'Booze curtains' love this idea. Very Orwellian but worth a try to reduce kids exposure to alcohol https://t.co/uPIHVZKQWW @AlcoholAdReview— Michael Thorn (@MichaelTThorn) October 27, 2016
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.
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.
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.
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.
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.
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
'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 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.
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.
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.
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.
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.
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.
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.
This has to be one of the silliest podcasts I have ever heard https://t.co/tkad9ZrVrH— David Colquhoun (@david_colquhoun) October 12, 2016
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Estimates from recent economic research show that the prices of foods and beverages effect [sic] purchase and consumption significantly.
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.
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
Growing evidence shows that appropriately designed fiscal policies, when implemented with other policy actions, have considerable potential for promoting healthier diets.
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.
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.
(6) Fiscal policy options with potential for improving diets for the prevention of noncommunicable diseases (NCDs) (draft). Geneva: World Health Organization; 2015.
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.
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.
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.
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?
However in the case of both obesity and alcohol, the current Government is reluctant to take action.
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.
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.
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.
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.
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.
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.
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.
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.
