Monday 28 February 2022

Vital Strategies, another Bloomberg puppet

It's hard to keep up with Mike Bloomberg's web of front groups. The mothership is Bloomberg Philanthropies which funnels money down to the likes of STOP (which funds Anna Gilmore's crew at Bath University) from which cash drips down to groups like the Investigative Desk

Then there is the Campaign for Tobacco-Free Kids which was originally funded by the USA's Master Settlement Agreement but now get millions from Mini-Mike. And there is his funding of the WHO's MPOWER programme and the WHO in general, with Bloomberg Philanthropies explicitly funding a WHO report on vaping. All these organisations now take a hard anti-vaping line.

One of the main Bloomberg mouthpieces is Vital Strategies. I had always assumed that Bloomberg created this organisation from scratch, but reading this thread made me realise it used to be a legitimate public health group. Bloomberg pumped his cash into it with the usual result that it became a vocal opponent of harm reduction.

But not all harm reduction. It was recently publishing newspaper ads supporting harm reduction for drug users. Vital Strategies finds itself in an absurd position. On one hand, it wants to cling to its credibility as a public health group. On the other hand, it wants to keep the Bloomberg cash rolling in. And so it runs campaigns like this...


While simultaneously campaigning to ban and restrict e-cigarette use as much as possible.  

How humiliating.

Thursday 24 February 2022

My life

I did the Media Masters podcast recently, talking about the COVID-19 pandemic, lockdowns, paternalism, libertarianism and what I do working for a think tank. You can listen here.

Wednesday 23 February 2022

The temperance mask slips

From an anonymous editorial in Lancet Global Health...

For an addictive substance with profound public health consequences, alcohol also remains stubbornly engrained in much of the world's social and cultural structures, openly indulged in and endorsed by people of all rank and profession.
Cry more.

As long as the status of alcohol consumption as an enjoyable and even beneficial recreation remains, not least via the multitude of advertising outlets globally, the alcohol industry will be free to exert its nefarious influence while policymakers turn a blind eye.

Was this written by Carrie Nation?

The editorial is about the WHO's Global Alcohol Strategy. This is the most revealing bit...

The draft Action Plan approved at the 150th WHO Executive Board session in January was drawn up in light of the limited policy traction seen, particularly in low-income and middle-income countries, since the Global Strategy to Reduce the Harmful Use of Alcohol was endorsed in 2010. One of the key barriers, according to the Action Plan preamble, is industry interference in alcohol policy development and implementation and governments’ reluctance to resist it, whether from weak leadership or competing interests.
Ironically, the Action Plan itself seems to have been subject to such interference, according to a report from the Centre for Alcohol Policy Research at La Trobe University, Melbourne, Australia. The report's authors examined submissions to WHO's online consultation on the draft Action Plan in 2020, finding that 60 (24%) of 251 submissions were from alcohol industry actors. The thrust of many of these submissions centred on countering the Action Plan's proposals to limit industry involvement in policy making and the Plan's focus on reducing overall consumption rather than minimising harms. More worryingly, these tactics appear to have worked. An analysis of before-and-after versions of the draft Action Plan by the Foundation for Alcohol Research and Education showed that one of the global targets had been changed from a reduction in per capita alcohol consumption to a reduction in the “harmful use of alcohol”, and that reference to “self-regulation” by industry had been inserted.
Why would anyone in public health be bothered by the WHO targeting the harmful use of alcohol rather than alcohol consumption per se? Surely they should support this change. They're meant to be all about health, right? It's not some moral crusade, is it? 

Or is it?

Tuesday 22 February 2022

Buy your own lateral flow test

I've written for the New Statesman about how we could find better ways of spending £2 billion a month than testing people for SARS-CoV-2.

NHS Test and Trace has been the subject of an extraordinary amount of misinformation since it was set up in May 2020. There are corners of the internet where people seem to genuinely believe that £37 billion was given personally to Dido Harding or to Serco and that all the money was spent on an app. It is widely believed that the system has “failed”. In fact, Harding has not been involved with it since last April, Serco never received more than a small portion of the budget and the amount spent on the app was smaller still. Nearly all of its money goes on testing and if that has failed, why are so many people desperate to keep doing it?

As ever, have a read.

Monday 21 February 2022

A swift half with Lionel Shriver

It was a great pleasure to interview best-selling author and columnist Lionel Shriver on The Swift Half last week. We covered various issues, not least vaping which is a subject I remember her writing about years ago and wondered if she still had strong opinions about. It turns out she did. You can see the vaping segment here. The full episode is below.


Saturday 19 February 2022

Apparently, the NHS has money to burn

From the Guardian...

The NHS has severed its links with the charity GambleAware due to concerns over its connections to the gambling industry.

Announcing two new clinics to deal with record demand for gambling addiction services in England, the mental health director of the NHS, Claire Murdoch, decried the “predatory tactics” of gambling companies.

... GambleAware, which describes itself as “an independent, grant-making charity commissioning prevention and treatment services” is funded almost entirely by donations from the gambling industry.

Last year it announced a three-year funding arrangement with the UK’s four biggest gambling companies totalling £100m. It has previously been criticised for having too big an influence on the funding of research into and treatment of gambling addiction.

NHS England has had a “dual commissioning and funding” arrangement with GambleAware since 2019, with £1.2m a year going into the National Gambling Treatment Service, which currently operates five clinics in London, Leeds, Manchester and Sunderland as well as a national telephone helpline.

This is outrageous. The taxpayer is going to have to step in to make up the shortfall because this woman has an irrational moral aversion to using money from the gambling industry to treat problem gamblers. 
There is absolutely no upside to this. It is pure virtue signalling. So much for the NHS being 'under-funded'. 

It is particularly ridiculous because in 2019 Claire Murdoch was calling on the industry to "ensure a fair amount of its profits help its customers who may suffer from addiction". It is less than a year since she was telling the industry to provide more money for treatment. From the Guardian in April 2021...

“After seeing the destruction the gambling industry has caused to young people in this country, it is clear that firms are focused on profit at the expense of people’s health, while the NHS is increasingly left to pick up the pieces,” she said.

“In a year when the NHS has dealt with our biggest challenge yet in Covid-19, the health service’s psychologists and nurses having been treating hundreds of people with severe gambling addictions.

“The gambling industry must take more responsibility, as the nation has come together over the last year to support the NHS, whether it be volunteering as vaccinators or showing their gratitude to staff. The bookmakers must also step up and agree to a mandatory levy to pay for dealing with the harms of problem gambling.”

There is a lot to unpick in this quote. Firstly, you may have noticed that Murdoch sounds more like an activist than a senior NHS official. She has form for this. She often uses NHS press releases to attack the gambling industry in Student Union terms, accusing it of "hijacking sport in pursuit of profit" and being "shameless".

Secondly, she hasn't been keeping up with developments if she thinks the bookmakers have got money to spare. They've been busy closing down thousands of betting shops since the government effectively outlawed fixed-odds betting terminals. Wasn't that supposed to reduce the number of problem gamblers, by the way? How's that going? 

Thirdly, the industry could agree to a mandatory levy but it cannot implement one. Alternatively, the government could implement one and it wouldn't matter whether the industry agreed with it or not. The fact is that the government hasn't implemented a mandatory levy so the only way the industry can contribute is with voluntary donations. 
In any case, GambleAware isn't 'the industry'. It is an independent charity funded by industry. 

Unfortunately, this fanatic won't accept voluntary donations even from GambleAware so taxpayers have to put their hand in their pocket again.

It's a disgrace. Sajid Javid needs to look into this. Why has an anti-gambling activist been appointed mental health director of the NHS? Why is she being allowed to use the NHS as a platform for her little rants about a legal industry? And why hasn't she been told to get on with job with whatever money is available?

Last Orders with Dominic Frisby

 We were pleased to welcome back Dominic Frisby for this month's Last Orders podcast. Have a listen.

Friday 18 February 2022

Calories and the Transport for London food advertising ban

From the Guardian...

A ban on junk food advertising by Transport for London has contributed to a 1,000 calorie decrease in unhealthy purchases in people’s weekly shopping, a study has estimated.

... Dr Amy Yau, from LSHTM and the study’s lead author, said: “Many governments and local authorities are considering advertising restrictions to reduce consumption of HFSS products as part of obesity prevention strategies.

“However, evidence of the effectiveness of such policies, especially away from broadcast media, is scarce.

“Our study helps to plug that knowledge gap, showing TfL’s policy is a potential destination for decision-makers aiming to reduce diet-related disease more widely.”

As you can probably tell from Dr Yau's quote, the study in question was created a number of activist-academics who are keen supporters of food advertising bans, including Emma Boyland and Martin White
The claim they are making is a big one. 1,000 calories a week is quite a lot. Even divided by the 2.1 people in the average household, it amounts to 476 calories a week or 68 calories a day. This is much, much more than the Department of Health - and several of the authors of this study - expect to achieve from its pre-watershed broadcast advertising ban and its total online ban combined. Could an advertising ban on 'high in fat, sugar and salt' food (HFSS) on buses and trains in one city really reduce calorie consumption by this much? It seems fishy from the outset.
The study uses Kantar survey data to see how food purchases changed in the ten months after the ban started. The Kantar survey involves enrolling households to scan the barcode of all food brought into the home. Importantly, it does not include restaurant meals, fast food, snacks bought outside the home, etc. This is significant not only because a large amount of HFSS food is bought from the 'out-of-home' sector, but because this is the kind of food that is (or was) most often advertised on TfL. I use the Tube fairly regularly and in my experience it was companies like Pizza Hut and McDonalds that were advertising. It would be interesting to see the breakdown, but I don't remember seeing adverts for biscuits or breakfast cereal very much.
Data from nearly a thousand households in London and a similar number in the North of England were used in the study. The North of England was chosen as the control because the people there are unlikely to take the tube (or, as the authors put it, suffer from 'contamination ... through regular commuting to London'!). 

If you look at the data, both sets of households reduced their overall calorie purchases and they reduced the amount of HFSS food purchased. HFSS food sales fell by 1.47% in London and by 0.51% in the North. Click to enlarge...
Both groups increased the amount of chocolate and confectionery they bought. Both groups reduced the amount of sugary drinks and sugary cereals they bought. The Londoners slightly decreased their purchases of puddings and biscuits while the Northerners slightly increased them. And the Northerners slightly reduced their purchases of savoury snacks while the Londoners slightly increased them. 

The differences here are tiny and seem indistinguishable from random noise. The biggest difference is in the 'puddings and biscuits' category, purchases of which went up in the North by 35 calories a week and down by 31 calories in London. It seems unlikely that this was caused by a ban on advertising 'junk food' on trains and buses in London and it should be put in the context of overall calorie purchases which amounted to 26,819 a week in London and 29,133 a week in the North before the ban was introduced (note the large difference between the two areas).

There isn't much to see here and certainly no evidence of the TfL food ban reducing household calorie consumption by 1,000 calories a week. To achieve this finding, the authors turn to their old friend, the opaque counterfactual model. In classic 'public health' style, details about the variables in this model are thin on the ground, but once the authors start imaging what might have been had Sadiq Khan never banned Burger King adverts, they come up with a much more impressive conclusion:

The implementation of HFSS advertising restrictions was associated with a relative reduction in average weekly household energy purchased from HFSS products of 1,001.0 kcal (95% CI 456.0 to 1,546.0), or 6.7% (95% CI 3.2% to 10.1%), in the intervention group compared to the counterfactual.

Er, OK. If you say so. For what it's worth, here's the model...

Even with a model of their own design, they fail to find a statistically significant difference between London and the North for most categories. The main exception is chocolate and confectionery...
Chocolate and confectionery. Using the whole study period, average weekly household purchases of energy from chocolate and confectionery fell by 317.9 kcal (95% CI 200.0 to 435.8) in the intervention group relative to the counterfactual, equivalent to an observed decrease of 19.4% (95% CI 13.4% to 25.4%).

This is slightly astonishing because the actual data show that the amount of chocolate and confectionery rose in both areas, by 3.3% in London and by 4.9% in the North. Somehow, the authors have turned a 42 calorie increase in chocolate and confectionery purchases in London after the TfL ban into a 318 calorie reduction! 

A look at the model shows how this trick was pulled off. They created a counterfactual in which purchases of these products in London (blue line), which had consistently been well below the North in the recent past (orange line), suddenly leapt up in late 2019 to Northern levels (dotted blue line).

Why would demand for chocolate and confectionery rise so far above the secular trend in London out of the blue like this? Alas, the authors do not explain, but we don't need to worry about it because HFSS food ads were banned on the Tube before it could happen. Phew, what a close shave!

If you believe this obvious nonsense, you will believe anything.

London mayor Sadiq Khan said: “I am pleased to see the positive impact these groundbreaking measures have had, leading to a real reduction in the amount of junk food being purchased.”

We're being taken for fools.

Still, a reduction of 1,000 calories a week is enough to make a real impact on obesity rates so I'm sure we can expect them to start falling any day now, right?

Tuesday 15 February 2022

Spot the odd one out

Three messages from Mike Bloomberg's prohibitionist outfit Vital Strategies. One of these things is not like the other ones...



Friday 11 February 2022

China's war on vaping

The Chinese government has arrested Chu Lam Yiu, the owner of Huabao, China's biggest e-cigarette company.
She is being held in “residential surveillance”, a form of off-grid detention used by the Chinese Communist party and criticised by human rights groups for lacking due process. Her son, Lam Ka Yu, who was educated in the US and the UK and is in his late 20s, was also detained. 
.. For Chu, the future is far from clear. The CCDI, the highly secretive extralegal body that can investigate and detain party members, might afford some leniency in exchange for co-operation. But acquittals are a rarity in a judicial system with a near-100 per cent conviction rate. 
The Cercius Group, which has studied Chu’s political connections and that of her husband, businessman Lam Kwok Man, said it did not “expect any good outcome”.

Eighteen months ago I asked why the Chinese government, which owns the world's biggest tobacco company, was clamping down on vaping. It was a rhetorical question. Vaping is an existential threat to tobacco. I said...

It is obvious what China Tobacco's motivation is. They fear missing out on cigarette sales if people switch to vaping. The Chinese government, insofar as it can be distinguished from the tobacco monopoly, doesn't want to miss out on tax revenue. More vapers means fewer smokers, hence the online sales ban and scare stories.

Does this sound familiar? The United States has been awash with scare stories about e-cigarettes for several years, culminating in the 'EVALI' panic last year. A ban on online sales (disingenuously titled the Preventing Online Sales of E-Cigarettes to Children Act) passed the Senate earlier this month and will be voted on in the House any day now.

The only difference is that China Tobacco doesn't have the 'public health' lobby cheering it on.
But it seems that I was wrong. China Tobacco does have the 'public health' lobby cheering it on.  

For months, the e-cigarette market has been squeezed by dual pressures. Health groups are concerned about youth uptake, supporting government clampdowns on online advertisements and sales to minors.
The smoking rate in China is 45 per cent. You'd think 'health groups' had bigger fish to fry.
Chinese health groups also happen to be awash with money from the anti-vaping fanatic Mike Bloomberg. The China National Tobacco Corporation and Bloomberg Philanthropies have teamed up to keep people smoking. See how it works yet? 

Thursday 10 February 2022

A suggestion for Jacob Rees-Mogg

Jacob Rees-Mogg, who is now Brexit minister, has an article in The Sun today...

I want Sun readers to write to me and tell me of ANY petty old EU regulation that should be abolished

The Brexit dividend is to be drawn from a few great projects but it will also come from hundreds of small actions that make daily life a little bit easier. 

... I implore you all to write to me with the regulations you want abolished — those which make life harder for small businesses, which shut out competition, or simply increase the cost of operating. Through thousands of small changes, we can enact real economic change — which means The Sun’s readers will feel a real Brexit bonus in their pockets and in their lives  every day.

I applaud this initiative, but would draw his attention to a statement from the public health minister yesterday.

Martyn Day (SNP): To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 15 December 2021 to Question 84415 on Oral Tobacco: Health Hazards, if he will publish his Department's assessment on the risks of adverse health outcomes caused by snus.

Maggie Throup (Conservative): There is no available data related to the mortality rate as a result of the use of cigarettes or for Swedish snus. The Department has made no formal assessment of adverse health outcomes caused by snus. However, there is evidence of increased all-cause mortality among snus users although this is lower than for tobacco smokers. Snus use also has cardiovascular risks.

We are exploring a range of proposals to reduce the harms caused by smoking as part of the forthcoming tobacco control plan. This will not include proposals to introduce additional tobacco products into the market, such as oral tobacco.

As Professor David Nutt, chair of the Drug Science group, says...
'ignoring the remarkable health benefits of snus is an extremely retrograde step. Snus has almost totally eliminated smoking in Sweden and is on the way to doing the same in Norway – just a few years after being introduced. There is no evidence that snus is a risk factor for any form of cancer. There is overwhelming evidence that it reduces harm.'
The 'cardiovascular risks' of snus are equivalent to those from nicotine patches and insofar as snus users have 'increased all-cause mortality' it has nothing to do with the snus since snus does not cause cancer or any other serious disease

The ban on snus was a shameful episode in the EU's history. It should have been reversed in the last Tobacco Products Directive, but epic corruption got in the way. The man at the centre of it - John Dalli - is in court this week on charges of bribery

There is no scientific or ethical justification for the ban, so why not write to Mr Rees-Mogg and let him know?

Wednesday 9 February 2022

Political journalists don't understand Chaotic Evil

I've written a little something for The Critic about the verbal assault on Keir Starmer which political journalists have (willfully?) misunderstood.

Political journalists have a habit of assuming that what matters to them matters to everybody. They also tend to assume that they are dealing with rational actors. And so when they see Keir Starmer accosted by a mob and hear the word “paedophile”, they immediately make a connection to the story that has preoccupied them and the rest of the Westminster lobby for the last week and to the broader story of whether the Prime Minister can survive. Here, it seemed to them, was cause and effect. It was proof that the story had “cut through” to ordinary people and that Johnson’s fake news had inflamed their animal passions. 

But the “protesters” are quite obviously neither rational nor ordinary and they cannot be understood by journalists who think the world revolves around Prime Minister’s Questions and cabinet reshuffles. They are a tiny group of people on the fringes of mental health with no coherent political views who are understandably ignored by the media most of the time despite their frequent visits to Trafalgar Square. Their obsession with paedophile rings has no more broader political significance than their obsession with “clot shots’, the World Economic Forum or, er, low emission zones.


If you've been following this story, you may also be interested with this interview with some of the protesters. 


Tuesday 8 February 2022

The thirdhand smoke grift continues

Third-hand smoke is the health scare that really never took off but won't quite die. That's mainly thanks to the persistence of psychologist Georg Matt who managed to get hold of a stack of cash from the Californian government to set up the laughable Thirdhand Smoke Resource Centre.

Matt is back with yet another study today... 

Almost all kids have tobacco on their hands, even in non-smoking homes

Young children touch everything - carpets, tabletops, toys, clothes, etc. - and then touch their mouths and faces. This makes them especially vulnerable to thirdhand smoke, the chemical residue from tobacco smoke left behind in dust and on surfaces after someone smokes or vapes.

How does their health suffer when they encounter this terrifying substance? Alas, the researchers don't say.
A team of researchers from San Diego State University and the University of Cincinnati used a novel method of swabbing the hands of children 11 years of age and younger to measure the levels of nicotine present, an indicator of thirdhand smoke exposure. 

More than 97% of the 504 children in the study had some level of nicotine present on their hands. More surprisingly, more than 95% of children in non-smoking households and home smoke bans still had nicotine on their hands.

This is a tribute to the incredible sensitivity of whatever they're using to pick up these tiny traces of nicotine.

The researchers plan to continue analyzing other markers of thirdhand smoke exposure and investigate health outcomes. They hope their research will further support stricter smoking bans, remediation practices, and policies requiring real estate agents and landlords to disclose thirdhand smoke levels in homes.

Nothing screams 'serious science' like the researchers telling you what policy objectives they hope to achieve by doing it!
Great use of taxpayers' money.

Friday 4 February 2022

A swift half with Ed West

There's a new episode of the Swift Half. This week I spoke to conservative journalist and author Ed West whose latest book I strongly recommend.

Thursday 3 February 2022

Getting the facts right with Tim Stockwell

Neo-temperance activist-academic Tim Stockwell has been talking to the Irish media about minimum pricing...

Everyone in the alcohol research and epidemiology world pretty much agrees that MUP is probably the single most effective strategy to reduce drinking with the least downsides. In Scotland, which brought it in in 2018, alcohol consumption and deaths have already gone down.

So whatever people feel about it, I think it’s really good to get the facts straight because they’re very well researched.

Yes, it is very important to get the facts straight. Facts like Scotland's rate of alcohol-related mortality being at a nine year high, for example.  


Could more expensive booze lead to people drinking cheaper liquids, like hand sanitizer or rubbing alcohol?

The studies we’ve done with people with severe alcohol use disorders show “non-beverage” is their absolute last resort. Mostly, they avoid it like the plague.

The proof in the pudding is this – you wouldn’t get the decrease in liver cirrhosis rates we see if they were just shifting their drinking.

What decrease in liver cirrhosis rates would this be? The link (which I assume Stockwell gave the journalist to insert) goes to a study from 2014, four years before minimum pricing was tried anywhere. Its lead author is MUP campaigner Nick Sheron and all it did was look at how much some heavy drinkers who had liver cirrhosis spent on alcohol and work out how much more they would spend under minimum pricing. It didn't even model the impact on liver cirrhosis rates. 
Facts, eh?

Wednesday 2 February 2022

Swapping fizzy drinks for beer

Impact of the Seattle Sweetened Beverage Tax on substitution to alcoholic beverages


Taxes are increasingly used as a policy tool aimed at reducing consumption of sugar-sweetened beverages (SSBs), given their association with adverse health outcomes including type 2 diabetes, obesity and cardiovascular disease. However, a potential unintended consequence of such a policy could be that the tax induces substitution to alcoholic beverages.

Indeed. Studies have found some evidence of this in the past.


At two-years post-tax implementation, volume sold of beer in Seattle relative to Portland increased by 7% (ratio of incidence rate ratios [RIRR] = 1.07, 95% CI:1.00,1.15), whereas volume sold of wine decreased by 3% (RIRR = 0.97, 95% CI:0.95,1.00). Overall alcohol (both beer and wine) volume sold increased in Seattle compared to Portland by 4% (RIRR = 1.04, 95% CI:1.01,1.07) at one-year post-tax and by 5% (RIRR = 1.05, 95% CI:1.00,1.10) at two-years post-tax. The implied SSB cross-price elasticities of demand for beer and wine, respectively, were calculated to be 0.35 and -0.15.

Well played, people of Seattle. Well played.

Tuesday 1 February 2022

The Covid Jeremiahs

I've written about England's dire Covid modelling for The Critic

It is not as if the models only seem flawed in hindsight. The idea that Covid could kill 5,000 people a day in heavily vaccinated England was always insane. It would require an infection rate so enormous that the whole thing would burn itself out within days. 

In an interview with The Times, Graham Medley admitted that the chances of there being 7,000 hospital admissions a day in October was as unlikely as Burnley winning the Premiership, but it was included in the model because it was theoretically possible. By implication, admissions never reaching 1,000 a day — which is what actually happened — was not included in the model because it was considered to be essentially impossible.

Something has gone badly wrong when likely outcomes are routinely treated as black swan events. It is not true, as some believe, that the modellers only look at worst case scenarios. Perhaps the most pitiful aspect of this pseudo-science is that the models include such a huge range of scenarios that dumb luck should ensure that one or two of them hit the mark. In reality, with only a handful of exceptions, a blindfolded chimpanzee could do better. This suggests something more than mere incompetence. It suggests a systematic bias towards pessimism and a hankering for restrictions. 

Whatever the reason, there can be no way back for the modellers after this. They have made astrology look like physics. Although I would never advocate tarring and feathering anyone, they should never be heard from again.

No paywall. Do read.