I'm on the Bright Blue podcast with Tom Chivers this week talking about obesity and free will. Do have a listen.
Referenced in the podcast is this article by Tom with which I disagree and this study about obesity being contagious which has been debunked.
Friday, 29 March 2019
Thursday, 28 March 2019
Turning drinking into smoking
You may have seen reports today about a bottle of wine being the cancer equivalent of ten cigarettes. The figure is false and the comparison is meaningless. It is an attempt to scare the statistically naive and promote the idea that drinking is the new smoking.
I wrote about it for Spectator Health...
Do have a read.
I wrote about it for Spectator Health...
The most shameless example yet of the deliberate conflation of smoking and drinking was published today. A study in BMC Public Health claims that drinking one bottle of wine a week increases the risk of cancer by the same amount as smoking ten cigarettes a week (if you’re a woman) or by five cigarettes (if you’re a man). Its authors say that their intention is to provide ‘a useful measure for communicating possible cancer risks that exploits successful historical messaging on smoking’. They insist that they are ‘not saying that drinking alcohol in moderation is in any way equivalent to smoking’.
Yeah, right. The only reason this study was conducted was to generate headlines to the effect of 'drinking is as bad as smoking' - and it has worked. The 'study' might boost the impact factor of the journal that published it, but it has no academic merit. There is no reason for it to exist other than as propaganda.
Do have a read.
Wednesday, 27 March 2019
Sugar taxes - the state of the evidence
I'm going to use page to post links to studies looking at sugar/soda taxes. Updates will appear at the bottom. Here's the story so far...
Early research came from the USA, where more than 30 states have some form of tax on soda. In 2009, Powell et al. found 'no statistically significant associations between state-level soda taxes and adolescent BMI'.
Similarly, Fletcher et al. (2010) looked at the effect of soda taxes on soda consumption and body weight among minors and found 'a moderate reduction in soft drink consumption' but no impact on weight because 'this reduction in soda consumption is completely offset by increases in consumption of other high-calorie drinks.'
In 2013, Fitts and Vader looked at the impact of soda taxes on adult obesity and, again, found no effect:
Our research does not support the theory that soda taxes have a negative effect on body-mass index.
However, they suggested that this might be because most of the taxes on soda were quite low...
Current soda tax rates range from two percent to 7.25 percent and it’s possible these may not be high enough to affect BMI.
To test this, Fletcher et al. (2015) looked specifically at the largest soda taxes. Alas, the results were much the same. Regardless of whether the taxes were small or large (they ranged up to 12 per cent), there was no impact on body weight or obesity:
Together, our results cast serious doubt on the assumptions that proponents of large soda taxes make on its likely impacts on population weight. Together with evidence of important substitution patterns in response to soda taxes that offset any caloric reductions in soda consumption (Fletcher et al. 2010a), our results suggest that large changes to policy proposals relying on large soda taxes to be a key component in reducing population weight may be required to successfully reduce weight.
In the same year, Colantuoni and Rojas looked at two reasonably substantial soda taxes in Ohio and Maine (5.5 per cent). Their conclusion?
Results suggest that neither sales tax had a statistically significant impact on the consumption of soft drinks.
A systematic review published in 2013 identified the usual problem with substitution effects and found little evidence of any beneficial effect on health. Note that this review was available long before George Osborne announced the sugar tax in the UK.
Price increase may lead to a reduction in consumption of the targeted products, but the subsequent effect on caloric intake may be much smaller. Only a limited number of the identified studies reported weight outcomes, most of which are either insignificant or very small in magnitude to make any improvement in public health.Conclusion: The effectiveness of a taxation policy to curb obesity is doubtful and available evidence in most studies is not very straightforward due to the multiple complexities in consumer behavior and the underling substitution effects.
By 2015, the real world evidence hadn't shaped up too nicely for the soda tax campaigners. Fortunately, several of them had been running their own computer models and the results were published to widespread attention. Researchers like Mike 'God is calling me to work towards the introduction of soft-drink taxes in this country' Rayner and Kelly 'Twinkie Tax' Brownell came up with studies like this and this which promised small but non-trivial health gains if their assumptions were right.
Their main assumption was that soda taxes work, so it was all a bit circular, but from around 2014 a few places experimented with soft drink taxes of around ten per cent. Mexico and Berkeley, California both offered a chance for researchers to study the impact of a substantial soda tax on calorie consumption, weight and health.
In January 2016, a study was published which claimed that Mexico's soda tax had reduced consumption by six per cent in its first year. Newspapers spread the story around the world, but only those who read the study carefully noticed that the authors - among them veteran soda tax campaigner Barry Popkin - were not reporting an actual decline in soda consumption, rather they were comparing the actual rate to a counterfactual that they had created.
Months later, Mexico's National Institute of Public Health admitted that soda consumption had not declined after the tax was implemented (in 2014). In fact, it had gone up slightly.
As keen advocates of the tax, the Institute was anxious to point out that 'it is not possible to make determinations on the usefulness of the tax on sugar sweetened beverages in Mexico during 2015 using raw sales data'. Like Popkin, they claimed that sales would have gone up even more in the absence of the tax. Perhaps they would. It is a hypothesis that is impossible to falsify. But it is clear that consumption did not go down and, therefore, that the tax could not possibly bring about the promised decline in obesity.
Sure enough, the number of obese Mexicans rose by four million between 2012 and 2016.
Popkin returned in 2017 with a study of the Berkeley soda tax which, he claimed, had led to sales falling by 9.6 per cent. This time, the flaw was in plain sight. The 9.6 per cent decline (compared with a counterfactual) related to stores in Berkeley, but the tax encouraged people to do their shopping out of town. Although sales fell by 0.8 fluid ounces per transaction in Berkeley, they rose by 0.7 fluid ounces per transaction in neighbouring areas.
The authors found that self-reported sugary drink consumption' did not change significantly compared to baseline'. Not only was there no statistically significant change in calorie intake from sugary drinks among Berkeley residents, but the authors noted that 'caloric intake of untaxed beverages (milk and other diary-based [sic] beverages) increased.' Energy consumed from sugary drinks fell by a statistically non-significant six calories while energy consumed from dairy drinks rose by a statistically significant 32 calories. In other words, overall calorie intakes from beverages actually increased after the tax was implemented. Great success!
Finally, there is Chile. The coverage of a study of Chile's sugar tax last year followed the by-now familiar pattern of big press release, impressive claim and underwhelming study. This time the claim was that an increase in tax on soft drinks in 2011 had caused sales to 21.6 per cent.
This would have been remarkable if true. The tax on sugary drinks only rose from 13 per cent to 18 per cent while the tax on low/zero-sugar drinks dropped from 13 per cent to 10 per cent.
But it wasn't true, and the researchers were kind enough to show us the sales figures so that we could see it wasn't true.
They also admitted that...
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.
So how did they come up with the idea that there had been a decline of 21.6%? They never explained, other than to say they had used a model. It must have been quite a model.
To my knowledge, these are the only studies of the impact of soda taxes on soda sales and/or calorie consumption in the real world. None of them managed to find a measurable decline in soda or calorie consumption, let alone in obesity. Back to the computer models, lads!
UPDATE
Study of Oakland's sugar tax finds...
...a slight decrease in the volume of SSBs purchased per shopping trip in Oakland and a small increase in purchases at stores outside of the city, and we find some evidence of increased shopping by Oakland residents at stores outside of the city. We do not find evidence of substantial changes in the overall consumption of SSBs or of added sugars consumed through beverages for either adults or children after the tax.
Study of Philadelphia's sugar tax, published in December 2018, concluded...
There is no significant substitution to untaxed beverages (water and natural juices), but cross-shopping at stores outside of Philadelphia completely offsets the reduction in sales within the taxed area. As a consequence, we find no significant reduction in calorie and sugar intake.
However, a new version of the study was put online in October 2019, with somewhat different findings and emphasis...
A large amount of cross-shopping to stores outside of Philadelphia off-sets more than half of the reduction in sales in the city and reduces the net decrease in sales of taxed beverages to only 22%. Among taxed beverages, demand decreases more strongly for relatively healthier products. Due to cross-shopping and compositional changes in demand, we find that calories and sugars decrease by only 16% and 15% (p-values of 0.07 and 0.09).
Very curious. You can see the original here.
Study of sugar taxes in four US cities finds an impact on soda purchases in only one of them.
When we examine results separately by city, we find that the decline was concentrated in Philadelphia, where the tax decreased purchases by 27.7 percent. We do not find impacts of the taxes in the other three cities combined.
Study finds that demand for soda in Mexico is less elastic than previously assumed.
Important study finds that price elasticity estimates suffer from a systematic flaw and explain why sin taxes work much less well than advocates predict.
Tuesday, 26 March 2019
EU Health Commissioner wants med regs for e-cigarettes
Some things never change. The EU Health Commissioner, Vytenis Andriukaitis, who has previously claimed that vaping is 'a danger for
public health', wants e-cigarettes regulated like medicines...
It seemed as if the argument on e-cigarette regulation had been won a few years ago. All the EU countries which regulated e-cigs like medicines, such as Denmark, legalised them as consumer products and the EU stepped back from its plans to introduce med regs in the Tobacco Products Directive. And yet here is this nanny state dinosaur banging on as if it's still 2011.
Furthermore...
That's the kind of claim that can be tested empirically, as it was in the New England Journal of Medicine recently...
It's a shame Andriukaitis doesn't keep abreast of the scientific literature. He could have asked the EU's Chief Scientific Officer about it if the position hadn't been abolished after lobbying from anti-science NGOs.
One liberal argument against Brexit is that British politicians are often even keener to trample on freedom than the control freaks in Brussels. There is some truth in that, but at least if we leave the EU there is the possibility of things getting better. There is no chance of the EU becoming more liberal and on the issue of vaping and tobacco harm reduction, it is a near certainty that an independent Britain would be freer than an EU member state.
And don't bother trying to tell me that Andriukaitis is one bad apple having a rant. He's the Health Commissioner and the problem is institutional. Let's not forget that his second-in-command comes out with gems like this:
After I tweeted about this earlier, this little charmer from the European Commission popped up in the timeline...
The UK has the second lowest smoking rate in the EU, after Sweden which managed to swerve the EU ban on snus.
Every time I start to think that staying in the EU might not be that bad, another of these grubby little bureaucrats opens his mouth. Can we leave now, please?
'If one uses electronic cigarettes as a method to stop smoking, it has to be managed by medical doctors and specialists, to be sold in pharmacies and not in supermarkets.'
It seemed as if the argument on e-cigarette regulation had been won a few years ago. All the EU countries which regulated e-cigs like medicines, such as Denmark, legalised them as consumer products and the EU stepped back from its plans to introduce med regs in the Tobacco Products Directive. And yet here is this nanny state dinosaur banging on as if it's still 2011.
Furthermore...
Andriukaitis insisted it was better to use smoking cessation aid such as Nicorette.
That's the kind of claim that can be tested empirically, as it was in the New England Journal of Medicine recently...
A total of 886 participants underwent randomization. The 1-year abstinence rate was 18.0% in the e-cigarette group, as compared with 9.9% in the nicotine-replacement group...
It's a shame Andriukaitis doesn't keep abreast of the scientific literature. He could have asked the EU's Chief Scientific Officer about it if the position hadn't been abolished after lobbying from anti-science NGOs.
One liberal argument against Brexit is that British politicians are often even keener to trample on freedom than the control freaks in Brussels. There is some truth in that, but at least if we leave the EU there is the possibility of things getting better. There is no chance of the EU becoming more liberal and on the issue of vaping and tobacco harm reduction, it is a near certainty that an independent Britain would be freer than an EU member state.
And don't bother trying to tell me that Andriukaitis is one bad apple having a rant. He's the Health Commissioner and the problem is institutional. Let's not forget that his second-in-command comes out with gems like this:
'There are scientific reports saying that e-cigarettes are less harmful than cigarettes. But it’s still tobacco.'
After I tweeted about this earlier, this little charmer from the European Commission popped up in the timeline...
please close the door after you so that we don't get the cigarette smell— sylvain giraud (@GiraudSylvain) March 26, 2019
The UK has the second lowest smoking rate in the EU, after Sweden which managed to swerve the EU ban on snus.
Every time I start to think that staying in the EU might not be that bad, another of these grubby little bureaucrats opens his mouth. Can we leave now, please?
Farewell then, Steve Brine
Steve Brine, the public health minister, resigned on Monday night. Let's have a quick look at his achievements.
Friday, 22 March 2019
Global Nicotine Forum - book now
I'll be going to the Global Nicotine Forum in Warsaw in June. I haven't been able to go to it in the last few years, but I had a good time at the first two.
I mention this in the hope that some of you will also be going and we can keep the ratio between normal people and 'public health' types at a tolerable level.
Details here.
Also, I'll be at the London School of Economics in conversation with Yaron Brook on Monday. Come along if you can. Tickets are free.
On Wednesday, I'll be debating with Robert Lustig and Graham MacGregor at the Global Sugar Summit. Tickets are very far from free, I expect, but it will be live-streamed.
I mention this in the hope that some of you will also be going and we can keep the ratio between normal people and 'public health' types at a tolerable level.
Details here.
Also, I'll be at the London School of Economics in conversation with Yaron Brook on Monday. Come along if you can. Tickets are free.
On Wednesday, I'll be debating with Robert Lustig and Graham MacGregor at the Global Sugar Summit. Tickets are very far from free, I expect, but it will be live-streamed.
Wednesday, 20 March 2019
An exhibition of motivated reasoning with Gary Taubes
If you've got a spare 2 hours and 37 minutes and are interested in the debate about carbs/obesity, yesterday's edition of the Joe Rogan Experience should be up your street. It features a showdown between journalist Gary Taubes and neuroscientist Stephan Guyenet.
These two have fallen out in the past over Taubes' belief that carbohydrates, rather than calories and inactivity, are the cause of the obesity 'epidemic'. Towards the end of the show, I was interested to hear that Guyenet started off as a fan of Taubes and his book Good Calories, Bad Calories, but that all changed when he looked at the empirical evidence.
I haven't read Guyenet's book, The Hungry Brain, but I follow him on Twitter where he posts some interesting evidence on nutrition. I haven't read Taubes' books either, but I've read about them and I've read some of his articles. I've also read The Big Fat Surprise which repeats his key claims about carbs and calories.
I was surprised by how little evidence Taubes brought to the table during the debate. While Guyenet was nerdishly citing numbered scientific studies, Taubes told stories and anecdotes. After all these years, his line is that he has a potentially important hypothesis and scientists should look into it. When told that scientists have looked into it at great length over a long period of time using every approach available to them, Taubes dismisses all their efforts as rubbish.
While accusing scientists of having a closed mind, Taubes more or less admits that the first thing he does when confronted with a study that goes against his theory is look for a flaw in the methodology (or question the impartiality of the scientist) so he can dismiss it. Since no study is perfect and no single study can answer every question, it is always possible to find room for improvement. In Taubes' mind, the slightest element of doubt is sufficient for evidence to be discarded in its entirety.
By contrast, he doesn't think his own hypothesis requires any evidence for it to be taken as seriously as the mainstream view. The failure of scientists to come up with studies that confirm it, even at his own institute, is just that - a failure of scientists. The video is worth watching as an exhibition of motivated reasoning and confirmation bias, if nothing else.
Does Taubes have any doubts about his ideas, I wonder? Is there anything that could persuade him? I suspect that he has been writing about this for too long and has too much invested in it for him to ever admit that he got it wrong.
These two have fallen out in the past over Taubes' belief that carbohydrates, rather than calories and inactivity, are the cause of the obesity 'epidemic'. Towards the end of the show, I was interested to hear that Guyenet started off as a fan of Taubes and his book Good Calories, Bad Calories, but that all changed when he looked at the empirical evidence.
I haven't read Guyenet's book, The Hungry Brain, but I follow him on Twitter where he posts some interesting evidence on nutrition. I haven't read Taubes' books either, but I've read about them and I've read some of his articles. I've also read The Big Fat Surprise which repeats his key claims about carbs and calories.
I was surprised by how little evidence Taubes brought to the table during the debate. While Guyenet was nerdishly citing numbered scientific studies, Taubes told stories and anecdotes. After all these years, his line is that he has a potentially important hypothesis and scientists should look into it. When told that scientists have looked into it at great length over a long period of time using every approach available to them, Taubes dismisses all their efforts as rubbish.
While accusing scientists of having a closed mind, Taubes more or less admits that the first thing he does when confronted with a study that goes against his theory is look for a flaw in the methodology (or question the impartiality of the scientist) so he can dismiss it. Since no study is perfect and no single study can answer every question, it is always possible to find room for improvement. In Taubes' mind, the slightest element of doubt is sufficient for evidence to be discarded in its entirety.
By contrast, he doesn't think his own hypothesis requires any evidence for it to be taken as seriously as the mainstream view. The failure of scientists to come up with studies that confirm it, even at his own institute, is just that - a failure of scientists. The video is worth watching as an exhibition of motivated reasoning and confirmation bias, if nothing else.
Does Taubes have any doubts about his ideas, I wonder? Is there anything that could persuade him? I suspect that he has been writing about this for too long and has too much invested in it for him to ever admit that he got it wrong.
Tuesday, 19 March 2019
Defining junk food - almost nothing has changed
I've got a piece in The Times today about the ban on 'junk food' advertising. I wrote it on Sunday, shortly after the government announced a public consultation on the policy. One part of the press release particularly interested me...
The consultation was published yesterday and answered that question. I've written about it for Spectator Health today...
Read The Times article here (£) and the Spectator article here.
And if you have a view on where the government can stick its latest ban, you can respond (fairly easily) to the consultation here.
When this was finally announced at the weekend, it came with an anxious reassurance from Steve Brine, the public health minister, that “this isn’t about banning everyday staples like butter and olive oil”.
If, as this suggests, the government is going to grant ad hoc exemptions for certain products, the thinly veiled snobbery that lies behind the war on food will be laid bare. The high in fat, salt or sugar measure may be puritanical but it has the virtue of being consistent. You can’t give a pass to fatty or sugary products just because middle-class people buy them from Waitrose.
The consultation was published yesterday and answered that question. I've written about it for Spectator Health today...
The government intends to apply the advertising ban to any product that is both defined as HFSS and is included in Public Health England’s sugar and calorie reduction programme. This gets butter and olive oil off the hook because the former is only included in the salt reduction programme and olive oil is not part of the reformulation programme at all.
So many foods are included in the sugar and calorie reduction programme that the new exemption makes little difference to the advertising ban’s vast scope. It means that there is an exemption for butter, which is great news for Johnny Rotten, but Public Health England’s documents reveal that the only other HFSS foods that will benefit from the loophole are fat spreads, olive oil, baked beans, stock cubes and cheese.
The following categories will still be covered by the ban:
Breakfast cereals, yoghurts, fromage frais, sweet biscuits, savoury biscuits, cakes, pastries, croissants, pain au chocolat, puddings, ice cream, sweets, chocolate, jam, marmalade, honey, pasta products, rice products, quiche, breadsticks, noodle products, crackers, crispbreads, ‘bread with additions (eg. ciabatta with olives)’, ‘ready meals with carbohydrate accompaniment’, ‘meal centres without carbohydrate accompaniment’, ketchup, mayonnaise, pretzels, flapjack, oatcakes, ricecakes, cereal bars, bacon, kebabs, ham, pepperami, haggis, sausage rolls, pesto, fish fingers, guacamole, salsa, salad dressing, curry sauces, pasta sauces, ‘egg products’ (but not eggs), ‘potato products’ (but not potatoes), pasties, pies, sausages, milk drinks, sorbets, hummus, coleslaw, potato salad, soup, sandwiches and ‘food-to-go’. I could go on.
A few of these could be viewed as ‘junk food’ and several of them should be considered as treats, but more of them look like the kind of ‘everyday staples’ that Brine claims to be protecting. It is debatable whether many of them ‘have little nutritional value’ or needed to be shielded from children’s delicate eyes. The purported war on ‘junk food’ remains an assault on what most of us simply call ‘food’.
Read The Times article here (£) and the Spectator article here.
And if you have a view on where the government can stick its latest ban, you can respond (fairly easily) to the consultation here.
Thursday, 14 March 2019
If more gambling laws are the answer, what's the question?
From The Guardian...
That would be one in ten suicides, if true. Perhaps it is true, I don't know, but the article rightly points out that the causes of suicide are 'very likely to be multi-factoral' and that it is 'hard to isolate the role played by gambling'. According to the Office for National Statistics, there were only 21 suicides between 2001 and 2016 (ie. 1.4 per year) in which gambling was mentioned on the death certificate, but this is bound to underestimate the true number.
When Tracey Crouch MP resigned last year on the (false) premise that the government had delayed the clampdown on fixed-odds betting terminals, she claimed that two people kill themselves a day due to gambling problems. The Regulus blog tracked the source of this figure down to a 2010 study from Hong Kong...
How very scientific...
Still, it is at least interesting that the estimate from Sweden is fairly close to the Hong Kong estimate. Moreover, as the Guardian points out, it seems to be more reliable because of its large sample size and is more suitable for extrapolating to the UK because of the similarity between the two countries' problem gambling rates...
No doubt The Guardian is right to say that the study has prompted 'calls for swifter action by the government to tackle betting addiction'. It is, after all, open season on gambling since the government capitulated to Derek Webb and his boys at the Campaign for 'Fairer' Gambling. But what do these figures - if accurate - tell us about gambling regulation?
Hong Kong has a state-sanctioned monopoly on horse-racing, football and lotteries. Casinos are banned, and so is online gambling. Gambling is nevertheless extremely widespread both legally onshore and across the water in Macau as well as on the $12 billion illegal market. As in China, where nearly all gambling is illegal, rates of problem gambling are high in Hong Kong. When the 2010 study mentioned above was written, problem gambling prevalence was around two per cent.
Sweden also has a state monopoly for gambling and fairly tight regulation, but not as tight as Hong Kong. There are only four casinos in the whole country and you have to be at least 20 years olds to get in them. Unlike Britain, there have never been any fixed-odds betting terminals. Unlike Hong Kong, it legalised online gambling years ago. According to The Guardian, it has a problem gambling rate of around 0.5 per cent and - if the studies are to be believed - a similar rate of gambling-related suicide as Hong Kong.
Britain has a relatively liberal gambling market. It has no state monopolies on gambling, unless you include the lottery. Casinos are legal and, though limited in number, accessible to most people. Bookmakers and FOBTs are accessible to all (until next month). Online gambling has always been legal and is widely advertised. It is one of a small number of countries to have gambling products that children are allowed to play. As The Guardian says, it has 'a similar prevalence of problem gambling' to Sweden and a much lower prevalence than Hong Kong.
What, exactly, are we supposed to learn from these real world case studies about the optimal level of gambling regulation? Sweden and Hong Kong regulate gambling quite strictly and have similar gambling-suicide rates despite having very different problem gambling rates. Britain regulates gambling in a comparatively laissez-faire manner and yet has a much lower rate of problem gambling than Hong Kong and the same rate of problem gambling than Sweden. Moreover, the rate of problem gambling has not risen in the last fifteen years despite significant liberalisation and the emergence of new gambling products, including FOBTs and online.
And yet we need 'swifter action by the government to tackle betting addiction'?
So let me get this straight. Britain should clamp down on gambling because if we extrapolate the gambling-suicide rate from Sweden, a country that regulates gambling more harshly than Britain, we get a figure that is nearly as high as if we extrapolate it from Hong Kong, a country that regulates gambling even more harshly?
Huh?
And - plot twist! - Sweden doesn't actually have a problem gambling rate of 0.5 per cent. Academic studies and official government surveys suggest that the real figure is much higher than that of Britain at around two per cent.
Maybe these countries should be learning from Britain?
People with a gambling problem are 15 times more likely to take their own life, according to the largest study of its kind, prompting calls for swifter action by the government to tackle betting addiction.
... Campaigners said that if the same results were applied to the UK, the Swedish study would indicate around 550 suicides a year in which gambling played a part, or more than 10 per week.
That would be one in ten suicides, if true. Perhaps it is true, I don't know, but the article rightly points out that the causes of suicide are 'very likely to be multi-factoral' and that it is 'hard to isolate the role played by gambling'. According to the Office for National Statistics, there were only 21 suicides between 2001 and 2016 (ie. 1.4 per year) in which gambling was mentioned on the death certificate, but this is bound to underestimate the true number.
When Tracey Crouch MP resigned last year on the (false) premise that the government had delayed the clampdown on fixed-odds betting terminals, she claimed that two people kill themselves a day due to gambling problems. The Regulus blog tracked the source of this figure down to a 2010 study from Hong Kong...
The research project examined 150 cases of suicide in Hong Kong and found that 17 of the victims (or 11.3%) were “probable pathological gamblers”. Applying this rate to suicides in Great Britain provides a figure of 674 deaths.
How very scientific...
Still, it is at least interesting that the estimate from Sweden is fairly close to the Hong Kong estimate. Moreover, as the Guardian points out, it seems to be more reliable because of its large sample size and is more suitable for extrapolating to the UK because of the similarity between the two countries' problem gambling rates...
But the study in Sweden is much larger than that of the Hong Kong research, took place over a longer period and monitored people who took their own lives as well as those who did not.
It is also based on a country with a similar prevalence of problem gambling to the UK at around 0.5% on the often-cited problem gambling severity index measurement, rising to around 1.6% when including people at moderate risk.
No doubt The Guardian is right to say that the study has prompted 'calls for swifter action by the government to tackle betting addiction'. It is, after all, open season on gambling since the government capitulated to Derek Webb and his boys at the Campaign for 'Fairer' Gambling. But what do these figures - if accurate - tell us about gambling regulation?
Hong Kong has a state-sanctioned monopoly on horse-racing, football and lotteries. Casinos are banned, and so is online gambling. Gambling is nevertheless extremely widespread both legally onshore and across the water in Macau as well as on the $12 billion illegal market. As in China, where nearly all gambling is illegal, rates of problem gambling are high in Hong Kong. When the 2010 study mentioned above was written, problem gambling prevalence was around two per cent.
Sweden also has a state monopoly for gambling and fairly tight regulation, but not as tight as Hong Kong. There are only four casinos in the whole country and you have to be at least 20 years olds to get in them. Unlike Britain, there have never been any fixed-odds betting terminals. Unlike Hong Kong, it legalised online gambling years ago. According to The Guardian, it has a problem gambling rate of around 0.5 per cent and - if the studies are to be believed - a similar rate of gambling-related suicide as Hong Kong.
Britain has a relatively liberal gambling market. It has no state monopolies on gambling, unless you include the lottery. Casinos are legal and, though limited in number, accessible to most people. Bookmakers and FOBTs are accessible to all (until next month). Online gambling has always been legal and is widely advertised. It is one of a small number of countries to have gambling products that children are allowed to play. As The Guardian says, it has 'a similar prevalence of problem gambling' to Sweden and a much lower prevalence than Hong Kong.
What, exactly, are we supposed to learn from these real world case studies about the optimal level of gambling regulation? Sweden and Hong Kong regulate gambling quite strictly and have similar gambling-suicide rates despite having very different problem gambling rates. Britain regulates gambling in a comparatively laissez-faire manner and yet has a much lower rate of problem gambling than Hong Kong and the same rate of problem gambling than Sweden. Moreover, the rate of problem gambling has not risen in the last fifteen years despite significant liberalisation and the emergence of new gambling products, including FOBTs and online.
And yet we need 'swifter action by the government to tackle betting addiction'?
So let me get this straight. Britain should clamp down on gambling because if we extrapolate the gambling-suicide rate from Sweden, a country that regulates gambling more harshly than Britain, we get a figure that is nearly as high as if we extrapolate it from Hong Kong, a country that regulates gambling even more harshly?
Huh?
And - plot twist! - Sweden doesn't actually have a problem gambling rate of 0.5 per cent. Academic studies and official government surveys suggest that the real figure is much higher than that of Britain at around two per cent.
Maybe these countries should be learning from Britain?
Wednesday, 13 March 2019
Mark Petticrew doubles down
Mark Petticrew has been going through the Twitter feed of Drinkaware, presumably because it beats working for a living and because 'public health' is such a shoddy enterprise that it will let him get another peer-reviewed study out of it. In 2017, Petticrew and his colleagues cherry-picked statements by various industry-funded educational organisations to claim that they downplayed, disputed and misrepresented the risks of drinking.
Amongst many other untruths, Petticrew accused Drinkaware of ignoring the link between drinking and breast cancer despite them having a whole webpage dedicated to the subject which downplays nothing and which his article ignored. His hatchet job was criticised for making 'a number of incorrect assertions' by the Portman Group and for being 'wholly unjustified and unprofessional' by Drinkaware's scientific advisors in a slew of responses published in Drug and Alcohol Review.
The latter concluded...
Fat chance. In the meantime, the neo-temperance lobby's grudge against Drinkaware has become more intense due to its partnership with Public Health England, and Petticrew is now back for more in the International Journal of Environmental Research and Public Health.
He wastes no time in repeated his previous slurs...
The reference cited to support this pack of lies is his own pisspoor study, of course. In his new study, Petticrew doubles down by making similar claims based around the Twitter feeds of three industry-backed alcohol information organisations.
The trick employed here is to compare Drinkaware, Drinkwise and Drinkaware Ireland to three hardline, anti-alcohol campaign groups whose mission is totally different: Alcohol Concern, Alcohol Action Ireland, and the Foundation for Alcohol Research and Education (FARE). Petticrew's conceit is to use the neo-temperance lobby as a control group, implicitly portraying them as neutral organisations that are only interested in giving the public an accurate impression of the impact of alcohol consumption on health.
After looking at every tweet sent by these six organisations in 2016, he and his minions conclude:
That's because they are not lobby groups.
Petticrew et al. count 23 Drinkaware tweets which warned of these 'physical harms' (excluding cancer) (2.8% of the total) whereas the now-defunct Alcohol Concern had 29 (4%). Not much of a difference, really, and they overlook the 101 tweets Drinkaware sent about 'drinking too much' - many of which would have been related to physical harms - compared to just 13 from Alcohol Concern (1.8%).
Alcohol Concern tweeted more about cancer (54 times) than did Drinkaware (27 times), but that is largely because Alcohol Concern liked being able to scare women with the claim that there is no safe level of drinking (for breast cancer) and were obsessed with treating alcohol like cigarettes, for which the cancer link was seen as a useful tool.
So what? These are perfectly valid things for an educational charity to be tweeting about. While the temperance groups are banging on about advertising and minimum pricing, the alcohol awareness groups are giving people practical information and advice on a range of issues. That is what they're supposed to be doing. If there is a problem here, it does not lie with Drinkaware.
That's an easy thing to check, so let's have a look at the year in question, shall we?
So that's a lie, then. In fact, Petticrew's own data show that Drinkaware tweeted about alcohol and pregnancy more times than Alcohol Concern did.
No. There is a difference between the missions of 'AI-funded bodies' and the missions of anti-alcohol groups. The former are there to educate people and give accurate, practical advice. The latter are there to create hysteria and lobby for illiberal legislation, rather like Mark Petticrew.
There's nothing else to say about this pitiful study so I will leave you with a quote from it which highlights the state 'public health' academia is in today.
Move over John Snow and Louis Pasteur.
Amongst many other untruths, Petticrew accused Drinkaware of ignoring the link between drinking and breast cancer despite them having a whole webpage dedicated to the subject which downplays nothing and which his article ignored. His hatchet job was criticised for making 'a number of incorrect assertions' by the Portman Group and for being 'wholly unjustified and unprofessional' by Drinkaware's scientific advisors in a slew of responses published in Drug and Alcohol Review.
The latter concluded...
It is vital that Drinkaware’s important public health function is not compromised by unjustified allegations of inaccuracy and by entirely unwarranted attacks on its independence and integrity. We therefore expect Petticrew et al. to address the inaccuracies in their paper, which we have highlighted in this commentary.
Fat chance. In the meantime, the neo-temperance lobby's grudge against Drinkaware has become more intense due to its partnership with Public Health England, and Petticrew is now back for more in the International Journal of Environmental Research and Public Health.
He wastes no time in repeated his previous slurs...
Drinkaware and other SAPROs ['an acronym Petticrew has made up, standing for 'social aspects/public relations organisations' - CJS] were recently found to be misleading the public on alcohol and cancer risk, including presenting misleading information about the independent effects of alcohol consumption on cancer risk, using similar framings to those developed by the tobacco industry to obscure the evidence on smoking and lung cancer, in some cases not mentioning cancer in general, and breast cancer specifically [19].
The reference cited to support this pack of lies is his own pisspoor study, of course. In his new study, Petticrew doubles down by making similar claims based around the Twitter feeds of three industry-backed alcohol information organisations.
We developed a series of hypotheses a priori based on previous evidence of AI [alcohol industry] strategies and campaigns. If AI-funded bodies are independent of the alcohol industry (as is argued by Drinkaware, see for example [40]), then no clear pattern should be observed, and their tweets should not reflect alcohol industry positions. On the other hand if, as has been noted previously [41], these bodies exist primarily to reflect and defend industry positions, then their Twitter activity should reflect industry arguments, concerns and topics, and should be significantly different from those of non-industry affiliated charities.
The trick employed here is to compare Drinkaware, Drinkwise and Drinkaware Ireland to three hardline, anti-alcohol campaign groups whose mission is totally different: Alcohol Concern, Alcohol Action Ireland, and the Foundation for Alcohol Research and Education (FARE). Petticrew's conceit is to use the neo-temperance lobby as a control group, implicitly portraying them as neutral organisations that are only interested in giving the public an accurate impression of the impact of alcohol consumption on health.
After looking at every tweet sent by these six organisations in 2016, he and his minions conclude:
AI-funded bodies were significantly less likely to tweet about alcohol marketing, advertising and sponsorship; issues related to alcohol pricing, including MUP...
That's because they are not lobby groups.
...physical health harms, including cancers, heart disease, dementia and diabetes; and fertility and pregnancy
Petticrew et al. count 23 Drinkaware tweets which warned of these 'physical harms' (excluding cancer) (2.8% of the total) whereas the now-defunct Alcohol Concern had 29 (4%). Not much of a difference, really, and they overlook the 101 tweets Drinkaware sent about 'drinking too much' - many of which would have been related to physical harms - compared to just 13 from Alcohol Concern (1.8%).
Alcohol Concern tweeted more about cancer (54 times) than did Drinkaware (27 times), but that is largely because Alcohol Concern liked being able to scare women with the claim that there is no safe level of drinking (for breast cancer) and were obsessed with treating alcohol like cigarettes, for which the cancer link was seen as a useful tool.
Alcohol industry-funded bodies were significantly more likely to tweet about drinking too much, cutting down, children and underage drinking, teens/parents, staying safe while drinking, alcohol units and guidelines, calories/obesity, and alcohol-free or low alcohol drinks. They are also more likely to tweet about drink driving.
So what? These are perfectly valid things for an educational charity to be tweeting about. While the temperance groups are banging on about advertising and minimum pricing, the alcohol awareness groups are giving people practical information and advice on a range of issues. That is what they're supposed to be doing. If there is a problem here, it does not lie with Drinkaware.
AI-funded bodies do not appear to use Twitter to raise awareness about pregnancy and fertility.
That's an easy thing to check, so let's have a look at the year in question, shall we?
Alcohol & your baby: Info & advice for women who are pregnant or breastfeeding https://t.co/1ZviK6O2N0 #infographic pic.twitter.com/5GiLF5Fb7y— drinkaware (@Drinkaware) February 3, 2016
Official #alcoholguidelines are now that pregnant women should not drink any alcohol at all: https://t.co/pIKETfnjDc— drinkaware (@Drinkaware) January 8, 2016
So that's a lie, then. In fact, Petticrew's own data show that Drinkaware tweeted about alcohol and pregnancy more times than Alcohol Concern did.
Overall, these suggest that there is a difference between the stated visions, values and missions of the AI-funded bodies, and their actual activities.
No. There is a difference between the missions of 'AI-funded bodies' and the missions of anti-alcohol groups. The former are there to educate people and give accurate, practical advice. The latter are there to create hysteria and lobby for illiberal legislation, rather like Mark Petticrew.
There's nothing else to say about this pitiful study so I will leave you with a quote from it which highlights the state 'public health' academia is in today.
[Social media] has also been identified as a potentially rich data source for health research, with a recent systematic review identifying 137 research articles using Twitter, 108 of which involved the analysis of tweets, primarily in the form of content analysis.
Move over John Snow and Louis Pasteur.
Tuesday, 12 March 2019
The nanny state blob
Taxpayer funding of ‘nanny state’ groups has not declined in recent years but it has evolved. In the debate about food, tobacco and alcohol, there are relatively few dedicated activist groups directly funded by central government. Alcohol Concern has lost its state funding and has now merged with Alcohol Research UK to become Alcohol Change UK. Its counter-part in tobacco control, the English branch of Action on Smoking and Health (ASH), has been funded by the Department of Health since its inception in 1971 and received a DH grant of £159,999 in 2016/17. ASH insists that this money is not used for advocacy or lobbying but is used to ‘support the Tobacco Control Plan for England’. It is not clear what this means in practice and its grant applications in the past have explicitly listed ‘media advocacy and lobbying’ as a deliverable. Like Alcohol Concern, ASH has never provided health, cessation or rehabilitation services.
The records appear to reveal no other pressure group focused solely on food, tobacco or alcohol that receives funding from Whitehall, although there are several state-funded organisations with a broader ‘public health’ remit which lobby for lifestyle regulation. The UK Health Forum received £216,306 from the Department of Health in 2016/17 in addition to £680,000 from Public Health England and an unrestricted grant of £371,660 from the European Commission. Of a total budget of £1,597,619, state funding amounted to £1,470,626 (92 per cent). It lobbied for a familiar assortment of paternalistic anti-market interventions in lifestyle choices - tax rises, bans, advertising restrictions, minimum pricing, mandatory food reformulation, etc. - before closing down after government funding was withdrawn last year.
Public Health England
Public Health England (PHE) is the new critical dynamic in the politics of the nanny state. Created in 2013, PHE has changed the face of state-funded activism in the field of lifestyle regulation in two ways. Firstly, it has a colossal budget of £4.5 billion, most of which is distributed to local authorities where dozens of Directors of Public Health lobby councillors for policies which restrict personal freedom and disrupt the market, such as outdoor smoking bans and tighter licensing restrictions for bars and off licences. As a semi-autonomous quango with a large pot of money, Public Health England can also grant funds to third parties without ministerial sign-off. For example, when the CEOs of several ‘public health’ organisations decided that they needed to create another umbrella group for their profession, Public Health England handed them £57,200 to create the UK Public Health Network. It has recently started funding ASH, with grants totalling £108,000 in the last quarter of 2018.
Secondly, PHE is itself effectively a pressure group. Through its publications and public pronouncements it has lobbied for such policies as minimum pricing for alcohol, outdoor smoking bans, plain packaging and bans on ‘junk food’ advertising. Every other ‘sock puppet’ group is a minnow by comparison. Public Health England has not made the smaller groups obsolete - the ‘swarm effect’ requires different voices to demand the same policies - but it is now the mothership around which the activist groups orbit. It is also the citadel to which several activists have departed. Martin Dockrell, formerly of ASH, is now the Tobacco Control Programme Lead at PHE, and various prominent anti-alcohol campaigners, including Ian Gilmore of the Alcohol Health Alliance, have been appointed to PHE’s Alcohol Leadership Board.
Public Health England is a more overtly political entity than the public health organisations, such as the Health Education Council, which preceded it. A similar drift towards activism can be seen in other state-funded ‘public health’ groups, up to and including the World Health Organisation. Even organisations that were not set up to preach lifestyle change have got involved, including the Local Government Association, the Food Standards Agency and Food Standards Scotland. Some of the activities of the latter, which received £15.8 million from the Scottish Government in 2017/18, are indistinguishable from those of Obesity Action Scotland as it campaigns for smaller food portions and congratulates the government on its obesity strategy. In 2018, one of its advisors even suggested that the government should put graphic warnings on red meat.
Activist-academics
Other sources of taxpayers’ money are available to activist-academics in the nanny state blob via the National Institute of Health Research (NIHR) and the Economic and Social Research Council (ESRC). Although higher educational institutes are exempt from the anti-sockpuppet rules, the gap between research and advocacy can be narrow to the point of invisibility. The UK Centre for Tobacco and Alcohol Studies (UKCTAS), which has academics from fourteen British universities, says that it is not a ‘lobbying group, but we do have close links with advocacy organisations and will assist them where appropriate.’
Between 2013 and 2017 it attracted £45 million in grant income from public and private sources, including the Scottish Government, Public Health England, the Medical Research Council, NICE, the NHS, the Medicines and Healthcare products Regulatory Agency, the European Commission, NIHR, ESRC, the Department of Health and the EU’s Smoke Free Partnership.
As a result of UKCTAS’s ‘meaningful and sustained collaborative relationships with advocacy organisations’, it is able to list the following political victories:
Similar advocacy-oriented academic organisations have emerged in recent years, including the Tobacco Control Research Group, whose funders include NIHR, ESCR, the NHS, the European Council and the Department of Health. In 2017, the ESCR - which is funded to the tune of £212 million by the Department for Business, Energy and Industrial Strategy - announced the creation of the UK Prevention Research Partnership, a £50 million project aimed at developing ‘robust new knowledge which contributes to demonstrable changes in policy and practice’ by ‘working closely with policy makers’. The same year saw the Department of Health announce that it would be setting up a new Obesity Policy Research Unit with £5 million of taxpayers’ money.
The Obesity Policy Research Unit will be run by Russell Viner, the president of the Royal College of Paediatrics and Child Health, who has been a regular fixture in the newspapers for years making emotive calls for sugar taxes, advertising bans and restrictions on fast food outlets. He accuses fast food chains of ‘enticing young people and their pocket money' and claims that only by banning advertisements for food that is high in fat, salt or sugar ‘can children reclaim their childhood’. It seems unlikely that the £5 million unit will produce any research that challenges these prior beliefs.
Clearly there is no shortage of money available to activist-academics who wish to tax and ban in the name of ‘public health’, but what is most striking is the extent of their activism and the narrowness of the clique to which they belong. Anna Gilmore, for example, was a board member of Action on Smoking and Health before joining UKCTAS and becoming the director of the Tobacco Control Research Group. She also sat on the Steering Committee and Programme Board of Smokefree Southwest until it closed in 2016. During this period, Smokefree Southwest granted £135,000 to Gilmore’s Tobacco Control Research Group and NHS Southwest gave the Tobacco Control Research Group £165,284 for ‘research and evaluation support’ for Smokefree Southwest.
Linda Bauld is the Deputy Director of UKCTAS and is on Public Health England’s tobacco control implementation board. She has also ‘been closely involved in the development of the UKPRP and is a member of the steering group for this new initiative’. Meanwhile, ASH Scotland’s CEO Sheila Duffy is on the Scottish Government's Ministerial Working Group on Tobacco Control and, more surprisingly for an anti-smoking campaigner, also on the steering committee of Obesity Action Scotland.
The EU and local government
Direct sock puppet funding continues to flourish in local authorities and devolved governments, and is endemic at the EU level. EU-funded organisations lobbying for lifestyle regulation include the European Network for Smoking and Tobacco Prevention (€314,039: 52 per cent of income), the Smoke Free Partnership (€400,749: 60 per cent of income), the TackSHS Project (€620,050: 100 per cent of income), EuroHealthNet (€901,000: 80 per cent of income), the World Obesity Federation (€444,672: 33 per cent of income), the European Public Health Alliance (€623,368: 80 per cent of income), Active – Sobriety, Friendship and Peace (€145,188: 63 per cent) and the European Public Health Association (€53,571: 19 per cent). Several likeminded pressure groups, such as the International Order of Good Templars and the Norwegian Policy Network on Alcohol and Drugs, are not EU-funded but are active in EU policy debates thanks to large grants from national governments.
In the regions, a variety of anti-smoking groups funded by local authorities come and go. In the northeast, Fresh continues to be funded through local public health grants, but similar organisations in the northwest and southwest have been wound down since the campaign for plain packaging was won. Smokefree Southwest broadened its remit in 2015 by changing its name to Public Health Action but lost its funding in June 2016 and is now little more than a Twitter account. Smokefree Northwest attempted a similar transformation by becoming Healthier Futures in 2016 but ceased trading in March 2017. Various local ‘Tobacco Control Alliances’ exist in such places as Rotherham, Camden and Durham but are now mainly focused on helping smokers to quit with cessation services and e-cigarettes rather than campaigning for legislative change. A new project called History Makers in Greater Manchester, funded by northwest local authorities, has expressed interest in such policies as banning smoking outdoors, licensing tobacco retailers and banning smoking on TV, but has not yet begun active campaigning.
The lack of overt political activity by these groups since plain packaging was introduced in 2016 probably reflects a dearth of new policies to lobby for and the government’s stated intention not to pass further anti-smoking legislation in this Parliament. The same cannot be said for Balance Northeast, an anti-alcohol group which shares an office with Fresh and, like Fresh, is 100 per cent funded by twelve local authorities. It has been campaigning for minimum unit pricing, warning labels on alcoholic drinks and advertising restrictions for nearly a decade. Its campaign for higher taxes is always more intense before the Budget.
Local authorities also fund pressure groups involved in food and soft drink regulation. Sustain for Life received £45,000 from the Greater London Authority and Royal Borough of Greenwich in 2016/17 in addition to lottery funding of £85,068 and £146,647 from the European Commission. This organisation funds the Children’s Food Campaign and runs SugarSmart, both of which were heavily involved in the campaign for the sugar tax and now lobby for a ban on ‘junk food marketing’. Sustain also set up and funded the Children’s Health Fund (with the help of Jamie Oliver) in 2015 to lobby for the sugar tax but this group was wound down once the tax was introduced in April 2018, with the group announcing that it was ‘passing the baton on to Government’.
The Birmingham Food Council, created in 2014 and funded by grants from Birmingham City Council, claims that sugar and high-fructose corn syrup are ‘psychoactive substances’ and that even sparkling water causes ‘dental decay and contributes to other health problems’. These dubious scientific claims accompanied a briefing paper urging Birmingham City Council to reject partnerships with Coca-Cola and to ‘avoid future commercial relationships with food and drinks companies whose products carry standard rate VAT’. This came in the wake of Coca-Cola giving £20 million to three local authorities to fund free activities in public parks, such as karate, Zumba and yoga. The Birmingham Food Council describes Coca-Cola as a ‘“food drug” corporation’ and calls for the sugar tax to be extended to all fizzy drinks even if they do not contain sugar. Its pronouncements on social media include ‘Shame we can’t ban sugar in public places’.
Scotland and Wales
The Scottish Government continues to be the primary funder of Alcohol Focus Scotland, with an unrestricted grant of £472,000 in 2017/18. Scottish Health Action on Alcohol Problems which, like Alcohol Focus Scotland, campaigns to limit the marketing, availability and affordability of alcohol, depended on government funding for 100 per cent of its €200,000 budget in 2015/16, according to the EU Transparency Register. Both organisations lobbied heavily for one of the Scottish National Party’s flagship policies - minimum unit pricing for alcohol - which was introduced in May 2018. When Alcohol Focus Scotland co-hosted the Global Alcohol Policy Conference in Edinburgh in 2015 - an event sponsored by the Scottish Government and NHS Scotland - SNP leader Nicola Sturgeon gave the opening speech and the organisers paid tribute to her ‘political courage’.
A similar arrangement developed in the Republic of Ireland where Alcohol Action Ireland, which relied on the state for 97.5 per cent of its income in 2015, not only lobbied for minimum pricing but set up another group, the Alcohol Health Alliance, specifically ‘to support the Public Health (Alcohol) Bill’ of which minimum pricing was the cornerstone. In addition to writing submissions to government as ‘an independent voice for advocacy and policy change’ and promoting the legislation in the media, Alcohol Action Ireland set up a webpage which enabled its supporters to lobby their parliamentary representative with a standardised e-mail (‘I urge you to please support the implementation of the Public Health (Alcohol) Bill, in full’ etc.). In 2016, Ireland’s Department of Health gave Alcohol Action Ireland an additional €75,000 ‘to engage with the EU to build support for the Public Health (Alcohol) Bill’ (Tighe 2016). The law was passed in October 2018.
State-funded lobbying does not get much more blatant than this, although the similarly named Obesity Action Scotland comes close. Founded in 2015 and wholly funded by a grant from the Scottish Government, it campaigns for a 9pm watershed on advertising for food that is high in fat, salt or sugar (HFSS), bans on price promotions such as buy-one-get-one-free and ‘regulations to control portion size’. It says that all this - plus food reformulation and the sugar tax - ‘will only be the start’ of restrictions on the free market in the name of obesity prevention. All of these policies were included in a consultation document put forward by the Scottish Government in October 2017. Obesity Action Scotland publicly welcomed the proposals and drafted an encouraging consultation response (its only complaint was that some of the measures did not go far enough). In July 2018, Scotland’s Diet and Healthy Weight Delivery Plan was published with all of Obesity Action Scotland’s demands met.
This kind of activity is relatively new in the area of food, but has long been practised in the field of tobacco. Today, both the Scottish and Welsh governments fund their branches of Action on Smoking and Health (ASH) more heavily than Whitehall funds the English branch. ASH Scotland received £604,798 directly from the Scottish Government in 2016/17 (77 per cent of its total income) while receiving just £3,126 in voluntary donations. ASH Wales received £207,872 from the Welsh Government in 2016/17 in addition to £136,247 from the EU’s Erasmus+ project. In total, ASH Wales depended on government grants for 69 per cent of its income, with just £3,570 coming from individual donations and legacies.
Taken from Still Hand in Glove? A re-examination of state-funded activism.
The records appear to reveal no other pressure group focused solely on food, tobacco or alcohol that receives funding from Whitehall, although there are several state-funded organisations with a broader ‘public health’ remit which lobby for lifestyle regulation. The UK Health Forum received £216,306 from the Department of Health in 2016/17 in addition to £680,000 from Public Health England and an unrestricted grant of £371,660 from the European Commission. Of a total budget of £1,597,619, state funding amounted to £1,470,626 (92 per cent). It lobbied for a familiar assortment of paternalistic anti-market interventions in lifestyle choices - tax rises, bans, advertising restrictions, minimum pricing, mandatory food reformulation, etc. - before closing down after government funding was withdrawn last year.
Public Health England
Public Health England (PHE) is the new critical dynamic in the politics of the nanny state. Created in 2013, PHE has changed the face of state-funded activism in the field of lifestyle regulation in two ways. Firstly, it has a colossal budget of £4.5 billion, most of which is distributed to local authorities where dozens of Directors of Public Health lobby councillors for policies which restrict personal freedom and disrupt the market, such as outdoor smoking bans and tighter licensing restrictions for bars and off licences. As a semi-autonomous quango with a large pot of money, Public Health England can also grant funds to third parties without ministerial sign-off. For example, when the CEOs of several ‘public health’ organisations decided that they needed to create another umbrella group for their profession, Public Health England handed them £57,200 to create the UK Public Health Network. It has recently started funding ASH, with grants totalling £108,000 in the last quarter of 2018.
Secondly, PHE is itself effectively a pressure group. Through its publications and public pronouncements it has lobbied for such policies as minimum pricing for alcohol, outdoor smoking bans, plain packaging and bans on ‘junk food’ advertising. Every other ‘sock puppet’ group is a minnow by comparison. Public Health England has not made the smaller groups obsolete - the ‘swarm effect’ requires different voices to demand the same policies - but it is now the mothership around which the activist groups orbit. It is also the citadel to which several activists have departed. Martin Dockrell, formerly of ASH, is now the Tobacco Control Programme Lead at PHE, and various prominent anti-alcohol campaigners, including Ian Gilmore of the Alcohol Health Alliance, have been appointed to PHE’s Alcohol Leadership Board.
Public Health England is a more overtly political entity than the public health organisations, such as the Health Education Council, which preceded it. A similar drift towards activism can be seen in other state-funded ‘public health’ groups, up to and including the World Health Organisation. Even organisations that were not set up to preach lifestyle change have got involved, including the Local Government Association, the Food Standards Agency and Food Standards Scotland. Some of the activities of the latter, which received £15.8 million from the Scottish Government in 2017/18, are indistinguishable from those of Obesity Action Scotland as it campaigns for smaller food portions and congratulates the government on its obesity strategy. In 2018, one of its advisors even suggested that the government should put graphic warnings on red meat.
Activist-academics
Other sources of taxpayers’ money are available to activist-academics in the nanny state blob via the National Institute of Health Research (NIHR) and the Economic and Social Research Council (ESRC). Although higher educational institutes are exempt from the anti-sockpuppet rules, the gap between research and advocacy can be narrow to the point of invisibility. The UK Centre for Tobacco and Alcohol Studies (UKCTAS), which has academics from fourteen British universities, says that it is not a ‘lobbying group, but we do have close links with advocacy organisations and will assist them where appropriate.’
Between 2013 and 2017 it attracted £45 million in grant income from public and private sources, including the Scottish Government, Public Health England, the Medical Research Council, NICE, the NHS, the Medicines and Healthcare products Regulatory Agency, the European Commission, NIHR, ESRC, the Department of Health and the EU’s Smoke Free Partnership.
As a result of UKCTAS’s ‘meaningful and sustained collaborative relationships with advocacy organisations’, it is able to list the following political victories:
‘We performed new analyses for the Scottish Government on the comparative effectiveness of Minimum Unit Pricing and alcohol taxation, and this work formed a key part of their successful defence of Minimum Unit Pricing in the Scottish courts'
'Academics from UKCTAS worked with Scottish groups including Alcohol Focus Scotland and Scottish Health Action on Alcohol Problems to advocate for a reduction in the ‘drink-drive limit’ in Scotland'
'Legislation prohibiting smoking in cars carrying children in England and Wales came into force in October 2015. UKCTAS played a leading role in bringing this legislation into place'
'Legislation to introduce standardised packaging for tobacco was passed in the UK parliament in the spring of 2015 and will be fully implemented from May 2017. This covers all parts of the UK. UKCTAS research played a key role in this decision.’
Similar advocacy-oriented academic organisations have emerged in recent years, including the Tobacco Control Research Group, whose funders include NIHR, ESCR, the NHS, the European Council and the Department of Health. In 2017, the ESCR - which is funded to the tune of £212 million by the Department for Business, Energy and Industrial Strategy - announced the creation of the UK Prevention Research Partnership, a £50 million project aimed at developing ‘robust new knowledge which contributes to demonstrable changes in policy and practice’ by ‘working closely with policy makers’. The same year saw the Department of Health announce that it would be setting up a new Obesity Policy Research Unit with £5 million of taxpayers’ money.
The Obesity Policy Research Unit will be run by Russell Viner, the president of the Royal College of Paediatrics and Child Health, who has been a regular fixture in the newspapers for years making emotive calls for sugar taxes, advertising bans and restrictions on fast food outlets. He accuses fast food chains of ‘enticing young people and their pocket money' and claims that only by banning advertisements for food that is high in fat, salt or sugar ‘can children reclaim their childhood’. It seems unlikely that the £5 million unit will produce any research that challenges these prior beliefs.
Clearly there is no shortage of money available to activist-academics who wish to tax and ban in the name of ‘public health’, but what is most striking is the extent of their activism and the narrowness of the clique to which they belong. Anna Gilmore, for example, was a board member of Action on Smoking and Health before joining UKCTAS and becoming the director of the Tobacco Control Research Group. She also sat on the Steering Committee and Programme Board of Smokefree Southwest until it closed in 2016. During this period, Smokefree Southwest granted £135,000 to Gilmore’s Tobacco Control Research Group and NHS Southwest gave the Tobacco Control Research Group £165,284 for ‘research and evaluation support’ for Smokefree Southwest.
Linda Bauld is the Deputy Director of UKCTAS and is on Public Health England’s tobacco control implementation board. She has also ‘been closely involved in the development of the UKPRP and is a member of the steering group for this new initiative’. Meanwhile, ASH Scotland’s CEO Sheila Duffy is on the Scottish Government's Ministerial Working Group on Tobacco Control and, more surprisingly for an anti-smoking campaigner, also on the steering committee of Obesity Action Scotland.
The EU and local government
Direct sock puppet funding continues to flourish in local authorities and devolved governments, and is endemic at the EU level. EU-funded organisations lobbying for lifestyle regulation include the European Network for Smoking and Tobacco Prevention (€314,039: 52 per cent of income), the Smoke Free Partnership (€400,749: 60 per cent of income), the TackSHS Project (€620,050: 100 per cent of income), EuroHealthNet (€901,000: 80 per cent of income), the World Obesity Federation (€444,672: 33 per cent of income), the European Public Health Alliance (€623,368: 80 per cent of income), Active – Sobriety, Friendship and Peace (€145,188: 63 per cent) and the European Public Health Association (€53,571: 19 per cent). Several likeminded pressure groups, such as the International Order of Good Templars and the Norwegian Policy Network on Alcohol and Drugs, are not EU-funded but are active in EU policy debates thanks to large grants from national governments.
In the regions, a variety of anti-smoking groups funded by local authorities come and go. In the northeast, Fresh continues to be funded through local public health grants, but similar organisations in the northwest and southwest have been wound down since the campaign for plain packaging was won. Smokefree Southwest broadened its remit in 2015 by changing its name to Public Health Action but lost its funding in June 2016 and is now little more than a Twitter account. Smokefree Northwest attempted a similar transformation by becoming Healthier Futures in 2016 but ceased trading in March 2017. Various local ‘Tobacco Control Alliances’ exist in such places as Rotherham, Camden and Durham but are now mainly focused on helping smokers to quit with cessation services and e-cigarettes rather than campaigning for legislative change. A new project called History Makers in Greater Manchester, funded by northwest local authorities, has expressed interest in such policies as banning smoking outdoors, licensing tobacco retailers and banning smoking on TV, but has not yet begun active campaigning.
The lack of overt political activity by these groups since plain packaging was introduced in 2016 probably reflects a dearth of new policies to lobby for and the government’s stated intention not to pass further anti-smoking legislation in this Parliament. The same cannot be said for Balance Northeast, an anti-alcohol group which shares an office with Fresh and, like Fresh, is 100 per cent funded by twelve local authorities. It has been campaigning for minimum unit pricing, warning labels on alcoholic drinks and advertising restrictions for nearly a decade. Its campaign for higher taxes is always more intense before the Budget.
Local authorities also fund pressure groups involved in food and soft drink regulation. Sustain for Life received £45,000 from the Greater London Authority and Royal Borough of Greenwich in 2016/17 in addition to lottery funding of £85,068 and £146,647 from the European Commission. This organisation funds the Children’s Food Campaign and runs SugarSmart, both of which were heavily involved in the campaign for the sugar tax and now lobby for a ban on ‘junk food marketing’. Sustain also set up and funded the Children’s Health Fund (with the help of Jamie Oliver) in 2015 to lobby for the sugar tax but this group was wound down once the tax was introduced in April 2018, with the group announcing that it was ‘passing the baton on to Government’.
The Birmingham Food Council, created in 2014 and funded by grants from Birmingham City Council, claims that sugar and high-fructose corn syrup are ‘psychoactive substances’ and that even sparkling water causes ‘dental decay and contributes to other health problems’. These dubious scientific claims accompanied a briefing paper urging Birmingham City Council to reject partnerships with Coca-Cola and to ‘avoid future commercial relationships with food and drinks companies whose products carry standard rate VAT’. This came in the wake of Coca-Cola giving £20 million to three local authorities to fund free activities in public parks, such as karate, Zumba and yoga. The Birmingham Food Council describes Coca-Cola as a ‘“food drug” corporation’ and calls for the sugar tax to be extended to all fizzy drinks even if they do not contain sugar. Its pronouncements on social media include ‘Shame we can’t ban sugar in public places’.
Scotland and Wales
The Scottish Government continues to be the primary funder of Alcohol Focus Scotland, with an unrestricted grant of £472,000 in 2017/18. Scottish Health Action on Alcohol Problems which, like Alcohol Focus Scotland, campaigns to limit the marketing, availability and affordability of alcohol, depended on government funding for 100 per cent of its €200,000 budget in 2015/16, according to the EU Transparency Register. Both organisations lobbied heavily for one of the Scottish National Party’s flagship policies - minimum unit pricing for alcohol - which was introduced in May 2018. When Alcohol Focus Scotland co-hosted the Global Alcohol Policy Conference in Edinburgh in 2015 - an event sponsored by the Scottish Government and NHS Scotland - SNP leader Nicola Sturgeon gave the opening speech and the organisers paid tribute to her ‘political courage’.
A similar arrangement developed in the Republic of Ireland where Alcohol Action Ireland, which relied on the state for 97.5 per cent of its income in 2015, not only lobbied for minimum pricing but set up another group, the Alcohol Health Alliance, specifically ‘to support the Public Health (Alcohol) Bill’ of which minimum pricing was the cornerstone. In addition to writing submissions to government as ‘an independent voice for advocacy and policy change’ and promoting the legislation in the media, Alcohol Action Ireland set up a webpage which enabled its supporters to lobby their parliamentary representative with a standardised e-mail (‘I urge you to please support the implementation of the Public Health (Alcohol) Bill, in full’ etc.). In 2016, Ireland’s Department of Health gave Alcohol Action Ireland an additional €75,000 ‘to engage with the EU to build support for the Public Health (Alcohol) Bill’ (Tighe 2016). The law was passed in October 2018.
State-funded lobbying does not get much more blatant than this, although the similarly named Obesity Action Scotland comes close. Founded in 2015 and wholly funded by a grant from the Scottish Government, it campaigns for a 9pm watershed on advertising for food that is high in fat, salt or sugar (HFSS), bans on price promotions such as buy-one-get-one-free and ‘regulations to control portion size’. It says that all this - plus food reformulation and the sugar tax - ‘will only be the start’ of restrictions on the free market in the name of obesity prevention. All of these policies were included in a consultation document put forward by the Scottish Government in October 2017. Obesity Action Scotland publicly welcomed the proposals and drafted an encouraging consultation response (its only complaint was that some of the measures did not go far enough). In July 2018, Scotland’s Diet and Healthy Weight Delivery Plan was published with all of Obesity Action Scotland’s demands met.
This kind of activity is relatively new in the area of food, but has long been practised in the field of tobacco. Today, both the Scottish and Welsh governments fund their branches of Action on Smoking and Health (ASH) more heavily than Whitehall funds the English branch. ASH Scotland received £604,798 directly from the Scottish Government in 2016/17 (77 per cent of its total income) while receiving just £3,126 in voluntary donations. ASH Wales received £207,872 from the Welsh Government in 2016/17 in addition to £136,247 from the EU’s Erasmus+ project. In total, ASH Wales depended on government grants for 69 per cent of its income, with just £3,570 coming from individual donations and legacies.
Taken from Still Hand in Glove? A re-examination of state-funded activism.
Monday, 11 March 2019
Monday reading
FOREST have got a report out today looking at smoking and vaping bans on NHS property. It finds that the majority of NHS Trusts ban vaping inside (89%) and outside (55%). The vast majority of Trusts also ban smoking outdoors. Read the full document here.
The Spirit Level turned 10 years old this month and so I had a look at some of their flagship findings to see if they can be replicated with up-to-data figures. You'll never guess what happened.
But if you're not in the mood for reading, I was on the State of the Markets podcast last week. We had a good conversation, starting off with nanny state issues before talking about all kinds of things, including Michael Gove's bottle deposit scheme, socialism and some Netflix tips. Have a listen on iTunes or Soundcloud.
The Spirit Level turned 10 years old this month and so I had a look at some of their flagship findings to see if they can be replicated with up-to-data figures. You'll never guess what happened.
But if you're not in the mood for reading, I was on the State of the Markets podcast last week. We had a good conversation, starting off with nanny state issues before talking about all kinds of things, including Michael Gove's bottle deposit scheme, socialism and some Netflix tips. Have a listen on iTunes or Soundcloud.
Friday, 8 March 2019
Junk food (part two)
Further to yesterday's post, the IEA has now published my short briefing paper looking at what qualifies as 'junk food' for British regulators. The actual category is HFSS (High in Fat, Salt or Sugar) and my primary conclusion is that...
Polling companies should avoid the term ‘junk food’ in surveys. The legally meaningfully term HFSS should be used (and explained) instead. Politicians and journalists should also familiarise themselves with the definition of HFSS and give the public an accurate impression of the range of food and drink products that will be impacted by further government regulation.
HFSS food is what the rest of us just call 'food'. Much of it is not particularly high in fat, sugar or salt and a lot of it has been eaten for generations, if not millennia. Moreover, Public Health England is in the process of making the lowering the bar even lower to accommodate the unscientific change in the sugar guidelines. Here's the proportion of products that are classed as HFSS currently and the proportion that will be HFSS once Public Health England is through. Click to enlarge.
This is more than a technical issue. After capitulating to Jamie Oliver last June, the government plans to ban HFSS advertising on TV before 9pm, ban HFSS food from being included in meal deals and BOGOFs, and ban shopkeepers from stocking HFSS food at the store entrance, near the till and at the end of aisles. If campaigners get their way, this will only be the start of state control of the food supply.
The ban on discounts could cost households hundreds of pounds a year. As I say in the briefing:
These policies will hinder competition and innovation in one of the country’s biggest and most important markets. The many negative impacts are beyond the scope of this briefing paper but, to take one example, most of the products which could be advertised on television before 9pm under government proposals are raw ingredients - meat, fruit, vegetables, etc. - which are not generally advertised because they are cheap and unbranded. Pre-watershed food advertising would therefore be limited to a relative handful of niche health foods. Broadcasters have not said how much money they would lose, but it would certainly be in the tens of millions of pounds. This is money that could be used to make television programmes. Ironically, HFSS food will continue to be promoted before the watershed in programmes such as Jamie and Jimmy’s Friday Night Feast and The Great British Bake Off, but it will be illegal to promote the same food in the ad breaks
The public has been misled - again.
You can download the briefing paper here.
Thursday, 7 March 2019
Junk food (part one)
Action on Sugar/Salt gets acres of news coverage every other week by looking at the labels on food and putting the figures on a press release, accompanied by a quote from some nutritionist who is 'shocked' by the amount of sugar/salt in it.
They were at it again on Monday with some claims about salt in restaurant meals. Their headline figure was that 40 per cent of meals tested have got saltier in recent years. This sounds dubious from the get-go and TGI Friday, whose chicken burger Action on Sugar/Salt claimed was the saltiest, said the pressure group was plain wrong:
“as independent nutritional analysis has shown our kids’ chicken burger meal to contain 1.5g of salt, not 5.3g as cited in the report."
Nevertheless, MacGregor's mob got blanket media coverage, just as they did two weeks earlier when they complained about the amount of sugar in breakfast cereal.
If there is an easier way of getting free publicity than collating readily available data from the side of food packaging, I'd like to see it. And yet the media never seem to get bored of it.
I mention this because today saw the release of an interesting report from the Advertising Association about a subject that has been in the news a lot recently: so-called 'junk food' advertising. The report contains some genuinely original research has some new and useful findings.
For instance, it finds that children's 'exposure' to HFSS food advertising has fallen by 37% since 2008 and that the average child sees a mere 11.5 seconds of it per day. Given that the government wants to ban HFSS food advertising on the pretext of tackling childhood obesity, you'd think that there would be some interest in this. You'd also think that there would be some interest in the fact that childhood obesity has not fallen over the period in which children's 'exposure' to these ads has declined.
Apparently not. Although the Advertising Association press released their report, I can only find one media outlet (City AM) that has reported it.
I'm going to go out on a limb here and suggest that there are two reasons for the media's indifference. Firstly, the Advertising Association is an industry body. Secondly, the findings do not serve the moral panic about childhood obesity and 'junk food' advertising.
I understand that journalists are there to sell newspapers and that hysterical claims are more appealing to readers than cold, hard facts, but if journalists insist on only telling one side of a story they shouldn't be surprised when they find themselves accomplices to a scam.
Take the confusion between 'junk food' and HFSS (high in fat, salt and sugar) food. I have been banging on about HFSS food not being 'junk food' for some time. Here are some recent tweets which predate the Farmdrop episode that finally brought attention to the issue...
CRUK are still using the campaigner's term 'junk food' which is has no legal meaning. They should be honest with the public and tell them which foods will be verboten. https://t.co/YmkwaJszXI— Christopher Snowdon (@cjsnowdon) January 14, 2019
'Junk food' is not being targeted here. HFSS food is being targeted (high in fat, sugar or salt) and that is a MUCH broader category. https://t.co/lniBarHpCZ— Christopher Snowdon (@cjsnowdon) January 14, 2019
The media invariably use photos of burgers to illustrate this story. But it is not about “junk food”. It is about food “high in fat, sugar and salt”. That is a MUCH broader category. https://t.co/lniBarHpCZ pic.twitter.com/m1bz7rpSMD— Christopher Snowdon (@cjsnowdon) February 25, 2019
“Protected from junk food ads”. There is no hope for an informed debate about what’s being proposed while the media talk like activists. https://t.co/1o0THeTGH9— Christopher Snowdon (@cjsnowdon) February 28, 2019
Also, stop calling it ‘junk food’. It’s essentially a ban on food advertising with an exemption for raw ingredients and health food.— Christopher Snowdon (@cjsnowdon) March 3, 2019
And here is the Telegraph's political correspondent yesterday...
TfL billed the advertising ban as being about junk food. But it has clearly been mis-sold.— Jack Maidment (@jrmaidment) March 6, 2019
It is a ban, per the TfL press release, on "all adverts for food and drink categorised as 'less healthy' under the Government's Nutrient Profiling Model".
So not just junk food.
Politician engages in spin - stop the press!
If journalists had bothered to do a bit of basic research (like, y'know, reading the second paragraph of the Mayor of London's press release) none of this would have come as a surprise.
And if the issue wasn't 'junk food' but Brexit or budget cuts or something more obviously political, journalists would have dug a little deeper. But white hat bias means that anything to do with 'public health' gets a free pass.
Still, all of this has been serendipitous timing for me because I have an IEA briefing out tomorrow that discusses the HFSS/junk food confusion in some depth. It was sent off to the graphic designer two weeks ago. Since then, the TfL advertising ban has come into effect and the Farmdrop case has exposed the problem perfectly. I wrote about the latter for The Sun today...
We are sleep-walking into legislation that is far more extensive than most of us realise. Hysterical claims about junk food have been used as cover for tobacco-style regulation being rolled out across the food supply.
The nation’s biggest and most important industry could soon be banned from advertising most of its products during daytime television, costing broadcasters tens of millions of pounds and lowering the quality of programming.
The ban on HFSS products being positioned at the entrance, checkout and end of aisle will cause shopkeepers all kinds of headaches, and the ban on discounts, such as buy-one-get-one-free, could cost consumers hundreds of pounds a year.
Surely a rethink is in order?
Have a read and check back here tomorrow for the briefing. There will be a video too...
Wednesday, 6 March 2019
Bloomberg's army
Last year, Mike Bloomberg gave $20 million to the Bath University's Tobacco Control Research Group
(TCRG) to create 'a brand new global tobacco industry watchdog called
Stopping Tobacco Organizations and Products, or STOP.' It was a tit for
tat move after Philip Morris gave $1 billion (over 12 years) to the
Foundation for a Smokefree World.
The TCRG is run by comedy legend Anna Gilmore. It is one of the UK's last hold-outs against vaping and is best known for creating a low quality pseudo-wiki which smears anyone with whom they disagree as as an ally of the tobacco industry. Their newfound wealth will allow them to finally employ some fact checkers, and there will be plenty left over to spend on other projects.
What will they do with the cash? Bath University is an academic institution. The TCRG sits within the university's Department of Health and has the word 'research' in its title. An organisation called Stopping Tobacco Organizations and Products doesn't sound like an academic group. It sounds like a campaign group - and so it is - therefore the challenge for Gilmore et al. will be for them to portray their crusade against vaping and tobacco harm reduction as (a) educational, and (b) pro-health.
It will be interesting to see how they square that circle, but you can expect to hear a lot from in the next couple of years because they are splashing some of the cash on a big recruitment drive.
So said Jo Cranwell in a recent interview. You may recall Cranwell from Monday's post in which she described the reality TV show Geordie Shore as a 'risk factor' for binge-drinking. An avid television viewer, she has published numerous studies complaining about smoking and drinking in TV programmes. She has found smoking in Love Island, 'inferred alcohol use' in Geordie Shore and has complained about tobacco use in films, alcohol consumption in music videos, and alcohol and tobacco content in music videos. Gilmore has managed to snap up this talent before she wins her first Nobel Prize.
Fromher interview, we learn that Cranwell worked as a reflexologist before running her own flooring business and then doing a PhD in whatever subject you have to do to call yourself a professor of public health these days. When asked which superpower she would like to have, she replies...
This makes her ideally qualified for a job in tobacco control where most of the work involves going through the Twitter feed of people you don't like and reading decades-old industry memos.
She's never published anything about tobacco marketing. She means people using tobacco on television and in films. She often gets these two mixed up.
The Framework Convention for Tobacco Control already includes a full ban on tobacco advertising. Again, she means people smoking on TV and in films.
Presumably she means 'how big tobacco companies market and promote vaping'. Vaping being 'used as a marketing tool' makes no sense, unless she thinks that vaping is being used to market tobacco which, come to think of it, is probably exactly what her 'research' will conclude.
Very wise. It's unlikely that the anti-vaping money will dry up any time soon but it makes sense to cover as many bases as possible to be on the safe side.
Speaking of which, another gravy train is rolling into the city of Bath on tomorrow...
I'm calling it now: the Tobacco Control Research Group will be called the Tobacco, Alcohol and Obesity Control Research Group within five years.
Now that these people have a billionaire sugar daddy, can we taxpayers stop funding them please?
The TCRG is run by comedy legend Anna Gilmore. It is one of the UK's last hold-outs against vaping and is best known for creating a low quality pseudo-wiki which smears anyone with whom they disagree as as an ally of the tobacco industry. Their newfound wealth will allow them to finally employ some fact checkers, and there will be plenty left over to spend on other projects.
What will they do with the cash? Bath University is an academic institution. The TCRG sits within the university's Department of Health and has the word 'research' in its title. An organisation called Stopping Tobacco Organizations and Products doesn't sound like an academic group. It sounds like a campaign group - and so it is - therefore the challenge for Gilmore et al. will be for them to portray their crusade against vaping and tobacco harm reduction as (a) educational, and (b) pro-health.
It will be interesting to see how they square that circle, but you can expect to hear a lot from in the next couple of years because they are splashing some of the cash on a big recruitment drive.
The Bloomberg funding over three years is huge news and is going to grow the Tobacco Research Group from a team of nine to around 35, it’s amazing.
So said Jo Cranwell in a recent interview. You may recall Cranwell from Monday's post in which she described the reality TV show Geordie Shore as a 'risk factor' for binge-drinking. An avid television viewer, she has published numerous studies complaining about smoking and drinking in TV programmes. She has found smoking in Love Island, 'inferred alcohol use' in Geordie Shore and has complained about tobacco use in films, alcohol consumption in music videos, and alcohol and tobacco content in music videos. Gilmore has managed to snap up this talent before she wins her first Nobel Prize.
Fromher interview, we learn that Cranwell worked as a reflexologist before running her own flooring business and then doing a PhD in whatever subject you have to do to call yourself a professor of public health these days. When asked which superpower she would like to have, she replies...
I’m really nosey and interfere with people’s business all the time, so probably invisibility so I could listen in on everyone’s conversations.
This makes her ideally qualified for a job in tobacco control where most of the work involves going through the Twitter feed of people you don't like and reading decades-old industry memos.
I’ve just taken my research on tobacco marketing, and that of colleagues around the world, to report on tobacco in entertainment media to World Health Organisation.
She's never published anything about tobacco marketing. She means people using tobacco on television and in films. She often gets these two mixed up.
I want them to sign up to a revised section of the Framework Convention for Tobacco Control that puts measures in place to limit the exposure of children to tobacco advertising.
The Framework Convention for Tobacco Control already includes a full ban on tobacco advertising. Again, she means people smoking on TV and in films.
In Western countries we may well focus on social media and how vaping is being promoted and used as a marketing tool by the big tobacco companies.
Presumably she means 'how big tobacco companies market and promote vaping'. Vaping being 'used as a marketing tool' makes no sense, unless she thinks that vaping is being used to market tobacco which, come to think of it, is probably exactly what her 'research' will conclude.
My work also includes alcohol and I’d like to develop this area of research further too, perhaps setting up my own related research group.
Very wise. It's unlikely that the anti-vaping money will dry up any time soon but it makes sense to cover as many bases as possible to be on the safe side.
Speaking of which, another gravy train is rolling into the city of Bath on tomorrow...
The University of Bath Postgraduate Group Bath Science in Policy is very pleased to co-host a lunchtime seminar with The University of Bath’s Tobacco Control Research Group. Our visiting speaker, Dr. Mélissa Mialon from the University of Sao Paulo, will present her research on The influence of the ultra-processed food and beverage industries on public policies and public opinion.
Speaker profile: Dr Mélissa Mialon is a food engineer with training in public health nutrition. She is currently a research fellow at the University of Sao Paulo in Brazil. In her research, she has adapted methods used in the field of tobacco control research to identify and monitor the influence of the ultra-processed food and beverage industry on public policies and public opinion.
I'm calling it now: the Tobacco Control Research Group will be called the Tobacco, Alcohol and Obesity Control Research Group within five years.
Now that these people have a billionaire sugar daddy, can we taxpayers stop funding them please?
Tuesday, 5 March 2019
The tobacco levy - a dead parrot
The zombie idea of a tobacco industry levy re-emerged at the weekend when ASH's puppet All Party group included it in their new list of demands. ASH are trying to portray the levy as 'making the polluter pay' as if it were a Pigovian response, overlooking the fact that there are no net financial costs of smoking and tobacco taxes are already sky high.
The conceit behind the levy is that the money will come from the industry's profits rather than from smokers (rather like the idea that the sugar tax is a levy on businesses). A childishly simplistic infographic from Cancer Research showed how this was supposed to work.
But that's not how it would work. After the idea was first mooted by George Osborne in 2014, there was some dispute about whether the cost would be passed onto the consumer (ie. 'public health' groups said it wouldn't while everybody else said it would). When HMRC ran the numbers they concluded:
Furthermore, HMRC estimated that a £150 million levy would only actually raise £25 million because of behavioural effects:
DEFRA's chief economist reviewed HMRC's work and concluded:
In late 2014, the Treasury ran a public consultation and Deborah Arnott of ASH said:
Alas for Debs, it wasn't to be. Despite the majority of respondents being taxpayer-funded organisations who strongly supported the levy, when the results were published the following year the Treasury concluded that it was a dumb idea.
This could be the first time a public consultation on tobacco has resulted in the policy not going ahead. I can't think of another. Either way, we are four years on and ASH are still banging their head against the same wall. Give it up, ASH. The tobacco levy has ceased to be. It has run down the curtain and joined the choir invisible. It is an ex-parrot.
ASH's 'new' list of policy demands is the same tired neo-prohibitionist wish list that they have been banging on about since 2015 with the addition of raising the smoking age to 21. The latter is a policy borrowed from the USA where the drinking age is 21. It doesn't make a lot sense there, but you can see how it could be defended. It makes no sense in Britain where you don't have to be 21 to do anything.
ASH's desperation to keep themselves relevant (and keep the grants rolling in) is palpable. They have had a good run but there's really no excuse for funding this dreadful organisation any longer. It has done quite enough damage. Put it out to pasture and spend the money on healthcare.
The conceit behind the levy is that the money will come from the industry's profits rather than from smokers (rather like the idea that the sugar tax is a levy on businesses). A childishly simplistic infographic from Cancer Research showed how this was supposed to work.
But that's not how it would work. After the idea was first mooted by George Osborne in 2014, there was some dispute about whether the cost would be passed onto the consumer (ie. 'public health' groups said it wouldn't while everybody else said it would). When HMRC ran the numbers they concluded:
Legally, the Tobacco Levy would be a direct tax, as traders would be liable for the tax. Economically, it would be entirely equivalent to an increase in the specific tax that currently exists on tobacco products.
... Evidence from the consultation, supported by evidence from changes to tobacco duties in recent years, was clear that manufacturers and importers would pay for the levy by fully passing on the Levy to consumers by raising retail prices.
Furthermore, HMRC estimated that a £150 million levy would only actually raise £25 million because of behavioural effects:
Higher prices lead to reductions in consumption of duty-paid tobacco and further switching to lower priced products. This reduces revenue from existing tobacco duties. Tax makes up a large proportion of tobacco prices, leading to large behavioural effects that almost completely offset the revenue raised by the Levy.
DEFRA's chief economist reviewed HMRC's work and concluded:
Based on this review and discussions, and the applications of economic theory and evidence, we believe that HMRC’s assessment is reasonable and appropriate. In particular, we believe that the crucial assumption that a significant proportion of the levy will be passed-on to consumers in the form of higher tobacco product prices as reasonable.
In late 2014, the Treasury ran a public consultation and Deborah Arnott of ASH said:
“It’s almost like Christmas come early to have the government launch a consultation on how to make the tobacco industry pay for the damage it does.”
Alas for Debs, it wasn't to be. Despite the majority of respondents being taxpayer-funded organisations who strongly supported the levy, when the results were published the following year the Treasury concluded that it was a dumb idea.
As announced in Summer Budget 2015, the government has decided not to introduce a levy on tobacco manufacturers and importers.
... Analysis of the responses shows that the impact of a levy on the tobacco market would be similar to a duty rise, as tobacco manufacturers and importers would pass the costs of a levy on to consumers. This is supported by HMRC analysis which shows that a levy of £150 million would only raise £25 million after behavioural effects.
This could be the first time a public consultation on tobacco has resulted in the policy not going ahead. I can't think of another. Either way, we are four years on and ASH are still banging their head against the same wall. Give it up, ASH. The tobacco levy has ceased to be. It has run down the curtain and joined the choir invisible. It is an ex-parrot.
ASH's 'new' list of policy demands is the same tired neo-prohibitionist wish list that they have been banging on about since 2015 with the addition of raising the smoking age to 21. The latter is a policy borrowed from the USA where the drinking age is 21. It doesn't make a lot sense there, but you can see how it could be defended. It makes no sense in Britain where you don't have to be 21 to do anything.
ASH's desperation to keep themselves relevant (and keep the grants rolling in) is palpable. They have had a good run but there's really no excuse for funding this dreadful organisation any longer. It has done quite enough damage. Put it out to pasture and spend the money on healthcare.
It turns out that 'junk food' doesn't actually exist
As I have been saying for some time, a ban on 'junk food' advertising is nothing of the sort. Reality has just caught up with a company called Farmdrop who have had this advert rejected by TfL because it shows bacon and butter.
I've written about this for Spectator Health.
I've written about this for Spectator Health.
Monday, 4 March 2019
The sockpuppet state in action
Last week, the IEA released my report Still Hand in Glove? which takes another look at state-funded activism. It would be nice to report that the problem is shrinking. In truth, it is evolving. Blatant sockpuppetry is alive and well in Scotland and Wales. In England, the baton has been largely passed onto Public Health England, local authorities and PHE's legion of Directors of Public Health, with assistance from a growing band of activist-academic 'research' institutions.
Over the weekend, there were a couple of small examples of how this works in practice. One of Britain's oldest sockpuppets, Action on Smoking and Health (ASH), was back, this time acting through the parliamentary mouthpiece it set up in the 1970s, the All Party Parliamentary Group on Smoking and Health, of which ASH is still the secretariat.
Having exhausted every other anti-smoking policy, ASH are really scraping the barrel in an effort to keep themselves relevant. Their next phase of action involves banning 18-20 year olds from buying tobacco, censoring television programmes and raising prices even further with a tobacco levy.
'Civil society' was straight out of the blocks to lend these extreme measures their support on Saturday, with a series of similar tweets. First up was ASH, of course, which got £160,000 from the unwitting taxpayer in 2016/17 and has recently started getting mysterious grants from Public Health England (£108,000 in the last quarter of 2018).
Then the regional sockpuppets piled in, including our old friends at FRESH, which is wholly funded by local authorities in the northeast...
And Breathe 2025, which is wholly funded by local authorities in Yorkshire and Humberside although you'd never guess that from looking at its website...
And the recently formed History Makers, wholly funded by local authorities in the northwest...
In my report, I noted that History Makers had 'not yet begun active campaigning' and that state-funded anti-tobacco groups, in general, had been fairly quiet recently:
Now they have their new policies, expect to hear more from them.
Meanwhile, in the northeast...
Regular readers will be familiar with Ms. Cranwell and her laughable research. It takes quite an imagination to believe that young geordies like to binge drink because they've seen it in Geordie Shore rather than that young geordies like to binge drink and therefore binge-drinking features in a reality TV programme about young geordies. Cranwell worked at the
It's not a charity. It's a neo-temperance pressure group that shares an office with FRESH and, like FRESH, is entirely funded by local authorities.
Of course he does. That's all he ever says.
The article contains no opposing viewpoints and is rounded off with a message from the £4.5 billion a year mothership...
Keep digging deep, taxpayers.
Over the weekend, there were a couple of small examples of how this works in practice. One of Britain's oldest sockpuppets, Action on Smoking and Health (ASH), was back, this time acting through the parliamentary mouthpiece it set up in the 1970s, the All Party Parliamentary Group on Smoking and Health, of which ASH is still the secretariat.
Having exhausted every other anti-smoking policy, ASH are really scraping the barrel in an effort to keep themselves relevant. Their next phase of action involves banning 18-20 year olds from buying tobacco, censoring television programmes and raising prices even further with a tobacco levy.
Deborah Arnott, chief executive of Action on Smoking and Health - which assists the group ["ASH wrote the report" - CJS], said: "Legislation to strictly regulate smoking used to be considered controversial and extreme by all mainstream political parties.
"Thanks to the dedication of the All Party Group, working closely with civil society, that's no longer the case."
'Civil society' was straight out of the blocks to lend these extreme measures their support on Saturday, with a series of similar tweets. First up was ASH, of course, which got £160,000 from the unwitting taxpayer in 2016/17 and has recently started getting mysterious grants from Public Health England (£108,000 in the last quarter of 2018).
Then the regional sockpuppets piled in, including our old friends at FRESH, which is wholly funded by local authorities in the northeast...
And Breathe 2025, which is wholly funded by local authorities in Yorkshire and Humberside although you'd never guess that from looking at its website...
And the recently formed History Makers, wholly funded by local authorities in the northwest...
In my report, I noted that History Makers had 'not yet begun active campaigning' and that state-funded anti-tobacco groups, in general, had been fairly quiet recently:
The lack of overt political activity by these groups since plain packaging was introduced in 2016 probably reflects a dearth of new policies to lobby for and the government’s stated intention not to pass further anti-smoking legislation in this Parliament.
Now they have their new policies, expect to hear more from them.
Meanwhile, in the northeast...
Five areas in the North East are among the top 10 worst places for underage drinking in the UK.
.. Dr Jo Cranwell, from the University of Bath, has specifically researched Geordie Shore and says that in scenes with “real people who young viewers in particular relate to” viewers are exposed to “extreme levels of alcohol content including high levels of intoxication”.
She found that nearly 80% of scenes throughout season 11 of the MTV show featured alcohol.
Dr Cranwell said: “This all suggests Geordie Shore might be a risk factor and could be exacerbating serious problems associated with binge drinking.”
Regular readers will be familiar with Ms. Cranwell and her laughable research. It takes quite an imagination to believe that young geordies like to binge drink because they've seen it in Geordie Shore rather than that young geordies like to binge drink and therefore binge-drinking features in a reality TV programme about young geordies. Cranwell worked at the
Her fear is shared by Colin Shevill, of North East alcohol awareness charity Balance.
It's not a charity. It's a neo-temperance pressure group that shares an office with FRESH and, like FRESH, is entirely funded by local authorities.
He said: “This north-south burden of harm long pre-dates Geordie Shore [well spotted! - CJS], but it does highlight the way alcohol is glamorised in TV shows and through advertising.
"There is overwhelming evidence that exposure to alcohol marketing increases the risk.”
He also believes the Government must push up the current “pocket money prices” of booze, as has already happened in Scotland.
Of course he does. That's all he ever says.
The article contains no opposing viewpoints and is rounded off with a message from the £4.5 billion a year mothership...
Rosanna O’Connor, director of drugs, alcohol and tobacco at Public Health England, said: “This is a top priority.”
Keep digging deep, taxpayers.
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