Thursday, 23 February 2023

Israel to ditch the hated sugar tax


The Israeli government is abolishing its sugar tax after barely a year, following the lead of Denmark, Norway, Chicago and other places around the world where the public have seen through this regressive tax grab. Like many such taxes, it wasn't really a sugar tax at all as it also applied to artificially sweetened beverages. It was just a money-grabbing shake-down.

An op-ed in The Lancet offers a chance for us to bathe in nanny statists' tears, so let's turn on the taps.
 
As members of the World Federation of Public Health Associations Non-Communicable Diseases Prevention & Health Promotion and Policy Working Groups...
 
Snappy name!
 
... and other leading scholars of nutrition policy, health sciences, and economics, we would like to convey extreme concern over the Israeli Finance Minister's decision to revoke the sweetened beverage tax as his first act on his first day in office.
 
Not just concern, but extreme concern! 
 
This decision, taken without consulting the civil service professionals in the ministries of health or finance, or without conducting any other independent expert review, is a grievous blow to public health. 
 
Imagine taking a decision based on what you promised in a recent election rather than doing what 'civil service professionals' want you to do. How grievous!
 
It runs counter to clear guidance from international agencies such as WHO and The World Bank...
 
Why does the World Bank have a corporate view on sweetened beverage taxes?
 
... as well as evidence from the Bank of Israel itself, showing that the tax substantially reduced sweetened beverage consumption.
 
I'm not sure why the Bank of Israel got involved, but we know from many other jurisdictions that a reduction in sugary drink consumption does not typically lead to a reduction in overall sugar consumption, let alone calorie consumption, and that sugar taxes have never been accompanied by a decline in obesity.
 
Revoking the tax will undoubtedly harm lives and increase the direct and indirect economic costs to Israel's health system and economy, both in the short term and long term.
 
Codswallop on stilts. Cry more.
 
More broadly, this act undermines hard won progress made elsewhere around the world. 
 
Good! This must explain why eight of the nine authors of this tear-stained tract are based in Geneva, Britain or the USA and only one is in Israel itself. It's no surprise to see Barry Popkin's name among them. Popkin has been campaigning for soda taxes longer than anyone and his name appears on a whole bunch of studies spuriously claiming that a soda tax has 'worked' somewhere or other, such as Berkeley, Mexico and Chile, usually in the journal PLoS One which he happens to be on the board of.
 
It is a serious setback for evidence-based public health policy and will be celebrated by vested interests who promote their products and disregard the need for policies that uphold the public's health and welfare.
 
It will also be celebrated by consumers in Israel, most of whom did not want the tax in the first place, and by people like me who just enjoy watching 'public health' hucksters throwing their toys out of the pram. 
 
This decision will be seen as prioritising sectorial political interests over incontrovertible scientific evidence and public health best practice. 
 
Bloody democracy, eh?
 
This decision seriously tarnishes Israel's international standing, its medical, scientific, and technological leadership, and reputation as an exemplar of sensible, evidence-based policy.
 
It really doesn't.
 
We support our colleagues in the Israeli health professions and society at large in calling on the Government of Israel to reconsider and retract this ill-conceived and hasty decision. Instead, let the revenue from the soda tax be used to combat chronic diseases including obesity, as well as promote nutrition security by increasing economic access to healthy diets, narrowing health disparities, improving the health and welfare of all Israeli citizens, and setting an example for world health leadership.
 
It's not leadership if you're just copying what lots of other countries have already done, is it? If anything Israel is showing leadership by standing up for the people against grubby 'public health' killjoys.  

If you want more tax revenue for healthcare, there are better ways of getting it. Sugar taxes have never worked anywhere in the world, they weren't going to work in Israel and the sooner other countries get rid of them, the better.


Wednesday, 22 February 2023

Pro-death, anti-choice lobby sides with the earthquake

I mentioned earlier how little use 'public health professionals' were during the pandemic.  
 
Let's not forget that these 'public health' academics spent the only genuine public health crisis of their lifetimes complaining about pubs being used as vaccination centres and whining about businesses donating food to the hungry and medical equipment to hospitals. Rarely has the chasm between public health and 'public health' been illustrated so starkly.

I had barely pressed 'publish' when I saw this story about anti-smoking activists trying to get the Turkish government to turn down a €1.8 million donation from Phillip Morris International for humanitarian aid after the recent earthquake.
 
Activists fume at tobacco industry for donating to earthquake-hit Turkey

The European anti-tobacco lobby has urged the international community to help earthquake-hit Turkey avoid a €1.8 million donation from Phillip Morris International (PMI) highlighting “hidden” lobbying activities. For its part, PMI rejected the accusations saying it’s money to help people in need.

On 15 February, PMI offered €1.8 million “to support immediate humanitarian aid and long-term recovery assistance” after an earthquake hit Turkey and neighbouring Syria causing thousands of deaths.

However, the move triggered a strong reaction from the anti-tobacco lobby.

 
What is this lobbying and how does this group know about it if it is hidden? No details are forthcoming in the article. Is it possible that these people are saying the first thing that comes to their head again?

“The tobacco control community in Turkey is concerned about the recent corporate social responsibility launch by Phillip Morris International about extending earthquake aid to Turkey”, Dr Elif Daglu from the Turkish Coalition on Tobacco or Health to the European Network for Smoking and Tobacco Prevention (ENSP) said in a statement.


Yes, that's the real concern in Turkey at the moment, isn't it? The word you're looking for, Dr Elif, is "thank you".
 
PMI employs a lot of people in Turkey and has a lot of money. It is understandable and commendable that it is helping the relief effort. What, I wonder, is the 'tobacco control community' doing to help?
 

Such donations from the tobacco industry constitute a breach of Article 5.3 of the WHO Framework Convention on Tobacco Control, to which Turkey is a party, he added.

 
That is just a lie. Why is that people who have made a career out of hating smokers are able to lie with impunity?

Contacted by EURACTIV, ENSP Secretary General Cornel Radu-Loghin said Turkish citizens “asked our organisation and other organisations to do whatever is possible to convince the Turkish government not to accept the tobacco industry money”.

 
Imagine being such a wretched human being that you spend your time trying to prevent humanitarian relief after an earthquake. It's difficult to think of a way of sinking any lower and yet this - for want of a better word - person is proud of it.
 

ESNP encourages the public health community to donate to the WHO foundation and the BTF relief fund, managed by the Turkish diaspora.


But they won't, will they? They will expect the government to do it for them, as usual.
 

ENSP claims that PMI and other tobacco industry organisations are using their social responsibility programmes, including donations, to lobby governments and to “clean their image”.

 
As with the generosity of the food, alcohol and tobacco industries during the pandemic, the only time we hear about these donations is when moral busybodies go to the media to whine about them. If it's a way of "cleaning their image", it is one that relies on 'public health' bottom-feeders publicising it. If it wasn't for them, no one would ever hear about these acts of charity!
 

“PMI and others are conducting an intensive campaign to legalise the sales and marketing, as well as probably their manufacturing, of novel tobacco and nicotine products in the Turkish market,” ESNP said.


It is no surprise that these parasitic fanatics are opposed to safer alternatives to smoking. Pro-earthquake and pro-smoking. It's all in a day's work for them.
 
E-cigarettes and heated tobacco are banned outright in Turkish thanks to these people. Turkey was supposed to be the golden boy of tobacco control. It did everything the WHO wanted and even got a WHO award for tobacco control, but it has all been a miserable failure. And smokers who want to switch to a vastly safer alternative are banned from doing so.

Way to go, guys! Which pro-death policy will you be adopting next?


No fat left to trim? The case of SPECTRUM

Back in 2019, I mentioned SPECTRUM which is, preposterously, meant to be an acronym for Shaping Public hEalth poliCies To Reduce ineqUalities and harM. At the time it was a new organisation that had just received £5.9 million from the unwitting taxpayer...

The Economic and Social Research Council is funded to the tune of £212 million by the Department for Business, Energy and Industrial Strategy. In 2017, it announced the creation of the UK Prevention Research Partnership (UKPRP), a £50 million project aimed at developing ‘robust new knowledge which contributes to demonstrable changes in policy and practice’ by ‘working closely with policy makers'. 
 
I suggested in Still Hand In Glove? that this had the hallmarks of another slush fund for political pressure groups. Some news yesterday removed all doubt...

We are delighted to announce that UKCTAS has been successful in securing future funding through a multi-funder research initiative; the UK Prevention Research Partnership (UKPRP). UKTCAS academics joined forces with new collaborators and a range of public and private sector organisations to apply to the UKPRP. The new consortium has now been awarded £5.9 million funding over five years and is called SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM).
 
A few months later, another new 'public health' organisation - called SIPHER - was set up and given £4.9 million of our money. After years of so-called 'austerity', there is was supposed to be no fat left to trim and yet the gravy train rolled on for the nanny state industry.
 
As I said at the time, SPECTRUM is a shameless slush fund for the worst people in the anti-capitalist, anti-freedom, authoritarian 'public health' racket. 
 
The list of SPECTRUM's 'co-investigators' features some other familiar faces, including John Britton (director of UKCTAS), Alan Brennan (Sheffield University fantasy modeller), Anna Gilmore (Tobacco Tactics conspiracy theorist) and Mark Petticrew (anti-alcohol crank), plus two senior staff from Public Health England.
 
I was reminded of them yesterday when they produced a video that they would call 'slick' if one of the many industries they hate had produced it. There is barely any attempt to pretend that they are not political activists.
 
 
 
As you'll see if you have the stomach to watch it, the video makes it clear that all you have to do is make a reference to 'health inequalities' and the government will shower you with cash to further your puritanical agenda. Presumably, we are supposed to be appalled by the behaviour we see in the animation, such as a couple relaxing in a cocktail bar, a man standing outside a bus shelter, in the rain, smoking a cigarette, and two people talking about tobacco and fast food.


Let's not forget that these 'public health' academics spent the only genuine public health crisis of their lifetimes complaining about pubs being used as vaccination centres and whining about businesses donating food to the hungry and medical equipment to hospitals. Rarely has the chasm between public health and 'public health' been illustrated so starkly.
 
They didn't allow themselves to be distracted by COVID-19. Apart from a few articles spreading doubt about the protective effect of smoking and a long rant about the help provided by 'unhealthy commodity industries', they have spent the last few years watching TV, scouring Twitter and responding to every government consultation they can find.

Since 2020, their published work includes the following indispensable contributions to the scientific literature.
 
 
 
 
 
 
 
 
 
Many of these 'studies' involve the ludicrous Mark Petticrew. That SPECTRUM is helping this buffoon pay his mortgage is reason enough to defund it. 
 
I am at a loss to see how taking millions of pounds from taxpayers and giving it to these juvenile quackademics can ever be justified. The government is burning our money. In fact, it would be better to literally burn the money that to spend it on this drivel.


Tuesday, 21 February 2023

Accolades for Aseem

Book early to ensure disappointment

Aseem Malhotra has gone all the way down the rabbit hole in the last year and is off the South Africa to spread his anti-vax messsage, having done likewise in India recently. The GMC say they won't investigate him because the vast majority of the British public have already been vaccinated and so the damage he can do to public health is limited. This is surely less convincing as an excuse for inaction when it comes to less vaccinated parts of the world. In any case, Malhotra is deliberately undermining confidence in mRNA technology in general, not just Covid vaccines.

Be that as it may, it is grimly amusing to see the flyer above using adoring quotes from people who fell for his low carb schtick back in the day. I wonder how anti-vaping fanatic Simon Capewell, anti-sugar zealot Robert Lustig and government-loving libertarian Shami Chakrabarti feel about their names being used to promote Malhotra's latest quackery?

It's a shame that there was no room on the flyer to quote Action on Sugar who worked out seven years ago that Malhotra was "completely mad", albeit only in relation to his views on statins and fat. Getting kicked out of Action on Sugar for being mad is like being kicked out of the KKK for being bigoted. But even they could see the signs.  

The signs were there from the very start. People in 'public health' didn't see them for the same reason they didn't spot that David Miller was a wrong 'un - they told them what they wanted to hear and so many cranks and conspiracy theorists work in 'public health' that it is easy for such people to hide in plain sight.



Monday, 20 February 2023

The sugar tax didn't work


The Mail on Sunday published a nice article this weekend looking at the sugar tax. It's refreshing to see a newspaper asking whether current policies are working rather than agitating for the next 'clamp down'.

It follows Israel's decision to repeal its tax on sugary drinks, something that Norway, Denmark and several US states and counties have already done. 'Public health' activist-academics from the World Federation of Public Health Associations Non-Communicable Diseases Prevention & Health Promotion and Policy Working Groups (snappy name!) are naturally appalled, but it seems unlikely that anyone is going to die as a result.

Alongside a number of quotes from my good self, the Mail on Sunday article includes some insights from Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London:
 
Prof Sanders says: ‘The idea behind the tax was right, but I think it’s dishonest to say it works.’

He says that data from the Government’s National Diet And Nutrition Survey showed the number of children who report having sugary drinks was already falling by five per cent annually from 2008 onwards – ten years before the tax. There is ‘no evidence’ the sugar tax has accelerated that.

‘A study looked at the impact of introducing minimum unit pricing for alcohol in Scotland. They thought the policy would have a beneficial effect, but heavy drinkers just spent more money on alcohol.

‘Will a broader tax on food work now, when so much is going up in price? Will people eat less, eat better, or consume fewer calories? I suspect they will just spend more of their disposable income on food, rather than cut back.'

 
I was also on the Medical Minefield podcast discussing this. Listen here. It features someone from Action on Sugar who pretty much admits the sugar tax hasn't worked but supports it anyway (which is Giles Yeo's view in the article too).
 

 


Friday, 17 February 2023

A swift half with Zion Lights

A new Swift Half has dropped and I'm delighted to say that Zion Lights was my guest. Formerly of the Green Party and Extinction Rebellion, Zion had a change of heart after an awkward interview with Andrew Neil in which she was expected to stand by some of XR's wilder claims. She now campaigns for nuclear power. Don't miss this one.




Thursday, 16 February 2023

Supernanny Sturgeon

Farewell then, Nicola Sturgeon. You put Scotland on international 'public health' map, but for all the wrong reasons, as I explain in the Scottish Daily Express today...
 

At every turn, Sturgeon and her government have preferred eye-catching gestures to effective health policies. Rather than address the root causes of alcoholism, obesity and drug addiction, they have opted for punitive and performative measures designed to set Scotland apart from England.

Sturgeon’s approach to Covid-19 amounted to clinging onto lockdowns and face-masks for longer than was sensible or necessary. Every time Boris Johnson relaxed restrictions, she would make a show of keeping them for a wee while longer.

This was supposed to make it look like Sturgeon cared more about people’s health than the Tories did. In truth, it made no difference to anyone’s health and made Scotland look like a laggard.

Without Sturgeon, the SNP has an opportunity to stop Scotland being a testbed for ill-advised nanny state ideas. There is nothing about the cause for Scottish independence that requires its supporters to be puritanical killjoys. 

 
 
One of the advantages of making your country a guinea pig for illiberal nanny state policies is that you are almost guaranteed a well paid job in the 'public health' racket once you leave front line politics. Jane Ellison (remember her?) has been at the WHO ever since she introduced plain packaging in the UK. Gro Harlem Brundtland became director-general of the WHO as a reward for her anti-smoking activism when she was Norway's prime minister.

Sturgeon is already on Mike Bloomberg's Task Force on Fiscal Policy for Health along with former New Zealand prime minister Helen Clark. If she does step away from politics, don't bet against her becoming a super-nanny globetrotter for Bloomberg, the WHO or the Global Alcohol Policy Alliance.



Tuesday, 14 February 2023

A man for our times

From The Courier...
 
McDonald’s Monopoly: Angus man’s fight to ban fast food promotions

Lewis McMartin, 36, wants to see promotions in restaurants such as McDonald’s banned in Scotland, saying rewarding people in this way fuels an NHS crisis.


Mr McMartin started a petition which so far has 18 signatures.

It has been pointed out that the government can't just ban a specific promotion by one company. It would have to ban every food company from using any promotion and that would have far-reaching implications.
 

The Scottish Retail Consortium said any new regulation in this area could extend to local chains such as Stephen’s Bakery and Tower Bakery, as well as convenience stores with hot food counters like Scotmid and The Coop.

It could also affect independent businesses such as chip shops, Chinese and Indian takeaways, sandwich bars and coffee shops if they offer any loyalty schemes.

 
You may be wondering why Mr McMartin has such a bee in his bonnet about this.
 

Mr McMartin said: “I have a chronic health condition with my pancreas so I am not able to eat big portions.

“But years ago I would find myself going to McDonald’s and instead of buying a medium meal I would buy a large one so I could get more stickers.

“But that just made my condition more painful and made McDonald’s richer.”

 
There is no cure for stupidity.
 
"Instead of sitting and moaning about it to my friends and whoever else would listen, I went right to the Scottish Government."
 
That's the spirit. Be the change you want to see in the world! 

“They said they wanted to do something but can’t because they don’t have the powers from Westminster.”

 
I don't think this is true, but I can well believe they said that.
 

Mr McMartin added: “I don’t know if it will make a difference, but I felt I needed to do something rather than moaning and having it irritate me.”

 
This being 21st century Scotland, 'doing something' means trying to get it banned. Truly a man for our times!
 
Never underestimate the power of a small group of petty killjoys and to change the world. In fact, it is the only thing that ever does these days.


Monday, 13 February 2023

WHO kills off Covid vaccine

 
The corrupt and incompetent World Health Organisation has killed of an effective Covid vaccine for quasi-religious reasons.
 

Health Canada approved the vaccine Covifenz in February of last year, after studies showed two doses were 71 per cent effective in protecting adults 18 to 64 against COVID-19 infection and disease. The vaccine was 70 per cent effective against Omicron.

The Medicago technology was also widely seen as having great potential for creating both vaccines and antibody treatments for other conditions, including cancers, arthritis and multiple sclerosis.

But the plants used in production are a cousin of the tobacco plant and were supplied by tobacco giant Phillip Morris, which was a minority (21 per cent) shareholder.


You can probably guess where this is going.

“It's well known the WHO and the UN have a very strict policy regarding engagement with the tobacco and arms industry, so the process is put on hold. It's very likely it won’t be accepted for emergency use listing," Mariangela Simao, a spokesperson for the WHO, said in a statement to CTV News Montreal at the time.

Without WHO’s endorsement, few governments were willing to buy the vaccine. 

 
At what point do people at the WHO ask themselves 'are we the baddies?' In 2021, I wrote an article contrasting the WHO's warm embrace of newly invented Covid vaccines which, despite rare adverse events, are a big net gain for public health, with its hostile approach to e-cigarettes, which are no longer new, have no major side effects and are also a huge net gain for public health. I said...

When it comes to vaccines, the WHO is interested in relative risks and the overall effect on the health of the population. When it comes to vaping, however, it cannot see beyond tiny – and largely hypothetical – absolute risks.

A major reason for the WHO's antipathy towards e-cigarettes is that the tobacco industry makes and sells some of them. When you have that kind of comic book mentality, I suppose it is only a short walk to rejecting effective vaccines on the basis that the vaccine comes from a tobacco-like plant and a tobacco company own a minority shareholding in the company that developed it.

It cannot be said too often that 'public health' is not about health. 

The Medicago technology was also widely seen as having great potential for creating both vaccines and antibody treatments for other conditions, including cancers, arthritis and multiple sclerosis.

 
But none of that will be happening thanks to the FIFA of public health.

Medicago had been preparing to launch full-scale production. However, its parent company, Mitsubishi Chemical Group, announced last week Medicago was closing down. Officials cited changes to the COVID-19 “vaccine landscape” and lower global demand for COVID-19 vaccines. 

... That decision in Geneva effectively started the company on a death spiral, with the closure leading to 600 job losses.


Nice work!

For more on this, read the CTV News article.


Saturday, 11 February 2023

Last Orders with Andrew Orlowski

There's a new episode of Last Orders out, this time with the Telegraph's technology correspondent - and fellow Middlesbrough supporter - Andrew Orlowski. We discuss the idiocy of our green elites, the rise and fall of FTX, and the cult of booze prohibition.

Listen here.



Wednesday, 8 February 2023

Worst science journalism of the week

From the Daily Mail...
 
EXCLUSIVE: Using snus or dipping tobacco may raise the risk of Type 2 diabetes by 30 PERCENT, study suggests

Using snus tobacco products may raise the risk of type 2 diabetes by up to 30 percent, a study has suggested.

... In the latest study, researchers in Sweden — where snus was invented and the product is popular — monitored nearly 37,000 people in the country for eight years.

This included 2,000 snus users who had never smoked a cigarette.

They found that these individuals were 29 percent more likely to develop type 2 diabetes compared to people who did not smoke cigarettes or take snus.


What the study actually says... 
 
In this study, no association between snus use and risk of T2D [Type 2 diabetes] in the entire study population, in the analysis adjusted for age, sex, and smoking or in a model adjusted for other confounders, was observed, which is in line with the results from several cross-sectional and case-control studies.
 
From the Daily Mail...
 

Dr Olga Titova, an epidemiologist at Uppsala University who led the research, suggested snus raised the risk of diabetes because it contained nicotine.

 
What the study actually says...
 
This study suggests that current and former smoking are associated with an increased risk of developing T2D in middle-aged and older participants. There was less evidence of an association of Swedish snus use with the risk of T2D, suggesting that compounds other than nicotine may have a larger adverse effect on the development of T2D.
 
I can handle sensationalist media coverage of epidemiological studies, but reporting the opposite of what a study found is a bit much, isn't it?


Tuesday, 7 February 2023

Does smoking cost Britain £173 billion?!?

If you say that a certain activity costs society £10 billion a year, most people would assume that if that activity disappears, society will save £10 billion a year.

They might have different ideas of what ‘society’ means. Some will assume that the £10 billion is a cost to taxpayers while others will assume that some of the cost is borne by private individuals and businesses. But the majority will, quite reasonably, assume that the cost is to other people, i.e. those who do not participate in the activity.

And nearly everyone will assume that the £10 billion is money in the conventional sense of cash that can be exchanged for goods and services.

But when it comes to estimates from ‘public health’ campaigners about the cost of drinking/smoking/obesity, all these assumptions would be wrong. Most of the ‘costs’ are to the people engaged in the activity and they are not financial costs. Taxpayers would not pay less tax if they disappeared. In general, they would pay more.

Last month I mentioned an estimate of the ‘cost’ of gambling in the UK and said:

These studies have no merit as economic research. They are purely driven by advocacy. The hope is that the average person will wrongly assume that the costs are to taxpayers and agitate for change.

The main aim of these Big Numbers is to convince the public that heavily-taxed activities place a burden on society that exceeds the tax revenue, thereby justifying yet more taxes and prohibitions.

In the case of smoking, this has become more and more difficult. Smoking has been a net gain for the Treasury ever since King James I started taxing it heavily in the 1600s. Today, as the smoking rate dwindles and tobacco duty rises ever higher, anti-smoking campaigners have got their work cut out duping non-smokers into thinking otherwise.

Tobacco duty brings in about £12 billion a year. For years, groups like Action on Smoking and Health (ASH) used a figure of £13.74 billion as the ‘cost of smoking’. This came from a flimsy Policy Exchange report which included £5.4 billion as the cost of smoking breaks and £4.8 billion as the cost of lost productivity due to premature mortality. Neither of these are costs to the taxpayer. They are not even external costs, i.e. costs to non-smokers.

Last year, in a review commissioned by the Department of Health, Javed Khan came up with a figure of ‘around £17 billion’ as the ‘societal cost’ of smoking. This included ‘reduced employment levels’ (£5.69 billion) and ‘reduced wages for smokers’ (£6.04 billion). Again, these costs fall on smokers themselves and are not external costs. They are, in other words, none of the government’s business.

Last week, a report commissioned by Action on Smoking and Health (ASH) pulled out all the stops and announced that the cost of smoking to Britain was now - wait for it! - £173 billion. Go big or go home, eh?

This is so far adrift from earlier estimates that even the casual observer might start to smell a rat. The report was written by Howard Reed of Landman Economics who used to do work for the people who campaigned against fixed odds betting terminals. He has previously produced a report for ASH claiming that smoking leads to unemployment and low wages, based on the simple observation that smokers are more likely to be unemployed and earn low wages. It is well known that smoking is far more common in lower socio-economic groups, but it is an absurd leap of faith to assume that smoking is the cause of unemployment and low wages.

Reed nevertheless assumed causality and, in his new report, reckons that smoking-related unemployment and low wages cost society (i.e. smokers) £15 billion a year.

But that is nothing compared to the £123.7 billion he attributes to the ‘cost of early deaths due to smoking’. He doesn’t show his workings for this calculation - or any other - but it is a combination of all the hours that could have been worked if smokers didn’t die prematurely plus the intangible costs of their lost years of life.

The savvy reader will have noticed that all these ‘costs’ fall under the category of None Of The Government’s Damn Business. If I die at the age of 75 rather than 80, I will lose the intangible benefits of five years of life, but that is my problem. Similarly, if I retire five years early and lose five year’s income, that’s up to me.

The absurdity of portraying lost years of life as a societal cost - let alone as a financial cost - can be illustrated by the example of contraception. The contraceptive pill has prevented billions of years of life, but it is very difficult to argue that it has cost society trillions of pounds. A society doesn’t become richer just because more people live in it; that’s why we use per capita GDP as the measure of national output, not overall GDP.

Certainly there are intangible costs to dying prematurely, but these costs fall on the individual. Moreover, there are intangible benefits to smoking which reports like this never acknowledge. Since both the intangible costs and the intangible benefits fall squarely on the smoker, it is for the smoker to decide whether the costs outweigh the benefits. It is no one else’s business.

The ‘societal cost’ figure of £173 billion is designed to make it look as if it is everybody’s business, but it is so obviously suspect that ASH haven’t been using it in their PR. Instead, they have focused on a claim from the same report that smoking imposes a net cost on taxpayers of £9.5 billion.

 

This estimate doesn’t include the bogus lost output or the intangible costs. It is more relevant to policy and it takes into account the taxes smokers pay on their tobacco. But is it plausible?

The figure breaks down as follows…

Reed says that tobacco duty (plus VAT on the duty) rakes in £11.05 billion (it is actually more than £12 billion but never mind). The challenge is for him to find costs to the taxpayer that exceed this.

First, he conjures up £8.4 billion in welfare benefits handed out to smokers to compensate them for their higher levels of unemployment and lower rates of pay. This hinges on the conceit that smokers are paid less and are more likely to be unemployed because they smoke. Whilst it is possible to imagine a scenario in which this could be a factor for an individual (largely thanks to ‘public health’ groups demonising smoking), it is very unlikely to be a general rule. A toilet cleaner is not going to be paid more just because she quits smoking and someone on the dole is not going to get a job just because he quits smoking.

Secondly, Reed reckons that the government would make an extra £8.2 billion if all the money spent on tobacco was spent on something else. It is true that this money would not disappear. It would be spent on other goods and services and some of those goods and services would be taxed, albeit at a much lower rate than tobacco is.

There would also be a multiplier effect of some kind which Reed assumes would create more jobs than expenditure on tobacco does. He says that “employment in the tobacco industry in the UK is close to zero”, although a footnote says that 5,000 people work in the industry. He then claims that tobacco retail and distribution “supports relatively few jobs in the supply chain”, which will be news to people who work in convenience stores.

Based on previous work he did for ASH, Reed estimates that if smokers stopped smoking and spent the money on all the things nonsmokers spend their money on, it would create more jobs and the government would make/save an extra £8.2 billion in taxes/benefits. He doesn’t show his workings so it is difficult to say how credible the estimate is, but there are two things to bear in mind.

Firstly, the revealed preferences of smokers shows that they would rather spend part of their income on tobacco than on anything else.

Secondly, jobs are a cost not a benefit.

Societies get richer by having the same things made by fewer people. What is being proposed here is having other things made by more people. Whatever those other things are, they are of less value to smokers than tobacco.

Thirdly, there is £2.2 billion in healthcare costs and £1.3 billion in social care costs. Fair enough, but what would these costs be if no one smoked? That is the relevant question and there is lots of evidence built up over decades that the costs would be higher because there would be more (mostly old) people requiring healthcare. Reed is aware of this but explicitly ignores it, more or less admitting that it would spoil his party if he took it into account.

Sometimes it is argued that in cost benefit analyses of policies which result in a reduction in the number of premature deaths in the population (such as tobacco tax increases or tougher tobacco regulations), the additional end-of-life healthcare costs incurred by the people who live longer should be taken into account. In the 2010 version of this model we argued that, even if this were the case, it would be a mistake to include these costs in the cost-benefit analysis (CBA) because there is a fundamental methodological flaw in this approach.

Taken to its logical conclusion, the inclusion of end-of-life healthcare costs in CBAs of this type would lead to the perverse conclusion that policies which result in larger numbers of premature deaths in the population have a positive benefit to society because they reduce healthcare expenditure on elderly people.

Yes it would! Because that’s what would happen!

The whole point of this calculation is to estimate the impact of smoking on the public finances, but as soon as it becomes clear that the government would save money from the healthcare budget, Reed has to turn a blind eye because it would lead to a ‘perverse conclusion’, i.e. a conclusion that would not suit the agenda of the people who commissioned it.

Reed is not even consistent in this. Elsewhere, he estimates that smoking saves the government £260 million a year in reduced pension costs due to premature mortality. Why include these savings but not the health and social care savings? Both are equally macabre insofar as they rely on people dropping dead.

(£260 million is a massive underestimate, by the way. The government spends £110 billion a year on state pensions. It is ridiculous to pretend that it would only spend an extra 0.2% on them if no one had ever smoked. When Mark Tovey and I conducted our own study in 2017 we found that the government would be spending an extra £9.6 billion on pensions if no one smoked.)

But whilst he won’t include healthcare expenditure foregone as a result of premature mortality, Reed does include £476 million in tax revenue foregone as a result of premature mortality. In other words, he thinks it is fair to include the taxes a smoker would have paid if they had lived longer, but it is not reasonable to include the healthcare they would have used - healthcare that would have been paid for, at least in part, by those very taxes.

This is economically illiterate nonsense that doesn’t stack up even on its own terms. Perhaps that is unsurprising when you consider that an anti-smoking pressure group not only commissioned it but helped to set its parameters.

The Model was commissioned by, and developed in collaboration with, ASH.

But it doesn’t really matter how the figure is arrived at because almost no one will read the report. All that matters is that ASH have a Big Number to cite when it’s lobbying for the government to pick of the pockets of smokers.

Which is, of course, what they immediately started doing…

Cross-posted from the Snowdon Substack



A swift half with Marc Sidwell

A new episode of The Swift Half dropped last week. I spoke to author and commentator Marc Sidwell whose book, The Long March, I belatedly read recently. We discuss the changing nature of leftism and the increasing power held by a small bureaucratic class. Check it out.



Thursday, 2 February 2023

Public health comic investigates the Beano

There's a laughable investigation into the Beano's website, of all things, in the British Medical Journal today. The Beano has responded, saying that the authors had chosen “to cite selective examples out of context”.

If you're familiar with the world of 'public health' academia, this will be enough of a clue for you to guess that Mark Petticrew is one of the authors, and you would be right.

I've written about  it for the Spectator
 

One of the regular characters in Viz is an old woman called Meddlesome Ratbag who goes to great lengths to engineer situations in which she can be offended so she can complain to the authorities. I was reminded of her this morning when I read the British Medical Journal‘s investigation into the Beano. Yes, you did read that correctly. One of the world’s leading medical journals has been devoting its attention to a children’s comic.

It turns out the Beano has a popular website that has been visited by nearly 48 million kids since its launch in 2016, according to the investigators. It stands accused of mentioning the brand names of various sweets, treats and fast food companies. These products are not advertised on the website and no money has changed hands. The owners of the comic have clarified that on occasions when they work with companies, this is ‘always clearly marked’ on their website and ‘would never include’ brands deemed by the government to be ‘high in fat, sugar or salt’ (HFSS).

The Beano is nevertheless accused on ‘exposing children to HFSS content’ by acknowledging the existence of the likes of Skittles and Greggs. In an overwrought editorial accompanying the investigation, the BMJ says:

Todays innocent fun” is tomorrows health crisis.

 
Read the rest here.


Prohibition failing everywhere

After the fall of the Islamic State, Bhutan was left as the only country in the world where tobacco sales were banned. Prohibition did not go well (who could have predicted that?)

The Bhutanese government legalised tobacco in July 2021 as a response to the COVID-19 pandemic. This was not because the government recognised the potential of smoking to reduce infections, but because so many tobacco smugglers were coming over the border carrying the virus.

The Tobacco Control blog has finally accepted that Bhutan has no plan to bring prohibition back. This makes it sad.
 

Bhutan reverses sales ban on tobacco

In 2010, Bhutan was lauded globally for being the first country to ban tobacco sales and smoking in public places. The ban lasted for over a decade until the circumstances posed by the COVID-19 pandemic compelled policy makers to change course, legalising the sale of tobacco within the country.

 
The Bhutanese legislation essentially banned everything except bringing a bit of tobacco in from abroad for personal consumption.
 

Building on the nationwide sales ban in 2004, the Tobacco Control Act, 2010 imposed a comprehensive ban on all tobacco products in Bhutan. The law prohibited cultivation, manufacture, supply and sale of tobacco products; imposed bans on advertisements, promotion and sponsorship of tobacco products along with restrictions in films; declared smoke-free public places or zones; and also prescribed a labelling requirement for display of country of origin and health warnings on tobacco products. Tobacco consumption, however, was not banned. Import of tobacco products for personal consumption was permitted, but taxed. The law also levied a sales tax of 100% for imported tobacco products from India and an additional custom duty of 100% for tobacco products from other countries. The Tobacco Control Regulations, 2013 and the Tobacco Control (Amendment) Act, 2014 imposed limitations on the quantities that could be purchased for personal consumption and required declarations of importer’s identity. The law also prohibited the illegal sale of tobacco and the use tobacco products in public places, punishable under the Penal Code Act of Bhutan, 2004

Despite the existence of a robust legal and regulatory framework for tobacco control, smuggling and a black market for tobacco was rampant in Bhutan.

 
Incredible use of the word 'despite' there. Here in the real world, we would say 'because of'.

Tobacco use in Bhutan has not decreased significantly, with a tobacco use prevalence of 24.8% and 23.9% as per the STEPS 2014 and 2019 respectively.
 
'Not decreased significantly' is one way of putting it. Another way of putting it would be 'increased exponentially'. In 2003, Bhutan had a smoking rate of just one per cent!
 
So that's tobacco prohibition gone for now. Over to you, New Zealand!
 
 
These politicians banned alcohol – now poisonous hooch is killing thousands

The world’s largest prohibition experiment since the 1920s pushed liquor production underground. The consequences have been disastrous.

 
 You don't say.


Wednesday, 1 February 2023

Learning lessons from Scotland?


 
Zero Covid enthusiast Devi Sridhar is in the Guardian today telling the English to learn some lessons from the Scots if they want to reduce alcohol-related mortality. Scotland has a far the highest rate of alcohol-specific death, so I'm not sure anybody is knocking on Nicola Sturgeon's door begging for advice, but let's roll with it.
 

Over the past 15 years, its devolved government has attempted to reduce alcohol-related harm through a ban on multi-buy price promotions on alcohol, minimum unit pricing, reducing the drink-driving limit and restricting alcohol marketing on TV. And partly due to these efforts, alcohol harm fell in Scotland between 2003 and 2012, before plateauing. The emphasis in Scotland continues to be on high-risk groups.

 

She is right to say there was a fall in alcohol harm, as measured by alcohol-related deaths, between 2003 and 2012, although the rate is still far higher than in England. 

 


So which policies does she think achieved this? As you can see, she names four.

1. Ban on multi-buy discounts. 

Introduced in October 2011. When it was evaluated in 2014 it was found to have had no effect on alcohol consumption.

2. Minimum pricing. 

Introduced in May 2018, long after the decline in mortality. Regular readers will be aware that this policy died on its arse. All the evidence to date suggests it reduced alcohol consumption slightly but not among heavy drinkers who are consuming more. There is no evidence of health benefits and some suggestion of harm.

3. Reducing the drink drive limit. Introduced in 2014, after the fall in alcohol-related deaths. It has been evaluated twice. Both studies concluded that it had no effect.

Firstly, this study in 2018 found that lowering the limit "was not associated with a reduction in RTAs [road traffic accidents]" but it did damage the pub trade.

Secondly, this study in 2021 found that lowering the limit "had no effect on drink driving and road collisions".

4. Restricting alcohol marketing on TV. 

This hasn't happened and the Scottish government doesn't have the power to make it happen. It is a figment of her imagination.

So, we have four policy changes, one of which is imaginary. The three that are real didn't work and two of them took place after the period in question. Top work from a public health PhD!

Devi doesn't ask why heavy drinking went up so much in 2020 and 2021 despite overall drinking going down, but if she gave it some thought she might find some useful lessons for how to reduce alcohol-related deaths in the future.