Monday, 15 October 2018

Minimum pricing and the reverse Midas touch of 'public health'

More evidence that the Sheffield minimum pricing model was flim flam...

This follows the release of data from the Retail Data Partnership which found the following trend in convenience stores:

Brian Eagle-Brown of The Retail Data Partnership (TRDP) gave an overview of convenience performance in recent months, noting that alcohol sales were up “across the board” since the implementation of MUP.

“What was unexpected is that the result of minimum pricing is not declining, but actually increasing alcohol sales. Gin sales are up 90% year on year,” he said.

And as a fun bonus:

In news that may further disappoint policy makers, sales of full sugar soft drinks also appear to have been largely unaffected by the introduction of the sugar tax.

Brian’s TRDP colleague James Loker said that there “had not been a massive impact” from the sugar tax, and that “essentially sugary drinks are doing as well as they always have, and in some cases actually better.”

TRDP data revealed that the drinks most disadvantaged by the tax were those that opted for a formula change, with Irn-Bru and Ribena suffering a sales downturn.

Oh dear, what a shame, never mind.

I'll just leave this here lest we forget...



Friday, 12 October 2018

Questions to which the answer is yes

The BBC asks are we are living in a nanny state? In the article, my classical liberal stance is described as ‘ultra-libertarian’ while a ‘conservative’ makes the Orwellian argument that bans give people more choice. It’s a pretty good illustration of how much the centre of gravity has moved in this debate over the years. Do have a read of it.

Meanwhile the government wants to regulate pizza toppings. Only an ultra-libertarian could disagree!

Thursday, 11 October 2018

The strange death of the liberal Netherlands

The Netherlands comes a respectable 24th out of 28th in the Nanny State Index (the fewer points, the freer the country). It's not quite as good as Germany on lifestyle liberty but it's definitely in the green zone. Its reputation as a liberal haven has been largely well earned.

That could soon change. I mentioned on Monday that the Dutch health minister, Paul Blokhuis, wants to fast-track plain packaging through the Dutch parliament. He also wants to introduce minimum pricing so that the price of a crate of beer doubles from €10 to €20. He wants to emulate the UK's food degradation programme and he wants to copy Chile's ban on the use of recognisable characters on food packaging.


As if that weren't enough, he wants to ban smoking on terraces, stop supermarkets selling cigarettes and include e-cigarettes in both the country's smoking ban and the plain packs legislation.

And he can do most of this without the need for primary legislation. Plain packaging is scheduled to be passed before the month is out. By this time next year, the Netherlands could jump from the bottom end of the Nanny State Index to the top.

What the hell's going on? To understand, you need to look at last year's election. As often happens under proportional representation, there was no outright winner and a four party coalition was required to govern. This turned into a complex and lengthy process. In the end, the largest party - the People's Party for Freedom and Democracy - formed a coalition with Democrats 66, Christian Democratic Appeal and the Christian Union.

Mr Blokhuis is from the Christian Union. They came eighth in the election with just 3.4 per cent of the vote. They only won five of the 150 seats available but since nobody wanted to deal with Geert Wilders' Party for Freedom, and the People's Party for Freedom and Democracy couldn't get on with the Greens, the Socialists or the Labour party, they somehow got into government.

The Christian Union is a socially conservative party rooted in the Protestant church. Unsurprisingly, they have a moralistic view of 'vice' and their price for going into coalition was that Blokhuis be made health minister so he could introduce a 'National Prevention Agreement' with a raft of nanny state measures.

None of the policies being proposed by the Christian Union are supported by credible evidence, but I doubt that will concern them. It's not about health. It's a moral crusade.

I don't know what the prospects are of stopping any of this. It doesn't sound like the kind of thing that is going to be popular with the average Dutch voter, which is why so few of them voted for Blokhuis's band of religious zealots in the first place. But it looks like the 'public health' racket has a new hero in the making.

Wednesday, 10 October 2018

They wouldn't let it lie

The anti-drink lobby

This is turning into my favourite story of the year and it just keeps getting funnier. From The Times...

Experts threaten public health body over link to drink industry

Hundreds of top academics have threatened to stop advising Public Health England unless it abandons plans to work with the alcohol industry.

Excellent. Shut the door on your way out.

This is all because PHE teamed up with Drinkaware to promote abstinence from alcohol on at least two days a week. Drinkaware is a charity set up by the government to promote responsible drinking. It gets most of its funding from alcohol companies and so, according to temperance dogma, is part of the 'alcohol industry'. And, according to 'public health' dogma, governments can't work with industries because they are evil.

The academics say they are “alarmed” that PHE is unconcerned by Drinkaware’s industry funding despite “clear-cut examples of inaccurate information on Drinkaware’s website.”

The claim that there is inaccurate information on the Drinkaware website is a lie based on a deeply dishonest piece of work by Mark Petticrew and a Twitter thread by Colin Angus, both of whom are signatories.

Other signatories include Petra Meier (Sheffield modeller), John Holmes (Sheffield modeller), Richard Horton (Marxist Lancet editor), Tim Lang (corn laws aficionado), Gerard Hastings ("the corporation will get you in the end"), David Miller (tinfoil hat wearer) and John Britton (anti-smoking fanatic). Even Kate Pickett, co-author of The Spirit Level, has signed it. It's a veritable Who's Who of quackademia.

John Holmes of the University of Sheffield, who organised the letter, said that while academics would not abandon PHE overnight, they would lessen co-operation if they felt they could no longer trust the agency.

A terrifying proposition! Alas, PHE supremo Duncan Selbie is having none of it...

Mr Selbie said yesterday: “Drinkaware is not the alcohol industry, rather an education charity with millions of unique visitors each year. We are taking this opportunity to ensure the advice it gives is evidenced, pragmatic and sensible. The health harms of alcohol require action. Public health has always involved controversy and we will not shy away from this."

The Times also gives them short shrift. They didn't publish the letter and instead put a story about the epidemic of teetotalism among the young on the front page. They also dedicated a leading editorial to slapping them down:

There is no good case for PHE to accede to the critics’ demands. The academics’ letter claims that “the reputational risk to the agency’s status as a provider of impartial, evidence-based advice is significant”. The critics also complain that the message on responsible drinking is part of a wider campaign on public health, and that it thereby links an industry-funded body with the notion of healthy lifestyles. Yet Drinkaware is not a front for the alcohol industry. It is an independent body whose funding comes from drinks companies rather than from the taxpayer. Provided that the relationship is transparent, it is benign and the joint campaign’s output can help Britain’s drinking culture for the public good.

The campaigning message is both sensible and realistic. The chief medical officer’s recommended upper limit for alcohol consumption is, for both sexes, 14 units a week, to limit the risk of cancer or liver damage. The campaign targets drinkers between the ages of 30 and 45 who typically drink wine, beer or spirits regularly above these medical guidelines. These recreational drinkers do not necessarily have an obvious problem of susceptibility to alcohol but they need to be aware of the risks to their health and wellbeing of regular, excessive consumption.

The very idea of a measurable “unit” of alcohol (about half a standard 175ml glass of red wine) may itself be unfamiliar to the public. Drinkaware has addressed the issue of public recognition, with mnemonics and slogans in pubs and by encouraging two “dry” days each week.

This is sound advice. Mr Selbie should not allow academics’ purist objections to the drinks industry to override his responsibility to work with it to develop a pragmatic approach to public education. Consumption of alcohol, which is pleasurable to many, is not in the same category as the use of tobacco products, which are intrinsically harmful and addictive. A successful drinks industry has social responsibilities. PHE is right to harness them in this initiative.

I strongly suspect that The Times is more in tune with public opinion than the people who signed the letter. The great thing about this story is that the 'public health' people just don't get it. It's obvious that PHE are not going to back down and there is no pressure from the public for them to do so. And yet they keep doubling down.

In their letter, they write...

“That PHE is seemingly not worried about such activity or believes that it is not vulnerable to industry influence is troubling” 

Do they really think that they are going to win over PHE by implying that they are gullible fools who are 'vulnerable to industry influence'? The egos of these people are the size of a planet. The more they scream and stamp their feet, the more obvious it becomes to PHE and the public that they are fanatics.

Normal people do not think that alcohol is as bad as tobacco. Normal people do not think that working with an industry-funded charity is unacceptable (or, indeed, working with industry - most people work for an industry). These beliefs are only considered normal in the 'public health' bubble. Expose them to sunlight and people are going to laugh at them.

UPDATE

I have sent a e-mail to Duncan Selbie in his darkest hour...

 

Tuesday, 9 October 2018

Stanton Glantz pays $150,000 to settle sexual harassment lawsuit

According to Planet of the Vapes, anti-smoking campaigner and alleged sex pest Stanton Glantz has settled his sexual harassment lawsuit out of court. In December last year, alleged sex pest Glantz denied claims that he had sexually harassed post-doctoral student Eunice Neeley. The alleged sex pest was also accused of taking her name off a paper she had worked on and making racist remarks. Another woman filed a similar lawsuit against the alleged sex pest in March.

It now seems that Stanton Glantz, an alleged sex pest, has settled out of court with Dr Neeley after paying her $150,000. The other lawsuit is yet to be settled.


I recommend reading this Carl Phillips post about the academic fraud angle that has been overshadowed by the other allegations.

Monday, 8 October 2018

The World Health Organisation's week

Enjoying myself outside the conference venue

I was in Geneva for a couple of days last week to check out the WHO's Conference of the Parties meeting (COP8). Not that there was much to check out. As is traditional, the public and press were kicked out at Monday lunchtime and weren't allowed back in.

It wasn't clear what was being discussed inside. Even now, two days after it finished, it's not clear what was decided. Neither the Framework Convention on Tobacco Control (FCTC) website nor its Twitter feed suggested that anything substantial had been agreed.

The closing address contained some waffle about sustainability and the usual paranoia about industry. I heard rumours that they had decided to regulate heated tobacco products as if they were cigarettes but the only thing that has been publicly agreed is the creation of yet another anti-tobacco organisation - the Global Strategy to Accelerate Tobacco Control - to 'reinforce government policies and accelerate global action for more effective implementation of the tobacco control treaty'.

I thought that was what the FCTC's job? Never mind, it will keep the money rolling in. At one point last week, the Framework Control Alliance (yet another NGO sucking on the taxpayer's teat) told us exactly much this shindig was costing us...



And they were right. It is even worse than I thought - and we Brits are footing the bill for most of it.

I suspect that the WHO is doing journalists a favour by kicking them out after a few hours. At the end of the day, COP is a 'public health' conference and therefore bound to be about the most boring thing on Earth. I expect it's one tedious presentation after another while all the grubby deals take place in hotel rooms. If the public weren't booted out, they would soon leave of their own accord.

Hats off to my friends from INNCO who were in town all week, speaking to the public about vaping and harm reduction at the Broken Chair, the only place in Geneva where you're legally allowed to protest - and, even then, only if you have a permit. I caught up with them on Friday...



And then I popped down to the main venue for a quick photo...


On Friday evening I held a meeting at the Mon Repos Hotel down the road to find out what the hell was going on. Spoiler alert: no one really knew, but it was good to have a chat with a few people anyway. Thanks to Dick Puddlecote, who filmed it with my iPad, you can see some of the conversations. The indefatigable Simon Clark also said a few words but, alas, we ran out of memory space two minutes into his remarks.

So here's Kim D. Peterson of INNCO...


Heneage Mitchell of FactAsia...


And Aaron Biebert (director of A Billion Lives) who I was delighted to meet for the first time...


I expected this to be my last time at a COP but apparently it's going to be held in the Netherlands in 2020 so there's a chance I might go again, especially if it's in Amsterdam. Unfortunately, the Dutch government is already trying to get in the WHO's good books by announcing an extension of its smoking ban and putting plain packaging on the table. Plain packaging is, of course, just the kind of utterly ineffective virtue signalling that COP delegates can't get enough of.

So too is divestment from tobacco stock. I have often wondered whether people in the divestment campaign have any idea of how the stock market works. This quote from the FCTC confirms that they they doesn't.

The campaign also has also begun striking at the heart of tobacco profits. In January 2018, ABP, the biggest Dutch pension fund and the largest pension fund in Europe, announced it would stop investing in tobacco. This has resulted in 3 billion Euros less in investments from the finance sector going to tobacco companies, said Mr. Blokhuis.

Regular readers know that the 'public health' mob struggle with the distinction between profits and revenue. Now it seems that they don't know the difference between profit and the sale of secondhand shares on the stock market.

“We need to convince more financial companies that investing in tobacco is bad for business, bad for their profit margins,” said Mr. Blokhuis. “This would be the final knockout for the tobacco industry.”

I regret to inform you that Mr Bolkhuis is the State Secretary for Health, Welfare and Sport in the Netherlands.

The FCTC is still in Geneva because today saw the start of MOP1 (yes, really), which aims to 'Eliminate Illicit Trade in Tobacco Products'. That's right, eliminate. With this kind of expertise, how can they fail?

Oh, and needless to say, the FCTC didn't take the opportunity to retract its warm words about vaping prohibition during COP8. Rumour has it that the UK delegation barely said a word all week.

Tuesday, 2 October 2018

Good COP, Bad Cop

The WHO's big anti-nicotine conference is underway in Geneva. As mentioned in a previous post, I'll be in town on Friday with Dick Puddlecote and others to see if we can find out what the hell is going on.

If you're in town or can make it to Geneva, you are warmly invited to come to our Good COP event that will take place at the Mon Repos Hotel at 6pm. We'll have a little discussion and a lot of drinks.

In contrast to COP8, all are welcome so long as you RSVP. Let me know in the comments below, via Twitter (my DMs are open) or via e-mail.




Monday, 1 October 2018

A plea for sanity on e-cigarettes

As COP8 kicks off in Geneva, 70 scientists have signed a letter to the WHO calling on it to abandon its negative position on e-cigarettes.

Dear Dr. Adhanom Ghebreyesus,

Innovation in tobacco control: developing the FCTC to embrace tobacco harm reduction

We write to express our hope that WHO will assume a leadership role in promoting effective and fast-acting policies for regulating tobacco and nicotine.  In this letter, we propose that WHO and related stakeholders adopt a more positive approach to new technologies and innovations that have the potential to bring the epidemic of smoking-caused disease to a more rapid conclusion. 

In the field of tobacco control and public health, the world has changed significantly since the Framework Convention on Tobacco Control was signed in 2003.  It is impossible to ignore or dismiss the rise of Alternative Nicotine Delivery Systems (ANDS). These are established and new technologies that deliver nicotine to the user without combustion of tobacco leaf and inhalation of tobacco smoke. These technologies offer the prospect of significant and rapid public health gains through ‘tobacco harm reduction’.  Users who cannot or choose not to quit using nicotine have the option to switch from the highest risk products (primarily cigarettes) to products that are, beyond reasonable doubt, much lower risk than smoking products (e.g. pure nicotine products, low-toxicity smokeless tobacco products, vaping or heated tobacco products). We believe this strategy could make a substantial contribution to the Sustainable Development Goal to reduce premature deaths through non-communicable diseases (SDG Target 3.4).

The concept of tobacco harm reduction is coded into the definition of ‘tobacco control’ set out in the FCTC (Article 1.d), and we believe it now needs to be fully expressed in the FCTC and by the Parties in their approach to implementation.  To that end, we offer some guiding principles for your consideration for the development of the next phase of global tobacco control, starting from the next Conference of the Parties (COP-8, 1-6 October, Geneva).

Tobacco harm reduction is integral to tobacco control. Harm reduction is a widely practiced strategy in public health (e.g. HIV, drug use, sexual health) and should become an integral component of tobacco control – helping smokers to quit smoking or diverting them from ever starting, and, in either case greatly reducing their risk.

From a health perspective, the major distinction between nicotine products is whether they are combustible or non-combustible.  It is not whether they are tobacco or non-tobacco products or whether they are established or novel. Given the principal focus of the FCTC is management of health risks, this distinction should be integral to the design and implementation of the FCTC.
Tobacco harm reduction is supportive and synergistic with the ‘MPOWER’ policies that underpin the FCTC.  By providing more diverse options for users to respond to taxes or other measures, harm reduction can improve the effectiveness of conventional measures and mitigate the unintentional harmful consequences of such policies to continuing users, for example the impact of cigarette taxes on people who continue to smoke.

Stakeholders should give appropriate weight to the benefits and opportunities of tobacco harm reduction and not focus exclusively on unknown risks to health, especially when these are minor or improbable risks.  A lost opportunity for public health is a real harm to public health, and should be recognised as such.

Youth uptake of any tobacco or nicotine product demands a coherent and adaptable strategy focussed on reducing present and future harms to young people. Policies to address youth nicotine use should be based on an understanding of youth risk behaviours, the interactions between use of different products (for example, for some young smokers the potential displacement of smoking by low risk products may be beneficial), and due regard for the overall balance of harms and benefits to both adults and to youth arising from interventions.

Uncertainty about long-term effects should not be a reason for paralysis. It is true we will not have complete information about the impacts of new products until they have been used exclusively for several decades – and given the complex patterns of use, we may never. But we already have sufficient knowledge based on the physical and chemical processes involved, the toxicology of emissions and exposure markers to be confident these non-combustion products will be much less harmful than smoking. We also know with certainty that the incumbent product (cigarettes) is extremely harmful.

FCTC and its implementation should embrace “risk-proportionate regulation”.  This means that the stringency of regulation or taxation applied to product categories should reflect risk to health. For example, there should be high taxes on cigarettes, but low or no taxes on vaping products. It is reasonable to ban all advertising of combustible products, and to place controls on advertising for non-combustible products (to protect never-smoking youth in particular) but allow enough promotion so that smokers can still learn of alternatives and can be encouraged to switch.  This risk-proportionate approach should be adopted throughout the FCTC.

WHO and Parties to the FCTC should be aware of and careful to avoid the harmful unintended consequences of prohibitions or excessive regulation. If WHO-endorsed policies make non-combustible alternatives to smoking less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, or inhibit innovation and development of new and improved products, then these policies can cause harm by perpetuating smoking.

The FCTC negotiations should become open to more stakeholders. There are many stakeholders, including consumers, the media and public health experts with pro-harm-reduction views, who should be part of the process. We are concerned that the FCTC has been excluding appropriately diverse perspectives and that its deliberations and decisions could be more robust and credible if its proceedings were more open.

We are concerned that WHO and the Convention Secretariat are not embracing these principles and in many cases are doing the opposite. We have seen the more detailed letter to you of 3 September by Abrams et al regarding prohibition and excessive regulation. We recommend that this letter be read carefully by everyone with an interest in the future of tobacco control.
We believe that it is time for tobacco control to embrace tobacco harm reduction. We hope that WHO and Parties to the FCTC will advance this agenda at the Eighth Conference of the Parties of the FCTC, starting today.

The authors of this letter confirm no conflicts of interest with respect to the tobacco industry and that no issues arise with respect to Article 5.3 of the FCTC.

Yours sincerely, 

  1. David B. Abrams, PhD
  2. Marion Adler, PhD
  3. Jasjit S Ahluwalia, MD, MPH, MS
  4. Sanjay Agrawal, MD, MBChB
  5. Philippe Arvers, MD, PhD
  6. Frank Baeyens, PhD
  7. Shamsul Bahri Mohd Tamrin
  8. Scott D. Ballin, JD
  9. Clive Bates, MA, MSc
  10. Robert Beaglehole, MD, DSc, FRSNZ
  11. Mihi Blair (Ngāti Whātua)
  12. Anne Borgne, MD
  13. Ron Borland, PhD
  14. Thomas H. Brandon, PhD
  15. John Britton, MD
  16. Dr Jamie Brown, PhD CPsychol
  17. Jean-Pierre Couteron
  18. Sharon Cox, PhD
  19. Kenneth Michael Cummings, PhD
  20. Lynne Dawkins, PhD
  21. Jean-Michel Delile, MD
  22. Allan C. Erickson
  23. Jean-François Etter, PhD
  24. Konstantinos Farsalinos, MD, MPH
  25. Prof. Antoine Flahault, MD, PhD 
  26. Jonathan Foulds, PhD
  27. Thomas J. Glynn, PhD
  28. Peter Hajek, PhD
  29. Wayne Hall, PhD
  30. Natasha A. Herrera
  31. Martin J Jarvis, DSc OBE
  32. Martin Juneau , MPs, MD, FRCPC
  33. Dr.Aparajeet Kar, MD
  34. Leon Kosmider, PhD, PharmD
  35. Lynn T. Kozlowski, PhD
  36. Hiroya Kumamaru, MD, PhD
  37. Christopher E. Lalonde, PhD
  38. Murray Laugesen QSO
  39. Jacques Le Houezec, PhD
  40. William Lowenstein, MD
  41. Karl E Lund, PhD
  42. Bernhard-Michael Mayer, PhD
  43. Olivia Maynard, PhD
  44. Andy McEwen, PhD
  45. Ann McNeill PhD
  46. Klim McPherson, PhD, FMedSci, Hon FRCP
  47. Colin Mendelsohn
  48. Robin Mermelstein, PhD
  49. Faares Mili, MD
  50. Thomas J. Miller
  51. Marcus Munafò, PhD
  52. Raymond Niaura, PhD
  53. Caitlin Notley, PhD
  54. David Nutt, DM, FRCP, FRCPsych, FMedSci, DLaws
  55. Konstantinos Poulas, PhD
  56. Philippe Presles, MD
  57. Lars M. Ramström, PhD
  58. Vaughan Rees, PhD
  59. Steven A. Schroeder, MD
  60. John R. Seffrin , PhD
  61. Lion Shahab, PhD
  62. Rajesh N. Sharan, Ph. D.
  63. Michael Siegel, MD, MPH
  64. Roberto A Sussman, PhD
  65. David Sweanor, JD
  66. Professor Umberto Tirelli MD 
  67. Natalie Walker, PhD
  68. Kenneth Warner, PhD
  69. Alex Wodak
  70. Naohito Yamaguchi, MD