Thursday 30 May 2019

In defence of food advertising

The Department of Health's consultation on banning adverts for HFSS (high in fat, sugar and salt) food and drink before 9pm on television closes on June 10th. The government's various allies and sockpuppets have been encouraging people to make a submission so I thought I would too.

Banning advertising is a hunch-based policy, but the Department of Health's impact assessment is obliged to make it look evidence-based. It acknowledges that there will be costs from a TV ban but reckons that it will have a net benefit of £2.3 billion over 25 years, close to £100 million per annum. Most of the putative benefit (£1.4bn) comes from health benefits due to lower calorie consumption, plus £600 million from 'reinvesting cost savings back in the NHS'. Food companies are also expected to save £300 million 'from no longer advertising on TV' (how strange that food companies haven't opted to make these savings voluntarily).

The government starts from three premises, all of which are false.

Problem and justification for action

1. Childhood obesity is one of the biggest health problems this country faces. Around one fifth of children in England are obese or overweight by the time they start primary school aged five, and this rises to more than one third by the time they leave aged 11.

2. Obesity is a major determinant of ill health. This imposes a substantial burden on the NHS, with overweight and obesity estimated to have cost the health service £6.1bn in 2014/15. Obesity causes further costs to society through premature mortality, increased sickness absence and additional benefit payments.

3. It’s clear from the evidence that marketing and TV advertising can be effective at influencing children's food and drink consumption, preferences and purchases. Although food habits are not perfectly stable over life, there is potential scope for influencing lifetime habits by intervening in childhood.

1. Regular readers know that the true rate of childhood overweight/obesity among five year olds is nowhere near 20 per cent and the rate among 11 year olds is nowhere near 33 per cent. Britain uses a measure of childhood obesity that has no scientific or clinical justification. The true rate of childhood obesity is not known because no one has bothered to send a representative sample of children to a clinician to be diagnosed, but it is almost certainly below five per cent for both age groups.

2. While obesity can certainly cause ill health and has associated costs, the £6.1 billion figure is a gross cost whereas the useful measure is the net cost. When the net cost is calculated, by subtracting savings to other departmental budgets and acknowledging the costs that would be incurred if people died of something else, the cost is greatly reduced. It could, in fact, be less than zero.

3. The evidence linking advertising to children's food and drink consumption is far from 'clear'. The impact assessment cites this review by the half-mad anti-capitalist Gerard 'the corporations!' Hastings to support its claim, so forgive me if I'm sceptical. I'll come back to the evidence in a moment.

In short, the government wants to tackle something that is far less common than it thinks by restricting something that is far less important than it thinks, in order to make financial savings that probably don't exist.

There is a moment of unintentional humour on page 24 of the impact assessment when the Department of Health expresses its concerns about children watching television after 7pm:

..children’s viewing time peaks between 6-9pm, when the programmes most likely to be broadcast are not children’s programming, but instead ‘family’ or adult programmes. This means that some of the shows most watched by children, such as X Factor, Saturday Night Takeaway, or Great British Bake Off, are not captured by the current restrictions.

Heaven forbid that kids should see sugary food promoted during the Great British Bake Off. Or, indeed, see adverts for takeaways during Saturday Night Takeaway.

The impact assessment's projections of health benefits and related financial savings rely on the assumption that '4.4 minutes of food advertising results in an additional 60kcal of consumption'. The Department of Health acknowledges that the 95% confidence interval for this estimate is 3.1kcal-116.9kcal, ie. it is barely significant, but nevertheless uses it as the basis for its projections on health and spending.

The 60 calorie statistic comes from a review published last year by Viner et al. (which was co-authored by activist-academic Russell Viner). It is unreliable, to say the least.

The figure comes from a meta-analysis of eleven studies, all of which were randomised experiments in which children had their food consumption monitored during or after being shown food/non-food advertising. These experiments do not reflect children's natural living environment in two crucial ways. Firstly, the children are allowed to consume an unlimited quantity of food at no cost. Secondly, there was no parental supervision.

Furthermore, all but one of the studies involved children aged 12 or younger (the other involved children aged 9-14). In three of them, the children were no older than seven. Research into advertising has shown that children are indeed susceptible to advertising under the age of seven - in so far as they tend to want what they see advertised - but that by the age of 12 they have acquired a 'global distrust' of it. Older children are, as Michael Schudson notes in Advertising: The Uneasy Persuasion, 'very much like adults in their skepticism'.

So whilst advertising directly to very young children is morally dubious, it doesn't greatly matter because they have very little purchasing power and don't do their own grocery shopping. Older children have more purchasing power but they are as sceptical about advertising as adults, so that doesn't greatly matter either.

What the government intends to do is ban HFSS food advertising in the evening when adults and older children are watching because research shows that advertising has an effect on younger children.

What does the research actually show? As mentioned, the experiments focus on the most suggestible age group and remove the two barriers that prevent children from acting on their urges - parental restraint and a lack of purchasing power - but even if we ignore these shortcomings, the evidence is not strong enough for the 60 calorie claim to be taken seriously.

Five of the eleven studies come from the same research team in Liverpool (Halford et al. 2004, Halford et al. 2007, Halford et al. 2008, Dovey et al. 2012, Boyland et al. 2013). The first of these studies found that children under the age of 12 tended to eat more food after watching 'unhealthy food adverts'. The subsequent studies have broadly replicated that result, but it has not been strongly replicated by research groups elsewhere.

Taken together, the other six studies in the Viner analysis provide very little evidence that food advertising has any consistent effect on calorie intake, even when food is given free and parents are absent. They are...

Anderson et al. (2015). This study of 9-14 year olds found that seeing food advertising was associated with higher food intake among overweight girls but not among normal weight girls or any group of boys.

Anschutz et al. (2009). This study of 8-12 year olds found that when the children had seen food commercials, food intake was higher among boys, but lower among girls.

Anschutz et al. (2010). This study of 8-12 year olds found no association between food advertising and food consumption ('there was no main effect of exposure to the food commercials on food intake').

Norman et al. (2018). This study of 7-12 year olds in Australia found that the children 'ate comparable amounts after both food (1933 ± 619 kJ) and non-food (1929 ± 678 kJ) advertising exposures'.

Only Harris et al. (2009) and Emond et al. (2016) support the advertising hypothesis, but the children in the latter study were very young indeed (2-5 years)  and the study was not well randomised; the group that watched the food adverts contained two obese children and six overweight while the group that watched the non-food adverts contained no obese children and four overweight children.

If one looks at the studies themselves, rather than rely on Viner et al's interpretation, it becomes clear that the 60 calorie claim is based on some very mixed evidence, dominated by a series of studies from one research group whose members have strong feelings about the subject. From this dubious figure, the impact assessment extrapolates health benefits worth over £2 billion pounds, based on the belief that it will reduce the number of children who are obese - most of whom are not actually obese to begin with.

The whole thing is a fantasy. As with so much in the modern 'public health' racket, it is a model within a model. The sunshine of reality is never allowed to creep through the curtains.

There is real world evidence to consult for those who are minded to seek it out. The impact assessment notes that there were 12.1 billion 'HFSS child impacts' in 2005. In 2009, after HFSS advertising was banned on children's television, this fell to 7.7 billion. By 2017, it had fallen to 3.6 billion, of which 2.6 billion were before 9pm.

Children's 'exposure' to HFSS food advertising on television has therefore declined by more than two-thirds in the last 14 years. Given the government's assumptions about the link between HFSS food advertising and childhood obesity, this should have led to a notable decline in childhood obesity. In reality, the rate of what the government defines as 'childhood obesity' has been basically flat since 2008 when the ban came into effect.

This is the elephant in the room. The government expects there to be a measurable decline in childhood obesity from HFSS 'exposure' dropping to 8% of the 2005 rate and yet there has been no apparent impact on childhood obesity from such exposure dropping to 30% of the 2005 rate. What is it they say about people who keep doing the same thing and expecting different results?

Although the Department of Health mentions the huge decline in 'child impacts', it never asks the obvious question and therefore never draws the obvious conclusion - that food advertising has a negligible effect on the number of calories children consume.

'But if advertising doesn't work', cry the simple-minded critics of advertising, 'why do businesses spend so much money on it?!' This reflects a basic misunderstanding of what advertising is trying to achieve.

Economists have long understood that advertising does not have the mystical powers that its critics attribute to it...

Borden's (1942) massive study of the effects of advertising on demand concluded that advertising is not generally an important determinant of industry sales. Exceptions arise in new and growing sectors, where advertising can serve to accelerate growth that would occur in any case. Recent work seems generally to support these conclusions...

Overall, advertising does not emerge from the empirical literature on consumer demand as an important determinant of consumer behaviour...

The government is on the brink of passing a law preventing biscuits being advertised until after dark. This should strike any reasonable person as absurd. It is also profoundly illiberal. Fundamentally, this is an issue of free speech. Under Advertising Standards Authority rules, commercials cannot be run unless they are decent, honest and truthful. Why would we want to ban something that is decent, honest and truthful?

We have got to the point where we are banning advertisements because the government and its cheerleaders don't like the product that is being advertised. Well, tough. As Seldon and Harris said in Advertising in a Free Society sixty years ago...

Because advertisements are used to sell almost every conceivable product and service, they offer a large target for those whose real objection is to the thing advertised. People who disapprove of betting, smoking, drinking, hire purchase, self-medication, birth control, Roman Catholicism or ‘Billy Graham’ campaigns, all find advertisements to condemn; and they are joined by those who object to the intrusion of commerce into their comfortable lives. No doubt advertising mirrors the imperfections of human society, but we shall not waste much time on critics who aim at the reflected image instead of declaring openly against smoking or gambling or hire purchase or whatever it is they dislike. While the law permits such activities, their advertising must be tolerated.

There is no meaningful difference between the state banning an advert because it disapproves of the product being advertised - or the views of the person featured in it - and the state censoring an article, speech or play being it doesn't like what is being said. If a ban on cakes, ice creams and jam being advertised before the watershed becomes law, it will give licence to every obsessive, single-issue fanatic to press for further prohibitions. Once we start banning inoffensive adverts for harmless products, the censoriousness will become a runaway train.

Wednesday 29 May 2019

Restaurant food exceeds imaginary guidelines

From The Sun...

Most kids’ meals sold in chain restaurants are too high in calories, fat or salt, a study reveals.

Researchers say the firms are fuelling the obesity crisis by making it hard to eat healthily away from home.

The study found a typical meal for six to 12-year-olds was 19% over calorie guidlinesIt comes after they analysed 39,266 meal combinations on the children’s menu at 20 leading eateries — including McDonald’s, KFC, Nando’s, Harvester, Brewers Fayre, Pizza Hut and Zizzi.

The average meal for kids aged two to five had 609 calories, 67 per cent more than the 364 official guidelines.

And a typical meal for six to 12-year-olds had 653 calories, 19 per cent more than the recommended 550.

The problem with it is that there are no 'official guidelines' on how many calories should be in an individual meal. There are guidelines for daily consumption, but it would be silly to think that the daily guidelines can be divided by three to get a 'limit' for an individual meal.

In December 2017, Public Health England created a 400-600-600 rule-of-thumb, telling people to try to stick to 400 calories for breakfast and 600 calories for lunch and dinner, but these numbers were plucked out of the air and have no basis in science. Add them together and you have a starvation diet of 1,600 calories. And at no point did PHE put forward meal guidelines for children.

So what are these researchers babbling about? Their study is here. It finds that:

The average meal for younger children (aged 2−5 years) contained 609 ±117 kcal, and for older children (6−12 years) 653 ± 136 kcal compared with guidelines of 364 and 550 kcal, respectively.

These guidelines don't exist, so where did they come from?

The authors say:

Public Health England’s guidelines for healthy and sustainable catering were assumed, and so for a single meal, 30% of daily energy requirements was referenced.[35]

Reference 35 is this report from Public Health England which doesn't mention calories once.

Later in the study they say:

In total, 66% of meals were above the 550 kcal recommended amount [28]

Reference 28 is this study. It doesn't say anything about limiting meals to 550 calories.

So the researchers have created some imaginary guidelines for children based on 30 per cent of a child's daily calorie recommendation and provided a couple of irrelevant citations to make them look sciencey. (Note that the official daily guidelines are lower than those of adults for younger children but higher than those of adults for older children - the authors focus only on the former.)

The implication is that a restaurant meal should provide less than a third of a ten year old's daily calorie intake. This is a ridiculous assumption and nicely illustrates why the government doesn't have official guidelines for individual meals.

Nevertheless, the authors come to the absurd conclusion that:

Eating in chain restaurants, in particular meal deals, does not contribute positively to the diet of children in the United Kingdom and Ireland. 

This is a patently subjective opinion so let me respond in kind. There is absolutely nothing wrong with children having 600-700 calories in a meal, especially for their lunch or dinner. Teenagers, in particular, should be aiming for this as a minimum.

This study seems to be the latest attempt to build support for Public Health England's unwanted  interference in the out-of-home eating sector and its insane calorie caps. A similar study, based on PHE's 400-600-600 nonsense was published late last year. As I said at the time...

The authors know full well that this is exactly what Public Health England is working towards, but state regulation of food portions is such an extreme policy that it requires lashings of propaganda before the public will swallow it. The calorie limits announced by PHE last December were plucked out of the air, but they are already being treated as gospel in a major medical journal. It has now been ‘revealed’ that these arbitrary guidelines are being habitually breached in restaurants. Why wouldn’t they be? They have no basis in reality and, in any case, they were only supposed to be recommendations.

Junk studies like this are a minor nuisance compared to what PHE has planned.

Oh, and by the way...

Meals from fast food restaurants contained fewer calories, less fat and less salt than full-service, sit-down ones.

Tuesday 21 May 2019

Jamie Oliver - revenge of the millennials

Jamie Oliver has given nearly everybody a reason to dislike him in the course of his career, not least by snatching Turkey Twizzlers from one generation and imposing a sugar tax on the next. He has been instrumental in ruining Coco Pops, Ribena and Lucozade and has even managed to annoy the TV company that employs him by calling for a ban on so-called 'junk food' advertising.

You can only get away with this for so long. The public have voted with their feet and exacted their revenge on this evildoer.

The tweets below give a sense of the public mood in the first 30 minutes after the news broke. I wouldn't be surprised if 'turkey twizzlers' is trending by the end of the day.


Monday 20 May 2019

Plain packaging - what happened?

In the first couple of years after plain packaging took effect in Australia, a number of studies were published claiming to find an immediate effect from the policy. Nearly all of them were co-authored by Melanie Wakefield, who was a leading advocate of plain packaging and was later given the job of evaluating it (have I mentioned before that 'public health' is utterly corrupt?).

The studies took many forms. One of them looked at whether smokers were more likely to cover their cigarette packs up after the packaging changed. One of them found that smokers didn't like the new packs as much as the old ones. Another found that adolescents couldn't distinguish between brands as well as they could before. And another claimed that there had been more calls to quitlines after plain packaging began.

I could go on. There were loads of them. None of them actually found that smokers were giving up as a result of plain packaging, nor that nonsmokers were less likely to start, nor that cigarette sales had fallen (it was later revealed that sales rose), but they served to give the impression that the policy had an almost instantaneous impact.

This was all designed to help Australia win its court case and to encourage countries like Britain to follow suit. For that reason we might not expect the same quantity of policy-based evidence to follow the introduction of plain packaging in Britain, but it is striking that there has been almost nothing. There was some flim-flam about smokers noticing the warnings more, as if that makes any difference to anything, and there was a study claiming that plain packaging caused prices to rise, but that's about it.

Today marks two years since the sale of cigarettes in plain packaging became mandatory. There has been not a word of it in the media. ASH haven't even mentioned it on Twitter. All those years spent campaigning for it. All those millions of pounds spent. And yet there is nothing to say and nothing to report.

Enough time has passed for us to see whether the policy had any short-term effect on the smoking rate. The Smoking Toolkit Study provides monthly estimates of smoking prevalence in England. As the graph below shows, in the first year of mandatory plain packaging, the smoking rate went up.

The rise in smoking from the spring of 2017 was driven by a pronounced increase in the smoking rate among men. The overall rise was steady and sustained in the first year in contrast to the secular decline which had been consistently downwards since late 2014. The downward trend did not resume until around May 2018, a year after plain packaging kicked in. The smoking rate is now more or less where you would expect it to be based on the longterm trend.

It is not obvious why the smoking rate went up between the spring of 2017 and the spring of 2018, nor is it obvious why there was a notable decline thereafter. But if plain packaging was responsible, it had a peculiarly delayed effect.

Note that plain packaging was not the only policy that came into full effect on May 20th 2017. It was also the date of full implementation of the EU's Tobacco Products Directive (TPD). Among other things, the TPD banned the sale of small packs of cigarettes/tobacco and restricted the amount of nicotine in e-cigarette fluid.

Note also that neither the TPD nor plain packaging came in overnight. From May 2016, tobacco and vape companies were given twelve months to clear out old stock. The tobacco industry made sure that there were plenty of branded packs available to retailers before the cut-off date of 20 May 2017 but some plain packs filtered onto the market before then. They remained quite rare until early 2017 and branded packs continued to be more common right up until the final day.

All of these policies were supposed to drive down the smoking rate. Given the amount of time, money and effort that went into turning the TPD and plain packaging into law, you would think there would be more interest in seeing what actually happened afterwards.

What happened was, at best, bugger all.

Thursday 16 May 2019

Hello unintended consequences, my old friend

Last October, Australia's Northern Territory introduced minimum pricing for alcohol because - according to one 'public health' academic - "evidence shows this works to reduce harm". This measure came on top of the Banned Drinker Register which was introduced in September 2017 and forbids certain individuals from buying alcohol.

Imagine my surprise when I heard that these policies have had perverse consequences which require yet more government action...

Buying mouthwash could soon require photo ID in the Northern Territory.

As the sale of alcohol becomes more restricted across the region, welfare groups said people are turning to easier-to-reach sources — like vanilla essence and cleaning products.

In the last three months they say these sales have spiked, with one person reportedly buying 21 litres of methylated spirits in a fortnight.

This is going well!

The Central Australian Youth Link Up Service (CAYLUS) — an organisation formed in 2002 to stop petrol sniffing — said it noticed a spike in the sale of methylated spirits after reports from local retailers and the Alice Springs Town Council.

The organisation's Blair MacFarland said the council reported a higher number of empty methylated spirit bottles being found on council parks and ovals.

Whoops! There's only one thing to do and that's form a new committee...

.. reports of an increase in the consumption of mouthwash and cooking essences have led to the formation of a new working group, made up of NGOs and the NT Health Department.

The group met for the first time in Darwin earlier this year, after community groups began noticing the trend at the end of 2018.

I wonder what happened in late 2018 that could have sparked a sudden interest in surrogate alcohol? Oh yeah. That.

NT Opposition Leader Gary Higgins said earlier this year that restricting access to alcohol through the BDR in Adelaide River had created a situation where people were spending more of their income on alcohol and less on food and essentials.

Yes, that's what happens. 

He also said it may have been a factor in commercial break-ins and youth crime, which has been on the rise.

Oh well, you can't make an omelette without breaking eggs. But where's the omelette?

Dr John Boffa of the People's Alcohol Action Coalition (who happens to be the aforementioned academic) said...

"The introduction for the minimal unit price in Darwin, coupled with the Banned Drinker Register, both of these measures are very effective and very targeted at the heaviest drinkers."

"We've seen that in Alice. We took action. It was very effective."

Image result for naked gun nothing to see here

Fake news about inequality

Imagine if a sports journalist regularly described Sergio Agüero as a Manchester United player and insisted that West Bromwich Albion won the Premier League this season.

Imagine a political correspondent routinely referring to the Liberal Democrats as the ruling party and claiming that the Chancellor was Michael Fabricant.

They wouldn't last very long. Readers and editors take a dim view of hacks who make basic mistakes with easily verifiable information. But when it comes to economic statistics that can be checked in a few seconds, standards are slacker. As a result, the British public have been told for over a decade that income inequality, relative poverty and child poverty are rising (or even 'soaring') when they are not.

The data on these economic variables are so easy to access via the Office of National Statistics (ONS) that journalists should be genuinely ashamed when they get it wrong. And yet shameless misinformation continues.

A classic example arrived today when the Institute for Fiscal studies launched what it called the 'most ambitious study of its kind' into inequality, to be led by the respected economist Angus Deaton. The project will look at 'inequality not just of income, but of health, wealth, political participation, and opportunity; and not just between rich and poor but by gender, ethnicity, geography, age and education'.

Under the headline 'Growing inequality threatens democracy',* two BBC journalists reported this news as follows:

Inequalities in pay and opportunities in the UK are becoming so extreme they are threatening democracy, an Institute for Fiscal Studies study has said.

The Institute for Fiscal Studies 'study' is actually a launch document which 'is intended to serve as an introduction to just a few of the issues that will be addressed as part of this project, to give a taste of what is to come. The aim is not to present answers, but to illustrate the breadth of the review'. It draws no conclusions and includes only one reference to democracy:

'With support for populist candidates rising on both sides of the Atlantic, and on both sides of the political spectrum, some question whether inequality may pose a threat not just to capitalism but also to our democratic system.'

This is immediately followed by an assurance that 'inequality does not necessarily spell crisis' and a sensible discussion about why people are concerned about inequality in some contexts but not in others. In an interview with the Today programme, Prof Deaton said that rent-seeking is one source of inequality about which people were right to be concerned. I can only concur.

According to the BBC:

The report says such widening gaps are "making a mockery of democracy".

The 'report' says no such thing because work on the report has barely begun. Presumably the BBC means the launch document, but the launch document doesn't say that either.

Nor is income inequality 'growing' in any meaningful sense. The launch document notes that when income inequality is measured with the standard Gini coefficient, it 'has remained broadly unchanged since the early 1990s'. This is correct. The rate of inequality has fluctuated in the last thirty years but has been basically flat. In its most recent data set, the ONS notes that it 'slightly increased' in 2017/18. Not enough to threaten democracy, surely?

The IFS also points out that...

Another common measure of household income inequality, the 90:10 ratio (which measures the household income of the person who is 90% of the way up the distribution – with a higher income than 90% of the population – relative to that of the person 10% of the way up), has actually fallen since the early 1990s. This means that household incomes are now more evenly distributed across most of the distribution than they were 25 years ago.

Nevertheless, the BBC continues:

[The IFS] suggests pay inequality in the UK is high by international standards - with the share of household income going to the richest 1% having tripled in the past three decades.

The launch document doesn't actually claim that earnings inequality is high by international standards although it is true that income inequality in Britain is much higher before taxes and benefits are taken into account. To illustrate the first claim, the BBC uses this graphic showing rates of income inequality in a few countries:

The word 'sample' is doing a lot of heavy lifting here. The OECD's data show that eight of the 38 countries in its analysis have a higher rate of inequality than the UK. Of these eight countries, only one (the USA) is shown in the BBC's graph.

Moreover, the figure used by the OECD for the UK is higher than that shown in other sources. The OCED uses a figure of 35.1 whereas the ONS uses a figure of 32.5 and the World Bank uses a figure of 33.2.

These might seem like small differences but they have a big effect on the rankings. If the ONS figure is correct, the UK does not have the ninth highest rate of income inequality out of the OECD's 38 countries but the nineteenth, ie. it is bang in the middle. When Ryan Bourne and I compared inequality data on rich countries (from the World Bank) in 2016 we found that income inequality in Britain is indeed pretty average.

Income inequality in the UK is not 'high by international standards', even if you look at rich countries. If you include poorer countries, it is well below average. If you want to see high rates of inequality, go to Africa and South America.

As for the top one per cent, data is patchier and we can be less confident about the estimates, but those in the top one per cent (who - let's remember - are not the same people from year to year) seem to have had a growing share of income between 1980 and 2000. But there has been no consistent rise in the last twenty years and their income share has not 'tripled in the last three decades', as the BBC claims. According to the IFS's figures, their share of income doubled between 1980 and 2000, from 4 per cent of income to 8 per cent, but it has remained at around 8 per cent ever since.

The latest ONS estimates show something similar, with sharp fluctuations from year to year but no overall rise in recent years. The share going to the top one per cent remains below pre-crash levels.

Finally, the BBC makes the following assertion:

The big picture, says the IFS, is the UK is becoming more like the US, with a concentration of wealth at the top and pressure on working families lower down the pay scale.

Once again, I can find no evidence of the IFS saying this - it certainly isn't in the launch document - but I agree that there are reasons to be concerned about wealth inequality. As the launch document rightly says, house price inflation has meant that fewer young people are getting on the housing ladder and are therefore 'accumulating significantly less wealth than previous generations'. Higher house prices also mean that if your parents own their own home, you are likely to get a significantly bigger inheritance than someone who does not.

But there are huge differences between the UK and the USA. Whilst the UK has not seen a rise in income inequality for a generation, income inequality in the USA has continued to rise. And it is a little known fact that the UK not only has a much lower rate of wealth inequality than the USA, it also has a lower rate of wealth inequality than supposedly egalitarian countries like Denmark and Sweden.

None of these statistics are hard to find. Some of them are in the IFS launch document. Professor Deaton is quoted as saying that 'people were troubled by inequality'. This is hardly surprising when the public is routinely misled about the facts.

Previously published on the IEA blog
* The BBC changes the headline and opening sentence after this post was writen. 

Wednesday 15 May 2019

Junk science + junk reporting = a lie

This is truly atrocious reporting from the Daily Mail...

Smoking among children has plummeted by 35% since cigarettes were banned from till points and almost nine in 10 say smoking seems ‘unacceptable’

This claim is based on a study in the low quality journal Tobacco Control conducted by our old friends Gerard Hastings, Linda Bauld, Crawford Moodie and others. It doesn't look at smoking rates at all. It looks at 'smoking susceptibility' which is defined as 'the absence of a firm decision not to smoke'.

The adolescents in the study were defined as being susceptible to smoking if they failed to answer 'definitely not' when asked if they would (1) be smoking when they are 18, (2) smoke a cigarette at any time during the next year and (3) smoke if one of their friends offered them a cigarette.

The researchers/campaigners surveyed about a thousand kids in 2011 and then in 2014 and then again in 2016 (although they were different kids). The display ban was introduced in supermarkets in 2013 and in all shops in 2015. The relevant date is really 2015 because people got their most 'exposure' to the terrifying sight of cigarette packs in normal shops.

To cut a long story short, 28 per cent of kids were classified as susceptible to smoking in 2011 and this fell to 18 per cent by 2016. Using ad hoc reasoning, the authors put this down to the display ban.

It's weak stuff but that's Tobacco Control for you. What the study certainly doesn't show is that the smoking rate in this age group fell from 28 per cent to 18 per cent, but that's how the Daily Mail's Senior Health Reporter interpreted it...

A study found the number of 11 to 16-year-olds taking up the habit fell by 35 per cent after the ban was phased in across the UK between 2012 and 2015.

.. Results - published in the British Medical Journal's Tobacco Control - revealed the number of the participants who smoked before the ban fell from 28 per cent to 23 per cent midway through its phasing in.

This then decreased again to 18 per cent after the ban was established.

For God's sake. You don't even need to read the study to see that this isn't what it found. The press release clearly states that...

Smoking susceptibility among never smokers decreased from 28 percent pre-ban to 23 percent mid-ban, and 18 percent post-ban.

Did Alexandra Thompson - for that is her name - not find it surprising that 28 per cent of 11-16 year olds were smoking in 2011? At the time, less than five per cent of 11-15 year olds were smokers. Did she not think it odd that the smoking rate among this age group was significantly higher than in the adult population?

Apparently not. She didn't give it any thought, and nor will most of her readers. They will assume that the headline is correct and have their bias confirmed by Kruti Shrotri, tobacco control manager at Cancer Research UK, who is quoted as saying:

'Glitzy displays and glamorous packaging helped the tobacco industry lure the next generation of smokers into taking up a deadly addiction.

'But contrary to 'Big Tobacco's' belief that banning displays would make no difference, this study shows by putting cigarettes out of sight and out of mind far fewer youngsters are taking up the deathly habit.'

And Duncan Selbie, chief executive of Public Health England, who says: 

'Banning the display of tobacco products at point-of-sale has worked and it's fabulous more young people are now turning their backs on smoking, literally saving thousands of lives.'

But it literally did nothing of the sort. If you look at the statistics for smoking among children, you will see that the rate was steadily ticking down until the display ban came into effect in 2015, after which it rose from 4 per cent to 5 per cent (a rise of 25%, as the Mail might put it). It stayed at 5% in 2017.

I wouldn't suggest that the display ban caused the smoking rate to rise but it does seem to confirm the prior view of 'Big Tobacco' that 'banning displays would make no difference'.

Leaving aside the Daily Mail's pathetic journalism, this is yet another example of 'public health' researchers ignoring the primary outcome in favour of subjective, survey-based data. The display ban was sold on the basis that it would reduce underage smoking. It hasn't and so they look at the meaningless category of 'smoker susceptibility' (we can see that it's meaningless because it doesn't correlate with actual smoking).

Similarly, sugar taxes are sold on the basis that they will reduce childhood obesity. They don't, and so researchers focus instead on the sale of sugary drinks.

Minimum pricing was sold on the basis that it would reduce alcohol-related harm by reducing per capita alcohol consumption. It hasn't reduced alcohol consumption and so activist-academics are having to pivot to a position of saying that it reduced alcohol consumption when compared to a counterfactual.

Plain packaging was supposed to reduce cigarette consumption and lower the smoking rate. It hasn't, and so researchers focus instead on people's opinions about the plain packs.

There is a theme here. Most nanny state policies simply do not do what they are supposed to do. It is almost uncanny how often they achieve the exact opposite of what they are meant to achieve: alcohol consumption up in Scotland in the first year of minimum pricing; cigarette sales up in Australia in the first year of plain packaging.

Even when they don't do the opposite of what they're intended to do, they almost never do what campaigners claim they do: reduce smoking rates, reduce alcohol harm or reduce obesity.

In this instance, we are being told that banning cigarette displays behind shop counters reduced the youth smoking rate and that the ban is 'literally saving thousands of lives'. A glance at the real world data shows this to be untrue, but what happens in the real world is never anything more than a minor inconvenience in the 'public health' racket.

Tuesday 14 May 2019

Last Orders with Brendan O'Neill

There's a new Last Orders podcast out with Brendan O'Neill and me in the UK and Tom Slater down the line from the USA. Plenty to talk about, as always...

Why is TFL spending thousands to censor its own advertising? What’s driving Michael Gove’s plastic politics? Has the war on vaping gone too far? spiked editor Brendan O’Neill joins Chris Snowdon and Tom Slater to discuss all this and more on the latest episode of Last Orders, our nanny-state podcast.

Monday 13 May 2019

Is premature death from heart disease on the rise?

As societies become healthier, people are more likely to die from heart disease. If you avoid other causes of death, eventually your heart will pack up. This explains the apparent paradox of smokers being less likely to die of heart disease than nonsmokers.

But whilst you might expect more heart disease deaths overall, you'd expect premature deaths from heart disease to decline.

According to an unreferenced press release from the British Heart Foundation today, that is no longer happening in Britain. The BBC reported is as follows...

Heart deaths up for first time in 50 years

Deaths from heart and circulatory diseases among people under 75 is on the rise for the first time in 50 years, UK figures show.

The British Heart Foundation (BHF) says increasing rates of diabetes and obesity are partly responsible. 

In 2017 there were 42,384 deaths in under-75s from heart and circulatory conditions, up from 41,042 in 2014.

The charity says the historic pace of progress in reducing these deaths "has slowed to a near standstill".

According to the BHF, mortality is rising even among the under-65s...

The number of deaths caused by heart and circulatory diseases in under 65s is also increasing, peaking at 18,668 in 2017, up from 17,982 five years earlier.

The BHF do not link to their source and only say that they come from the 'latest national health statistics'. They don't seem to tally with figures from the Office for National Statistics. 

The ONS stats only look at England and Wales, but the trends are in the opposite direction.

For cardiovascular disease, they show 14,929 deaths among the under-65s and 34,169 deaths among the under-75s in 2016. In 2017, the number deaths fell to 13,528 and 31,443 respectively. 

For ischaemic heart disease, there were 7,916 deaths among the under-65s and 18,170 deaths among the under-75s in 2016. In 2017, these figures fell to 7,291 and 16,819 respectively.

For both diagnoses combined, the number of deaths among the under-65s fell from 22,845 to 20,819 and the number of deaths among the under-75s fell from 52,339 to 48,262.

The fact that the BHF's numbers are all smaller, despite including the whole UK, suggests that they are using a somewhat narrower definition of 'heart and circulatory diseases'. It is theoretically possible that a huge rise in heart disease in Scotland and Northern Ireland could explain the difference between the trend reported by the BHF and that found by the ONS, although it is extremely unlikely in practice.

It would be more useful to show the death rate per 100,000 people as the absolute numbers are affected by the size of the population (this is particularly important now that the baby boomers have reached old age).

But these are relatively minor issues. I'd be interested to know which figures the BHF are using because the standard official data do not support the claim that 'heart deaths are up for the first time in fifty years'.

Friday 10 May 2019

The cronyism of the sockpuppet state

The Economic and Social Research Council is funded to the tune of £212 million by the Department for Business, Energy and Industrial Strategy. In 2017, it announced the creation of the UK Prevention Research Partnership (UKPRP), 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'.

I suggested in Still Hand In Glove? that this had the hallmarks of another slush fund for political pressure groups. Some news yesterday removed all doubt...

We are delighted to announce that UKCTAS has been successful in securing future funding through a multi-funder research initiative; the UK Prevention Research Partnership (UKPRP). UKTCAS academics joined forces with new collaborators and a range of public and private sector organisations to apply to the UKPRP. The new consortium has now been awarded £5.9 million funding over five years and is called SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM). 

UKCTAS is the UK Centre for Tobacco and Alcohol Studies. It claims that it is not a ‘lobbying group, but we do have close links with advocacy organisations and will assist them where appropriate.’ As a result of its ‘meaningful and sustained collaborative relationships with advocacy organisations’, UKCTAS 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.'

Linda Bauld is the Deputy Director of UKCTAS. She has also been ‘closely involved in the development of the UKPRP and is a member of the steering group for this new initiative’.

Guess who's just been appointed director of the £5.9 million Spectrum project? Linda Bauld. Small world, eh?

The list of SPECTRUM's 'co-investigators' features some other familiar faces, including John Britton (director of UKCTAS), Alan Brennan (Sheffield University fantasy modeller), Anna Gilmore (Tobacco Tactics conspiracy theorist) and Mark Petticrew (anti-alcohol crank), plus two senior staff from Public Health England.

And it gets worse [or does it? See update below - CJS]. Look who else has got their snout in the trough...

A new consortium involving the Alcohol Health Alliance has been awarded £5.9 million funding from the UK Prevention Research Partnership, a group of twelve funders including charities, research councils and government. 

The SPECTRUM Consortium (Shaping Public hEalth poliCies To Reduce IneqUalities and harM) is one of four consortia successful in the inaugural round of UKPRP funding. SPECTRUM builds on and expands the work of the UK Centre for Tobacco and Alcohol Studies, one of the AHA members.

SPECTRUM’s focus will be on the commercial determinants of health and health inequalities, considering alcohol, tobacco and unhealthy food. Commercial determinants are strategies and approaches used by commercial companies to promote products and choices that are detrimental to health.

SPECTRUM brings together the AHA as well as the Obesity Health Alliance, Smokefree Action Coalition and other alliances...

This is a scandalous use of taxpayers' money. At least UKCTAS has the decency to pretend to be a serious research organisation. These groups don't even pretend. The Alcohol Health Alliance is a political lobby group, plain and simple. So is the Obesity Health Alliance. So is the Smokefree Action Coalition. They exist solely to campaign for policy changes and make no bones about it, so why hell is the Economic and Social Research Council giving them our money? 

These are the financial arrangements of a failed state. While 'public health' groups complain about (modest) cuts to the 'public health' budget, there seems to be a bottomless trough of money for a small clique of activists to give to their mates.

Earlier this week, I wrote about the £635,000 of public money that has so far been given to the pressure group Obesity Action Scotland. Last year we discovered that the National Institute for Health Research had given £1.5 million to a handful of blatantly partisan academics to evaluate the sugar levy, including Martin White who just happens to be the Director of the National Institute for Health Research's Programme Advisory Board.

The cronyism is becoming increasingly blatant, with the same people appearing again and again with their fingers in ever more pies. 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 sat on the Steering Committee and Programme Board of Smokefree Southwest during which time 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. She is now on the board of Spectrum which, in turn, is funding UKCTAS.

Taxpayer funding for overt lobby groups such as the Obesity Health Alliance is the final insult. It is now seven years since Eric Pickles called on local government to "cease funding ‘sock puppets’ and ‘fake charities’". Pickles is gone but the sockpuppetry continues. The only thing that has changed is that they cannot get their cash direct from government departments and have to launder it through organisations like Public Health England, the National Institute for Health Research and the Economic and Social Research Council, as well as through newly created organisations like the £5 million Obesity Policy Research Unit - and now SPECTRUM.

Whatever your view of alcohol, tobacco and food policy, this is a racket.


Linda Bauld has been in touch with some good news. She assures me that the alliances that are involved with SPECTRUM will not be seeing any of its money.

She writes:

'Just to clarify - the funders are led by the Medical Research Council, not the ESRC. There are 12 funders involved (research councils, charities, government). The alliances like AHA etc are not receiving any funding - in fact in contrast they are contributing staff time in kind, as is PHE, Health Scotland, Public Health Wales and the two small companies involved. The funding is for academic staff time (primarily post docs etc) and data costs like extending the Smoking and Alcohol Toolkits that UCL runs to Wales and Scotland.'

UKPRP's core funders are: British Heart Foundation, Economic & Social Research Council, Engineering and Physical Sciences Research Council, National Institute of Health Research and the health departments, Medical Research Council, The Wellcome Trust.

Thursday 9 May 2019

The thirdhand smoke gravy train

You shouldn't

Now that the ISIS caliphate has fallen, California has regained the number one spot as the place that is more opposed to the Enlightenment than anywhere else in the world. Like ISIS, Beverly Hills is banning the sale of tobacco and has an insanely draconian smoking ban...

Beverly Hills already has strict regulations on how people smoke. Doing so while standing still, for example, is illegal — if you're going to smoke, you must be walking and continuously moving.

There is a suggestion that parts of California want to ban tobacco sales as a way of banning e-cigarettes, about which hysteria has reached new heights this year. That would certainly be its effect, thanks to US agencies ludicrously defining vaping products as tobacco products.

Facts and science have long been treated with suspicion in the Golden State. I don't know who the woman below is, but she was allowed to give 'evidence' to Beverly Hills city council yesterday in the prohibition debate (where a ban on tobacco sales was passed unanimously). She appears to believe in homeopathy.

She mentions the website and I would echo her advice to visit it. It's hilarious. Amongst its comic charms are such articles as 'How my grandfather's cigar damaged his possessions' which explains the basic idea:

Objects that have spent time in the home of someone who smokes are contaminated with thirdhand smoke pollution. Even when there is nothing you can see or smell, items can still be covered with toxic tobacco smoke residue.

Thirdhand smoke residue is sticky, and it stays around for years. It’s also aggressive—it doesn’t simply stay on the object, but it mixes with the air and forms even more toxic substances. Thirdhand smoke can stick to large items in your home, such as furniture, rugs, and window curtains. But it can also stick to other smaller items, such as toys, books, stuffed animals, throw pillows, and television remotes.  When we use the objects, we get exposed to the toxic residue and help spread the thirdhand smoke inside our home because it gets on our skin, hair, and clothing. 

The website promises to provide 'summaries of important research studies related to thirdhand smoke and its effects on human health'. Alas, the 'effects on human health' do not get a look-in (because they are non-existent). Instead, it provides a list of places where trace levels of nicotine have been found, including houses, casinos and hotel rooms.

The whole thing seems designed to appeal to California's legion of hypochondriacs. In the FAQs, smokers are advised to strip, shower and wash their clothes after every cigarette:

When outdoor smokers come inside, the odor they emit is not simply a nuisance. The tobacco smoke odor we smell is a direct sign that a mixture of odorant and odorless tobacco smoke pollutants has been brought into the home on the clothes, skin, hair, and in the exhaled breath of the smoker. Inside the home, the pollutants off-gas into the air, and nonsmokers are now exposed to them through inhalation. In addition, some of these compounds will now adsorb, deposit, and accumulate in the indoor environment even though no cigarettes were smoked indoors. There are three main strategies for preventing tobacco smoke pollutants from clothes and on persons from entering and building up in a home

1) Leave clothes worn while smoking outside the home (e.g., patio, garage).
2) Immediately wash clothes worn while smoking.
3) Ask smokers to wash their hands and shower immediately upon entering the home.

The website is the creation of Georg Matt. Long term readers will recall him as the psychologist who invented the concept of thirdhand smoke in the first place. 'Thirdhand smoke' isn't smoke and it isn't remotely dangerous. It is just the residue of old smoke that you might see on the yellow wallpaper of a heavy smoker.

Way back in 2004, Matt started looking for nicotine and cotinine on household surfaces using highly sensitive instruments. Unsurprisingly, he found more of these substances in the homes of smokers who claimed to smoke outside than in the homes of nonsmokers. But in every case, the nicotine concentrations were tiny. The bedrooms of nonsmokers had nicotine concentrations of 0.09 micrograms per cubic metre (μg/m3) whilst the children of smokers had concentrations of 0.22 μg/m3.

To provide some perspective, an air nicotine concentration of 50μg/m3 would not be uncommon in a bar which allows smoking and the legal limit of workplace exposure in the US is 500 μg/m3.

Matt wrote this up for the journal-comic Tobacco Control and everybody ignored it until the silly season of August 2006 when Matt gave it another media push and generated headlines such as 'Even smoking outside can harm your baby'.

But he had not yet coined the killer term 'thirdhand smoke'. That didn't happen until in 2009 when he published a study with Jonathan Winickoff. The sly genius of that piece of junk science was that it avoided the tricky task of showing that thirdhand smoke presents the slightest danger to health by simply assuming that it does. The study itself was no more than a survey asking people whether they agreed with the following statement:

“Breathing air in a room today where people smoked yesterday can harm the health of infants and children.”

65.2% of nonsmokers agreed, as did 43.3% of smokers. Matt and his team also found that people who agreed with the statement were more likely to ban smoking in their home. They therefore concluded that...

Emphasizing that thirdhand smoke harms the health of children may be an important element in encouraging home smoking bans.

The study did not show that thirdhand smoke actually does harm the health of children - because there was no evidence for that - but the study was published with a suitably incendiary press release and the media fell into line. The BBC, for example, reported it as follows:

Many people are unaware that even smoking away from babies or pregnant women presents a risk, according to US research.
Poisons in cigarette smoke can linger on fabrics or hair, but a survey of 1,500 households found that fewer than half of smokers knew this.

You almost have to admire the feral cunning required to pull off this trick. As I said at the time:

It was a masterstroke by Georg Matt and his team. Their greatest weakness was that thirdhand smoke was almost universally unrecognised even as a concept. Worse still, it had not one shred of evidence to support it. Ingeniously, they turned these weaknesses into their strengths. Like the tailors who made the emperor's new clothes, the authors dared the media to admit that they were ignorant of thirdhand smoke and, winning the bluff, blasted the idea into the public consciousness.

The concept of thirdhand smoke was clearly invented to encourage people to stop smoking in their own homes. In truth, it has never really taken off, even among anti-smoking groups like ASH, because most people intuitively know that it is preposterous. The exception is on the West Coast of America where people will believe almost anything. As a result, Matt has carved himself a nice little niche in San Diego where he has continued to produce study after study mining this seam of woo.

And now, thanks to the absolute state of California, he has hit the jackpot.

First Thirdhand Smoke Resource Center in Nation Opens at San Diego State University

The dangers of smoking and secondhand smoke have long been studied, but now the nation’s first public resource center on thirdhand smoke has opened up right here in San Diego.

Researchers with San Diego State University and the University of Southern California opened the Thirdhand Smoke Resource Center on the former’s campus Wednesday.

“There’s a big illusion that when tobacco smoke disappears, we’re safe,” said SDSU psychology professor and director of the resource center, Georg Matt. “Unfortunately, some of the most toxic compounds clinch to surfaces. They get embedded in carpets, they coat walls, they penetrate into walls. They become part of the indoor environment.”

 Needless to say...

The Thirdhand Smoke Resource Center is funded by revenues from a cigarette tax increase approved by California voters in 2016.

Matt has goldplated his theory over the years, moving from an unwarranted assumption that a room is dangerous if someone smoked in it the previous day to the utterly deranged assumption that a room is dangerous if someone smoked, vaped or used chewing tobacco in it weeks, months or years earlier. And yet, if you dig into the FAQs, you will find this crucial admission...

Currently, there is very little information on the unique health effects of THS because research on THS and health have only recently begun.

Only just begun? It's been fifteen years and there is still not a scintilla of evidence that human health is harmed by proximity to a smoker's old armchair.

Still, this new smoker-funded gravy train should provide enough money for Georg Matt to keep carrying out 'research' for the rest of his pointless career.