Tuesday, 28 January 2020

Alcohol sales after minimum pricing - the saga continues

Another NHS evaluation of minimum pricing (MUP) was published today. You can probably guess the general conclusion from the fact that it was the first item on BBC Politics Live, ahead of the big story about Huawei. The Beeb seems obsessed with promoting minimum pricing at the moment.

Just watch this garbage...


So much nonsense in so little time.

Firstly, there's been no research published on problem drinking in Scotland under MUP, so Smith is a fabulist to claim that it is 'on the way down'. All we have are the alcohol-related death figures for 2018 which rose in Scotland and fell in England and Wales (although you'd never guess that if you relied on the BBC for your news.)

Secondly, Scotland's alcohol consumption is not "average" for the UK, as Smith claims. It is significantly higher and has been for as long as anyone can remember.

Thirdly, Mexico has never had minimum pricing. I can only assume that Jo Coburn is confusing it with another regressive nanny state policy, the sugar tax.

In case you're wondering, the fourth guest was also in favour of minimum pricing. Lovely bit of balance. 

As for the report itself, it claims that there was a 3.6 per cent drop in off-trade alcohol sales in the twelve months after MUP was introduced. This, apparently, is what success looks like...

 

A 3.6% decline is a very different finding to that produced by the IRI sales figures that I have mentioned before.

IRI's figures show that there were 25 million more units of alcohol sold in the first nine months of minimum pricing than in the same period in the previous year. This is not a large rise, but it is certainly not a decline, even when you look at the figures on a per capita basis. Although I haven't seen the figures for the last three months of the year, I am told that nothing dramatic happened to sales that would have reversed this picture.


IRI uses a similar methodology to Nielsen in so far as they both look at what goes through the tills in a large sample of shops. Aldi and Lidl don't co-operate with either company so IRI and Nielsen have to estimate/guess how much alcohol they are selling. This leaves room for error in both sets of statistics and I cannot say which has the best system.

Nielsen gets data directly from 83% of the non-discount supermarkets and large convenience chains, of which there are over 10,000. But for the 33,000 independent convenience stores, it settles for a weekly random sample from which it makes an estimate.

That's a problem because there is good evidence that people are shopping more alcohol in convenience stores since MUP was introduced. Why wouldn't they? If supermarkets don't have a price advantage on cheap drink, you can just buy it from your corner shop.

It is unclear whether the discount supermarkets Aldi and Lidl have benefited from MUP, but we do know that people are using them more year-on-year for their grocery shopping. Therefore, the two sectors of the retail industry that are most likely to have been selling more alcohol since May 2018 have the least reliable information in the Nielsen data set.

I'm not saying it's necessarily wrong, nor am I saying that the IRI figures are necessarily better. It would obviously not be surprising if a price rise led to less consumption. Unless the alcohol industry publishes the IRI figures, people are naturally going to rely on the Nielsen figures. But the overall sales figures published today are far from definitive and may be way off.

And when you consider the cross-border and online shopping that has undoubtedly taken place - but which cannot be quantified - you should not mistake any sales figures for consumption figures.

Last Orders with Dominic Frisby

More podcastery for you. The new episode of Last Orders has landed, in which we are joined by Dominic Frisby to discuss Prohibition, fake news and taxation. Dominic has recently published a book about the latter. It's called Daylight Robbery, a reference to the window tax which, as you will hear on the podcast, lasted a lot longer than you might think.

It appears that the IEA's office was once a victim of it...


Listen, subscribe, etc.

Dominic is also trying to get his Brexit single to number one in the charts this weekend. You can help him here.

Yes, sugar consumption has declined

This tweet was doing the rounds last week, attracting the best part of 3,000 retweets and 10,000 likes.


The tweeter seems to have monetised his interest in the keto diet. It's unclear whether he's referring to the UK or the USA. Either way, his figures are wrong.

Sugar consumption in Britain is currently somewhere around 30 to 35 kilograms per year, as multiple sources confirm. That's 66 to 77 pounds.

We have been consuming more than 5 pounds of sugar a year since the 1710s and we were consuming 90 pounds of it by the start of the twentieth century. It reached a low under rationing during World War II but even then the amount consumed (70 pounds) was about the same as is consumed today. The peak seems to have been in the 1970s when the figure was 115 pounds.

If Britons stuck to the new guidelines, which have no scientific justification, per capita consumption would be well under 25 pounds a year, a level last seen in the early nineteenth century.

That is what the facts say - and we have plenty of facts on the production, import, sale and consumption of sugar. I have written about this before, but nobody wants to believe it because it doesn't fit the current, laxy narrative and it doesn't offer easy answers.

Nevertheless, sugar consumption is lower today than it was when obesity was at a fraction of the current level. A new study published this month confirms it, and finds a similar decline across the English-speaking world. Published in Nature Food, the authors 'analysed data for 171 countries on the availability of 18 food groups from the United Nations Food and Agriculture Organization' since 1961 and found that...

...in many Western countries the supply of animal source foods and sugar declined.
The animal source and sugar score increased most over the half-century in China, followed by countries in southern and eastern Europe, east Asia and parts of central Asia. Meanwhile, six of the nine largest decreases took place in high-income English-speaking countries (that is Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States of America).
...although east Asia also experienced a large rise in the animal source and sugar score, many Western countries, especially high-income English-speaking countries, experienced declines.
South Korea, China and Taiwan experienced the largest changes, with animal source foods and sugar, vegetables and seafood and oilcrops all becoming a more abundant component of food supply. This contrasts with high-income English-speaking countries, in which the animal source and sugar score has declined substantially.

Naturally, the study was not reported by the media anywhere.

Déjà brew: 100 years on from prohibition

With the 100th anniversary of the start of Prohibition two weeks ago, I did a podcast for the IEA talking about the lessons that have been learned and unlearned.

Do have a listen and get yourself subscribed to it if you haven't already.

I also wrote about the centenary for Spiked.

And see Monday's blog post if you need a reminder of the problems of neo-prohibitionism today.

Monday, 27 January 2020

Australia's tobacco bootleggers

In September, cigarette taxes will rise by 12.5% (plus VAT) in Australia for the eighth successive year. A pack of premium cigarettes will cost nearly $50.

The impact of these sky high prices on the smoking rate has been remarkably modest. Daily smoking prevalence has dipped from 14.5% in 2014-15 to 13.8% in 2017-18. This is less of a decline than many countries have managed without resorting to such extreme tactics, and is appreciably less than has been seen in countries which have allowed vaping to flourish (the sale of e-cig fluid is banned Down Under).

But the tax hikes have had very predictable effects in other ways...

In one month alone the Australian Border Force has seized 20 million cigarettes and almost 12 tonnes of illegal tobacco.

On June 1 2018 a joint Australian and Taiwanese operation intercepted two sea cargo containers full of black market smokes en route to Australia. 

The 20,100,000 illicit cigarettes would have resulted in about $14.2million in lost revenue, according to the ABF.

Just four days earlier ABF officers seized 1.6tonnes of illicit tobacco during a series of raids in Adelaide.

The raids came three days after another bust, this time involving about 10 tonnes of illicit tobacco.

This is going well!

Rohan Pike, who spent 25 years with the AFP and Border Force and created the Border Force’s Tobacco Strike Team, said he wasn’t surprised that smuggled cigarettes were so easy to come by.

“There were 300,000 seizures of illicit tobacco last year by the Border Force,” he said.

He said there are on average 1000 seizures a day.

Meanwhile, in Western Australia...

There has been an explosion in Australia’s tobacco black market after more than 300 tonnes of smuggled contraband was seized by officials in the past year.

Australian Border Force said the amount had tripled since 2017 as organised crime delved deeper into the illegal trade.

At this point, it would take an imbecile to deny that Australia's 'world leading' tobacco control policies has created an epidemic of black market activity.

Simon Chapman, respected tobacco control activist and health academic, said claims of a booming black market were overblown.

Image result for naked gun nothing to see


Thursday, 23 January 2020

How the regulatory ratchet works

The temperance lobby’s reaction to today’s study showing no impact of minimum pricing on underage drinkers has been depressingly predictable.

For years, they used children as a pretext for minimum pricing, endlessly complaining about ‘pocket money prices’. Here is Alcohol Focus Scotland in 2013, for example;

Chief executive of Alcohol Focus Scotland, Dr Evelyn Gillan, said: ‘We must be aware that our young people are growing up in a proalcohol society where drinking is portrayed as a normal part of everyday life. To better protect our children, one of the best things we can do is to increase the ludicrous pocket money prices at which some alcohol is sold.’

Get that? One of the best. Not one option. Not one possibility. But a proven policy of the first order.

Alcohol Focus Scotland’s message today was rather different. Their current CEO, Alison Douglass, didn’t reflect on the study’s principle findings at all. She barely even mentioned minimum pricing. Instead, she said:

“This study provides a unique – and concerning – insight into the lives of a group of teenage drinkers and shows that the cost of alcohol is only one factor in their alcohol consumption.

The apparent ease with which these young people are able to acquire alcohol raises serious questions about enforcement of existing licensing legislation and age-verification arrangements which are there to protect young people.

.. The research also points to many of the products favoured by these young people as already costing more than 50p per unit, before MUP was introduced. We also know that brands are important to children and young people whether we’re talking about clothes and trainers or indeed alcohol. More needs to be done to address the attractiveness of alcohol by controlling alcohol marketing.”

Scotland’s public health minister, Joe Fiztpatrick, is singing from the same hymn...

“This study of a very small number of young people found where they were consuming alcohol the products were priced above the minimum price of 50p per unit.

We want to go further to protect our children and young people from alcohol harms and that is why I intend this year to consult on potential mandatory restrictions on alcohol marketing and advertising. Scotland will be the first of the UK nations to do so.”

And so the regulatory ratchet continues to turn. As I have said many times before, ‘public health’ is not a results-driven enterprise. Win or lose, the answer is always more bans and higher prices.

More evidence that minimum pricing was a flop

The evaluations of minimum pricing, such as they are, keep on coming. The latest looks at the drinking habits of 13 to 17 years who 'reported that they were drinking before and after MUP was introduced'. Fifty of them, to be precise.

Here are the findings...

The study found that money and price changes were not perceived to be barriers to drinking by the children and young people interviewed.
The price of alcohol was not seen as an important factor in their drinking behaviour, and overall they did not report changing what they drank, how much they drank or how they obtained their alcohol, in response to price alone.

Oh.

The young people who reported that their favoured drink had increased in price tended to carry on drinking it because they said the price rise was not much and they could still afford it

Oh dear.

The study found no reported changes in the extent or nature of alcohol-related harms amongst the young people interviewed, following the introduction of MUP.

Hey ho, never mind. It was worth a try. (Narrator: It wasn't worth a try).

These results are not encouraging for those who wibbled on about the need to end 'pocket money prices' for the sake of the children. Let's recall what the Alcohol Health Alliance's Ian Gilmore said in 2016:

“In spite of a government commitment to tackle cheap, high-strength alcohol, these products are still available at pocket money prices. Harmful drinkers and children are still choosing the cheapest products - predominantly white cider and cheap vodka."

Apparently they weren't.

Interesting as this is, I hope we're going to get some quantitative evidence from the evaluation process soon. Studies based on statements from a small group of people are of limited value. However, when combined hard evidence that the sale of alcohol from shops rose after minimum pricing was introduced, and that the number of alcohol-related deaths rose in 2018, today's study is another piece of the jigsaw suggesting that minimum pricing has been a flop.

UPDATE

The BBC initially covered this story under the headline '"No impact" of alcohol pricing impact on young'.

But within a couple of hours - perhaps after a few phone calls from their friends in 'public health' - it was changed to this...


And they wonder why they are losing people's trust.  

Wednesday, 22 January 2020

The unsound Bristol Pound

At the weekend it was reported that the Bristol Pound, a local currency that is worth the same as a normal pound, has fallen on hard times and may soon be taken our of circulation. In practice, this means that the government has stopped squandering taxpayers' money on it.

I looked at the financial accounts of the company that runs the scheme and was astonished by the amount of cash it has got through. Every Bristol Pound spent in every transaction since 2012 has cost around 33p in administration costs. The only people who have benefited from the project are the people who run it.

I've written about it for Cap-X. Do have a read.

The World Health Organisation lies about vaping on an epic scale

The deadly coronavirus that has infected hundreds of people in China and has now spread to the USA is the biggest global public health threat we have seen for some years. Naturally, therefore, the World Health Organisation spent yesterday putting out a series of deranged tweets about vaping

As I mentioned on Monday, US health agencies have finally accepted that last year's 'vaping-related' deaths were due to vitamin E acetate in illegal THC cartridges, not regular e-cigarettes. Ignoring the facts entirely, the anonymous charlatans in the WHO's tobacco division put out this tweet...


That was just one tweet in a thread that should end all discussion about whether the WHO is a credible source of information on e-cigarettes. There was was also this...


I know of no evidence that e-cigarettes cause either heart disease or lung disorders (the WHO certainly doesn't cite any). And e-cigarettes don't really 'expose' non-smokers to nicotine because the user's lungs absorb the nicotine - that is kind of the point - and nicotine isn't dangerous anyway.

Things got even crazier with this...



What can you say about the claim that vape juice burns the skin, other than that it just doesn't? Nor can it cause nicotine poisoning unless you drink a vast quantity of it (even then, you'd probably throw up).

Oh, and it is also not highly flammable. In fact, it's not flammable at all (I've tried).

One thing everybody can agree on - even clowns like Stanton Glantz - is that e-cigarettes are less hazardous to health than combustible cigarettes. Everybody except the WHO, that is, who think they could be more dangerous...


And they weren't finished yet...


Again, there is simply no evidence of harm and the WHO can't cite any.


The evidence shows that taxing e-cigarettes leads to more people smoking. This is unsurprising. The two products are substitutes for one another.
 
There's even more of this garbage if you look at the whole thread. Suzi Gage spotted the irony in this one...



This appallingly dishonest propaganda obviously runs contrary to the facts. It also runs contrary to the position of the British government, so surely it is time for the UK to stop funding the WHO's tobacco division (the Framework Convention on Tobacco Control). We are its biggest funder by far.


So much for soft power. The WHO is incapable of reform. Pull the money.

PS. Vaper-hating journalist Sarah Knapton is lapping it up.

Tuesday, 21 January 2020

The Action on Sugar/Alcohol Health Alliance mash up

Two of Britain's most hysterical, illiberal and puritanical pressure groups have got together to mark Sugar Awareness Week. Action on Sugar, who invented this annual non-event, have done their usual thing of measuring the amount of sugar in various products and pretending to be shocked by the number of 'teaspoons' therein.

It's an old routine and even the press have shown signs of getting bored of it lately, so they have drafted in Alcohol Health Alliance to express additional outrage. It's like when Tim Burton directed Batman Returns and decided that two baddies would work better than one. Think of Action on Sugar as Catwoman and Ian Gilmore as the Penguin.

Naturally, this two-headed monster has found much to be appalled by. It turns out that if you mix spirits with a sugary drink, you will end up with a sugary alcoholic drink. To maximise their outrage about this, AoS/AHA have split the beverages into different categories. Under 'spirit/liquer and mixer (excluding gin)', for example, we are told:

The worst offenders in this category have in excess of 30g sugar (8 teaspoons) in a serving – more sugar than nine custard cream biscuits!

That's an Archers and lemonade, FYI.

Under 'traditional premixed cocktails', we are solemnly informed that...

Many drinks in this category were exceedingly high in sugar. Notwithstanding its larger pack size (500ml), TGI Friday’s Passion Fruit Martini has over 12 teaspoons of sugar (49.1g) – the same as drinking nearly two cans of Red Bull!

Gosh, that would be like having TWO vodka and Red Bulls! And since Red Bull comes in a 250ml can, I guess that makes sense.

There is also the usual 'reformulation is easy' shtick, but it only serves to remind you that quality requires natural sugar...

The findings also clearly demonstrate that lower sugar products can be produced easily. For example, Asda Vodka, Lime & Lemonade has 12g sugar (3tsp) in a 250ml can, whilst Classic Combinations Vodka Lime and Lemonade has over a teaspoon of sugar extra at 16.2g sugar per 250ml can.

This takes me back to when Action on Sugar slagged off Waitrose's Duchy Organic ice cream for having 'excessive' sugar and held up Asda Smart Price ice cream as the model to be followed. Which of those do you think tastes better?

This is the best vodka, lime and lemonade, as far as Action on Sugar are concerned. It's £1 a can.

And this, on the far right, is the worst...


I can't tell you how much the latter costs because no online supermarkets seem to sell it, but it's made by the Manchester Drinks Co. so I'm guessing it costs well over £1. I also suspect it tastes better than the Asda one.

Incidentally, what does the Alcohol Health Alliance think about their new pals encouraging people to drink the cheapest drinks?

Action on Sugar's perennially shocked Katharine Jenner seems to be in a competition with her boss, Graham MacGregor, to see who can express the most fury about the smallest things. She kicks things off the pearl-clutching by saying:

"If consumers knew how much sugar was really in these drinks, would they still happily choose to drink their way to tooth decay, obesity and type 2 diabetes?”

Not a bad bit of hyperbole there, but MacGregor ups the ante with...

It is a national scandal that because these drinks contain alcohol, they are not subject to the sugar tax or any form of coherent nutrition labelling."

A national scandal?! Action on Perspective, more like.

But, for my money, Dr Saul Konviser of the Dental Wellness Trust trumps them both with this zinger...

"It’s truly shocking that these popular ‘ready to drink’ pre-mixed spirits are packed with excessive sugar and hidden calories and it’s no wonder the UK has a tooth decay crisis on its hands."

There has never been less tooth decay, but never mind. He carries (caries?) on with some human rights banter...

"Good oral health is a basic human right yet for some reason, drink manufacturers are being allowed to peddle these unhealthy drinks with limited nutritional information on pack. It’s ludicrous that drinks such as lemonade are subject to the sugar tax yet a vodka and lemonade is exempt. Now is the time for tough government led action to protect this human right."

 We have a winner!

And what's the point of all this? As you might have worked out from comments above, he wants the sugar tax extended to alcopops. He doesn't seem to be aware that these drinks are already taxed at a very high rate. The tax on a can of ready-to-drink alcohol is at least four times higher than on a can of Coke. If he thinks that adding 6p to a gin and tonic is going to have any effect of sugar consumption, he needs his head examining.

As, indeed, he probably does.

Monday, 20 January 2020

America's anti-vaping scam

It took five months, but the US Centers for Disease Control has finally faced reality:

CDC no longer recommending people avoid all e-cigarettes, focuses on THC-containing products

The U.S. Centers for Disease Control and Prevention removed verbiage from its website this week suggesting that people refrain from all vaping products during its investigation into vaping-related lung injury.
The CDC previously urged people to consider refraining from the use of all e-cigarette or vaping products. Now the agency is focusing on THC-containing products.

This, and the role of Vitamin E acetate in the epidemic, was obvious a very long time ago to anyone who was paying attention.

Donald Trump reportedly regrets getting involved...

President Trump told his health secretary yesterday that he regrets getting involved in the administration's policy on vaping, according to two sources familiar with the conversation. "I should never have done that f***ing vaping thing," Trump said during an impromptu call on speakerphone in an Oval Office meeting.

Never mind. For the neo-prohibitionists, it's job nearly done. The FDA is banning flavoured vape cartridges. When this fails to slash youth vaping rates, they will push for a ban on all flavored vapes and/or all cartridge devices. San Francisco has already banned all vape products. Several states have banned all flavoured vape juices.

Future generations will be amazed at how easily a moral panic was orchestrated against e-cigarettes in 2019. Take Michael Bloomberg, for instance. Last September, he appeared on CBS News with Matt Myers of the Campaign for Tobacco-Free Kids. Barely a word of truth passed his lips. You can watch the interview below.



I won't fisk the whole thing but the following quotes give you an idea of the incorrigible dishonesty of he and his kind:

"All the progress we've made in reducing teen smoking in particular is being turned around because the kids like the flavour in the vaping products."

In fact, the biggest rise in vaping (in 2014) coincided with the biggest fall in cigarette smoking. There was a tiny rise in the smoking rate in 2018, but it then fell to just 5.8 per cent in 2019. This is a third of the rate it was before e-cigarettes arrived on the scene.

Bloomberg didn't have the data for 2019 when he did his interview, but I'm sure he'll use some of his vast wealth to set the record straight now...

Asked whether he stood by his claim that "tobacco companies are behind" the rise in underage vaping, he said:

"Oh, there's no question about that! They're advertising to kids. They run these enormous ads everyday in the paper saying 'we'll help you stop smoking', but they've never released any evidence whatsoever that it does anything to help you stop smoking."

They don't need to. There is plenty of evidence that e-cigarettes help people smoking. See, for example, this, this and this.

"In fact most people that vape never smoked before."

False. Most vapers are current or former smokers, as Konstantinos Farsilinos points out:

In all countries where e-cigarette use in the population has been monitored we find that e-cigarette use is largely confined to current and former smokers while use by never smokers is rare. For the US, I present below a graph with official data from the 2016 and 2017 (pooled) National Health Interview Survey, a population-representative US survey conducted by the National Center for Health Statistics. The graph shows that the vast majority of e-cigarette users are current or former smokers.

Bloomberg also came up with this bizarre factoid, apparently off the top of his head...

"Just think if your kid was doing this and winds up with an IQ 10 or 15 points lower he or she would have had for the rest of her life..."

This is lie is worthy of the quacks of Scientific Temperance Instruction. When asked if this has been demonstrated scientifically, even Matthew Myers couldn't bring himself to defend it.

And so it goes on. The American people have been conned by a shower of smooth talking charlatans. 

Friday, 17 January 2020

Prohibition - never again?


Today marks one hundred years since the start of Prohibition. I've written an article for Spiked about its legacy and the lessons that have and have not been learned.

The problem with arguing about whether prohibition ‘worked’ is that it implicitly acknowledges a false premise. It suggests that the policy would have been commendable had the government been able to enforce it properly. But as Daniel Okrent, author of the excellent Last Call, writes, the worst thing about prohibition was that ‘it took away an individual right’. All the problems we associate with prohibition stemmed from people responding to their right to drink being violated, but we should not imagine that prohibition would have been a ‘success’ if the public had meekly submitted.

In retrospect, it is obvious that there were far too many drinkers in 1920 for national prohibition to have ‘worked’ in the sense of being respected. But even if the US had avoided all the murders and poisonings, there would have been nothing noble about the experiment. It was a hideously illiberal policy with strong undertones of xenophobia and class prejudice, and would have been no less objectionable if drinkers had been an obscure minority. Prohibition was dreadful both in practice and in principle.

A recent study, which found some positive health effects from earlier statewide prohibitions, finished by saying: ‘Whether or not these benefits exceeded the costs of prohibition remains an open question.’ Why? Because ‘importantly, if individuals are utility maximising, value-of-life measures lose meaning since they do not incorporate the lost utility from forgone alcohol consumption’. The authors are economists, and it shows, but their point is that people enjoy drinking. Assuming they know the risks, drinkers take more out of alcohol than alcohol takes out of them (to paraphrase Churchill). If you deprive them of this pleasure, or make it pricier or more difficult to acquire, you are doing them real harm. This is a crucial aspect of public-health policy that is rarely mentioned in the public-health literature.

Do read it all.

I've also created a Twitter thread of prohibitionist propaganda.




Wednesday, 15 January 2020

The Nanny State Rich List

The Taxpayers' Alliance published the latest Nanny State Rich List last week. It's always worth a read if you get to get your blood pressure up. As usual, Public Health England makes up most of the top spots...



But some of the local directors of public health are not far behind.


The report says...

  • 21 public health employees received a higher salary than the prime minister’s current salary of £154,908 in 2018-19.
  • Britain’s 10 top paid public health employees earn an average of £242,650, with two individuals receiving over £250,000, including one individual receiving over £300,000.

  • UK local authorities’ directors of public health receiving over £150,000 have increased from 17 in 2017-18 to 22 in 2018-19, an increase of over 29 per cent.


It's a racket.

Tuesday, 14 January 2020

The problem gambling rate is still low

The latest estimates of the problem gambling rate in England were published last month. They received no media attention for reasons that will soon become obvious.

Two systems are used - the Problem Gambling Severity Index (PGSI) and the Diagnostic and Statistical Manual of Mental Disorders, fourth version (DSM-IV). Since we started measuring problem gambling rates in 1999, both systems have produced numbers within the narrow margins of 0.4 per cent and 0.9 per cent.

Three British Gambling Prevalence Surveys were published between 1999 and 2010. There was no clear trend, although there was a hint of a rise between 2007 and 2010.

1999: 0.6 per cent (DSM-IV), N/A (PGSI)

2007: 0.6 per cent (DSM-IV), 0.6 per cent (PGSI)

2010: 0.9 per cent (DSM-IV), 0.7 per cent  (PGSI)

Responsibility for collecting the data was then handed to public health bodies who came up with the following estimate for England and Scotland (combined) for 2012:

2012: 0.5 per cent (DSM-IV), 0.4 per cent  (PGSI)

From 2013, the figures were collected by the Gambling Commission which only uses the PGSI methodology. Results were as follows:

2013: 0.5 per cent

2014: 0.5 per cent

2015: 0.5 per cent

2016: 0.7 per cent

Problem gambling estimates have now been properly incorporated into the Health Survey for England. The latest figures (for 2018) are...

DSM-IV: 0.5 per cent

PGSI: 0.4 per cent

Despite all the panic about the Gambling Act, internet gambling and fixed-odds betting terminals, the story of problem gambling in Britain in the last two decades can be filed under 'nothing to see here'. Rates are low by international standards and have remained low.

Most people probably think problem gambling has been rising over the years. If so, it is because the media seize on statistically insignificant rises and fail to report commensurate declines. That is why we have seen so many reports of the problem gambling rate doubling. In truth, they are meaningless fluctuations within wide confidence intervals.

The problem gambling rate has been essentially flat for as long as we've been measuring it. If the next Health Survey for England shows a rate of 0.6 per cent under one of the measures next year, don't be surprised if the newspapers lead with the news that the number of problem gamblers has risen by 50 per cent. It's rubbish. Ignore it.

Monday, 13 January 2020

Sweet success for sugar tax?

The "i" newspaper has some apparently good news about the sugar levy on its front page today. The article itself is thin stuff. We are told that the average sugar content of soft drinks fell by 28 per cent between 2015 and 2018, but this is a figure from Public Health England's sugar reduction report published last September.

Apart from that, we are told that the study in question was published by BMC Medicine. If so, it's not online yet. The only author named is Lauren Bandy, who is a PhD student.

There is slightly more information in the Daily Mail, whose headline is...

Sugar tax is WORKING: Britons' consumption of sugar has dropped by a teaspoon a day since tax on sweetened drinks was launched

It includes this nugget...

Since 2015 the sugar in soft drinks sold in the UK has dropped by 30 per cent – equivalent to a daily reduction of 4.6g per person. That is the equivalent of cutting out more than one teaspoon of sugar each day.

I'm not sure if this is an estimate from the study or a back-of-an-envelope calculation by the Mail. Either way, it is not true. The PHE figures show a 28.8% reduction in the average amount of sugar in soft drinks, but a smaller reduction of 21.6% in the amount of sugar actually consumed in soft drinks.

And the amount of sugar consumed in food increased...

overall there has been an increase from 722,976 tonnes of sugar sold at baseline to 741,700 tonnes in year 2 which represents an increase of 2.6%

Finally, let's remember that the consumption of sugary drinks was in steep decline long before the government started taxing them. (Obesity, on the other hand, continued to rise.)


As I recall, the idea behind the sugar tax was to reduce obesity rates, not to pressure companies into producing soft drinks that people don't want to buy. There is no evidence from the UK or anywhere else that taxing sugary drinks has the slightest impact on obesity or health, so talk of 'sweet success' is premature, to say the least.  

When the study surfaces, I will let you know.

UPDATE

My old mucker Kate Andrews has written more about this here and has updated my graph. It appears that sugary drink consumption actually rose in 2018. This is masked in the PHE report because they only compare 2018 with 2015. Will the curse of 'public health' ever be lifted?




Friday, 10 January 2020

Jamie Oliver - the final humiliation

What is best in life?

McDonald's set to open at former Jamie's Italian restaurant in Guildford

McDonald's is to move into the former Jamie's Italian restaurant in Guildford town centre, planning documents reveal.

The fast food giant looks set to move into the large, vacant building at 13 Friary Street, which has been empty since chef Jamie Oliver's restaurant closed in May 2019.

To crush your enemies, to see them driven before you, and to hear the lamentations of their women.

Have a great weekend!



Thursday, 9 January 2020

The endless regulatory ratchet

Further to Tuesday's post about the number of smokers rising in Scotland, despite the introduction of wondrous policies like plain packaging, it is worth reading a document published last February by ASH's Westminster front group, the All Party Parliamentary Group on Smoking and Health. Titled Delivering the vision of a 'Smokefree Generation', it tries to justify an endless regulatory ratchet, saying:

The pioneering regulatory measures that the UK has adopted, such as the comprehensive advertising ban, smokefree laws, and packaging and labelling regulations including standardised packaging, have been highly effective and are largely self-sustaining.

They are not, however, sufficient to ensure smoking continues to decline, because it can be assumed that those who continue to smoke after a specific policy is put into effect have discounted it, so progressive strengthening of regulations over time is required.

Consequently, it calls for yet more laws, including a tobacco levy, licensing retailers and increasing the age of sale to 21.

I don't think I've come across this argument before. It certainly doesn't fit the logic of the traditional tobacco control narrative. We have been told for decades that tobacco control regulation is intended to deter new smokers from being 'recruited'.

When anti-smokers were lobbying for plain packaging, for example, they told us that it was needed because 207,000 children start smoking every year. Someone from Cancer Research UK said:

"Replacing slick, brightly coloured packs that appeal to children with standard packs displaying prominent health warnings is a vital part of efforts to protect health. Reducing the appeal of cigarettes with plain, standardised packs will give millions of children one less reason to start smoking."

That was in 2013, by the way. In 2019, ASH were still claiming that 'each year around 207,000 children in the UK start smoking' so I will let you be the judge of whether this shows that plain packaging was a flop or whether anti-smoking groups play hard and fast with statistics, or both.

But the point is they were clearly saying that a significant number of children start smoking because of 'slick, brightly coloured packs' and that this number would decline if such packs ceased to exist. Get rid of the packs and there is 'one less reason to start smoking'.

It was the same with the tobacco display ban, the advertising ban and other 'denormalisation' policies, including the smoking ban. These were permanent changes to the environment that would stop the evil tobacco industry 'luring' and 'recruiting' young people. They were supposed to make smoking less appealing and, on the margins at least, some of them may have done so.

These policies may not have any effect on current adult smokers, but that was not - ostensibly - their primary purpose. If fewer people start smoking, the smoking rate is bound to fall, because older smokers will quit or die. There is no reason why the smoking rate should bounce back, or even flatten out, if new policies are not introduced. If an advertising ban, high prices and plain packaging deter one generation of youngsters from smoking, they should deter the next generation and then the next.

As a matter of simple arithmetic, the argument in the ASH/APPG document makes no sense. Like many arguments in 'public health', it is post hoc rationalisation for a pre-ordained conclusion. It is nonetheless interesting for at least two reasons.

Firstly, it means that bans will continue to be ramped up ad infinitum, logically concluding with full prohibition.

Secondly, it is an overt statement of intent to go after adult smokers, rather than merely discourage minors from experimenting with tobacco. This, of course, has always been the case in practice - anguished pleas to 'think of the children' are nearly always a cover for restricting the freedom of adults - but the anti-smoking movement has traditionally pretended to respect the right of adults to smoke.

The new approach is nakedly illiberal, but what else can they do? They have run out of road on the argument about protecting kids. In tobacco control mythology, people don't enjoy smoking and they only start because the tobacco industry somehow manipulates them - after which they become hopelessly addicted and only think they enjoy it. By 2013, advertising had been banned for over a decade and it was becoming increasingly difficult for groups like ASH to explain why anybody took up the habit. Partly out of desperation, they portrayed cigarette packs as the 'last bastion of tobacco marketing' and fought for plain packaging.

They won. But, by accepting that the industry would have no conceivable way of attracting new customers once branding was banned, they implicitly accepted that anybody who took up smoking thereafter would do so of their free will.

The change in anti-smoking rhetoric has gone largely unnoticed, but it is crucial and may be decisive. The government's new tobacco control plan (in which ASH had a hand) is framed in the same way, as I noted when it was published last year:

Today’s announcement is not about stopping children smoking. It is about stopping everybody smoking. You could be smoking a fag in the middle of a field on your own during a gale and it would still be intolerable to the Department of Health. Under the Conservatives, there will be no more smoking.

The government gives no economic or ethical justification for stamping out a risky but pleasurable activity enjoyed by 14 per cent of the population over the next ten and a half years. It doesn’t bother with the usual tepid assurances about consenting adults having the right to smoke. How could it? The government doesn’t think anybody should smoke, and in the dying hours of Theresa May’s premiership, it is jolly well going to say so.  

Bullying adults into giving up smoking is incompatible with a free society, as is banning the sale of tobacco to young adults (as ASH now proposes). The question is whether, after decades of demonisation, smokers have enough allies who care about personal freedom to do anything about it.

Wednesday, 8 January 2020

The illogical war on energy drinks


When the government announced plans to ban the sale of energy drinks in August 2018, I wrote an article for the Spectator questioning the logic behind a ban.

It seemed to me that if sugar was the problem, the government would be restricting the many drinks that have more sugary in them than Red Bull - and would leave zero-sugar energy drinks alone.

But if caffeine was the problem, why was the government not proposing a ban on the many other caffeinated products that teenagers can get their hands on?

Last year, I decided to look at the issue more thoroughly for an IEA briefing paper (which was published on New Year's Eve). Studying the data in detail strengthened my belief that the proposed legislation is illogical, unscientific and pointless.

You could argue that kids do not consume many hot drinks so their caffeine content does not matter, but you would be wrong. British children aged between ten to seventeen only get 11 per cent of their caffeine from energy drinks. They get the rest from tea (39 per cent), cola (33 per cent), coffee (10 per cent) and chocolate (7 per cent). Even the heaviest adolescent consumers of energy drinks only get 17 per cent of their daily caffeine intake from them.

There is no campaign to ban the sale of tea, coffee and cola to anyone under the age of 18, so what is so special about energy drinks? They are not particularly high in sugar and caffeine and the government has not identified any other ingredients in them that could pose a risk to health.

Age restrictions are generally placed on the sale of products that can cause demonstrable harm to the user (e.g. alcohol, tobacco, solvents) or to others (e.g. knives, fireworks). Energy drinks have been on the market for a quarter of a century, have been studied extensively and have only recently became the subject of a moral panic after the failed businessman Jamie Oliver began claiming, without evidence, that ‘these drinks are turning our kids into addicts’.

In 2018, largely in response to Mr Oliver’s campaign, many supermarkets voluntarily banned the sale of energy drink to people under 16. In doing so, they lost sales to independent retailers and now hope to use the law to constrain the competition. The government says that there have been ‘strong calls’ for legislation from ‘some industry bodies and retailers’ and argues that a ban ‘would create a level playing field for businesses’. This suggests that the big supermarkets are trying to nobble their smaller competitors. If so, the government shouldn’t help them.

Banning the sale of energy drinks to minors on the basis of their sugar and/or caffeine content would set a troubling precedent. It would be no surprise if, having secured legislation, campaigners complain about the ‘loophole’ that allows adolescents to buy drinks that contain more sugar or caffeine than those which had just been banned.

A ban would affect adults as well as children. If it goes ahead, anyone who does not look well over the age of 18 will have to provide ID when buying an energy drink. If the government also proceeds with its proposal to ban the sale of energy drinks in vending machines and from certain buildings, it will reduce consumer choice for adults and children alike.

Most people would regard a ban on the sale of tea, coffee and sugary products to teenagers as disproportionate and ridiculous. There is no scientific reason to view a ban on the sale of energy drinks to teenagers any differently.


You can read my research into this in Vox Pop: Why banning energy drinks doesn't make sense


Tuesday, 7 January 2020

Smoking rates have flatlined in Scotland

From the Scotsman...

Scotland records first rise in smoking for seven years

Smoking in Scotland is on the rise for the first time in seven years, prompting fears over the prospect of achieving flagship plans for a “smoke-free” country by 2034.

There has also been a fall in the number of smokers trying to quit, official figures have revealed, while spending on cessation campaigns has seen a dramatic drop. Estimated smoking numbers increased from 806,817 in 2017/18 to 808,829 in 2018/19, official health service figures show.

This is not the first indication that anti-smoking policies are failing in Scotland. Last year, ASH Scotland reported that 'smoking prevalence rates amongst 13 and 15 year olds have flatlined since 2015'. It CEO, Sheila Duffy, said:

“It’s disappointing that the youth smoking rate has stopped falling across Scotland and that 12% of 15 year olds and 4% of 13 year olds are smoking either regularly or occasionally.  This mirrors what we saw in the adult smoking figures from the Scottish Health Survey 2018 – where the smoking rate has hovered around 18% since 2017– and suggests that the impacts of tobacco reduction policies have stalled."

Naturally, this has led to a crisis of confidence in the Scottish 'public health' movement. Anti-smoking groups have had to admit that plain packaging - which was introduced in 2017 - was a waste of time, and Nicola Sturgeon is lobbying Westminster to repeal it.

I'm joking of course. There will no period of reflection. Instead, they're demanding MOAR MONEY!

Sheila Duffy of ASH Scotland says:

“This is an invisible epidemic, which disproportionately affects the poorest people in society. That’s why we’ve been calling for tobacco to be recognised as the major public health epidemic that it is and for urgent action to tackle it. This must be a priority for the new Public Health body."

Er, the government has been taking 'urgent action'. It has done everything groups like ASH have asked of them - endless tax hikes, plain packs, display bans, smoking bans. Own it.

“As part of this, we’d like to see more funding for mass media campaigns and smoking cessation services, which have been proven to help people quit.”

According to the Scotsman:

The figures reveal spending on smoking cessation campaigns fell to £55,223 in 2018/19 – down from £552,975 the year before.

If this is a problem, I have the solution. In 2018/19, the Scottish government gave ASH Scotland £671,741. ASH Scotland does not run smoking cessation services or smoking cessation campaigns. It never has. All it does it lobby the government for useless policies.

The Scottish government should therefore stop giving taxpayers' money to a pressure group and instead spend it on more productive activities. If ASH Scotland's activities are wanted by the public, it will have no problem surviving on voluntary donations - which in 2018/19 amounted to a grand total of £2,417.

Monday, 6 January 2020

David Nutt on alcohol - wrong in every possible way

The 'public health' lobby have been eerily quiet since Christmas, which is odd because it is normally their peak time. So we will just have to settle for the publication of Tom Watson's new book and wait for David Nutt's book which he has previewed in the Daily Mail.

If the article is any guide, it's going to be a stinker. It's been a while since I read anything so densely packed with cherry-picking, false information and sloppy research.

Now a new decade has begun, everyone is making resolutions to go to the gym, stop smoking and eat less chocolate.

I haven't, so that claim is wrong straight away.

In the UK, we’re particularly keen on drinking — so keen that our alcohol consumption has nearly doubled since the Sixties.

Per capita alcohol consumption was at an historic low between 1930 and 1960. It then rose until 1980, although it was still lower than it had been before the First World War.

There was a further rise between 1995 and 2004, after which consumption dropped by 16 per cent. Per capita consumption today is at the same level as it was in 1980.

As for being 'particularly keen on drinking', alcohol consumption in the UK is lower than it is in most EU countries.


According to the Global Drug Survey, Britons get drunk an average of once a week, and one in ten of us are drunk on five or more days a week.

The Global Drug Survey is a non-random survey of illegal substance users. It doesn't tell you anything about the average Briton. 64 per cent of the respondents took cocaine, for goodness sake. Honestly, one in ten of us are drunk at least five times a week?! Does that sound remotely plausible?

(I'm amazed to find I haven't blogged about this before. I regularly use it - and the execrable news coverage of it - in my presentation about junk statistics.)

A staggering 10.8 million of us drink at levels that pose a risk to our health.

Only because the 'safe' drinking level was lowered for no good reason in a demonstrably crooked process.

Indeed, alcohol is now the leading cause of death for men aged between 16 and 54

No, it's suicide.


Alcohol is also the reason policing public drunkenness costs us more than £6 billion a year. It’s why the costs to the NHS are over £3 billion.

That depends how you measure it. The cost to the taxpayer is much lower than this and is far exceeded by revenues from alcohol duty of over £14 billion.

A couple of years ago, we discovered that just a single drink a day increases the risk of breast cancer.

The evidence that one drink a day raises the risk of breast cancer is actually rather weak. The graphic below shows the results from a meta-analysis of cohort studies looking at moderate/light drinking and breast cancer risk. Of the 25 studies, only six produced statistically significant results and the overall estimate was an increased risk of just nine per cent. There are significant doubts about causality.


Even light to moderate drinking raises your risk of developing an irregular heartbeat (cardiac arryhthmia), which can make you feel faint, short of breath and potentially lead to a stroke.

And yet people who drink moderately have a lower risk of stroke.

What’s frankly terrifying, though, is that a large 30-year study found evidence of faster cognitive decline in people who drank only up to seven units weekly, than in teetotallers.

I think Nutt must be referring to this study of hippocampal atrophy. However, this study used the same data set and found that people who drunk moderately had a lower risk of dementia. This meta-analysis of twenty epidemiological studies found the same thing. See what I mean about cherry-picking?

You may think you’ll be fine if you follow the UK chief medical officer’s advice to drink no more than 14 units a week. 

Not only do I think that I'll be fine. I know that I can drink more than that and live longer than a teetotaller.

And if you stick to these levels (roughly two pints of beer or two glasses of wine a day, spread out over three days a week, with days off in between), your risk of dying due to an alcohol-related condition is only around one per cent. 

It is around zero per cent.

One study concluded that having a couple of drinks on more than four days a week raises the risk of premature death by 20 per cent.

I can't guess which study this refers to, but I prefer to look at the totality of the evidence, and the evidence shows that abstinence kills.


And a recent report from the European Commission concluded that drinking any more than two units a year increases your risk of cancer, although the increased risk is very small. That’s just one pint of low-strength lager!

I think this is a reference to this rubbish which even Ian Gilmore described as 'speculative'. I can't imagine that there are enough people who drink one beer a year to build any kind of study around. It's pure scare-mongering. Nutt is clutching at straws.

In any case, why should I be worried about a very small risk of cancer when moderate drinking confers very large benefits to the heart?

The graphic below shows the results of a meta-analysis of 31 prospective cohort studies which found that drinkers are 25 per cent less likely to die from coronary heart disease than teetotallers. Note that - in contrast to the breast cancer studies - most show a statistically significant reduction in risk.


Naturally, Nutt dismisses any evidence that reflects well on drinking...

Hang on — what about all those studies that apparently showed benefits from drinking a daily glass or two of red wine? Sorry to disappoint, but a 2018 review of all the evidence — published in the leading medical journal, The Lancet — concluded that any partially protective effect on the heart is more than cancelled by negative effects, such as raised risk of cancer.

That study involved some opaque modelling to arrive at a conclusion that is not supported by any science. I wrote about it when it was published. It is a terribly flawed piece of work, as many others have pointed out (see here, here, here and here). Even if it were more robust, a single study doesn't refute hundreds of other studies.

Let me put it this way: If alcohol had been discovered in the past year or two, it would be illegal.

Probably, but that says more about the times we live in than it does about alcohol. In such a scenario, Nutt would presumably be seeking to legalise it, as he does with all other drugs.

The safe limit, if you applied current food-standards criteria, would be one glass of wine a year.

Wibble.

Would you take a new drug if you were told it would increase your risk of cancer, dementia and heart disease, or that it shortened your life? You wouldn’t touch it.

We would if we enjoyed it, and that is why billions of people drink alcohol. The fact that it lowers the risk of dementia and heart disease when consumed in moderation is just a bonus.

Yet over the past 50 years, alcohol has become entrenched in our lives. 

Past 50 years? Past few thousand, surely?

We drink for social bonding. We drink together to clinch business deals and come to agreements. We drink to celebrate the birth of a child, to commiserate with each other when someone dies. We drink because we’ve had a stressful day at the office, because we’re feeling anxious or just because it’s Friday.

Indeed we do. Great, isn't it? If we paid attention to Nutt's silly league table of drug harm, we would be taking, er, GHB and poppers instead. Something tells me that's not going to work.

Alcohol used to be a special purchase: you had to go to an off-licence or the pub — during limited hours — to buy it. Now it’s so easy to buy that many of us just chuck it into our supermarket trollies.

As already mentioned, alcohol consumption is at the same level today as it was 40 years ago.

We’re now the sick man of Europe. Take the drink-driving limit, for example, of 80mg blood alcohol. It hasn’t changed since 1967, thus leaving the UK with one of the highest drink-driving limits in the world. In most of Europe, the level is 50mg. Norway and Sweden, among others, have lowered it to just 20mg, which effectively allows for a dab of alcohol in a pudding.

Did Scotland reduce the number of road accidents when it reduced the drink-drive limit? No.

Is there any correlation between drink-drive limits and drink-driving accidents? No.


Some countries have gone much further, adopting successful policies to curb other damage caused by alcohol. The consequences in France are impressive.

The French introduced stringent advertising restrictions on alcohol in the early 1990s and put health warnings on the labels. The French still drink a lot more than the British and have one of the highest rates of alcohol consumption in the OECD.

Back when I was a medical student, it was rare to see someone in a UK hospital with alcoholic liver cirrhosis. But not in France, which is why we called it the French disease. Now, however, French cirrhosis rates are lower than the UK’s.

They are very slightly lower for women, but are still considerably higher for men. Overall, Nutt is wrong again.


So WHY haven’t we adopted any of these sensible policies?

Because advertising doesn't affect overall demand?

Because the Government makes so much money from taxes on alcohol. That is short-term thinking. The fact is that when you add in the costs of alcohol to society, there’s a net loss to the Exchequer.

Wrong yet again. Alcohol duty revenues cover the costs to government three times over.

These are: £3.5 billion annually on health; £6.5billion for policing drunkenness; £20 billion for lost productivity through hangovers. That comes to £30 billion.

Lost productivity is not a cost to the Exchequer. The £3.5 billion cost figure for health is an exaggeration. And the £6.5 billion cost for 'policing drunkenness' is simply made up.

Add in other factors such as alcohol-related costs to social care, the criminal justice system and the fire services, and the cost zooms to £55.1 billion.


Indeed, I’d argue that we need to go much further than France, starting by taxing drinks on the amount of alcohol they contain.

This is actually a good idea which I proposed in A Rational Approach to Alcohol Taxation. Nutt doesn't want to tax alcohol rationally, however. He just wants people to stop drinking (perhaps taking his synthetic substitute instead), and so he wants a tax rate much higher than the 9p per unit that can be justified by economics.

We should also cut the availability of super-cheap booze, and stop supermarkets using discounted offers on alcohol as loss leaders. On what planet does it make sense for a poison to be sold at less than the price of water?

This old canard again! Even if you ignore the tap in your kitchen, you can always buy water more cheaply than alcohol.

We should also repeal the licensing law so pubs once again shut up shop at 11pm...


And we should follow Scotland’s lead in introducing a minimum price per unit of 50p. At the time the law was passed last year, more than half of all alcohol was being sold below this price level — mostly to teenagers and alcoholics.

As far as I can tell, the claim about 'teenagers and alcoholics' is a Nutt invention, but it is true that minimum pricing has increased the price of most of the alcohol sold. It is not a targeted intervention.

There are already promising signs that the amount drunk in Scotland is decreasing.

It's been decreasing for years, and there are less promising signs about alcohol-related mortality, which rose in Scotland while it fell in England and Wales. Funny that Nutt doesn't mention that.

Come on, Boris, you know it makes sense. One of your predecessors, David Cameron, supported minimum unit pricing and set up a committee in 2010 to bring it about.

Nutt doesn't Boris very well if he thinks this is the way to persuade him. And that's fine with me.