Friday, 25 June 2021

Boris the nanny

On Boris's food advertising ban in the Spectator...

Within hours of the new policy being announced, Boris Johnson tweeted a photo of himself tucking into a Jam ’n Cream Ring at the Fox’s Biscuits factory in Batley. Had his spin doctors let him down with bad timing? Or was it a cry for help from a Prime Minister who finds himself pushing nanny state policies that were too extreme for his predecessors and which he would have ridiculed without mercy if he was still a journalist? 



Wednesday, 23 June 2021

Smileys revisited

I've written for CapX about the latest smiley variant. The arguments continue to mutate and become more virulent.

This is all nonsense and easy to disprove. The more interesting question is why they want to believe the vaccines are useless. Why are people who were insistent that there would be no second wave last winter because of herd immunity so sure that there will be a massive wave this winter despite 87% of adults already having antibodies? Why has there been such a shift towards anti-vaxxing among lockdown sceptics, including some of the most prominent figures, such as Piers Corbyn, Michael Yeadon and Naomi Wolf (all of whom have been kicked off Twitter)?

When I wrote about the smiley phenomenon in January, I pointed to the power of confirmation bias. None of us wanted this pandemic and its lockdowns. If someone tells us that it is all hoax and it’s just the flu, we want to believe them. But why would anyone want to believe that there is no end in sight?


Tuesday, 22 June 2021

The WHO's war on vapers

I had an article up at ConHome last week about the WHO's forthcoming conference on tobacco and why vapers should care about it. 

The World Health Organisation’s decision last month to give a special award to India for banning the sale of e-cigarettes was proof that the agency has no intention of taking an ethical and evidence-based approach to tobacco harm reduction. This puts it squarely at odds with countries such as the UK and New Zealand which have successfully embraced vaping as part of their tobacco control strategy.

In November, the WHO will hold its ninth Framework Convention on Tobacco Control Conference of the Parties (COP9). The Framework Convention on Tobacco Control (FCTC) is the first and, to date, only international treaty of the World Health Organisation. Adopted in 2003 and signed by 168 countries, it explicitly defines tobacco control as “a range of supply, demand and harm reduction strategies”. Unfortunately, harm reduction is unlikely to feature much at the conference, except as an object of derision and contempt.

.. But there is a phrase in medical ethics that is relevant to this debate: “Nothing about me without me”. Vapers have little chance of being even being allowed to view COP9 online, let alone being permitted to speak at it. Their only hope is to contact their elected representatives and demand that pressure be put on the FCTC to take a more open and evidence-based approach. COP meetings fly under the media’s radar and that is how the FCTC Secretariat likes it. It thrives in darkness.

Journalists should ask more questions about what goes on in these meetings. Governments which recognise vaping’s potential to lower smoking rates and save lives should make that case strongly at COP9. They should pick strong, articulate advocates as their delegates, not bureaucrats. If the WHO continues to spread misinformation about e-cigarettes and if COP9 is held in secret again, these governments should withdraw their funding of the FCTC Secretariat. The FCTC Secretariat should be put on notice. COP9 is the last chance for the WHO FCTC to mend its ways and operate as a transparent and evidence-based organisation. If it cannot be reformed, it should be disbanded.

The conference is being held entirely online this year. In a sane world, that would mean that it is live-streamed so everyone can see it. I doubt that will happen, but vapers need to make as much noise as possible because I have a feeling the hammer is going to fall quite soon.
As evidence, I present you with the recently published WHO Technical Report 1029 which mostly looks at heated tobacco products. It's a weighty document of more than 300 pages and must have taken someone quite a bit of time to write. They needed have bothered because the conclusions were preordained. In particular, it tells governments...
to apply the most restrictive tobacco control regulations to heated tobacco products (including the device), as appropriate within national laws, taking into account a high level of protection for human health;

to prohibit all manufacturers and associated groups from making claims about reduced harm of heated tobacco products, as compared with other products, or portraying heated tobacco products as an appropriate approach for cessation of use of any tobacco product and to ban their use in public spaces unless robust independent evidence emerges to support a change in policy;

to ban all commercial marketing of electronic nicotine delivery systems, electronic non-nicotine delivery systems and heated tobacco products, including in social media and through organizations funded by and associated with the tobacco industry;

to prohibit the sale of electronic nicotine delivery systems and electronic non-nicotine delivery systems in which the user can control device features and liquid ingredients (that is, open systems);

You can read the whole article here.

Monday, 21 June 2021

The hounding of Katherine Flegal

Way back in 2013, I wrote about a meta-analysis published in the Journal of the American Medical Association which assessed 97 individual studies encompassing a total sample group of 2.88 million people. It found that people who are overweight have a slightly reduced risk of mortality compared to people of 'healthy' weight (RR = 0.94 (0.91-0.96)).

I first wrote about it when it was published because the BBC was using the old trick of putting criticism of the study front and centre. 

There are two ways to report news that divides opinion.
The first is to report what has happened and then include comments from those who have a view on it, including critics. 
The second is to lead off with disparaging comments from the critics so that the news itself becomes incidental. 
This latter approach amounts to poisoning the well and is mainly favoured by propagandists and media outlets which have a blatant editorial bias. So, with that in mind...

From the BBC:

'Weight is healthy' study criticised

A study which suggests being overweight can lead to a longer life has caused controversy among obesity experts.

One labelled the findings a "pile of rubbish" while another said it was a "horrific message" to put out.

The criticism from certain people was fierce. So fierce as to suggest a religious schism rather than a scientific debate. Tam Fry, from the National Obesity Forum, said: 
"It's a horrific message to put out at this particular time. We shouldn't take it for granted that we can cancel the gym, that we can eat ourselves to death with black forest gateaux." 
That was a bit of a straw man, but it was constructive and courteous compared to the quote from veteran anti-obesity crusader Walter Willett of Harvard School of Public Health:

"This study is really a pile of rubbish and no one should waste their time reading it."
As I wrote at the time...

How heartening it is to see the spirit of intellectual enquiry thriving at the Harvard School of Public Health. Perhaps Dr Willett and his friends will make a bonfire out of copies of the Journal of the American Medical Association and dance around it.

And that is pretty much what he did. As Nature subsequently reported, Willett "organized the Harvard symposium—where speakers lined up to critique Flegal's study—to counteract that coverage and highlight what he and his colleagues saw as problems with the paper."
The study's lead author, Katherine Flegal, has now written a full account of what happened and it really shows what you leave yourself open to when you get on the wrong side of 'public health' activists. The data she had was fine and her findings have been replicated many times. Her critics' problem was not really with the data but with 'the message' her findings supposedly sent out. This was obvious from Tam Fry's comment above as well as subsequent comments made by Walter Willet, such as...

Studies such as Flegal's are dangerous, Willett says, because they could confuse the public and doctors, and undermine public policies to curb rising obesity rates.

“There is going to be some percentage of physicians who will not counsel an overweight patient because of this,” he says. Worse, he says, these findings can be hijacked by powerful special-interest groups, such as the soft-drink and food lobbies, to influence policy-makers.
... Willett says that he is also concerned that obesity-paradox studies could undermine people's trust in science. “You hear it so often, people say: 'I read something one month and then a couple of months later I hear the opposite. Scientists just can't get it right',” he says.
“We see that time and time again being exploited, by the soda industry, in the case of obesity, or by the oil industry, in the case of global warming.”

And so she was attacked and hounded. It turns out that this process had been going on since 2005 when, as a scientist at the CDC, she published a study which...
...found that overweight was associated with slightly but significantly fewer deaths than normal weight. A quick glance at the literature suggested that our findings about overweight were not particularly unusual. We were unprepared for the firestorm that followed.

You should read the whole article (no paywall), but here are a few lowlights from her experience:

I fielded dozens of press calls as soon as our article was published. To my surprise, after the first few hours, many of the journalists who called me had already spoken to a professor, Walter Willett, (let's call him Professor 1) from a prestigious school of public health (PSPH). He was not a statistician and had no expertise in estimating the number of deaths associated with obesity. Our article was not intended to have anything to do with his work. He had apparently begun pre-emptively contacting the press, inserting himself into the discussion, positioning himself as an expert, and providing negative and antagonistic comments on our article before reporters had spoken to me. He used strong language to disparage our article, describing it as “really naive, deeply flawed and seriously misleading”.

.. In the same year, a post-doc at PSPH posted the following on a blog: “Numbers from Flegal's paper had been subsequently RETRACTED [sic] by the CDC, and she has subsequently been demoted at the CDC for writing the erroneous paper.” Every single one of these statements was false. CDC had not retracted our findings, and I had not been demoted. In fact, our paper had received CDC's highest science award, the Shepard award, in 2006.

.. Around the same time, some unusual statements were anonymously inserted in the Wikipedia entry on “overweight.” These statements asserted with no references that our article had been “widely discredited and regarded as fatally flawed by researchers from the Harvard School of Public Health, Harvard Medical School, American Cancer Society, and even the CDC agency itself, which has backtracked on the findings from the Flegal report.” This was part of what appeared to be an ongoing campaign to present our article incorrectly as having been repudiated by reputable sources.

.. In 2007, I accepted an invitation to give a named lecture at the 2008 meeting of a scientific society. The invitation included no mention of a rebuttal. When I received the final program a month before the meeting, to my surprise Professor 2 from PSPH had been added as a rebuttal speaker. This is an unusual way to treat an invited lecturer. As part of Professor 2's rebuttal, he presented a slide supposedly “based on” our research that strangely showed precisely the opposite of what we had found. It turned out that Professor 2 and his group had misunderstood a table in our published article and misinterpreted the results. Although I wrote him an email to clarify the table, Professor 2 and his colleagues nonetheless submitted an article for publication with the same errone- ous analysis. Fortunately, their article was rejected. This led me to realize that if such an article were to get published with such an erroneous analysis, it would likely be quite difficult for me to ever correct the situation. This episode as well as others also led me to realize that some, perhaps many, of our critics had very little understanding of our article.

.. Another line of attack was something like “this is just one study.” According to the 2007 hit piece in Scientific American, “Decades of re- search and thousands of studies have suggested precisely the opposite ...”, adding “Flegal is not necessarily wrong, but the preponderance of evidence clearly points in the other direction.” In fact, many other studies had already shown no excess mortality associated with overweight. The 2013 obesity guidelines put out jointly by the American Heart Association, the American College of Cardiology and The Obesity Society, also reported the finding that overweight did not appear to be associated with excess mortality, rating the strength of the evidence as “moderate.” Professor 2 was a coauthor of these guidelines. 

The initial intent of these attacks seemed to be to discredit our work completely. They employed denigrating and insulting remarks (“rubbish,” “ludicrous,” “complete nonsense,” “fatally flawed and widely discredited”) implying that our work was not worthy of serious consideration. There were also suggestions that we were unqualified, and my integrity and competence were questioned. Some attacks were surprisingly petty. At one point, Professor 1 posted in a discussion group regarding salt intake that JAMA had shown a track record of poor editorial judgment by publishing “Kathy Flegal's terrible analyses” on overweight and mortality. Similarly, again using a diminutive form of my name, Professor 1 told one reporter: “Kathy Flegal just doesn't get it”. It became clear that one of the things that critics found disturbing was that what they called the “lay media” or the “popular press” (which apparently extended to the New York Times, Scientific American and even Nature, a leading scientific journal) had reported on our findings as though they were worthy of serious discussion. One of the effects of the public insults may also have been to deter or intimidate other investigators. An anonymous researcher was quoted elsewhere as saying if character assassination is the price for publishing data that contradicts established beliefs, fewer academics will be willing to stick out their necks and offer up fresh thinking.

This is the 'public health' playbook. When the evidence doesn't go your way, resort to appealing to authority (as Flegal says, Willett is a leading academic in nutrition but not in the kind of work she does). Resort to the media (the BBC was only too happy to slant its coverage in their direction). Resort to editing Wikipedia, to holding one-sided symposiums, to fiddling the figures and to personal abuse. 
We've seen it before with the Australian sugar 'paradox' and very recently with vaping. Even John Snow got this treatment when he contradicted miasma theory. As far I can tell, the only part of the playbook that was not employed in this instance was accusing Flegal of being funded by 'Big Food', but I bet they were tempted. 

It's an incredible amount of defensiveness for an issue that shouldn't really matter. It's not an 'obesity-paradox' because people who are overweight are not obese. It should be possible to accept that people who exceed the entirely arbitrary BMI threshold of 25 - but who are not obese - do not suffer significant health risks, while those who exceed the threshold of 30 do - and that the fatter they get thereafter, the greater the risk.

But 'public health' doesn't really do nuance, does it?

Tuesday, 15 June 2021

The Impact of COP9 on Vapers

We have discussed the Framework Convention on Tobacco Control's (FCTC) Conferences of the Parties on this blog many times. Typically, they are cursed events - by Ebola in Moscow in 2014, by air pollution in Delhi in 2016 and by Covid in the Netherlands in 2020. The Netherlands meeting was cancelled and rearranged for this year, but the decision has now been made to hold it online only.

This would be a good opportunity to broadcast it to the world, but I expect the usual extreme secrecy at this taxpayer-funded World Health Organisation (WHO) event. 

That would be a shame because the conference has never been more important to vapers. In the last eighteen months, the WHO has gone completely off the rails on this issue. At the start of the pandemic, it tweeted a series of bizarre lies and half-truths about vaping. Last month, it gave India a special award for banning the sale of e-cigarettes nationwide
I've now written a brief history of the COP meetings for the Property Rights Alliance: The Impact of COP9 on Vapers.
It concludes...

Governments differ on how they view tobacco harm reduction, but those which recognise its potential to lower smoking rates and save lives should make that case strongly at COP9. They should pick strong, articulate advocates as their delegates, not bureaucrats. If the WHO continues to spread misinformation about e-cigarettes and if COP9 is held in secret, they should with-draw their funding of the FCTC Secretariat. The FCTC Secretariat should be put on notice. COP9 is its last chance to mend its ways and operate as a transparent and evidence-based organisation. If it cannot be reformed, it should be disbanded.

You can download the report for free here.

Saturday, 12 June 2021

A Swift Half with Dolly Theis

In the latest episode of The Swift Half with Snowdon I spoke to Dolly Theis who is doing a PhD in 'public health'. We spoke about obesity, the nanny state and her mission to achieve gender balance in parliament. Watch below.

Thursday, 10 June 2021

Did Brits drink more under lockdown?

As the Daily Mail reports, people in the UK supposedly drank more alcohol than usual during the first lockdown...
Alcohol consumption fell in countries across Europe during the Covid pandemic – but not in the UK.

Across 21 European countries, the UK was the only one to see an increase in drinking, a study has found.

Researchers surveyed almost 32,000 people across Europe, including 836 in the UK, between April and July last year.

So the claim about the UK comes from a survey of 836 people? This doesn't sound good.

The study, such as it is, has been published in Addiction. It was not just a survey, it was an online survey that people heard about via "social media and postings on institutional websites, via press releases, or student and professional networks". This self-selecting group of people filled in the survey, presumably just once, between 24 April and 22 July 2020.
Based on this sliver of information, the authors conclude that there was a 10 per cent increase in alcohol consumption in the UK.
Of all the countries examined in our project, only the United Kingdom reported a significant mean increase in alcohol consumption. In Ireland, no statistically significant change was reported.

The problem is that we don't need to survey a few hundred people to find out how much people are drinking. We literally have the receipts. In the UK...

The total volume of alcohol sold during lockdown (the 17 weeks to 11 July 2020) fell to 1.3bn litres, down from 2bn the previous year, data from Nielsen Scantrack and the CGA found, despite value sales through the major retailers rising £1.9bn over the same period.

Sales of booze at the supermarket during the four month period hit £7.7bn, it said, however with the on-trade remaining shut, the overall volume of alcohol bought in the UK was far lower than last year, despite the increase in value.

Overall, according to the Euromonitor International Proprietary Alcoholic Drinks data, alcohol sales fell by 10.1% in the UK in 2020 and by 6.6% in Ireland

We also have the tax receipts from HMRC which show that the government received less alcohol duty revenue in April-July 2020 than in the previous year. The decline shown below actually understates the size of the drop because there was a switch from beer to wine and spirits under lockdown. A unit of beer is taxed at a lower rate than a unit of wine or spirits. The number of units sold therefore declined more sharply than the amount of tax received.

And if you're wondering whether people were just drinking all the alcohol they stockpiled before the lockdown, alcohol duty receipts in January to April were also lower than in 2019. (It should be noted that the pandemic caused some delays in tax payment, but the totals for 2019/20 and 2020/21 were no higher than 2018/19.)

This kind of evidence is pretty hard to argue against. Unless the British public were making moonshine on in industrial scale, there is absolutely no chance that they were drinking more under lockdown, or in 2020 as a whole, than they normally would. 

All the study in Addiction shows is that people in 'public health' can get any old rubbish published in a peer-reviewed journal. If this is what they are doing when their claims can be easily tested, what are they getting up to the rest of the time?