeganey
director, Centre for Drug Misuse Research

Dr Fiona Measham
senior lecturer, criminology, Lancaster University; chair, Advisory Council on the Misuse of Drugs Polysubstance Use Working Group

Chair: Suzy Dean
freelance journalist; co-founder, IoI Current Affairs Forum

Eating ethics: are some foods morally bad for you?

Saturday 29 October, 1.30pm until 3.00pm, Café Food Fight

Felicity Cloake
journalist and food writer; columnist, Guardian

Matthew Fort
freelance food writer and TV presenter; judge, The Great British Menu

Kirk Leech
freelance journalist; researcher, development and environment

Alex Renton
award-winning journalist; writer on food and food policy; author, May Contain Bones (forthcoming); contributing editor, Prospect magazine

Chair: Rob Lyons
deputy editor, spiked; writer on science and risk; author, Panic on a Plate: how society developed an eating disorder

Moral panics or just panic?

Saturday 29 October, 5.15pm until 6.30pm, Upper Gulbenkian Gallery Thought for the day

David Aaronovitch
columnist, The Times; author, Voodoo Histories

Brendan O'Neill
editor, spiked; author, Can I Recycle My Granny and 39 Other Eco-Dilemmas

Jenni Russell
columnist and broadcaster; writer, Evening Standard, Sunday Times and Guardian; 2011 winner of Orwell Prize for Political Journalism

Chair: Claire Fox
director, Institute of Ideas; panellist, BBC Radio 4's Moral Maze

And many more...

Another barking mad idea from a doctor

2011-10-26T00:45:00.001+01:00

A letter in this week's British Medical Journal has been press released around the world and may feature in today's newspapers. Although it appears to have been written by a precocious child, it is actually from the pen of a grown man, and a doctor at that.

The letter is actually an online comment to an article in the BMJ from last month. The BMJ must have been so impressed by its startlingly original contents that it deemed it worthy of a wider readership.

Fundamental re-think on smoking is needed
Paul D Jepson
F2 doctor, public health

Excuse my naivety, but isn’t smoking’s continued legality one of the most important factors accounting for its slow rate of decline?

If you mean that fewer people would smoke if smoking was illegal, then yes, but it's not quite as simple as that, is it?

Any other drug causing a fraction of the morbidity and mortality of tobacco would have been outlawed long ago, putting aside alcohol for the moment.

Why should we put aside alcohol? Perhaps because it doesn't fit your argument?

In 2010 mephedrone became a class B drug following widespread media coverage and reports of some deaths in the preceding months, although the evidence surrounding the dangers of mephedrone does not exist.

I agree. Mephedrone should not have been banned, as I argued in The Art of Suppression. Unfortunately, we live in prohibitionist times and there is no greater engine of prohibition than the public health establishment, as epitomised by the British Medical Journal.

This is in stark contrast to tobacco, which is responsible for around 100,000 deaths each year in the UK. Why should smoking get special treatment?

I suppose because 1.5 billion people worldwide like consuming tobacco and people can function perfectly well under the influence of nicotine in a way that they can't under the influence of party drugs and amphetamines. The majority of people believe smoking should be legal so it is. We call it democracy and, in a free society, informed adults have a right to put what they like into their bodies even if it carries a risk to their health. The question is not why should smoking get special treatment, but why shouldn't drugs be legal?

For mainly economic and political reasons, adults with enough change in their pocket can walk into their local shop and buy a packet of cigarettes. They will not be judged and will not feel ashamed: smoking is an acceptable addiction.

If that is true - and broadly speaking, it is - it is not for want of trying from the denormalisers of public health. Every effort is made by alleged health campaigners to stigmatise smokers, demonise tobacco and villify the manufacturers. If this hate campaign has not yet led to actual lynch mobs, it only shows that the general public are more tolerant than the British Medical Association. That, again, answers your question as to why smoking remains legal.

If the tabloid press were to publish a list of the names of the more than 250 people killed by smoking related disease each day, would the government be as fast to react as it did for mephedrone?

[splutter]

[wipes coffee from keyboard]

Assuming this to be a serious suggestion, I will attempt a serious reply. Leaving aside the extraordinary distastefulness of the idea and the unconscionable invasion of privacy, the main problem is that such a scheme would be impossible to carry out. No one is able to name these hypothetical 250 people because doctors and coroners very rarely list smoking as a cause of death. Although the BBC recently affected shock at the reluctance of doctors to name smoking on death certificates, all smoking-related diseases are multi-factoral (ie. have more than one cause) and all smoking-related diseases can be contracted by nonsmokers.

So while there is a good chance that a smoker who dies of lung cancer developed the disease because of his smoking, there is a chance that he would have got it even if he had not smoked. In the case of heart disease - which is the biggest contributor to the 100,000 figure - it is impossible to say that smoking was the cause of any one death. This lack of certainty in individual cases is the main reason why personal injury lawsuits against tobacco companies tend to fail in court.

Imagine a fat smoker with a family history of heart disease, a poor diet and a stressful job. Can a doctor say with any certainty that his heart attack was 'caused' by his smoking, his diet, his stress, his genes or his diet? It can't be done. The 100,000 figure comes from assumptions taken from the epidemiological literature based on aggregate data from hospitals. It is an estimate. It is not based on a running total of clinically proven 'smoking-related deaths'.

Even if such a list could be created, who is going to pay for the column inches in the tabloids every day? Since this letter was written by an authoritarian doctor of public health, we must assume that the taxpayer will, as ever, be expected to foot the bill. And why only tabloids? Are we to assume that smokers do not read the broadsheets?

Finally, on a practical note, the great majority of the 250 daily deaths would be of people in their 70s, 80s and 90s. Smoking prevention campaigns are largely targeted at people in their teens and twenties. It is doubtful whether listing the names of people who, for the most part, enjoyed the proverbial 'good innings' is really going to have desired the shock value for the target group of devil-may-care youngsters.

People’s attitude towards drugs should be evidence based, and not informed by politics or popular opinion.

Quite so. Let's legalise them. Prohibition didn't work with alcohol, it doesn't work with drugs and it won't work with tobacco.

How must smokers feel when they are encouraged to quit their habit by the same government that welcomes tobacco taxes so gladly?

I suppose it makes them think that politicians are greedy hypocrites. A valuable lesson learned, no?

While smoking remains legal, the number of smokers is never going to fall significantly—no matter how much taxes rise, how plain cigarette packets become, or how many millions of pounds is spent on cessation.

Smoking rates have actually fallen very significantly over the years and may continue to do so. Admittedly, they have flat-lined since 2006, when the government began listening to the 'experts' of tobacco control and introduced divisive, ill-considered policies like total smoking bans, graphic warnings and display bans. Maybe the politicians will learn their lesson and withdraw their funding from astro-turf anti-smoking groups in the same way as it has recently stopped funding Alcohol Concern. (Rather than try and raise money from the general public, Don Shenker has realised that the game is up and has resigned. Cheers!)

Perhaps the smoking rate will continue to flat-line. Or it might start going back up. Or it might fall again. Who knows? It's none of your business and it's none of mine either. The risks of smoking are universally acknowledged and there is a great big warning on every pack saying 'Smoking Kills'. Having accepted that prohibition doesn't work, we must also accept that informed adults have the choice to smoke or not smoke. There really isn't more to say on the matter. You live your life and I'll live mine.

As I mentioned, this letter may be the subject of some news coverage today, presumably because it raises the spectre of the 'next and final step'. I'll be on BBC Radio Sussex at around 9.50am talking about it.

A fat man explains the slippery slope

2011-10-25T01:55:00.000+01:00

Kelly "two chins" Brownell.
This man is an anti-obesity campaigner. Seriously.

A day might come when I get sick of reminding self-righteous nonsmokers that the anti-tobacco campaign was only a template for a larger war against every pleasure, but that day is not today.

"It's only smoking," they squealed. "Alcohol, food and fizzy drinks are completely different." Not to the British Medical Association they're not, nor to the Royal College of Physicians, the Surgeon General nor Kelly "wide load" Brownell who writes the op-ed below. Sit back and enjoy how the gluttonous soda tax campaigner draws a direct parallel between Coca-Cola and British American Tobacco. Are we getting the message yet?

Meet Big Soda — as Bad as Big Tobacco

Subtle enough for you?

...But the beverage industry, dominated by Coca-Cola and PepsiCo, and represented by the American Beverage Association, has exercised its might against this public health initiative in ways reminiscent of the tobacco industry when it came under attack in the 1950s. The beverage industry argues that such taxes are “discriminatory” in singling out one category of food, that taxes would not work, and that government should not tell people what to eat. The tobacco industry said taxes would not work (they did work — tremendously well) and that government should stay out of people’s choice to smoke.

Similar to tobacco companies, the soda industry has created a front group, Americans Against Food Taxes, to run anti-tax campaigns (a Super Bowl ad, for example). The name of the group implies a patriotic, grass roots movement, not a highly financed entity initiated and organized by industry. The tobacco industry paid scientists who did research disputing links between smoking and lung cancer, the addictive nature of nicotine, and the dangers of second-hand smoke. The soda industry funds scientists who reliably produce research showing no link between SSB consumption and health. The tobacco industry bought favor from community and national organizations by giving large donations. In an ironic twist, Coca Cola and PepsiCo are corporate sponsors of the American Dietetic Association.

Over time, the tobacco companies were outed for their dirty tactics...

And so on and so. You can read the whole thing here. There are soda taxes in more than thirty US states. Hungary and Denmark already have fat taxes. The British Medical Association says it's "time to denormalise drinking". Squeal on suckers. Like it or not, we're all smokers now.

Minimum pricing - still illegal

2011-10-22T17:22:00.001+01:00

Scotland's dreadful health secretary Nicola Sturgeon has been banging the drum for minimum alcohol pricing policy at a SNP conference. As with plain packaging in Australia, the opportunity of attracting some media attention from an otherwise indiffernt world is the pathetic carrot being dangled.

The 1,300 gathering heard Ms Sturgeon say: "Delegates, I can tell you today that our minimum pricing bill will be reintroduced to parliament within the next month.

"When that bill is passed, Scotland will become the first country to introduce a minimum price per unit of alcohol. The world is watching us."

Not so much "when" as "if", since minimum pricing is almost certainly illegal under EU law. Rather than wasting time and money on this doomed policy, the Sturgeon General should listen to expert opinion, like this report from Rand Europe.

Minimum prices for alcoholic beverages, also sometimes called Social Reference Prices, are used in different ways in a number of areas outside the EU, including several Canadian provinces (Saskatchewan, Ontario, Newfoundland, New Brunswick, etc) where the regulation applies to licensed on-trade premises (Strang 2008).

But while a recent Scottish expert consultation concluded that minimum pricing is possible under EU competition law, ‘provided that minimum prices are imposed on licensees by law or at the sole instigation of a public authority’ (SHAAP 2007), minimum pricing practices have tended to be seen as trade-distorting by the European courts (as setting an artificial price floor amounts to resale price maintenance, limiting and distorting price competition), and therefore not typically put in place in the EU (Baumberg and Anderson 2008).

Minimum prices had also been considered, and even introduced through legislation in a few Member States such as Austria and Ireland, for cigarettes as a public health measure, but these moves were contested by the European Commission. This was in line with the jurisprudence of the European Court of Justice, which considers that minimum prices infringe Community law, distort competition and benefit manufacturers by safeguarding their profit margins.

Council Directive 95/59/EC states that manufacturers and importers of tobacco products have the right to determine the retail selling price of their products; according to ECJ jurisprudence minimum prices impair this right and are therefore not compatible with this Directive. The ECJ also stated that minimum prices are not necessary since their health objectives can be achieved through increases in taxation.

This report was commission by the European Commission and the sources given in this particular section include "personal communication from European Commission Directorate General Competition official."

When is Sturgeon going to take the hint?

Review of The Art of Suppression

2011-10-21T12:47:00.000+01:00

Tom Miers—the author of Democracy and the Fall of the West—has reviewed The Art of Suppression over at The Free Society. Here's an excerpt...

Campaigners build themselves into a self-righteous position from which they cannot climb down, fuelled by selectively interpreted science. ‘Moral entrepreneurs’, lacking in empathy for their fellow man, forge a career for themselves, glorying in their political and financial successes. For success breeds success and their relentless proselytising finds willing adherents. Government is attracted by the sense of decisiveness attached to prohibition. And the general public is guilty as well, our neighbourly intolerance lending widespread popular support to bans.

Prohibitionists find willing allies in the commercial rivals of those producing the product in question. Brewers supported the early US temperance movement, hoping to damage distillers. Modern pharmaceutical companies fear that the rise of tobacco substitutes like snus will undermine the market for nicotine patches.

Yet for all this, prohibition is doomed to founder on the rock of human desire. It is in our bones to seek out physical pleasure, sometimes at considerable cost. “When the law cuts off one avenue of pleasure, new sources are invariably found,” as Snowdon puts it. If there is any great demand for a certain product, be it food, drink, drugs or sex, then the risks of purveying it are met by colossal rewards.

The Art of Suppression is full of great facts – its description of opium-addicted Britain before the wars is particularly memorable. But its real impact is its pithy denunciation of the prohibitionist cause. It ends with a modest proposal for a more practical and tolerant approach to drugs of all kinds. In his modesty Snowdon does not hold much hope for implementation. But this book must make that goal more likely.

Read the rest here.

You can order The Art of Suppression from Amazon UK, Amazon USA, Barnes and Noble, Waterstones or directly from me.

Alcohol Concern's sleight of hand

2011-10-20T15:52:00.003+01:00

Alcohol Concern have a habit of using children in their opinion polls, presumably because young people tend to be stupid and impressionable, and therefore more likely to support neo-prohibitionist policies.

Their latest effort is so piss-poor that only The Guardian has bothered to cover it. It finds that...

Under-18s want more protection from alcohol marketing exposure

A survey of over 2300 children and young people reveals concern at alcohol marketing exposure and support for stronger regulation that robustly protects under-18s, finds Alcohol Concern

People under 18 can't buy alcohol and they can't vote, so as far as I'm concerned they can keep their opinions to themselves. But if some of the quotes reprinted in the report are genuine, we might as well pack our bags now. The final triumph of the nanny state cannot be far off.

“[Alcohol products] should contain shocking images like the image you see on packets of cigarettes, as you do not actually see how ill people can get from alcohol”

Female, 15 years-old

However, there are good reasons to doubt whether this survey is reliable.

The survey was disseminated via a targeted email (to youth groups, schools, local-authority youth services and interested individuals) and published on the Alcohol Concern website and on Twitter.

Indeed it was. Here is the tweet announcing it to the world...

The only to people to see this tweet would have been those who follow Alcohol Concern on Twitter, which is to say a self-selecting sample of temperance folk, 'public health professionals' and people like me who like to keep an eye on them. The people who visit the Alcohol Concern website are likely to have a similar bias.

These people will be predominantly adults but they might encourage their children to complete the survey, perhaps with a little helping hand.

Or they might just pretend to be children and fill it in themselves. After all, as the survey found, it is not hard to bypass online age checks...

Alcohol websites ask you to enter a date of birth to prove you are not under-18. Is this enough to stop under-18s from visiting these sites?

No, it's easy to enter another date: 78.2%

Yes, this is enough to stop me: 16.6%

Indeed. And this equally applies to Alcohol Concern's online survey which was strictly for the under-18s but whose only age verification process was this:

The survey itself was designed by 13 to 18 year olds (seriously) and it shows. A professional polling outfit would not resort to leading the witness as blatantly as this survey does. Take the introduction to the survey, for example (no longer online, but saved here):

Alcohol companies spend over £800 million each year in the UK on advertising (ads) to increase sales of their product. Under existing rules young people under 18-years-old should be protected from seeing most alcohol ads, but many studies show this isn't the case.

Today, advertising use technoloy to reach us in lots of different ways, like: TV; radio; cinema; billboard/posters; the internet; via mobile phones; through the sponsorship of music festivals and sports events; and even on football shirts... along with many other avenues.

You don't think all this talk of rampant alcohol advertising ("even on football shirts"!) and rules being breached could plant ideas in the respondent's mind, do you?

The report itself claims that...

The Youth Policy project specifically chose not to detail the existing alcohol-promotion regulations to The Voice or to survey participants, wanting to capture their expectations of alcohol-promotion regulation based on what young people see and hear around them.

These are weasel words. It is true that the survey doesn't "detail" the policies. Instead, it misrepresents them. Existing rules do not say that under-18s should be "protected" from seeing alcohol ads; it says that these ads must not target the under-18s. That is a big difference.

The report (and accompanying press release) emphasises in shocked tones that young people do not even recognise alcohol marketing when they see it.

The survey findings suggest that large numbers of young people regularly do not recognise alcohol marketing when it is channelled through sponsorship, product merchandise or via social networking sites – non-media channels known as ‘below the line’ promotion. Approximately half of young people do not consider alcohol promotion via such mediums as ‘marketing’, a finding which is consistent across both genders and all ages. This is of particular concern because investment in such strategies is increasing and is central to the alcohol industry’s efforts to associate with youth culture.

• 51.4% do not recognise official alcohol product Facebook groups as marketing

• 51.7% do not recognise alcohol branded events, such as festivals, as marketing

• 49.6% do not recognise alcohol sponsorship of football team shirts as marketing

• 49% do not recognise alcohol product merchandise as marketing.

The Guardian leads with this appalling insight into the ignorance of the young:

Most young people would like more protection from alcohol advertising, but under-18s do not recognise that drink logos on football shirts are a form of marketing, according to a survey.

This is extremely misleading. The question in the survey does not use the word 'marketing'. It uses the word 'ads'. Advertisements are clearly not the same thing as sponsorship, having a website or merchandising. All are forms of marketing, but they are not all forms of 'ads'. The actual question posed was:

Which of the following do you consider to be alcohol ads? (Tick as many boxes as you like)

• A viral video for an alcohol product

• Joining a Facebook group for an alcohol product (e.g. Smirnoff Facebook group)

• User generated content (e.g. an unofficial Facebook page for an alcohol product)

• A festival named after a product (e.g. Carling Weekend)

• A piece of alcohol product merchandise (e.g. Revolution bar’s ‘I love vodka’ t-shirts)

• Brand ambassadors (people who are paid to attend events and promote certain brands)

• Sponsorship of team shirts (e.g. football)

So, if you don't consider sponsorship to be an ad—which it isn't—or if you don't consider joining a Facebook group to be an 'ad'—which doesn't even make sense—then Alcohol Concern assume that you also don't think these things constitute marketing—which they are. This, they say, "is of particular concern."

Alcohol Con, on the other hand, are acutely aware of the difference between advertisements and marketing, which is presumably why they used the word 'ads' in the survey and the word 'marketing' in the report and press release. This sleight of hand is brushed over in the text of the report, which says...

"the term ‘ads’ was inserted by The Voice to encompass ‘marketing’, ‘advertising’ and ‘promotion’ as the group felt that these terms meant the same thing to most young people."

Well, it doesn't, and not all kids are as thick as the ones who allegedly designed this survey. The change from 'ads' in the survey to 'marketing' in the final report must be regarded as highly suspect.

And finally, just in case the respondents hadn't quite worked out what the pollsters wanted to hear, the last question in the survey was:

Would you like to be kept informed of a youth led campaign that will challenge Government to reduce the amount of alcohol advertising we see?

No hint of a bias there then. Considering the standard of the survey, we can perhaps take heart that the majority of respondents still opposed Alcohol Concern's desired policy of a total ban on alcohol advertising on billboards, television and cinema.

Although the evidence suggests that a total ban on alcohol advertising would significantly reduce youth drinking, the majority of young people surveyed are not supportive of such strong regulatory intervention.

It also interesting that the under-11s were much keener or bans than the 16-17 year olds. Which just goes to show that neo-prohibitionism is a childish ideology that most people grow out of.