Friday, 14 December 2018

Calories found in restaurant meals

A study appeared in the BMJ yesterday claiming (correctly, it seems) that sit down restaurant meals tend to have more calories in them than fast food meals. The authors found that the vast majority of meals served in restaurant chains exceed ‘public health recommendations for energy content’. Those recommendations have no scientific basis and were plucked out of the air by Public Health England last December, but they are now being treated like government targets.

I wrote at the time...

The idea of having 'limits' for individual meals is entirely new and I suspect that there is an agenda at work here. The 400-600-600 'rule' will allow PHE and its army of scolds to name and shame every restaurant portion, takeaway and ready meal that contains more than the government-approved quantity of calories. Individual meals will be portrayed as hazardous per se and will become targets for advertising bans, taxes and reformulation. A whole Pandora's Box is being quite deliberately opened.

So it turned out. The next phase of Public Health England's crazy reformulation scheme involves pressuring restaurants and cafés into degrading their businesses.

I've written about this for Spectator Health... 

It is less than a year since Public Health England told us that we should be consuming no more than 1,600 calories a day from meals. Specifically, we must limit breakfast to 400 calories while lunch and dinner should be capped at 600 calories. Since grown men are told by the same quango that they should be consuming 2,500 calories a day, this implies that Public Health England wants us to get through 900 calories a day from sugary drinks, snacks and alcohol. Some realistic health advice at last!

No other country on Earth issues guidelines on how many calories should be in a meal, and there is absolutely no evidence behind PHE’s 400-600-600 rule, but there was method in the agency’s madness. Behind the scenes, it is busy trying to cajole restaurants and cafés into accepting the same policy of shrinkflation and food degradation (AKA ‘reformulation’) that it has foisted on the rest of the food industry.

Do read the rest.

Thursday, 13 December 2018

Lowering the drink-drive limit had no effect in Scotland

Drunk driving isn't a very popular cause, and rightly so. It is obviously wrong to risk the lives of others by driving while inebriated. By contrast, driving after consuming a small quantity of alcohol poses no threat to others and is fine, but it is this that the temperance lobby is going after. It's so much easier to hassle normal people for having a pint after work than to clamp down on the dwindling number of habitual drunk-drivers.

Always eager for an easy, feel-good headline, the Scottish government voted unanimously in favour of reducing the drink-driving limit from 80 mg of alcohol per 100 ml of blood to 50 mg of alcohol per 100 ml of blood. The change came into effect in December 2014. The rest of the UK kept it at the same level.

The new law was announced with the usual smug, patriotic, self-righteous rubbish from the politicians responsible:

Scotland's Justice Secretary Michael Matheson has predicted the lower limit will save lives.

Mr Matheson said: "Scotland is leading the way across the UK. The new limit has backing from experts, road safety campaigners and the majority of the public north and south of the border."

Amongst the "experts" were our old friends at the Sheffield Alcohol Research Group. You may remember them from their game-changing modelling of minimum pricing. Less well known is their modelling on what would happen if the drink-driving limit was reduced from 0·08 g/dL from 0·05 g/dL. Their model was limited to England and Wales but their conclusion should broadly apply to Scotland as well. It predicted that...

...lowering the legal limit would reduce fatalities by 6.4% and injuries by 1.4% in the first year after its implementation.

Evidence has steadily emerged over the last few years showing that the reduction in the limit has had absolutely no effect on road traffic accidents or fatalities. For example...

The study by Strathclyde University found that the lower limit for blood alcohol content (BAC) had not been followed by a statistically significant overall drop in road fatalities, including during the peak accident periods of night-time and weekends.

There was also little change in the death rate for young drivers aged 16-25, who are seen as one of the highest-risk groups for drink-driving.


The introduction of a lower drink-drive limit in Scotland has had virtually no impact on the rates of offending, police statistics have revealed.

None of this has made any difference to policy. Nanny state legislation is never repealed.

What is clear, however, is that the legislation has had a predictably negative effect on rural pubs. The pub trade and the Campaign for Real Ale said that it was hurting trade without bringing about any reduction in road accidents, but they were ignored. The Scottish government paid no attention and the puritans probably considered the damage to the evil booze industry to be a bonus.

Today, the reality has emerged in the Lancet of all places:

Lowering the driving BAC [blood alcohol content] limit to 0·05 g/dL from 0·08 g/dL in Scotland was not associated with a reduction in RTAs [road traffic accidents], but this change was associated with a small reduction in per-capita alcohol consumption from on-trade alcohol sales.

Note the use of the word 'but', as if the total failure of the policy is compensated by the success in reducing pub sales. For the 'public health' lobby, the destruction of pubs counts as a success. It's never really about health.

Not only does the study show no benefit from the change, the authors find that the number of road traffic accidents has increased relative to England and Wales:

...the reduction in BAC limit for drivers was not associated with a significant change in weekly RTA [road traffic accidents] rates in Scotland, after adjustment for seasonality and underlying temporal trend (model c; rate ratio [RR] 1·01, 95% CI 0·94–1·08; p=0·77; table 2).

Further, relative to England and Wales, where the reduction in BAC limit for drivers did not occur, we found no change in weekly RTA rates after this reduction in BAC limit for drivers in Scotland (model c; 1·07, 0·98–1·17; p=0·10).

Further adjustment for the driver characteristics of age, sex, and socioeconomic deprivation produced similar results, showing a significant 7% increase in weekly RTA rates in Scotland relative to England and Wales (model d; 1·07, 1·02–1·13; p=0·007).

The latter finding is based on a counter-factual and is therefore speculative but it is now beyond doubt that there have been no benefits to road safety from the Scottish government's decision to lower the drink-driving limit.

In a desperate attempt to salvage something from this pub-destroying policy, the authors suggest that the failure to reduce drink-driving accidents is due to a lack of enforcement:

One plausible explanation is that the legislative change was not suitably enforced—for example with random breath testing measures. Our findings suggest that changing the legal BAC limit for drivers in isolation does not improve RTA outcomes.

In truth, this is far from 'plausible'. The study itself shows that pub sales fell after the law came into effect, and the pub trade has been complaining about the negative effect on business almost from the outset. Both of these facts suggest that people in Scotland have been abiding by the new law. Enforcement has nothing to do with it.

A more likely explanation is that drink-driving accidents are caused by people who are heavily intoxicated, not by people who have consumed a trivial amount of alcohol. Therefore, clamping down on motorists who are not in the least bit drunk was never likely to tackle the damage done by drunk-driving.

Anyone with a bit of common sense could have told the SNP that in 2014. Instead they chose to believe some expensive guesses from the clowns at Sheffield University (not for the last time).

Will the limit be changed back? Of course not. Was the ban on alcohol discounts repealed when it was shown to have had no effect? No. Will minimum pricing be repealed if it is shown to have no effect? No.

As I have said many times, 'public health' is not a results-driven business.

Tuesday, 11 December 2018

Science and Technology Committee on e-cigs - the government responds

The government has responded to the Science and Technology committee's report on e-cigarettes and there are some encouraging signs. In particular (emphasis is mine)...

Recommendation 5 The Government, together with the ASA and the MHRA, should review all these regulatory anomalies and, to the extent that EU directives do not present barriers, publish a plan for addressing these in the next annual Tobacco Control Plan.

The Government broadly accepts this recommendation and is committed to reviewing tobacco legislation as and when appropriate. While the UK Government is a member of the EU it will continue to comply with the requirements of the EU’s Tobacco Products Directive 2014/40/EU (TPD), transposed into UK legislation through the Tobacco and Related Products Regulation 2016 (TRPR). The Government has made a commitment to review the TRPR by May 2021 to consider its regulatory impact. In addition, as announced in the Tobacco Control Plan the Government will review where the UK’s exit from the EU offers us opportunities to re‐appraise current regulation to ensure this continues to protect the nation’s health. The Government will explore those areas identified by the Committee, such as the 20mg/ml maximum nicotine refill limit, a size restriction of 2ml on the tank, a block on advertising e-cigarettes’ relative harm-reduction potential and the notification scheme for e-cigarette ingredients.

Although there are advertising restrictions on vaping, they are less stringent than those which apply to tobacco products. The Government will of course consider when it reviews the legislation whether these restrictions fully reflect the differing risks of harm arising from tobacco products and e-cigarettes. We would note to the Committee that the Government has issued a direction to Ofcom clarifying that under the current code on television and radio advertising it is permissible for public health campaigns to promote the generic use of e-cigarettes for quitting smoking. This direction will support campaigns such as Stoptober which have promoted the use of e-cigarettes for quitting.


Recommendation 7

The Government should conduct a review of regulations on e-cigarettes and novel tobacco products which are currently applied under EU legislation, to identify scope for change post-Brexit, including an evidence-based review of the case for discontinuing the ban on ‘snus’ oral tobacco. This should be part of a wider shift to a more risk-proportionate regulatory environment; where regulations, advertising rules and tax/duties reflect the evidence on the relative harms of the various e-cigarette and tobacco products available. While an evidence-based approach is important, it also may help bring forward the behaviours that we want as a society—less smoking, and greater use and acceptance of e-cigarettes and novel tobacco products if that serves to reduce smoking rates.

The Government accepts this recommendation. We have committed in the Tobacco Control Plan to review where the UK’s exit from the European Union offers us opportunities to re-appraise current regulation to ensure this continues to protect the nation’s health. We will look to identify where we can sensibly deregulate without harming public health or where current EU regulations limit our ability to deal with tobacco. The Government’s goal will remain to achieve a proportionate approach to managing risk, one which protects the young and non-smokers, whilst giving smokers access to products which will reduce harm. As part of this the Government will consider reviewing the position on snus and whether the introduction of this product onto the UK market would promote that kind of proportionate harm reduction approach.

The report also recommends that heated tobacco products should be taxed at a lower rate than cigarettes (a much lower rate is implied). You can read the response here.

Friday, 7 December 2018

The whole population approach doesn't work

The latest stats on alcohol-related mortality were published this week. According to the Whole Population Approach beloved of temperance/'public health' campaigners, a significant decline in alcohol consumption must lead to a commensurate fall in alcohol-related deaths.

It's what the World Health Organisation believes:

... lowering the population mean for alcohol consumption will also predictably reduce the number of people suffering from alcohol abuse.

And it is the official policy in Scotland and Ireland. As Alcohol Focus Scotland say (emphasis in the original):

The specific outcome of the Scottish Government’s alcohol strategy is to achieve a reduction in overall alcohol consumption.

Moreover, the theory suggests that reductions in mortality should happen rapidly because the 'lag effect' is minimal. Some benefits are apparent almost immediately, other take no more than a few years.

It is now 14 years since per capita alcohol consumption peaked in the UK. According to the latest BBPA figures, consumption among people aged 15+ fell from 11.6 litres to 9.7 litres between 2004 and 2017. This is a fall of 16.4 per cent.

So how has the biggest decline in drinking since the war impacted alcohol-related mortality?

Age-standardised alcohol-specific death rates per 100,000 people (UK)

2004:  11.5

2017: 12.2

Can we put this myth to bed now?

Thursday, 6 December 2018

The gambling industry feeds the crocodile

Farewell, sweet prince

From the BBC...

Gambling firms agree 'whistle-to-whistle' television sport advertising ban

Britain's biggest gambling companies have voluntarily agreed to a "whistle-to-whistle" television advertising ban.

The Remote Gambling Association (RGA), which includes Bet365, Ladbrokes and Paddy Power, has struck a deal to stop adverts during live sports broadcasts.

It follows political pressure about the amount of betting advertising on TV.

This is not wholly surprising. In recent months, some of the big players have come out in support of the further restrictions on gambling ads. Why would a business want its commercial speech to be curtailed? There are three possibilities.

Firstly, incumbent businesses tend to benefit from advertising bans because they raise a barrier to entry for new competitors.

Second, advertising does not increase aggregate demand (contrary to what campaigners claim) and is a zero-sum game. There is a large element of game theory to it. Each company advertises because the other companies are advertising. If one company doesn't keep up, it will lose market share, but if all the companies give up at the same time, they save a great deal of money. This is exactly what happened with tobacco.

Thirdly, the industry hopes to fend off further regulation by capitulating on this issue. There is a belief that the bookies could have avoided a £2 stake if they had voluntary reduced the stake below the controversial £100 mark (very few people gambled at £100 a spin anyway). Anti-FOBT campaigners Derek Webb and Matt Zarb-Cousin were probably right when they said in 2017...

“If [the gambling industry] had the ability to understand who we were and accept what the truth is, then they could have come up with [a maximum stake] of £20 a few years ago, and they might have got away with it,” says Mr Webb.
“Not now. It’s too much of an issue now,” adds Mr Zarb-Cousin.

But you only to read the BBC's article today to see that the voluntary ban will encourage, not prevent, further statutory regulation...

Could shirt sponsorship be next?

Matt Zarb-Cousin is a spokesperson for Fairer Gambling, a not-for-profit entity campaigning to reduce gambling-related harm and crime.

It is long overdue, there has been a huge amount of pressure on the sector over the volume of advertising which has increased exponentially year on year.

But for it to be truly effective, it should also include shirt and league sponsorship and digital advertising around a pitch.

Will it make a difference?

Marc Etches is the chief executive of GambleAware, a leading charity committed to minimising gambling-related harm.

We have been saying for a long time now that gambling is being increasingly normalised for children. They are growing up in a very different world than their parents, one where technology and the internet are ever present.

So while we welcome this move by betting companies, it is important to pay attention to analysis that shows the marketing spend online is five times the amount spent on television.

Without missing a beat, these anti-gambling campaigners have moved onto sponsorship and online advertising. What defence is the industry going to put forward for these forms of advertising now that it has implicitly accepted that gambling advertising is an evil?

Businesses should be far more robust in defending their right to free speech. Neither they nor the broadcasters have sold the benefits of advertising to the public.

I have a particular interest in this as a snooker fan. The game suffered terribly when tobacco sponsorship was banned. Prize money fell dramatically, as did the number of events. For a while, the entire sport only had five or six tournaments a year. In recent years, Barry Hearn has done a fine job of reviving the game by selling TV rights and getting new sponsors, most of which seem to be gambling companies. For example, the Betway UK championship is currently being played. In January, the Dafabet Masters will begin.

There are now more tournaments than ever and most of them are shown on Eurosport. Eurosport is a relatively niche channel which largely relies on gambling ads. The ads are shown between frames. A 'whistle to whistle' ban would be ruinous. A fall in advertising revenue would reduce the value of TV rights which would mean less money going into the game. Same applies to a ban on sponsorship.

Note that the proposal is not actually 'whistle to whistle'. According to the BBC, 'no adverts will be broadcast for a defined period before and after a game is broadcast' in addition to during the game.

Note also that a 'whistle to whistle' ban is the policy of the Labour Party, not the government. The fact that the industry has introduced such a ban to prevent the government doing it first tells you where Theresa May gets her policies from. To quote Webb and Zarb-Cousin again...

The campaigners also cite last year’s referendum on UK membership of the EU, which led to Theresa May becoming prime minister, as a key moment.
Mr Zarb-Cousin describes Mrs May as a “Red Tory” — a social conservative less inclined to listen to industry claims that curbs to FOBTs would lead to job losses at betting shops. “It’s one of the most important positives of Brexit,” says Mr Webb.

He adds he may broaden CFG’s focus to target online gambling next. “I want to fight where I can win,” says Mr Webb.

Say what you like about the casino tycoon and his young apprentice but they know what they're doing and who they're dealing with.

Wednesday, 5 December 2018

Temperance censorship

I'm late to this because I've only just come across it, but print workers in Lithuania are having to cover up alcohol ads in imported magazines to protect people from the sight of booze. A small country of less than three million souls, it imports a lot of foreign magazines, but it's either that or ripping the pages out completely, as Reuters reports...

Print distributors in Lithuania are being forced to tear pages out from magazines such as Vogue and National Geographic after the country introduced an alcohol advertising ban on Jan. 1.

The situation is an unintended consequence of an alcohol control bill signed into law in June by President Dalia Grybauskaite, who herself likened the outcome to medieval times and said it brought shame on the country.

It certainly looks a bit totalitarian when you see the photos of them at work...

Banning advertising is censorship, plain and simple. Needless to say, the Alcohol Health Alliance wants to follow in Lithuania's footsteps with a total ban on alcohol advertising and sponsorship.

Bartasevicius said the country’s largest retail chain had refused to stock the altered magazines, deeming them “damaged goods”.

However, he said the publishers of National Geographic had told him they could not create an edition of a magazine free from alcohol ads for a country which only sells up to 500 copies of a title per month.

Politicians do not yet have any solution to a problem they have created.

Sounds familiar.

“It is reminiscent of medieval times and it brings international shame on Lithuania,” Grybauskaite told reporters on Wednesday. “We must have laws without such flaws.”

This is what happens when you let the ignorant zealots of the 'public health' lobby make laws. They neither know nor care about the unintended consequences. To quote H.L. Mencken, their solutions are clear, simple and wrong.

We're going to see this kind of unravelling in the UK where the government has taken naive ideas from fanatics and imported them wholesale into its ludicrous obesity strategy policy.

Tuesday, 4 December 2018

Energy drinks are safe so let's have minimum pricing!

The Science and Technology Committee published its review of energy drinks today and found no scientific justification for banning their sale to minors.

In our view, there is insufficient evidence as to whether children’s consumption habits are significantly different for energy drinks compared with other caffeinated products such as tea and coffee.

.. On balance, we conclude that the current scientific evidence alone is not sufficient to justify a measure as prohibitive as a statutory ban on the sale of energy drinks to children. Single portions are within the European Food Safety Authority’s suggested limit for caffeine intake by children. This limit may be exceeded if other products containing caffeine are also consumed, or if energy drinks are consumed in excess, but the same can be said for many products available for sale to young people, including other drinks containing caffeine.

Recognising that the government is already committed to this policy, the committee adds that it might still want to introduce a ban 'on the basis of societal concerns and qualitative evidence, such as the experience of school teachers'. If so, the government 'should set out the reasoning for its decision.'

I, for one, look forward to hearing the government explaining why it ignored empirical, scientific evidence in favour of anecdotes from teachers.

The ban on energy drink sales to under-18s has always been a solution looking for a problem. As I said in August, it is arbitrary and illogical. If the issue is caffeine - and if a ban to minors is appropriate - then the logical approach is to ban the sale of caffeinated products to children. If the issue is sugar (the proposed ban is part of the childhood obesity strategy) then it should logically be extended to all products which contain a similar quantity of sugar/calories.

Neither approach would strike the general public as reasonable or proportionate and so the government has to portray energy drinks as being in some way special. But why? A can of Red Bull has less caffeine than a cup of filter coffee and the sugar content of energy drinks is no higher than that of Coca-Cola. I dare say the zealots who pushed this policy on the government would like to ban the sale of sugar and caffeine, but we are not there yet.

So how has the 'public health' lobby reacted to the Science and Technology Committee's evidence-based conclusion?

Professor Russell Viner, President of the Royal College of Paediatrics and Child Health (RCPCH) said it was "disappointing not to see a recommendation today to ban the sale of these drinks to children.

"We believe that the evidence is already compelling that energy drinks bring no benefits and only harm to children."

Well, Russ, you are wrong.

Prof Viner said the Government should introduce "a minimum price for energy drinks as we know their cheap price tag is a key driver for their purchase".

Talk about doubling-down! On the day that a cross-party committee recognises that these products are safe, Russell Viner demands not only their sale be banned to minors but that the price be hiked up for adults.

If the name Russell Viner rings a bell it's because the government gave him £5 million in 2017 to carry out research and give 'independent advice to policy makers'. This is not the first time he has made statements that fly in the face of evidence. Not very encouraging is it?