Monday, 17 December 2018

Call for research proposals

I'm on the lookout for original research proposals in the field of lifestyle economics. I'll be commissioning them for the IEA at the start of next year with a view to publishing them in spring/summer. We're paying £7,000 for each one so if you have an idea that encompasses nanny state regulation and the free market, get in touch.

Here's the spec:

Friday, 14 December 2018

Calories found in restaurant meals

A study appeared in the BMJ yesterday claiming (correctly, it seems) that sit down restaurant meals tend to have more calories in them than fast food meals. The authors found that the vast majority of meals served in restaurant chains exceed ‘public health recommendations for energy content’. Those recommendations have no scientific basis and were plucked out of the air by Public Health England last December, but they are now being treated like government targets.

I wrote at the time...

The idea of having 'limits' for individual meals is entirely new and I suspect that there is an agenda at work here. The 400-600-600 'rule' will allow PHE and its army of scolds to name and shame every restaurant portion, takeaway and ready meal that contains more than the government-approved quantity of calories. Individual meals will be portrayed as hazardous per se and will become targets for advertising bans, taxes and reformulation. A whole Pandora's Box is being quite deliberately opened.

So it turned out. The next phase of Public Health England's crazy reformulation scheme involves pressuring restaurants and cafés into degrading their businesses.

I've written about this for Spectator Health... 

It is less than a year since Public Health England told us that we should be consuming no more than 1,600 calories a day from meals. Specifically, we must limit breakfast to 400 calories while lunch and dinner should be capped at 600 calories. Since grown men are told by the same quango that they should be consuming 2,500 calories a day, this implies that Public Health England wants us to get through 900 calories a day from sugary drinks, snacks and alcohol. Some realistic health advice at last!

No other country on Earth issues guidelines on how many calories should be in a meal, and there is absolutely no evidence behind PHE’s 400-600-600 rule, but there was method in the agency’s madness. Behind the scenes, it is busy trying to cajole restaurants and cafés into accepting the same policy of shrinkflation and food degradation (AKA ‘reformulation’) that it has foisted on the rest of the food industry.

Do read the rest.

Thursday, 13 December 2018

Lowering the drink-drive limit had no effect in Scotland

Drunk driving isn't a very popular cause, and rightly so. It is obviously wrong to risk the lives of others by driving while inebriated. By contrast, driving after consuming a small quantity of alcohol poses no threat to others and is fine, but it is this that the temperance lobby is going after. It's so much easier to hassle normal people for having a pint after work than to clamp down on the dwindling number of habitual drunk-drivers.

Always eager for an easy, feel-good headline, the Scottish government voted unanimously in favour of reducing the drink-driving limit from 80 mg of alcohol per 100 ml of blood to 50 mg of alcohol per 100 ml of blood. The change came into effect in December 2014. The rest of the UK kept it at the same level.

The new law was announced with the usual smug, patriotic, self-righteous rubbish from the politicians responsible:

Scotland's Justice Secretary Michael Matheson has predicted the lower limit will save lives.

Mr Matheson said: "Scotland is leading the way across the UK. The new limit has backing from experts, road safety campaigners and the majority of the public north and south of the border."

Amongst the "experts" were our old friends at the Sheffield Alcohol Research Group. You may remember them from their game-changing modelling of minimum pricing. Less well known is their modelling on what would happen if the drink-driving limit was reduced from 0·08 g/dL from 0·05 g/dL. Their model was limited to England and Wales but their conclusion should broadly apply to Scotland as well. It predicted that...

...lowering the legal limit would reduce fatalities by 6.4% and injuries by 1.4% in the first year after its implementation.

Evidence has steadily emerged over the last few years showing that the reduction in the limit has had absolutely no effect on road traffic accidents or fatalities. For example...

The study by Strathclyde University found that the lower limit for blood alcohol content (BAC) had not been followed by a statistically significant overall drop in road fatalities, including during the peak accident periods of night-time and weekends.

There was also little change in the death rate for young drivers aged 16-25, who are seen as one of the highest-risk groups for drink-driving.


The introduction of a lower drink-drive limit in Scotland has had virtually no impact on the rates of offending, police statistics have revealed.

None of this has made any difference to policy. Nanny state legislation is never repealed.

What is clear, however, is that the legislation has had a predictably negative effect on rural pubs. The pub trade and the Campaign for Real Ale said that it was hurting trade without bringing about any reduction in road accidents, but they were ignored. The Scottish government paid no attention and the puritans probably considered the damage to the evil booze industry to be a bonus.

Today, the reality has emerged in the Lancet of all places:

Lowering the driving BAC [blood alcohol content] limit to 0·05 g/dL from 0·08 g/dL in Scotland was not associated with a reduction in RTAs [road traffic accidents], but this change was associated with a small reduction in per-capita alcohol consumption from on-trade alcohol sales.

Note the use of the word 'but', as if the total failure of the policy is compensated by the success in reducing pub sales. For the 'public health' lobby, the destruction of pubs counts as a success. It's never really about health.

Not only does the study show no benefit from the change, the authors find that the number of road traffic accidents has increased relative to England and Wales:

...the reduction in BAC limit for drivers was not associated with a significant change in weekly RTA [road traffic accidents] rates in Scotland, after adjustment for seasonality and underlying temporal trend (model c; rate ratio [RR] 1·01, 95% CI 0·94–1·08; p=0·77; table 2).

Further, relative to England and Wales, where the reduction in BAC limit for drivers did not occur, we found no change in weekly RTA rates after this reduction in BAC limit for drivers in Scotland (model c; 1·07, 0·98–1·17; p=0·10).

Further adjustment for the driver characteristics of age, sex, and socioeconomic deprivation produced similar results, showing a significant 7% increase in weekly RTA rates in Scotland relative to England and Wales (model d; 1·07, 1·02–1·13; p=0·007).

The latter finding is based on a counter-factual and is therefore speculative but it is now beyond doubt that there have been no benefits to road safety from the Scottish government's decision to lower the drink-driving limit.

In a desperate attempt to salvage something from this pub-destroying policy, the authors suggest that the failure to reduce drink-driving accidents is due to a lack of enforcement:

One plausible explanation is that the legislative change was not suitably enforced—for example with random breath testing measures. Our findings suggest that changing the legal BAC limit for drivers in isolation does not improve RTA outcomes.

In truth, this is far from 'plausible'. The study itself shows that pub sales fell after the law came into effect, and the pub trade has been complaining about the negative effect on business almost from the outset. Both of these facts suggest that people in Scotland have been abiding by the new law. Enforcement has nothing to do with it.

A more likely explanation is that drink-driving accidents are caused by people who are heavily intoxicated, not by people who have consumed a trivial amount of alcohol. Therefore, clamping down on motorists who are not in the least bit drunk was never likely to tackle the damage done by drunk-driving.

Anyone with a bit of common sense could have told the SNP that in 2014. Instead they chose to believe some expensive guesses from the clowns at Sheffield University (not for the last time).

Will the limit be changed back? Of course not. Was the ban on alcohol discounts repealed when it was shown to have had no effect? No. Will minimum pricing be repealed if it is shown to have no effect? No.

As I have said many times, 'public health' is not a results-driven business.

Tuesday, 11 December 2018

Science and Technology Committee on e-cigs - the government responds

The government has responded to the Science and Technology committee's report on e-cigarettes and there are some encouraging signs. In particular (emphasis is mine)...

Recommendation 5 The Government, together with the ASA and the MHRA, should review all these regulatory anomalies and, to the extent that EU directives do not present barriers, publish a plan for addressing these in the next annual Tobacco Control Plan.

The Government broadly accepts this recommendation and is committed to reviewing tobacco legislation as and when appropriate. While the UK Government is a member of the EU it will continue to comply with the requirements of the EU’s Tobacco Products Directive 2014/40/EU (TPD), transposed into UK legislation through the Tobacco and Related Products Regulation 2016 (TRPR). The Government has made a commitment to review the TRPR by May 2021 to consider its regulatory impact. In addition, as announced in the Tobacco Control Plan the Government will review where the UK’s exit from the EU offers us opportunities to re‐appraise current regulation to ensure this continues to protect the nation’s health. The Government will explore those areas identified by the Committee, such as the 20mg/ml maximum nicotine refill limit, a size restriction of 2ml on the tank, a block on advertising e-cigarettes’ relative harm-reduction potential and the notification scheme for e-cigarette ingredients.

Although there are advertising restrictions on vaping, they are less stringent than those which apply to tobacco products. The Government will of course consider when it reviews the legislation whether these restrictions fully reflect the differing risks of harm arising from tobacco products and e-cigarettes. We would note to the Committee that the Government has issued a direction to Ofcom clarifying that under the current code on television and radio advertising it is permissible for public health campaigns to promote the generic use of e-cigarettes for quitting smoking. This direction will support campaigns such as Stoptober which have promoted the use of e-cigarettes for quitting.


Recommendation 7

The Government should conduct a review of regulations on e-cigarettes and novel tobacco products which are currently applied under EU legislation, to identify scope for change post-Brexit, including an evidence-based review of the case for discontinuing the ban on ‘snus’ oral tobacco. This should be part of a wider shift to a more risk-proportionate regulatory environment; where regulations, advertising rules and tax/duties reflect the evidence on the relative harms of the various e-cigarette and tobacco products available. While an evidence-based approach is important, it also may help bring forward the behaviours that we want as a society—less smoking, and greater use and acceptance of e-cigarettes and novel tobacco products if that serves to reduce smoking rates.

The Government accepts this recommendation. We have committed in the Tobacco Control Plan to review where the UK’s exit from the European Union offers us opportunities to re-appraise current regulation to ensure this continues to protect the nation’s health. We will look to identify where we can sensibly deregulate without harming public health or where current EU regulations limit our ability to deal with tobacco. The Government’s goal will remain to achieve a proportionate approach to managing risk, one which protects the young and non-smokers, whilst giving smokers access to products which will reduce harm. As part of this the Government will consider reviewing the position on snus and whether the introduction of this product onto the UK market would promote that kind of proportionate harm reduction approach.

The report also recommends that heated tobacco products should be taxed at a lower rate than cigarettes (a much lower rate is implied). You can read the response here.

Friday, 7 December 2018

The whole population approach doesn't work

The latest stats on alcohol-related mortality were published this week. According to the Whole Population Approach beloved of temperance/'public health' campaigners, a significant decline in alcohol consumption must lead to a commensurate fall in alcohol-related deaths.

It's what the World Health Organisation believes:

... lowering the population mean for alcohol consumption will also predictably reduce the number of people suffering from alcohol abuse.

And it is the official policy in Scotland and Ireland. As Alcohol Focus Scotland say (emphasis in the original):

The specific outcome of the Scottish Government’s alcohol strategy is to achieve a reduction in overall alcohol consumption.

Moreover, the theory suggests that reductions in mortality should happen rapidly because the 'lag effect' is minimal. Some benefits are apparent almost immediately, other take no more than a few years.

It is now 14 years since per capita alcohol consumption peaked in the UK. According to the latest BBPA figures, consumption among people aged 15+ fell from 11.6 litres to 9.7 litres between 2004 and 2017. This is a fall of 16.4 per cent.

So how has the biggest decline in drinking since the war impacted alcohol-related mortality?

Age-standardised alcohol-specific death rates per 100,000 people (UK)

2004:  11.5

2017: 12.2

Can we put this myth to bed now?

Thursday, 6 December 2018

The gambling industry feeds the crocodile

Farewell, sweet prince

From the BBC...

Gambling firms agree 'whistle-to-whistle' television sport advertising ban

Britain's biggest gambling companies have voluntarily agreed to a "whistle-to-whistle" television advertising ban.

The Remote Gambling Association (RGA), which includes Bet365, Ladbrokes and Paddy Power, has struck a deal to stop adverts during live sports broadcasts.

It follows political pressure about the amount of betting advertising on TV.

This is not wholly surprising. In recent months, some of the big players have come out in support of the further restrictions on gambling ads. Why would a business want its commercial speech to be curtailed? There are three possibilities.

Firstly, incumbent businesses tend to benefit from advertising bans because they raise a barrier to entry for new competitors.

Second, advertising does not increase aggregate demand (contrary to what campaigners claim) and is a zero-sum game. There is a large element of game theory to it. Each company advertises because the other companies are advertising. If one company doesn't keep up, it will lose market share, but if all the companies give up at the same time, they save a great deal of money. This is exactly what happened with tobacco.

Thirdly, the industry hopes to fend off further regulation by capitulating on this issue. There is a belief that the bookies could have avoided a £2 stake if they had voluntary reduced the stake below the controversial £100 mark (very few people gambled at £100 a spin anyway). Anti-FOBT campaigners Derek Webb and Matt Zarb-Cousin were probably right when they said in 2017...

“If [the gambling industry] had the ability to understand who we were and accept what the truth is, then they could have come up with [a maximum stake] of £20 a few years ago, and they might have got away with it,” says Mr Webb.
“Not now. It’s too much of an issue now,” adds Mr Zarb-Cousin.

But you only to read the BBC's article today to see that the voluntary ban will encourage, not prevent, further statutory regulation...

Could shirt sponsorship be next?

Matt Zarb-Cousin is a spokesperson for Fairer Gambling, a not-for-profit entity campaigning to reduce gambling-related harm and crime.

It is long overdue, there has been a huge amount of pressure on the sector over the volume of advertising which has increased exponentially year on year.

But for it to be truly effective, it should also include shirt and league sponsorship and digital advertising around a pitch.

Will it make a difference?

Marc Etches is the chief executive of GambleAware, a leading charity committed to minimising gambling-related harm.

We have been saying for a long time now that gambling is being increasingly normalised for children. They are growing up in a very different world than their parents, one where technology and the internet are ever present.

So while we welcome this move by betting companies, it is important to pay attention to analysis that shows the marketing spend online is five times the amount spent on television.

Without missing a beat, these anti-gambling campaigners have moved onto sponsorship and online advertising. What defence is the industry going to put forward for these forms of advertising now that it has implicitly accepted that gambling advertising is an evil?

Businesses should be far more robust in defending their right to free speech. Neither they nor the broadcasters have sold the benefits of advertising to the public.

I have a particular interest in this as a snooker fan. The game suffered terribly when tobacco sponsorship was banned. Prize money fell dramatically, as did the number of events. For a while, the entire sport only had five or six tournaments a year. In recent years, Barry Hearn has done a fine job of reviving the game by selling TV rights and getting new sponsors, most of which seem to be gambling companies. For example, the Betway UK championship is currently being played. In January, the Dafabet Masters will begin.

There are now more tournaments than ever and most of them are shown on Eurosport. Eurosport is a relatively niche channel which largely relies on gambling ads. The ads are shown between frames. A 'whistle to whistle' ban would be ruinous. A fall in advertising revenue would reduce the value of TV rights which would mean less money going into the game. Same applies to a ban on sponsorship.

Note that the proposal is not actually 'whistle to whistle'. According to the BBC, 'no adverts will be broadcast for a defined period before and after a game is broadcast' in addition to during the game.

Note also that a 'whistle to whistle' ban is the policy of the Labour Party, not the government. The fact that the industry has introduced such a ban to prevent the government doing it first tells you where Theresa May gets her policies from. To quote Webb and Zarb-Cousin again...

The campaigners also cite last year’s referendum on UK membership of the EU, which led to Theresa May becoming prime minister, as a key moment.
Mr Zarb-Cousin describes Mrs May as a “Red Tory” — a social conservative less inclined to listen to industry claims that curbs to FOBTs would lead to job losses at betting shops. “It’s one of the most important positives of Brexit,” says Mr Webb.

He adds he may broaden CFG’s focus to target online gambling next. “I want to fight where I can win,” says Mr Webb.

Say what you like about the casino tycoon and his young apprentice but they know what they're doing and who they're dealing with.

Wednesday, 5 December 2018

Temperance censorship

I'm late to this because I've only just come across it, but print workers in Lithuania are having to cover up alcohol ads in imported magazines to protect people from the sight of booze. A small country of less than three million souls, it imports a lot of foreign magazines, but it's either that or ripping the pages out completely, as Reuters reports...

Print distributors in Lithuania are being forced to tear pages out from magazines such as Vogue and National Geographic after the country introduced an alcohol advertising ban on Jan. 1.

The situation is an unintended consequence of an alcohol control bill signed into law in June by President Dalia Grybauskaite, who herself likened the outcome to medieval times and said it brought shame on the country.

It certainly looks a bit totalitarian when you see the photos of them at work...

Banning advertising is censorship, plain and simple. Needless to say, the Alcohol Health Alliance wants to follow in Lithuania's footsteps with a total ban on alcohol advertising and sponsorship.

Bartasevicius said the country’s largest retail chain had refused to stock the altered magazines, deeming them “damaged goods”.

However, he said the publishers of National Geographic had told him they could not create an edition of a magazine free from alcohol ads for a country which only sells up to 500 copies of a title per month.

Politicians do not yet have any solution to a problem they have created.

Sounds familiar.

“It is reminiscent of medieval times and it brings international shame on Lithuania,” Grybauskaite told reporters on Wednesday. “We must have laws without such flaws.”

This is what happens when you let the ignorant zealots of the 'public health' lobby make laws. They neither know nor care about the unintended consequences. To quote H.L. Mencken, their solutions are clear, simple and wrong.

We're going to see this kind of unravelling in the UK where the government has taken naive ideas from fanatics and imported them wholesale into its ludicrous obesity strategy policy.

Tuesday, 4 December 2018

Energy drinks are safe so let's have minimum pricing!

The Science and Technology Committee published its review of energy drinks today and found no scientific justification for banning their sale to minors.

In our view, there is insufficient evidence as to whether children’s consumption habits are significantly different for energy drinks compared with other caffeinated products such as tea and coffee.

.. On balance, we conclude that the current scientific evidence alone is not sufficient to justify a measure as prohibitive as a statutory ban on the sale of energy drinks to children. Single portions are within the European Food Safety Authority’s suggested limit for caffeine intake by children. This limit may be exceeded if other products containing caffeine are also consumed, or if energy drinks are consumed in excess, but the same can be said for many products available for sale to young people, including other drinks containing caffeine.

Recognising that the government is already committed to this policy, the committee adds that it might still want to introduce a ban 'on the basis of societal concerns and qualitative evidence, such as the experience of school teachers'. If so, the government 'should set out the reasoning for its decision.'

I, for one, look forward to hearing the government explaining why it ignored empirical, scientific evidence in favour of anecdotes from teachers.

The ban on energy drink sales to under-18s has always been a solution looking for a problem. As I said in August, it is arbitrary and illogical. If the issue is caffeine - and if a ban to minors is appropriate - then the logical approach is to ban the sale of caffeinated products to children. If the issue is sugar (the proposed ban is part of the childhood obesity strategy) then it should logically be extended to all products which contain a similar quantity of sugar/calories.

Neither approach would strike the general public as reasonable or proportionate and so the government has to portray energy drinks as being in some way special. But why? A can of Red Bull has less caffeine than a cup of filter coffee and the sugar content of energy drinks is no higher than that of Coca-Cola. I dare say the zealots who pushed this policy on the government would like to ban the sale of sugar and caffeine, but we are not there yet.

So how has the 'public health' lobby reacted to the Science and Technology Committee's evidence-based conclusion?

Professor Russell Viner, President of the Royal College of Paediatrics and Child Health (RCPCH) said it was "disappointing not to see a recommendation today to ban the sale of these drinks to children.

"We believe that the evidence is already compelling that energy drinks bring no benefits and only harm to children."

Well, Russ, you are wrong.

Prof Viner said the Government should introduce "a minimum price for energy drinks as we know their cheap price tag is a key driver for their purchase".

Talk about doubling-down! On the day that a cross-party committee recognises that these products are safe, Russell Viner demands not only their sale be banned to minors but that the price be hiked up for adults.

If the name Russell Viner rings a bell it's because the government gave him £5 million in 2017 to carry out research and give 'independent advice to policy makers'. This is not the first time he has made statements that fly in the face of evidence. Not very encouraging is it?

Sunday, 2 December 2018

Deal or no deal?

"If I were you, I wouldn't start from here" is the punchline to a joke about a tourist asking a local for directions. If you were looking for a satisfactory resolution to Brexit, you certainly wouldn't start from here. Theresa May has made a catastrophic misjudgement in assuming that Leave voters are as obsessed with immigration as she is. The European Commission exploited her weakness and myopia to negotiate a deal that is widely, and accurately, regarded as a national humiliation.

The Conservative Party has inexplicably stuck with a leader who lacks every leadership quality apart from perseverance and who lost a 20 per cent poll lead against an antediluvian Marxist. Meanwhile Momentum (t/a the Labour Party) only cares about rerunning the general election and Stronger In (t/a People's Vote) only cares about re-running the referendum.

Every road now leads to something approximating ruin. A so-called People's Vote might resolve the issue in the short term but it would not resolve the question of whether Britain wants to leave the EU. A second referendum would have to offer a binary choice (the idea of having two Leave options and one Remain option would shamelessly rig the result in favour of the europhiles). The options would be May's version of Brexit versus staying in the EU. Given this Hobson's choice, many people will stay at home. Remain could still lose the referendum, but if it won it would be on a lower turnout and with a blatantly restrictive question. It would not show that the UK had changed its mind about leaving, only that people considered May's deal worse than remaining.

It would also poison politics for a generation and whichever party was seen to be responsible (and this would not necessarily be the Conservatives) would be held in contempt. The same would apply if parliament somehow kept Britain in the EU without a second referendum, perhaps more so.

A general election would solve nothing. Neither Labour nor the Conservatives are likely to get a majority, let alone a sufficient majority to push through a Brexit plan, and Labour doesn't have a Brexit plan anyway.

Given how unsatisfactory these options are, many people are tempted to damn the establishment's eyes and go for no deal, AKA a 'clean Brexit', AKA WTO terms. This is the legal default unless something changes, but it is also a road to ruin. In fact, it is the road to greatest ruin.

Far too many people on the Leave side are complacent about a so-called clean Brexit. They do not take the predictions of the Treasury and the Bank of England seriously because they were laughably wrong about what would happen in 2016. It is true that the pre-referendum predictions were woeful as anything other than propaganda. It is also true that last week's predictions from Mark Carney were based on such implausibly pessimistic assumptions that Paul Krugman scoffed at them from across the water.

Remainers have engaged in so much ridiculous scare-mongering in the past three years that it is tempting to ignore their every warning. This is a mistake. Just because the boy falsely cries wolf does not mean there isn't a wolf. It was never likely that planes would be grounded and EU nationals deported, but these wild claims should not us distract us from the real problems that no deal would entail.

Queues at the border are an obvious example. Interestingly, Krugman is relatively relaxed about this, writing:

Britain is an advanced country with high administrative capacity — the kind of country that history shows can cope well with huge natural disasters, and even wars. Would it really have that much trouble hiring customs inspectors and installing computers to recover from an 8 or 10 percent drop in GDP?

And even in the short run, I wonder why Britain couldn’t follow the old prescription, “When all else fails, lower your standards.” If laxer enforcement, special treatment for trusted shippers, whatever, could clear the bottlenecks at the ports, wouldn’t that be worth it, despite the potential for fraud, as a temporary measure?

I'm not so sure. As the Economist notes...

Small delays add up to large tailbacks. Researchers at Imperial College London have calculated that two minutes more transit time per lorry at Dover and the Channel Tunnel translates into a 47km traffic jam.

This is important because...

Britain’s big supermarket chains hold as little as one-and-a-half days’ worth of fresh food in their supply chain at any given time, and say they have no capacity to hold more.


Consider the plant in Oxford where BMW churns out 1,000 Minis a day. Each is made up of 4,000-5,000 parts. Bringing 4m parts to the factory on 200 lorries every day is a “significant logistical challenge”, says Graham Biggs, the firm’s communications director. Three-fifths of them come through Dover or the Channel Tunnel; their contents are unloaded directly onto the apposite part of the production line. Reconfiguring its supply chains to circumvent hold-ups and tariffs would take years if it were possible at all.

It is true that most of our trade is already with non-EU countries, though it is a slim majority and many of them have trade deals with the EU. It is not beyond the wit of man to invest in customs inspectors and IT projects. We should have started doing it in June 2016, not least because we would have got a better deal if Brussels thought there was a realistic prospect of us walking away (it would have cost money but what's the worst that could have happened - shorter queues?). We didn't. Even now, with less than four months to go, there appears to be very little planning for no deal. In the long run, we could adjust but in the short run we would have supply problems that would make the fuel protests of 2000 look like the lettuce shortage of 2017.

This is not the fault of people who voted to leave the EU. The government has let us down. Still, you wouldn't start from here.

There are plenty of other potential problems with a clean Brexit. Passporting for financial services, the Irish border, the European Exchange Warrant and countless logistical issues which are obscure but important. Some of them may be easier to solve than they first appear. Others may prove almost intractable. We won't find out until March 30th when the government will have to tackle them all at once. Has the government and the civil service done anything in recent years to make you confident that they are up to the job?

The biggest issue is tariffs and we can predict with reasonable certainty what will happen here. As a third country, the EU will put its tariffs on our exports. No ifs, no buts. For example, there will be a 12.8% tariff on lamb, a 13.6% tariff on cauliflowers, a 16% tariff on tractors, a 10% tariff on cars and an 8% tariff on many clothes. For some items, tariffs exceed 20%. Some even exceed 100%.

It is not Project Fear to point out that these tariffs will make our goods unappealing to consumers in the EU; that is kind of the point of them. A large number of British businesses - whole industries - will be affected and many of them will go bust or, if possible, relocate in the event of a no deal Brexit. Industries which cannot relocate, such as Welsh lamb farmers - who depend overwhelmingly on exports - will go to the wall and they will not go quietly (nor should they).

On the other hand, consumers will be free of EU tariffs on imports and will be able to buy New Zealand lamb, for instance, at a lower price. This is an undoubted benefit of leaving the EU properly but under no deal it is debatable whether these benefits outweigh the costs of widespread unemployment, recession and falling incomes that will come from what Michael Gove describes - with some understatement - as the period of 'considerable dislocation and disruption'.

I happen to be in favour of unilateral free trade, but even I would not introduce it overnight. There is no evidence that the government is in favour of it at all. The most likely outcome is that the government will choose to introduce its own tariffs (which Remainers dishonestly portray as 'WTO tariffs') on anything that competes with British industry. It may even impose them on some products that are not made in Britain. These tariffs - which will have to apply to non-EU imports as well - will naturally lead to a higher prices and exacerbate the inflation caused by the inevitable drop in the pound, but they are not as senseless as they may seem. The government will have concluded, with some justification, that the EU will be in no rush to sign a trade deal with a country that has already dropped its tariffs.

None of this is a natural consequence of Brexit as some Remainers will claim. The EU has always been keen to have tariff-free trade with Britain and tariff-free trade is one of the few things that Mrs May has successfully negotiated. It would have been part of a Canada+ deal, a Norway+ deal or any other deal. It is only absent from no deal and it would not be a temporary problem. It would probably take years to negotiate a free trade deal if we walked away from the deal that is currently on the table, especially if we walked away with the £39 billion that the EU considers - rightly or wrongly - to be theirs as a matter of legal fact.

(It has been suggested that we could use the £39 billion to alleviate the problems suffered by the industries that are harmed by tariffs. I have no idea whether this sum would be sufficient - I suspect not, and the EU would certainly pursue some portion of it through the courts - but a system in which our exporters have tariffs imposed on them while consumers pay higher prices and the government spends billions trying to prop up industries that have been screwed by protectionism is not the free trade Brexit I voted for.)

Time is now running very short. It is conceivable that a better deal could yet be negotiated. It is conceivable that EFTA/EEA could be the solution. Conceivable - but it becomes less likely every day. Unless Article 50 is extended, it is a choice between May's deal and remaining in the EU and, as Gove points out, remaining in the EU could be worse than it was before:

Like a guilty partner who had threatened to leave for another and come crawling back, we would be forced to accept far tougher terms than we have now.

Keeping the rebate? Forget about it. Stopping a tide of new EU laws? No way. Halting progress towards a European army? Nope. Guaranteeing we wouldn’t have to pay billions to bail out euro members in the future? I’m afraid not.

You don't need to be a Brexit purist to consider May's deal a betrayal. In a normal political environment, May would resign and the Conservatives would be punished by the electorate for their incompetence. But British politics is in a period of extreme abnormality and the only realistic alternative to the Conservatives is the far-left sect that has taken over the Labour Party who would relish no deal because it would make the winter of discontent look like the summer of love and do to the Tories' long-term electoral prospects what that winter did to Labour's. It would also remove many of the legal and constitutional barriers to the planned economy that John McDonnell has in mind.

There are some who think that Britain needs a short, sharp shock to push the government towards the kind of liberalisation and deregulation that would put a rocket under the economy. A no deal Brexit certainly offers the opportunity to reform the economy but, as Sam Bowman points out, there is no reason to think that the current government - and Mrs May in particular - have any interest in seizing it...

Theresa May is the most illiberal, anti-market Prime Minister the UK has had since at least the 1970s. She seems obsessed with cutting immigration. Her government is pushing through unprecedented new powers to allow the politicians to block or intervene in takeovers of British firms that might come with unpopular job cuts or factory closures. She has brought in price caps in energy instead of doing anything to make the market more competitive or consumer-friendly. Her government cannot stop banning things as trivial as plastic straws, on ludicrously thin evidence that doing so provides any benefit to anyone anywhere.

May would surely be forced to quit under no deal and it is likely that her successor would be more liberal, but it is doubtful whether he/she could bring about sufficient reform in time to outweigh the damage done by tariffs. In any case, no deal would not be a short, sharp shock because it would not be short.

If Brexit is cancelled it will be nauseating to see people like Andrew Adonis gloating but it will be worse to hear them say 'I told you so' when the economy collapses under no deal. The only way for Brexit to end up approximating the Project Fear predictions would be for us to leave without a deal.

There was nothing inevitable about our current predicament and you wouldn't start from here, but now that we're here it would be irresponsible to jump from the frying pan to the fire. The European Commission and the British establishment have won. The Brexiteers have been outmaneuvered. We have lost and it is not worth wrecking the economy and opening the door to socialism to make a point. The only realistic choice now is between remaining in the EU and accepting May's deal. No deal is a no go.

Having said that, I would be delighted to be wrong, so if you disagree with my analysis please leave a comment.

Friday, 30 November 2018

Something for the weekend

There's a new Last Orders podcast out. This month we have comedian and author Dominic Frisby on to discuss fixed odds betting terminals, vaping and the meat tax.

It's now a standalone podcast (ie. not part of the Spiked feed) so subscribe on iTunes or whatever. Alternatively, listen here.

Also, I was on the World Service yesterday talking about the furore over the proposed meat tax and angry low carbers. It's available online for the next few weeks. My contributions start at seven minutes and 25 minutes. Listen here.

And, as if that were not enough, I'm on the IEA podcast with Rebecca Lowe and Darren Grimes talking about the Banny State. Listen here on iTunes or here on Podbeam.

Thursday, 29 November 2018

A feeble defence of the nanny state

I have never been a huge fan of the term 'nanny state' because it implies a degree of care and compassion that is largely absent from the spiteful 'public health' lobby. Nevertheless, it has the advantage of being readily understood by the public. It has an immediacy and efficiency that more accurate terms like 'coercive paternalistic lifestyle regulation' lack.

It also has the advantage of really annoying people in 'public health' and that alone is a good reason to use it. Every few years one of them tries to discredit or reclaim it. I wrote about one such effort in 2015. One of their journals dedicated a whole issue to it in the same year.

The problem with these critiques is that their authors are unable to pass the Ideological Turing Test. They don't seem to understand the arguments of their opponents and, as John Stuart Mill said, he who knows only his own side of the case knows little of that.

For example, the distinction between banning something that harms other people and banning people from doing things that only harm themselves is pretty fundamental. It is the difference between nanny state regulation and plain old regulation. But it is amazing how often defenders of the nanny state conflate the two. When Simon Chapman listed his 'One hundred and fifty ways the nanny state is good for us' in 2013, most of his examples were laws that protect individuals from other people, such as building regulations, speed limits and killing mosquitoes.

To be fair, Chapman is an imbecile whereas the latest contender - John Coggan, a professor of law at Bristol University - may not be. His essay was published by the Faculty of Public Health yesterday and it shares many of the shortcomings that undermined its predecessors. In particular, it prefers to attack straw man versions of the libertarian and economic arguments rather than addressing the real objections.

I don't know whether this is conscious misrepresentation or a simple failure to understand the arguments against his position, but it is a big problem for a critique. Coggan considers there to be three basic arguments against nanny statism. One of them is that 'health is an entirely subjective concept' and that the government therefore has no business getting involved. I have never met anyone who believes this so I will leave it to one side.

The other arguments seem more familiar at first glance. He describes them as 'Philosophical Libertarianism' and 'Economic Libertarianism'.

He defines Philosophical Libertarianism as follows:

... it may be claimed that to respect persons as moral agents the government must always respect their rights to make their own decisions for themselves unless their choices cause unjustified harm to other people or other people’s property. This holds where a person’s decision seems unwise to other people, or even where a person’s decision seems unwise on her own terms (for example when a person prioritises short-term interests over long-term happiness and security, such as by opting out of a pension scheme that she wants to be in).

If we accept philosophical libertarianism, we hold that the government and public health community have no right to interfere with people’s right to smoke cigarettes, to treat activities such as gambling as public health concerns, or more generally to prioritise values other than autonomy (or liberty/freedom).

On this view, the great majority of public health activities and agendas are nannying because, regardless of whether in fact they promote better health, they are unjustifiably paternalistic: people have a natural right (on some counts even a duty) to make their own choices without the influence of the state or the public health community.

This is his full description and it is quite inadequate. It suggests that Philosophical Libertarianism is little more than an assertion that the government should leave people alone. There is, of course, a lot more to it than that. John Stuart Mill wrote a whole book about it but Coggan never refers to Mill or his arguments. There is no hint here that the philosophical argument is consequentialist. It is not that libertarians think that free speech, free association and free trade are self-evidently human rights. It is that individuals and society are better off with them than without them.

I would concede to Coggan that the theory of natural rights is just a bald assertion and can be dismissed as much, but there are philosophical and practical arguments for limited government and individual liberty that go far beyond natural rights. Coggan doesn't discuss them but they are mostly covered by what he calls Economic Libertarianism, which he sees as a separate category.

I'm not sure they are separate categories. The line between philosophy and economics is blurred. Mill was both a philosopher and an economist, and economics started as a branch of philosophy. The view in economics that society is best served by free markets unless there are market failures is very similar to the philosophical view that society is best served by individuals being free unless they cause harm to others. But economics is more explicit in its focus on wellbeing (utility) and so I regard it as more useful in explaining why coercive paternalism is harmful.

Unfortunately, Coggan ignores most of the economic arguments and gets the rest of them wrong. He claims that:

Economic libertarians do not (of necessity) claim that health is unimportant; rather, they claim that health is best achieved without public health interventions. 

No they don't! They claim that wellbeing is best achieved without government interventions in self-regarding activities.

He describes his version of Economic Libertarianism at greater length on page 23. This is what he says (in full):

One category of argument against the nanny state holds that, as a matter of practical reality, health outcomes and opportunities are best realised through market freedoms and individual choice.

On this reasoning, most public health measures are economically inefficient. Furthermore, such arguments may hold that health promotion measures and campaigns (for example the provision of a publicly-funded healthcare system; anti-obesity programmes) are harmful to population health as they reduce personal responsibility for health: by providing a ‘safety net’, it is suggested, such policies encourage people to become less healthy by incentivising unhealthy behaviours and attitudes.

From the perspective of economic libertarianism, health protection and promotion are nannying because they infantilise: they leave people who would in fact be able best to take care of their health unable to do so.

This is almost entirely wrong. Very few people, if any, claim that health will be maximised by leaving people to their own devices, although it is true that some 'public health' policies have led to worse health (hello, snus ban!). The claim of economic libertarians is that wellbeing will be maximised. 

Wellbeing is the most important thing and health is only one component of it. There are trade-offs between risk and reward and between health and enjoyment. Maximising health requires sacrificing pleasure and bearing unwanted costs, such as turning away the dessert trolley and going to the gym. Different individuals place different values on the costs and benefits. Some people are more risk averse than others. Some people enjoy going to the gym and some people hate the taste of tobacco. Other people feel quite the opposite. 

It is because people value different things differently that individuals need to make their own trade offs to suit their tastes and preferences. Almost nobody values health and longevity to the exclusion of all other concerns. Maximising health would lead to sub-optimal wellbeing for almost everybody because the sacrifices would be too extreme. As such, coercive policies that are fundamentally rooted in the presumption that health is the most important concern can only do damage - not necessarily to everybody, but to a large number of people.

Why does Coggan think that economic libertarians believe that freedom maximises health? He refers to the idea that people would take better care of themselves if they had to pay for their own healthcare. I have heard people say this on occasion but the evidence for it is weak and it is a side issue at best. It is certainly not the central argument for economic libertarian, as Coggan implies. The real issue is human welfare and utility, which Coggan completely ignores.

In response to his straw man, he writes:

The arguments here rest on empirical claims; arguments (putatively) based on facts about the world. Responding to them therefore relies on evidence-based public health.

This is where members of the public health community likely feel most comfortable responding to nanny state arguments. Arguments devised in response to economic libertarian accusations of nanny statism should be guided by the best interpretation of the scientific evidence: where public health science (e.g. on commercial, political, or social determinants of health) shows that interventions would (likely) improve health or reduce health inequalities, this will rebut economic libertarian arguments.

If the libertarian objection to the nanny state was that it makes people less healthy, it would indeed be easy to rebut. But it isn't. If you want to know what the real economic/libertarian objectives to paternalistic lifestyle regulation are, read Killjoys.

Wednesday, 28 November 2018

The facts according to ASH

It must be a nice feeling to know that you can get away with saying whatever you want no matter how untrue it is. That's been Deborah Arnott's fortunate position as the head of ASH for many years now. The facts are whatever she wants them to be.

At the moment she wants Scotland to ban smoking in prisons. This has been a disastrous policy in England and Wales so, writing in The Sun, she simply changes the facts.

In particular, she says...

Fears of riots and unrest were unfounded, and after prisons went smoke-free the level of assaults and self-harm went down, not up, in prisons.

Eh? What about the massive riot at HMP Birmingham last year in which prisoners set fire to large parts of the prison while demanding tobacco?

Or the nine hour riot at HMP Haverigg a month earlier?

Or the riot at Drake Hall Women’s Prison the month before that?

Or the riot at HMP Erlestoke? All of them directly caused by banning smoking.

As for assaults and self-harm going down after smoking was banned in the long roll-out between 2015 and 2018, where to begin? In the year to March 2018 there was a 16 per cent rise in both self-harm and assaults, including a nine per cent rise in serious assaults and a 26 per cent rise in assaults on staff.

Self-harm and assaults are both at a record high in prisons in England and Wales, according to the Ministry of Justice, with rates rising rapidly after 2015.

This has all been widely reported in the press. You may even recall the prisons minister pledging to resign if he doesn't get a grip on the problem.

Nobody would claim that the smoking ban is the sole cause of rising rates of violence and self-harm but to claim that rates have fallen since smoking was banned is as insane as claiming that the ban hasn't led to riots.

Caught red-handed

I spotted this tweet by a chap called Nason Maasi yesterday. He works with Mark Petticrew and Martin McKee at the LSHTM and his view of business is informed by their conspiratorial, Marxist way of thinking.

PMI is Philip Morris International, the tobacco company. And yes, it would be an astonishing thing for them to say if it was 1972.

But it is 2018 and regular readers know that the people who are most likely to economical with the truth are unaccountable, stop-at-nothing, ends-justify-the-means zealots in 'public health'.

To illustrate my point, meet Lindsay Robertson. She is a tobacco control activist-academic from New Zealand who recently made the following claim about PMI's heated tobacco product IQOS...

And now meet Moira Gilchrist, vice-president of PMI, who notes that the video evidence does not support Robertson's claim...

As Nason Maani would say, wow.

Thursday, 22 November 2018

The Golden Nannies 2018

(l-r) Simon Clark, Ian O'Doherty and me good self
I was in Dublin for the Golden Nanny Awards on Tuesday night. It's a fun event put on by Forest and Students for Liberty that 'celebrates' the cream of Ireland's paternalistic busybodies. As last year, the winner - Marcella Corcoran Kennedy - turned up in person to pick up her award. One of Ireland's finest journalist, Ian O'Doherty (pictured above), was also given award for fighting the nanny statists.

I gave the opening speech. This is what I said...

Nannies, killjoys, wowsers, curtain-twitching puritans, po-faced poobahs, puritanical prodnoses, lemon-sucking busybodies, meddlesome ratbags, hatchet-faced prohibitionists, fun sponges, health fascists, pocket dictators, little Hitlers, nicotine Nazis, gambling Gestapo, sugar Stasi, tobacco Taliban, interfering, hateful, miserable, little bossy boots whose very existence is a curse on humanity. They suck the light out of the room. The grass withers beneath their feet.

Those are just some of the things people say about the nominees for tonight’s prestigious award, just because they try to stamp out the small pleasures that make life bearable. I think this is unfair. What a lot of people forget is that interfering in other people’s lives is the only pleasure these people get. So in a way, it’s Forest that are the killjoys.

You won’t be hearing any childish name-calling or vulgar abuse from me tonight. I come here in the spirit of friendship. I am British, you are Irish. Rather than fight amongst ourselves, we should unit against our common enemy: Finland. As you may know, I compile the Nanny State Index. It’s fairly self-explanatory; it’s a league table of the most meddling, paternalistic, busybody countries in the EU. Ireland is at number 3, the UK is at number 2.

Finland is at number one. And despite the best efforts of our respective governments, neither of our great nations can get close to Finland which has come top of the table in both editions and looks certain to win again next year.

So the big question for us tonight is what can we do to knock Finland off its perch? At the moment it seems invincible. Its alcohol shops are a state monopoly. It has a ban on liquorice being advertised if it shaped like a pipe. It regulates e-cigarettes like tobacco. You can't even advertise vape juice that doesn't have nicotine in it, in other words: basically water. It doesn't just tax sugary drinks, it taxes non-sugary drinks. It has the highest taxes on beer and wine in Europe and the second highest tax on spirits. It’s illegal to buy a round of drinks in a pub and it's illegal to buy any drinks with a credit card.

And it’s not just Finland we have to worry about. If some of the Eastern European countries carry on like they are, we’ll be lucky to hang on to our bronze and silver medals when the next Nanny State Index comes out. Earlier this year, Lithuania closed the off licences at 8pm and raised the drinking age to 20, making it the only country in Europe where the legal age for buying alcohol isn’t 18 or less. Last year, Estonia slapped a tax on e-cigarette fluid, a tax on all soft drinks - whether they contain sugar or not - hiked up wine duty by a third and doubled the tax on beer.

These countries mean business - and they have decades of experience under totalitarian governments to draw on.

Achieving a podium finish next year, let alone taking Finland's crown, seems a hopeless task but I’m here to tell you to keep your chin up. There are two reasons for Ireland to be optimistic.

Take Estonia. Yes, they doubled the beer tax, but the result was that Estonians went over the border to Latvia to buy their booze, and people from Finland, who had previously being going to Estonia for their beer, went elsewhere. And so the Estonian government lost €90 million in revenue and cancelled their plans for further alcohol tax rises next year.

They bottled it! At the first sign of trouble, they gave up. Ireland would never do that. If there’s one thing the Irish government has proven over the years it’s that no amount of cross-border trade, smuggling and black market activity is going to get in the way of its campaign to stop poor people enjoying themselves.

The second reason is that, as hard as it is to be a genuine world beater in the field of puritanical lifestyle regulation, if anyone can do it, it is the people nominated for this prestigious honour this evening. Although we are only trying to honour the biggest nanny statist in Ireland tonight, it’s difficult to imagine the list of nominees looking much different if it was a global award. We are talking créme de la créme.

There is Simon Harris, who recently celebrated the introduction of minimum pricing as if it was the Emancipation Proclamation.

There is last year's winner Catherine Noone who wants to regulate the amount of sugar that can be put in sweets and wants to regulate the chimes of ice cream vans because, she says, they lure children towards deadly ice creams and lollies.

There’s Marcella Corcoran Kennedy, champion of the sugar tax, who neatly summarised the role of politicians in Irish society, saying - “basically, you’re the mammy.” That’s the spirit!

There’s Donal O’Shea who says “I am not in favour of a nanny state”. This would hinder of his chances of lifting the trophy tonight if it were true, but fortunately it isn’t. He lobbied for the sugar tax and, having achieved that, now wants to tax chocolate and other tasty food. He has said: “The food and drinks industry hides behind kids and uses them as human shields”. Just a normal guy saying normal things.

This year he was in the papers crusading against the perils of Easter Eggs. As it happens, I had the pleasure of meeting him this morning when we were on the radio together. He was keen to assure me that he had been misquoted on this issue. He hadn’t said that Easter Eggs should be restricted to one per household. He said they should be restricted to one per child. I’m happy to set the record straight.

Then there’s Adrian Cummins from the Restaurants Association of Ireland, a man who only takes his foot out of his mouth to shoot it. He said “we were one of the major supporters of the no smoking ban when it first came in. Publicans were opposed to it, we supported it.” He has since called for a ban on smoking outdoors and a ban on vaping indoors. It is only a matter of time before he calls for a ban on consuming food and alcohol in restaurants.

Speaking of smoking bans, no list of Irish nanny statists would be complete without the legendary James Reilly who is surely due a lifetime achievement award. It was largely thanks to James’ tireless efforts that, in 2004, Ireland became the first country in the world to discover the incredible smells that tobacco smoke had been masking in pubs all those years.

But the politicians couldn’t do it without the help of the front groups that they fund with taxpayers’ money to lobby for their own policies, so I was delighted to see not one but two nominations for the tireless workers behind Alcohol Action Ireland, a charity that gets 0.07 per cent of its funding from voluntary donations. The rest comes from the unwitting taxpayer. It took state-funded activism to new heights in 2015 when it set up another group - the Alcohol Health Alliance - specifically to lobby for the Public Health (Alcohol) Bill. The rest is history.

Last but by no means least is Patrick Doorley from that other state-funded pressure group, ASH. He’s always busy. He’s a busy body. This year, he complained to RTE and the Broadcasting Authority of Ireland when a character in a television programme was shown smoking. He’s also been busy trying to get smoking banned on university campuses. And just smoking, vaping too, because he’s not at all keen on vaping and actively discourages smokers from switching to it. The government has capitulated to every ASH demand in recent years - graphic warnings, the display ban, plain packaging, massive tax hikes - and the results speak for themselves. Since 2012 the smoking rate has plummeted from 23% all the way down to 22%. Clearly, this guy knows what he’s doing. If this progress continues, Ireland will have achieved its goal of getting the smoking rate below 5% in the year 2107. Admittedly that is 82 years later than planned - Ireland is supposed to be “tobacco free” by 2025 - but let that take nothing away from these evidence-based, peer-reviewed policies.

Good luck to all the nominees. It’s going to be tough to pick a winner and in a way it’s a shame there has to be winner. To me, they are all losers.

It’s been a pleasure speaking you tonight in perhaps the only country in the world where the term nanny statist is taken as such a compliment that you can get them to come to an event which is aimed at taking the piss out of them.

For those of you who are capable of having a good time, I hope you have one tonight.

Wednesday, 21 November 2018

Has problem gambling amongst children quadrupled?

The Gambling Commission published its annual figures on gambling amongst 11-16 year olds today. The media have understandably picked up on one particular statistic.

From the BBC...

Number of child gamblers quadruples in just two years

The number of children classed as having a gambling problem has quadrupled to more than 50,000 in just two years, a report has claimed.

Anti-gambling campaigners have been quick to blame this apparent rise on advertising and online gaming. However, as I explained in a post earlier this year, participation in online gambling is almost non-existent in this age group - not surprising given how difficult it is for a child to set up an account. Insofar as 11-16 year olds use the internet for gambling, it is mostly to buy lottery tickets with their parents' consent.

The most common forms of gambling by children are private bets with friends, wagers on private card games, Category D amusement games (with stake limits of 10p) and the National Lottery. Everything else has a prevalence rate of one per cent or less.

Nevertheless, a quadrupling of problem gambling - from 0.4 per cent to 1.7 per cent - is striking. So striking that it almost defies belief. It is rare for anything to quadruple in two years without a change in methodology. Sure enough, the methodology of the survey that supplies the statistics has been changed significantly.

You have to read the technical report to see what's happened and that report isn't easy to find (I had to ask the Gambling Commission for it). Strangely, it does not mention one of the most important methodological changes which is that the 2016 figure (0.4%) was based on 11-15 year olds whereas the 2018 figure (1.7%) is based on 11-16 year olds.

This makes a big difference because 16 year olds have the highest rate, as you can see by comparing the two charts below.



The Gambling Commission may have decided to not bother mentioning this because the switch to 11-16 year olds happened last year, not in 2018. The change probably explains why the rate appeared to rise from 0.4 per cent in 2016 to 0.9 per cent in 2017, but it cannot explain the apparent rise to 1.7 per cent this year.

But there have been other changes in 2018 which have led to a bigger number. Significantly, the 2018 survey is the first in which the children were given the option of completing the survey online. Previously it had been a written survey only, but this year the schools which participated were given a choice between paper and online - and 70 per cent opted for online.

This doesn't sound like it should make much difference but it does. As the report explains...

One of the key metrics captured in the Gambling Commission’s study is the proportion of young people who are ‘problem’ or ‘at risk’ gamblers, as measured by the DSM-MR-IV-J, a screen consisting of 9 domains (see Chapter 3 for more about the screen). Responses across these domains are aggregated to form an overall score; respondents scoring 4 or more are classified as ‘problem gamblers’ and those scoring 2-3 are ‘at risk’ gamblers. The problem gambling rate among those answering on paper is in line with rates in 2017, while the aggregate 2018 rate (including the online and paper samples) is higher than 2017.

Only those who gamble are given the problem gambling questions. This year, many more children were given these questions because gamblers were screened on the basis of whether they had gambled in the past year rather than - as before - in the past week. The rate of problem gambling is obviously higher among gamblers than among the entire cohort and, again, the online survey produced much higher numbers than the paper survey.

.. the proportion of those screened who were classified as problem gamblers was higher among those responding online (5.6%) than on paper (1.6%), despite similar screening rates (35% and 34%, respectively). This is because online respondents were more likely to indicate problematic behaviour at 7 of the 9 domains on the screen. As such, it appears that differences by mode as well as the improved screening rate are factors in the increased problem gambling rate seen in 2018.

It is not entirely clear why the online version elicits higher rates, nor is it clear which version produces the more accurate responses. The Gambling Commission says that 'respondents are more likely to give responses indicating problematic or socially undesirable behaviour when answering a survey online rather than on paper' and cites this study as evidence.

Whatever the reason, the results from the 2018 survey are simply not comparable to the 2017 survey, let alone the 2016 survey. The 2016 survey was paper only and used a younger cohort.

The 2017 survey had the same age group but it was all paper whereas this year's study was mostly online. The difference this makes becomes crystal clear on page 10 of the technical report. If you compare the paper responses in 2018 to the paper responses in 2017, the rate of problem gambling has actually declined! I've circled the relevant figures below - click to enlarge. The apparent rise is due solely to the online responses.

It is fair to say that the Gambling Commission could have done more to flag up the apples and oranges problem here. They have a section in the technical report titled 'The impact of moving the survey online' but the technical report is not available from their webpage and is only briefly referenced on page 32 of the main report. I doubt any journalists would have read it.

Even if they had, few journalists would pass up the chance to report a quadrupling of problem gambling in the space of just two years. It must have seemed almost too good to be true. As it happens, it isn't true.

Monday, 19 November 2018

Teetotallers still dying too young

In April, the Lancet published one of those 'no safe level' studies about alcohol. It was garbage but it got the kind of media coverage its authors doubtless anticipated, with the Guardian declaring that ‘Drinking is as harmful as smoking’ and the BBC asserting that ‘One drink a day “can shorten life”‘. Interestingly, the BBC headline has since been changed to the more credible 'Regular excess drinking can take years off your life' but the damage has been done.

It's all part of the drip-drip campaign to erase the health benefits of alcohol consumption. Lies like this travel the world while the truth is getting its shoes on. Last week, I mentioned the article by Alexandra Freeman and David Spiegelhalter criticising a similar study that was published in August. It did not receive the same level of interest from the media as the original, to put it mildly.

Nor did the letters in Friday's Lancet criticising the April study so I will flag them up here. The trick employed in that study was fiendishly simple. The authors simply removed non-drinkers from the analysis, leaving graphs that imply no health benefits from moderate drinking...

If you put the never-drinkers and ex-drinkers in, the usual J-Curve emerges. Drinkers have to consume quite a lot of booze before their health risks exceed those of teetotallers.

I don't know why it has taken seven months for a rebuttal to this deeply misleading study be published in the Lancet, but two have now come along at once. As the first letter says:

Taking out the non-drinkers as a reference group is the only novelty in this study compared with existing scientific literature, and causes the complete elimination of the left rising arm of the J curve (as shown in the figure and in the Article's appendix, p 31). This is also not the first time a study has suggested that the mortality curve bends at a drink per day or less. By removing the non-drinkers, Wood and colleagues make it difficult to establish whether any amount of moderate alcohol consumption has a different effect to abstaining. Thus, we believe that the study has little to add to existing scientific literature and cannot contribute to public health advice.

The second letter makes a similar point...

Over the past decades, observational studies have taught us a lot about the relation between alcohol consumption and health. The effects of alcohol on health are now understood to differ depending on the amount of alcohol consumed, the age and gender of the consumer,1 and the various endpoints studied. Most studies find that individuals who abstain entirely from alcohol consumption might be worse off than moderate drinkers, and virtually none have reported a beneficial effect of abstention on mortality compared with moderate consumption.

.. By disregarding ex-drinkers and never-drinkers and the differing effects patterns of alcohol consumption had on mortality, the main message emerged that less alcohol consumption was better. A more informative message based on the findings hidden in the appendix could have been that the study added further evidence to support a beneficial effect of moderate alcohol consumption (especially wine) on mortality. The headlines might have then resembled those of just a year ago: “A glass of wine or pint of beer a day can help people to live longer, according to new research”.

The authors have replied to these criticisms but are unable to credibly defend the decision to exclude non-drinkers - who are, after all, the only relevant control group if you're going to encourage total abstinence. They don't deny that non-drinkers have higher rates of mortality than moderate drinkers, nor do they deny controlling for every conceivable confounding factors. Instead they make vague assertions about non-drinkers possibly being unhealthy for reasons nobody can think of.

...never-drinkers might differ systematically from drinkers in ways that are difficult to measure, but might be relevant to disease causation.

Well, they might. Just as heavy drinkers might be more likely to get liver cirrhosis for reasons that have nothing do with drinking, but since every alternative explanation has been studied and found wanting, we would reject this notion as desperate straw-clutching. Same rules apply.

NB. I wrote about this study at the time for Spectator Health.