A new Last Orders dropped this week. We welcomed back friend of the show Julia Hartley-Brewer to discuss the world cup, free speech on campus and how to keep your house warm.
You can send your questions to lastorders@spiked-online.com and we’ll try to answer them in the next episode.
... given that sugar-sweetened beverages are well understood as a casual factor of overweight and obesity, the year 2014 saw the implementation of a tax of one Mexican peso per liter on beverages with added sugars, as well as on food items with an energy content ≥275 calories per 100 g.
Snack foods, sweets and desserts, and sugar-sweetened beverages were not statistically significant contributors in the model (p = 0.112 and 0.098, respectively), but seem to show weak associations.
The pseudo-panels of the study showed that those food groups considered as protective, such as fruits and vegetables, protected against overweight and obesity in school-age children. On the other hand, intake of snack foods, sweets and desserts, and sugar-sweetened beverages were associated with the presence of both outcomes.
We also found that greater fiber consumption was associated with lower overweight and obesity in school-age children, even when this association was not statistically significant.
Although this association is inconclusive in the scientific literature, we suggest that a greater fiber content in food items indicates a lower caloric density, as well as a lower consumption rate and possibly a greater sense of satiety.
Notably, when facing a problem of the magnitude of school-age child obesity, permanent government strategies and actions are required to ensure the containment, prevention, and management of this outcome in order to avoid serious consequences for long-term health and national development. To the present, various strategies have been implemented in Mexico, as well as in other countries around the world.
Although these have been associated with some positive results, they are not public policy actions which demonstrate an overall effective impact.
An example of this is the establishment of regulations on the sale and distribution of foods and drinks in the school environment dating back to 2010, and which were only put in place in 2012 and whose implementation was monitored only starting in 2015.
Other actions implemented on the national stage and not only targeting the school-age population include the 2014 tax of one Mexican peso on sugar-sweetened beverages, and one previous study found a reduction of 6% in buying of taxed beverages in 2014. Furthermore, from 2014 to 2015 changes were observed in the buying of taxed and non-taxed beverages, where buying of taxed beverages diminished by 5.5% in 2014 and 9.7% in 2015: an average reduction of 7.6% over the study period.
Nonetheless, the tax is too small to expect the provocation of biological impacts such as a reduction in obesity.
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| Nicola Sturgeon yesterday |
The Scottish National Party has been fully captured by the temperance lobby. Minimum pricing has crashed and burned, but they are still listening to the alleged experts from the pressure groups whose wages they pay. Banning alcohol advertising was always next on the agenda for the Scottish temperance groups and the Scottish Government has produced a consultation document that reads like it was written by Carrie Nation.
I have been reviewing and practising alcohol related law in Scotland over some years, in my role as a licensing lawyer representing the trade, and I have written on this topic widely. I have often been a “critical friend” of the Scottish Government, having sat on many working groups and bodies on licensing reform, and must also concede I have been withering in my analysis of the efficacy of some of the licensing law which the Parliament has produced. That being, said even I am amazed at just how far these new proposals go, and the absence of balance.
“It is crucial that any potential restrictions to reduce the volume of alcohol marketing are as comprehensive as possible.”
Event Sponsorship
This part of consultation starts by telling us there is no evidence at all as to whether sponsorship of “events”, by which they mean music, cultural events and so on (as opposed to sporting events) by alcohol has negative outcomes. Nevertheless, unhindered by any expressed desire to wish to proceed with probative and proportionate policy-making, they plough on and ask whether there should be a prohibition on alcohol sponsoring all events across Scotland. This, if enacted, would end alcohol sponsorship of musical or cultural festivals as well as local community led events. Heaven knows how you organise a beer festival.
Brand-sharing and merchandise
Not content with proposing a complete ban on all alcohol advertising in all public spaces, and the shuttering of shop-fronts, they go further, and suggest that there should be a ban on the sale of all alcohol-branded merchandise altogether. No more hats or mugs. No more t-shirts. No more craft brewery hoodies. In the context of this consultation, these have become “walking billboards“. The Scottish Government go further still, and present a case that even alcohol-free products should be banned as they are, in essence, “gateway” brands to expose people to the alcoholic variants, because of the use of the same names and logos:
“This demonstrates the need to carefully consider restricting these other distinctive and identifiable elements associated with the alcohol brand, in addition to restricting use of the alcohol brand name.“
... Perhaps the most incredible proposal within this consultation is the suggestion that there should be a complete ban on any and all promotion/advertising of alcohol in public places. This notion is suggested not, it would seem, as an intrinsic goal, but on the basis that it might be quite difficult to create a more nuanced law. Consider the following paragraph:
“Given the difficulties around defining places as places children and young people frequent, as well as the likely impact of alcohol marketing on adults too, a prohibition of alcohol advertising in public spaces may be the best course of action.”
I find that to be a remarkable statement. Here we have the Government saying that, because it might be too complex to prohibit alcohol marketing under defined circumstances, they should just go ahead and ban it altogether. We are looking at the white-washing of the alcohol industry across the country.
... Hard-working alcohol producers will be vexed, I would suggest, to see the following comment:
“Without branding and other marketing strategies, alcohol products in each beverage sub-sector are essentially variations of the same thing“.
This is an overt effort to eradicate the diversity and personality of individual alcohol products; to reduce them to a denominator common to those who are so opposed to it; that is, to see alcohol only as a harmful commodity, a vice. This one sentence discounts centuries of craft, effort and enterprise. This one sentence discounts the joy in sampling one malt whisky over another and sharing that experience with a friend. These, of course, are positive traits and experiences, which explains their absence.
... They even take us into territory where alcohol must be seen in the same context as tobacco:
“Where alcohol is displayed behind the checkout this could be required to be in a closed cupboard, like tobacco products.”
Some of you may be familiar with the Risk-Monger, David Zaruk. If not, you can make his acquaintance by watching this week's Swift Half. David has been battling anti-science NGOs in Brussels for many years. We talk about the precautionary principle, Glyphosate, neo-nics and why the Dutch government is closing down farms. Do have a watch.
Environmental groups have called for the sale of single-use e-cigarettes to be banned due their “rapidly escalating threat”.
In an open letter to environment secretary Thérèse Coffey and health secretary Steve Barclay, 18 environment and health groups, including Green Alliance and RSPCA, argue that disposable vapes are “unnecessary electrical items” that contain single use plastic, nicotine and batteries, all of which are “hazardous to the environment and wildlife when littered”.
Vaping has been incredibly effective in driving down smoking rates in Britain, but 28 per cent of smokers have still never tried an e-cigarette and the majority of those who have tried them have not become longterm users. If more smokers are going to switch to vaping, they need products that are simple, convenient and cheap.
There’s an eye-catching claim splashed over the front of The Times today under the headline ‘Big rise in gambling addiction’:
The health service will announce tomorrow that it has opened clinics in Southampton and Stoke, adding to a national network of five commissioned in 2019. Figures seen by The Times show that 599 patients have been referred to the service in the past six months, a 42 per cent increase on the same period last year and up 65 per cent from 2020-21.
The figures come from here. ‘Gambling addictions’ rising by 42 per cent in one year is so unlikely that it is worth asking whether these statistics accurately reflect what is going on.
Astute readers will recall the coronavirus pandemic of 2020-21 and wonder whether the accompanying restrictions, which included the total shutdown of face-to-face gambling support for months, may have led to the figures for these years being lower than they would otherwise have been. It seem almost certain that they did.
2019/20 would be a better baseline to compare the most recent years to, except that a lot of these clinics didn’t even exist for part or all of that year. This significant fact is hiding in plain sight in the paragraph quoted above:
The health service will announce tomorrow that it has opened clinics in Southampton and Stoke, adding to a national network of five commissioned in 2019.
The whole point of these clinics is to give problem gamblers somewhere to go for face-to-face support. When the NHS Northern Gambling Service was opened in September 2019, Dr Matthew Gaskell said:
“I’m delighted to be opening our new clinic in Manchester. This will help make our service more accessible to people in the North West of England where we know there are thousands who need our support.”
As intended, problem gamblers are using these relatively new facilities. When more clinics are opened in Southampton, Stoke and elsewhere, it will presumably lead to even more people attending a gambling clinic. It will disappointing if they don’t, but it will not be evidence of a ‘big rise in gambling addictions’, although perhaps The Times will portray it as such
The aforementioned Dr Gaskell is quoted by The Times…
He said the patients referred to NHS addiction clinics were a “drop in the ocean” of those suffering mental health problems because of problem gambling.
Perhaps so, but it is an increasingly large drop in the ocean as the number of NHS clinics proliferates and word gets around that they exist.
If you want to know whether there has been a rise in problem gambling, you need to look at the problem gambling surveys which have been running since 1999. They show that the rate of problem gambling has been flat and low for over 20 years. According to the latest data…
the overall headline problem gambling rate as measured by the short form PGSI is statistically stable at 0.3%.
In short, there is a fairly obvious ‘if you built it they will come’ aspect to this story. I suspect that journalists at The Times are smart enough to see this but have had their minds clouded by the paper’s editorial line which resembles a moral crusade (why else would this half-story be on the front page?)
The rest of the article pushes the sports betting angle, with Dr Gaskell making the pointed and remarkably convenient claim that his clinics are “filled with young men in football shirts“. He is not a man averse to hyperbole…
“People start gambling as soon as they wake up in the morning; they’re gambling in the shower, gambling while they’re driving to work. The NHS is picking up the tab.”
The mind boggles at the idea of gambling in the shower. As for the NHS picking up the tab, the government made over £3 billion from gambling duty revenue last year and the industry was willingly paying for gambling treatment services via GambleAware until the puritans at the NHS decided that it could no longer accept this tainted money and passed the bill to the taxpayer.
If ‘gambling addictions’ have really risen by 65 per cent in two years, you have to wonder what the point of ridding the country of fixed odds betting terminals was. Remember them? They were the root of all evil according to dozens of Times articles until April 2019 when they were effectively banned. There were the ‘crack cocaine of gambling’, no less.
How does The Times square its victory over the dreaded FOBTs with the spiralling rates of gambling addiction it is now reporting? Perhaps it is relying on its readers having short memories.
Cross-posted from the Snowdon Substack.
The media love stories about vaping so it is odd that only the Daily Mail covered the latest Cochrane Review when it was published yesterday. Cochrane Reviews are at the very top of the evidence pyramid and only include randomised controlled trials (RCTs).
There is an argument that RCTs are not best way to measure the benefits of vaping for smoking cessation because smokers tend to switch to vaping organically, sometimes gradually, and often without intending to quit. Nevertheless, RCTs have still shown vaping to be more effective than nicotine patches and placebos. The last Cochrane Review in 2020 concluded that there was 'moderate-certainty' evidence that e-cigarettes are effective in helping smokers quit.
We included 78 completed studies, representing 22,052 participants, of which 40 were RCTs. Seventeen of the 78 included studies were new to this review update. Of the included studies, we rated ten (all but one contributing to our main comparisons) at low risk of bias overall, 50 at high risk overall (including all non‐randomized studies), and the remainder at unclear risk.
There was high certainty that quit rates were higher in people randomized to nicotine EC than in those randomized to nicotine replacement therapy (NRT) (RR 1.63, 95% CI 1.30 to 2.04; I2 = 10%; 6 studies, 2378 participants).
Gambling: Boy, 16, lost thousands after seeing advertA 16-year-old boy lost thousands of pounds gambling in just a few weeks after seeing adverts at a football game, a support worker has said.
Nick Phillips, from Swansea, said the boy opened an account in his father's name an hour after a match.
Mr Phillips helps those struggling with gambling in Swansea, said the boy's family have stopped going to football matches because they want to avoid putting their son at risk.
He said: "This poor lad has gone home an hour after the match and opened an account in his dad's name after seeing the gambling ad."
Carolyn Harris, MP for Swansea East, said legislation needed updating to keep up with technology.
She said: "If you think about the last Gambling Act in 2005, the first iPhone was invented in 2007, who could have foreseen how technology would come along in the way that it has."
I have a new peer-reviewed study out in Economic Affairs ($) this month looking at the total consumption model theory as it pertains to alcohol. It builds on some of the research I did for Lockdown Lessons in Health Economics in which I showed that greatly reducing the availability and advertising of alcohol during the pandemic did not lead to fewer alcohol-related deaths (as 'public health' theory would predict). Instead there was a large increase in such deaths.
Put simply, 'public health' theory inspired by the neo-temperance movement that emerged in the 1970s says that drinking patterns in society move in concert, so if moderate drinkers drink less, heavy drinkers will drink less. They believe that if per capita consumption of alcohol declines, the amount of heavy drinking - and therefore alcohol-related mortality - will also decline.
It is important to stress that the single distribution theory is not presented as a rough rule of thumb, but as an iron law. Skog (1985, p. 90) asserted that “when mean consumption increases, the consumption level of all kinds of drinkers increases”. Rose wrote in The Strategy of Preventive Medicine that “from the average alcohol intake of a population one can precisely predict the number of heavy drinkers” (2008, p. 121; emphasis added).
Adherents of the total consumption model do not believe merely that shifting the curve to the left is one way of reducing heavy drinking, but that it is the only way. As Cook and Skog (1995, p. 31) put it, “heavy drinkers will reduce their drinking if – but only if – the others cut back too”. Rose and Day (1990, p. 1034) argued that “to help the minority the “normal” majority must change”.
Far from moving ‘in concert’, there is evidence of polarisation in drinking patterns in Iceland, Sweden and UK, with heavy drinkers consuming more and moderate drinkers consuming less (Bjarnason, 2006; Meier, 2010; Zeebari et al., 2017).
Further evidence can be found in the alcohol-specific mortality data, which can be used as a proxy for heavy drinking. In the UK, an 18 per cent decline in per capita alcohol consumption between 2004 and 2016 was not accompanied by a decline in alcohol-related deaths or hospitalisations (Whittaker et al., 2020, p. 1987). In the WHO European Region, per capita consumption declined between 1990 and 2014 but alcohol-attributable mortality rose (Hallgren et al., 2018). In the Australian state of Victoria between 1999 and 2007, there were “significant increases in alcohol-related harm” despite “relatively stable alcohol consumption levels” (Livingston et al., 2010, p. 368). In Norway and Ireland, rates of liver cirrhosis fell between 1980 and 2000 as per capita consumption rose (Bentzen & Smith, 2011).
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Taken together, the evidence leads us to a conclusion that is almost diametrically opposed to the public health orthodoxy, but is likely to strike the reader as no more than common sense. The amount of alcohol consumed by the average drinker does not affect the amount consumed by heavy drinkers. Unless the average consumer is drinking a dangerous amount, there is nothing to be gained from making her drink less. If efforts are to be made to tackle heavy drinking, they should be directed towards heavy drinkers rather than the general population.
In the latest episode of Last Orders - which is now coming out every fortnight - Tom and I spoke to Nick Gillespie of Reason magazine about US politics, nicotine-free cigarettes and Twitter. Check it out here, subscribe on iTunes (or whatever) or listen below.
Remember The Price of Time, the book about interest rates that I reviewed last week? I managed to get the author to do The Swift Half interview yesterday. Enjoy!
I spoke at the British Society of Lifestyle Medicine conference in September in front of a surprisingly large crowd of 800 at Spurs' ground in Tottenham. I didn't realise at the time but the Q & A was being filmed. The topic was sugar taxes and other government interventions involving diet.
I haven't watched it back but I recall it getting a bit heated when Tim Spector, who had just given a presentation telling us that everything we knew about food was wrong, insisted that governments were acting with perfect information when they interfere in the food supply.
A few years ago, I ordered a pint of Stella Artois in Washington, DC. I used to drink Stella quite a lot back in the day, but had fallen out of love with it for reasons I couldn’t quite identify. I ordered it on this occasion because it was the only beer that looked familiar. And oh, what a sensation that first sip was! How the memories came flooding back! It was then that I appreciated something I already knew but had subconsciously ignored. Stella Artois had been reformulated in the UK for tax reasons. The ABV had dropped from 5.2 percent to 4.8 percent and later, monstrously, to 4.6 percent. This was done stealthily. We weren’t supposed to notice and in a sense I hadn’t. I had just gradually gone off it until I was reminded of how it was meant to be.
I mention this because something similar happened with the Beatles’ seventh studio album, Revolver. The music was great but the stereo mix created in 1966 was awful. The only people who owned stereos back then were nerds, and so the Beatles, like other bands, treated the stereo mix as an afterthought. In the mid-’60s, mixing for stereo meant chucking half the instruments in one channel and everything else in the other channel. The result was a thin and incohesive sound that the Fabs only started to improve upon with Sgt. Pepper the following year.
This was the mix that appeared on compact disc in the 1980s and it is the only mix most people under the age of 60 know. It is the 4.6 percent ABV version of Revolver and I hold it wholly responsible for the album’s steady slide down the Greatest Albums of All Time charts in the last 40 years. It hasn’t slipped down the list because bands have made better albums in the meantime. They obviously haven’t. The blame lies solely with that weedy, disjointed stereo mix, the deficiencies of which have only become more apparent as the album has aged.
It was with this trenchant view that I approached the new deluxe edition of Revolver with an unusual degree of excitement. Contrary to what you may have inferred from the previous paragraphs, I am not an audiophile. I can’t tell the difference between a remastered album and an original (in fact, I suspect the whole remastering thing may be a con to part gullible middle-aged men from their money). But I do like a remix, and Giles Martin’s subtle remixes of the Beatles’ 1967–70 classics were well worth the admission fee.
On Revolver, Martin has made use of technology developed by the FBI to isolate the voices of mafiosa on murky wire recordings. This has allowed him to tease apart instruments that have been glued together ever since they were “bounced down” on four-track 56 years ago. Martin has cleaned them up, placed them appropriately in the stereo mix and—boom!—Revolver is finally in 3D.
NHS Strategic LeadThis a senior role within public health charity Action on Smoking and Health (ASH) to engage the NHS in action to tackle smoking.
This leadership role will seek to engage NHS leaders across prevention and health inequalities programmes as part of helping to secure the Government’s vision of smokefree England by 2030. It will develop and galvanise a professional network involved in delivering support and develop tools and resources to support system change.
This a senior role within public health charity Action on Smoking and Health (ASH) to engage the NHS in action to tackle smoking. ASH is public health charity established by the Royal College of Physicians, working to end the harms from smoking. We campaign to secure evidence-based policy change and work with public sector and others to support policy implementation. This role is to deliver on an NHS England funded project.
By slashing interest rates to historic lows, central bankers turned off one of the most important signals in the economy. Since this often required pricing money, quantitative easing became the bedfellow of unnatural interest rates in the new economic orthodoxy. QE began as part of a desperate effort to save the banking system from collapse but, emboldened by the apparent lack of inflation it caused, central banks began using it for lesser crises. The Bank of England had fresh bouts of QE in 2012 to help it reach its inflation target — i.e., to raise inflation — and again in 2016 “to help the economy after the EU referendum”. When the Federal Reserve engaged in its third splurge of QE in 2012, the stated objective was to help the jobs market.
Throughout this period, interest rates were kept at rock bottom for fear of dampening economic growth. Society quickly became addicted to cheap money. House prices rose to absurd levels, made possible only by freakishly low mortgage rates. Corporations took on debt to carry out a string of mergers and buyouts which produced returns for shareholders without the businesses having to go to the trouble of becoming more productive. Zombie companies proliferated, making just enough money to avoid insolvency, but not enough to ever pay back their debts.
All of this was sustainable only if interest rates never returned to normal levels. That, in turn, required inflation to remain abnormally low forever. In other words, it was not sustainable at all. The longer it went on, the bigger the bang would be when the bubble burst.
Since the start of last month, it has been illegal in the clown country of Great Britain for supermarkets to put 'junk food' such as marmalade and pain au chocolat at the end of their aisles. This has led to shoppers being unable to find the things they want.
Rumour has it that the supermarkets are not entirely unhappy about this as it means people walk around the store more and pick up more items, but it has naturally meant that so-called junk food has to stocked in the aisles rather than at the end of them.
In a development that will no doubt shock you, it appears that the government's outright capitulation to their lunatic demands is not enough for Action on Sugar who think it is outrageous that sugary products are being stocked in the middle of aisles.
Middle aisle promotions are the new 'end of aisle' marketing loophole! Clearly not in the spirit in which these restrictions were intended. so disappointing to see @Tesco, but they are not alone @dollytheis @actiononsalt @mollclayton ...🧵 https://t.co/a8EKXwPfPX
— Action On Sugar (@actiononsugar) November 3, 2022
This isn't the first time I've seen the word 'loophole' used by public health cranks to describe something that was never intended to be covered by the legislation in question, but it is a particularly hilarious example.
Where do they think these products should be stocked??
The answer, of course, is nowhere.
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The government is working on its Smoke-Free 2030 Plan. Earlier this year, Javed Khan proposed some frankly mental tax-and-ban policies fed to him by the prohibitionist wing of the 'public health' movement. My plan is more realistic, more humane and would be more effective. It includes a simple 12 point plan to encourage smokers to switch to safer alternatives, or at least letting them know that they exist!
And there's a little video...
🚨New IEA research!
— IEA (@iealondon) November 2, 2022
🚭IEA Head of Lifestyle Economics, @cjsnowdon, has written his 'Alternative Smoke-Free By 2030 Plan', to counter the prohibitionist 'Khan Review', published earlier this year.
Watch Christopher explain his strategy below👇 pic.twitter.com/4aSq1VeVVR