Towards prohibition

I was spoke to Brent Stafford at Regulator Watch when I was at the Global Nicotine Forum in June. We discussed vaping, prohibition and why things will get worse before they get better. Here's the video.

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Has the ultra-processed food panic peaked?

 

Remember Joe Wicks, the chirpy gym bunny whose YouTube channel got children exercising during lockdown? He was quite famous in the spring of 2020 but was rather less famous five years later. In 2021, at the peak of its success, Joe Wicks Ltd. had £2,181,299 in the bank. By 2024, it had just £78,758. 

Whether the fading fame and fortune of Mr Wicks had anything to do with his decision to get onboard the bandwagon against ultra-processed food (UPF), we may never know, but it has certainly got him back on prime time TV. He has been on the breakfast sofa with Ed Balls and Susanna Reid, and viewers were treated to a whole hour of him on Channel 4 this week (Joe Wicks: Licensed to Kill). His promotional device is the “Killer” protein bar which he has created and is portraying as “the most dangerous health bar” ever. It supposedly causes cancer, stroke and heart disease — and yet it is legal! Why won’t the government do something?!

Inevitably, the documentary involves Wicks going on a poorly scripted “journey” to discover the truth about what is really going on in our food environment, blah, blah, blah. Equally inevitably, his tutelage leans heavily on the opinions of Chris van Tulleken who has recently been made a professor and is beginning to look as crazy as he sounds. For cinematic reasons, van Tulleken is portrayed as living in a dimly lit, underground laboratory surrounded by bottles of dangerous chemicals. The vibe is that of a strange but brilliant scientist who has accidentally unleashed the zombie apocalypse and is humanity’s only hope of ending it. Once Wicks gets to work manufacturing his unhealthy snack, van Tulleken occasionally surfaces with an intense stare, urging his youngish protégé to see it through to the end.

Read the rest at The Critic. 

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Dewi Evans' response to the latest Letby documentary

Dewi Evans has sent a response to journalists following the broadcast of Conviction (AKA Lucy Letby: Murder or Mistake) which I reviewed last week. He says it's free to be shared so here it is for anyone who might be interested... 

Danny Bogado, Rosy Milner and the Channel 4 team took on a challenging documentary (Murder or Mistake, Channel 4, 29 September 2025). Producing a 2 hours' documentary from evidence that took Cheshire Police several years to collect and led to the longest criminal trial in English legal history is in itself remarkable. 

It was a privilege to be considered the chief prosecution witness in a trial that has led to the lifelong incarceration of England’s worst female killer. Her conviction would not have succeeded without Cheshire Police’s diligence and attention to detail, and the evidence of my fellow independent witnesses and the numerous nurses and doctors from the Countess of Chester Hospital. The evidence of all the witnesses was crucial. 

Lucy Letby’s new barrister has broken new ground in launching an appeal via press and media, providing of course a very selective version of events. Mark McDonald helpfully summarised 6 issues on his agenda; the rota, the experts, air embolus, insulin, the neonatal unit, and the media. Despite his natural thespian skills and his considerable bravado Mr McDonald and his supporters failed to offer any evidence not disclosed at Letby’s trial, or would stand scrutiny at a clinical or scientific presentation or the rigours of cross examination. 

The relevance, or not, of the rota, and Letby’s presence, has been flogged to death. Peter Elston, statistician and investment manager, just could not understand the difference between information that is statistically significant and that which is clinically significant. Statistics will point you in a certain direction. It does not prove that something took place. It’s why statistics did not play a part in the prosecution’s case. Presumably it’s why the Defence did not seek a statistical explanation either. 

Private Eye’s Dr Phil Hammond claims credit for exposing the concerns regarding what became the Bristol Heart Scandal. He conveniently overlooks the fact that the same magazine took over 10 years to admit it got it wrong in relation to discredited medic Andrew Wakefield and his flawed MMR / autism claims. His claim that my diagnosis of air embolus was because I “couldn’t think of anything else” reflects his clinical limitations, not unexpected given he is best known as a comedian who writes for The Eye. My diagnosis of air embolus was supported by my fellow independent witnesses, belatedly by the Chester paediatricians, and backed up by 18 publications. 

Shoo Lee may well be an eminent epidemiologist. His experience of air embolus is limited to reporting 3 cases from the 1980s. More tellingly he has no background of medicolegal matters because “I don’t do medico-legal cases. I don’t like them”. Bogado's programme did not have time to include my detailed critique of his 2 published papers.  If his most recent paper (published in December 2024) had been available before the trial its content would have been very useful - for the prosecution. His criticisms of my role, disclosed at the press conference, were all factually incorrect. Summaries from other members of the Panel were awash with errors, some of the weakest reports I have seen during my career.

Given the time constraints it was inevitable that the documentary concentrated on just a couple of cases. The timing of Baby C’s collapse created confusion. In my very first report (7 November 2017) I raised concerns regarding the event late on Saturday 13 June 2015 that led to his collapse and death. Over the next 5 years the dates seem to have become confused, leading to the prosecution alleging that the assault took place the previous day. I recognised the confusion at the Trial, reaffirming my original concern that the fatal assault was late on 13 June. I believe that Cheshire Police, the CPS, and the Prosecution team should set the record straight. 

Back in 2017, when I first raised concerns regarding Baby C’s demise, I was unaware of Letby’s presence on the unit, let alone that she was up close to Baby C at the time of his collapse. There is nothing in Baby C’s clinical records to confirm Lucy Letby’s presence. 

Baby O’s demise was given considerable attention, and we were presented with some extraordinary explanations from British Columbia based neonatologist Richard Taylor and the Brighton duo of Neil Aiton and Svilena Dimitrova. According to them Baby O’s death was due to a cannula inserted into the baby’s abdomen 20 - 30 minutes before he died. This fails to explain why the baby was moribund, sadly at death’s door, before the cannula was inserted. For good measure Aiton claimed that the ventilator pressures used to resuscitate the baby were too high. This does not explain why the baby required resuscitation in the first place. He had never required resuscitation following his birth, and his collapse took place when in Lucy Letby’s care. The Taylor, Aiton, Dimitrova hypothesis has been widely condemned by others, including a pathologist who gave his opinion on a recent Panorama programme. Their opinion should be confined to the Donald Trump School of Evidential Science. 

The controversy regarding insulin poisoning has been widely explored. Professor John Gregory recently endorsed (on the same Panorama programme) the opinion of his fellow paediatric endocrinologist Prof Peter Hindmarsh, stating that baby F and baby M were both poisoned with insulin. Insulin poisoning had been accepted by Letby’s Defence team at the trial, and indeed by Lucy Letby herself. 

Criticism of the neonatal unit building was reasonable, and the unit has long moved to more suitable premises. Alleging that the department was “failing” or unsatisfactory is unfair and unreasonable. Survival rates, the best quality control of any neonatal unit, were as good in Chester as the ONS [Office of National Statistics] figures for England & Wales, even for the smallest babies. The Thirlwall Inquiry confirmed that staffing was similar to other units in the North West of England. 

Mark McDonald and his team failed to show any new evidence that would justify another appeal. Unhelpfully for him, this week’s Law Society Gazette article by Bianca Castro (26 September) states: “Conviction did not uncover anything new, a potential problem if the CCRC [Criminal Cases Review Commission] are to refer the case back to the Court of Appeal.”  

The victims in the Letby Trial are the babies harmed and murdered by Lucy Letby, and their families. A campaign to release England’s worst female serial killer is beyond my understanding. It adds to the hurt and grief the families have suffered for the past decade. 

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"Nicotine control" and the WHO

I wrote about the WHO for the Telegraph over the weekend. One of its Regional Directors has said that he wants to "erase" alcohol. In the article I discuss the malign influence of "Movendi" - the temperance group formerly known as the International Order of Good Templars - who are official partners of the WHO (fun fact: they are funded by the Swedish lottery).

 

Movendi is one of the “civil society” groups that Dr Piukala described as “essential” in his speech this week. Drinkers everywhere should be worried about a gospel temperance society collaborating with the world’s biggest health agency, although the WHO has become so puritanical and dogmatic in recent years that it is hard to know which of them is more extreme.

They both want to denormalise alcohol through advertising bans, licensing restrictions and sin taxes. They both claim that drinking is harmful at any level. They both compare alcohol to tobacco and equate the alcohol industry with the tobacco industry. This is no small thing when WHO Europe explicitly says that its goal is to create a society that is not just “tobacco-free” but “nicotine-free”.

 

More fool anyone who isn't worried about the direction of travel. The WHO didn't always want to eradicate tobacco. At one time, it would have accused anyone who suggested that it had prohibitionist intentions of being hysterical. They now explicitly want to eradicate not just tobacco but nicotine. If you don't think they would like to eradicate alcohol, even as a WHO Regional Director essentially says as much, then I am afraid that you are gullible.

 

On the point of erasing nicotine, Clive Bates points out that the UN's snappily titled Political declaration of the fourth high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases and the promotion of mental health and well-being has been made worse since it was first drafted. In the first draft, there was "only one asinine reference to nicotine" (a reference to electronic nicotine delivery systems), but now member states are urged to focus on "nicotine control".

 

This is supposed to be a statement about NCDs (i.e. cancer, cardiovascular disease, COPD, etc) finalised after a lengthy deliberative process. It is intended to focus on UN SDG Target 3.4, which aims to reduce mortality in adults aged 30-70 from major NCDs by one-third by 2030. The target that is likely to be missed by some distance. Yet, the text refers throughout to “tobacco and nicotine control” even though the primary driver of NCDs is not tobacco per se or nicotine, but smoke, including tobacco smoke.

  

The good news is that the UN was forced to water down some of the messaging in the final draft. For example, member states were told to "Increase taxation on tobacco, alcohol and sugar-sweetened beverages" in the first draft, but in the final draft this has been changed to "Consider introducing or increasing taxes on tobacco and alcohol to support health objectives, in line with national circumstances".

 

But its crusade against nicotine has been ramped up, with member states encouraged to:

 

(a) significantly reduce tobacco and nicotine use by: (i) implementing health warnings on all tobacco and nicotine packages; (ii) restricting tobacco and nicotine advertising

 

A nicotine-free world isn't going to happen. It is a pie in the sky prohibitionist fantasy. But, as I say in the Telegraph article, people can do a lot of damage reaching for Utopia. 

 

The irony is that, even if you think that using state coercion to create a smoke-free world is an ethical objective, it is made much more difficult if you fight a parallel war against nicotine, firstly because you will be using scarce resources on multiple targets and secondly - most importantly - because people are more likely to stop smoking if they can use a safer form of nicotine.

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Plain packs for vapes

The one-club golfers in 'public health' want plain packaging for vapes because of course they do. I've written about it for The Critic...

 

The epidemic of misinformation about the risks of vaping is one of the great public health disasters of the century and is all the more shameful for having been driven by people who have words “public health” in their job titles. The “popcorn lung” myth, the EVALI hoax and an endless series of tabloid scare stories — combined with the enduring misconception that nicotine causes cancer — have turned public understanding on its head. As the graph below shows, twice as many Britons think that vaping is as dangerous as smoking, if not worse, than correctly believe that it is far less harmful.

If vaccines or paracetamol were subjected to the same level of misinformation, public health professionals would be working frantically to move the public’s perceptions towards reality. Insanely, they are doing the opposite. The government’s Tobacco and Vapes Bill will give the health secretary Henry VIII powers to regulate vapes like cigarettes, thereby cementing the notion in the public’s mind that the health risks are comparable. The government is being cheered on by a motley assortment of fork-tongued “public health” academics and activists who pay lip service to the benefits of e-cigarettes while doing everything they can to suppress demand for them. 

A particularly egregious example of this was reported by the Independent this week. Members of the tiny, state-funded, prohibitionist pressure group Action on Smoking and Health have teamed up with researchers from King’s College to demand plain packaging for e-cigarettes. There is, of course, only one other product that comes in plain packaging: combustible tobacco. 

 

Do read it all. As an aside, one of the authors of the study is Deborah Arnott who memorably claimed that 'the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false'. She was campaigning for plain packaging at the time.

 

 

 

 

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A ban on lying

A new law is going through Parliament to ban public officials from misleading the public. It sounds like a good idea, but it has the potential to spiral out of control very quickly. I've written about it for The Critic.

 

The bear trap in the Public Office (Accountability) Bill is the unprecedented creation of a new criminal offence, punishable with up to two years in prison, of “misleading the public”. Section 11 of the Bill reads as follows:

A public authority or public official commits an offence if, in their capacity

as such an authority or official—

(a) they act with the intention of misleading the public or are reckless as

to whether their act will do so, and

(b) they know, or ought to know, that their act is seriously improper.

The reason journalists prefer to use cumbersome words such as “falsehood” and “untruth” rather than the more direct “lie” is that it is inherently difficult to prove that a person has deliberately fabricated something rather than made a simple mistake. The Bill attempts to swerve this problem by making it a crime to be “reckless” about misinformation, but this is so vague as to give lawyers a ludicrous degree of latitude. If the person knows – or “ought to know”! – that their untruth is “seriously improper”, they could face jail, but what is “seriously improper”? According to the Bill, it is anything that “a reasonable person would consider … to be seriously improper”. So that clears that up. It is also anything that “caused, or contributed to causing, harm to one or more other persons”. But what is “harm”? The Bill defines it as “physical harm, psychological harm (including distress) and economic loss”. This, again, seems rather broad.

On the face of it, this appears to mean that if any of the state’s six million employees says something untrue which someone else finds upsetting, they have committed a crime. Whether they are convicted will depend on a jury believing, firstly, that the individual knew that what they were saying was untrue — or were “reckless” in not checking whether it was true — and, secondly, that they knew that it would cause “psychological harm”. 

This example might seem a bit reductio ad absurdum, but assuming the worst is not a bad way to test legislation in the current year. Section 11 takes up barely a page of the 66 page Bill and leaves so much open to subjective judgement that it is impossible to predict how it will be used, but it is not difficult to see how it could be weaponised for political reasons. The most obvious targets will be politicians themselves. In the future, when you see an MP on Question Time claiming that Liz Truss crashed the economy or that the Tories spent £37 billion on an app, instead of complaining about it on Twitter, you can call the police, citing emotional distress.

 

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The lifestyle medicine of Aseem Malhotra

 

Taking a rare break from trying to free Lucy Letby, Private Eye's Phil Hammond has written a justified excoriation of the star turn at Reform UK's recent conference, Aseem Malhotra. I agree with most of it and I have said same much the same myself, but I was struck by this sentence...

 

Malhotra is particularly dangerous because he talks sense in some areas (eg. lifestyle medicine) while spouting scaremongering conspiracies with no credible evidence base.

 

When, exactly, did Malhotra ever talk sense about "lifestyle medicine" or anything else? When he said that saturated fat was good for you? When he said that exercising won't help you lose weight? When he said that Italians have a low carb diet? 

 

Perhaps Hammond is thinking about the time when he claimed that sugar was the new tobacco, but that's not really based on "credible evidence", is it? 

 

Or perhaps he's thinking about when he claimed - in a journal article that had to be corrected - that the food industry has been “buying the loyalty of bent scientists". Doesn't that sound like a scaremongering conspiracy theory?

 

Maybe he's thinking about the time he said that people who have high cholesterol live longer than people who don't, and that Big Pharma doesn't want you to know that? Again, that sounds like a bit of a scaremongering conspiracy with no credible evidence base to me.

 

You can go back as far as you want but you will not find Malhotra "talking sense" about anything. All that has happened is that he has swapped high status conspiracy theories for low status conspiracy theories. 

 

What makes Malhotra dangerous is not that he talks sense but that he abuses the trust that people have in doctors by cherry-picking evidence to suit a particular narrative. He's been doing it from the start. That is why he was able to hide in plain sight among 'public health' campaigners for so long.

 

 

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