Friday 28 October 2016

Delete your account

Ireland's retail display ban for alcohol is attracting interest in Australia where they can't believe they didn't think of it first.

Michael Thorn is the head of the state-funded temperance group FARE...

Here's a tip for you. If you're going to describe something as 'very Orwellian', don't use the following words in the same sentence:

1. 'But'

2. 'Worth a try'

3. 'Love this idea'

Thursday 27 October 2016

The alcohol display ban - another slip down the slope

Last year, the UK's Department of Health published a handy myth-buster on the implementation of the tobacco display ban which included the following:

Is restricting the display of tobacco a slippery slope to a nanny state on other products such as unhealthy food, or alcohol? 

No. It is right that tobacco is treated uniquely in regulatory terms, because it is an addictive harmful consumer good.

It's always comforting to hear that there is no slippery slope, but while campaigners demand graphic warnings on alcohol and researchers look into plain packaging for food, the world's top nanny states are getting on with the job of transferring anti-smoking policies to other products. San Francisco recently introduced cigarette-style health warnings on cans of pop and Ireland has dipped into the tobacco control playbook for its new idea of 'booze curtains'.

The Public Health (Alcohol) Bill is a piece of good old-fashioned temperance legislation with the modern twist that the Irish government set up its own sockpuppet lobby group specifically to campaign for it. It includes a sky-high minimum price of €1 and extensive advertising restrictions. As the Department of Health explains, the aim is to 'reduce visibility, accessibility and availability of alcohol'. To that end, it wants to protect shoppers from the untold trauma of seeing beer and wine in convenience stores.

The Irish Independent has got hold of some mock-ups that the government has put together to show what shops will look like when the 'public health' lobby makes Ireland a good, clean, pure country. They are quite something.

Option 6, in particular, has a familiar feel to it, does it not? This is the tobacco display ban being blatantly rolled out to alcohol - an example of tobacco control and the temperance lobby learning from each other.
If this all looks like the denormalisation strategy applied to the 'unique product' of tobacco then you'd be right, but it turns out that tobacco isn't the only unique product. Alcohol, says the Irish government, is 'not an ordinary consumer product'.

As I have been saying for years, drinkers who support fanatical anti-smoking policies are laying the groundwork for their own stigmatisation. This unmistakable example of the slippery slope might be enough to wake some of them from their slumber, but it is probably too late.

Wednesday 26 October 2016

Sugar in ice cream and the madness of reformulation

The food fascists at Action on Sugar have been doing some of their pioneering research and have discovered that ice cream contains sugar. Sugar! Who would have thought it?

I've written about the anti-sugar crusade and Public Health England's horrendous reformulation policy for Spectator Health...

You would think that people who support sugar taxes would be pleased to find that high-sugar ice cream is more expensive than low-sugar ice cream, but the permanently outraged pressure group Action On Sugar has today turned its sights on the heir to the throne for putting his name to a luxury ice cream that contains more sugar than many of the budget brands. According to the Guardian, Prince Charles’ organic range of Duchy ice cream, which is exclusively sold in Waitrose, ‘appeals to children’ and should therefore have its sugar content slashed ‘to an acceptable level’. 
Our future king’s brand currently has 84 per cent more sugar in it than Asda’s budget brand. I have tasted neither, but I suspect the reason Waitrose can sell its ice cream at ten times the price of Asda’s is because it is a better product. It tells you a great deal about the future of food under the government’s reformulation scheme that an economy brand from a budget supermarket is being held up as a model for others to follow. To put it bluntly, if you want the government to force food companies to remove sugar, fat and salt from their products, you had better be prepared for your food to taste worse.

Tuesday 25 October 2016

Who's to blame - journals or journalists?

In the age of 24 hour news, all the dead tree press have left are embargoed studies from journals - and, boy, do they like to make the most of them. Two front page stories caught my eye today. Both are largely rubbish. The question is who is at fault: the journalists or the journals?

First, this from the Guardian...

Women now drink as much alcohol as men, global study finds

Women have caught up with men in the amount of alcohol they drink and are doing increasing amounts of damage to their health as a result, according to a global study that looked at the consumption habits of four million people over a period of over a century.

The change is partly the result of successful marketing campaigns and the creation of sweeter products aimed at young women or girls, as well as cuts in price, say health campaigners.

These claims are not borne out by the Office for National Statistics which has consistently found that men are the bigger drinkers. In the most recent drinking survey, conducted in 2014, the ONS found:

Men were more likely than women to drink alcohol, as well as consuming higher amounts. In the week previous to the survey, 64% of men had drunk alcohol, with over half (52%) drinking more than 4.67 units on their heaviest drinking day. In comparison, 53% of women had drunk alcohol in the previous week, with only 37% of those drinking more than 4.67 units on the heaviest day. Men were 3 times more likely to have drunk over 14 units on their heaviest drinking day, 12% of men compared with 4% of women.

If that's the situation in Britain, it seems unlikely that women are out-drinking men in some of the less socially progressive in the world, but let's see what the study - published in BMJ Open - says:

Among those born in the early 1900s, males were 2.2 (95% CI 1.9 to 2.5) times more likely than females to consume alcohol, 3.0 (95% CI 1.5 to 6.0) times more likely to drink alcohol in ways suggestive of problematic use and 3.6 (95% CI 0.4 to 30.3) times more likely to experience alcohol-related harms. Among cohorts born in the late 1900s, males were 1.1 (95% CI 1.1 to 1.2) times more likely than females to consume alcohol, 1.2 (95% CI 1.1 to 1.4) times more likely to drink alcohol in ways suggestive of problematic use and 1.3 (95% CI 1.2 to 1.3) times more likely to experience alcohol-related harms.

As you can see, the authors make the infuriating mistake of using '1900s' to describe the twentieth century rather than the first decade of the twentieth century. (This is not pedantry. If this common error becomes universal, historians will have no way of describing the first decade of a century.) Assuming that by 'late 1900s' they mean 1980-1999 rather than 1907-09, the study shows that the gap between male and female drinking rates has narrowed, but has not reached parity. Men are 20 per cent more likely to drink heavily and are 30 per cent more likely to experience alcohol-related harms. The whole premise of the Guardian front page story is therefore incorrect.

The study - actually an evidence review - doesn't show the actual rates of consumption, nor does it show trends for either sex. It focuses only on the gap. As the authors acknowledge...

It is important to note that the sex ratio metric used in the current study provides information on the relative prevalence of alcohol use or related harms in males versus females. This metric does not empirically determine whether observed changes in the sex ratio are being driven by increases or decreases in male or female prevalence

However, they say that in most instances rates of drinking have risen among women. That has certainly been the case in Britain but it is also the case that drinking amongst men has fallen sharply since 1900 (and has fallen amongst both sexes since 2004). It would be possible for the gap to narrow even if both sexes drank less.

The authors do not discuss the reasons for the narrowing of the gender gap other than to mention greater equality in the labour market, but this does not prevent the Guardian from inviting the usual neo-prohibitionist talking heads from Alcohol Concern and the Institute for Alcohol Studies to spout off about marketing and the 'need' for health warnings on drinks.

You can't blame the journal for this shoddy reporting. The study is not misleading and the press release repeatedly stated that women were 'catching up', but had not caught up, with men. The press release also said that the study did not 'address whether alcohol use is falling among men or rising among women' and that the authors 'did not set out to explain the reasons behind their observed findings'.

Verdict: Bad journalism

Meanwhile, the Times led with this story...

On its face, this is a crazy idea. Doctors have very little time with patients as it is without weighing everybody who comes in to see them. Most people are not obese and you don't need to weigh somebody to tell if they are fat. Moreover, the claim that heart disease would be cut by 23 per cent and diabetes would be cut by 17 per cent if doctors sent their patients off to Weight Watchers to lose two pounds seems deeply implausible.

The study in question was published in the Lancet. It's a randomised experiment in a real world setting in which GPs said something along the following line to obese patients:

'While you’re here, I just wanted to talk about your weight. You know the best way to lose weight is to go to [Slimming World or Rosemary Conley] and that’s available free on the NHS?'

The doctors didn't weigh the patients - only obese people were selected for the study - and so the intervention only took around 30 seconds.

The take-home message from the study is that the vast majority of obese people do not mind doctors raising the issue of their weight, and most of them appreciate the offer of help. Those who were offered help lost a bit more weight than those who didn't (1.4 kg on average).

The predictions about heart disease and diabetes are contained in the study, but the figures are relative to a counter-factual of future obesity rates. As regular readers know, 'public health' forecasts of future obesity rates are worthless and so are these.

While some of the basic facts in the Times story are correct, the headline claim that 'patients should be weighed during routine GP appointments' is not being made by anybody, as far as I can see - not in the study and not in the press release. The BBC has a somewhat more accurate report of the study here.

Verdict: Mostly bad journalism

Monday 24 October 2016

Gay cakes

From the BBC...

The Christian owners of a Northern Ireland bakery have lost their appeal against a ruling that their refusal to make a "gay cake" was discriminatory. Appeal court judges said that, under law, the bakers were not allowed to provide a service only to people who agreed with their religious beliefs.

Two years ago, the family-run firm refused to make a cake iced with the slogan: "Support Gay Marriage". The order was placed at its Belfast shop by gay rights activist Gareth Lee.

The firm argued that the cake's message was against the bakers' religious views.

Reacting to the ruling, Daniel McArthur from Ashers said he was "extremely disappointed" adding that it undermined "democratic freedom, religious freedom and free speech".

"If equality law means people can be punished for politely refusing to support other people's causes then equality law needs to change," he said.

I know there are strong view on both sides and that many people celebrating this outcome have the best intentions, but I'm with the bakers.

The government is a lumbering, cowardly bully. When the majority of Britons regarded homosexuality as immoral, irreligious or otherwise socially unacceptable, it was illegal. The lives of many gay men were ruined by imprisonment, blackmail and forced sterilisation. By 1967, attitudes had softened to the extent that homosexual acts were legalised, albeit only for men aged 21 or over, and for the next few decades, they were legally tolerated while continuing to be the subject of widespread but dwindling social disapproval.

Attitudes then swung decisively. Between 1985 and 2012, the proportion of Britons who believed that homosexuality was ‘wrong’ fell from 69 per cent to 28 per cent and it was now homophobia that became socially unacceptable.

Sensing the changing mood of the majority, the cowardly, bullying state swung to the opposite extreme and began prosecuting those who displayed prejudice against homosexuals. In 2011, a Christian couple were fined £3,600 for refusing to allow a gay couple to stay in a double room in their bed and breakfast. Three years later, the bakery involved in this dispute was fined £500 for refusing a request from a customer to bake a cake with the words ‘support gay marriage’ on it. In effect, they were being forced to promote an opinion with which they totally disagreed.

Neither the old attitude to homosexuality nor the current attitude to homophobia is recognisably liberal. Under John Stuart Mill’s harm principle, it would not matter whether it was homosexuality or homophobia that was deemed immoral by the majority. Neither would be a matter for the police.

The government has used the law to persecute first one side and then the other. It never seems to occur to these moral imbeciles that there is a third option of allowing people to voluntarily trade and associate with whomever they want, and to not persecute anybody.

Saturday 22 October 2016

Minimum pricing, the law and the dominance of 'public health'

I wrote a piece for Spectator Health about the Scottish court ruling that sided with the government in the minimum pricing case.

Those of us who voted Leave in June understood that there is a trade-off between sovereignty and trade. The SNP are an overtly paternalistic party with authoritarian tendencies, but they have been resoundingly elected by the Scottish people. If they want to drain the pockets of the poor by putting a deadweight cost on alcohol, there is a case for respecting their sovereignty. On the other hand, they are party to a trade deal in the form of the common market which, until today, seemed to forbid such actions. 

For those of us who like free markets and oppose minimum pricing, the EU’s ban on such restrictive practices was one of the things we were going to miss after Brexit. After today, it is one less thing to worry about.

I suspect that this will now got to the Supreme Court. The judge's rationale was far from compelling and, to my mind, did not fully engage with the objections raised by the European Court of Justice. We shall see, but I don't think the lawyers are going to lose out from this saga. 

Thursday 20 October 2016

Living in the pre-truth world

I spoke at the launch of the Orwell prize last night about 'post-truth Britain'. Here is roughly what I said...

The emblem of the post-truth society is a red bus that has come to assume rather more importance since the vote to leave the EU than it did during the referendum campaign. This bus famously claimed that we send £350 million to the EU every week and that we could be spending this cash on the NHS instead. Alas, this is physically impossible because the £350 million figure includes a rebate that never gets sent to the EU in the first place. The real figure is - depending on how you look at it - £190 million or £250 million.

This is hardly the first time a dodgy statistic has been used in a political campaign, so what was it about this particular claim that made it so offensive to those of us who care about facts?

There were other questionable claims made in the referendum campaign such as the idea that Turkey is set to join the EU. It is very, very unlikely that Turkey will join the EU in the short or medium term and yet it is not technically impossible. The EU has spent money looking into its membership. David Miliband was very keen on getting Turkey to join when he was foreign secretary, but Turkey has gone backwards since then and it would take a near-miracle for it to meet the EU’s criteria for entry. So not a total lie, perhaps, just a very implausible prediction.

The Remain side had their own implausible predictions. There would be a punishment budget if we voted to leave. There would be an immediate recession. David Cameron promised to invoke Article 50 straight away and stay on as prime minister. Instead, he resigned as prime minister straight away and Article 50 has still not been invoked. Having stepped down as prime minister he then promised to stay on as an MP, but he has since quit politics entirely. Were these lies? Did he really think he could stay on as prime minister if the country voted for Brexit? It seems unlikely, but it cannot be proven. It is therefore possible that he was sincere and later changed his mind.

It seems to me, therefore, that the ‘post-truth’ porky is something that cannot possibly be true and is uttered by someone who knows it is not true. So that's why we're in the post-truth era, because politicians never used to do things like that.

But then I thought of Harold Wilson going on television to tell the British public that devaluing the pound would not affect the value of the pound in their pockets. I thought of Ronald Reagan telling the American public that he had never traded arms for hostages. I thought of Jonathan Aitken and his “simple sword of truth" before he was jailed for perjury and perverting the course of justice.

I remembered Bill Clinton insisting that he had not had sexual relations with "that woman". I thought of Jeffrey Archer and Neil Hamilton and Richard Nixon and I’m tempted to say that the list is endless, but actually it is not. Deliberate, flat out lies are relatively rare in politics because so many people are watching and waiting to pounce on the slightest slip. As Jeremy Corbyn found out after he claimed not to be able to find a seat on a train, it is not the size of the lie that matters. The public can tolerate incompetence, but will not put up with deceit.

All of the politicians I’ve mentioned were found out. The £350 million figure was widely challenged at the time; Sarah Wollaston switched from Leave to Remain as a result. The intense scrutiny of politicians, which has only increased in the age of social media, gives them a big incentive to get their facts right, or at least to get them wrong in a way that can be defended.

In the examples of political lying I’ve just given, most involved politicians denying things from their own past when cornered, rather than inventing statistics from whole cloth. But that seems to me to be narrowing the definition of a lie down to an excessive degree and, anyway, statistics don’t need to be entirely made up in order to mislead people. They can be easily twisted in a way that will trick the public without resorting to outright fraud. Politicians - and journalists - often cite dodgy figures, but they have usually been given them by lobbyists, pressure groups and charities. And if you look at the vast pool of false claims and nonsense in society, you will find these groups more culpable than politicians.

There’s a man I know who debunks bad statistics for a living. When I told him I was looking for some good examples in advance of this event, he gave me three words of advice: ‘Beware good causes’. In the past few weeks, I have seen a headline on the front of a national newspaper asserting that e-cigarettes are as bad as smoking. No one who has studied the evidence believes this to be remotely true. I have seen The Times report the news that the Gambling Commission announced that rates of problem gambling have doubled in the last three years. The Gambling Commission has made no such claim and all the evidence shows no change in problem gambling prevalence since records began in 1999.

I’ve seen the Advertising Standards Agency condemn Friends of the Earth for making claims about fracking that can most politely be described as unsubstantiated. This comes after 107 Nobel prize winners wrote a letter to Greenpeace asking them to end their campaign against Golden Rice, a campaign they described as being ‘emotion and dogma contradicted by data’. A few weeks ago, Oxfam claimed that the UK is one of the most unequal countries in the developed world. The Office for National Statistics says income inequality is ‘close to the overall EU average’ and Credit Suisse says wealth inequality is ‘very typical for a developed country’. No media outlet challenged this claim, as far as I know, despite the data with which it could be debunked being readily available.

A list of false or misleading factoids from special interest groups really would be endless and I'm not accusing any of the people involved of being conscious liars. When the magicians Penn and Teller created a television series debunking the claims of frauds and charlatans some years ago, they called the programme ‘Bullshit!’, because accusing someone of lying is potentially actionable whereas accusing them of talking bullshit is, in legal terms, mere vulgar abuse.

Lying may be more morally objectionable, but bullshit is more common and it is just as damaging to public understanding of the world we live in. My argument is not that we are living in a truthful age. On the contrary, there is bullshit everywhere but deliberate political lies make up a very small portion of it - and that portion is not growing.

As long as people have an appetite for having their biases confirmed, newspapers will continue printing bullshit. As long as people think they can get away with it, they’re going to mislead the public. I don’t think we live in the post-truth era because I don’t think there was ever an era of truth. We are still in the pre-truth era and probably always will be.

Tuesday 18 October 2016


ASH have produced an amusingly inept report today which has received a justifiable lack of interest from the media. The document - Counter-arguments - is designed to soften up retailers for the day when ASH push for full prohibition. It makes a ham-fisted attempt to persuade them that selling tobacco, despite all appearances, is not a good way of making money.

The "counter-arguments" are ridiculous, bordering on dishonest...

Profits. Despite the high volume of tobacco sales in convenience stores, accounting for 25% of total sales income in our sample, small retailers make very little money from tobacco. The margin on tobacco products is around 6% compared to an average of 24% for the other products they sell.

This is a pathetic claim. 80 per cent of the price of a pack of cigarettes is tax. If 80 per cent is tax, it is impossible to make a 24 per cent margin. The main job of a tobacco retailer is to collect tax for the government. The real question is how much of the pre-tax price goes to the retailer. The answer is closer to 40 per cent. Elsewhere in the report, they mention that retailers make an average 44p profit on tobacco transactions. Given that the pre-tax price of a pack of cigarettes is barely more than £1 this is a pretty generous margin.

If ASH are so concerned about retailer margins, they should support a cut in tobacco duty. Every cut in tax would increase the margin as a percentage of the price. That won't actually make retailers any more money, though, because it is the amount earned not the percentage that matters to their livelihoods. On such a heavily taxed product, the post-tax margin is an irrelevance.

Footfall. Tobacco manufacturers claim that retailers do well from tobacco sales because smokers buy other products while they are in the shop. However, other than the money they spend on tobacco, smokers do not spend significantly more than people who do not buy tobacco.

This is a bit of a straw man. The importance of footfall is not getting smokers to spend more money than nonsmokers - though they do - it is getting them in at all. If smokers bought their cigarettes from supermarkets rather than newsagents, they are likely to buy their drinks and newspapers from supermarkets at the same time. The small shops would get nothing.

Variety of stock. Tobacco manufacturers encourage retailers to maintain the availability of their own brands and brand variants. Yet the cost to retailers of ignoring this advice is low: a few disappointed customers per week add up to a very small cut in profits.

I don't know if the cut in profits would be small or not, but it shows how little ASH know about small shopkeepers, who work incredibly long hours in a difficult trading environment, that they think they would be prepared to sacrifice any size of profit - or disappoint any customers - on the whim of an extremist single issue pressure group.

Opposition to new legislation. The claim that tobacco control measures increase the size of the illicit market does not stand up to scrutiny. In Britain, the market share of illicit tobacco has declined since 2000 despite all the changes to how tobacco is sold. The size of the illicit market is determined principally by the effort put into law enforcement.

ASH always use 2000 as their starting date for measuring the illicit trade - and it is true that the illicit trade is smaller now than it was then. What they don't mention is that 2000 saw a massive spike in cross-border shopping to the EU after successive tobacco duty rises in the 1990s. This taught the government that it could not keep hiking up taxes ad infinitum and for the next eight years, it froze tobacco duty in real terms. In the last five years, however, there have been steep tobacco duty rises and - surprise, surprise - the illicit market has grown. Even by the questionable estimates of HMRC, the share of tobacco that is non-duty paid has risen by a third since 2011/12. We shall see what effect the display ban and plain packaging have, but the news is unlikely to be good for legitimate retailers.

As a point of fact, there is a direct relationship between tobacco taxation and illicit tobacco sales. The UK, Ireland and France have the highest taxes on cigarettes and, not coincidentally, also have the largest illicit markets in Western Europe. The belief that black markets can be eliminated through enforcement is a myth dating back to the Anti-Saloon League.

A new approach. Retailers could benefit from a declining population of smokers if they reduce their stock of tobacco to core products, shift their gantries out of customers’ line of sight, and use the freed-up space to promote and sell higher margin products. They can keep regular smokers among their customers while reducing the burden of smoking on their cash flow and, potentially, increasing their profitability.

I suspect that shopkeepers know rather more about how to make a living from running a shop than an economically illiterate, state-funded, nanny state lobby group. The reason retailers keep tobacco products close at hand is that they need to be reached many times a day and need to be kept out of the way of shoplifters; thanks to the aforementioned taxes, they are worth thousands of pounds.

ASH live in such a world of fantasy that they can make claims like 'in Australia, the introduction of standardised packaging actually increased the efficiency of retail sales' with a straight face. Their latest report will raise a hollow laugh from shopkeepers in the real world.

Saturday 15 October 2016

New Last Orders podcast

There's a new Spiked Last Orders podcast out featuring me and Tom Slater with special guest Timandra Harkness. Lauded by Twitter communist David Colquhuon as the silliest he's ever heard, it includes our thoughts on David Nutt's synthetic alcohol, the NHS's social engineering and the claim that modern life is killing us. Subscribe on your device or click here to listen.

Friday 14 October 2016

The WHO's Opposition to Tobacco Harm Reduction

Julian Morris has written a great report for Reason about the World Health Organisation's backwards attitude towards harm reduction. It is heavy on facts and includes an excellent primer on snus.

Here are a few samples:

On the WHO's abuse of the precautionary principle...
In general, the WHO demands an excessively high standard of evidence for new products. In Tobacco: Deadly in Any Form or Disguise it asserted: “For new products and for those under development, additional research is needed to understand more precisely whether their risks are the same as the products they would replace. Such research will take years, or even decades. Until such research is completed, the most prudent course is to assume that their health risks are extraordinarily high compared with any ordinary consumer product and to make every effort to prevent their use along with all other tobacco products.” Given that decades of data were already available on the effects of snus by the time the WHO published this, one wonders if any amount of data will ever be sufficient to persuade it of the merits of harm reduction products.

On the secretive dealing of the Framework Convention on Tobacco Control meetings...

Articles 29, 30 and 31 of the FCTC’s Rules of Procedure permit certain “Observers” to “participate without the right to vote in public or open meetings of the Conference of the Parties and of its subsidiary bodies.” The rules state that Observers are also permitted to “speak” during open or public meetings of the Conference of the Parties (COPs) and subsidiary bodies.  This gives the appearance that the FCTC is extremely participatory — more so than most other intergovernmental agreements.

But actual, permitted participation in the FCTC is extremely narrow. The FCTC currently lists only 20 NGOs as Observers on its website. By contrast, the Framework Convention on Climate Change lists over 2,000 NGOs as Observers on its website. Moreover, there is essentially no participation by representatives of many affected groups, including users of tobacco and vape products, vendors, and farmers. Participation by IGOs has also been restricted; even Interpol has been denied Observer status, despite its expertise in combating illicit trade in tobacco — a key topic covered by the Convention.

And what the WHO should do...

If the FCTC is genuinely committed to the “right to health” then it must listen to those who are taking control of the things that determine their health — and to those who are helping them to do so. In other words, it should open itself up to participation by groups representing vapers, snus users, and companies producing these and other less harmful nicotine - containing products.

A more open, participatory FCTC would not produce papers in secret and make them available only a few weeks before COPs. Instead, it might issue a call for papers and encourage all parties with an interest in the issue to submit materials. It might then allow pu blic scrutiny of those papers and form a committee, the composition of which is determined by votes from a much enlarged group of Observers, who can then review submissions and form conclusions.

At the same time, if the FCTC is genuinely concerned about avoiding conflicts of interest, then the best approach is to open itself up to scrutiny. That means, at the very least, permitting journalists to attend all sessions of COPs and technical committees. Better yet, the FCTC might livestream all its proceedings over the Web — in much the way that the Framework Convention on Climate Change livestreamed its 21 st Conference of Parties.

You can download The WHO's Opposition to Tobacco Harm Reduction here.

Washington's Taxpayer Protection Alliance has also recently put out a report on the WHO: World Health Organisation in need of intensive care: World taxpayers funding failing international organisation.

Thursday 13 October 2016

E-cigarettes and the Nudge Unit

I mentioned in a recent article the role of the Nudge Unit in keeping e-cigarettes on the market in Britain. According to David Halpern in his book Inside the Nudge Unit, his team were instrumental in lobbying for light touch regulation after he came across an e-cigarette by chance in 2010. Here are a few excerpts....

At some point, Rory [Sutherland] produced an 'e-cigarette'. Back in 2010, these were still very rare. I think he'd got his own on a recent trip to Japan. Almost as an aide, he waved his e-cig and proclaimed that maybe these were a good thing.

In the same year, the question of how to regulate vaping was raised in government...

It wasn't a clear call. Policy decisions are often like this. Prime Ministers and Ministers, with the aid of their advisors, often have to make decisions in the face of incomplete evidence. We looked hard at the evidence and made a call: we minuted the PM and urged that the UK should move against banning e-cigs. Indeed, we went further. We argued that we should deliberately seek to make e-cigs widely available, and to use regulation not to ban them but to improve their quality and reliability.

Enter the MHRA...

We deliberated whether we could regulate e-cigs like foodstuffs or electronics, but eventually concluded that our best route might be a 'light-touch' medical route to regulation. The inverted commas are appropriate because, as anyone who deals with regulation will know, 'light-touch' is not necessarily the default instinct of regulators. Nonetheless, we asked the body that regulated medicines in the UK, the Medicines and Healthcare Products Regulatory Authority (MHRA), to develop as light a touch regulation as they could - just enough to make sure e-cigs didn't have other toxins, and that they had enough nicotine in them to be effective.

And then the 'public health' industry came bumbling out...

The public health sector might have been caught unaware by e-cigs and our rapid action in 2010. But through 2011-12, significant sections of the policy community, and particularly the public health sector, started to turn against e-cigs in earnest. The Chief Medical Officer moved from being on the positive side of neutral to firmly against. Pharmaceutical companies that made nicotine patches and gum weren't too pleased about the new competition, and started lobbying against e-cigs. The argument wasn't helped by big tobacco companies, who moved from being bemused and slightly hostile observers, to becoming actively interested in the products and even, it was rumoured, buying up some of the e-cig companies.

Meanwhile, government regulators had decided - surprise, surprise - to over-regulate...

By the time the proposals came back from the MHRA, they didn't look quite like the light-touch regulation we had in mind. The issue was also becoming a European matter, with many countries arguing for a ban, or at least very heavy regulation. Faced with a backlash in the public health sector, one of the UK's largest retailers withdrew e-cigs from its shelves. Despite our early efforts, we were losing the battle. We were heading towards heavy restriction of e-cigs in Europe, where they might only be available on prescription. Some wanted to go further still, and to follow the Australians towards an outright ban, or availability only possible under tight medical supervision. Even the MHRA was concerned that the European position would go too far.

Halpern and his team then looked at the evidence and found that e-cigarettes were clearly helping people quit smoking and were not acting a 'gateway' to smoking for nonsmokers....

We took the evidence back to the PM and the Cabinet Secretary. As it happens, David Cameron was one of the only people in No. 10 who had been a smoker [and still it, it seems - CJS], and had even tried an e-cig (he wasn't especially impressed). We took the decision to stick to our line: to ensure that, for now at least, e-cigs should be widely available; to push for light-touch regulation to ensure that they were free of other toxins but had enough nicotine to satisfy smokers' cravings; and to legislate to ensure that they were not to be sold to the under-18s. Available, but safe, was to be our line.

Based on behavioural and other evidence, and with the help of a new Public Health Minister and our European and Global Issues Secretariat (EGIS), this is the line we took and pushed and more or less secured in the UK and Europe. It is a situation we continue to watch.

Nobody could seriously describe the EU's Tobacco Products Directive as light-touch regulation, but never mind. There's an even greater threat in the WHO...

As with much of policy, this is an unfinished story. In July 2014, the World Health Organisation published a report concluding that countries should pursue a 'two-pronged regulatory strategy - regulating ENDS [e-cigs] as both a tobacco product, in accordance with the provisions of the WHO Framework Convention on Tobacco Control, and as a medical product. They did not recommend a ban, but for many countries regulating e-cigs in this way would dramatically curtail their availability.

He concludes:

Though time will tell, the initial indications are that by helping people quit - and possibly opening the door to a future outright ban on smoking - e-cigs may prove to be the biggest boost to public health in a generation. Even more extraordinarily, much of the public health bodies [sic] would have blocked them.

Not so extraordinary when you consider that it's never really been about health. It's about control.

In some respects, it's a good news story that the Nudge Unit helped to get a relatively liberal regulatory regime in Britain, but it is also worrying that so many big decisions come down to the right people being in the right place at the right time. What would have happened if Halpern had not come across a friend using an e-cigarette in 2010? If the dice had fallen differently, we could have ended up with the mendacious 'public health' industry winning the battle and securing a ban, as has happened in other countries. Our liberties shouldn't really be in the hands of random people like this.

You can buy Inside the Nudge Unit here.

Wednesday 12 October 2016

The WHO is lying about food and drink taxes

The WHO's excrucitaing decline continued yesterday when it published a document calling for fiscal measures in the food supply, ie. taxes and subsidies. Written anonymously, as is their style, its report - Fiscal Policies for Diet and Prevention of Noncommunicable Diseases - makes a number of unsupported claims, such as this...

There is increasingly clear evidence that taxes and subsidies influence purchasing behaviour, notably when applied to sugar-sweetened beverages and this contributes significantly towards addressing the obesity and diabetes epidemic, especially when part of comprehensive multisectoral population-based interventions.

It is a statement of the bleeding obvious that price influences consumption and it is equally obvious that taxes and subsidies affect price. But where does the belief that taxing sugary drinks 'contributes significantly towards addressing the obesity and diabetes epidemic' come from? No country has ever reduced the prevalence of these health conditions with taxation. There is not a jot of real world evidence to support this claim, and the WHO does not offer any.

The authors continue...

Estimates from recent economic research show that the prices of foods and beverages effect [sic] purchase and consumption significantly.

Well, duh.

As taxes increase, the purchase price of certain foods increases and consumers thus reduce their purchases. As a consequence, industry may produce less of the food in question.

I love the use of the word 'may' here. In fact, it's safe to say that if people buy less of a product, the industry will produce less of it.

The fundamentals to the effect of fiscal policies on diet and the basics of price elasticities include:

a) demand for SSBs [sugar-sweetened beverages] is generally elastic, with price elasticities around -0.9 to -1.3

No, demand for sugary drinks is generally inelastic.

Growing evidence shows that appropriately designed fiscal policies, when implemented with other policy actions, have considerable potential for promoting healthier diets.

Really? And where is this growing evidence?

These will improve weight outcomes and other diet-related risk factors, and will contribute, ultimately, both to the prevention of NCDs and to the reduction of the NCD health and economic burden.

Note the switch from talking about the 'potential' of these policies to the certainty that they 'will' work.

A meta-review of 11 recent systematic reviews on the effectiveness of fiscal policy interventions for improving diets and preventing NCDs (6) showed that the evidence was strongest and most consistent for the effectiveness of SSB taxes in the range of 20–50% in reducing consumption, and of fruit and vegetable subsidies in the range of 10–30% in increasing consumption.

Finally, some evidence! Let's have a look at reference (6) shall we?

(6) Fiscal policy options with potential for improving diets for the prevention of noncommunicable diseases (NCDs) (draft). Geneva: World Health Organization; 2015.

The report is citing itself! I've never seen that before.

Whatever evidence the FIFA of Health claims to have in mind can only be based on theoretical models. No country taxes sugary drinks at 20-50% (excluding sales taxes such as VAT). Even Mexico and Berkeley only tax them at 10%. Nor do any countries subsidise fruit and vegetables at 10-30%. It is simply dishonest to pretend that these policies have been shown to work. They haven't even been tried - and with good reason.

There is also growing evidence for the likely effectiveness of combinations of taxes and subsidies, particularly as a mechanism to reduce potential substitution with unhealthy foods.

Sheer bullshit again. No one has tried this.

The WHO goes on to discuss eleven countries that have dabbled with policies of this kind. Perhaps this is the 'meta-review of 11 systematic reviews on the effectiveness of fiscal policy interventions' that they mention when referencing themselves. It must be because it's the nearest thing to evidence that appears in the report. If so, it is mendacious.

Denmark’s tax on saturated fat – implemented on 1 October 2011 and abolished on 1 January 2013 – proved to be efficient in reducing the intake of saturated fat as well as in improving other dietary measures and reducing mortality from NCDs.

Unevidenced, unmitigated tripe. There is no evidence - none - that a short-lived tax on saturated fat reduced mortality from non-communicable diseases.

The WHO then mentions Ecuador where a tax on soft drinks and some food 'faced challenges which made the tax difficult to implement'. It mentions Egypt where 'the government has not adopted taxes on unhealthy food as a tool to reduce consumption. On the contrary, it has imposed low tax rates on some unhealthy foods, such as sugar'. Great success!

Then there is Finland which 'has a long history of using price policies to influence food consumption'. Has it reduced obesity or improved health? We don't know because it 'has not been formally evaluated'.

And so it goes on. A soda tax in Mauritius 'has not been assessed'. A bill to introduce a soft drink tax in the Philippines (a despotic country admired by the WHO) has not been passed but a computer model reckons that 'a tax that would increase the price of SSBs by 20% would reduce overall consumption by 24%'. Hungary has lots of food and drink taxes but there's no evidence of any improvements in health. France has a small tax on fizzy drinks, but it applies to sugary and non-sugary drinks alike. Thailand taxes sugary drinks at a lower rate than non-sugary drinks but gets a mention anyway. Mexico saw soda sales drop after a tax was introduced if you compare it to a 'public health' counterfactual but sales didn't actually drop. Finally, the USA gets a mention because most of its states have a soda tax of some sort but the WHO neglects to mention all the studies showing that they have had no impact on obesity because of substitution effects.

That, apparently, is the 'growing evidence' for taxing food and soft drinks. This unelected, secretive agency is pushing governments to introduce regressive taxes that it does not understand and willfully misrepresents.

In most cases, however, the demand for foods and beverages is typically inelastic (i.e. consumers are not very responsive to price changes). This should not be viewed, per se, as hindering the pursuit of public health goals. It simply means that the tax rate will have to be high enough to reduce the consumption of the taxed products to an extent that will generate meaningful health effects.

Be afraid.

Still more obesity predictions

There were more obesity predictions made yesterday and they were deeply implausible, as usual. I wrote about them for Spectator Health...

Whether obesity rates rise in the future remains to be seen but there is no particular reason to assume they will. Nor is there any reason to assume that they will rise among boys but not girls, or among poorer children but not wealthier children. In fact, I would happily wager a reasonable sum of money on obesity rates being well below the predicted 43 per cent in 2020 for any group you choose to name.

It’s all so much flim-flam, but the objective is not to make an accurate forecast. The objective is to scare people into accepting bans, taxes and restrictions. A sugar levy is already planned for 2018, and when you recall how loudly the ‘public health’ lobby campaigned for this regressive tax, you’d have thought their models would show a fall in childhood obesity between now and 2020. Instead they forecast an implausibly large increase. If the sugar tax is not going to have any impact — and of course it won’t — why are we going ahead with it?

No one has taken me up on my bet yet.

Read the whole piece here.

Tuesday 11 October 2016

Yes, you are a nanny statist

A blog post at the website of the UK Temperance Alliance (now known as the Institute for Alcohol Studies) doesn't allow comments so I'll put them here instead...

However in the case of both obesity and alcohol, the current Government is reluctant to take action.

Sugar tax? Alcohol tax? Marketing restrictions? Reformulation? Licensing laws? Hello?

Part of the reason for this, is that MPs are usually expected to represent their constituents' preferences and are reluctant to support unpopular policies. Effective legislation to limit the global health burden of both obesity and alcohol therefore relies on public backing in order to be passed. In our society, the dominant dogma is that to maximise the welfare of our citizens we have to maximise freedom and personal choice. Policies to to dictate what we eat or lower alcohol consumption tend to be seen as contrary to this central tenet and therefore tend to be disliked by voters.

Democracy's a bugger, isn't it?

We need a paradigm shift where intervention is not seen as interfering or the actions of a ‘nanny state’. In his book, ‘The Paradox of Choice: Why more is less’, Professor Barry Schwartz argues against this set of beliefs and how ‘too much choice’ actually shifts the burden of responsibility to the individual and makes us less satisfied.

I've read Schwartz's book. It's the pitiful whining of a rich man who has nothing to worry about except what style of jeans to buy. Anybody who is impressed by it is, frankly, a moron and anyone who thinks that free choice is a problem should move to a fascist, communist or theocratic country.

The current reliance on voluntary action by the food and alcohol industry has not worked. It is in the interest of industry to paint organisations such as the World Obesity Federation and Alcohol Health Alliance as nanny statists when in fact the Government has an opportunity to protect the next generation from many diseases including liver disease and cancer and reduce the crippling burden of obesity and alcohol on the NHS and society.

Voluntary action? Alcohol is taxed to the hilt and has legal restrictions on when and where it can be sold, and on who it can be sold to. Its advertising is restricted to the point that companies cannot make truthful claims about their product. The same is increasingly the case for food.

If you try to stop adult consumers from doing things that might only harm themselves, you are a nanny statist, and the Institute for Alcohol Studies is a temperance group. You might not like these terms - and so you shouldn't - but that's what you are.

When accompanied by good education, we know that simple legislative measures can and do work. In just 6 months, the introduction of a 5p charge for plastic bags has resulted in 7 billion fewer bags being used and more than £29 million being raised for charities and community groups. Let’s have a similar game changing approach for unhealthy food and drink.

Fine. Let's have a 5p tax on drinks. Now jog on.

Monday 10 October 2016

Introducing the International Network of Nicotine Consumer Organisations

I'm pleased to report the launch of a new e-cigarette consumer group, the International Network of Nicotine Consumer Organisations. They've published a press release today...

Among INNCO’s priorities is to demand an end to the prohibition, disproportionate regulation, and punitive taxation of safer nicotine products like e-cigarettes and snus. The network seeks a dialogue with the World Health Organisation (WHO) over its opposition to e-cigarettes and other safer ways to use nicotine – an issue which INNCO believes is fuelling a rising tide of resentment towards the UN health agency.

INNCO is concerned that the WHO has shown a generally negative response to e-cigarettes since their introduction. Despite the increasing wealth of scientific evidence which supports their unique potential for harm reduction, the WHO tends to ignore the positives and selectively focus on unsubstantiated fears.

The WHO seventh Conference of the Parties (CoP7) to the Framework Convention on Tobacco Control (FCTC), will take place in Delhi, India next month and INNCO believes it is likely that the organisation will seek to entrench their prohibitionist stance yet further. The CoP7 agenda contains several proposals which, if enacted, would make it even harder for current users or smokers wishing to switch to access e-cigarettes, or use them in public places.

INNCO finds the WHO's refusal to engage with the most important stakeholders concerning. It is consumers who actually use reduced-risk nicotine products, and therefore ignoring them throughout the decision-making process contradicts the UN and WHO advice to engage with affected communities.

At previous meetings, the press was dismissed from the proceedings after the opening statements were completed. INNCO worries the WHO has normalized secrecy, with the conference amounting to little more than a biennial lesson on how to avoid transparency.

This is very true. The WHO is one of the biggest obstacles to an evidence-based (let alone liberty-based) approach to nicotine consumption anywhere in the world. Their conference in Delhi will be a secretive farce, as usual. They have shown no signs of interacting with anybody outside of their prohibitionist clique. 

On 2nd October, INNCO wrote to Margaret Chan, Chairman of The World Health Organisation, enclosing its response to the WHO FCTC CoP7 report ‘Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS)’ and formally requested a meeting to discuss our concerns over increasing disproportionate global regulation. INNCO has yet to receive a response. 

They'll be waiting a very long time, but I wish them luck.

Read the whole press release here.

Friday 7 October 2016

The Times' gambling problem

It seems to be that gambling is in the cross-hairs of the wowsers this season. The Times has a bee in its bonnet about it (along with sugar) and so runs front page stories like this...

The proportion of people with a severe gambling problem has almost doubled in three years from 0.4 per cent of the population to 0.7 per cent, the equivalent of 336,000 people, according to the Gambling Commission.

As I have tried to explain many times, almost everything people think they know about gambling in Britain is wrong. That is hardly surprising when anti-gambling folk spend all their time trying to mislead them, but there really is no excuse for this.

The Gambling Commission does not say what The Times claims. Not even close. Surveys of problem gambling were carried out in the UK in 1999, 2000 and 2010, with a further survey of England in 2012 and Scotland in 2013. There has been no survey since. The Gambling Commission published its latest report on the matter in July 2014. It was comprehensive and concluded the following:

Overall, the rates of past year gambling reported in the combined health survey series [of 2012-13 - CJS] are typically lower than those reported in the BGPS series [of 1999-2010 - CJS]. Results from this present health surveys report showed that 65% of adults had gambled in the past year, whereas estimates from the BPGS series ranged from 72% in 1999, to 68% in 2007 to 73% in 2010.

According to the combined health survey data, the problem gambling rate as measured by the DSM - IV was 0.5%. This was similar to problem gambling rates observed in the BGPS series which for England and Scotland were 0.6% in both 2007 and 1999 and 0.9% in 2010. The differences between survey years were not significant.

Problem gambling rates according to the PGSI were also similar between the surveys, being 0.4% for the combined health survey and 0.6% in BGPS 2007, and 0.7% in BGPS 2010.

Rates of problem gambling according to either the DSM-IV or PGSI did vary by survey year. Estimates were highest in 2010 (1.2%) and were lower in both the BGPS 2007 (0.8%) and the combined health survey data (0.6%).

Overall, problem gambling rates in Britain appear to be relatively stable, though we caution readers against viewing the combined health survey results as a continuation of the BGPS time series. This is because of the change of survey vehicle which could affect our ability to make direct comparisons.

So there are fewer people gambling and no change in the rate of problem gambling. The rise of online gambling, the introduction of fixed-odds betting terminals and a dramatic increase in gambling advertising has had no effect on rates of problem gambling.

The rates recorded in each survey for England and Scotland (combined) (with two different methodologies used in each instance) are as follows:

You would have to be on drugs to interpret this as problem gambling 'almost doubling'. Indeed, a literal interpretation of the figures from 2010 and 2012 would suggest that it has almost halved.

That would be wrong, however, because these are only estimates - albeit from a large sample - and the differences between survey years are not statistically significant.

But The Times is wrong on so many levels (as is The Sun). There are no data for the last three years. Neither methodology is designed to identify a 'severe gambling problem'. Such data as there is suggests no change in problem gambling prevalence and the Gambling Commission has said so.

The next survey must be imminent but even if its shows a rate of 0.7 per cent, it wouldn't indicate that problem gambling has 'almost doubled'. It would be, at best, regression to the mean.

This isn't the first time Britain's newspaper of record has printed complete bollocks about gambling on its front page. In today's edition there is even an op-ed from casino tycoon Derek Webb of Prime Table Games (trading as the Campaign for Fairer Gambling) demanding a clampdown on gambling machines in bookies.

Sunday 2 October 2016

Conservative conference 2016

In a few hours I'll be heading off to Birmingham for the Conservative party conference. If you happen to be going, you might be interested in these events...

Monday 3rd October

12.30pm in the Policy Exchange Marquee

Sugar and Stability: Will taxing soft drinks create more economic harm than benefit? 

Speakers: Jacob Rees-Mogg MP, Member, Treasury Committee; Gavin Partington, Director General, BSDA; Christopher Snowdon, Journalist; Camilla Cavendish, Director, No. 10 Policy Unit (invited)

2.30pm in the Think Tent

Personal freedoms vs. protecting the vulnerable: How should we strike the balance?

Speakers: • Bob Blackman, MP for Harrow East • Nirj Deva MEP • Malcolm George, Chief Executive, Association of British Bookmakers • Syed Kamal MEP • Feargal Sharkey, Lead singer, The Undertones (Chair) • Chris Snowdon, Head of Lifestyle Economics, IEA

Tuesday 4th October

3pm at IET Austin Court 80 Cambridge Street (Adam Smith Institute)

Innovate not Regulate: How the nanny state harms public health 

Speakers: Lord Callanan, Former Leader of the Conservative Party in the European Parliament; Christopher Snowdon, Institute of Economic Affairs; Prof. David Nutt, Independent Scientific Committee on Drugs; Dr Madsen Pirie, Adam Smith Institute (Chair)

The Tuesday event is outside the secure zone, the others are inside it. There are also the usual parties outside the secure zone including the always-excellent FOREST bash.