Wednesday 30 March 2011

Harm maximisation

Bit busy at the moment but there are a couple of harm reduction-related stories that you might be interested in.

Via F2C, I see that the BBC has implied that e-cigarettes might have killed a man in North East England.

Gateshead doctor calls for research into 'e-cigarettes'

A doctor from Tyneside has called for more research into "electronic" cigarettes following the death of one of his patients.

The wording of this non-story is extremely vague for the very good reason that there is no evidence that e-cigarettes did—or could—contribute to this man's death. El Beeb doesn't mention that the deceased had been a heavy smoker for decades, nor that the doctor involved—Dr Robert Allcock—is not any old GP, but is on the advisory panel of Smokefree Northeast and campaigns for various anti-tobacco policies. UKVapers has a more sober assessment of the story here.

And via Snus Central, it seems that another alleged health group is turning the screw in its efforts to keep people smoking cigarettes:

The Swedish snus eStore owned by World Wide Snus AB has been shut down and its assets seized. At the time of this writing, we're told a cancer organization in Finland filed suit against the Swedish snus store for allegedly selling snus to customers in Finland. This cancer organization apparently won the suit.

Latest information is that Finland presented the findings to Swedish Customs. On Tuesday, March 22nd, the Swedish Customs Service and local Police raided the facilities and seized them along with the inventory and other contents. World Wide Snus AB's bank accounts were simultaneously frozen.

If I'm not mistaken (let me know in the comments) this represents enforcement of the existing EU ban and is not a new restriction. It is illegal to export snus from Sweden for sale in any EU state—and that includes mail order and internet sales. Nevertheless, it is interesting that a "cancer organisation" would go to such trouble to prohibit a product that does not cause cancer.

Hopefully, the EU will see sense and repeal this absurd and counter-productive ban when the new Tobacco Products Directive is issued. In the meantime, Finns will have to buy their snus illegally, or from the US, or get back on the cigarettes.

Saturday 26 March 2011

Meddlesome Ratbags

One of Viz magazine's characters is a woman called Meddlesome Ratbag who goes out of her way to engineer situations in which she can be offended, thereby demanding that her will be imposed. An example is here (via Pavlov's Cat) which relates to this story from 2008.

I was reminded of Ms Ratbag when I read this article from CNN about airport smoking lounges. It's an unusual article because it doesn't seem to have any real purpose and it's not inspired by current events. It is, however, a nice little piece about an obscure subject and reminds the reader that many people get a little bit of pleasure from having a place to smoke in the relentlessly tobaccophobic world of airline travel.

"Isn't this nice?" traveler Colleen Sherretta said of the concourse C smoking lounge at Atlanta's Hartsfield-Jackson International Airport, as others cycled through the sliding automatic door, filling the room to capacity...

"I'm glad they have one," Sherretta said cheerily during a recent midday connection from Savannah, Georgia, to Newark, New Jersey, as she stubbed out her Camel Blue. "They don't have these in Newark."

Indeed not. As the article states, there are fewer smoking lounges than there were ten years ago. New York has, unsurprisingly, clamped down on them.

"It's a necessity for people who have long layovers," a patron of Atlanta's concourse B smoking lounge said in between long drags of a Marlboro Red from a tar-stained plastic cigarette holder. "I don't think they'll ever go away."

"I love to people watch in here. You have all walks of life coming in here. Even though it's not accepted by a majority of the public you see all walks of life in here. I also love to listen to the soldiers' conversations. They really impress me. They're so clean cut. I'm surprised they smoke," he said.

Well, they do. And so do many other people, which is why the lounges exist as a place for people from all walks of life to take a break without bothering anyone in any way whatsoever.

But what we really need is the view of a licensed psychologist with a cool sounding name. Yes, you sir...

"As we're learning more about the tremendous dangers of smoking, fewer people are willing to tolerate exposure to second-hand smoke, which leads to smokers being pushed to the periphery," said licensed psychologist Clifford Lazarus. "But it is a right, people can smoke just like they can drink and have guns, it's just that the government is being a bit more controlling in terms of creating parameters in which people can engage in this marginalized behavior."

'A bit more controlling' might be a slight understatement, but it's certainly true that 'fewer people are willing to tolerate exposure to second-hand smoke' and that's why the airports have bent over backwards to stop that happening...

"We have four indoor smoking areas. Two designated smoking lounges and two restaurants that offer separate smoking areas," said Laura Cole, spokeswoman for Denver International Airport in Colorado. "All four are fully enclosed and DIA uses completely separate ventilated systems for the smoking areas. We believe that by using separate systems to ventilate the smoking lounges and the concourse we're creating a second layer of protection from second-hand smoke."

A sealed off smoking lounge and two entirely separate ventilation systems. What rational person could ask for more? So why do the airports go to all this trouble?

"Hartsfield-Jackson provides designated, specially designed smoking lounges on each concourse for the convenience and comfort of our passengers who choose to smoke," airport spokesman John Kennedy said in an e-mail.

Convenience and comfort. That's sounds like excellent customer service. And there would be practical considerations as well, I imagine?

"The Airport's layout and design does not allow for outside smoking areas in the sterile concourses and the smoking lounges eliminate the need for passengers wishing to smoke to exit and then re-enter the secured areas, or seek other alternatives to smoke inside the Airport."

This all sounds eminently reasonable. All the bases have been covered and Hartsfield-Jackson airport appears to be a picture of harmony and mutual respect. But hang on a moment, is that a meddlesome ratbag I see before me, coughing and waving her hands?

"We're optimistic that the trend is still going toward 100% smoke free, like the airlines. The question is who will be the last?" said Cynthia Hallet, executive director of Americans for Nonsmokers' Rights, a California-based lobbying group. "The bottom line is this is a health issue. We know what smoking and second-hand smoke can do to us, and the safest policy is a smoke-free policy."

The bottom line, Cynthia my dear, is that these airports do have a smoke-free policy in every area except that tiny enclosed room into which you need never stick your sensitive nose. Seriously, could there ever be a more apt occasion on which to say 'mind you own fucking business' than when you're standing in a sealed off, separately ventilated smoking lounge that takes a fraction of one percent of the space of an airport?

And here comes another one...

"It's just disgusting. I can smell the smoke even though those doors are closed," traveler Cathy Urchin said as she waited in line at Seattle's Best Coffee, across from the smoking lounge.

Like a wasps at a picnic, aren't they?

"I used to smoke...

Yes, I detected the perpetual rage of the self-righteous ex-smoker in your opening remarks. Come to think of it, Cathy Urchin is an even more evocative name than Meddlesome Ratbag.

...Now I'm just glad I live in Minnesota, where you can't smoke in bars or the airport," she said. "I think they're becoming extinct. Or at least I hope they are."

The milk of humanity just pours out of these people, doesn't it?

Wednesday 23 March 2011

Urgh, California

With Britain vying for pole position in the tobacco control freak race with its zany plain packaging/display ban proposals, reigning champion California is having to raise its game. Can it rise to the challenge? Of course it can...

Smoking on open patios and balconies will be prohibited for the 18,500 apartment and condominium residents in Laguna Woods if the City Council on Wednesday gives final approval to an amendment to the city's smoking ordinance.

Yes, that's an outdoor smoking ban on your own private property. And even that doesn't go far enough for the illiberal goof-balls of this clown state.

The council also considered prohibiting smoking inside homes unless all windows and doors of the units are closed, but tabled that provision for further study.

"We are not yet ready to regulate smoking within houses," said Mayor Pro Tem Cynthia Conners.

Don't mistake that for 'we don't want to' or 'we would never'. They're just not ready yet. The baby steps of prohibition have got them this far, so why start taking bigger strides now? There's plenty of time for smoking bans in the home, don't you worry.

Meanwhile, up the coast in Santa Cruz...

The Santa Cruz County Board of Supervisors voted 4-1 Tuesday to require retailers to obtain a license to sell tobacco, joining dozens of other communities statewide.

The excuse urgent justification for this policy is to reduce youth access to cigarettes.

The county says a recent survey demonstrated county retailers' poor compliance with laws prohibiting sales to those under 18. "It shocked everybody," said Bob Kennedy, the county's environmental health director.

It would be interesting to learn where this shocking study came from and who funded it but, I guess we should all be thankful that this licensing system is going to stop retailers selling cigarettes to kids, um, somehow. How exactly will that work again?

The new license applies to all of the county's 104 retailers who sell cigarettes, and will cost $318 annually.

So you can't sell cigarettes to kids unless you can scrape together $318 a year? That should stop 'em.

That $318 is the whole point, of course. It won't stop shop-keepers selling tobacco to under-18s but it will penalise tobacconists in the hope that some of them will say 'screw it' and stop selling cigarettes. Places that don't sell many cigarettes will do that, for sure, and prohibition takes one step closer.

The whole point of the exercise is to make selling cigarettes less profitable and make buying cigarettes more inconvenient. That's why it's been on the anti-smokers' agenda for some time. It's got sweet nuthin' to go with youth access which, as ever, needs to be addressed with enforcement. Speaking of which...

The county hopes to run at least one compliance check on businesses per year, with first-time violators facing a 60-day suspension of tobacco sales.

Those who are cited four times over five years can lose their tobacco licenses.

If stopping kids buying tobacco was really these people's concern, they'd be doing all this already. They don't need to charge store-owners several hundred dollars a year for a junk license before they start enforcing the law. Or is the State of California seriously claiming that it doesn't already get enough money from cigarette taxes and the Master Settlement Agreement to afford doing a measly one check a year?

And finally, back down the coast in Los Angeles, Bernard Parks is doing his stuff. Parks is a supremely stupid man with totalitarian tendencies who believes that "secondhand smoke is the number one cause of preventable health disease in America". He also believes that "inhaling secondhand smoke is more harmful than actually smoking". If this is the kind of bumpkin that gets elected (and re-elected) in California these days, then it's no wonder the State has become a bankrupt citadel of intolerance.

Parks' previously efforts to turn LA into a bully state include an outdoor smoking ban in the city's streets and he has now turned his beady eyes—as they all do sooner or later—to food. As the video from Reason shows below, he's going to ban restaurants he doesn't like. The fact that LA residents obviously do like them doesn't enter into it.

With San Francisco banning Happy Meals and New York putting a tax on soda (thanks to Michael Bloomberg, another smoking ban obsessive who took the 'next logical step'), this is only the start of the war on food. For the time being, Bernie Parks is only going after the fast food joints. As they might say in nearby Lacuna Woods: "We are not yet ready to regulate eating within houses."

Tuesday 22 March 2011

Think of the (very small) children!

What age-group do you think of when someone says the word 'children'? 16 years or younger? Under-18 perhaps?

And what about 'young children'? Ten year olds? Eight year olds? Maybe younger?

So what about 'very young children'? That would have to be toddlers and pre-school children, right? Six or seven at the most.

So what can we make of Diane Abbott saying this?

"It is wrong that very young children can get out of their skulls for less money than it takes to buy a bottle of Coca-Cola."

Leaving aside the fact that a bottle of Coke costs 70p, which is far too little for anyone to get 'out of their skulls' on, Abbott's twist on the old 'think of the children' canard means one of the following:

a) she have a unique definition of what a 'very young child' is

b) she honestly believes that very young children are getting 'out of their skulls' on alcohol for 70p

c) she is one of the stupidest people to ever become an MP in British history

d) she is deliberately using misleading language to scare people into supporting minimum pricing

It could very easily be a combination of (c) and (d). Incredibly (or not), this serial incompetent and self-confessed hypocrite in on Labour's shadow cabinet. Still more incredibly, she is the spokesperson for health, which should be interesting when she has to tackle obesity (something she has clearly never attempted before).

Still, it gives me an excuse to show this again:

Thursday 17 March 2011

Idiotic statistics

Tobacco Control recently published an 'e-letter' (known to the rest of us as an 'e-mail') from Konstantin Krasovsky, Head of Tobacco Control Unit in Ukraine, about the WHO's measure of "selected smoking-related causes". Bear with me, because it's more interesting than it sounds.

The WHO has a handy website for accessing health and demographic data. One of things you can look up is the smoking-related mortality per 100,000 people. But, as Krasovsky points out, these estimates seem to have no basis in fact.

In the case of Ukraine, to consider just one example, the WHO HFA database shows that in 2004 male "smoking-related mortality" was 1081 per 100,000 population. However, all-cause male mortality for the same year was 1920. So 56% of all deaths were to be considered smoking-related deaths. The respective figures for women were the following: 586, 978, and 60%.

Even if we ignore the fact that female smoking prevalence in Ukraine was about four times lower than among males, it is obvious that smoking could not cause so many deaths even for men.

He's got a point. According to this database, Armenian women—of whom just 1.5% are smokers—have a smoking-related mortality rate of 138 per 100,000, which is 16.3% of all deaths.

This is not a great deal lower than the rate for Armenian men—52% of whom are smokers—who have a rate of 259 per 100,00, or 19.6% of all deaths.

In Kyrgyztan, the smoking rate for women is just 1.7%, and yet the smoking-related mortality is 607 per 100,000. Since the total female mortality rate is only 931 per 100,000, this means that a habit practised by less than 1 in 50 women is responsible for 65% of all female mortality.

For men in Kyrgyztan, the smoking rate is 41%, but smoking is responsible for 60% of male deaths (934 per 100,000 out of total mortality of 1532 per 100,000).

No one expects absolute precision from these kinds of estimates, but what we have here are figures that are so wildly implausible they don't even pass the basic test of common sense.

The WHO quietly acknowledges their uselessness on the page of definitions which almost no one will ever read:

The mortality from combined, selected causes of death which are known from literature to be related to smoking. It has to be pointed out that it is relatively rough indicator and it is NOT the estimate of tobacco-attributable mortality, which is more complex and difficult to calculate.

In other words, they have taken all deaths from any cause that is related to smoking and bundled them together even if the person didn't actually smoke. Nonsmoker dies of a heart attack? Smoking-related death. Nonsmoker dies from throat cancer? Smoking-related death. Seriously, this is what it's come to.

So remember, "smoking-related mortality" is not the same thing as "tobacco-attributable mortality". One is only vaguely related to smoking and has no basis in fact, the other is too "complex and difficult" for the World Health Organisation to bother with.

I'm sure that campaigners, journalists, broadcasters and politicians will understand that these figures are essentially worthless and will explain that carefully to the public before citing figures that might as well have been plucked out of the air. And I'm sure that no serious researcher would ever use these meaningless figures as a basis for making real-world estimates.

Yes sir, that will definitely never happen.

Wednesday 16 March 2011


Several times in Velvet Glove, Iron Fist I referenced a book called Smoking: The Artificial Passion by David Krogh (1991) which takes a non-hysterical and scientific look at nicotine as a drug.

Although it should not seem strange that a drug that has been used for thousands of years has positive benefits to the user, that simple truth is close to heresy today. Krogh's book—which is sadly now out of print—was a fascinating study of some of these benefits and so I was interested to see, when I looked it up on Amazon, that several reviewers also found it a very useful book to help them quit smoking. I'd never considered it to be that kind of a book at all, which just goes to show that honest information and education work better than threats and hyperbole.

The reason for this post is to let you know that our Danish friend Klaus K, along with Niels Ipsen, has written an extensive review of the experimental science surrounding nicotine which covers similar ground and includes much new research.

Go read.

ASH Wednesday (part 2)

I didn't finish writing about the UK government's 'new' tobacco strategy last week (the strategy being to do whatever ASH say despite their appalling record of failure and broken promises).

Reading the government's Tobacco Control Plan 2011, the first thing that struck me was that it was identical in style and content to the numerous public health papers that came out in the Labour years. Now, obviously I didn't expect Andrew Lansley to write the thing himself but, seriously, it was indistinguishable. I would hazard a guess that the whole thing was the creation of ASH, Cancer Research and other "stake-holders" in collaboration with the same people from the Department of Health who were instrumental in dictating policy to the previous lot. And we know from the Dark Market e-mails how closely these groups like to work together.

The headline news is that the ludicrous display ban is to be brought in as planned and the bat-shit crazy plain packaging plan will probably follow. Why both should be required is a mystery. Common sense dictates that they both do the same job of shielding evil colours and fonts from the eyes of naive young consumers. Bring in one and you don't need the other. Still, ASH are "delighted".

Plain packaging is not yet a done deal. There is to be a public consultation. Perhaps it's started already, who would know? It's not as if they advertise these consultations to the public, but you can be sure those in the club are always kept well informed. We know how this process will work. The fake charities and the quangos will collect names by e-mail using state funds and the voices of private citizens will be expunged from the record. Like this guy said:

"It will come as no surprise to us if the Department of Health has funded organisations that provide the responses to consultations that the Government is looking for. The public are understandably cynical about the way Labour consults the public—it's time we had a Government that treats the public and their views with the respect they deserve.”

Those are the words of Andrew Lansley, speaking about the consultation for the display ban while he was in opposition. The same Andrew Lansley who has just given the green light to the display ban and has authorised another pretend consultation on a measure that even the Labour party seemed unsure about. Funny old game, politics, isn't it?

What is the evidence that any of this will further the government's arbitrary goal of reducing smoking prevalence to 18.5% by 2015? There is almost nothing to go on. ASH's "evidence" that plain-packaging had public support was such a pathetic concoction of wishful thinking that even they seemed embarrassed by it and resorted to getting Martin Dockrell to launch it on a left-wing blog. Every media outlet, including the BBC, ignored their what-if survey.

A few countries have tried the display ban but there has been no effect on the smoking rate. Evidence from Canada and Ireland suggests that it has increased both smuggling and youth smoking. No one's tried plain packaging.

But evidence just doesn't come into it. It's about being a world leader at the lowest possible cost and that's something that's always attracted politicians to tobacco control. It's cheap and you can look like a tough guy for a day. We'll try anything now. England has been sprung into the position of having Californians pointing and laughing at us for a change. How very embarrassing. We are now the test bunnies for moral entrepreneurs everywhere. We are in the do-anything business. It's as if the anti-smoking lobby is throwing anything and everything out there before they start being judged on results.

And time is running out. Even in their line of work, you cannot keep making promises and failing to deliver indefinitely. This, from the BBC's report on the plans:

A fifth of adults smoke - a figure which has remained steady in recent years after decades of rapid falls.

Every other report made a similar point but failed to grasp its significance. Before 2007, Britain had almost nothing in the way of anti-smoking legislation. There were no graphic warnings on packs. You could smoke at 16. You could smoke in a pub, in an office, in a nightclub—pretty much anywhere so long as the owner of those private premises agreed. Taxes went up every year and there were no cigarette advertisements, but that was about it. And then everything changed. The whole professional anti-smoking blueprint was unleashed like a flood. It was never out of the news.

And what happened? Smoking rates suddenly stopped falling after dropping for many years. For the first time since they were behind the bike sheds, smokers weren't just people who smoked. They were an identifiable community. The government was turning the act of lighting a cigarette into an act of defiance once more.

If you inclined to such theorizing, you might go even further and say that, in its small way, smoking is becoming—and with these new policies will become more so—a political act. It's certainly a more effective political act than voting these days. As this policy document makes crystal clear, voting changes nothing when it comes to public health legislation. Nothing could make this more apparent than the fact that both Tories and Lib Dems opposed the display ban in opposition and then pushed it through in power.

Public health rolls on regardless of which government is in charge. If you want to see what legislation will come about this decade you only have to look at the list of what legislation they want to come about (12 Steps to Better Public Health).

Does it not seem perverse and strange that all three parties are behind measures which are widely derided by the public? The most common response I've encountered to both the display ban and plain packaging is a tut, a shake of the head and perhaps a swear-word. Even the BBC's coverage could not disguise the fact that most of the population thinks these schemes fall somewhere between stupid, pointless and loopy. How can it be that the majority of people who think these ideas are barmy have to vote for minority parties if they want to voice their democratic disapproval? Has something not gone badly awry in the political class when this happens, and happens so often?

Yay-sayers are quick to point out that none of this prevents people buying cigarettes. It will be a major cost and inconvenience to shop-keepers, of course, and that is deplorable, but the consumer goes untouched. This is true. In a way, we should be thankful that the anti-tobacco industry has found a way of attracting derision without penalising smokers more directly.

But this misses the point. Regardless of who is being directly penalised here, I don't want a government that treats its people with such contempt that they think we cannot see some cigarettes without wanting to buy them. I don't want to live in a country where a product consumed by millions of ordinary people is sold in Soviet grey behind curtains and boards with a nudge and a whisper. Nor do I want to live in a country where those same millions are denormalised by people who are anything but normal themselves.

It is an absolute racing certainty that the temperance movement will demand graphic warnings and plain packaging on alcohol in the fullness of time. It would be not just inconsistent but hypocritical to do otherwise, and surely we no longer have to demonstrate that the slippery slope exists.

The most plausible reason for Lansley's headlong into anti-tobacco extremism—as hinted at elsewhere—is his desire to throw the neo-prohibitionists a bone in the area of smoking while disappointing them in the area of drinking. In the last few days, he'll have noticed that such a policy doesn't work. The neo-pros' attempts to undermine the government on drinking will have shown him that they always bite the hand that feeds it. This should be a lesson learned for the coalition. No matter they do, the prohibitionist beast will keep howling. You might as well starve it instead.

UPDATE: Somewhat related from Prime Minister's Questions today:

For me, the significant moment was Mr Cameron’s response when Mr Miliband reminded him that the British Medical Association has criticised Coalition health plans.

The PM’s response was agressive, a full-frontal attack on the BMA as just another trade union opposing public sector reform.

The BMA opposed foundation hospitals, longer GP opening hours and every others significant reform of recent years, Mr Cameron said.

Mr Miliband couldn’t resist backing the BMA because he instinctively sides with the sectional interests of organised labour, the PM said:

“Just as he has to back every other trade union, he comes here and reads a BMA press release.”

The attack on the BMA reflects ministers’ private anger at the doctors. Aware of the public standing of the medical profession and the central role GPs will take in a reformed NHS, Coalition criticism of the BMA has so far been muted. Does Mr Cameron’s flash of anger signal a new willingness to take on the doctors?

Tuesday 15 March 2011

Laughing at you, not with you, Stan

One of the joys of America's SmokeFree Movies campaign is that it brings frothing-at-the-mouth anti-smoking mentalism under the noses of people who otherwise wouldn't pay attention. It's a pleasure to watch the jaws of people who are largely apathetic about smoking bans drop as they learn that there are people in the world who genuinely seem to believe that the depiction of smoking in films kills 100,000 Americans every year.

They also believe that no fewer than 390,000 American "kids" start smoking every year because of the smoking they see on screen, and they've got the studies to prove it. Admittedly, these studies are nearly all written by the guy who runs SmokeFree Movies, Stanton Glantz, who also founded Americans for Nonsmokers' Rights, but I'm sure he would never let his personal obsession lead his conclusions.

While the SmokeFree Movies claims are not inherently more ludicrous than anything else that comes out of Glantz's mouth, they are perhaps more obviously ludicrous to the casual observer. His latest pearl of wisdom is that: "A lot of kids are going to start smoking because of this movie". The movie in question is Johnny Depp's Rango. I haven't seen this film and probably never will, but according to a shocked spokeswoman for Breathe California, smoking is depicted many times:

Because there are so many scenes in which characters smoke, she said, her group might not be able to get a definitive count until Rango comes out on DVD.

It would, of course, be premature to say exactly how many "kids are going to start smoking because of this movie" until this crucial piece of scientific research has been carried out. Let's pray that the carnage is not as bad as first feared.

Jacob Sullum has written about this at Reason and the National Review has reported it with the suitably sarcastic headline 'Tobacco study suggests smoking on film may kill the audience':

The anti-smoking movement has undoubtedly been of great benefit to the health of Quebecers. The province, long derided as Canada’s ashtray, saw its smoking rate drop to 22.5% in 2009 from more than 30% in 1998. But when it has come to sitting in front of movies with a stopwatch, noting whether a smoking character conveys sexiness, rebellion or some other veiled message, you are well on your way to earning your reputation as a killjoy.

But best of all is Filmdrunk, who must have missed Glantz's chest-pounding about Avatar last year, because the great man has only just come onto his radar.

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.

Additionally, and I don’t even know if this is possible, but I’m picturing him with two sole patches.

On Feb. 23, Smoke Free Movies, a project of Glantz’s, ran a full-page ad in Variety and the Hollywood Reporter that slammed the smoking in Rango. “How many studio execs did it take to OK smoking in a ‘PG’ movie?” the ad asked.

Said Glantz, “If we had known it’s as bad as it is, this ad would have been even tougher.”

I love that he thought the original ad was tough in the least. I just picture him sitting around saying, “Yes, this smugly worded question will surely cut through these executives like a samurai sword."

Nevertheless, Rango has renewed the call by Glantz and other anti-smoking advocates for the Motion Picture Association of America, or MPAA, to rate any film that shows smoking as “R.”

(*spins directly off planet*)

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.

The comments don't suggest that Glantz is getting a lot of support from the movie-going public either.

Monday 14 March 2011

Fish. Barrel. Gun.

OK, it's a cheap shot but Daily Mail hack Jan Moir really has brought this on herself:

Want to stub out smoking? Put Kate's mug on every pack

Plans for selling brands in plain packets unblemished by alluring brand logos have also been mooted — but I have a better suggestion.

If Kate Moss carries on smoking her good looks away, perhaps they should put a picture of her kippered Croydon pram face on the front of every packet?

Kate Moss

Jan Moir

Don't fancy yours much.

United Nations on standby as temperance groups "walk away from the table"

From the Beeb:

Six leading health groups have dealt the government a blow by refusing to sign up to its new "responsibility deal" on alcohol in England.

Do these health groups sell alcohol? No. So how is the non-cooperation of a bunch of pompous, unelected temperance groups a "blow" to an agreement made between the drinks industry and the government? Why have these zealots even been asked to "sign up" to it in the first place?

The deal covers voluntary agreements with the drinks industry on issues such as promotions and labelling, aimed at tackling alcohol abuse. But the organisations, including Alcohol Concern, accused ministers of not being tough enough on the industry.

Well, duh. There is nothing the government could do to "industry" that would silence Alcohol Concern for more than five minutes. And let's remember that "industry" is a euphemism for "drinkers" since that it is they who would be penalised by Alcohol Concern's proposed tax hikes.

The full details of the responsibility deal have yet to be unveiled...

Not that that has stopped the anti-alcohol lobby from queering the pitch and undermining the government before the plans have even been anounced.

...but under it, the drinks industry would be expected to sign up to a number of alcohol pledges.

Let's face it, there's only one kind of pledge that interests Alcohol Concern.

These reportedly include ensuring 80% of products on the shelf are labelled for unit content, raising awareness of the unit content of drinks in pubs and clubs and taking action to reduce under-age drinking.

There would also be a pledge to commit to action on advertising and marketing by promoting responsible drinking and keeping alcohol adverts away from schools.

The health groups said they had lost confidence with the approach because of the lack of clarity over what would happen if industry did not meet the commitments.

You're kidding, right? We know exactly what happens when industry fails to capitulate to "voluntary agreements". Let's cast our mind back to the previous government's 'voluntary agreement' on alcohol:

It is not known how many drinks firms will sign up for the scheme, but ministers said if the industry did not comply, the government would introduce legislation.

Or its voluntary agreements on food:

Cheese makers say they are under pressure to slash levels of salt to meet the Department of Health's targets.

Although Whitehall is encouraging voluntary reductions, it could force companies to reduce salt by law if they are slow to act.

As the Devil so rightly says:

Uh oh: we all know what these fuckers mean when they say that something is voluntary, don't we? That's right: it's voluntary unless you don't do it—in which case it becomes compulsory.

But back to the Beeb...

They said the pledges were neither specific nor measurable, they lacked scope and there was no evidence they would even work.

Ho, ho. A bit like minimum pricing and plain packaging, then?

Don Shenker, chief executive of Alcohol Concern, said: "It's all carrot and no stick for the drinks industry and supermarkets.

Isn't that what nudging is all about? Don, have you considered that people respond better to incentives than to threats, or are you really just interested in beating industry with a stick for the hell of it?

"By allowing the drinks industry to propose such half-hearted pledges on alcohol with no teeth, this government has clearly shown that, when it comes to public health, its first priority is to side with big business and protect private profit."

Who does this fellow think he is? Why should his opinion carry any more weight than that of any other crank on the street? Why, above all, does the government continue to pay for a temperance society which can barely scrape together a few thousand pounds in voluntary donations? From

Its 2008/09 accounts show a total income of £1,137,582, of which:

Department of Health (restricted grant): £142,000
Department of Health (unrestricted grant): £400,000
Big Lottery Fund: £127,275

Total £669,275 (58.8% of all income)

It received just £8,186 in public donations.

Really, Lansley, could you stop using our money to fund your—and our—enemies?

And if Don Shenker's chutzpah isn't nauseating enough, how about this from the British Medical Association?

The BMA has thought long and hard about walking away from the table but ultimately we do not feel we have any option.

Can someone remind me how many candidates the BMA put up in the last election? How many votes did they get exactly? It must have been a lot, otherwise they would risk coming across as unbelievably arrogant making statements like this. But fear not, because the temperance alliance's official statement indicates that there could still be hope for the peace process:

The alcohol health community remains completely open to dialogue with the government and is prepared to continue to engage in discussions about how industry can act as responsible producers, distributors and promoters of alcohol.

How gracious! How magnanimous! Bloody hell. At this rate the provisional wing of the "alcohol health community" will be turning up at Number 10 to discuss "talks about talks".

Saturday 12 March 2011

Not bad science, but awful logic

In today's soar-away Guardian, Ben Goldacre has taken on the subject of plain-packaging:

This week our government committed itself to the removal, albeit slowly, of cigarette displays in shops. But plain packaging on cigarettes has been delayed for further consultation.

The Unite union is unimpressed. It represents 6,000 people in tobacco production and distribution, and put out a statement: "Switching to plain packaging will make it easier to sell illicit and unregulated products, especially to young people." This, the union added, "may increase long-term health problems".

Tory MP Philip Davies said: "Plain packaging for cigarettes would be gesture politics … it would have no basis in evidence."

Everyone is entitled to their own opinions, but not, sadly, their own facts.

Strong words, from which we must assume that Goldacre has found the "facts" to show that plain packaging will not help the illicit trade and does have basis in evidence.

But if he has, there's no trace of them in this article. What we get instead is a mildly interesting précis of surveys showing that some smokers believe that low tar cigarettes are less hazardous. This, says Goldacre rather hyperbolically, is "one of the most important con tricks of all time: people base real decisions on it, even though low-tar cigarettes are just as bad for you as normal cigarettes, as we have known for decades."

The collected data from a million people shows that those who smoke low-tar and "ultra-light" cigarettes get lung cancer at the same rate as people who smoke normal cigarettes. They are also, paradoxically, less likely to give up smoking.

The study he links to is Harris, 2004, which found that smokers of low-tar cigarettes have a similar lung cancer risk to those who smoke what Goldacre calls "normal" cigarettes. But the study also shows that smokers of high tar cigarettes (+22mg tar) have a statistically significant 44% increase in risk compared to those smoking lower tar cigarettes. To be fair, Goldacre's decision not to mention this latter finding could be justified on the basis that cigarettes of this strength are no longer legal in the EU. But when they were available (1930s to 1990s), there is plenty of epidemiological evidence to show that low tar cigarettes reduced risks somewhat.

As late as the 1960s, cigarettes regularly had tar yields of 40mg and over. Reducing tar yields to a quarter of this level does seem to have made them less hazardous in many respects—that is why the EU has made cigarettes progressively weaker. So it is not quite true to say that people believe light cigarettes are less hazardous purely because of the tobacco industry "con trick". For many years, they really were.

The EU's limit is now just 10mg of tar, which means that, by earlier standards, all cigarettes smoked today are ultra-light. The difference between a modern 5mg 'light' cigarette and a 'strong' 10mg cigarette is pretty negligible and the corresponding effect on health is likely to be similarly negligible. For the sake of argument, let's assume that modern lights are indeed no better than modern full-strengths.

What is not true is that smokers of low tar cigarettes are "paradoxically, less likely to give up smoking." The study Goldacre cites does not support that. In fact, it says the exact opposite:

We observed the smoking habits of all participants only at enrolment in 1982. However, based on a 13% subsample of participants who were re-enrolled in the CPS-II nutrition cohort, we found that men and women who smoked very low tar and low tar cigarettes in 1982 were more likely to have quit smoking by 1992.

But what does any of this have to do with plain-packaging? The answer is not very much at all. Goldacre does a pretty good job of debunking an argument that nobody is making, but does a poor job of rebutting what Unite and Philip Davies are saying. He implicitly assumes that by stopping the industry using colours to show which products are low tar, the myth of safer cigarettes will disappear and this will benefit public health. But that's just a hope and a prayer. Low tar cigarettes will still be available under plain packaging and smokers will still know that Marlboro Lights are on sale, regardless of what they are called or what they look like.

And even if low tar cigarettes disappeared altogether, there is no reason to think that people who smoke them will quit rather than simply switch to "normal cigarettes". Some of them might quit, of course, but that is mere supposition and we're supposed to be dealing only in facts here.

The truth is that there is very little evidence on either side of this debate because, if we go through with this scheme, we will be the first country on earth to try it. It is fatuous to pretend that there is any proof that it will work; likewise, there's no solid evidence that it will make things worse. Goldacre finds it plausible that banning colours will remove the illusion of reduced risk and lead people to quit (campaigners said the same when they banned the word 'light', but as Goldacre points out, it made no real difference).

Other people—including Unite—find it plausible that plain packaging will make it easier for the illicit trade to make counterfeit cigarettes and will draw smokers to the black market by turning the white market grey. (And we do know from chemical analyses that counterfeit cigarettes are more hazardous than official brands, if that's our concern.)

There are what-ifs on both sides of the argument, and neither side should claim that they are dealing with "facts" while their opponents deal only in "opinion".

At the end of the day, there can be no evidence for something that has never been tried. It is, therefore, factually accurate for Philip Davies to say that the policy "has no basis in evidence" and wrong for Goldacre to portray his hopes as facts.

Friday 11 March 2011

Is that a slippery slope I see before me?

How many times have smokers warned drinkers that the neo-prohibitionists will not stop with tobacco? I suggested a few ago that non-smokers should actively oppose the anti-smoking crusade if only because smoking provided a buffer between the puritans and other pleasures. So long as that buffer remained it place, they could not get their teeth into drinking, food, driving, meat eating and the rest. Back then, the popular view was that smoking was a unique case. That particular piece of self-delusion is pretty hard to maintain today.

If there's one industry that should understand the threat of prohibition it's the drinks industry. Just as the moral entrepreneurs moved from alcohol to tobacco without missing a beat when Prohibition was enacted in America, history is repeating itself with the twist being that the move is now from tobacco to alcohol.

Did the drinks industry really believe that people who use a junk science estimate of 54 hospitality workers dying each year to bring about a total smoking ban in every pub in the land were going to think twice about using the same tactics on an industry they blame for 40,000 deaths each year?

The drinks company Diageo seems to have finally woken up to this inevitable mission creep. Lord knows, the neo-prohibitionists could hardly have made it more obvious for them when they arranged a get together (at the taxpayer's expense, natch) to discuss how to use anti-smoking methods against drinkers. They then took another leaf out of the tobacco control manual by banning the drinks industry from the event.

Finally taking this a subtle hint that alcohol is next, Diageo have kicked off. From the Scotsman:

Drinks giant Diageo has cut its ties with Scotland's most prominent alcohol awareness charity over controversial moves by the campaigning group to link the impact of alcohol to that of smoking.

The company, which makes Johnnie Walker, Bell's, Guinness and Smirnoff, has retaliated against Alcohol Focus Scotland after being frozen out of a conference next week which the group is co-hosting with anti-smoking lobbyist ASH.

Quite right too. Banning the drinks industry from a discussion about 'alcohol control' (expect to hear that phrase more and more) is a good indication that the neo-pros don't so much want to work with industry as go to war with it. What do they have to fear from having people who understand the drinks industry attend their cosy little shindig? Do they really feel they have nothing to learn or are they worried that a bit of real-world knowledge might make their carefully prepared Powerpoint presentations look a tad naive?

Banning stake-holders from industry from attending meetings is a policy that started when the EU banned all tobacco industry delegates from attending tobacco control meetings. When they first did this, there were warnings that it would lead to representatives from oil companies, drinks companies, car manufacturers etc. being similarly banned. No, no, said the neo-pros. Tobacco was a special case. There's no slippery slope here, don't be silly.

Edinburgh-based Diageo has written to AFS, arguing it is "misleading and unjustified" to suggest smoking and drinking should be tackled in the same way when there is evidence that responsible drinking causes no harm.

They're still not quite getting it, are they? There are important differences between smoking and drinking, but, to the neo-pros, they differ only by degrees. Alcohol Focus, like David Nutt, see no fundamental distinction between tobacco and alcohol. They never have. Smoking just happened to be an easier target, just as alcohol was an easier target in 1920. Diageo are complaining because they resent having their products grouped in with cigarettes, but what they want is of minimal importance. The fact is that moralists and puritans have always grouped smoking and drinking together.

Having given Alcohol Focus £140,000 in recent years, it has also decided to redirect funding to other alcohol education programmes.

Talk about making a rod for your own back. Now, a little too late, Diageo have started to realise that these people can't be bought off or compromised with.

AFS claim the drinks and tobacco industries regularly share tactics on how best to counter public health arguments and that new research suggests even small amounts of drink could be harmful.

No safe level of alcohol. As I said the other day, this is true prohibitionist rhetoric.

Mark Baird, head of corporate social responsibility, said: "We believe it is misleading and unjustified to suggest alcohol and tobacco should be treated the same way with regard to public health policies and we strongly believe the recent moves by AFS to associate the two are a serious mistake which cannot go unchallenged."

It's too late for that, sunshine. You are now the evil 'liquor trade'. You had every chance to take a principled stand on personal liberty but ignored your allies and funded your enemies. If you're going to sup with the devil, bring a long spoon. It's not as if these people haven't shown you time and again that they are not your friends.

AFS said it had decided not to invite drinks firms to the summit because organisers did not want "vested interests" involved in a discussion on possible public health reforms.

A brave and principled stand, and one that I'm sure Alcohol Focus Scotland's new partners at ASH will support 100% because if there's one thing they hate, it's having vested interests at their events.

Day One: Monday 14th June 2010

Room 1
How to interpret a scientific paper and make your own conclusions
Craig Beck and Imran Khan, Medical and Scientific Relations, Pfizer Ltd, Tadworth, UK

Room 2
Lose the Smoker in You: A community approach to quitting in New Parks, Leicester
Louise Ross, Tobacco Control Delivery Manager, NHS Leicester City, UK and Kay Harris, Head of Local Marketing, Pfizer Ltd, Tadworth, UK

Thursday 10 March 2011

ASH Wednesday (part 1)

Man goes to the doctor to hear the results of his test. Doctor says: "Do you want the good news or the bad news?" The man says he'll take the good news. "You're going to have a disease named after you."

That's how it was yesterday when the government's "new" policy on smoking was announced. I'll come to all the bad news tomorrow in a much longer post, but there was one small silver lining, as the Ashtray blog reported:

In an extremely positive piece of news for the UK electronic cigarette industry the UK Medicines and Healthcare Product Regulatory Agency (MHRA) have announced what they are going to do about the electronic cigarette.


At least for now.

Good news for e-cigarette users. Not such good news for cigarette users (more tax, more denormalisation, plain packing, display ban) and terrible news for snus users (UK will continue to support the EU ban).

Meanwhile, the BBC's medical correspondent Fergus Walsh has expressed his own strong views on the subject of smoking and provides a clue as to why the BBC is prepared to rewrite any old press release from the anti-smoking lobby.

De-normalising smoking is a key part of discouraging the young from taking up the habit.

As I've said before, denormalisation is a sinister term with sinister consequences. Aside from the fact that it suggests that the government can decide what is and is not normal, denormalisation is stigmatisation by another name. Stigmatisation creates hatred and allows the most hateful people to come in from the fringes and be regarded as something close to normal. You only have to read some of the comments to Walsh's piece to see this.

John_from_Hendon wrote:

Passive smoking also needs to be curtailed: so ban smoking in public, in vehicles, at sea etc. even if the only person present is the smoker.

Smokers could then kill themselves with their vile addiction, but not be able to harm others either financially or health-wise.

Alternatively perhaps we could put something in the water (or more rationally the cancer sticks / coffin nails) that made smokers violently sick every time the took a puff (or in every twentieth fag)!

I prefer the option of poring scorn on smokers ghastly habit. Make smokers be subject to sets of practical jokes - for example vile diseased lungs in a packet of cigarettes on a random basis. Illegality with addictive substances only creates a very profitable criminal distribution system.

I would also hope that smokers were put to the bottom of all heath service queues - or that they should fear that this will happen.

ASH must be very proud.

Tuesday 8 March 2011

David Nutt shows his true colours

David Nutt by name, temperance nut by nature

One of the most important factors that brought about Prohibition in America was something called Scientific Temperance Instruction. Without it, Prohibition would have been "practically impossible" according to the Anti-Saloon League's chief tactician, Ernest Cherrington.

Scientific Temperance Instruction (STI)  was the brainchild of a prohibitionist zealot named Mary Hunt, who realised in the 1870s that Prohibition would takes decades to achieve. Playing the long game, Hunt believed that if children were indoctrinated with extreme anti-alcohol views in school they would become “trained haters of alcohol" who would one day "pour a Niagara of ballots upon the saloon.” This policy was adopted by the Woman's Christian Temperance Union in 1880 and through relentless lobbying, they succeeded in having mandatory STI in almost every school in America.

These campaigners wanted to move from temperance (ie. moderation) to total abstinence. To do this, they had to convince people that:

(a) alcohol could be fatal even in small doses
(b) alcohol was a poison
(c) alcohol had no medicinal benefits
(d) alcohol was instantly addictive

These were the four central messages in STI and they were hammered into school children for decades.

The problem was that science did not agree with any of these claims. Alcohol could be a poison, of course, but the dose makes the poison. Alcoholic drinks cannot, by any normal definition, be described as inherently poisonous (alas, the same could not be said of the moonshine that came with Prohibition).

It was certainly not true to say alcohol was fatal in small doses, nor that it was instantly addictive, nor that it had no medical benefits. To get round this problem, Mary Hunt began creating her own text-books and eventually got herself into a position whereby she effectively had a veto over which physiology text-books reached American class-rooms. Authors either had to rewrite their books to demonise alcohol or face being black-listed.

As would be discovered after her death, Hunt was a crook and a fraud. She used her power of veto to demand bribes from publishers and stashed away royalties in a secret 'charity' which paid her mortgage. More importantly, the text-books she presided over were full of junk science. When a distinguished committee of academics investigated them in 1903, they found that she had misrepresented the views of scientists and fabricated quotes from the leading figures in the field. If she could not misquote a leading scientist, she would pretend that any old quack who agreed with her was a 'leading authority'. Her books completely ignored the medical benefits of alcohol and used fictitious horror stories to terrify children into believing that total abstinence was the only way to avoid the perils of alcohol.

One STI text-book, for example, told the story of a boy who “once drank whisky from a flask he had found and died in a few hours.” Another insisted that alcohol burns the flesh from the throat leaving it bare and raw. Above all, STI hammered home the message that fermentation turned food into a poison which could never be consumed safely. “This alcohol is poisonous,” read one text-book. “It is in its nature, even in small quantities, to harm any one who drinks it.”

The committee found that Scientific Temperance Instruction was “neither scientific, nor temperate, nor instructive.” They concluded that:

“The text-books are written with a deliberate purpose to frighten the children, the younger the better, so thoroughly that they will avoid all contact with alcohol.”

All of this is well documented. STI has gone down in history as a prime example of fanatics infiltrating the educational system for political ends. But what else could the prohibitionists do? If they accepted the real scientific evidence, they would have to accept that alcohol—as everyone knew—was dangerous in excess but benign, indeed healthy, in moderation.

I was reminded of STI today when I read a staggering article by David Nutt in The Guardian, in which he repeated all the lies about alcohol that were popularised by Mary Hunt in the 19th century.

The myth of a safe level of drinking is a powerful claim. It is one that many health professionals appear to believe in and that the alcohol industry uses to defend its strategy of making the drug readily available at low prices. However, the claim is wrong and the supporting evidence flawed.

There is no safe dose of alcohol for these reasons:

First we have the poison claim:

• Alcohol is a toxin that kills cells such as microorganisms, which is why we use it to preserve food and sterilise skin, needles etc.

The dose maketh the poison, David. This is the same kind of deliberate attempt to scare and deceive that leads fanatics to say that e-cigarettes contains a product that is used in anti-freeze or that secondhand smoke contains a chemical that is used in car batteries. It is deceit without having to tell a lie. They know, or at least they bloody well should know, that the levels are far too low to conceivably cause harm to man or beast, but they say it any way because, frankly, they are not the most honest of people and they know most people will interpret this information as intended (ie. wrongly).

Alcohol kills humans too. A dose only four times as high as the amount that would make blood levels exceed drink-driving limits in the UK can kill.

In some rare instances, perhaps. But people dying from excessive drinking is hardly proof that there is "no safe dose of alcohol."

Then we have the claim of instant addiction:

• Although most people do not become addicted to alcohol on their first drink, a small proportion do.

Evidence please.

As a clinical psychiatrist who has worked with alcoholics for more than 30 years, I have seen many people who have experienced a strong liking of alcohol from their very first exposure and then gone on to become addicted to it.

As opposed to people who have experienced a strong dislike of alcohol and then become addicted to it? As opposed to people who have never drunk alcohol but become addicted to it? What kind of nonsense is this? Obviously alcoholics started drinking at some point and later became addicted. That is hardly proof that people become addicted on their first drink—a claim for which there is no serious evidence whatsoever.

We cannot at present predict who these people will be, so any exposure to alcohol runs the risk of producing addiction in some users.

That is self-evident but, again, you have not supported your original argument. You're also assuming that alcoholism is the fault of the alcohol itself whereas most experts believe that alcoholism is a psychological disorder which could just as easily manifest itself in drug addiction or any other compulsive behaviour. Since most people do not become addicted to alcohol, let alone on their first sip, the consensus view seems more likely to be correct.

Then we have the no medicinal benefit claim:

• The supposed cardiovascular benefits of a low level of alcohol intake in some middle-aged men cannot be taken as proof that alcohol is beneficial. To do that one would need a randomised trial where part of this group drink no alcohol, others drink in small amounts and others more heavily. Until this experiment has been done we don't have proof that alcohol has health benefits.

This is a phony argument. We have masses of studies which have compared non-drinkers to light drinkers, and light drinkers to heavy drinkers (and not just for "some middle-aged men"). Virtually every single study has come to the same conclusion—that alcohol use reduces heart disease risk. A recent review of 31 studies in the British Medical Journal showed this very clearly.

Click, as ever, to enlarge. Everything to the left of the bold line is a reduction in risk. 29 of the 31 studies showed a reduction in risk, with 18 achieving statistical significance.

We all know that correlation doesn't equal causation but if we're going to treat these data skeptically, we need to have some alternative explanations for what is behind these findings if the obvious conclusion is to be rejected. Nutt has got nothing. Instead, he plays the Nirvana fallacy card. Since no epidemiological study is ever perfect, he wants us to ignore all the evidence until science can come up with an experiment that meets his criteria of 'proof'.

That will never happen. He knows perfectly well that a randomised study of the kind he demands could never be performed. It would require forcing a random selection of people to drink specified amounts of alcohol for decades. What he's doing here is no different to what the tobacco industry did when they said there was no absolute proof that smoking caused lung cancer. He's picking at one possible, but minor, flaw in the epidemiological evidence and demanding an impossible degree of proof without acknowledging the weight of evidence that already exists. It's a classic obfuscation tactic used by—for want of a better word—denialists.

• For all other diseases associated with alcohol there is no evidence of any benefit of low alcohol intake – the risks of accidents, cancer, ulcers etc rise inexorably with intake.

Have the studies that showed these inexorable rises been carried out under Nutt's exacting conditions? Of course not. They were normal epidemiological studies, but since they support his position he asks no questions of them. Nor does he mention that the cancers alcohol is associated with (primarily oral, throat and liver) are much rarer than diseases of the heart.

And here comes another rhetorical device favoured by those deep in denial...

A recent example of where an epidemiological association was found not to be true when tested properly was hormone replacement therapy. Population observations suggested that HRT was beneficial for post-menopausal women, but when controlled trials were conducted it was found to cause more harm than good.

This is such a tired and cheap trick. You pick one example of a study that later turned out to be incorrect and then imply that a totally unconnected body of evidence must also be wrong. It is a deliberate attempt to conflate preliminary studies that turn out to be wrong (as preliminary studies often are) with a body of evidence that consistently produces the same statistically significant results over many decades across large and diverse populations. This trick is usually associated with homeopaths, charlatans and assorted loonies who live by the mantra that "science doesn't know everything" (and, therefore, convince themselves that science knows nothing and they know it all).

We must not allow apologists for this toxic industry to pull the wool over our eyes with their myth of a safe alcohol dose, however appealing it might be to all us so-called "safe" drinkers.

His mouth is starting to froth a little now, I think. This appeal against industry is a familiar one these days for all sorts of single-issue campaigners. It was familiar in the nineteenth century too, with prohibitionists blaming their every set back on the 'liquor trust'. It was hokum then and it's hokum now. The scientific evidence that shows that alcohol is safely consumed by the vast majority of drinkers has not been manufactured by the drinks industry (or their "apologists"), nor has the evidence showing that alcohol has many medical benefits. It's based on science which is as reliable as epidemiology can get. Never perfect, I agree, but a damn sight more impressive than the muddled-thinking and innuendo that Nutt relies on.

Nutt finishes off by quoting JFK's famous speech in which he said a myth is more dangerous than a lie (prohibitionists used to quote Lincoln out of context when he was dead as well). Seriously, how dare this guy accuse other people of peddling myths when he has nothing to offer but lies, distortions and fallacious arguments? There is scarcely a grain of truth in Nutt's whole article, but there is much that is designed to mislead (successfully, judging by some of the comments).

David Nutt was briefly regarded as a heroic maverick a couple of years ago when he was sacked for his 'brave stance' on drugs. Like Brendan O'Neil and the Pub Curmudgeon, this blog warned at the time that his talk about drugs being less harmful than alcohol was not rooted in a desire to see a more liberal drugs policy but to see a more draconian alcohol policy. He has since proven us spectacularly correct but this new outburst plumbs new depths.

The stoners and alleged liberals who worship this guy need to wake up to the fact that he's just an old-fashioned temperance zealot who's finding it more and more difficult to cloak his hatred of alcohol in the language of science. One wonders how long it will be before he starts preaching in the street. As he unravels before our eyes, it seems less remarkable that the last government dispensed with his services than that they ever hired him in the first place.

Plain stupidity

The UK government (you know, the new one that's against the nanny state) has apparently decided to legislate for the plain packaging of tobacco products. I wasn't going to blog about it. When things like this actually happen I try to distract myself with other things and pretend that the creeping nightmare of British idiocy is too preposterous to be real.

Fortunately, Dick Puddlecote has a very good account of the whole thing so I needn't keep you. One thing that caught my eye was a quote from some Australian lobby group which also wants to ban those evil colours and fonts that lure in the chiiiildren:

If we act quickly, Australia can overtake the British Government and become the first country in the world to mandate that cigarettes be sold in plain packaging. 

That sounded so much like a parody of the prohibition-as-sport mentality that I had to follow Dick's link to check these people actually existed. They do and they did say that. It really is just a game to these people, isn't it? A pissing contest for rent-seeking professional half-wits to decide who buys the champagne at the next international public health conference.

Not only that, they want the graphic warning to cover 95% of the packet. And, having challenged the Aussie government to be the first country in the world to pass this legislation, they say in the very next line:

There is good evidence that this would have a profound effect on young image-conscious teenagers.

Pray, where does the evidence for this world-first come from? The Martian Health Organisation? Venusians for Nonsmokers' Rights? How pathetic that it has come to this. How sad and risible that countries with the standing of Britain and Australia have been deceived and intimidated into tolerating stupid, senseless and illiberal measures for no other reason that a few well-funded and well-organised obsessives are saying "go on, give it a try."

The only silver lining to this particular cloud is that it has inspired the best blog post of the year thus far from the marvellous Ian B at Counting Cats:

The tide is eternally flowing in the opposite direction to that in which I wish it were flowing. I cannot think of a single new law, or new initiative, or economic policy, which I have approved of in more years than I care to remember. I feel as if I am living in a nation of aliens; or rather, that I am alone alien teleported into 21st century Britain and trying to understand and survive it. I increasingly feel like I’ve nothing in common with everyone around me. How can I be so out of step with public opinion? Is everyone else mad, or is it me?

I can see the world I grew up in being dismantled, bit by bit. There are times I wish they’d just get it over with. In a sense, it is the gradualism that is unbearable. There are times I wish they’d just ban everything - baccy and beer, burgers and bangers, and all the rest - once and for all. Instead, they creep forward one apparently tiny step at a time. It’s like being executed with a bacon slicer.

There's much more of this. Please do go read the whole sublime thing.

Saturday 5 March 2011

Victim of happiness

You'll recall our old friend the King of Bhutan, the racist tyrant who invented Gross National Happiness. He is a hero to fans of Utilitarianism, who believe in the greatest happiness for the greatest number of people. Not all the people, mind, just the majority. If you don't agree with the state's definition of happiness then you're out in the cold. Or, if you live in Bhutan, in prison:

No Smoking: Monk jailed for three years in Bhutan

The Himalayan Kingdom of Bhutan, famed for its unspoilt natural beauty and social policy of gross national happiness, found itself at the centre of bitter controversy yesterday after a Buddhist monk caught carrying tobacco worth under £2 was jailed for three years.

Sonam Tshering, the first person to be punished under tough new anti-smoking legislation, wept after he learnt of his sentence. "I should be punished, but the penalty could have been lighter," the tearful 23-year-old told reporters. "I wasn't aware about the act."

The headline is misleading as Mr Tshering was caught with chewing tobacco.

Bhutan banned the sale of tobacco in 2005 and tightened its laws last year to combat smuggling, requiring consumers to provide valid customs receipts for cigarettes bought outside the country. The monk was stopped crossing the border back into Bhutan in January carrying 48 packets of chewing tobacco he had bought in India.

That's not as not as much as it sounds. Indian chewing tobacco comes in a little package the size of a ketchup sachet with enough in it for one use. They cost about 3p.

In an eight-page ruling handed down by the district court in the capital, Thimphu, judges said the monk was clearly in breach of the Tobacco Control Act of Bhutan 2010 because he had not paid duty for the tobacco.

So is this a tax evasion issue rather than a possession issue? It is the case that even in Bhutan you can use tobacco so long as the government gets a cut? This aspect of the case hasn't been mentioned in previous new stories and is not expanded upon here.

The ruling added: "Ignorance of law is no excuse ... The law represents the popular will of the people."

No it doesn't. Bhutan is not a democracy. And even it was, could there be a better illustration of the tyranny of the majority than sending a man to prison for chewing a plant?

The sentence, though technically the most lenient for the offence...

The mind boggles.

...has triggered a wave of anger within Bhutan. Supporters of Mr Tshering, who have held rallies and organised Facebook pages, argue that the punishment does not fit the crime.

D'ya think?

"I think this will adversely affect the image of our country," said Lily Wangchuk, a former diplomat and now director of the Bhutan Media Foundation. "We have a very good reputation right now. We are known for having visionary leadership that has set in place a sensitive and balanced growth, we have gross national happiness, people know us as a land of paradise, a Shangri-La."

Only because people don't know a damn thing about the place, and particularly about its persecution of Nepalese immigrants.

"Personally, I feel that a harsh sentence for such a small crime will get us bad publicity."

Good. Perhaps people will see in the phony backwater of Bhutan the inherent despotism of Gross National Happiness. Until the government can be trusted not to fall back on coercion and suppression (ie. never), its only legitimate function is to facilitate the pursuit of happiness. In the case of private behaviour, that means getting out of the way and keeping its bigoted opinions to itself.

I've mentioned this before but it bears repeating: When Bhutan banned tobacco in 2005, the Lancet said 'This is progress". Progress indeed. Monks thrown in jail and police raiding people's homes with sniffer dogs. And all in the name of tobacco control. I'd like to end by saying it couldn't happen here, but I really can't see any reason why not.

Friday 4 March 2011

Consultation time again

Another public consultation is quietly going on at the Office of National Statistics where 'the public' (or whichever sections of the public can be rounded up by political pressure groups like this one) are being asked to tell the government what makes them happy. Presumably the idea is to send the responses to David Cameron's vapid National Well-being Committee, or whatever the hell it's called.

Like the people in the video [cue video of people giving reasonable but banal reasons for happiness, none of which involve the state], we want to know what you think is most important in your life and in the lives of those around you.

Is it what you earn or is it the time you spend with your family? Does the value of your house count, or is the state of the environment more important?

Use this website to tell us what matters to you.

This website will be open for your comments until 15 April, after which we will publish a summary of your responses. This will help us as we move from defining what national well-being is to the next step: looking at how we might measure it.

There you have it. You've got until April 15 to tell the government what would make you happy. Do it before someone makes the decision for you.

Wednesday 2 March 2011

Passive smoking and breast cancer

From the Beeb:

Passive smoking 'raises breast cancer risk'

Er, no. The study does not say that. This is what it says:

Our data suggest that extensive exposure to passive smoking may increase breast cancer risk. However, since risk of breast cancer was restricted to the most extensive passive smoking category with no clear dose response, the association with passive smoking should be considered suggestive only and needs confirmation from other studies.

The statistical association between passive smoking and breast cancer in this study is actually about as suggestive as a burka. The associations are all over the place and none of them achieve statistical significance. The main finding, based on a fairly substantial 1,515 cases, show that nonsmokers exposed to secondhand smoke have a nonsignificant relative risk of 1.08. Has epidemiology really got to the point where anything other than a relative risk of exactly 1.00 is considered "suggestive"? (Chance alone dictates that RRs of 1.00 are rare, but epidemiologists don't believe in chance when they want to make a name for themselves.)

The fact of the matter is that there has never been any good evidence that active smoking causes breast cancer, which makes an association with passive smoking somewhat unlikely, to say the least. Nothing has been more closely studied in the last sixty years than smoking and disease. Since breast cancer is the most prevalent form of cancer in the world, if there was a real association with smoking, it would have been spotted long before now.

It hasn't been for want of trying. Anti-smoking campaigners have always been very keen to find an association because the high incidence of breast cancer would allow them to create even more stratospheric estimates of how many lives are lost to smoking/passive smoking than already exist. But, as I wrote in Velvet Glove, Iron Fist, they have always failed to do so.

A 1994 paper published in the British Journal of Cancer found no link between breast cancer and first or secondhand smoke, nor did a massive assessment of 53 studies that encompassed 55,515 breast cancer patients in the British Journal of Cancer. The Centers for Disease Control, the American Cancer Society, the IARC, the Australian Medical Journal, the British Medical Journal and the US Surgeon General all agreed that there was no link. Geographical and historical spread of cigarette consumption showed no correlation between breast cancer prevalence and smoking, and while lung cancer rates in women began rising in the US from the mid-1960s, breast cancer rates were unaffected by the post-war surge in female smoking.

Velvet Glove, Iron Fist; p. 237

The authors of this new study even acknowledge the lack of evidence for the smoking/breast cancer hypothesis:

...systematic reviews of epidemiological studies published as of 2002 concluded that there was no overall association between active smoking and breast cancer risk, and attributed conflicting results of individual studies in part to the confounding effects of alcohol.

But add that:

However, recent reappraisals of evidence from recent cohort studies have suggested an increased risk of breast cancer that is independent of the effects of alcohol

In other words, decades of research failed to show anything until a few studies were "reappraised" in the era of anything-goes epidemiology in which eager epidemiologists and fevered advocacy groups leap on every finding, no matter how weak. We are now invited to ignore a mountain of evidence built up over decades in favour of single digit relative risks which hover around 1.00, fail to reach significance and fail to display a dose-response relationship. What a state this field of science is in.

If, fifty years ago, you told the scientists who developed the techniques of epidemiology that you thought "passive smoking raises breast cancer risk" because you'd found a statistically insignificant elevated risk of 8% they'd punch you in the face.

That is all.


Nigel Hawkes has an excellent article up at Straight Statistics looking at Ian Gilmore's recent claims about drinking and liver cirrhosis in the UK.

In short, Gilmore et al., disregarded data from recent years which show rates of cirrhosis plateauing and made a simplistic and very unlikely prediction based on the increase between 1986 and 2003. They also suggested that Britain could reduce rates as sharply as France has in the past without acknowledging that rates in France were 4 times higher in 1975 when the French decline began than our rates are today.

Nigel has some illuminating graphs in his article, but I've also created the graph below for reference (from the same WHO source). Click to enlarge.

This is a very necessary article. Please read it.

Tuesday 1 March 2011

Ireland's illicit tobacco trade

Pinch, punch, first of the month. Blogging may be light for a few days as I catch up with some writing. Meanwhile, I recommend this quite entertaining, and certainly informative, documentary about the illicit tobacco trade in Ireland.

I can't embed it so click to view.

PS. On another note entirely, this just in from the BBC:

Dr Vivienne Nathanson, head of science and ethics for the British Medical Association, said: "We have to start de-normalising alcohol."

Be afraid.