Thursday, 19 July 2018

The Tobacco Control Plan debate


 

In the previous post, I mentioned the parliamentary debate on tobacco control that had been organised by Action on Smoking and Health (ASH). It took place this afternoon and was streamed online so I watched it. As you can see from the photo above, it was sparsely attended. What you can't see is that was dominated by members of the All Party Group on Smoking and Health, a sockpuppet in-house pressure group created by ASH in the 1970s of which ASH remains the secretariat.

It began with a speech by Steve Brine who said that there are no plans for any more legislation but that the government would work hard to achieve its self-imposed target of having a smoking rate of no more than 12 per cent by 2022.

It is important to recognise that this is now the sole justification for the harassment, extortion and stigmatisation of smokers. The tobacco control crusade is no longer based on market failure arguments, as weak as those were. Nor is it based on equally flimsy claims about the tobacco industry somehow tricking people into smoking. The justification now is that the government has set arbitrary targets for how many people should be smoking by a certain year and that these must be met. It doesn't matter whether you want to smoke or not. It doesn't matter whether you enjoy smoking. It doesn't matter whether you understand the risks and are prepared to take them. The government has decided that the country will be 'smokefree' at some point in the next two decades (note how the meaning of 'smokefree' has changed since 2007) and that is the end of the matter.

Steve Brine might not want more legislation in the foreseeable future but ASH does. After Brine spoke, Bob Blackman, the chairman of their APPG, argued for ASH's pet policies, notably a tobacco industry levy modelled on the Master Settlement Agreement, more money for stop-smoking services and more anti-smoking campaigns. He was followed by Alex Cunningham, also an APPG member, who thanked ASH for helping him prepare his speech and called for a clampdown on smoking on TV (another ASH favourite), raising the age of purchase to 21 and licensing tobacco retailers. He also wants some sort of leaflet to be inserted in cigarette packs to tell people that smoking is bad for their health (who knew?).

Kevin Barron, the vice-chair of the APPG, stood up and called for much the same. There was some delusional stuff about eliminating the illicit trade in tobacco while continuing to raise tobacco duty, and there was much talk of tackling health inequalities which, in tobacco as in food, is code for forcing the habits of the managerial class upon ordinary people. Nauseatingly, both Barron and Cunningham gave figures of how many people would be lifted out of poverty if they stopped smoking. With tobacco duty making up 80-90 per cent of the price of tobacco products, this only confirms how regressive this form of taxation is. It is the tax, not the tobacco, that causes the secondary poverty.

Barron noted that Ireland and the UK have exactly the same anti-smoking legislation and yet the UK's smoking rate has fallen by a quarter since 2012 whereas, he said, the smoking rate had fallen by very little in Ireland. He attributed the difference to the UK embracing e-cigarettes and he is doubtless correct, but he did not draw the other obvious conclusion: that the 'world class' anti-smoking legislation which both countries have embraced is useless.

In short, the government has looked back on five years in which the smoking rate has fallen at a remarkably fast pace and decided to take a legislative breather. Tobacco taxes will continue to rise above inflation and we can expect to black market to rise further as a result, but Steve Brine is not concerned about this because he has signed a WHO treaty aimed at eliminating the illicit trade (stop giggling at the back).

None of the speakers mentioned the damage done by EU legislation on snus, e-cigarettes or novel nicotine devices, nor did they propose that this legislation be repealed after Brexit. To be fair, there was some recognition that e-cigarettes have been behind the recent trend in smoking cessation but the speakers were too blasé in assuming that the trend towards harm reduction will continue given the regulatory obstacles it faces.

ASH are in charge

Public health minister Steve Brine tweeted yesterday about a parliamentary debate on the Tobacco Control Plan that is being held today.


This makes it sound as if it was the decision of Brine and his department to organise the debate but an e-mail circulated to MPs on July 4th tells a different story:

As you may know, Action on Smoking and Health (ASH) have applied for a Backbench Business debate for late-July, to note the one-year anniversary of the Tobacco Control Plan (TCP) and discuss its vision for a ‘smokefree generation’. I wanted to let you know that the debate has been secured, for three hours in the Chamber, and should be on 19 July 2018. 

The full e-mail is below...


Isn't it interesting that a tiny pressure group can get a parliamentary debate whenever it feels like it? This is only possible because ASH are, in effect, part of the government. The Department of Health outsourced tobacco policy to these extremists many years ago. When ASH says 'jump', the government asks 'how high?' As I have mentioned before, it is no coincidence that ASH's Deborah Arnott is seen grinning behind Brine in his Twitter photo.


As it happens, there are some tobacco issues that need to be discussed in parliament. The Tobacco Control Plan specifically mentions the possibilities that Brexit opens up. It would be nice to see some MPs talk about their plans to legalise snus, or repeal the Tobacco Products Directive, or allow Juul to be launched in Britain (a low nicotine version hit the market this week; the real thing is illegal under EU laws). They might also discuss reforming the advertising laws to allow reduced risk products such as IQOS to make themselves known to smokers.

Alas, I suspect that the debate will mostly be about money. ASH have virtually run out of policy proposals since the government implemented everything they could think of. They now exist to keep themselves and their fellow travellers in work.

Tuesday, 10 July 2018

The drinking guidelines fiddle

I've got an article in the current issue of Wetherspoons News about the lowering of the drinking guidelines in 2016 after a process that I would describe as fraudulent. Wetherspoons recently turned its back on the internet so here it is in pixels...

It is two years since the government changed its official drinking advice. Lowering the weekly guidelines for men from 21 units to 14 units, Britain became one of a small handful of countries to issue the same guidance to both sexes. When she announced the new limits, England’s Chief Medical Officer, Sally Davies, took the opportunity to tell the nation that there is no safe level of drinking and that the health benefits of moderate drinking are ‘an old wives’ tale’.

Such advice is easy to ignore. You are probably ignoring it right now. But guidelines are not always designed to be followed. Sometimes they serve a political purpose.

Every indicator shows that the UK has become a more sober country in the last fifteen years. Rates of binge-drinking, underage drinking and drink-driving have all fallen dramatically. On a per capita basis, we drink no more than we did in 1980, and millennials are particularly abstemious. Lowering the guidelines for men created two million ‘hazardous’ drinkers overnight, thereby inflating Britain’s supposed drink problem and increasing the perceived need for more government intervention.

When the previous guidelines were set in 1995, the government assembled a group of experts who had no known bias for or against alcohol. They issued a call for evidence, held hearings and received dozens of submissions before making their minds up.

The process that led to the new guidelines in 2016 could not have been more different. Most of the committee’s members were openly in favour of heavy regulation and several of them were associated with temperance groups. Their agenda was simple: to regulate alcohol like tobacco. In effect, this means making a pariah of the drinks industry, portraying alcohol as a major cause of cancer and asserting that there is no safe level of drinking.

For the new guidelines, there was no call for evidence and there were no hearings. The names of the committee members were not even made public until after the guidelines had been changed. But the minutes of the meetings were eventually published and they make for interesting reading. As early as June 2013, the chair of the evidence evaluation group, Mark Petticrew, told his colleagues that the number of people who benefited from moderate drinking was ‘very small’ and that the benefits were ‘limited to a low consumption level of half a drink per day’. The ‘beneficial effects’, he said, ‘could be considered not to be relevant in the context of an overall population message, advice or guidance.’

From this starting point, it was a small step to claiming that the benefits of drinking were an old wives’ tale. There was only one problem: the science does not support it. A mountain of evidence stretching over five decades shows that non-drinkers are more likely to suffer from heart attacks, angina, diabetes, dementia and stroke. Studies have shown that people who drink up to 35 units a week live longer than those who do not drink at all. If the guidelines were to be evidence-based, they should have been raised, not lowered.

Since the empirical evidence did not agree with them, the guidelines group commissioned some computer modelling to replace it. A team at Sheffield University that was known to support anti-alcohol policies was hired to build a model to put a figure on a ‘safe level of drinking’, but this, too, failed to support a reduction in the guidelines. And so, in a scandalous move, the committee told the Sheffield team to change the model.

The original model had assumed that chronic conditions, such as alcoholic liver cirrhosis, could only develop in somebody who drank heavily for many years. The evidence for this was indisputable and yet the committee insisted that the model be based on the assumption that even light drinkers were at risk.

The Sheffield Team knew that this was absurd and protested the change, saying that ‘it does not seem right to assign people drinking at very low levels a risk of acquiring alcoholic liver disease and similar conditions’. But they were given little choice and, for a fee of £7,800, they changed their model and came back with new findings which, unsurprisingly, found moderate drinking to be more dangerous than previously thought.

The committee finally had the evidence they needed to justify lowering the drinking guidelines. Admittedly, it was only a hypothetical model that they themselves had rigged by inserting assumptions that nobody could justify, but it was enough. Why did they go to so much effort? Because, as the minutes of one of the meetings points out, ‘while guidelines might have limited influence on behaviour, they could be influential as a basis for government policies’. Lowering the guidelines was a small but important step in the growing war on alcohol.


Saturday, 7 July 2018

Au revoir


I'm on holiday until 16th July so blogging will be almost non-existent. If you need some hot takes while I'm away check the sidebar of shame for the finest deviants the blogosphere has to offer.

And if you have half an hour to spare and didn't catch my longform interview on BBC Scotland a few months ago, I notice that there is now a permanent link to it here.

Don't let anything stupid happen while I'm gone.

XXX

CJS

Thursday, 5 July 2018

Chile's soda tax "success"

The sugar tax junk science just keeps coming. It's amazing how hard it is to find evidence that taxes on sugary drinks has any effect on consumption, let alone calorie intake or obesity.

First we had the Mexico study which claimed to have found a 6 per cent drop in sales. This was plausible enough for a 10 per cent tax, but it turned out to be false. Per capita consumption was almost exactly the same after the tax was introduced as it had been before.

Then we had the study of Berkeley, California where sales fell in the town of Berkeley but rose in the surrounding area where the tax was not in force. Thanks to out-of-town shopping and increased consumption of substitute beverages, the tax led to more calories being consumed in soft drinks than before.

Daily usual taxed beverage intake was 121 g/d pre-tax and 97 g/d post-tax (−13.3%, p = 0.49), while mean caloric intake of taxed beverages went from 45 kcal/d to 39 kcal/d (−19.8%, p = 0.56) (Table 1); neither difference is statistically significant. From the pre- to post-tax period, mean volume of untaxed beverage intake went from 1,839 g/d to 1,897 g/d (+3.2%, p = 0.21). Reported mean caloric intake of untaxed beverages rose from 116 kcal/d to 148 kcal/d (+27.6%, p = 0.02).

It's a pretty dismal record but the crusade for sugar taxes marches on regardless thanks to the dozy media and headlines like 'Sugar tax in Mexico cuts sales of sugary drinks by 12 per cent' and
'First US sugar tax sees soft drink sales fall by almost 10%, study shows'.

Yesterday saw the publication of a study of Chile's soda tax and it's a belter if you like quackery. Chile's tax change was so minor that no reasonable person would expect to see much effect. The tax on sugary drinks rose from 13 per cent to 18 per cent and the tax on diet drinks dropped from 13 per cent to 10 per cent. In practice that means...

... the tax change, if fully transmitted to the consumer, would increase the prices of a 500ml sugary beverage from 500 pesos (£0.60) to 525 pesos (£0.62), and it would drop the price of an equally priced non-sugary beverage to 485 pesos (£0.57).

A 2p increase on a 60p half-litre of Coke isn't much of a deterrent. At best, you might expect sales to fall by 4 per cent. In the event, it doesn't seem to have managed one per cent.

For some reason, the tax has been evaluated by some academics at York University and they have been helpful enough to show us the consumption figures:


If you can't see any difference in consumption after the tax (dotted red line), you are not alone. Neither could the researchers...

For all soft drinks and for the relevant soft drink subcategories (except the no-tax soft drinks, which show a trend increase), it is hard to detect a clear overall time trend based on pure visual inspection alone. While the peaks in the data certainly become less pronounced over time, so have some of the troughs. It is equally difficult to discern an obvious pre- versus post-tax pattern in any of the categories.

That should have been the end of it. Consumption was unchanged and so the tax can't possibly have had any obesity which, let's not forget, is supposed to be the primary outcome. But no one goes home empty hand in the 'public health' racket, so they did some modelling. What kind of modelling? They don't say, but it had one hell of an effect because...

Our main estimates suggest a significant, sizeable reduction in the volume of high-tax soft drinks purchased (21.7%)
 
What?! Consumption fell by 21.7 per cent as a result of a five per cent tax rise?! In what universe does that sit with basic economics and common sense, let alone tally with the graph that we can see with our own eyes?

It's as if 'public health' research is one big wind-up and they're seeing how much they can get away with before they get busted. But there's no sign of that happening if the Telegraph's coverage is any guide...

Major new study shows Chile's sugar tax has sharply reduced sales of sugary drinks

Chile’s sugar tax seems to be successfully chipping away at the nation’s preference for all things sweet, according to new research. The findings will likely encourage other countries battling their own obesity epidemics.

The study by an international team led by researchers at the University of York looked at sales of sugary drinks in Chile between 2011 and 2015.  It found purchases fell by 21.6 per cent following the introduction of the tax.

And, inevitably...

The researchers called for sugar taxes to be applied to food and well as drinks. "Policy to reduce sugar intake should not only target the sugar contained in soft drinks, but also in food," said Prof. Suhrcke.

Chile now joins the growing list of sugar tax success stories along with Mexico, where sugary drink consumption was unaffected, and Berkeley, where people drank more calories after the tax came into effect. In both cases, modelling by activist-academics conjured successful outcomes out of thin air.

Now we have the Chilean miracle in which a small tax rise had essentially no effect on anything but modelling turned this into a 22% decline in consumption. The phrase 'junk science' doesn't really do this justice. 'Junk science' implies some kind of methodological flaw or statistical trick. The Chile study is just a... lie. It's literally fake news.

Campaigners for sugar taxes are in a fantasy world of their own making. They model the effects of the tax when they are lobbying for it and then, once it has been introduced and achieved nothing, they model it again to prove that it worked. Perhaps they will one day model a decline in obesity and a decline in mortality. If we can have an imaginary decline in soda consumption, why not have some imaginary weight loss to go along with it?

Wednesday, 4 July 2018

Prohibition is bad for mental health

With Canada, Uruguay and a growing number of US states abandoning cannabis prohibition, there is a real chance of European countries following suit. In Britain, enthusiasm for reform has since faded since the 1990s as a result of ‘skunk’ taking over the market. In 2004, when Tony Blair’s government reclassified cannabis as a Class C drug, it was still considered to be a relatively ‘soft’ drug and there was significant political support for its legalisation, but by the time Gordon Brown returned it to Class B status in 2008, public perception of the drug had begun to change. Cannabis is now synonymous with high potency skunk which is associated with dependency and psychosis. Around 70 per cent of the cannabis seized by police in the 1990s was resin. Today, more than 90 per cent is skunk.

Skunk is typically high in tetrahydrocannabinol (THC), which is associated with psychosis, and low in the non-intoxicating antipsychotic drug cannabidiol (CBD). THC is the main psychoactive substance in cannabis that makes the user feel stoned, but it can also cause side effects such as paranoia which tend to be mitigated by CBD. With high levels of THC and low levels of CBD, skunk poses a threat to the mental health of a small but significant minority of users. Although the number of cannabis users fell by a third between 2006 and 2014, demand for treatment of cannabis-related mental health problems increased by more than 50 per cent.

It is no wonder than the campaign for liberalisation has stalled. And yet the dominance of hazardous, high strength cannabis in the illicit market makes the case for legalisation stronger, not weaker. Opposing legalisation on the grounds that skunk has taken over the market is akin to opposing the end of alcohol prohibition because moonshine had taken over the market. Moonshine virtually disappeared after alcohol was re-legalised in the USA in 1933 and the same would happen to the strongest strains of cannabis if the drug were re-legalised today.

Legalising cannabis would alleviate the mental health issues associated with cannabis in two ways. Firstly, it would allow safer, regulated cannabis with maximum THC levels and minimum CBD levels to displace the more dangerous strains that have taken over the market. Secondly, it would generate tax revenue that could be spent on mental health services.

Instead of spending money on the lost cause of prohibition we could be saving money and generating taxable income. In a report published by the Institute of Economic Affairs today, I estimate that 255 tonnes of cannabis were sold in the UK in 2016/17 at a cost to end users of £2.6 billion. This is not a trivial sum. Under legalisation, prices would fall, but the industry would still be worth around £2 billion per annum, making it twice the size of the cider industry and three times the size of the bingo industry. It would be a small but significant part of the economy.

With maximum limits on THC levels, minimum limits on CBD levels and strict age controls, tax on the product alone could realistically produce revenues of £690 million per annum. Additional streams of revenue from income tax, corporation tax and business rates paid by the industry and its suppliers could run into the hundreds of millions of pounds. In 2015, the legal marijuana industry in Colorado - a state with a population that is less than a tenth of the UK’s - created 18,000 full-time jobs. Excise tax on marijuana is expected to reach $1 billion in California this year.

Not everything can be reduced to nickels and dimes but the public interest arguments for maintaining prohibition have collapsed. Cannabis has become more dangerous to its users’ mental health because of prohibition, not despite it. In many parts of the country, children find it easier to obtain cannabis than alcohol. Done properly, cannabis legalisation is a win-win-win: criminals lose a lucrative industry, the burden on the general taxpayer is reduced and consumers get a better product at a lower price.

Governments around the world are waking up to this. As the world’s largest producer of cannabis, albeit for medical use, the UK is well placed to lead the way in Europe. It is high time to legalise.


Cross-posted from the Telegraph. You can download the new IEA report Joint Venture here.

Tuesday, 3 July 2018

Smoking rate rises in first year of plain packaging and TPD

The Office for National Statistics has just released its annual publication, Adult Smoking Habits in Great Britain, with data for 2017.

2017 was the year that plain packaging and the Tobacco Products Directive effectively began. Both were introduced in May 2016 but retailers were allowed to sell their old stock until 20 May 2017. The tobacco industry made sure plenty of branded packs were available and few smokers saw a plain pack until 2017. The vaping industry also tried to make sure there were good, non-EU regulated e-cigarette fluids available for as long as possible.

Since e-cigarettes went mainstream in around 2012/13, the smoking rate had been falling sharply. It dropped from 20.4% in 2012 to 16.1% in 2016.

Now that the British and EU governments have saved us from the perils of branded cigarette packs, packs of ten and high strength vape juice, the rate must have fallen still further, right?

Wrong. As I mentioned in May, the data from the Smoking Toolkit Study show the smoking rate inching up in 2017. This has now been confirmed by the Office for National Statistics, which reports that smoking prevalence has gone up to 16.8%, the first rise in six years. 


The Tobacco Products Directive makes the most popular substitute for smoking less appealing. Plain packaging makes smokers more likely to buy tobacco on price rather than on brand, and if they want a branded pack they have to buy on the black market where cigarettes are cheaper. Banning packs of ten and small tobacco pouches means that smokers have to buy more tobacco than they might intend.

It doesn't take a genius to work out that this isn't going to reduce the smoking rate and yet the 'public health' lobby spent years - and vast sums of taxpayers' money - lobbying for these idiotic regulations. It was revealed this week that the Australian government spent $39 million on plain packaging. In Britain, hundreds of thousands of pounds were spent on billboards advertising this ridiculous policy. Their slogan used takes on a new meaning now that plain packaging has proven a damp squib in Britain, France and Australia.


The campaigners have already moved on. Banning smoking in the home, censoring television programmes, changing the colour of cigarettes... It goes on and on, without end and to no end.

Will anyone be held accountable? Of course not. The whirlwind of destruction will continue because it makes politicians feel good. Intentions are everything. Outcomes are irrelevant.


UPDATE

The NHS has chosen today to release its Statistics on Smoking report which is based on the Annual Population Survey and reports a decline from 15.8% to 15.1%. This is a survey of people aged 18 and over whereas the figures above, based on the Opinion and Lifestyles Survey, covers people aged 16 and over. You pays your money and takes your choice, but I have always used the 16+ figures which, incidentally, are closer to the figures that are taken every month in the Smoking Toolkit Study and also show a slight rise in 2017 (see below):




Monday, 2 July 2018

Shut down the Local Government Association

The march towards state control of the food supply is accelerating at such a pace that even the craziest ideas barely raise an eyebrow. On Friday, the Local Government Association made a new demand that passed almost without comment.

Off the back of some politically driven nonsense from Public Health England about the 'clustering' of takeaway shops in 'deprived' (ie. urban) areas, Izzi Seccombe, Chairman of the LGA’s Community Wellbeing Board, said:

“We urgently need to take action to tackle child obesity and councils are playing their part, but need more planning powers to help tackle this epidemic [sic] which has made the UK the most obese nation in western Europe [actually, that's Malta - CJS].

“Councils appreciate that a flourishing hospitality sector in our towns and cities is good for local economies and where they have introduced restrictions on takeaways are working with businesses to help create healthier menus for their customers.

“Numerous councils have set curbs on new fast food outlets but current legislation means they lack planning powers to tackle the clustering of existing takeaways already open.

“New legislation is needed to empower councils to help drive forward an effective redesign of damaging food environments to help address health inequalities and tackle the obesity crisis, which requires a joined-up approach.”

Leave aside the fact that the evidence does not support the belief that living near a fast food outlet makes you more likely to be obese.* And leave aside the fact that people should be free to eat wherever they want. What the LGA is saying here is incredible. Not only do they want to stop new food outlets from opening, they want to have the power to close down businesses that are already trading

'Sorry Mr Smith. We know your fish and chip shop's been here for 100 years, but our data tell us that there is an over-supply of fast food in the area so we're shutting you down.'

'Sorry Mr Wang. Your Chinese takeaway might be popular but the rate of obesity in this ward is higher than the national average, so it's the Jobcentre Plus for you.'

What are these people thinking? When did destroying local businesses become an explicit goal of the Local Government Association? How do we shut this obscene organisation down before they shut the high street down?

It somehow comes as no surprise to find that Izzi Seccombe is a Conservative councillor.


* Public Health England lie about this in their document, claiming that 'There is a growing body of evidence on the association between exposure to fast food outlets and obesity, although some studies show mixed results.'

Sunday, 1 July 2018

The domino theory revisited

As predicted from leaked reports last year, the World Trade Organisation has rejected the appeal of various countries against plain packaging. This is an unfortunate but important development because it shows that the WTO will not stand up for trademarks and intellectual property rights.

As a precedent, the implications go far beyond tobacco. With the court case settled (appeals notwithstanding), the Guardian has come clean....

'Resounding victory': Australia wins tobacco plain packaging dispute

WTO rejection of challenge seen as global test case could lead to tighter rules for unhealthy foods and alcohol

... Australia’s law, introduced in 2010, bans logos and distinctively-coloured cigarette packaging in favour of drab olive packets that look more like military or prison issue, with brand names printed in small standardised fonts.

The challenge to it was seen as a test case for public health legislation globally, and could lead to tighter marketing rules for unhealthy foods and alcohol as well as tobacco.

But, but, but, didn't Deborah Arnott of ASH reassure us - when talking specifically about plain packaging - that...

...the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false.

I can't believe the 'public health' people tricked us again! If only someone had warned us!

Image from the 2015 Tobacco Atlas

Oh well, I guess it's open season on the packaging of any product that displeases the puritans.

As for the legal case itself, Sinclair Davidson shows how the Australian government lied to the WTO here and here.