Wednesday, 28 October 2020

Vulture prohibitionists

The emergence of COVID-19 towards the start of the year was always going to go one of two ways for the 'public health' establishment. 
One possibility was that westerners would see what a genuine public health problem looked like and ask why they were handing over billions of pounds to people who knew little or nothing about infectious disease and who were more interested in political virtue-signalling and trivial lifestyle regulation.
The other possibility was that the lifestyle regulators of 'public health' would watch in awe as governments stripped people of their civil liberties and conclude that they could be more draconian than they thought.
As you would expect, the 'public health' racket has been busy working towards the second of these outcomes. After the initial shock of the pandemic subsided, they started talking about how obesity is the real pandemic and smoking kills more people than COVID-19, etc. Richard Horton, the Marxist loon who edits the Lancet, claimed that COVID-19 wasn't a pandemic at all, rather it was a 'syndemic' and that the real problem was the 'non-communicable diseases' that can lead to underlying health conditions. Conveniently, this meant that Horton et al. could get back to controlling people's lifestyles rather than tackling the virus.
The 'public health' establishment has spent decades trying to conflate the risks from self-regarding actions with the risks from infectious diseases. JK Rowling neatly mocked this stupidity in a single sentence earlier this year.

The shameless opportunism of 'public health' wowsers is on full display in this week's Lancet where John Ionnidis and Prabhat Jha suggest exploiting COVID-19 to ban smoking. 
Does the COVID-19 pandemic provide an opportunity to eliminate the tobacco industry?

Ionnidis has made himself unpopular in the scientific community this year by making some fairly wild claims about COVID-19's infection fatality rate (which he thinks is similar to that of bad flu - it isn't). Perhaps he thinks that a bit of prohibitionist tub-thumping will help him get back in their good books.

Tobacco use is the top modifiable global health problem,but the global tobacco market grows 3% annually. Most anti-tobacco measures to date target demand (eg, higher excise taxes). However, the endgame might require reducing supply.
The 'endgame' should require informed adults choosing for themselves whether to smoke or not. That is the only outcome that is acceptable in a free society.
The main counterarguments are financial (eg, economic damage or lost jobs) and defences of personal choice. 
The rest of the article attempts to address the financial arguments but, tellingly, it does not return to the issue of personal choice. 

Most importantly, public health has little experience in enforcing major changes that disrupt markets. 
What?! Disrupting markets is all they know. They explicitly focus on restricting advertising, availability and affordability - three of the main levers of competition. And they have plenty of experience of prohibition, as vapers and drinkers in many countries can tell you.

The ongoing societal response to COVID-19 offers a precedent for drastic action taken to eliminate the tobacco industry.
COVID-19 is a natural experiment: expedient public health considerations have led to decisions being made that have important socioeconomic repercussions. The cumulative disease burden of COVID-19 is large but uncertain. However, if COVID-19 actions were deemed defensible, the risk–benefit ratio for actions to eliminate tobacco is far more favourable.
Smoking is not an infectious disease and 'drastic action' is not required. Individuals can judge the 'risk-benefit ratio' of smoking for themselves.  
Ionnidis and Jha's argument boils down to 'in for a penny, in for a pound'. They are arguing that lockdowns have caused such enormous economic devastation that the problems of tobacco prohibition will seem trivial by comparison. It is the same warped thinking that makes some people think that Britain has already ruined itself with its Covid response so it might as well have a No Deal Brexit for good measure.
Even if all 100 million tobacco-related jobs were lost, this number is still much lower than the number of jobs lost by lockdown measures for COVID-19 worldwide
What an incredibly stupid thing to say.
Until now, only Bhutan has tried banning cigarettes, with mixed effects
That's putting it very delicately. When researchers studies Bhutan's prohibition in 2011, they found...

'... a thriving black market and significant and increasing tobacco smuggling… 23.7% of students had used any tobacco products (not limited to cigarettes) in the last 30 days… tobacco use for adults has not ended or is even close to ending… cigarette prohibition is instrumental in encouraging smuggling and black markets… The results of this study provide an important lesson learned for health practitioners and advocates considering or advocating, albeit gradual, but total cigarette ban as a public policy.'
Bhutan lifted the ban on tobacco in August this year because it was worried that the numerous tobacco smugglers pouring in from other countries would spread the coronavirus. Ionnidis and Jha neglect to mention any of this.
Concerns about smuggling would naturally arise. However, large-scale smuggling can be effectively countered.
Alas, they don't say how this miracle will come about.
They conclude that...

... now that major decisions and actions for health are acceptable under exigency, an unique [sic] opportunity exists to eliminate the tobacco industry.
It's the old fallacy of thinking that what's necessary in times of war will be good in times of peace. The great danger of the COVID-19 crisis is that governments have learned that fearful people will put up with more infringements on their liberty than was thought possible. For prohibitionist vultures, this is an opportunity, as Ionnidis and Jha openly admit. As I wrote back in May, liberal-minded people will have to fight hard to get all our freedoms back when this is all over. While 2020 has been hell for most people, it has been a glimpse of heaven for others.

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