Wednesday, 19 June 2019

Scottish government spinning last year's alcohol statistics

The newspapers are full of 'good' news stories about minimum pricing today...

Scottish alcohol sales drop as minimum price kicks in (BBC)

Alcohol consumption in Scotland falls to 25-year low following minimum pricing introduction (Telegraph)

Minimum pricing policy for alcohol has sobering effect (Times)

Scottish alcohol sales at lowest level in 25 years after price controls (Guardian)

This seems to contradict previous reports of alcohol sales rising since minimum pricing, and the Scottish government is milking it for all it is worth. So what's the story?

The figures come from Scotland's annual MESAS study and look at the calendar year of 2018. Minimum pricing wasn't introduced until May 2018, so the figures do not show what happened after minimum pricing came in. They show what happened in a year in which minimum pricing was in force for eight months.

Nielsen data show that sales in Scotland went up by every measure - volume, value and units - in the first nine months of minimum pricing. A sharp decline in cider and perry sales was more than offset by a rise in sales in other categories, particularly spirits, lagers and fortified wine, leading to a two per cent increase in the number of units sold overall - a rise of 25 million units. (Unfortunately, these data are not available in full online.)

None of this is irreconcilable with the MESAS figures released today (which are also based on Nielsen data) for two reasons.

Firstly, as mentioned, the MESAS figure is for the whole year and it is quite possible that sales were lower than average in the four months before minimum pricing began.

Secondly, the MESAS figure is - quite properly - an estimate of per capita sales. Per capita figures are obviously affected by population growth. If there has been significant immigration, per capita sales could fall even while overall sales rise.

The MESAS authors say that they use the mid-year population estimates from National Records Scotland. Interestingly, however, those estimates show little population growth between 2017 and 2018. The population rose from 5,424,800 to 5,438,100, a rise of just 0.24 per cent. The more relevant comparison is the adult population but this, too, has only grown slightly, from 4,560,646 to 4,572,359 (0.26 per cent).

Notwithstanding the different time periods involved, the difference between the unit sales figures and the MESAS per capita figures remains unexplained. A set of monthly Nielsen figures covering 2017/18 and 2018/19 would clarify things, but I have yet to see this.

In any case, it's worth looking at the trends in the MESAS report. If you only got your information from the BBC, you would think that sales plummeted in 2018 as a result of minimum pricing.

Scottish alcohol sales drop as minimum price kicks in

Scots bought less alcohol in 2018 than any year since records began in the early 1990s, according to a new report.

Hmm, sort of. Last year's MESAS report showed that alcohol consumption was 'at a level similar to that seen in 1994' in 2017, so this is hardly an historic moment. 

Leaving aside the fact that the figures don't actually show what happened after minimum pricing (let alone as a result of minimum pricing), the per capita estimates for 2018 don't show anything special.

Sales in the on-trade declined, as they have done for years (note the sharp decline in the years following the 2006 smoking ban) and sales in the off-trade dipped a bit. The off-trade decline was of the same magnitude of that seen between 2015 and 2016 and was less steep than that seen between 2011 and 2012. 

If you don't recall the BBC reporting those sales declines it's because they didn't, although they did report the rise between 2013 and 2014, perhaps because the Scottish government put out a press release saying that the figures 'reinforce [the] need for minimum unit pricing'. See how it works? 

When the 2016 figures were published, I said...

If a rise of 0.1 litres is enough to garner headlines, you'd think that a fall of 0.3 litres would be newsworthy, but you'd be wrong.

But that was then, this is now. Today, a fall of exactly 0.3 litres per head is suddenly highly newsworthy because it can be wrongly attributed to a policy that wasn't even in place for a large part of the year in question.

If minimum pricing hadn't been introduced last year, the drop in per capita consumption wouldn't have been reported at all, just as it wasn't when a drop of exactly the same size occurred in 2016. And with good reason: it is neither large nor unusual.

In conclusion, if you want to see what happened to alcohol sales after minimum pricing began, I humbly suggest you look at alcohol sales after minimum pricing began.

Tuesday, 18 June 2019

Prohibition doesn't prohibit - prison edition

The erstwhile legal high Spice was banned in the UK in 2016. At around the same time, a ban on smoking in English prisons began to be phased in. Scottish prisons followed suit in November 2018.

Action on Smoking and Health predicted that the smoking ban wouldn't lead to prison riots. It led to a lot of prison riots. Violence in prisons is now at an all-time high.

And now we discover that...

Prison staff are falling ill from spice drug fumes

More than a third of prison officers and nurses have felt ill as a result of inhaling second-hand smoke from the drug known as spice that is plaguing jails.

A survey of more than 1,600 members of prison staff found that 53 per cent had been exposed to psychoactive substances taken by prisoners; 39 per cent said that they had felt unwell from the effects of the drugs, with 97 per cent of those affected reporting symptoms including dizziness and confusion.

Great success! Is there any problem that prohibition can't exacerbate?

In May, a group of activist-academics in Scotland found that levels of tobacco smoke had fallen in Scotland, and said:

“This research confirms that exposure to second-hand smoke has been drastically reduced and, ultimately, this will have a positive impact on the health of prison staff and prisoners.”

Meanwhile, back in the real world:

Scotland’s jails are in the grip of a new drugs crisis with the number of prisoners needing medical attention rising five fold in the last three years.

More than 1,600 prisoners needed medical attention after using psychoactive substances – formerly known as legal highs – last year.

And the number of cases continues to increase – with 1,100 prisoners affected already this year.

Banning smoking in prisons has caused the problem to escalate, warders say, with inmates now using government-issued e-cigarette devices to inhale the drugs.

Perhaps the authorities will now ban e-cigarettes, thereby further increasing the risk of violence?

Prison officers say the situation across the country’s jails is already out of control.

One said: “We seen prisoners foaming at the mouth and rampaging around with their eyes bulging out of their heads.

“Others look as if they are zombies.

“They exhibit super-human strength and are just completely out of control – it’s like walking into a zombie apocalypse.

“They don’t feel pain. We’ve seen then inflicting terrible injuries on themselves and others.”

Spice and other drugs are substitutes for tobacco. Tobacco has a calming effect on people, but the simple and effective solution of repealing the ban, at least outdoors, will never be entertained because British lawmakers are in the grip of fanaticism.

And so the carnage will continue.

Monday, 17 June 2019

Critiques of the Lancet's 'no safe level' study

A study appeared in the Lancet last August which claimed to have virtually erased the J-Curve from alcohol epidemiology. The authors used an unconventional methodology, modelling aggregate data from whole countries rather than looking at risk to individuals, and came up with this:

According to their model, there is no reduction in mortality risk from moderate levels of alcohol consumption. It did not quite show that there is 'no safe level', despite the authors claiming that '[o]ur results show that the safest level of drinking is none', but it came close. It has since been cited by the Lancet and others as conclusive evidence that no amount of drinking is safe and that alcohol should be treated like cigarettes.

The methodology was too opaque to allow a full immediate critique, but David Spiegelhalter discussed it here and I wrote about it at the time. Among its flaws was the inclusion of tuberculosis as an alcohol-related disease (debatable in itself) which lifted the risks of drinking even in countries where TB is virtually nonexistent.

The Lancet has now published criticisms from three groups of scientists. You can read them here, here and here, along with the authors' reply here. The authors defend themselves by saying that their conclusion is broadly supported by two reviews by Tim Stockwell and another study published in The Lancet last year. In fact, the latter study found clear evidence of a J-Curve and Stockwell's one man crusade against the J-Curve is based on extreme cherry-picking and 'questionable statistical methods'. In the end, the authors say:

Debates concerning whether the safest level of consumption is zero or near zero are missing the point.

You see what they did there? That's what you call moving the Overton window. It's not actually a question of zero or near zero. It's a question of moderate consumption versus not so moderate consumption; 20-odd units a week versus 30-odd units a week. Either way, more than the UK government's evidence-free 'safe drinking' guideline of 14 units.

If you're interested in this issue, hit the links above.

Thursday, 13 June 2019

Last Orders for Jamie Oliver

I'm off to the Global Nicotine Forum until Saturday so I will leave you with the latest Last Orders podcast with me, Tom Slater and TV's Kate Andrews. It's a special Jamie Oliver schadenfreude edition. Look at our sad faces.

Tuesday, 11 June 2019

American idiots

I haven't written about vaping in the USA for a while because the debate over there is so incredibly stupid that it's senseless to try to intervene.

Take this, for example. Anti-smoking groups want to raise the age at which people can buy tobacco to 21 because, well, they like bans. The tobacco industry says that is in favour of this policy. That has discombobulated the tobakko kontrol movement because they put the infantile 'scream test' at the heart of their dogma (ie. "the louder tobacco companies scream, the more impact we know a measure will have"). By their logic, if the manufacturers of cigarettes support an anti-smoking policy, it can't work.

Bear in mind that the Americans ludicrously define e-cigarettes as tobacco products. The Tobacco 21 policy is really an attempt to crack down on vaping, not smoking - and on Juul in particular - so you see why some tobacco companies might look kindly on it.

Jeffrey Hardesty, research program manager at Johns Hopkins University’s Institute for Global Tobacco Control, says he’s skeptical of the tobacco industry’s sudden support for Tobacco 21, noting that it “does not make amends for decades of obituaries.”

Whatever. Policies should be judged by their merits. This one is illiberal, although given that the US government treats people under the age of 21 like children when it comes to alcohol, it is harder to argue against it than it would be in Britain.

But even still, he says the laws are a good idea at their core.

How many dark nights of the soul did he have before aligning himself with the evil tobacco barons, I wonder?

Hardesty agrees that Big Tobacco’s involvement “has the markings of corporate social responsibility.” Nonetheless, he says grouping vapes and traditional cigarettes under the same regulatory umbrella is a smart strategy for improving public health.

No, it's an exceptionally dumb strategy because they are substitute products, one of which is vastly safer than the other. Any regulation designed to deter use of the safest form of a product will have a similar effect to regulation designed to encourage the use of the most dangerous form of the product.

“If you’re only applying legislation to e-cigarettes…you could drive people back to a potentially more harmful product,” Hardesty says. 

Only applying them to e-cigarettes would be lunacy, even by American standards, but I don't think anyone is suggesting that. What is being suggested is that paternalistic regulation be commensurate with the relative risks.

It doesn't take much brain power to invert Hardesty's argument and conclude that if you only apply the regulation to tobacco cigarettes, you could drive smokers towards the least harmful product. This is Harm Reduction 101.


Sunday, 9 June 2019

Panorama and alcohol, a toxic combination

A few weeks ago I was asked by BBC Panorama to do an interview about alcohol. Panorama has an atrocious history of making one-sided, error-riddled programmes about booze which amount to temperance propaganda. However, the new episode is hosted by Adrian Chiles, who I have always quite liked and who made a half-decent documentary about his own drinking last year, so I thought there was a glimmer of hope of it being reasonably objective and I agreed to the interview.

That hope was quickly snuffed out when he gave a speech to the fanatics of the Alcohol Health Alliance a few days after we met and I have since been told that my interview won’t feature in the programme at all.

To end all doubt, Chiles has written an article for The Observer in which he implicitly blames the alcohol industry for him drinking above the guidelines and portrays those guidelines as evidence-based (which they are not).

Judging by the article - and my unaired interview - the Panorama show tomorrow will be mainly about labelling, with Chiles concluding that the booze industry is lying to its customers by not advertising the new, evidence-free guidelines on their products.

People should be able to drink what they like, but they should do so with complete information. And that’s something the industry seems intent on keeping from us.

Consider a pub, with its long row of beer taps. On some you will see the percentage of alcohol in the beer. But why doesn’t it tell you how many units of alcohol there are in a pint? For that matter, why doesn’t it also tell you how many calories there are?

This, I think, is fair enough and I said so when he asked me about it. I don’t think it would make much difference to how much people drink - let’s face it, Chiles was smashing the old guidelines so there’s no reason to think he would abide by the new ones - but I’m not against consumers having information.

Labelling on beer taps doesn’t strike me as a big enough issue to justify 30 minutes of primetime television, but it gets worse when he actively defends the new guidelines...

In 2016 our chief medical officers set the safe drinking guidelines at a new lower level – 14 units a week for both men and women. Three years later, on the vast majority of products we looked at for Panorama, most producers still aren’t seeing fit to mention this. 

Good. No company should put manifestly untrue information on its products.

Small wonder that fewer than one in five of us are aware of the crucial 14-unit figure, as it’s on hardly any packaging at all. In most cases, the old advice – 28 units for men and 21 for women – is all you’ll get.

That’s not what is shown on most alcohol packaging. The guidelines haven’t been 28 units for men and 21 units for women since the 1980s. Most alcohol bottles and cans show daily guidelines with a warning to not regularly exceed them. Fairly sound advice.

As regular readers know, the new 14 unit guideline for both sexes has no empirical evidence to support it and was created in a demonstrably corrupt process. If Panorama was interested in investigative journalism, rather than being a mouthpiece for special interest groups, this is the story it would cover. Instead...

As for the 14-unit weekly safe drinking guidance, for what it’s worth – unlike many in the alcohol business – I choose to believe the conclusions of countless studies by scientists all over the world.

Utter guff. Not a single epidemiological study supports the 14 unit limit whereas countless studies show that people can consume around 30 units a week and still have a lower risk of mortality than a teetotaller. The only evidence for 14 units is a modelling effort from the hired guns at Sheffield University whom Public Health England paid to change their methodology at the eleventh hour because their original modelling supported the previous guidelines. Chiles’ claim is the exact opposite of the truth.

One piece of junk science from Sheffield is not enough for Adrian, so he doubles down by claiming that...

...most of the industry’s profits have to come from the other 30% of us. We need to keep pretty hard at it for them. If we were all to drop our drinking to safe levels, those profits would be hit to the tune of well over £10bn.

This can only be a reference to a laughable study published last August which claimed that alcohol revenues (not profits) would fall by £13 billion if all drinkers consumed exactly 14 units a week each.

I wrote about this economically illiterate piece of garbage at the time (see here and here). In short, the UK booze industry doesn’t make anything approaching £10 billion of profit so it cannot possibly lose ‘well over £10bn’. (You’d hope that someone who used to present a TV show about business could have worked that out for himself.) The authors of the study confused revenues with profits and ignored production costs and taxation. It should never have been published. In any serious academic field, it wouldn’t have been.

I hope the fact-checking is going to be better in the show itself, but despite Panorama getting itself in hot water in 2012 when it took a dodgy alcohol statistic on trust (yes, it was those lads at Sheffield Uni again), I have a feeling that it won’t be.

Wednesday, 5 June 2019

Plain packaging for food, part 94

The IPPR, a left-wing think tank, got a lot of media attention yesterday when they called for plain packaging of sweets, cakes, crisps etc. Their report is an intellectually thin document with multiple typos (they write a lot about confectionery but rarely spell it correctly) and none of the analysis that you might expect from a think tank.

If you're going to propose Soviet-style regulation of the food supply, you need to answer a few basic questions. What is the source of the problem you are trying to solve? What is the likelihood that your policies solve it? What are the costs? What are the benefits?

The IPPR doesn't even ask those questions. The policy conclusions seem to have been cobbled together down the pub, mainly borrowing ideas that have been tried (and failed) in tobacco control.

I doubt the IPPR is particularly interested in obesity, but it is interested in having a go at capitalism, so it makes sense for them to get into bed with the 'public health' lobby. It describes plain packaging for food as a “challenge to the power of corporate manufacturers”, so that's nice.

The plain packs stuff got the headlines but other policies proposed were equally bizarre and illiberal. They want to 'extend the smoking ban to all public places' which presumably means banning smoking outdoors. They want to raise the smoking age to 21. They want to not only prevent new fast food shops opening near schools but shut down existing fast food shops to meet their target of 'no fast food restaurants with [sic] 0.1 miles of schools in England.' And they want to extend the sugar tax to various foods which displease them.

Pretty grim stuff, but good clickbait for the IPPR and another vindication for those of us who warned that this would happen.

I've written about it for The Sun today...

Those of us who opposed the sugar levy warned that the nanny state zealots would soon demand similar taxes on a range of everyday food products.

Similarly, we opposed plain packaging for tobacco because it would create a slippery slope, with food, soft drinks and alcohol next in the firing line.

A report published by the Institute for Public Policy Research (IPPR) proved the naysayers correct.

Not only are they calling for plain packaging for sweets, crisps and fizzy drinks, the IPPR is calling for tobacco-style sin taxes on cakes and confectionery, plus an extensive advertising ban for anything that the Government considers to be high in fat, sugar or salt.

Some of the IPPR’s justifications for these Stalinist diktats border on the ­surreal.

They claim that plain packaging for so-called “junk food” will “level the playing field between confectionary [sic] products and fruit and vegetables”, as if children would be eating turnips rather than chocolate bars if it weren’t for colourful wrappers.

Do read it all.

The Sun's leader is pretty solid...