Wednesday 31 March 2021

Smokers told to cough up again

Apparently smokers still aren't paying enough tax. The government is looking into the idea of taxing tobacco companies to claw back the £40 million that cigarette litter supposedly costs to clean up each year.

This tax will inevitably be passed on to Britain's seven million smokers who already pay £11 billion a year in tobacco duty (including the VAT on the duty). Simple maths tells you that the average smoker is paying more than £1,500 a year in tobacco taxes alone. But it's never enough for the depraved fanatics at ASH who have suddenly become interested in littering.

The plans were welcomed by Action on Smoking and Health (Ash), the anti-smoking charity Deborah Arnott, its chief executive, said that the group was “delighted that ministers are working collaboratively to use environmental legislation to make tobacco manufacturers clear up the toxic waste caused by cigarette butts”.


Toxic waste, my foot. Arnott is only pretending to care about this because it gives her another excuse to extract money from some of the poorest people in the country.

The Times also asked me to comment...  

Christopher Snowdon, head of lifestyle economics at the Institute of Economic Affairs, the think tank, said: “This tax will inevitably be passed on to smokers who already give the government £11 billion a year. Britain has some of the highest tobacco taxes in the world and they fall disproportionately on those with the lowest incomes.”

He added: “If the government was serious about cigarette litter, it would provide appropriate street bins.”

Monday 29 March 2021

A new dawn or Public Health England 2.0?

So Public Health England's nanny state functions will be passed to a new agency called the Office for Health Promotion. We don't know how much it will cost or who will be running it. Is there any hope that it will be anything other than Public Health England Mark II? Probably not, but let's not rush to condemn it just yet.

I've written about this for the Telegraph...

The Office for Health Promotion presents an opportunity for a fresh start. There is an appetite among the public for health improvement, but the activist-driven sledgehammer approach of taxes and bans favoured by Public Health England has run its course. By setting up an agency for health protection and a separate agency for health improvement, the government is acknowledging the difference between public health issues, such as Covid-19, and personal health issues, such as obesity. The former can justify a certain degree of coercion. The latter cannot.

The new agency needs some fresh faces and fresh thinking. The government has so far said nothing about how much it will cost or who will be running it, but the appointment of Dr Jenny Harries as Chief Executive of the National Institute for Health Protection – which has already been renamed the Health Security Agency – does not bode well. Formerly a regional director for PHE, Harries personifies the UK’s disastrous response to Covid-19. Every call she made in the crucial early months of the pandemic was wrong and yet she is being rewarded with a plum job. They take care of their own in public health.  

There is a chance that the Office for Health Promotion will abandon the failed policies of the past and rely on persuasion rather than force. There is a chance that it will cut out the dead wood and employ some smart people from a range of disciplines. There is a chance that it will become an effective and efficient operation rather than another self-serving, tax-sponging bureaucracy.  

It is all very unlikely, but it is not beyond the realms of possibility. The decisions made by government in the coming weeks will be crucial. Does it want an Office for Health Promotion or Public Health England Mark II?


Sunday 28 March 2021

The future of UK tobacco harm reduction

I'm chairing a panel (online, natch) about the future of tobacco harm reduction on Monday at 6pm GMT. Martin Cullip, Clive Bates and Mark Pawsey MP are my guests so it should be lively.

Details here. You can watch it here or in the screen below.

Saturday 27 March 2021

Victory (part two)

It's been a bit of a good news week. On Monday, AG Barr announced that its "limited edition" full sugar version of Irn-Bru would be on the shelves permanently, and now we're hearing that the online ban on tasty food advertising is being dropped.

An online junk-food ads ban is to be axed as it would have almost no effect on obesity.

The proposal would cut a child’s annual calorie intake by just 700 — equivalent to four packets of crisps.

Even that claim is extremely dodgy. It's based on experiments in which young children are put in a room with a television, no parental supervision and an unlimited quantity of free food. Half of them are shown adverts for the free food and the researchers see if they eat more of it. They do - marginally - and this is then somehow extrapolated to online advertising. It's junk science

Following a review, Whitehall insiders say ministers now accept that a boycott would be “disproportionate” as it would cost businesses tens of millions.

As I've said from the outset, the policies in the obesity strategy came straight from the desks of nanny state fanatics and hadn't been thought through. It was left to bureaucrats in Whitehall to turn them into workable legislation. That proved largely impossible because the definition of 'junk food' is ludicrously broad and food companies need some way of communicating with their customers. Laws aimed at McDonald's were going to affect the bakery on the high street and the local wedding cake business.

The whole thing is now disintegrating on contact with reality. The policy of mandatory calorie counts in the out-of-home sector has been stripped back so it only affects large chains (as I said it would have to) and the round-the-clock digital advertising ban is going to be scrapped entirely. 

The next thing to be scrapped or watered down is going to have to be the ban on positioning so-called unhealthy food at the end of aisles, front of store and checkout. This is clearly impossible for smaller retailers and will be a big problem even for supermarkets. 
The watershed TV advertising ban should also go. It's going to cost broadcasters a fortune and leave us with wall-to-wall food adverts after 9pm. Let's just accept that teenagers can handle seeing adverts for ice cream.
If people want this kind of stuff they can vote Labour, Lib Dem or Green, but there needs to be at least one mainstream political party that doesn't want to launch an unprecedented and unevidenced assault on the food supply.

As the Sun says: 

What took the Government so long to scrap the ludicrous proposed ban on online ads for fast food?

The scientific evidence showed it would cut a child’s daily calories by about two . . . that’s a biscuit crumb.

All at a monstrous cost to businesses.

The Sun pointed this out last November. It shows the power of the nanny-state lobby that this mad idea wasn’t immediately laughed out of the room.

But we welcome No10 seeing the light now.

How about applying the same common sense to other failed measures?

Like the sugar tax, which won’t trim an ounce off anyone’s weight.

Then concentrate on the real solutions:

Better education on diet — and exercise.

Friday 26 March 2021

"Well, well, if it isn't the consequences of my own actions"

It's been a while since we had a laugh at Simon Chapman on this blog. He used to bring us so much entertainment. Australia's leading vaping prohibitionist is still knocking about in his nursing home shouting at clouds. He's been recently complaining about a "tsunami" of black market e-cigarettes. This is not a problem we have in Britain for some reason.

Meanwhile, Australia's black market for real cigarettes continues to flourish. Industrial scale tobacco smuggling and vast illegal tobacco farms didn't exist Down Under until the government fell under the spell of Chapman and his buddies and made the legal product unaffordable and unattractive.
Here's a typical story from earlier this month.
Illicit tobacco crops worth more than $84m seized in raids near Murray River

Authorities say illicit tobacco crops seized and destroyed in raids on properties near the Murray River this month are among the biggest busts of their kind in Australia.

Officers from the multi-agency Illicit Tobacco Taskforce uncovered more than 40 hectares of the plant growing on properties either side of the Victoria-New South Wales border, near the regional centre of Swan Hill.

The tobacco's potential value was estimated at $84.3 million.

More than 183 tonnes of tobacco was found in the first of three raids on a property at Kyalite, in south-west NSW, which the Natural Resources Access Regulator also attended to investigate possible water theft.

183 tonnes!
And here's another from this month...

The Australian Border Force (ABF) led Illicit Tobacco Taskforce (ITTF) has disrupted the activities of two alleged organised crime syndicates involved in the importation and distribution of illicit tobacco throughout Victoria and Western Australia.

The first operation occurred on Wednesday and Thursday this week (10 & 11 March 2021) when ABF officers from the ITTF executed Customs Act 1901 search and seizure warrants at a number of residential and commercial properties in suburban Melbourne.

The targets allegedly belong to an organised crime syndicate that smuggles illicit molasses tobacco into Melbourne and distributes it throughout Victoria.

During the warrants approximately 1,000 kilograms of molasses tobacco was located and seized, along with jewellery and $100,000 in cash, alleged to be the proceeds of crime.

The estimated value of evaded duty for this amount of tobacco is more than $1.5 million dollars.

Somewhere there's an organised crime boss commissioning a gold statue of Simon Chapman. Where would they be without him?

Vaccine passports

No thanks
The government is running a public consultation on 'COVID-Status Certification' - vaccine passports to you and me. If it was hoping to grab the public's attention, it has succeeded. People have been talking about little else for the last two days.
It began with Boris Johnson rightly suggesting that pubs should be free to serve whoever they want, but the idea of the government banning people from going to the pub unless they can prove they haven't got the virus soon took hold. 
It's difficult to tell whether the government is seriously entertaining this or if it is media spin. Johnson's comments have been pretty vague so far and both Johnson and several ministers have previously ruled out the idea. On the other hand, the government is not exactly going out of its way to squash these rumours and we know from the last twelve months that the 'public health' zealots advising the government never miss an opportunity to stick the boot into the licensed trade.
It has been suggested that people prove they don't have the virus in one of three ways:
- An antibody test (for those who have previously had COVID-19)
- A certificate of vaccination
- A negative lateral flow test
Weirdly, it has been suggested that this won't happen in the short term, but will be ready for Christmas.
The arguments in favour of this idea are that a spike in cases is plausible once we reopen, particularly among the under-50s who have mostly not been vaccinated. 
Israel is pretty much back to normal but requires vaccine passports for various events (although not, I think, for merely going to a bar). 
Other countries are almost certainly going to require a vaccine passport if you want to go on holiday so you might as well get one. 
The vast majority of the British public look set to have the vaccine, so the people who lose out will be mostly anti-vax idiots and assorted smileys, and they can still take the lateral flow test. 
From the perspective of the pub trade, it's less costly to administer a status certification system than to mess around with social distancing measure.

The arguments against - which I find more compelling - are that the vaccines are remarkably effective and any spike in cases is going to have a low mortality impact and is not worth the cost and the blow to civil liberties. I haven't seen any cost estimates yet, but it is likely to be very expensive and time consuming.

It involves the government handling data and creating an app so it will almost certainly be a technological fiasco.

The system won't be up and running by 17 May when pubs are due to reopen. If there's going to be a 'third wave', it will probably happen in summer when large numbers of people are still not vaccinated. By Christmas, the whole thing should be over and COVID-19 should have an infection fatality rate equivalent to flu. So what's the point?

There is still very little evidence that pubs are significant venues of infection. There was no spike in cases when they reopened last July. Admittedly, this doesn't apply to nightclubs and other venues that could be required to demand certification.
Antibodies don't usually last very long in people who have had Covid-19. After a few months they get protection from T-cells which can be tested for but it is quite expensive. 
Antibody testing involves a blood test which seems a bit extreme when all you want to do is have a pint. The government has a record of all the people who have tested positive for Covid. That should suffice.

Although you are likely to need 'status certification' to go on holiday abroad, you only do that once a year. Taking a test every time you want to go to the pub is rather more onerous.

Putting up these barriers, even if only to a minority of customers, is going to deter people from going out. That is bad for them and for the businesses that rely on them. For all the talk about pubs this week, you'd think it was the 1930s when people went to the pub every day because they had nothing else to do. The reality is that pubs have been in decline for decades. Thousands of them close every year. Most of them are virtually empty until the evening. They are an expensive luxury, not a mainstay, for most people. Part of the reason for this is that people have nice homes to live in and get their friends round for a drink - which is exactly what they will do if the government literally treats them like lepers. This is economically and epidemiologically sub-optimal.
There is no obvious endpoint to it. The government and the public health establishment can't be trusted to relinquish its control. Quite a few of them have always liked the idea of identity cards and this is a step towards them.

It looks like young people won't get their first dose of the vaccine for at least a couple of months. The system is therefore inherently discriminatory against the young. Vaccine coverage among the under-40s would be nice to have, but the fatality rate among this age group is so low that it shouldn't unduly concern them or us whether they get a jab or not. Yes, they could possibly pass the virus on to older people, but the older people have been given a vaccine that gives them approximately 100 per cent protection against hospitalisation. Let's remember what Matt Hancock said only two months ago.

When Covid hospital cases fall and pressure on the NHS is lifted, he says, ‘That is the point at which we can look to lift the restrictions.’ So what about herd immunity, vaccinating so many people that the virus dies out? ‘The goal is not to ensure that we vaccinate the whole population before that point, it is to vaccinate those who are vulnerable. Then that’s the moment at which we can carefully start to lift the restrictions.’ But at that point the majority would remain unprotected. Would he — as Health Secretary — still say it’s time to abolish the restrictions? ‘Cry freedom,’ he replies.

Whatever you think of these arguments, they are all better than what the government seems to be thinking.
The Guardian confirms this:

A UK government source said: “If the argument on health grounds doesn’t really wash because young people think they’re going to be fine and their grandparents and parents have all taken it, the strongest nudge is: ‘You’re not going to be able to be as free as you’d like.’ Not being allowed into pubs may focus minds.”

If only people who talk about 'nudging' would read Nudge. The whole point of nudging is that it doesn't make people less free. A nudge would be telling people that 90% of their age group is going to get the vaccine, or perhaps warning them of the dangers of long Covid. Banning people from going out unless they have an injection is, quite obviously, a form of coercion.

The consultation ends of Monday. It's straight forward. You just e-mail with a comment. Keep it clean.

Thursday 25 March 2021

Chris Whitty - back to the day job

Chris Whitty had barely got his feet under the desk at the Chief Medical Officer's office when COVID-19 came calling. This week he gave an online lecture to remind us what his day job is when he doesn't have a real public health issue to deal with. 
The subject was obesity and he took up where Sally Davies left off. He doesn't seem quite ready to call for a ban on people eating on trains, but he stuck to orthodox 'public health' line about the food 'environment' being the problem and the government being the answer. 
Have a read of his slides.

Chris Whitty is not a member of the public. He is a highly paid member of a state bureaucracy. The public 'engages with the food industry' by buying the food they like from a range of products unparalleled in human history. Chris Whitty and his cohorts engage with the food industry by threatening them, telling them how to make their products, raising prices and restricting what they can say to the public. 
Whitty et al. are part of a special interest group that knows woefully little about food production, human behaviour or economics. They seem to think there is a market failure, but cannot explain why. Their sledgehammer approach is going to create lots of problems and solve nothing.

I can't see exactly what is shown in the photo of Whitty's supermarket. Presumably it is the confectionery aisle (are those Easter eggs?). If this is how the CMO is portraying the food environment in Britain, it is frankly dishonest. 

Next slide please.

How can we emulate the success of Ethiopia and Bangladesh? That's the big question in 'public health' today. 

Incidentally, calorie availability - which is what this scatter plot actually shows - is not a great measure. According to the source data, the 'daily supply of calories' is higher in Norway than in the UK and it is above 3,400 in both countries. Even in Africa, it exceeds the 2,500 calories recommended for an adult male. I don't know about Norway but the average person in Britain consumes a lot less than 3,400 calories a day, and the amount has declined over the decades, even if you make big adjustments for under-reporting.

Next slide please.

This is just a list of everything the 'public health' lobby has been demanding in the last few years. Nearly all of it has been done or is in the process of becoming law under Boris Johnson's spineless government. 

Whenever Chris Whitty says that something is a "political question" or a "matter for politicians", all I hear is "we are going conjure up so much junk science and produce so many dodgy models that it will become politically impossible for the government to take anything other than the most authoritarian course of action." Regular readers will be familiar with this approach from 'public health', but more people have seen how it works in the past year.

Speaking of junk science...

Aside from the flimsiness of the correlation and the bizarre way the categories have been split up, anyone who says there is an association between the proximity of fast food outlets and obesity has not bothered to look at the evidence.
Next slide please.

Tuesday 23 March 2021

Lockdown, one year on and still in

It's a microphone

I've made the case for speeding the lockdown roadmap for CapX. Let's have more focus on data and move those dates forward.
I was talking to the great Simon Evans about the anniversary of lockdown in the first episode of my new IEA chat show, The Swift Half With Snowdon. It is, as the title hints, half an hour long. It's early days for me as a sort of interviewer, so let me know what you think in the comments. More great guests to come.

Monday 22 March 2021


Some happy news to cheer you up in these troubled times...

IRN-BRU bosses have revealed their 1901 recipe which is crammed with MORE sugar than the axed pre-sugar tax original is back for good.

AG Barr's confirmed the 'old and unimproved' recipe will return to shops permanently today.

We previously revealed the 1901 Bru from the firm's archives is packed with 10.6g of sugar per 100ml.

The original Irn-Bru — axed after a new sugary drinks tax — had 10.3g.

Fans hailed the 1901 version of the drink as 'glorious' during a limited run last year.


In effect, AG Barr's sugar reduction scheme has led to there being more sugar in Irn-Bru than there was before. Way to go, Public Health England!

For more on this elaborate reverse ferret, see my article from 2019.

Thursday 18 March 2021

Keep on vaping

A new study from the UK provides yet more evidence that vaping helps people quit smoking. It found that smokers who used a disposable e-cigarette were three times more likely to quit and people who used a refillable e-cigarette were five times more likely to quit.

Compared with using no help, the odds of abstinence were increased by daily use of disposable/cartridge ECs (OR=3.31 (1.32, 8.26), p=.010) and daily use of refill/modular ECs (OR=5.47 (2.70, 11.11), p<.001). Odds were reduced by non‐daily use of disposable/cartridge ECs (OR=0.23 (0.08‐0.63), p=.005), and by use of disposable/cartridge ECs to quit and no longer using at follow‐up (OR=0.10 (0.16‐0.62), p<.013). Secondary Results were similar to the primary outcome; however, odds of abstinence were also increased by use of smoking cessation medication (OR=4.15 (1.79, 9.62), p=.001).

Two of the authors have commented to the press to underline the significance of their findings.
Dr Máirtín McDermott, Research Fellow at King's College London's National Addiction Centre and lead author of the study, said: "Our results show that when used daily, e-cigarettes help people to quit smoking, compared to no help at all. These findings are in line with previous research, showing that e-cigarettes are a more effective aid for quitting than nicotine replacement therapy and prescribed medication.

"It's important that we routinely measure how often people use e-cigarettes, as we've seen that more sporadic use at follow up -- specifically of refillable types -- was not associated with abstinence."

Dr Leonie Brose, Reader at King's College London's national Addiction Centre added: "Despite the World Health Organization's (WHO) cautious stance on e-cigarettes, studies like ours show they are still one of the most effective quitting aids available.

"The WHO is especially concerned about refillable e-cigarettes, as these could allow the user to add harmful substances or higher levels of nicotine. However, we've shown that refillable types in particular are a very effective quitting aid when used daily, and this evidence should be factored into any future guidance around their use."

The evidence keeps piling up - and that makes anti-vaping dinosaur Stanton Glantz angry. In a classic piece of cherry-picking, he has focused on the ineffectiveness of occasional vaping to shore up his flanks.
Glantz doesn't seem to have realised what a self-own this is. Remember folks - for the best results, vape regularly and vape often!

Wednesday 17 March 2021

Vaping's image problem

A new Eurobarometer survey came out last month looking at attitudes towards vaping in the EU. It makes grim reading. Things are going backwards on every level.

I wrote about this for New Europe

The survey shows that among those who have little or no experience with vaping, only 20 per cent think e-cigarettes and heated tobacco products help smokers quit. Seventy per cent think they do not. The proportion of all respondents who believe that e-cigarettes are ‘harmful to the health of their users’ increased from 27 per cent in 2012 to 65 per cent in 2020. The survey does not ask what they mean by ‘harmful’ and no one claims that e-cigarettes are completely risk-free, but there are indications elsewhere that the average member of the public thinks the risks are much greater than they are. A study published last year found that 59 per cent of Europeans wrongly believe that vaping is as dangerous or more dangerous than smoking.

Things aren't much better in Britain. 

Even in England, where health agencies have largely embraced vaping, the number of smokers who think vaping is as dangerous or more dangerous than smoking rose from 36 per cent in 2014 to 53 per cent in 2020. Less than a third of them believe – correctly – that vaping is less harmful than smoking and 40 per cent of them wrongly believe that nicotine causes cancer. A recent report from Public Health England concluded that ‘perceptions of the harm caused by vaping compared with smoking are increasingly out of line with the evidence’.


And do tune in to the Epicenter webinar 'Harm Reduction or Humbug?' tomorrow at 1pm GMT where I'll be on a panel talking about it.

Tuesday 16 March 2021

Last Orders with Nick Cater

There's an episode of Last Orders out. I can't say it's new because I forgot to mention it when it came out two weeks ago, but our guest is Nick Cater - once a Brit, now an Aussie - who wrote an excellent book titled The Lucky Culture which I'm told is a favourite of Boris Johnson's. It explains how Australia got taken over by the metropolitan left and is relevant to many other countries.

In the pod, we discuss Zero Covid, internet censorship and a few other things. Check it out.

Friday 12 March 2021

Cash for honours at the W.H.O.

The World Health Organisation has given the UK an award. Public health minister Jo Churchill picked it up on a Zoom call on Wednesday and the Secretariat of the WHO Framework Convention on Tobacco Control made a little speech
We are very pleased that the United Kingdom has been awarded a 2020 United Nations Inter-Agency Task Force Award recognizing the UK’s role in the global prevention and control of noncommunicable diseases. 
How exciting. 

The award recognizes the UK’s commitment to tackling tobacco use in low- and middle-income countries – through the FCTC 2030 project. 

What, you might ask, has the UK been doing to tackle tobacco use is low- and middle-income countries? 
The answer is that it has been bunging the WHO a lot of money. Specifically, it has been handing millions to the people at the WHO Framework Convention on Tobacco Control (FCTC).

This project was established with generous official development assistance funding from the UK Government, and is today also funded by Australia and Norway.
Generous is the word. No country gives more to the FCTC in assessed contributions than the UK on a per capita basis (the biggest contributors in absolute terms are the WHO's mates in China), but these payments only scratch the surface. The UK also gives the FCTC bonus payments, such as the £15 million (to be spent over five years) dished out in 2016. The British civil servant involved in this transaction landed himself a plum job at the WHO shortly afterwards. What a small world!
The trouble is that the agenda of the WHO - and the FCTC specifically - is diametrically opposed to that of the British government. While the UK encourages smokers to switch the e-cigarettes, the WHO wants to ban them. With the possible exception of Mike Bloomberg - who was also bestowed with an honour after giving the WHO lots of money - the FCTC is the biggest threat to tobacco harm reduction on the planet. 

The UK government is using taxpayers' money to finance prohibitionists and what are we getting in return? A little wooden plaque. This has to stop.

On a related theme, I strongly encourage you to watch this excellent little film from Yorkshire Cancer Research about vaping. This is what real public health work looks like.

Thursday 11 March 2021

The sugar tax evaluation

From the Independent....

Consumption of sugar from soft drinks fell in the year after sugar tax brought in

Consumption of sugar in soft drinks was falling long before anyone took the idea of a sugar tax seriously, as I pointed out in 2016.

However, the headline is not quite a statement of the obvious. It refers to a new study in the BMJ which looks at soft drink consumption between 2014 and 2019. It is part of the official evaluation which, in classic 'public health' fashion, is being conducted by academics who spent years cheer-leading for the policy. And it's costing the taxpayer £1.5 million.

The study's conclusion is - obviously - that the sugar tax was a success. The authors report no change in the number of drinks sold, but claim there was a 9.8% fall in sugar consumed in soft drinks after the tax was implemented. That's 29.5 grams a week per household.

Reasonably enough, the authors attribute this to manufacturers reducing the sugar content. They even try to reach out to the 'food [sic] industry' in the text.
... the overall reduction in sugar with no change in volume we report here might represent a valuable benefit for public health with little harm to the food industry. 
As artificial sweeteners are cheaper than sugar, that may be true. However, the data only go up to March 2019 and it's worth remembering that the summer of 2018 was unusually hot and therefore saw more drink sales than normal (a fact that has been mentioned in connection to minimum alcohol pricing which also began in spring 2018).
The SDIL [Soft Drinks Industry Levy] has also been found to have had no long term negative effects on the share value or turnover of UK soft drinks companies, suggesting that, contrary to industry predictions, public health can gain without negatively affecting the soft drinks sector.

Firstly, tell that to AG Barr whose share price has never recovered from its poorly received reformulation of Irn-Bru.  

Secondly, there hasn't really been any 'public health gain', has there? Obesity rates haven't declined and it is not clear whether calorie intake has declined either. Sugar consumption has been gradually falling for decades and yet people keep getting fatter. All the sugar tax did was ruin some erstwhile delicious drinks.

It's not even clear that the sugar tax had the effect that the authors are claiming. They compare the real world evidence with a counter-factual, which always has the potential for mischief but was inevitable given the strong downward trends in sugar consumption prior to the tax being introduced.
The study divides the timespan into three periods: 2014-16 (pre-announcement), 2016-18 (post-announcement) and 2018-19 (post implementation). Table 1 shows the volume of drinks and amount of sugar consumed in each phase.  

Sales of high-sugar drinks were clearly falling before the sugar tax was announced, let alone implemented. Did the rate of decline increase after the tax was implemented? At a push, you can just about see a small step-change.

But if you combine all the drinks (high, medium, low and zero sugar), you'll see that the average household was consuming 141.5g of sugar from them in the 2014-16, 109.5g in 2016-18 and 80.1g in 2018-19. In other words, there was a bigger decline (32g) between the two periods before the tax was implemented than between the post-announcement and post-implementation period (29.4g).
Curiously, the data behind the figure that has driven the headlines today - the 10% drop in sugar consumption - doesn't appear in the main text, but is tucked away in the supplementary material. It is quite underwhelming. At the risk of being accused of 'eye-balling' the data, there doesn't seem to be much going on here. As so often in these studies, it all depends on how much you trust the counterfactual.
It wouldn't be surprising if the sugar tax led to some reduction in the amount of sugar consumed in soft drinks, especially since several companies felt inspired to take the sugar out of their flagship brands. But in the decade leading up to 2014, the amount of sugar consumed in soft drinks had already dropped by 45% and it would drop further before George Osborne announced the sugar tax (as this study shows). 
Was it really worth all the fuss? The secular trend is far stronger than anything that can be attributed to the sugar levy. Call it fashion, education or persuasion, but people had greatly reduced their consumption of sugary drinks long before the 'public health' lobby barged in with their regressive tax. Previous reductions in sugary drink - and indeed sugar - consumption have not been accompanied by a decline in obesity rates and that seems unlikely to change regardless of whatever marginal effect the 'public health' lobby tries to take the credit for since 2018.

Wednesday 10 March 2021

New IEA report on gambling - A Safer Bet

In December, the government launched a consultation on how to make gambling regulation 'fir for the digital age'. It runs until the end of the month. No doubt every anti-gambling group will be responding to it demanding more bans and restrictions. 

There has been no shortage of fresh regulation in recent years, but the kind of policies being demanded by anti-gambling groups would take things to a new level and could be very damaging to players, to the industry and to the Treasury. I've written about this in a new report for the IEA - A Safer Bet. Have a read of it and see what you think. 

I've also written about this for the Telegraph and ConHome.

Monday 8 March 2021

The elites are revolting

From The Times... 

Anti-obesity activists using the lever of forcing unwanted shareholder resolutions on blue-chip companies have claimed victory after Tesco agreed to set itself public targets to sell healthier food.

Britain’s biggest supermarket group pledged to try to lift the proportion of healthy products it sells from 58 per cent of total sales today to 65 per cent by 2025.

I can't imagine Tesco being too upset about people discovering that most of the food it sells is 'healthy' (ie. low in salt, fat and sugar). 

Sources close to Tesco played down the impact of ShareAction, arguing that it had been moving in this direction anyway.

I daresay that is true, but who are these brave activists holding corporations to account? 

ShareAction assembles and orchestrates private shareholders to buy one share in the companies it targets. Under English company law it only requires 100 shareholders, no matter how small their holdings, to force a company to put a resolution to all shareholders.

ShareAction is otherwise known as the Fairshare Educational Foundation. According to a puff piece by Harry Wallop, also in The Times, they are "the corporate equivalent of Swampy, Blue and their fellow HS2 tunnellers". I'm not sure about that. They have an annual turnover of more than two million pounds and their list of donors is an A to Z of the third sector establishment: Friends of the Earth, Joseph Rowntree, Christian Aid, Greenpeace, Amnesty, WWF, Comic Relief, etc. 

Its biggest source of income is - you guessed it - the British government in the form of a £506,700 grant from the Department for International Development. The charity's accounts don't say what the grant was for or how the money was spent.

ShareAction's Chief Executive is an Oxford graduate with a biography that reads like a parody of a lefty establishment figure.
Catherine joined ShareAction as Chief Executive in 2008. ShareAction coordinates civil society activism to promote responsible investment across Europe. She is a board member of the Scott Trust, owner of The Guardian, serving on the Scott Trust’s investment committee. She also serves on HM Treasury’s Asset Management Taskforce. She was a Member Nominated Trustee of The Pensions Trust for five years until Spring 2013. Catherine was recognised by the World Economic Forum as a Young Global Leader in 2014.
They're activists for sure, but it's not what you'd call a grassroots movement. It looks more like a bunch of well connected, well-funded elitists telling the plebs what to eat. Many such cases!

Saturday 6 March 2021

That World Obesity Federation scatter plot

It was World Obesity Day recently so we got the inevitable press release from the World Obesity Federation, with the inevitable COVID-19 tie-in. 
The media picked up on one striking claim in particular...
Obesity warning as report shows nine out of 10 COVID-19 deaths have been in countries with high rates of obesity
The correlation cited in the report is actually with overweight, not obesity, but journalists nearly always get those two mixed up. Obesity is a risk factor for COVID-19 mortality, especially morbid obesity. Being overweight, not so much. 

Nevertheless, the claim is that 90 per cent of COVID-19 deaths have taken place in countries where more than 50 per cent of the population is overweight. The, er, 'correlation' between the two is shown in the WOF report in a graph that is the stuff of statisticians' nightmares.

I'm not quite sure where the trend line is meant to go there.

For those who are still not convinced, we were given some examples of countries with low rates of obesity and low rates of COVID-19.

Author of the report Dr Tim Lobstein, who is a senior policy adviser to the World Obesity Federation and visiting professor at the University of Sydney, said: "We now know that an overweight population is the next pandemic waiting to happen.

"Look at countries like Japan and South Korea where they have very low levels of COVID-19 deaths as well as very low levels of adult obesity."

The Guardian reported... 

Among countries where more than half the adult population is overweight, Belgium has the highest level of deaths, followed by Slovenia and the UK. Italy and Portugal are 5th and 6th, while the US is 8th.

Vietnam, by contrast, has the lowest lowest level of overweight in the population and the second lowest Covid death rate in the world.

But these Asian countries didn't have many deaths because they didn't have many cases. Unless the WOF is claiming that being slim stops you catching and spreading the virus, these examples are meaningless. 

If you look at the maps from the WOF report, you can see that the countries with low Covid mortality are nearly all in Asia and Africa. The death rate is low in these countries because they had low infection rates (China, Vietnam, etc.) and/or a young population (India, most of Africa). Obesity had, at best, a marginal impact.

I wrote a quick letter to the Times about this. 

Sir, Tim Lobstein says “there is no escaping the clear correlation between some of the world’s worst Covid death rates and worst obesity rates”. The correlation may be clear, but we should not infer causation from the fact that 90 per cent of Covid-19 deaths take place in countries where more than 50 per cent of the population is overweight. The lowest death rates have been in places that have controlled the virus, such as Vietnam and Japan, or have a young population. In India, only 5 per cent of the population is aged over 65. In Africa, the average age is 20. Such places have had relatively few Covid deaths despite high infection rates.

Obesity certainly increases the individual’s risk of dying from Covid-19 but it is not a decisive factor when comparing nations, as the cases of New Zealand and Australia (both of which have a higher rate of obesity than the UK) can confirm.

Christopher Snowdon
Head of lifestyle economics, Institute of Economic Affairs

Naturally, the letter printed below mine calls for a 50 per cent tax on 'burgers, ketchup, ready meals (unless the individual has a genuine physical or medical reason for exemption) biscuits, cakes, fruit yogurts, gentlemen’s relish, etc.'

Friday 5 March 2021

Fantasy modelling and a 70p minimum alcohol price

Is the Sheffield Alcohol Research Group aware that minimum pricing has been in force in Scotland for nearly two years?
Their latest study suggests not. Using their computer model (what else?), they conclude that minimum pricing has more of an effect on men than on women.
For example, a £0.50 MUP led to a 5.3% reduction in consumption and a 4.1% reduction in admissions for men but a 0.7% reduction in consumption and a 1.6% reduction in hospitalisations for women.
The problem here is that it is an indisputable fact that the number of alcohol-related hospitalisations has not fallen since the £0.50 minimum unit price was introduced. There were 35,544 of them in 2017/18 and 35,781 in 2019/20.

If you want to split hairs, there was a minuscule decline in the rate of admissions, from 668.8 per 100,000 people in 2017/18 to 666.6 per 100,000 people in 2019/20, but that is just 0.3%, nowhere near the 3% implied in the new Sheffield study nor the 4% predicted in the model they produced before the policy came into effect.

In the press release, lead author Petra Meier (who is now at Glasgow University) gives further indications that she hasn't heard about the policy being introduced.

“Our modelling suggests that men’s drinking and risk of alcohol-related hospital admissions would decrease substantially more than women’s for both duty increases and minimum unit pricing policies."

But did it, Petra? We have the empirical data now, surely? Judging by the overall admission figures, minimum pricing had an effect on both sexes that could most charitably be described as minimal. 

Perhaps the most significant aspect of the study is that it also modelled the impact of a 70p minimum price. Brace yourself, Scottish drinkers.

Thursday 4 March 2021

Smoking and COVID-19: new update

As North Carolina announces that smokers and ex-smokers can jump the queue for the SARS-CoV-2 vaccine, it's time to take another look at the evidence on smoking and COVID-19.

Regular readers will recall the evidence showing smokers heavily under-represented in Covid wards around the world. It made a few headlines last spring, but it has since faded away as a news story. Public Health England's false claim about smokers being 14 times more likely to develop severe COVID-19 remains online.

That doesn't mean the studies have dried up. The ongoing meta-analysis by the UCL academics is now in its eleventh edition and the song remains the same. With 121 studies under review, smokers are still less likely to get COVID-19. 
Current compared with never smokers were at reduced risk of SARS-CoV-2 infection (RR = 0.71, 95% Credible Interval (CrI) = 0.61-0.82, τ = 0.34). Data for former smokers were inconclusive (RR = 1.03, 95% CrI = 0.95-1.11, τ = 0.17) but favoured there being no important association (4% probability of RR ≥1.1).
My understanding of the evidence last year was that smokers were less likely to be hospitalised with Covid but more likely to suffer severely when they did. That wouldn't be surprising given the impact of underlying health conditions in worsening outcomes. But even that now looks doubtful. The outlook for ex-smokers is worse than for never-smokers, but it's far from clear that current smokers do any worse.
Former compared with never smokers were at increased risk of hospitalisation (RR = 1.19, CrI = 1.1-1.29, τ = 0.13), greater disease severity (RR = 1.8, CrI = 1.27-2.55, τ = 0.46) and mortality (RR = 1.56, CrI = 1.23-2, τ = 0.43). Data for current smokers on hospitalisation, disease severity and mortality were inconclusive (RR = 1.1, 95% CrI = 0.99-1.21, τ = 0.15; RR 1.26, 95% CrI = 0.92-1.73, τ = 0.32; RR = 1.12, 95% CrI = 0.84-1.47, τ = 0.42, respectively) but favoured there being no important associations with hospitalisation and mortality (49% and 56% probability of RR ≥1.1, respectively) and a small but important association with disease severity (83% probability of RR ≥1.1).

I'm not sure how 'important' that last finding is given that the result is not statistically significant. Since current smokers don't have a higher rate of Covid mortality, perhaps not much.

Fair play to the UCL researchers for sticking with this when a lot of people in 'public health' would have run a mile. Not that many people are paying attention to these inconvenient facts. 

There is a surprisingly large amount of evidence on this stuff once you start looking. This study from New York didn't find smoking to be a factor in any Covid outcomes. This study from Turkey found that there were fewer smokers with COVID-19 than would be expected from the general smoking rate and that smokers did no worse than nonsmokers if they contracted it. This meta-analysis found smokers to be 82 per cent less likely to be hospitalised with COVID-19! 
This study of grocery workers in the USA found 21 symptomatic cases, only one of whom was a smoker. The authors say: 

Our finding of fewer current smokers with a positive SARS-CoV-2 assay result, while in agreement with recent epidemiological studies, contradicts common perception and clinical recommendation on risks and effects of cigarette smoking on lung health warranting further research investigations.

It sure does. All sorts of possible explanations have been advanced for this.
On the other hand, this study from Brazil found smokers to be three times as likely to be hospitalised with Covid. And yet it found them no more likely to die from Covid and - most unusually - nor did it find obese people being more likely to die from it.

See this post of mine from last year for more studies or, if you want a deep dive, go through the studies listed in the living meta-analysis.

'What about vaping?' you may ask. Most vapers are former smokers so there is an obvious confounding factor waiting to trip up the sloppy epidemiologist. There hasn't been much research in this area, but a study published last month gives vaping the all clear. 

There were no differences in diagnosed/suspected Covid-19 between never, current and ex-vapers... Among UK adults, self-reported diagnosed/suspected Covid-19 was not associated with vaping status.
Hurrah! And...

Bayes factors indicated there was sufficient evidence to rule out small negative (protective) associations between vaping status and diagnosed/suspected Covid-19.


In conclusion, there isn't any obvious justification for making smokers a priority group for the vaccine, although there is a stronger case for ex-smokers. The system in North Carolina says that anyone who has smoked more than 100 cigarettes in their lives can jump the queue. It is impossible for authorities to verify this, so I guess they're relying on North Carolinians being very honest.

Wednesday 3 March 2021

Lockdown libertarianism?

I was on the Accad and Koka podcast this week talking about why I support the current UK lockdown.