Sunday 31 July 2011

EC consultation backfires spectacularly

Last September, I mentioned the European Commission's public consultation on tobacco control. It asked questions about whether snus should be legalised and what new tobacco control measures should be enacted.

Well guess what? The results are in and it seems that—unlike in the UK where the Department of Health's front group respond en masse to these things—real people have responded. Over 80,000 of them in fact; 96% of whom are ordinary EU citizens. Shall we see what they said?

A significant majority of (citizen) respondents were against extending the scope of the Directive (ie further regulations).

A vast majority of (citizen) respondents ... were in favour of lifting the ban on snus.

A significant majority of (citizen) respondents disagreed with the regulation of ingredients at the EU level.

A significant majority of (citizen) respondents opposed limiting access to tobacco products.

Oh dear, oh dear. If you ever wondered why the government needs to create astro-turf groups and fake charities to manufacture support for its policies, wonder no more. Taking Liberties has the whole hilarious story. It's a must read.

Friday 29 July 2011

A little snus coverage

Apropos nothing, The Guardian has run a little story about a snus.

It's not snuff, it's not snout … it's Snus

Could this brown, sticky Swedish stuff save smokers from their addiction?

It is brown, sticky and can cover your teeth in discoloured drool...

Sounds real tempting so far, doesn't it? They're talking about loose snus here, which doesn't come in a bag and is therefore a messier affair. It's much less popular than pouched snus so I'm not sure why they're focusing on that, or why they use a picture of loose snus at the top of the article, but don't worry, it gets better...

– but Snus might be gaining ground as the answer for smokers wanting to give up.

Now you're talking.

Pronounced Snooss, this moist tobacco powder, made in Sweden since the 19th century, is proving a hit worldwide, with sales by manufacturer Swedish Match booming in the US and Canada.

Snus is unlike either snuff, which is sniffed, or chewing tobacco, which releases nicotine only when chomped on. Instead, users squeeze it into rabbit dropping-sized pellets...

Yes, that recognised unit of size: the rabbit dropping.

...or use pre-packed sachets that look like miniature teabags, slipping them under the upper lip for up to an hour. Absorbed into the bloodstream through the lip, Snus has a softer but longer nicotine buzz than cigarettes.

Described as "something they would use in the far northern backwoods" by fan Marcus Rosengren, well-to-do Swedes once considered the use of Snus a bit coarse. In the past 30 years, however, many have switched to it from cigarettes, giving Sweden the lowest number of smokers in Europe.

Yes indeed. The 'Swedish experience'—which could be emulated elsewhere in Europe were it not for alleged health campaigners who say they want to, er, reduce the number of people who smoke...

Meanwhile, in Europe, the Swedes are lobbying to quash an EU ban that permits the consumption of Snus but bans its sale.

As a pre-emptive plug, I should say that the bizarre history of the EU's ban on snus will make up one chapter of my forthcoming book on prohibition. It should be out in September; more details will follow.

Though Snus has been linked to raised blood pressure and an increased risk of pancreatic cancer...

Actually, the pancreatic cancer myth was pretty thoroughly debunked at the start of the year, when the biggest study ever conducted into it found no risk from snus. is not as harmful as smoking.

It is, let's be clear, somewhere in the region of 99% safer than smoking.

Sweden has the lowest rate of tobacco-related diseases in the west, and a low rate of the oral cancers Snus was once thought to encourage.

That Swedish experience again. Can we end the stupid EU ban now?

The Guardian article is welcome and fairly accurate, even if it does make snus sounds more icky than it actually is. Any exposure of the snus issue and, by extension, the folly of anti-tobacco extremists is to be encouraged, and it was good to see twitterati supremo Stephen Fry mentioning it to his three million followers.

How good of him to spread the word and how strange that tobacco control—whose only legitimate function is to help smokers who want to quit to do so—should be so reticent to speak out against the EU ban (although there are some notable, and noble, exceptions). Never forget that until recently, ASH (UK) actively supported the repeal of the ban. That was in the days before Deborah Arnott and pharma-sponsored anti-smoking conferences. I'm sure this is just a coincidence though [cough].

Finally, an amusing advert for snus I've just seen on Youtube. (Disclaimer: I'm not endorsing this particular company, I haven't tried their product and I haven't received any money from them, yadda, yadda, yadda. I just thought you might enjoy it.)

Thursday 28 July 2011

This is not a drill

“A hot dog a day could send you to an early grave,” says PCRM [Physicians Committee for Responsible Medicine] nutrition education director Susan Levin, M.S., R.D. “Processed meats like hot dogs can increase your risk for diabetes, heart disease, and various types of cancer. Like cigarettes, hot dogs should come with a warning label that helps racing fans and other consumers understand the health risk.”

Both the billboard and the quote above are real. This is actually happening right now in 2011. Simon Cooke has the details.

UPDATE: It appears that Physicians Committee for Responsible Medicine is a vegan/animal rights mob who are using the diet wars as a way to strike a blow for their four-legged friends. From Wikipedia:

The National Council Against Health Fraud, a nonprofit, health agency focused upon health fraud, misinformation, and quackery views the PCRM as a propaganda machine whose press conferences are charades for disguising its animal rights ideology as news events.

The American Council on Science and Health, a non-profit, consumer health education and advocacy organization states that the PCRM is unscientific and that it publishes unreliable nutrition information to consumers by emphasizing only data that supports their animal rights agenda. They go on to state that PCRM exaggerate the reliability and importance of data, and that they obfuscate rather than clarify what can be a confusing body of information. The American Council on Science believe that those who purport to represent consumer interests, such as the PCRM should be responsible enough to present accurate and balanced information to the public.

The American Medical Association have accused PCRM practices as irresponsible and potentially dangerous to the health and welfare of Americans and that they are blatantly misleading Americans on a health matter and concealing its true purpose as an animal 'rights' organization. They have also accused the PCRM of making misleading, false claims and misrepresenting the critical role animals play in research and teaching.

People for the Ethical Treatment of Animals (PETA) and the foundation that manages it—the Foundation to Support Animal Protection, also known as the PETA Foundation—donated over $850,000 to PCRM between 1988 and 2000, and Barnard sat on the Foundation's board until 2005. Barnard also writes a medical column for Animal Times, PETA's magazine.

The BBC stands by its junk journalism

Seven days after sending an e-mail to the BBC about its story which falsely claimed that obesity, drinking and smoking are the three biggest risk factors for breast cancer, I received a short and anonymous reply.

The original BBC story stated:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

This is arrant nonsense for several reasons, as I said in my e-mail to the Beeb (see here for the details). In summary, there is not a scientist in the galaxy who believes that obesity and drinking are the main "drivers" of breast cancer and only a handful of certifiable anti-smoking maniacs like Stanton Glantz believe that smoking is a risk factor for breast cancer AT ALL.

The BBC's reply:

Dear Chris

Many thanks for getting in touch and raising your concerns.

You are correct that it is important to stress that the findings mean that obesity affects the levels of sex hormones. The article does this. We were mindful of this and discussed this point and the wording with cancer research uk before publication of the article. We explain that it applies only to hormone sensitive breast cancer in postmenopausal women and that the link suggests obesity drives up hormone levels.

Thanks again for contacting us. We value your feedback.

Kind regards

Since this ignores every point I raised in my earlier e-mail, I replied:


I don't take issue with the bulk of the story in question, which reflects the study accurately in some respects. The main problem is the headline and the first two paragraphs, ie:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

Every word of this is demonstrably untrue. It is not a matter of interpretation or wording. Obesity is NOT the biggest driver of breast cancer - as with all cancers, age is the biggest driving force. Between the age of 29 and 69, a woman's odds of developing breast cancer increases from 1 in 2000 to 1 in 13. As Cancer Research UK's website says: "The strongest risk factor for breast cancer (after gender) is age"

After that, there is reproductive history. Childless women have twice the risk as women with large families (who breast-fed).

Family history of the disease also doubled the risk.

These are the true driving forces of breast cancer. Way down the list is overweight and obesity, with a 10-30% increase in breast cancer risk. Again, from CRUK: "Compared to lean (BMI 22.5-24.9) women, overweight post-menopausal women have a 10-20% increased risk of breast cancer, and obese post-menopausal women a 30% increase in risk."

Alcohol is also a risk factor, varying on consumption, but generally is considered to form a 10-50% increase in risk. (eg.

Smoking is not generally considered a risk for breast cancer AT ALL, despite efforts by the BBC and the Daily Mail to tell the public otherwise. To claim that it is the third biggest driver of the disease is ignorant and inexcusable.

Sex hormones are undoubtedly a risk factor, and a major one. The study you reported on shows that obesity is a risk factor for higher sex hormones and that drinking and smoking may be "moderate" risk factors for higher sex hormones. The crucial points - which I hoped I explained in the previous e-mail, but perhaps not - is that (a) the authors of the study NEVER claimed that obesity, drinking and smoking are the main risk factors for higher sex hormones, let alone breast cancer, and (b) even if these 3 factors were the main risk factors for higher sex hormones, it does not follow that they are the main risk factors - or the 'leading drivers' - for breast cancer itself. Indeed, we know with as much certainty as is possible to have in science that they are NOT.

Your article did not "stress" that obesity affects sex hormones. On the contrary, it stressed, quite wrongly, in the headline and opening sentences that obesity is "the biggest driving force behind the most common form of breast cancer in older women". This is untrue. It then stressed that drinking and smoking were the next biggest drivers of breast cancer. This is untrue. You say that: "This latest work, published in the British Journal of Cancer, suggests obesity should go at the top of this list [of risk factors for breast cancer]". This is untrue. The author of the study said, in the press release you were doubtless sent:

“Our study shows that changes in hormone levels might explain the association of established risk factors such as obesity with breast cancer risk. Other studies have found that weight and alcohol can affect hormone levels and this research confirms and adds to these findings and provides more information about how breast cancer develops.”

Nothing in the CRUK press release or the study itself in any way supports the premise of your article. Are you prepared to stand by your claim that obesity, drinking and smoking are the "biggest driving forces" for breast cancer? If not, the article should be changed. It is too late to avoid misleading the bulk of its readers, but it would at least be an acknowledgement that the BBC knows when it has made a mistake.


Chris Snowdon

Their reply...

Thank you for your comments, which have been noted.

BBC News website

Translation: 'Piss off and leave us to report Cancer Research UK press releases in anyway we see fit.' Needless to say, the article in question remains unchanged, so any woman who has recently been diagnosed with breast cancer can read it and blame herself for the disease.

I should say that my interest in pursuing this—as I will continue to do—is not because it is the worst example of BBC reporting I have ever seen. Far from it. It is because it is an open and shut case. Their reporting of this particular story is wrong in essence and in fact. To publish such garbage in the first place is lamentable, if forgivable, but to stand by it is appalling.

Thursday 21 July 2011


As you may have read elsewhere, Paul Bartlett's outdoor smoking ban was crushed on Tuesday evening. None of the nine other councillors were prepared to second the motion and only Bartlett was prepared to speak out in favour of it.

One speaker asked for a show of hands to see how many people in the room supported Councillor Bartlett's proposals. There were around 150 people in attendance and only 2 people raised their hands - one of those was Councillor Bartlett himself.

When it became apparent that nobody was prepared to second Councillor Bartlett's proposals, there were calls from some members of the public for him to also withdraw the proposal that had been moved to the 20th September. Other people were calling on Councillor Bartlett to resign from his position on the Town Council.

148 votes to 2. Ouch. The proposal may or may not re-emerge on 20 September. If it does, it looks certain to be rejected.

When Cllr Bartlett stood up to speak on his motions, he was heckled by the crowd on several occasions.

How very unfortunate.

Following this, several members of the public called for Cllr Bartlett's resignation.

Excellent. As I mentioned in a previous post, such was the degree of public interest that the meeting was held in the church, rather than the town hall. Hence this amusing announcement from the vicar:

This prompted Father Ross Northing, who later spoke out against a ban, to remind people where they were, and ask them to refrain from swearing and using the Lord's name in vain.

Sounds like a heated, if one-sided, debate. The majority made themselves heard, Bartlett was put in his place and all is right with the world.

What can we learn from this little episode? Firstly, I think, it tells us that we in Britain have not yet succumbed to the hypochondria and misanthropy of those few parts of California that have banned smoking outdoors. This is no great surprise—California is in a league of its own when it comes to health hysteria. The next phase of the anti-smoking crusade depends heavily on smokers being regarded as second- or third-class citizens and it's pleasing to see that this kind of bigotry is not thriving, at least in Stony Stratford.

Secondly, and more importantly, while Bartlett is a strange and risible fellow, his initiative brought out the true colours of the Department of Health and their astro-turf group ASH, both of whom came out in favour of the idea. Those of us who have been following the tobacco control movement have known where these people are heading for some time, but it is only in the last week that the public has seen beyond doubt that they are—properly defined—anti-smoking fanatics.

Most nonsmokers have not been adversely affected by the 2007 smoking ban and they are entirely indifferent to issues such as the display ban and plain packaging. Why wouldn't they be? Regardless of whether they buy into the passive smoking panic, it is easy for them to believe that the 2007 ban was a legitimate health and safety measure, albeit one that went too far.

But the outdoor ban is an entirely different animal. As brazen as they might be, none of the anti-tobacco extremists have been able to bring themselves to pretend that smoking out of doors poses a health threat to others. Bartlett's talk about germs on cigarette butts and children being burnt in the street has rightly been dismissed as the ravings of a lunatic. Instead, the case was made on the openly authoritarian grounds that this is for your own good.

It hasn't worked—on the contrary, it has induced a wave of revulsion—but it is a watershed moment insofar at it marks the point when all pretense of this being about nonsmokers' rights was finally dropped and the paternalism became overt. I would expect ASH et al., to regroup and revert to the Fabian tactics of infringing liberties incrementally, but the cat is out of the bag. We know where they stand.

Wednesday 20 July 2011

More awful reporting from the BBC about breast cancer

Michelle Roberts of the BBC has produced a wholly misleading report about a study of sex hormones and breast cancer risk based on a press release from Cancer Research UK. It's a 38% cut and 45% paste job according to It's a shame it's not 100% cut 'n' pasted because although CRUK rather glorified the study, their press release was at least factually accurate.

The Beeb's version is this:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

This follows the well-worn path of blaming food, alcohol and tobacco for every disease known to man, which is presumably why the Beeb reported it. But this conclusion is in no way borne out by the study itself or even Cancer Research UK's press release. Obesity and drinking are moderate risk factors for breast cancer and the balance of evidence suggests that smoking is not a risk factor for breast cancer at all.

The best advice that could be given to women to avoid breast cancer is to have children early in life and have lots of them. This, however, doesn't fit into the sin = death narrative of our times and so the usual lifestyle factors must be trotted out.

If you look at CRUK's list of risk factors for breast cancer, you will see that obesity and alcohol feature a long way down and that the charity concedes that the weight of evidence, including an IARC monograph, shows that smoking is not a factor.

How then, does the BBC conclude that obesity is the number one 'driving force' for breast cancer, closely followed by alcohol and smoking? The answer is that, once again—and in common with the Daily Mail—Beeb reporters simply can't read a scientific study properly.

The paper in question looked at risk factors for high concentrations of sex hormones in postmenopausal women which, in turn, is one risk factor—though not the main one—for breast cancer. They found a reasonably strong correlation with weight and rather more modest correlations with drinking and smoking. The researchers don't claim that these factors are the main cause of sex hormone concentrations, let alone of breast cancer itself. The researchers also note that most studies have found no link between smoking and breast cancer.

In other words, the BBC has completely misinterpreted the study. It's not the worst health reporting I've ever seen, it's just routine incompetence that will mislead many thousands of women.

I wrote to the BBC earlier today about this, but as I entertain no hope of receiving a reply, I'll reprint what I said here:

Dear Michelle,

Your report today about sex hormone concentrations fundamentally misrepresents the study in question. It begins:

"Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers. Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK."

This is not what the study says at all, nor is it what the Cancer Research UK press release says:

"Weight is the biggest factor affecting the level of sex hormones that increase breast cancer risk in post menopausal women, according to new research published in the British Journal of Cancer today (Wednesday)."

There is a crucial difference between these two statements. Sex hormone concentrations are one risk factor, though not the main one, for breast cancer. The study in question looks at three possible risk factors for higher sex hormone concentrations and finds a reasonably strong relationship with weight and more modest relationships with alcohol and smoking. The study does not say that these three factors are the main contributors to sex hormone concentrations and it certainly does not say that they are the three main risk factors for (or 'driving forces' of) breast cancer itself.

The main risk factors for breast cancer, as stated on Cancer Research UK's website, are age and reproductive history. There are moderate associations with obesity and alcohol, but the weight of evidence shows that smoking is not a risk factor at all. In reference to smoking, CRUK states: "In 2004, the International Agency for Research on Cancer concluded on the basis of the existing evidence that smoking and secondhand smoke do not cause breast cancer". This is also stated in the study you reported on today:

"Most epidemiological studies have suggested that smoking has little or no effect on breast cancer risk (Collaborative Group on Hormonal Factors in Breast Cancer, 2002; International Agency for Research on Cancer, 2004)" (p. 11)

Both sources mention that a minority of studies have found a link between smoking and breast cancer in certain instances and that - as ever - more research is needed, but as the evidence stands, there is not a convincing link.

Any lay person reading your report cannot fail to conclude that obesity is the main driver of breast cancer, closely followed by drinking and smoking. This is untrue and should be corrected.

All the best,

Chris Snowdon

And, while we're at it, here's the unanswered e-mail I sent to the BBC last time Michelle Roberts misled women about breast cancer risks ('Passive smoking 'raises breast cancer risk'- 02.03.11)


The story that appeared on the health section of your website today titled "Passive smoking 'raises breast cancer risk'" is inaccurate and misleading. Your use of quotation marks seeks to distance yourself from the claim that passive smoking raises breast cancer risk but the authors of the study you reference make no such claim either.

Even a cursory reading of the study reveals that the researchers say that "extensive exposure to passive smoking *may* increase breast cancer risk." They add that "the association with passive smoking should be considered suggestive only." Your headline does not reflect these doubts, nor does your report mention that the results found were statistically insignificant. You also focus on the highest relative risk (32%) when the overall relative risk was just 8%. You compound this by prefacing it with the words 'for example', thereby implying this was a typical finding rather than the most extreme scenario. Using the same study I could equally say that 'for example' women who are exposed to passive smoke in the home are 11% *less* likely to get breast cancer.

Finally, you claim that this study is the largest yet undertaken. This is untrue. Several studies have been larger including Peto et al (see below).

Before scaring and misleading your readers, you should make it clear that decades of research have shown that neither smoking nor passive smoking increases the risk of breast cancer. A 2002 review in the British Journal of Cancer, for example, looked at 53 studies and concluded that "smoking has little or no independent effect on the risk of developing breast cancer." An extensive review by Richard Peto in 2008 concluded: "incidence of breast cancer is similar in women who did and did not report passive exposure to tobacco smoke either as a child or as an adult."

There is no reason to report today's highly equivocal study as proof when you have not, to my knowledge, reported any of the dozens - possibly hundreds - of studies showing no effect.

Lax reporting of health stories seem to be endemic at the BBC of late. I appreciate the press releases you receive may sensationalise the findings in epidemiological studies, but it is time the BBC realised that medical journals are magazines like any other and rely on news coverage to maintain their profile, readership and advertising income. Press releases from these journals should be treated with the same caution as would press releases from any other business. If there is no one at the BBC who can (a) understand statistics and (b) make themselves familiar with the scientific literature, then you should either find someone who can or stop reporting these stories entirely.

Where do they find these bloody people?

Tuesday 19 July 2011

Dept of Health wants outdoor smoking bans - it's for your own good

I'm much obliged to Man Widdecombe for recording this morning's debate about the Stony Stratford outdoor smoking ban on BBC Radio Sussex. Rather foolishly IMHO, 'health experts in Surrey' have put their weight behind Bonkers Bartlett and want a county-wide ban. They are not using the passive smoking argument per se, and instead are saying it will bring down the smoking rate. Maybe it would, although the indoor smoking ban didn't and, besides, whether adults choose to smoke is none of their business.

On the show was Karen Simmonds a 'tobacco control alliance co-ordinator' who is, presumably, one of the aforementioned experts, but since she thinks that "many countries" have outdoor smoking bans (actually none do, except possibly Bhutan), that California has a state-wide outdoor smoking ban (it's only a few towns and suburbs), that heart attacks fell after the smoking ban (they fall every year) and that outdoor smoking bans are "self-enforcing" (the New York ban has been completely ignored), this requires a broader-than-average definition of expertise.

I spoke after her. Man Widdecombe has this sound file and others. Go listen. It's interesting that the Department of Health and its front groups have come out publicly in favour of outdoor bans despite the fact that the public are overwhelmingly hostile to them. It's all good. People are starting to see the true nature of the anti-tobacco extremists and they don't like it one bit. I love the smell of hubris in the morning.

Monday 18 July 2011

Drinking is the new smoking (part 94)

Those who were at Stony Stratford on Saturday will have heard Roger Helmer predicting that the day would come when those who ordered wine in restaurants would be given a bottle emblazoned with a picture of a diseased liver.

Pro-smoking hyperbole? Reductio ad absurdum? Not at all. Regular readers will know that such images have been considered in Thailand and that the plan is for 'graphic warnings' to go worldwide.

In Australia (where else?), the hapless drinks industry has decided to play ball with the neo-prohibitionists under the pathetic illusion that they are dealing with reasonable people. Consequently, they have agreed to place written health warnings on their cans and bottles.

Well, guess what? The wowsers still aren't happy...

The industry’s move to put messages on the labels of all alcohol products is theoretically the right move and one that we’ve been advocating for.

Indeed you have, indeed you have. You must be delighted.

“The labels introduced voluntarily by the industry do not go far enough,” Dr Hambleton [president of the Australian Medical Association] said.


The Alcohol Policy Coalition recommends health messages that are outcome-related, that takes up 25 percent of the package surface and includes prominent text and graphic warnings.

Well, colour me flabbergasted. A bunch of temperance cranks demands the drinks industry put health bigger, graphic warnings on booze and when they foolishly oblige—and before the change has even been implemented—the cranks start crying that it's not enough. We've been here before, have we not?

And then, as Penn and Teller would say, there's this asshole...

Public Health Association of Australia spokesperson Professor Mike Daube said the push was little more than public relations rather than a meaningful public health promotion.

Does that name ring any bells? It should. Mike Daube was the president of ASH (UK) in the late 1970s when he put that organisation firmly on the path to prohibition. If drinkers have any doubt that they're on the same trajectory as smokers they might take note that they're not just faced with the same rhetoric, but with the same personnel.

But, hey, all these guys want is a graphic warning that covers 25% of the pack, just like cigarettes. After that they'll calm down and move onto something else, just like these anti-smoking campaigners did...

Larger packet warnings fail to satisfy anti-smoking lobby

Regulations requiring tobacco manufacturers to carry larger pictorial and written warnings on cigarette packets have failed to satisfy tobacco control groups.

Tobacco control groups failing to be satisfied?! Say it ain't so!

They say the graphic warning pictures of cancers and other diseases which can be caused by smoking do not go far enough to deter smokers.

This is completely out of character for these folks. Usually, they're so easy to please. Something must have really rattled them this time, so what gives?

Churit Tengtrisorn, director of the Public Health Ministry's Office of Tobacco Control Committee, has announced regulations requiring tobacco companies to increase the size of anti-smoking pictures to cover 60% of the pack, up from the current 55%.

And how right he is. With so many people thinking cigarettes are good for them, expanding the warning from 55% and 60% should make literally millions of people give up smoking. Thank God this man has brought this discrepancy to light. But perhaps we could do even more?

Bungon Ritthiphakdee, director of Southeast Asia Tobacco Control Alliance, said Uruguay had succeeded in introducing warning pictures which made up 80% of the space on cigarette packs.

Well, there you go. Still, that's Southeast Asia. Nothing so silly could happen in Australia, the land the of fearless individualism, could it now?

In its release of draft plain packaging bill, Australian government also announced it would increase size of picture warnings to 75% of front and 90% of back of tobacco packs from 2012. Australia will then have overall world's largest pack health warnings, with average of 82.5% of front and back.


Drinkers, don't make me spell it out to you, this is getting embarrassing for both of us. Let me just say it again in two words.

You're next.

Oh, and they're banning swearing in Victoria. As Clive James once said, the problem with Australia isn't that we sent a load of prisoners there, but that we sent a load of prison wardens there. Poor buggers.

Saturday 16 July 2011

The Stony Standoff: Sanity 1, Bartlett 0

I've just returned from the beautiful town of Stony Stratford to join many others in offering my scorn for Paul Bartlett's ASH-approved plans for an outdoor smoking ban. It was standing room only in The Bull pub where a crowd of well over a hundred (*UPDATE: the BBC estimates 200) heard various politicians and pundits condemning the proposal and calling for the nanny/bully state to the reined in.

Protesters had travelled from Cumbria, North Yorkshire and even further afield to make themselves heard, making my own five hour round trip from the south coast look like a short commute. Some had stayed overnight in the town to make sure they were around when things kicked off at 11 am. And all at their own expense, on a Saturday and in torrential rain.

As for the residents, many of them popped into the pub from time to time to show support for their visitors. They seem bemused by the proposal and embarrassed by their councillor, who may be called to account at the next election. A rather splendid article in today's Guardian gives a flavour of the atmosphere:

Bartlett is well known for his zero tolerance views. He's a kind of mayor Giuliani for Milton Keynes or to put it another way "a total twat". So said Stony resident Gina Sherwood. "I think it's absurd. There are too many people against it. I don't know one person who is for it."

The head of the local business association called for the proposal to be quashed and expressed disappointment that the town's efforts to pull in tourists were being undermined by Bartlett's mania—although today was clearly an exception. Needless to say, the man himself did not put in an appearance and if anyone in Stony Stratford agrees with him, they did not make their presence felt. And if, as the councillor has claimed, Stony Stratford has a problem with cigarette litter, somebody had helpfully cleared it up before we arrived. The streets were as spotless as they presumably were on the day Bartlett was forced to travel 10 miles to Milton Keynes for his publicity shot.

Several speakers pointed out this is not an issue of health, but liberty—a point underlined by the large number of nonsmokers in attendance, including Roger Helmer MEP who pledged to smoke a cigarette in the streets of Stony if the anti-smokers got their way. I doubt that will be necessary. Such has been the public interest that the vote has been moved from the council office to the (much larger) church and it seems likely that Bartlett will lose by a wide margin. Perhaps that would have always been the outcome. The people of Stony Stratford seem a sensible lot and are not prone to intolerance or extremism. Bartlett is the cuckoo in the nest. As a Stony resident said in the Guardian article:

"This is just victimising people. Can't we just be non-smokers? Why do we have to be anti-smokers?"

A perceptive comment, that. The anti-smoking movement relies on a small handful of obsessives claiming to represent all non-smokers. They don't, they never have and they never will. Normal people do not wish to create division, segregation and 'denormalisation' in society (one of the placards today read 'Denormalise Councillor Bartlett'). ASH and Bartlett represent non-smokers about as much as David Koresh represented Christianity. Claiming that there is a war that must be fought is the great deception that the zealots must commit to fulfill their long-term goal of prohibition. More and more people are beginning to see through that lie.

No doubt similar proposals will be raised by unhinged councillors and attention-seeking MPs in the future. With a few tweaks here and a few bogus health scares there, outdoor smoking bans could yet become palatable to voters in the least liberal parts of the country. They are, after all, 'the next logical step'. But, for now, the sane majority looks likely to prevail. Put that in your pipe and smoke it, Bartlett.

Friday 15 July 2011

A line in the sand

A bigot yesterday

Most readers will by now be familiar with the name of Stony Stratford, the small Buckinghamshire town that has hit the headlines thanks to a loony (pictured left) who wants to use the force of law to ban that which displeases him. 

His name is Paul Bartlett and he suffers from some sort of pathological hatred of smokers which appears to stem from issues with his pipe-smoking father whom he describes as "disgusting." 

His proposed ban on smoking in the streets of Stony does not seem likely to become law, largely because Bartlett himself is seen as a risible figure even within his own party. He confirmed this impression on TalkSport last night when, having bottled the opportunity to debate the issue with Dick Puddlecote, he turned up—tired and emotional—and fulfilled every stereotype of the foaming-at-the-mouth, anti-smoking fanatic. I am still none-the-wiser as to what his reasoning is for the ban, other than that he doesn't like smoking. That, however, is enough these days.

Dick Puddlecote is leading a delegation to Stony Stratford tomorrow to give Councillor Bartlett a figurative one-figured salute and I will be joining him. I hope you will too, because there are three reasons why a line needs to be drawn in the sand.

Firstly, the fact that the proponent of this piece of draconia is a Napoleonic fantasist with the charisma of a dead haddock does not mean that outdoor smoking bans could not be successfully introduced by individuals who possess a more convincing mask of sanity and better public relation skills. As indeed they have. New York fell to the prohibitionists with barely a squeal after Michael Bloomberg took his obsession to a new level. Several parts of California have done the same thing. 

Secondly, the Department of Health's anti-tobacco front group ASH has given its blessing to the ban. This tells us—should we be in any doubt—where they're heading.

Thirdly, Bartlett has opened an Overton Window and made the unthinkable appear merely unlikely. This shifting of the sands is a common tactic for prohibitionists. You may recall the Lancet editorial of 2003 which called for the total prohibition of tobacco sales in the UK. Since the Lancet cannot seriously have believed this to be a practical possibility, it can only be viewed as an attempt to extend the parameters of public discourse. By discussing the impossible, it made the previously unthinkable option of a smoking ban in pubs seem plausible. It made a total smoking ban almost seem like a compromise.

It's an old trick but it works because normal, decent people are naturally inclined towards compromise. On last night's radio show, for example, most callers were appalled by the prospect of an outdoor smoking ban, but some were prepared to consider designated outdoor smoking areas—ie. segregation—as a 'compromise'. I venture to suggest that such a move was not on the cards before Slaphead Bartlett opened his mouth.

The problem with compromising is that it only works when both sides are normal, decent people. It doesn't works with fanatics because the deranged never stop. Not interested in finding a reasonable solution, they seek only to impose their will. It is their nature to eat away at tolerance and decency in society. They cannot be reasoned with. They need to be reminded that they are not normal.

Details of the Stony Standoff are here.

Wednesday 6 July 2011

Then they came for the drinkers...

"Prohibition is won, now for tobacco."

So said the great anti-saloon preacher in 1919. 2011's version is only slightly different.

Cigs war won: Now cancer campaigners set their sights on beer

This is from Australia, natch. Nonsmoking drinkers should pay attention, particularly those of the complacent Campaign for Real Ale variety. This is all about you now.

HEALTH activists who believe even one alcoholic drink can cause cancer are lobbying MPs in Canberra today for limits on how much we consume and how much we pay for it.

If they're successful in branding alcohol a carcinogen it could lead to tough restrictions similar to those applied to tobacco, including warnings on labels and laws requiring plain packaging.

Oh, what a tangled web we weave. Still, at least there isn't an equivalent of Action on Smoking and Health to fight a vociferous campaign against drinkers. No, hang on, there is.

Today's offensive on drinking problems, including limits on how much we consume and how much we pay for it, is being launched by the National Alliance for Action on Alcohol (NAAA), a group of health and community organisations formed in March last year.

But surely they wouldn't equate the risks of drinking with the risks of smoking?

The Cancer Council of Australia argues even one drink is dangerous, a view similar to its position that even one cigarette can injure health.

And don't bother pointing out that a little alcohol is good for your health. The wowsers have got that one covered as well.

It’s bad news for wine lovers - a leading health researcher has dismissed one of the cherished hopes of drinkers everywhere - that a couple of glasses a night is good for the heart.

Professor Tanya Chikritzhs, of the National Drug and Research Institute, says the health claims are based on flawed and biased research.

My, my. This is terribly surprising news isn't it? And all the more ironic since only last week the drinks industry was  whining about a BAT advert depicting a beer can in plain-packaging as a warning of what is to come.

Stephen Strachan, the chief executive of the Winemakers Federation of Australia, said his members would reject any suggestion of a link between alcohol products and tobacco that the ad implied. There was no suggestion that alcohol products were to be subject to plain packaging.

"Our industry does not like any association between tobacco and alcohol," Mr Strachan said.

As I've said many times before, it doesn't matter a damn how the drinks industry sees itself. It only matters how the neo-prohibitionists see them, and they see alcohol as a carcinogen that causes death, disease and "passive drinking".

It is undeniable that alcohol causes some cancers, so any dunce who justifies extreme anti-smoking policies because of the "I don't see why I should pay for smoking-related disease" argument (which is a myth anyway), should bear in mind that they've sowed the seeds of their own vilification.

As Dick Puddlecote wrote a couple of years ago:

I once suggested to some beardy tossbag from CAMRA that he should throw his weight behind objecting to tobacco prohibition because his vice was next. He piffled that drinkers were too numerous to be subject to the same denormalisation.

May God rot his middle class pompous paunch if he doesn't now realise that he was disastrously wrong.

Well, guess what? Wowsers, health fanatics and puritans are not the drinker's friend. Never have been, never will be. Those of us who enjoy pleasures that carry a measure of risk are on the same side. Always have been, always will be. The temperance lobby met with ASH in Scotland recently to swap notes, for God's sake. How far down the slippery slope do you need to be before you realise you're on your arse?

On the plus side, the temperance lobby are following the anti-tobacco blueprint to the letter, so drinkers know what's coming. On the down side, many of them have conceded so much ground to their enemy by accepting their arguments against smokers that it's difficult for them to put up a consistent defence of their own pleasures.

Still, good luck, and remember...

Tuesday 5 July 2011

Does Champix cause heart attacks? Hmm, maybe.

The news that Champix/Chantix has been linked to heart disease has been widely reported in the last day or two, after a meta-analysis found that those who use the controversial stop-smoking drug had a 72% increased risk of adverse cardiovascular events.

The lead author, Sonal Singh, has been getting rather excited about the results.

"This is just like driving a car without brakes,” he said. “Going forward, I don’t know how we will convince our patients to take Champix for what, to increase your risk for heart attack?... People should be concerned. They don’t need Chantix to quit and this is another reason to avoid Chantix all together."

The days of the sober, disinterested academic may be over, but it would nice if researchers could release their results without sounding quite so much like campaigners. Especially when your results really aren't that impressive.

The meta-analysis took 14 studies and found a relative risk of 1.72. That sounds OK until you look at the results of the studies themselves (click to enlarge).

Of the 14 results, only one of them is statistically significant (just) and the rest of them are miles away from achieving significance. This is because the number of people suffering heart attacks is tiny—about one in a thousand overall. In only one of the studies was there more than seven cardiovascular events between the Champix users and the placebo group combined. In six of the studies, there was only one heart attack in the entire cohort. When all studies are combined you still only have 79 heart attacks from over 8,000 people (and 45 of these come from just one study, which clearly used a very different methodology). This, at the very least, indicates that if there is a risk here—and there may be—it is very small in absolute terms. It is simply impossible to take these studies as proof of anything.

This is not the (original) researchers' fault. The studies are too small for enough cases to emerge. If and when larger studies are conducted, it may become apparent that there is a real risk. The fact that 11 of the 14 studies show an increase in risk—albeit a very flimsy one—is suggestive of an effect, but I would put it no more strongly than that. Comparing it to driving a car without brakes is ludicrous and suggests a certain crusading zeal from the study's authors that may have biased their approach.

This is the problem with meta-analysing statistically nonsignificant relative risks. It's a fallacy to think that by combining different studies with different flaws and biases you are creating one good, robust study. You're not. If the original studies don't tell you anything, combining them usually doesn't make them any more informative. Meta-analyses are pretty good at estimating an accurate relative risk when there is strong evidence that a risk exists. When the risk is far from proven—and most of these studies aren't even suggestive—they generate more heat than light.

I realise that this view is far from universal in the debased world of modern epidemiology (not least by those who gather together a similar grab-bag of weak and conflicting secondhand smoke studies to 'prove' various outcomes), but achieving statistical significance by combining a bunch of near-useless studies is, in my view, tantamount to cheating. It is the equivalent of multiplying zero by ten and coming up with two. Consequently, the researchers have found a relative risk of 1.72 that is much higher or much lower than any of the risks found in the studies themselves. That should be a clue that something is wrong.

Lord knows, I hold no brief for the pharmaceutical industry and there are already good reasons not to take Champix without worrying about heart problems, but if the drug really does cause users to have heart attacks, this meta-analysis falls a long way short of proving it. It would be wrong and inconsistent to expect a lower burden of proof against Champix just because it is made by Big Pharma. This is one of those instances where more research really is needed.

Monday 4 July 2011

One in, one out

It's with some sadness that I see Carl Philips has announced a hiatus for his blog Ep-ology. At the start of the year Carl took on the challenge of writing one post a day about epidemiology and 'unhealthful news'. Six months on, he has amassed an archive that is essential reading for anyone interested in how epidemiological research is conducted, peer-reviewed and published in the real world, and why the media reports it so badly.

Hopefully Carl will be back in the near future, but whatever he does, he's left a body of work that is worth catching up on. If you haven't been reading him this year, do it now. It's witty and incisive stuff and is much more in the spirit of skepticism than some of the self-proclaimed skeptics' sites out there.

I should also mention Dave Atherton's new(ish) blog Lifestyle Reviews. Dave is a regular commenter here and elsewhere, and he's great at unearthing little-known studies and reports.

On Saturday he looked at the claim that supermarket booze has got cheaper since 2007. This, of course, is a reason/excuse often given for why so many pubs have closed in the UK since the smoking ban. Although often given, few people have bothered to check whether it's true. Dave has, and according to his figures, there hasn't been any real change. If true, this is interesting not only in the context of the smoking ban but in the context of the supposed rise in binge-drinking (which is a myth anyway). Go take a look.

The pleasure vaccine

From The Australian:

US scientists believe they are close to developing a vaccine for nicotine addiction that could stub out smoking for good.

They are testing a synthetic molecule that destroys tobacco's "feel-good" effect by stimulating white blood cells to smother nicotine when it reaches the bloodstream. This prevents nicotine from creating an artificial high in the brain.

Scientists at the Scripps Research Institute in California hope to try out the injection on humans within three years. If it works, the principle could be adapted to vaccinate children against addiction to drugs, including cocaine and heroin.

Aldous Huxley would have been proud to come up with such an idea (satirically, of course). Perhaps this is the answer to the age-old problem of people enjoying themselves in ways that displeases the government. This is more than a cessation device; it will make it pharmacologically impossible to derive pleasure from stimulants and narcotics. Kind of brings a new meaning to the word 'kill-joy', doesn't it?

It's interesting that the 'vaccine' is not even being pitched as an aid to quitting for people who want to do so. Instead, it is explicitly cited as a means "to vaccinate children" who, by definition, cannot consent. One of the researchers mentions that this would raise "profound moral questions". No kidding. But prohibition also raises profound moral questions and yet that has not stopped an Icelandic politician raising a private member's bill to do just that...

Iceland is considering banning the sale of cigarettes and making them a prescription-only product.

And yes, that is prohibition. Doctors were able to prescribe drink in 1920s America and can still prescribe hard drugs today.

To think that it all started with an assurance that they only wanted to warn smokers of the hazards of smoking and have non-smoking sections in restaurants.

As Johnny Rotten once said, do you ever get the feeling you've been cheated?

New York: protecting smack-heads from passive smoke

From Jon Stewart's ever-wonderful Daily Show, a dry look at New York's open air smoking ban. Finally, drug addicts and drunks won't have to put up with the nuisance of traces of cigarette smoke in a park that's bigger than Monaco. Happy Independence Day.

Friday 1 July 2011

Direct from the ASH bunker

You may have heard about the recent meeting in Parliament to discuss amending the smoking ban. As word spreads that there is an easy way to accommodate smokers and nonsmokers without killing off thousands of pubs, ASH's latest press release is a masterpiece of denial and disinformation.

Four years on: More smokers support than oppose smokefree law - no evidence of adverse impact on hospitality trade

On the fourth anniversary of England's smokefree law, new figures show that public support for the measure remains high with 78% of the population in favour of the law. Significantly, almost half of all smokers (47%) support the law.

Or to put it another way, a significant minority of the public—millions of people—still oppose the ban four years after it was brought in and less than half of smokers support the law.

The very fact that a large number of people, especially including those who are most directly affected, oppose the ban is precisely the reason why it should be amended it so that everybody can be happy. Everybody, that is, except the lunatic fringe of the anti-smoking movement that is represented by ASH.

The survey complements an independent Government-commissioned review of the impact of the smokefree law which found no significant decrease in the number of people visiting pubs or restaurants before or after the legislation.

I'm going to start invoicing ASH for all the coffee soaked keyboards they've made me ruin with statements like this. If I remember correctly, the review in question was actually ditched by the Coalition when they came to power but the Department of Health produced it anyway because they had spent three years manufacturing the evidence to support a law they themselves had lobbied for. It was entirely written by Linda Bauld, a professional anti-smoker who is a member of the ASH Advisory Council, a member of the Smokefree South West Programme Board and a member of the International Network of Women Against Tobacco. It would be hard to imagine anyone less qualified to produce an "independent review". We shall come back to her in a moment.

These findings stand in stark contrast to the claims made by the 'Save Our Pubs' campaign - a tobacco industry funded font group...

You know what these font groups are like. They start off campaigning against the use of Times New Roman, the next thing you know they want a ban on Comic Sans.

...that the smokefree law is causing pubs to close. The real agenda behind this campaign is to amend the law to allow smoking in pubs 

Oh no, they've been rumbled! And they would have got away with it too, if they hadn't put 'Amend the Smoking Ban' on every single piece of campaign literature.

However, the pro-tobacco lobby's claims that the smoking ban has led to pub closures are unfounded. In 2007, the year England went smokefree, the number of licensed premises for "on sales" of alcohol actually increased by 5% and there has been a net increase in the number of people reporting going to pubs since the smokefree law came into effect.

It's actually quite sad how ASH cling to this factoid as if it was proof that pubs aren't closing in huge numbers. As everybody keeps trying to tell them, the number of on-licenses is completely unrelated to the number of pubs. A license is required to sell alcohol and there has been a steady rise in the number of licenses granted since the Licensing Act relaxed the licensing laws in 2005.

The number of pubs, on the other hand, has fallen year after year since 2007, when the smoking ban came in. Nobody—other than the terminally self-deluded—disputes that there has been a massive and unprecedented fall in the number of pub since 2007. It has been one of the most thoroughly reported business stories of the last few years. People have come up with alternative explanations for why the pub industry has crashed but only ASH deny that there has been a crash at all.

If ASH had the slightest interest in seeking the truth, they could easily have consulted figures from the British Beer and Pub Association which show that over 4,000 pubs have closed since the ban came in.

Or they could have looked at the survey from the British Institute of Innkeeping, which found:

  • The proportion of smoking customers dropped from 54% to 38%;
  • 66% reported that their smoking customers were staying for shorter periods;
  • 75% reported that smokers were visiting less frequently;
  • 47% of businesses had laid off staff, although 5% had recruited additional staff;
  • Income from drinks fell by 9.8%;
  • Income from gaming machines fell by 13.5%.

They didn't do any of this. Would it really hurt them to at least acknowledge that thousands of pubs have closed? Do they really have to deny everything?

But wait, what's this? Is Deborah Arnott about to hint at the truth?

Commenting on the findings, Deborah Arnott, Chief Executive of ASH, said:

"Pubs, like all small businesses have been hard hit by the recession...

Nice try, but the recession didn't begin until late 2008 and it doesn't explain why Scotland and Ireland suffered a similar loss of pubs when they brought in their bans in 2004 and 2006. Since pub numbers declined at a similar level in different countries in different years, there really can be only one explanation for the phenomenon.

But the tobacco lobby group assertion that thousands of pubs in England and Wales are under threat of closure due to the smoking ban does not stand up to scrutiny.

Evidence or STFU. Pubs have closed and will continue to do so until their numbers have fallen to the level needed to satisfy the lowered demand for smoke-free venues. ASH's assertion—for that is all it is—contradicts every piece of evidence from Britain and abroad. It is at odds with what publicans, market analysts, customers, publicans and the stock market have said. It defies reason, common sense and the evidence of one's own eyes for ASH to continue with this charade. It's my view that the case has been proven beyond reasonable doubt. There simply is no other factor can can explain the data. However, even if you don't believe the evidence to be compelling, it is simply a lie to say that there is "no evidence of [an] adverse impact on the hospitality trade." There is plenty.

The British public are enjoying the benefits of smokefree drinking and dining and there is little appetite for a return to the bad old days of smoky pubs."

This a straw man argument. The Save Our Pubs campaign is calling for ventilated smoking rooms adjacent to the bar, not for "the bad old days of smoky pubs" (y'know, those bad old days when pubs weren't closing in their thousands). There has always been public support for a law that accommodates smokers and nonsmokers alike because the British, in general, are a tolerant and reasonable bunch. This makes ASH a profoundly unBritish organisation. As with all extremists, compromise and tolerance are their natural enemy, which is why ASH will fight tooth and nail to make sure that tools of denormalisation and social exclusion remain law.

There is one simple way of testing whether the smoking ban has been popular and successful—get rid of it. If people really don't want to go back to the days of smoky pubs, there is really no reason to have a law forcing pubs to be smokefree. Get rid of the law, let the market decide, and if pubs remain entirely nonsmoking we'll know that ASH were right all along. If, however, pubs decide to accommodate smokers once more, we'll know, if we hadn't realised already, that ASH cannot be trusted.

That, however, is not what is being proposed. All the Save Our Pubs campaign is doing is suggesting that if publicans want to, they should be able to have separate, ventilated smoking rooms on their own property. This would bring us in line with most of the other countries in the world which have smoking bans and would be such a small and reasonable exemption that only a zealot could oppose it.

All figures, unless otherwise stated, are from YouGov Plc.

...which is run by Peter Kellner, who sits on the board of ASH. Does ASH have any evidence that is not directly or indirectly supplied by people who are members of their organisation?

And this brings me back to Linda Bauld's abomination. I didn't write about her effort when it came out because it didn't get much media coverage and everything in it had been debunked long before the document was published.

Imperial Tobacco, on the other hand, have now decided to tackle it. They've released a report (PDF) which shows very clearly how Bauld misrepresents the truth and ignores evidence that doesn't suit her case. Its conclusions are refreshingly forthright:

We have become used to the public health community and the anti-tobacco lobby groups churning out made-to-measure studies to suit their objectives.

Bauld’s review should be submitted to public scrutiny. Without such transparency how can
anyone have confidence in Government policy going forward?

The report is of interest because it comes directly from the tobacco industry, whose campaign of doubt regarding smoking and lung cancer in the twentieth century has been well documented. There is, then, good reason to treat what they say with scepticism. And on the opposing side, we have an anti-tobacco industry with a dreadful record of using misleading data and junk science in the twenty-first century. Each side have obvious partisan interests—one is financial, the other is ideological.

Who to trust? The answer, surely, is to trust no one and instead trust the evidence—a pretty good rule of thumb in general. You can make up your own mind. Imperial's report is here. The Bauld report is here. From where I'm sitting it looks like a slam-dunk for Imperial.

Of course, ASH et al. will keep squealing "tobacco industry, tobacco industry" as if this somehow changed the facts. In recent weeks, the anti-smokers' reliance on this ad hominem has reached fever pitch. An online squabble at Liberal Vision saw a number of tobacco control freaks emerge from the woodwork, apparently worried that ASH's image as a grass-roots charity is falling apart. Amongst those who added a comment was none other than Linda Bauld who said that ASH is...

"...a small organisation working to reduce death and disease from smoking, not demonise smokers or restrict liberties [sic], as the tobacco industry and its representatives (who have contributed the majority of the posts above) would have us believe."

This is a pretty explicit claim. Bauld is saying that the majority of comments on the Liberal Vision article were from tobacco industry representatives. How could she possibly know this? She can't and she doesn't. She has no evidence for this allegation and it is almost certainly untrue (I know a number of the people who posted and they are certainly not in the pay of tobacco companies). This is how she appears to operate: make a wild claim without any facts to back it up and hope it sticks. The scientific credibility of ASH has been in free fall for years, so we shouldn't be too surprised by any of this, but their increasing reliance on misguided ad hominems suggests an unhealthy paranoia and desperation as they try to defend the indefensible. If they had the facts on their side, they wouldn't have to resort to name-calling.

You can't blame Imperial Tobacco for sticking their oar in on this one. The anti-smokers have produced a document which is effectively one-stop shop for all the heart miracles, bogus studies and distorted facts that have characterised their defence of the smoking ban in the last four years. It positively begs for derision and that, quite rightly, is what it has received.