Glantz attempts to debunk e-cigarette study

Stanton Glantz, founder of Americans for Nonsmokers' Rights and purveyor of bargain basement junk science, has put on his skeptic's trousers in an attempt to poo-poo the latest e-cigarette study.

Published this week in Plos One, Camponetto et al.'s twelve month study found that...

In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects.

The sample group was split between three sub-groups who were initially given a set of e-cigarettes to last them twelve weeks. Group A were given standard 7.2mg nicotine cartridges. Group B was given 7.2mg cartridges as well as a set of 5.4mg cartridges. Group C was given cartridges with no nicotine in them.

The results are shown below. All groups saw quit rates that were well above the norm for unmotivated smokers (8.7 per cent). Those who used the e-cigarettes that contained nicotine were nearly three times more likely to be abstinent after a year than those who used the zero nicotine products.

The remarkable thing about this study—as with the 2011 Polosa et al. study—is that the smokers were not motivated to quit beforehand. It is notoriously difficult for smokers to quit even when they want to. The Cochrane Review found that only 3-5 per cent of unassisted quit attempts are successful after 6 to 12 months (p. 13). Getting smokers who do not intend to quit to do so by merely giving them e-cigarettes to take home is extraordinary. To put it another way, the unmotivated smokers in this study who were given nicotine-containing e-cigarettes had a higher success rate than motivated smokers observed in other studies who are given nicotine patches. If the study had involved motivated quitters (and, perhaps, stronger nicotine cartridges), I am sure the results would have been even more impressive.

So this is good news for anti-smoking campaigners, no?

No. Not for those whose careers depend on following the neo-prohibitionist model. As Michael Siegel reported yesterday, Stanton Glantz has been sniffing around for information that might help him debunk the study and today he has launched his attack.

Glantz offers two criticisms. Firstly, he says that this double-blind, randomised controlled study doesn't really have a control group. In other words, we don't know how many of the unmotivated smokers would have suddenly given up smoking when the experiment began.

It seems to me that Group C is the control group. Not only is it the control group, but it is a control group that has been given the placebo of a zero nicotine e-cigarette. It is true that the study doesn't include a group of people who are given nothing at all but, as the study's authors note, that is hardly necessary when we know that the quit rate amongst unmotivated smokers is close to zero.

We considered it unrealistic to have a control for e-cigarette use per se in a study in which smokers were not interested in quitting. However, to provide an idea of the size of the effect, please consider that the quit rate of up to 8.7% at 1-year follow up in ECLAT compares very favorably with the national average cessation rate of 0.02% on an yearly basis over the 2001–2011 period in the general population

Glantz's second criticism is that the difference between quit rates in the nicotine groups (A & B = 11 per cent) and the quit rate in the zero nicotine group (C = 4 per cent) is not statistically significant. The authors say that the difference is significant at the normal 95 per cent confidence level (p = 0.04) but Glantz claims that if the result is adjusted in the way he thinks is appropriate, it is only significant at the 90 per cent level (p = 0.07). Therefore, he says, "the level of nicotine in the e-cigarette (including zero nicotine) has no detectable effect on quitting smoking".

I will let the statisticians argue about this technical point, but it is richly ironic to see Glantz dismissing a finding on the basis that it can only be shown with 90 per cent, rather than 95 per cent, confidence. I have written before about the way Glantz defended the Environmental Protection Agency when, in 1993, it dropped the 95 per cent confidence interval and replaced it with a 90 per cent confidence interval for its meta-analysis on secondhand smoke. Without doing this (and various other tricks), the EPA could never have found a correlation between secondhand smoke and lung cancer.

When the EPA was criticised for lowering the burden of proof, Glantz said that quibbles about confidence intervals was "hairsplitting that only professors care about". He also said: "I know that scientifically it's widely used, but there is a strong body of thought that people are too slavishly tied to 95 percent."

A few years later, when the World Health Organisation's IARC study failed to find a statistically significant link between secondhand smoke and lung cancer, Glantz suggested that the whole concept of 95 per cent confidence intervals was an invention of the tobacco industry:

"The [tobacco] industry imposes a one-sided interpretation of confidence intervals, focusing the entire discussion on whether the lower bound of the 95% CI [confidence interval] for a relative risk includes 1. By definition, if the lower bound exceeds 1, then the risk is statistically significantly raised (with p=0.05).

Whether or not there is anything magic about 95%, the true risk is equally likely to be anywhere inside the 95% CI, including values above the point estimate. In environmental and health and safety regulation, it is common to take the health-protective approach of basing public policy on the upper 95% confidence limit... The industry has represented the fact that the increase in risk observed did not reach statistical significance as indicating that the study did not find any increased risk."

For the record, I agree that epidemiological findings that fail to reach significance at the conventional 95 per cent level should not be taken too seriously. I therefore have something in common with the Stanton Glantz of 1978, who wrote an article to remind researchers about the importance of sticking to the 95 confidence interval. I also have something in common with the Stanton Glantz of 2013, who has just reaffirmed his rigid belief in 95 per cent confidence intervals. Alas, I have nothing in common with the Stanton Glantz of 1986-2012 who consistently defended weaker epidemiological findings and who claimed that those who insisted on standard epidemiological methods were "hairsplitting".



For more on Stanton Glantz's flexible views on science, see this old blog post.

(PS. If there is a legitimate criticism to be made of this study, it is the ludicrous non-acronym of its name. 'EffiCiency and Safety of an eLectronic cigAreTte' stands for ECLAT, apparently. What's wrong with ESEC?)

(PPS. A quick reminder that the IEA is holding a panel discussion about e-cigarettes on July 15th. Free if you RSVP.)


UPDATE

Michael Siegel and Rory Morrison take a similar view.

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Tobacco Products Directive - What next?

The last few days have seen some amendments to the EU Tobacco Products Directive which Reuters describes as 'weakening' the legislation. There was always going to have to be room for compromise because the initial proposal was so extreme—and looked like becoming even more extreme after Linda McAvan suggested some loony amendments. There is also the problem that Ireland currently holds the EU presidency and we know that the Irish government is wedded to the failed policies of neo-prohibition. This contrasts with Eastern Europe where the attitude is, as one Polish politician puts it: "When are you going to prohibit us from drinking wine or vodka, or stop us using white sugar? Maybe you will also tell us to go to bed early because going to bed late is also unhealthy."

Insofar as the new TPD is a compromise, the only issues that will meaningfully affect consumers are the dropping of a proposed ban on 'slim' cigarettes and the exclusion of snus from the ban on 'characterising flavours'. The latter is hugely important since a wide range of snus products require flavourings such as mint and licorice. However, this is only of relevance to the people of Sweden since no one else is allowed to buy the stuff and the Swedish government appears to have accepted this concession as a quid pro quo for dropping its campaign to repeal the scientifically insupportable snus ban (Denmark has held steady on this, however). If the anti-smoking lobby really cared about smokers and their health, they would be furious about the ban staying in place. Instead, they maintain their disgraceful silence.

The only other real change is increasing the size of health warnings on packs to 65 per cent instead of the originally proposed 75 per cent. This is a trivial difference and remains well above the 50 per cent that the EU's own legal commission viewed as acceptable. However, the decision to compromise on this issue, albeit only mildly, suggests that the EU knows that branding is really not that important—in contrast to the hysterical campaigners that the UK has had to endure for the past two years.

Elsewhere, the mentality continues to be 'if it moves, ban it'. This includes banning menthol cigarettes (as reported in the New York Times recently, but barely mentioned in the docile British media).

As for e-cigarettes, things have got even worse...

As concerns grow over the unregulated use of increasingly popular electronic cigarettes, ministers tightened proposed controls by agreeing that those containing 1 milligram (mg) of nicotine or more would be classified as medicinal products requiring prior EU marketing approval.

One milligram is an even lower threshold than was originally proposed and it unquestionably amounts to a de facto ban of e-cigarettes as we know them—with far-reaching implications for the future, as I recently explained in Spiked. It seems that the MHRA decision has toughed the Eurocrats' resolve, as expected. Incidentally—but importantly—it is worth reading this recent Early Day Motion which complained about the pharmaceutical industry's influence over the MHRA. Also see Angela Harbutt's article here.

In sum, the Tobacco Products Directive has been slightly modified—in some cases for the worst—but the so-called compromises amount to putting lipstick on a pig. There is still time for MEPs to see sense, but it is running out.


If you are in London on July 15th, join us at the Institute of Economic Affairs where a panel will be discussing the potential of e-cigarettes, snus and other alternative nicotine products to be free market solutions in health. It's free if you RSVP.

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The Scottish heart attack fantasy revisited

Of all the policy-based evidence used to retrospectively justify smoking bans, none is more heavily cited than the claim that the number of heart attacks fell by 17 per cent after Scotland went smokefree at the end of March 2006. No amount of fact-checking has been enough to kill of this zombie assertion (see here and here, for example, as well as numerous previous articles on this blog).

The myth continues to surface in the media. For instance, in this recent article in The Herald...

Scotland's groundbreaking ban on smoking in public places of March 2006 has probably done more to boost public health than any other piece of legislation passed by the Scottish Parliament.

The number of people being taken to hospital with heart attacks dropped by 17% in the year following its introduction...

And this from The Scotsman...

Unless you operate a pub, a tobacconists or a First World War troop ship, chances are you consider the smoking ban the gift that keeps on giving.

Its legacy just gets richer. By 2007, a year after the ban in Scotland took effect, the incidence of heart attack had dropped a reported 17%.

It has also been quoted—and misquoted—many times in Parliament....

"I understand that recent research shows that since the ban, the number of heart attacks in Scotland has gone down by almost 30 per cent."

Regular readers will know that Scotland's NHS data shows this claim to be a lie. The smoking ban had no effect whatsoever on the heart attack rate in Scotland, nor in any other country where hospital admissions data has been checked.

Nevertheless, as long as this fantasy continues to be peddled it is worth drawing attention to the facts so I am grateful to Brian B. for pointing me to the latest figures from ISD Scotland which include two graphs which tell the (non-)story. The first shows the rate of acute myocardial infarction discharges in Scottish hospitals per 100,000. The second shows incidence of coronary heart disease.

 

Rates of coronary heart disease have been falling steadily for many years in Scotland, as they have in England. However, the number of heart attacks appears to be at the highest level for a decade. ISD Scotland points out that the rise is largely (and perhaps entirely) due to changes in diagnosis. That is probably true, but it is not what concerns us here. The important thing is to see what happened at the time of the smoking ban (which I show with the red arrow*).

The answer is nothing. Nada. Zilch. The gradual rate of decline that existed before the ban continued at the same gradual rate after the ban (ditto England). This is not a question of sorting correlation from causation. There is no correlation. There never was a correlation. I grow tired of saying it, but the Scottish heart miracle is a figment of the imagination of a tiny group of campaigners-cum-researchers. It is a grotesque rewriting of history and a confirmation that there is no fiction too ridiculous to become conventional wisdom when there is the political will to believe.



[* The data show annual figures based on financial years (April-March). The timing of the ban (March 26th) closely coincides with the start of the financial year. Unlike the junk study that created the 17 per cent myth, the Scottish NHS provides directly comparable figures from all Scottish hospitals, not researcher-derived figures from a selection of Scottish hospitals which were then compared to a totally different set of figures from England.] 

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The nonsense of health inequalities

The Times has written an editorial (£) about 'health inequalities' which is bound to enrage sociologists, statists and public health types. Banging on about health inequalities is one of many methods used by the Left in the post-Soviet era to campaign for socialism without actually calling it socialism.

It is well known that rich people—on average—tend to live longer, healthier lives than the poor. Life expectancy in Kensington and Chelsea, for example, is an astonishing 89 years (too long, in my opinion). From this, the leftists deduce that the way to get rid of health inequalities is to get rid of income inequalities. By a happy coincidence, economic equality is what they were striving for anyway, but the rhetoric about health makes it sound as if capitalism is killing people.

It's certainly true that people tend to be healthier as they get richer, but that is an argument for making everybody richer rather than addressing inequality per se. That, however, would not fit the politics of envy, so 'health inequalities' it is.

But income is only one factor that influences health outcomes and the relationship between the two is not as simple as is often implied. Poor health will likely lead to low incomes, for example (reverse causation), and the same character traits that lead to unhealthy lifestyles may also lead to poorer job prospects (the third variable). It is the latter point that The Times stresses in its editorial...

It isn’t fat and sugar that kills people so much as fecklessness: a trait that will always be concentrated in the less well-off. Of course there are poor people who eat sensibly and there are wealthy people who smoke, drink and snort their way to oblivion, but the reason that more than twice as many people die before the age of 75 in Manchester, England’s unhealthiest district, than do in Wokingham, the healthiest, is because on the whole people in middle-class commuter towns look after themselves better. The same values that help them to postpone reward to train for jobs and to pay their mortgages help them to refrain from excess at the dining table.

No politician dare risk saying any of this, however. Instead, the tendency of the poor to die early is explained by the vague concept of “deprivation” — without it being clear of what they are supposed to be deprived.

The reason no politician dare say this is that it leads to the conclusion that people have free will and personal responsibility. This goes against the grain of the ludicrous, but widely accepted, sociological consensus that individuals are victims of circumstance whose destiny is decided at birth based on the postcode they were born in and the occupation (if any) of their father.

As Sam Bowman has been saying on Twitter, "fecklessness" is not quite the right word here. People are making a rational choice to prioritise pleasure and enjoyment ahead of health and longevity—a decision that many middle and high earners also make. Recklessness might be a better word, but even that invites moral disapproval.

It's like blaming ignorance for people being uninterested in politics or laziness for them not exercising. What if they just don't like it?
— Sam Bowman (@s8mb) June 20, 2013

I'd love to know how to play the piano but I judge the time and effort as being too costly to do so compared to alternatives. Am I feckless?
— Sam Bowman (@s8mb) June 20, 2013

Public health folk would argue that such choices are not rational (because of hyperbolic discounting and suchlike) and sociologists would argue that they are not free (because accidents of birth make them more likely to choose the unhealthy option). I have little time for such arguments. Accusations of irrational consumption invariably revolve around the moral judgement of the accuser while choices, even if constrained by imperfect information and financial circumstance, are still choices. The fact that the smoking rate is higher in Glasgow than Sevenoaks, for instance, in no way predisposes a Glaswegian to smoke. It is not 'victim-blaming' to point this out.

Insofar as 'lifestyle factors' are a determinant of longevity, they are optional. They are freely entered into with all the costs and benefits borne by the individual. Any serious attempt to get rid of 'health inequalities' must necessarily involve forcing everyone to live the same way. This, as The Times says, is a great threat to liberty...

To have any chance of ironing out “inequalities” a government would have to be ruthless. It would need to deploy health police to close down all takeaways within miles of poor areas and replace them with greengrocers. As for education, it would have to detain poor children at school, in a proper learning environment, and not let them home until bedtime, if at all.

Some of these measures, of course, might be unpalatable from a human rights perspective. We might just have to put up with the inevitability that some social classes will live longer and get better exam grades than others — and stop worrying about it.

The only health inequalities that should concern the government are inequalities in state healthcare provision. So long as the government operates an egalitarian system of nationalised healthcare, it should be of the same standard everywhere. Running the NHS can be seen as a proper function of government; running people's lives cannot.

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The nicotine takeover

I've written an article for Spiked about the medicalisation of e-cigarettes. The recent MHRA decision was bad news for vapers, but there is a bigger picture. It is not just e-cigarettes that will be controlled by the medical establishment. All 'nicotine-containing products'—except tobacco—will henceforth be regulated as medicines, including products which have not been invented yet.

This is the continuation of a process that began with the 1868 Pharmacy Act (UK) and the 1915 Harrison Narcotics Tax Act (US) which restricted the sale of opium to chemists and doctors, after lobbying from the Pharmaceutical Society and the American Medical Association respectively. By 1920, the medical establishment had brought all narcotics under its authority on both sides of the Atlantic and paved the way for the war on drugs. In America this extended to alcohol, with doctors able to prescribe medicinal liquor during Prohibition (a privilege they greatly abused). British medics have never seized control of the drinks industry, but the MHRA ruling will give them authority over the other remaining outpost of chemically induced pleasure – nicotine.

This is an audacious move with profound implications for the years ahead. The conventional mass-produced cigarette is arguably a relic of the nineteenth century which will be gradually rendered obsolete by twenty-first century technology. Recreational nicotine use in a few years time will look radically different to that of the cigarette era. It is reasonable to expect e-cigarette technology to improve significantly if a competitive market is allowed to flourish. It is also likely that other safe, or vastly safer, nicotine products will emerge to compete with them.

All this could be jeopardised if the authoritarian and moralistic public health lobby becomes the judge, jury and executioner of the recreational nicotine industry. Their instinctive asceticism takes little account of the desire for pleasure that motivates nicotine users and their obsession with legislation and top-down behavioural control is irreconcilable with the spirit of free enterprise that created these revolutionary products in the first place.

Please read the rest.

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Graphic warnings for alcohol

More news from the slippery slope. The EU-funded public health lobby group Eurocare has been presenting their 'next logical steps' in Ireland. Following the anti-smoking blueprint to the letter, they've mocked up some graphic warnings for wine bottles. Fetching design, don't you think?

We did tell you this would happen, you know. Plain packaging will be next.

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Bent cucumbers, olive oil and the exact diameter of cigarettes

Today sees the 25th anniversary of EEC Regulation No 1677/88, a piece of European legislation that has gone down in infamy for banning bent cucumbers and which was the precursor to the equally infamous ban on bent bananas. Such regulations have been used as a stick with which to beat Eurocrats ever since.

Regulation No 1677/88 specified that cucumbers must be "reasonably well shaped and practically straight" with a maximum height of the arc being "10 mm per 10 cm of the length of cucumber". If you can bear to read the entire list of rules, you will see that the EU's reputation for bureaucratic micromanagement is well deserved. As Dan Hannan and others have pointed out, it is not a myth.

Legislation of this sort has become an embarrassment to Brussels and, in recent years, the EU has sought to overturn some of the more absurd examples in an attempt to regain its credibility. The desire to meddle runs deep, however, as the recent farce (and U-turn) on olive oil bottles demonstrated. The EU is a Leviathan with too many staff and too much time on its hands. Endless bureaucracy is the result. It simply cannot help itself.

Much of the discussion about the forthcoming Tobacco Products Directive has focused on the EU's intention to kill off the emerging e-cigarette industry, as well as its failure to re-legalise snus. These failings are so glaring that the petty rule-making that dominates its text has been overlooked, but they are worth mentioning.

For example, the Commission wants to ban cigarette packs which are 54 mm wide, but will allow packs that are 55 mm wide (and only 55 mm wide). It will allow cigarettes to be sold if they have a diameter of 7.5 mm, but no more and no less than 7.5 mm. Only cigarettes which have a flip top lid will be allowed. Menthol cigarettes will be arbitrarily banned. Cylindrical rolling tobacco tins will be banned, but rectangular pouches will be tolerated. Packs of 20 will be OK, but packs of 19 will be illegal.

Much of this is relatively trivial—laughable, even—but some of it will have a negative impact on consumer choice. The bans on menthol and slims, in particular, will likely create a black market in those products (even Guardian writers have found a ban they don't like in the menthol proposal). But it is the very triviality of the proposals that is the issue. This directive will take several years, countless meetings and huge sums of money to put into place, and for what? Does anyone seriously think that nonsmokers are drawn to cigarettes that have a 7.3 mm diameter? Does even the most deluded anti-smoking crank believe that nonsmokers are strangely repelled by flip-top boxes?  

What is the point of any of it? At its worst—and its worst is diabolical—the Tobacco Products Directive will actively encourage smokers to keep smoking by deterring the use of e-cigarettes and snus. At its best, it is merely useless; a feeble assortment of barrel-scraping policies that confirm the worst stereotypes of the European Commission as an obsessive-compulsive institution whose first instinct is to vomit up mindless, petty and ill-considered regulation for no other reason than that it can. 

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Joyless puritans

I was on Radio Merseyside on Wednesday talking about Alcohol Concern's predictable desire to ban alcohol sponsorship. You can listen to it for the next few days here — my segment begins at around 1 hour 6 minutes.

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All you need to know about Simon Chapman

Reptilian sociologist Simon Fenton Chapman is holding forth in this week's issue of the British Medical Journal in a two-headed debate about e-cigarettes. Naturally, the prohibitionist is touting the benefits of prohibition under the following heading:

Should electronic cigarettes be as freely available as tobacco cigarettes? No

Consider that for a moment. Simple Simon thinks it's better to make real cigarettes more available than a non-tobacco, non-combustible product that is around 99 per cent safer. He says...

Many smokers want to access e-cigarettes to quit or reduce risk, and they should not be denied this opportunity.

This from a man who fought (successfully) to have e-cigarettes banned in Australia! Is Chapman having another senior moment or is he being disingenuous? As he goes onto show, it's the latter.

But the needs of often desperate smokers must not become the tail that wags the dog of tobacco control policy

Er, why not? Are smokers not the people that the anti-smoking lobby set out to help? What is the public health movement for if not to improve the health of smokers? As the war on e-cigarettes shows, whatever altruism existed in the anti-smoking lobby has long since past. Today, it is sheer puritanism, anti-capitalism and the narcissism of the likes of Simple Simon that wag the dog of tobacco control policy. Truly, as Dick Puddlecote likes to say, it has never been about health.

Meanwhile, public health seat-filler Martin McKee brings two bonkers ideas together to create the perfect neo-prohibitionist tweet...

If reading that has made you feel like you need a shower, scrub down with Jean-François Etter's sane and humane response to Chapman's bile: Should electronic cigarettes be as freely available as tobacco cigarettes? Yes

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Close encounters of the third variable

From yesterday's Metro...

Chemical in plastics 'causes obesity in many young girls'

Young girls exposed to a chemical found in a variety of plastics could be up to five times greater risk of obesity, a study suggests.

Sceptical minds will have noticed that this epidemiological finding relates only to girls, not boys—always an indicator of a data dredge. Notwithstanding the unlikelihood of a single chemical 'causing' obesity, what kind of bizarre substance would cause obesity in females but not males?

Those aged nine to 12 with 'extremely high' levels of bisphenol-A in their urine were most likely to be grossly overweight, the Plos One journal reports.

What could possibly explain this phenomenon?

The substance can be found in drinks bottles, food cans and till receipts.

So people who drink lots of drinks and eat lots of food are more likely to be obese? Who'd a thunk it?*



(* "Surely the researchers adjusted their findings to take into account diet?!", I hear you cry. Not really, your honour. They adjusted for the amount of 'junk food' and vegetables eaten because these are seen as good/bad by public health boneheads, but there was no accounting for the number of calories consumed. You can read the study here.)

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E-cigarettes: The control lobby shows its true colours

You've probably heard today's disgraceful news. In short, the medical establishment was given an opportunity to grab some more power and it took it. I'll write more about it when I have time, but here's the statement I put out with the IEA:

"There is no more reason to treat e-cigarettes as medical products than there is to treat alcohol-free beer or chewing gum as pharmaceuticals. They are emphatically not medicines and they make no claim to treat any disease. They are alternatives to smoking which many smokers have found to be effective substitutes for cigarettes.

E-cigarettes have the potential to make conventional cigarettes obsolete, but only if they are allowed to flourish in a free market. The medical establishment has played no part in the rise of this remarkable product and, shamefully, many anti-smoking campaigners want them banned.

The MHRA's decision will stifle innovation, raise prices and lead to a black market in potentially lethal nicotine fluids amongst existing e-cigarette users. In the short term, e-cigarettes will have to be taken off the market, potentially for years and possibly forever. In the meantime, most of the UK's one million e-cigarette users will return to smoking cigarettes. The only winners will be the tobacco industry and the pharmaceutical industry.”

I'll write more about this as soon as I get the time, but I recommend you read Dick Puddlecote...

Today is the apex of tobacco control industry stupidity. Ultimate and resounding proof of what I have been saying for years. It has never, ever, been about health. And now they have illustrated it beyond reasonable doubt.

And Clive Bates...

Medicines regulation involves disproportionate costs, compliance burdens and restrictions – none of which apply to cigarettes. So this is a good day for the cigarette makers, and their competition will be weakened. We need regulation to encourage these products to compete with cigarettes, not smother them with red tape.

What the e-cigarette sector doesn’t need is ‘boring’. That has been tried and failed with NRT. It needs marketing verve, style and buzz, not the dull deadening hand of bureaucratic approvals. That applies to product design, packing, marketing, sponsorship – the works… the public health challenge is to get as many smokers to switch as possible, not to make perfectly safe products that no-one wants.

And, most cathartically, Longrider...

Scum, the lot of them. They should be taken out and strung up from the nearest lamp post. Then their heads put on spikes outside Traitor’s Gate, while the ravens peck out their eyeballs. These evil people are trying to effectively ban a product that is less harmful than tobacco and is helpful to people trying to give it up. It isn’t about health. It was never about health. It is and always has been, about control.

Let the battle lines be drawn. These people are not only the enemies of liberty, they are also the enemies of the one thing they claim to be advocating for—health.

Tobacco control. It's not about tobacco, it's all about control.

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Alcohol Concern: Stick to the Ideology

It is brave for a lobby group that has a long track record of using dodgy surveys, junk science and misleading press releases to release a report entitled Stick To The Facts, but that is what state-funded sock puppet charity Alcohol Concern have just done. [No link yet, even though the embargo has passed.]

The report can only be viewed as audacious political kite-flying since even the most optimistic temperance zealot cannot seriously believe that the British government is ready to ban all alcohol sponsorship of sporting, music and cultural events—goodbye, the Carling Weekend, farewell, the Budweiser FA Cup—let alone limit all alcohol adverts to basic information about "the product’s strength, origin, composition, and means of production". Alcohol Concern even wants it to be illegal to print alcohol branding on merchandise and clothing (goodbye, Sunday league football).

With tiresome predictability, Alcohol Concern says this must all be done for the sake of "children". There is, it seems, no interference into adult pastimes that cannot be justified in the name of those who are prohibited from engaging in them. For the moral busybody, all the world is a creche. In this, as in so many other ways, the temperance lobby has learned from their colleagues in tobacco control.

Alcohol Concern says that the government's Alcohol Strategy "acknowledged the link between advertising and consumption, particularly in young people under-18-years-old". It is true that the government accepts the findings of a study authored by some well known temperance campaigners at Sheffield University which asserts such a link, but Alcohol Concern do not mention that the government also says that "we have not seen evidence demonstrating that a ban is a proportionate response". Indeed, the Strategy acknowledges the strength of the current arrangement which is a combination of regulation (through Ofcom) and self-regulation (through the Advertising Standards Agency and the Portman Group).

Alcohol Concern refers extensively to the work of the Youth Alcohol Advertising Council. This (front) group of 16 to 19 year olds (the aforementioned "children") was formed by Alcohol Concern and continues to be—as they admit—"coordinated" by them. Alcohol Concern encourages these teenagers to lodge complaints about various alcohol advertisements, most of which are rejected by the Advertising Standards Agency. Alcohol Concern suggests that the ASA's habit of rejecting their complaints "raises serious concerns about the current framework of control". They do not contemplate the more likely explanation that these teenagers' complaints are frivolous and absurd.

Alcohol Concern repeatedly states that the drinks industry spends £800 million a year on marketing as if this were somehow shocking. What do they suppose would be an acceptable figure? Nine out of ten adults drink and we spend £42 billion on alcohol each year, of which £16 billion goes to the state in tax. Seen in this context, £800 million seems almost miserly (the answer to the question of how much they think would be acceptable is, of course, zero). They then proceed to make the classic blunder of assuming that advertising is designed to increase overall consumption rather than promote specific brands. Moreover, they assume that this particular form of advertising is designed to increase overall consumption amongst those who are too young to buy the product—a rather implausible business strategy.

Alcohol Concern claims that "self-regulation is failing". Notwithstanding the fact that there is a large amount of coercive regulation to buttress the self-regulation, this statement is highly questionable. Alcohol consumption in the UK has fallen by 16 per cent in the last decade. Britons consume no more than the European average. The proportion of the population drinking more than the government's (arbitrary and evidence-free) guidelines has fallen for both men and women in recent years, as have the number of 'binge-drinkers'. And, most relevantly of all, the proportion of school pupils who have drank alcohol in the last week has halved since 2001.

These statistics should make any temperance group happy, but that would be to misunderstand the nature of the beast. Moral entrepreneurs and professional reformers can never be happy. Their jobs depend on them being perpetually disgruntled. No matter whether rates of underage drinking rise, fall or stay the same, the agenda is fixed. They are no more impressed by the UK having some of the world's toughest restrictions on alcohol marketing than they are by the UK having some of the world's highest alcohol taxes.

Whatever the level of marketing, it is too much. Whatever the price of a drink, it is too little. It is folly to expect such people to ever be appeased. Indeed, in this new report, Alcohol Concern all but admit that their latest list of demands—extreme though they are—are only a stepping stone towards the total prohibition of alcohol marketing in all its forms.

There is, then, very little to say about Stick To The Facts. You didn't need a crystal ball to see it coming, and it was coming regardless of "the facts". Like every temperance group of the last two hundred years, the only tools Alcohol Concern have at their disposals are the blunt instruments of price rises and prohibitions. They don't understand why people drink and they don't understand how advertising—or business—works. They merely see something move and, like a caveman, they whack it with a mallet in the hope of solving the problem. Such people should—and, I suspect, will—be ignored.


(Cross-posted from the IEA Lifestyle Economics blog)

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While I was out

I've just spend a week in Spain, the healthiest country in the EU—where a litre of premium lager costs less than a pound and smoking prevalence is well above the continental average. While I was away, the English speaking world's downward spiral towards a dictatorship of public health has continued. Here are some lowlights:—

Over in Ireland, where plain packaging for tobacco has recently been mooted, the utterly predictable has happened...

The official conference European Week Against Cancer said that the Irish are drinking 700 percent over recommended safe alcohol level to prevent cancer. Scholars at the conference have called for plain packaging for alcohol in the interest of public health.

Equally predictably, these tax sponging temperance nuts "scholars" also want a complete ban on alcohol advertising and sponsorship "which the Irish government has recently done for tobacco". Dick Puddlecote has more on that supposedly mythical slippery slope here and here.

Meanwhile in the Australian supernanny state, anti-gambling cranks want the government to tell you what you can and can't wear:

Football jumpers emblazoned with betting company logos and gambling advertisements at sporting grounds could be banned after a parliamentary committee raised concerns about the effect the punting culture is having on children.

Yes, it's all about the chiiiiiiildren.

The proposals raise questions as to whether the new rules will actually protect children from the "normalisation" of gambling culture.

Denormalisation and think-of-the-children rhetoric. Sound familiar?

A fortnight after Julia Gillard intervened to head off the public backlash at Tom Waterhouse and other spruikers of live odds, the joint select committee on gambling reform has asked whether regulation has gone far enough in insulating children.

The real question is whether enough is being done to insulate the rest of the world from the horrors of Australian lifestyle fascism.


Speaking of stupid antipodean ideas, in January 2012 I wrote an article about plain packaging in which I speculated on what the next piece of idiocy would be...

With plain packaging in place, the extremists have exhausted all of the options I listed in the final chapter of Velvet Glove, Iron Fist. What fresh lunacy will follow? Warnings on individual cigarettes?

Ho, ho. But, as ever in tobakko kontrol, life imitates satire:

A leading tobacco control researcher says the next step to encourage smokers to quit is to print warning labels on cigarettes.

Naturally, this chap has some "qualitative" research to turn this crackpot idea into "evidence-based policy".

The qualitative study surveyed 10 smokers and then preliminary sketches and mock-ups were presented. “We found it has a profound effect on smokers. They literally have the risk under their nose, day after day, week after week, with every cigarette. It really brings the hazard home.

“I have to say of all the times I’ve done these qualitative, focus testings, I’ve never had such a response that was so consistent across smokers.”

A qualitative study survey of ten smokers? And so the inevitable body of "overwhelming evidence" begins to take shape.

Future generations will look back in wonder at how so many fruitcakes and monomaniacs came to wield influence in the foul years of the early twenty-first century. Sack the lot of them, abolish their grants, bulldoze their workplaces and pour salt on the land so that nothing ever grows there again.

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