Sunday 31 May 2015

21st century bootleggers and baptists

From Australia, a classic case of moral entrepreneurs getting into bed with real entrepreneurs. The puritans want to make buying cigarettes an embarrassing inconvenience while the sex industry wants a monopoly on selling cigarettes, and so...

Adult industry lobby group the Eros Association and the Australian Sex Party want tobacconists and other cigarette sale points to become adults only premises.

The idea is supported by the Cancer Council and Quit Victoria, who say the suggestion warrants consideration, along with other restrictions on tobacco sales.

This is such an unimprovable example of the bootlegger and baptist problem that economics teachers should use it to teach students about rent-seeking.

Saturday 30 May 2015

Just a spoonful of sugar

Action on Sugar, the bastard offspring of Consensus Action on Salt, has noticed that dried fruit contains sugar. As with every utterance from the pressure group, the BBC thinks this is newsworthy. Based on an unpublished undergraduate research project, Action on Sugar says that 85 per cent of "fruit snacks" contain more sugar than 100 grammes of Haribo sweets - "with some containing over 4 teaspoons of sugar!", as the excitable press release proclaims.

In these intellectually stunted times, a teaspoon of sugar is rapidly becoming a unit of harm that requires no further explanation. To be clear, a teaspoon of sugar only contains 16 calories. As an adult male, I am told I need 2,500 calories a day to maintain a healthy weight. A ten year old child requires 2,000 calories. If a "fruit snack" contains 64 calories, I think we can handle it.

If we must talk about fructose and glucose in terms of "teaspoons" of sugar - and if four teaspoons is a hazardous amount - it should be said that there are six teaspoons in an orange and five teaspoons in an apple. The logical conclusion to Action on Sugar's crusade would be to tell people to stop eating fruit, but since this would make even most sympathetic observer question their credibility, they are not prepared to do so. If they demanded "punitive taxes" (their words) on oranges because they contain more sugar than Haribo, the penny might drop that we are in the midst of an obsessive and puritanical campaign. Instead, they condone fruit-eating on the basis that fruit contains fibre, but if you want fibre, there are plenty of better foods to eat, many of which contain those evil carbohydrates that Action on Sugar so dislike. A more sensible reason to choose apples over Jelly Babies is that fruit contains vitamin C, but Action on Sugar are reluctant to say this because you can get vitamin C from drinking fruit juice and they don't want you to do that either.

I suspect that the real reason Action on Sugar turn a blind eye to sugar in whole fruit is that it is very difficult to claim that apples and pears have been "spiked" with sugar by "Big Food". They cannot be included in the Orwellian sugar reduction strategy that they want the government to enforce, despite the fact that the dominant sugar in fruit - fructose - is the one that they claim is worst for you. Consequently, they are forced to make a specious distinction between dried fruit sold in a plastic bag and whole fruit sold by a grocer. In terms of sugar, there is no distinction to be made.

Most of the products examined by Action on Sugar do not contain any added sugar and it is misleading to suggest that they contain "teaspoons" of anything. They are sweet because they contain naturally occurring fructose and glucose, the quantities of which are no greater than you would find in many pieces of whole fruit. If you have a problem with that, take it up with Mother Nature.

Friday 29 May 2015

Yet another smoking ban miracle

Here we go yet again...

Almost 90,000 children spared illness by smoking ban: 11,000 fewer a year admitted to hospital with lung infections since law was introduced

Banning smoking in public places has saved nearly 90,000 children from serious illness, according to new research.

Smoking inside public buildings - including restaurants, train stations and pubs - was banned throughout England in June 2007.

Analysis of hospital admissions data shows a dramatic drop in the number of children treated for serious breathing problems in the intervening years.

Some 11,000 fewer children have been admitted to hospital with lung infections since the ban was enforced, the numbers show.

Aside from the question of whether kids were significantly affected by a smoking ban in pubs and workplaces, long time readers will know that dozens of studies claiming a 'dramatic decline' in various types of hospital admission have been published in the last ten years. Not a single one of them has stood up when the actual hospital admissions data are checked.

The news story relates to a study published in the European Respiratory Journal which claims to be based on Hospital Episodes Statistics data and claims to have found the strongest effect for lower respiratory tract infection. That database can be viewed online. The NHS hospital admissions data for lower respiratory tract infection amongst children aged 15 and under is here (the ERJ study only looks at those aged 14 and younger, but there is no reason why 15 year olds should be immune from the smoking ban's protective powers). The smoking ban started in 2007. The number of admissions between 2003/04 and 2012/13 were as follows:

2003/04: 31,353
2004/05: 31,702
2005/06: 36,819
2006/07: 32,344
2007/08: 33,924
2008/09: 36,170
2009/10: 39,148
2010/11: 42,857
2011/12: 40,053
2012/13: 43,895

The reality is, then, that there were 36 per cent more admissions in 2012/13 than there were in the year before the smoking ban. Part of this will be due to population growth, but the age-standardised rate per 100,000 also increased sharply - from 348 in 2006/07 to 424 in 2012/13. Hospital admissions are not an exact proxy for incidence, but then the study doesn't talk about incidence, it makes a specific claim about admissions falling when they actually rose.

It's the same old story. A well-reported study says one thing while the data say the opposite. As with the English heart miracle, the study is not what the newspapers claim. Faced with rising admissions, the authors construct a theoretical model of how many admissions there might have been in a counter-factual scenario in which there was no smoking ban. Surprise, surprise, their model predicted more admissions than there actually were and they were able to go to the media and say how wonderful smoking bans are and how they should be extended. Good for them, but there never was a 'dramatic decline'. It's another fiction.

An open letter to the new government

This is a guest post by Paul Chase which I endorse.

The aftermath of a general election provides the opportunity for a bit of special pleading. So here are my 10 pieces of advice to the Secretaries of State and civil servants of all those government departments whose remit impacts on the licensed retail sector (Treasury, Home Office, Health and BIS at least):

Dear Minister/Sir Humphrey

When considering policy proposals, please bear in mind the distinction between real ‘public health’ (scientific medicine, sewage disposal, refuse collection, clean drinking water, hygienically produced food and the like) and the ideology of ‘healthism’ (puritanism, nanny-statism, coercive lifestyle regulation, enforced product reformulation, sin taxes and a general tendency towards world domination).

When so-called ‘evidence-based’ alcohol and food policy proposals are put to you, don’t confuse ‘evidence’ with ‘eminence’. The two words sound the same, but they don’t mean the same.

‘Evidence’ is real science from which policy recommendations flow. ‘Eminence’ is cited in support of junk science for a pre-determined policy proposal - to which a spurious authority is lent because it’s publicised by someone who says “Don’t you know who the bloody hell I am?” Minimum pricing and Professor Sir Ian Gilmore comes to mind.

When considering ‘research evidence’ in relation to the alcohol we drink, don’t confuse ‘causation’ with ‘correlation’ or ‘association’. Example: smoking tobacco causes lung cancer. It is also highly correlated with drinking beer because a lot of people who like a fag, like a pint. Therefore beer drinking is ‘associated’ with lung cancer. The deliberate conflation of causation with correlation is what enables healthists to make exaggerated claims about alcohol-related health-harms.

Please recognise that healthists can and do pluck facts and figures out of thin air. The ‘sensible drinking’ limits and the BMI cut-off points for ‘normal weight’, ‘overweight’ and ‘obese’ are salient examples. And if you are a civil servant, please try and persuade ministers not to say “Alcohol abuse costs the taxpayer/NHS/society £21 billion a year and leads to 1.2 million hospital admissions” because neither of these numbers are true, and anyway the minister quoting them doesn’t have a clue where they come from.

Please bear in mind that it isn’t the availability of alcohol that makes people drink it. So healthist policy proposals that seek to reduce availability (close pubs) will not impact on harmful consumption. If there is a high-density of licensed premises in a given area, that’s because there are lots of people who like a drink living in, or resorting to, the area concerned. Demand begets supply, not the other way round.

Please understand, that with the exception of new product launches, advertising beverage alcohol products (or any product), does not drive primary demand, it facilitates brand or category switching. So, please recognise that proposals to restrict the advertising of alcohol are about de-normalising drinking, not “protecting children”.

As a matter of priority you should stop the public funding of anti-alcohol political lobby groups, such as Alcohol Concern, by government departments and quangos like Public Health England - who recently gave AC half a million pounds to fund its latest failed campaign - otherwise known as ‘Dry January’.

Recognise that claims such as “the binge-drinking epidemic, and the obesity time-bomb” will “bankrupt the NHS” if not tackled immediately by sin taxes, are bollocks.

And in conjunction with the point above, please recognise that the notion that sin taxes will make people more virtuous is a fundamentally improbable proposition. Actually, all sin taxes do is distort markets and disproportionately impact upon the poor. So, no sugar or fat taxes please!

Recognise that ‘healthism’ is the ideology of ‘the health of the nation’; it is dogmatic and totalitarian. If you’re unsure if a policy proposal is healthist or not, just ask yourself whether Andy Burnham or Dianne Abbot would be likely to support it, and if they would – don’t do it!

I make the special pleadings above more in hope than anticipation, because the healthist fifth column has infiltrated not just our healthcare system, but our medical research establishment and the socialist World Healthist Organisation – sorry ‘World Health Organisation’.  “Health in every policy” is an iniquitous credo that seeks to assert that populations must be governed in a way that subordinates all other considerations, such as jobs and investment, to a narrow, dogmatic, coercive notion of public health that nobody has voted for.

Paul Chase

Thursday 28 May 2015

Junk science from farm to fork

This has been doing the rounds on Twitter and deservedly so. It's an excellent demonstration of how quack science is conducted, published and reported.

John Bohannon got sixteen volunteers, a statistician and some chocolate with the hope of finding an association with something - anything - for an epidemiological study.

One group followed a low-carbohydrate diet. Another followed the same low-carb diet plus a daily 1.5 oz. bar of dark chocolate. And the rest, a control group, were instructed to make no changes to their current diet. They weighed themselves each morning for 21 days, and the study finished with a final round of questionnaires and blood tests.

It turned out that the chocolate-eating group lost ten per cent more weight than the other two groups. A newsworthy finding? It shouldn't have been.

Here’s a dirty little science secret: If you measure a large number of things about a small number of people, you are almost guaranteed to get a “statistically significant” result. Our study included 18 different measurements—weight, cholesterol, sodium, blood protein levels, sleep quality, well-being, etc.—from 15 people. (One subject was dropped.) That study design is a recipe for false positives.

... With our 18 measurements, we had a 60% chance of getting some“significant” result with p < 0.05. (The measurements weren’t independent, so it could be even higher.) The game was stacked in our favor.

He then submitted it for - cough - peer review...

Our paper was accepted for publication by multiple journals within 24 hours. Needless to say, we faced no peer review at all. The eager suitor we ultimately chose was the the International Archives of Medicine. It used to be run by the giant publisher BioMedCentral, but recently changed hands. The new publisher’s CEO, Carlos Vasquez, emailed Johannes to let him know that we had produced an “outstanding manuscript,” and that for just 600 Euros it “could be accepted directly in our premier journal.”

And awaited the ladies and gentlemen of press...

We landed big fish before we even knew they were biting. Bild rushed their story out—”Those who eat chocolate stay slim!”—without contacting me at all. Soon we were in the Daily Star, the Irish Examiner, Cosmopolitan’s German website, the Times of India, both the German and Indian site of the Huffington Post, and even television news in Texas and an Australian morning talk show.

 That's how it easy it is folks. Do read the whole article.

Illegal highs

The government has decided to ban all substances that could have a psychoactive effect, including those yet to be invented/discovered, because some of them might be bad for you. Tobacco, alcohol and coffee will be exempt (for now, at least). The intention is to use this sledge-hammer to crack the nut of 'legal highs', but the legal implications are profound.

I've written about it at Spectator Blogs. Do have a read.

Ian Dunt has written an excellent article about the same issue.

Wednesday 27 May 2015

Under-reporting alcohol

From the Telegraph...

Just one alcoholic drink a day damages hearts of elderly women, Harvard study warns
Only one alcoholic drink a day damages the hearts of elderly women, a new study has warned.

Despite previous research that suggested a drink a day might protect against some cardiovascular disease, the findings suggested otherwise, at least in the elderly.

Women who have just one alcoholic drink a day are defined as light to moderate drinkers. Yet new research found women with an average age of 76 who drink moderately had small reductions in heart function because of an enlargement of the wall of the heart's main pumping chamber - the left ventricular mass.

I'll take a small reduction in heart function at the age of 76 if it means I have less chance of getting heart disease. And make no mistake, heart disease is significantly less prevalent amongst drinkers than it is amongst teetotallers.

The temperance lobby hates this fact, which is why there is a concerted and growing effort to persuade people that there is no safe level of drinking. I don't know whether this particular study was designed to serve that end but the merchants of doubt will be pleased to see it in the media.

Also in the media recently was a story about drinkers under-reporting what they drink. This comes up from time to time (eg. here in 2013) and could give the unwary reader the impression that Britons drink much more than was previously thought. This would be true if we estimated how much people drink by asking them, but we don't. We work out national consumption by looking at how much is sold. This does not give a perfect picture because some alcohol is never drunk and some alcohol is bought illegally (and therefore doesn't show up on HMRC tax receipts), but it is fairly accurate and it is certainly more accurate than asking drinkers.

Under-reporting was in the news last week because some researchers decided to ask people how much they drink on holiday and on special occasions. Surprise, surprise, they drank more than in the average working week.

This is much as might be expected. Under-reporting in endemic in the alcohol field and researchers are rightly sceptical about self-reported evidence. But the important point is that virtually all alcohol epidemiology is based on self-reported evidence. If people under-report their consumption by 40-60 per cent, then observational studies which show a risk from some disease or other at (for the sake of argument) 50 units a week actually show risk kicking in at 75 units a week.

Alcohol researchers occasionally mention this. Here is Sadie Boniface in 2013, for example...

Much of what is known about the relationship between drinking and harm is based on self-reported data, where consumption was under-reported. This means that the relationship between drinking and harm may have been over-estimated, and that drinking is effectively ‘safer’ than the Government’s drinking guidelines suggest. This raises the question of whether the guidelines should be raised to reflect the actual relationship between drinking and harm, creating perverse incentives for alcohol policy (not just in the UK but worldwide).

So it's not that researchers are unaware of the problem. They just don't seem to be as interested in it as they could be considering the implications (tellingly, Boniface says that "there wasn’t space to discuss [this issue] in detail in the paper [that she had just published]"). Certainly, there is no urgency to raise the guidelines. Quite the reverse.

Last week, the subject got an airing in The Parliament Magazine. Referring to research conducted in the US, it concluded...

In summary, scientific data clearly show a relation between heavy drinking and certain types of cancer. For even light-to-moderate drinking, many studies have shown a slight increase in the risk of certain cancers, especially breast cancer.

However, when subjects likely to be underreporting their intake are removed from that pool, new data indicate that light to moderate drinking is not associated with an increased risk for breast cancer or for other types of cancer.

The question of alcohol and cancer boils down to dose: heavy consumption increases risk but light to moderate consumption is unlikely to increase risk.

This is the exact opposite of what the 'no safe level' faction of the neo-temperance lobby want you to believe so you can expect the message to be confined to niche publications and blogs while claims about the putative health risks of drinking tiny amounts of alcohol - which are not, in all probability, so tiny - proliferate.

Monday 25 May 2015

Is 'neo-liberalism' making us ill?

I was on BBC Scotland on Saturday morning discussing the hypothesis that 'neo-liberalism' makes us ill with a Marxist academic. The subject came up because another Marxist academic has written a book that blames obesity and stress on the free market. The unspoken message is that we would all be healthier in a socialist society. We'd be thinner, I suppose. I'm not so sure about the rest of the theory.

If you're interested, you can listen to me from 49 minutes here. The author of the book explains her thesis a few minutes earlier.

In the meantime, c'mon the Boro!


Middlesbrough 0 - Norwich 2

Sunday 24 May 2015

Brace yourself

The Westminster government's decision to introduce plain packaging has left that the tobacco control industry looking for new ways to collect government grants. Having portrayed plain packaging as something akin to a vaccine for lung cancer (no, really), I expect them to now play down the benefits of plain packaging for two reasons. Firstly because it will soon become very clear to the people of Britain that plain packaging doesn't have any benefits, and secondly because if they are perceived to have solved a problem, they will be out of work.

Fortunately for the tax leeches of 'public health', there is always one more batshit crazy policy ripe for expensive pseudo-research.

From the Sunday Post...

Cigarettes could soon be produced in unpleasant colours, with health warnings emblazoned across the stick, under new proposals to make smoking unglamorous.

Experts believe the white papers which traditionally encase tobacco have connotations of purity and cleanliness.

They have conducted research which suggests producing cigarettes in unappealing browns and greens, to represent yellowing teeth or even phlegm, will make them look distasteful, particularly to style-conscious young women.

This idea has been taken wholesale from a nutter in New Zealand who proposed the same thing last May (see Dick Puddlecote here and here)...

Anti-smoking group wants to change white paper to unattractive green, brown and orange shades

Public health researchers say the Government's next step after introducing plain packaging for tobacco should be to make cigarettes ugly by changing them to a dark green or brown colour which made young people think of "slime, vomit or pooh".

A tobacco control lobby group told a parliamentary committee that cigarettes themselves were the "new canvas" for anti-smoking initiatives.

The Sunday Post article is based on the ramblings of Crawford Moodie, one of Gerard Hastings' henchman from the Institute of Social Marketing. He makes the rather implausible claim that focus groups are "incredibly positive" about the idea. Try asking your friends about it this weekend. I suspect that most of them will say it is ridiculous, if they believe you at all (have these muppets noticed realised that a cigarette with brown paper is a cigar?)

More plausibly, the Post says that Moodie has "previously written around 40 expert reports on tobacco packaging". Forty! This gives you an idea of how much money that is swilling around for those who are prepared to stoop low enough. It also explains why you have almost certainly not heard the last of this.

Friday 22 May 2015

Revisiting the Danish fat tax fiasco

A minister I've never heard of told the chattering classes at the Hay Festival that he supports a sugar tax. I was on the World at One (Radio 4) earlier today explaining the lessons that should be learnt from the Danish fat tax fiasco. I've also written a post for The Spectator so do please have a read.

Thursday 21 May 2015

Bad science by press release

Ben Goldacre wrote a book called Bad Science a few years ago which explained why obvious quackery was quackery. The targets were deserving, though a bit soft for my tastes (homeopaths, nutritionists etc.), and it sold a lot of copies so it must have said something people needed to hear. He also used to write a column in The Guardian which often worth reading.

On his good days, Goldacre would patiently explain the difference between trustworthy evidence and dubious evidence. Published studies are better than unpublished studies, peer review is better than no peer review, randomised control trials are better than observational studies, literature reviews are better than individual studies, and so on. In short, the pyramid of evidence looks like this...

Goldacre has built his reputation on being a dispassionate, apolitical observer of human folly; a man driven by a thirst for evidence, not ideology. Given the choice between a Cochrane review of randomised control trials (top of the pyramid) and an unpublished conference abstract (third from bottom), it's pretty obvious which one he would prefer, right?

Wrong. In December, the first - and so far only - Cochrane review of e-cigarettes was published. It found 'evidence from two trials that ECs [e-cigarettes] help smokers to stop smoking long-term compared with placebo ECs'.

This week, a conference abstract for another literature review - one that included non-RCTs - was released to the press. It concluded that 'Evidence that electronic cigarettes are effective for smoking cessation long-term is lacking'.

To my knowledge, Goldacre has never mentioned the Cochrane review, nor has he mentioned the systematic review that was published in PLoS One last month which concluded that 'Use of e-cigarettes is associated with smoking cessation'. Nor, indeed, has he mentioned the study in Addiction which found e-cigarettes to be more than twice as effective than nicotine-replacement therapy, or the study published three months ago which found that intensive users of e-cigarettes were six times more likely to quit than non-users. But when presented with an unpublished conference abstract, he wasted no time in spreading the news with this bilious Twitter communiqué...

What's got into him? He has previously referred to e-cigarettes as the 'tobacco industry's latest scheme', seemingly unaware that until 2012 there was no tobacco industry involvement in the sector whatsoever and even today the combined might of global Big Tobacco owns just seven of the thousands of brands on the market. On the subject of vaping, Goldacre has shown himself to be no better than the two-bit hacks who write "I reckon" articles about e-cigarettes based on whatever stray thought enters their head. Gateway! Formaldehyde! Children!

But this is not a post about Goldacre's confirmation bias. There is another mistake he makes which was also made by the Daily Mail, namely that the study shows that 'e-cigs don't help smokers quit'. Even the press release doesn't claim that. It says only that, based on its findings, the evidence is 'lacking'.

Absence of evidence is not evidence of absence, particularly when you look at the results in the abstract. The review found the odds of e-cig users (versus placebo users) staying abstinent after one month were 1.71 (1.08-2.72). After three months they were 1.95 (0.74-5.13) and after six months they were 1.32 (0.59-2.93). The first of these is statistically significant, the others are not, hence the lack of firm evidence for cessation at six months.

The study also mentions that the 'only study to evaluate continuous abstinence' found that e-cigarette users' odds of abstinence were 1.77 (0.54-5.77) after six months compared to the placebo group. This, again, is not statistically significant, but nor is it close enough to 1.0 for a positive effect to be ruled out. The same is true of the other findings, all of which are well above 1.0. It would be quite wrong to say that these statistically non-significant odds ratios proved that e-cigarettes work better than placebos, but it is equally wrong to say that they show that 'e-cigs don't help people quit'. All they show is that larger trials will be needed unless e-cigarettes more than double the chance of quitting. The Cochrane review identified one randomised controlled trial which did indeed find that e-cigarettes more than doubled the chances of quitting. We don't know which studies the conference review included (or why) because, as I say, it hasn't been published.

I wouldn't claim for a moment that the Cochrane review is the last word on e-cigarettes and nor do its authors. Cochrane reviews only look at RCTs and only two RCTs have so far been conducted, making the review weak by Cochrane's high standards. Nevertheless, it does have the merit of being peer-reviewed and published, which is normally the minimum Goldacre requires before taking research seriously. That is, unless he wants to wind up a section of society - most of whom no longer smoke thanks to e-cigarettes - that he deems 'vile', in which case any old press release will do.

Wednesday 20 May 2015

Pubs and predictions

The IEA have just published my new report Drinking, Fast and Slow - you can download it here. It looks at the gloomy predictions about what the Licensing Act (AKA 24 Hour Drinking) would do to the sovereign people of England in 2005.

The short read is on the IEA blog and Guido has a handy infographic.

The even shorter read is that all of the predictions have been proven wrong. The major reason why they were wrong is that there were informed, consciously or not, by the simplistic temperance idea of 'availability theory'.

Anyway, here's the long read. Enjoy.

As an amusing footnote, it is worth remembering that the Licensing Act was a Labour policy. Paul Flynn, the Labour MP, voted strongly for the policy and then voted against delaying its implementation. But that didn't stop him having an involuntary spasm this morning when he heard that the IEA had concluded that the law wasn't a complete disaster.

It's an affliction with these people, isn't it? For the record, none of my IEA reports are commissioned, they are all my own work (aside from editing), nobody funds specific reports and the first the pub/booze industry heard about this report was yesterday when the press release went out (if not today). As far as I know, the Licensing Act isn't a live issue for the alcohol industry's lobby squad as there is no chance of it being repealed or amended in the near future. The Act is, however, an excellent example of deregulation working and illiberal people being hilariously wrong. Hence my interest.

Speaking of regulation, the first rays of reality are dawning on CAMRA and the deeply misguided 'Save The Pub' campaign. Now that the government has broken the beer tie, Enterprise Inns are going to flog off a thousand pubs and convert another thousand into commercial properties. Some of them will remain pubs, of course, but certainly not all. As Ed Bedington says in the Morning Advertiser...

We are starting to see the unintended consequences of the pubs code... Enterprise's announcement shows that from its current estate of more than 5,200 pubs, at least 2,000 of those are at risk - by my maths, that's about 40%.

... And for all those well meaning politicians watching those unintended consequences coming home to roost? Cheers guys. The first round in post-MRO landscape is on you.

I made my prediction of what would happen if the government fell for CAMRA's schtick last year. So far, it's proving to be more reliable than the predictions made about the Licensing Act.


I've written more about this at The Spectator. Please have a read. 

Monday 18 May 2015

Alcohol Concern, Dry January and dodgy figures

Alcohol Concern has been dishing out awards to its Dry January champions. Tellingly, all but one of the awards has gone to public sector organisations. The sock puppet charity also put out a press release claiming that...

More than 2 million go dry for biggest Dry January yet

Alas, the figure of 'more than 2 million' was contradicted by the quote in the press release from Alcohol Con's head lobbyist...

Emily Robinson, Director of Campaigns at Alcohol Concern, said: “We’re incredibly proud of all our participants and fundraisers and want to recognise and celebrate those who took the biggest Dry January campaign yet to a new level.”

“The aim of Dry January is to help people to think about their drinking, and to get support in breaking bad habits. With over 50,000 people taking part, it’s great to see how people took this further and supported their friends and communities.

The figure of 50,000 has previously been cited by Alcohol Concern and it is the figure that appears on the Dry January website. It is much the more believable of the two.

When this was pointed out to Alcohol Concern they amended their press release... by removing the reference to 50,000 sign ups! (You can still see the quote in the various local rags that churnalised the press release eg. here and here.)

A tweet made it clear that only 50,000 had signed up for Dry January but two million 'were dry for January'.

Considering that there are more than two million observant Muslims and Methodists—not to mention children—it is not much of a claim to say that more than two million people happened to be teetotal in January. These people took part in Dry January in the same way that I took part in Elton John's boycott of Dolce and Gabbana. They were never likely to do otherwise.

In January, the Daily Mash published an article headlined 'Non-alcoholics enjoying pretend battle with drink'. Life has imitated satire.

Why this urge to inflate the figures by a factor of forty? Two possibilities spring to mind.

Firstly, Public Health England gave Alcohol Concern £500,000 to increase the profile of Dry January. I have written about this disgraceful squandering of taxpayers' money before, but even a bloated quango like Public Health England must conduct some sort of cost-benefit analysis after the event. 50,000 participants sounds pretty feeble (because it is). Two million sounds more impressive.

Secondly, Cancer Research UK does exactly the same thing in the same month under the name 'Dryathlon'. This year it got 54,000 people to sign up. The difference is that the Dryathlon doesn't suck up a penny of taxpayers' cash.

In short, Dry January wastes public money trying to do something that another charity does better, hence the need to fiddle the figures. If Public Health England throws another half a million pounds at Alcohol Con next year, there should be a public enquiry.

Sunday 17 May 2015

E-cigarette survey

The Centre for Drug Misuse Research is conducting a large, international survey of e-cigarette users. If you have ever used an e-cigarette, you should complete it. It takes about five minutes and you could win a prize.

Complete the survey.

Friday 15 May 2015

We are the 82 per cent

82 per cent of Britons do not think that obesity is a disease and 1 in 5 people who are technically overweight do not consider themselves fat. I think they might have a point.

Read more at The Spectator.

A tiny victory

Royal Society for Public Health is a ghastly organisation which I wrote about when they decided they wanted doctors to get into town planning. Earlier this week, they put out a press release to accompany the dodgy OECD report on alcohol under the headline 'UK's rising alcohol consumption a stark reminder of the need for tougher action began'. It began...

New research which shows alcohol consumption in the UK is on the rise is a stark reminder of the pressing need for tougher action

Alcohol consumption is not rising, of course. On the contrary, it has been falling faster than at any time for 80 years. Anybody who claims to speak with authority on the subject should know this. To its modest credit, the RSPH subsequently removed this press release and replaced it with this...

We welcome the OECD report which has brought tackling alcohol related harm back into the spotlight.

RSPH have long been advocating for the implementation of a range of measures to combat alcohol-related harm, including minimum unit pricing, calorie labelling and compulsory PSHE education, and urge the new government to take action.

We are however concerned that the figures in the report do not correlate with official government statistics which lean towards a downward trend for alcohol consumption and binge drinking in the UK. It is important the public is presented with an accurate picture of the nation’s health and an evidence base that is robust. The health and social consequences of excessive drinking are too serious to risk confusing the public.

This admission comes a few weeks after the RSPH criticised Aseem Malhotra's guff in the British Journal of Sports Medicine about exercise. Slightly pathetically, the RSPH only complained about Malhotra 'sending mixed messages' rather than being scientifically illiterate, but it was better than nothing.

You don't win any medals for pointing out the bleeding obvious, but as far as I know the RSPH is the only 'public health' organisation to have responded to the OECD report by drawing attention to the fact that alcohol consumption is falling—and, even then, only after putting out a press release saying the exact opposite.

Such is the level of endemic deceit in the public health racket that one organisation accepting one easily verifiable fact counts as a win. These scoundrels will have to be dragged kicking and screaming before they face reality.

Thursday 14 May 2015

Aseem Malhotra screws up again

Our old friend Aseem Malhotra is starting to become a regular at Retraction Watch. A year after sparking an investigation at the British Medical Journal, Malhotra found himself in hot water with the British Journal of Sports Medicine.

You almost certainly heard about Malhotra's article in the BJSM attacking the 'myth' that exercise helps people lose weight. This risible claim was broadcast around the world. What you probably did not hear is that the article was taken offline within 48 hours and only reappeared last week.

Why was it suspended? Any number of factual inaccuracies could have been responsible (see here for an example), but rumour had it that undisclosed conflicts of interest were the main reason. As I mentioned at the time, Malhotra's co-authors are neck deep in the low-carb/Atkins/banting diet and one of them has a book to sell. This is a fairly mild competing interest, but it is typical of a BMJ publication to be more concerned about an author receiving an indirect financial benefit than about his article being truthful.

The competing interest was not the only reason, however. The article has been subtly altered and the following notice has been added...

Correction notice This article has been amended from the original published on 29th April 2015. The body of the text was slightly edited and a reference removed. Competing interests have been added.

The edited part looked like this in the original...

It now looks like this...

As you can see, the journal has removed the part about the tobacco industry "buying the loyalty of bent scientists". This is important because the paragraph in question accuses the food industry of using "tactics chillingly similar to those of big tobacco."

And, in case anybody was in any doubt that Malhotra et al. are accusing the food industry of hiring 'bent scientists', reference 5 (which has now also been removed) was 'Sugar: spinning a web of influence' by Jonathan Gornall. I wrote about Gornall's article (which was published in the BMJ) a few months ago.

A theme is emerging in his hatchet jobs. First, he takes a policy which is controversial with the public but which has legitimate arguments for and against. He then treats the policy as a no-brainer which could only possibly be opposed by vested interests. He then looks for any kind of funding from business to civil society and the public sector; if he cannot find any he implies that it exists. Finally, he pads out his articles with quotes from activists and presents their failure to persuade government to bring in the controversial policy as being the result of 'webs of influence'.
Last year it was minimum pricing with the Alcohol Health Alliance. This time it's food reformulation with Action on Sugar.

Gornall's articles for the BMJ have all been of a very low quality and the journal embarrassed itself by publishing the sugar article, in particular. Gornall failed to understand that collaborations between the government and the food industry are not a dirty secret. On the contrary, they are the norm, and everybody who works in the field understands this.

The great and the good of 'public health' nutrition lined up in the Rapid Responses to attack the article. Prof Barry Popkin described it as "not only naïve but misguided" and said that Dr Susan Jebb, who bore the brunt of Gornall's poison pen, was "quite incorrectly impugned". The Chief Executive of the Medical Research Council said "please add my name to your 'tangled web'. It would be an honour to stand alongside scientists such as Susan Jebb, Ann Prentice and Ian Macdonald, who are committed to improving public health through research." It's worth reading the Rapid Responses in full.

This should have been enough for the BMJ to end its association with Gornall but I understand that he is currently carrying out more "research" for the journal. Even Gornall, however, did not describe Susan Jebb, Ian MacDonald et al. as "bent scientists". By using that phrase and citing Gornall's article as proof, Malhotra and his chums came very close to doing so. In the eyes of the libel lawyers, they may actually have done so, hence the retraction and correction.

Here we have two people—Malhotra and Gornall—who should not be allowed within a hundred miles of a medical journal publishing utter tripe, with one referencing the other. This Laurel and Hardy act would be quite amusing if it didn't push, and indeed exceed, the boundaries of what can be printed in a serious magazine. As I have shown time and again on this blog, Malhotra writes down the first thing that comes into his head. He is extremely credulous and not terribly bright. This is the second time in twelve months that he has got a journal into trouble, despite the fact that he rarely writes for journals. How many more chances is he going to be given?

Wednesday 13 May 2015

That OECD report on booze

The OECD, a think tank, has produced a report on alcohol which has received worldwide news coverage. Funded by the European Commission, the report contains nothing new and much that is false. Its alcohol consumption stats for the UK bear no resemblance to the usually accepted figures and therefore don't inspire much confidence in the figures it gives for other countries.

The aim of the report appears to be promoting minimum pricing and advertising bans. The fat controller Martin McKee wrote a chapter on the former while Henry Saffer, who is virtually the only economist to have published research which concludes that advertising increases aggregate consumption, wrote a heavily self-referencing chapter on the latter.

It beggars belief that in 2015—after ten consecutive years in which alcohol consumption has declined—journalists still have the nerve to pretend that drinking is on the rise. Nick Triggle, the public health lobby's favourite BBC poodle, put out a report which claimed that alcohol consumption is higher than it was in the early 1990s and that youth drinking is "on the rise". Both claims are demonstrably untrue.

I've written a blog post about this nonsense for The Spectator so please do have a read.

Monday 11 May 2015

The non-epidemic of 10 year olds smoking

From the Beeb...

Children as young as 10 'smoke before exams', survey suggests

OMG! We're going to hell in a handcart!!

Children as young as 10 are smoking cigarettes, eating junk food and drinking energy drinks for breakfast before sitting exams, a study says.

Memo to the BBC: a survey is not a study, however much you think calling it one gives it gravitas.

Who are these chain-smoking, Red Bull swilling, junk food scoffing reprobates? The first thing to note is that there are very, very few of them. As usual, the study survey is not available to read, but the Beeb's report says that "more than a thousand" (1,042 in fact) 10 to 11 year olds were surveyed. Of these, eight—yes, eight—said they had smoked on the day of their exam.

It is obviously troubling that any child of this age is smoking, but we are talking about less than 0.8 per cent of the sample. Moreover, the data is self-reported and, as I have said before, there are always going to be some respondents to surveys who don't read the question, don't understand the question, don't tick the right box or are having a laugh.

There have always been children of this age who smoke but there are probably fewer of them today than ever before. The latest figures from the ONS showed that 0.5 per cent of eleven year olds claim to be regular smokers. One child smoking is one too many, blah, blah, blah. The point is that eight kids out of more than a thousand is not a big enough number to be newsworthy.

What's more interesting about the report is the way that eating biscuits, chocolate and crisps is gradually being grouped in with smoking as a forbidden habit. Again, the numbers are remarkably small...

30 children had high-sugar drinks for breakfast on the morning of their exam, while 45 had biscuits, 19 had crisps, and nine had a pasty or sausage roll.

To put it another way, more than 97 per cent did not have a high-sugar drink, more than 96.5 per cent did not have a biscuit, more than 98.1 per cent did not have crisps and more than 99 per cent did not have a pasty or sausage roll.

Nobody would recommend a breakfast of biscuits and chocolate bars, but when did eating them before midday become deviant behaviour? When I was at school, we were sold biscuits and chocolate bars during the morning break. We were even sold pasties at lunchtime. The horror! Thanks to Jamie Oliver, I suppose they would be breaking all sorts of laws if they tried that now.

What is this research trying to achieve? At first glance it looks like it's based on a press release to kick off yet another anti-smoking drive for the chiiiiiildren, but it isn't. The BBC report includes a quote from someone who wants more schools to have breakfast clubs, but it's not from them either. The survey was actually commissioned by Kelloggs, presumably as a way to publicise the benefits of eating cereal for breakfast, but since the 'public health' lobby have turned on cereals that seems a lost cause.

Apparently Kelloggs are donating a load of food to breakfast clubs, but since the media didn't report that part of the story and instead led with the negligible findings on smoking they must wonder why they bothered.

Eat less, move more

At The Spectator today, I conclude my posts about diet, physical activity and weight loss. This is my final word on the subject (for now).

Do have a read.

Saturday 9 May 2015

Reflecting on the election

“China will go capitalist. 
Soviet Russia will not survive the century. 
Labour as we know it will never rule again.” 
Arthur Seldon, The Times, August 6, 1980

A couple of hours before the polls closed on Thursday night I had a conversation with a friend who was asked me to imagine people looking back with amazement on the wave of mass hysteria that led them to believe that Ed Miliband ever had a serious chance of becoming Prime Minister. He decided to put £25 on a Tory majority at odds of 25/1. The exit polls came out two hours later. The rest, as they say, is history.

Regrettably, I didn't join him in his bet. I had already put £100 on a Tory majority nine months earlier (at 3/1) with a further £100 on a hung parliament (at 6/5) as insurance. The one thing I have always been sure of over the last five years is that Labour wouldn't win a majority under Ed Miliband, and by Thursday the betting market firmly agreed (it was 100/1 the night before the election).

For five years I have been saying that the Tories could sneak a win if (a) the economy recovered by the time of the election, and (b) if Ed Miliband remained leader of the opposition, but by Thursday night I had accepted that this wasn't going to happen. The opinion polls were unanimous. The Conservatives had, in my opinion, run a campaign so lacklustre that it was hard to tell if it had ever begun. The leaders' debates had moved the Overton window dramatically to the left by including the nationalist parties and the Greens. It seemed that the public really had swallowed the fiction about so-called austerity being an ideological choice rather than a modest attempt to get the country living within its means. They had, perhaps, even fallen for the perennial lie about the NHS being privatised.

David Cameron had already failed to beat Gordon Brown, the worst Prime Minister of my lifetime, and it now seemed certain that he would fail to beat the worst candidate in a generation. If he couldn't beat Miliband, it was hard to see the Conservatives ever winning a majority again.

We now know that the leftward shift in public opinion was a chimera. The polls were so wrong that few people will ever take them seriously again. But it was the polling that was shocking, not the result. There is nothing shocking about a centre-right party winning a slim majority against a weak opponent in a growing economy. If, in 2011, you gave the following information to anybody who is familiar with how the British electorate has voted for the last 40 years, they would have correctly predicted the result:

1. The Liberal Democrats are unpopular and are no longer a protest vote.
2. The economy is doing well and the Tories are perceived to be tackling the national debt.
3. Ed Miliband is the leader of the opposition.
4. Lots of people are determined to vote UKIP.
5. There is a huge swing to the SNP.

All of these facts were well established by the time people went to the ballot box. The only question was where the UKIP votes would come from and where the Lib Dem votes go. Even now, the answer is not fully clear, but overall the Tories benefited from the decline of the Lib Dems and UKIP damaged Labour more than it damaged the Tories.

For all the talk about the SNP, the simple truth is that their landslide in Scotland had no impact on the final outcome. The Tories would still have a majority if Labour had held every one of their Scottish seats. Labour was not defeated by a wave of nationalism, as Miliband has implied. The battle was won and lost in England. Insofar as the SNP had an influence on the result, it was by making people vote Tory out of fear of a Labour-SNP pact, but even this aspect of the election has, I think, being overhyped.

With hindsight, it is obvious that the Lib Dems would not merely lose half their seats, as the conventional wisdom had dictated, but would lose nearly all their seats. Why did we ever buy into the nonsense about dozens of Lib Dem MPs clinging on because of their local popularity? Because the opinion polls said so.

As for UKIP, it does not even require hindsight to see that they were never going to win the dozen or even half-dozen seats that were predicted after they won the European election. The logic of first past the post made this impossible. My own prediction was two or three seats, and most people I spoke to thought this was unrealistically low. In the end, they got one. Is it unfair that a party which received four million votes has only one MP? Arguably so, but everyone knew how the voting system worked before the election took place and UKIP themselves set themselves the more realistic goal of coming second in many seats as a springboard for 2020.

So much rubbish has already been written about Labour's failure to win. I'll tell you in six words why they lost: England is not a socialist country. The only Labour politicians who have won elections in the last 60 years are Harold Wilson and Tony Blair, both of whom were on the right of the Labour party and both of whom could have comfortably joined the Conservatives. Wilson's government was considerably more left-wing than Blair's, I grant you, but that only goes to show that Britain has become less left-wing over time.

The opinion polls led us to believe in a fantasy. All of the political chat of the last few months—nay, years—was based on an illusion, an illusion that many people were eager to believe. You could see it on Twitter, on Newsnight and in the pages of The Guardian. The illusion of the progressive consensus. The illusion of the leftward lurch. The illusion that inequality, not growth, was the defining issue of our time. It was an illusion that ultimately guaranteed Labour's defeat because it prevented the party from doing the one thing that would have given them a chance, ie. getting rid of Ed Miliband.

Looking back, there were two moments in the campaign which illustrated the clash between fantasy and reality. The challengers' debate provided the fantasy. By sheer force of numbers, three leaders—Bennett, Sturgeon and Wood—portrayed Miliband as something akin to a right-wing fanatic because he was not deemed to be sufficiently 'anti-austerity'. What an extraordinary sight this was, this amen corner of socialist utopianism in which money fell out of the sky and government solved everything. This was political debate as seen from the coffee shops of Islington, where the centre-ground lies somewhere between the left and the far-left. In this company, the risible, economically illiterate quasi-Bolshevism of the Green party was taken more seriously that the views of Nigel Farage, whose party would go on to win more votes than the SNP, the Greens and Plaid Cymru combined.

That was the fantasy. The reality came later when the leaders faced a Question Time audience in Leeds. This time the real questions were asked. Did Labour overspend? How can Labour be trusted on the economy? How are you going to cut the deficit? Do you understand, let alone support, business? After stumbling in front of this audience, Ed Miliband must have been relieved when the media focused on him merely stumbling off the stage. The lefty Twittersphere erupted with complaints about the supposed right-wing bias of the audience. Another fantasy. It was simply the English electorate.

Thursday 7 May 2015

Obesity balls

In 2006, they said a third of men would be obese by 2010. They were wrong.

In 2007, they said a third of men would be obese by 2015. They were wrong again.

Now they say 36 per cent of men will be obese by 2030. I'll put money on them being wrong yet again.

And the predictions they've made for women are just as bad.

Read my take at The Spectator...

Wednesday 6 May 2015

Physical activity and obesity revisited

The fake controversy about physical activity and obesity—new blog post from me for The Spectator. Do have a read.

Tuesday 5 May 2015

The voting dilemma

At the IEA blog today I suggest that voting is a waste of time therefore you should waste it properly.

Do have a read.

Monday 4 May 2015

Tobacco black market still growing in Australia

KPMG have published their latest figures on illicit tobacco consumption in Australia. After a large rise between 2012 and the first half of 2014 (11.5% to 14.3%), there was a more modest rise in the consumption of illicit tobacco as a proportion of all tobacco in second half of 2014 (to 14.5%). The resulting tax gap is $1.35 billion.

The Aussie Daily Telegraph notes that there has been "a 30 per cent increase in black market trade in the past two years". It's actually 26 per cent, but the point remains that the rise has been steep. It has, of course, coincided with the implementation of plain packaging (December 2012) and two large tax rises (December 2013 and September 2014). The 'public health' cult still laughably pretends that neither plain packaging nor tax rises fuel the illicit trade.

The KPMG research is based on inspection of 12,000 discarded cigarette packs collected around the country. For roll-your-own tobacco, sales of rolling paper are compared with legal sales of tobacco. This is how governments used to evaluate the size of the black market before they decided it would be cheaper to use guesswork or, as seems to be the case in Australia, not bother at all.

In Britain, HMRC simply estimates how many cigarettes are smoked (based on the number of people who say they smoke) and works backwards from the amount of tobacco duty received to estimate the number of cigarettes sold on the black market. The trouble is, people notoriously under-report their smoking status and smokers drastically under-report how many cigarettes they smoke. Even so, it is estimated that 48 per cent of hand-rolling tobacco does not have tax paid on it and, contrary to tobacco control dogma, HMRC says the illicit trade in manufactured cigarettes has been rising in recent years. Officially, it is currently at between 5 and 15 per cent, but this is very likely to be an underestimate.

It would be nice if governments put a fraction of the billions of pounds they receive in tobacco duty into measuring the illicit trade properly, but it is not in the interests of 'public health' lobbyists to let people know the true scale of the problem. And so it is left to the tobacco industry to commission research, which the aforementioned lobbyists dismiss out of hand because it is funded by industry. This is not a rational response, of course, unless the research itself is flawed. The anti-smoking lobby won't risk libel by calling a respected organisation like KPMG liars and frauds, and since their methodology is the best available, it needs to be taken seriously.

What is interesting about the KPMG data is the way the black market has evolved. I have noted before that it did not move exactly in the direction that was expected after plain packaging, ie. with large quantities of plain packs being counterfeited. Instead, there was a steep rise in the number of 'illicit whites' being sold. These are cigarettes which don't exist legally in the domestic market and, in some instances, have never existed legally anywhere. Well known examples include Manchester and Jin Ling. Interestingly, the surge of illicit whites seen in 2013 seems to have subsided, with unbranded tobacco (loose leaf rolling tobacco, known in Australia as 'chop chop') filling the gap.

KPMG reports a big decline in illicit whites and a big rise in unbranded tobacco. However, as a share of the tobacco market, illicit whites were always a relatively small player (less than 2%) whereas chop chop makes up more than half. The other illicit sector is contraband (ie. legal brands smuggled in from other countries) which has seen its share fall by 8.6 per cent.

Overall, KPMG estimates that 2,549 tonnes of illicit tobacco was bought in 2014, seven per cent more than in 2013. The quantity of unbranded, loose leaf tobacco rose from 964 tonnes to 1,375 tonnes. Most of the rest was contraband shipped in from abroad.

KPMG's estimates are supported by several other sources. The finding that unbranded tobacco is rising at the expense of counterfeit is supported by government figures which show that customs are seizing a greater proportion of the unbranded tobacco than they did in 2013. The overall rise in illicit tobacco is supported by survey data (see below) which shows that an increasing number of people are buying illicit tobacco and that those who buy it are buying more of it.

How much of this can be attributed to plain packaging and how much can be attributed to the tax rises? The major black market surge occurred in 2013, in the absence of any tax hike, so it is reasonable to attribute most of it to plain packaging. It is impossible to tell whether the decline of the illicit white market and the rise of chop chop is due to better policing of Australian ports or changes in the supply chain. Either way, Australia differs from Britain in that it has the climate for domestic tobacco growing on a large scale. Every tax rise provides an added incentive to budding entrepreneurs and the deliberate positioning of tobacco as a semi-prohibited product—sold from behind shutters in unbranded packaging—can only help them.  

What are the lessons for Britain if and when plain packaging comes in? Unlike Australia, we don't have an illicit tobacco growing industry in our backyard, but we do have a great deal of loose leaf tobacco delivered from overseas which is then repackaged in the UK. Also unlike Australia, we have many countries with lower taxes on our doorstep. If smokers like cigarette packaging as much as ASH claim, cigarettes from Belgium and Spain will become even more attractive. Moreover, whereas it is illegal to bring in more than 50 cigarettes into Australia (seriously!), Brits can bring in virtually unlimited quantities from EU countries for their own consumption. In practice, they can bring in very large quantities for sale. The former is legal, the latter is illegal, but everyone knows it happens. Whether legal or illegal, it is bad news from Her Majesty's Treasury and it is they who will be most concerned when plain packaging arrives.

When I was in Australia last August, I saw plenty of cigarette packs that had clearly been brought in from other countries. Some were counterfeit (the giveaway is that they had no health warnings). And yet you could hardly ask for a better place to bring in plain packaging. Australia is a long way from anywhere. Britain is not.

If it does nothing else—and we can be fairly sure it won't reduce legal sales of cigarettes—plain packaging will bring the size of Britain's non-duty paid tobacco market into sharp focus. Any cigarettes that are not in 'standardised' packaging will, by definition, not have had UK duty paid on them. You will see them wherever you see smokers. This observable fact will come too late to prevent the ridiculous policy being introduced, but the reality of plain packaging will make it impossible to deny the reality of Britain's black market.