Thursday 30 May 2024

Australia's tobacco fiasco


 
As two more tobacconists go up in flames in Melbourne, the Australian Broadcasting Corporation (ABC) can no longer deny the illicit tobacco crisis Down Under. This article is worth reading.
 

Rohan Pike is a former Australian Federal Police (AFP) and Australian Border Force (ABF) officer who helped establish the original tobacco strike team, when the black market was, as he describes it, a “modest problem”.

“The number one driver of the problem is the enormous price of tobacco,” Pike says bluntly.

When the taskforce was established in 2018, more than 400 million cigarette sticks were detected and seized at the border. 

Last year, it was 1.7 billion.

 
Even Simon Chapman's half-witted protégé has accepted reality.
 

Becky Freeman, an associate professor of public health at the University of Sydney, acknowledges the only reason people buy black market cigarettes is because “cigarettes are expensive”.

 
Naturally, being an imbecile, her answer is to ban vapes harder.
 
All of this was completely avoidable. All they had to do was allow affordable cigarettes and vapes to be sold to consenting adults. Instead, they allowed clowns and fanatics to call the shots and Australia became an object lesson in what not to do. The UK is not far behind. Are you watching, Mr Streeting?

PS. Speaking of clowns, this guy is in charge of the Australian Medical Association and apparently believes that every smoker in the country costs the economy $70,000 a year.
 
 
But he suddenly becomes sceptical when modelling suggests that taxing something that is currently illegal will raise tax revenue.



There is a lot of ruin in a nation but no society endure quite so many charlatans and fantasists without paying a price.




Wednesday 29 May 2024

Vape tax consultation - my response

The vape tax consultation closes today, so hurry if you want to respond to this awful idea (which Labour is also keen on). Clive Bates has put his excellent submission online here, but here's what I sent them...


5. Do you agree that the rates and structure outlined in Chapter 3 will achieve the stated objectives of the duty?

Yes and no.

The stated objectives are ‘to reduce the number of non-smokers and young people that vape’ and to shift vapers towards lower nicotine products. Further objectives include raising tax revenue and not making smoking more attractive. It is notable that the government’s stated objectives do not include reducing smoking rates among middle-aged and elderly adults who are at most risk from smoking-related harm, nor improving the health of the nation.

Substitution effects

It is well established that vaping is much less harmful to health than smoking and that e-cigarettes and cigarettes are direct substitutes (McNeill et al. 2022). It is also well established that switching to e-cigarettes is a highly effective way of quitting smoking (Hartmann-Boyce et al. 2022) and it is highly likely (though difficult to prove categorically) than the use of e-cigarettes by nonsmokers who would otherwise have started smoking has a prophylactic effect, i.e. it prevents smoking uptake. Ample evidence for this exists in the public health and economics literature and can be inferred in the UK from both routine statistics and general observation.

Any policy that deters consumption of e-cigarettes is therefore likely to result in more people smoking. This effect has been shown in several studies looking specifically at e-cigarette taxation (eg. Pesko et al. 2020; Saffer et al. 2019; Cotti et al. 2022). The extent to which this will occur if the UK introduces a vape tax is difficult to predict since illicit e-cigarettes make up a large share of the market and existing laws are poorly enforced.

The government acknowledges that e-cigarettes are direct substitutes for cigarettes and that there is a cross-price elasticity issue that means that a vape tax will make smoking relatively more appealing. This is correct and the government proposes yet another tobacco duty rise to offset this. The proposed rise is relatively small compared to the proposed vape tax. For example, the e-cigarette fluid I use will rise from £3 per bottle to £6.60 per bottle while a pack of cigarettes will rise from around £16 to £16.50. This still represents a substantial price difference, but the gap is relatively much smaller. Moreover, it is easy to buy a pack of cigarettes in the shadow economy for £5. Official retail prices are increasingly irrelevant as a comparator.

Nicotine levels


The government appears to believe that lower nicotine vapes are somehow more addictive or more harmful than higher nicotine vapes and that e-cigarettes will be consumed less if high-nicotine fluids are discouraged. This is the same mistake that was made when nicotine yields in cigarettes were lowered by law, although this did at least have the effect of simultaneously reducing tar yields. There is no such compensating benefit from lower-nicotine vape juice since lowering the nicotine will not reduce exposure to the other substances in e-cigarettes. In practice, vapers (and smokers) titrate nicotine to achieve the optimal level of nicotine consumption (which varies from person to person). Those who have a higher tolerance/demand for nicotine will vape more if they can only access low-nicotine fluid.

A vape tax may well switch consumers towards lower-nicotine vapes, but this is not an objective worth pursuing and could be counter-productive. Insofar as vaping causes harm to health (which remains unproven), it is not from the nicotine but from the other ingredients, flavourings, etc. in the fluid, which users will be more exposed to if they are priced out of buying higher-nicotine fluid. They will certainly end up spending more money.

It should be mentioned that high-nicotine fluid cannot legally be sold in the UK as a result of the EU’s Tobacco Products Directive which caps fluids at the relatively low level of 20mg/ml.

Tax revenue

A vape tax will obviously raise tax revenue. It will be a significantly regressive tax because vapers, like smokers, tend to be disproportionately on lower incomes. It will also be, in effect, a tax on quitting smoking and will be seen as a cynical and hypocritical cash grab by the general public.

6. Do you agree that the rates and structure will encourage manufacturers to reduce the nicotine content of their products?

No. As mentioned above, this is not a worthwhile objective. Manufacturers will follow demand. They already sell vapes and vape juice with a range of nicotine strengths. They do not need to do any reformulation. They will simply sell more of one type and less of another.

7. What do you think the likely impact the rate structure will have on consumers’ vaping behaviours?

Those who have a higher demand for nicotine will vape more, buy vapes from informal, untaxed sources or buy vapes from abroad by mail order.

8. Should production of vaping products by individuals for their own use be within scope of the duty?

No.

How exactly are you going to do that? It is completely impractical. The vape tax and the government’s other anti-vaping policies will very likely lead to more home production and more illicit sales, but the failure to enforce existing laws suggests that the state will be powerless to stop it. Billions of pounds of tobacco and e-cigarette sales take place in the shadow economy every year and this trend will doubtless continue. The government explicitly intends for all tobacco sales to be conducted on the black market eventually. It may hope to keep some sort of a grip on the e-cigarette market, but the vape tax and other anti-vaping policies currently proposed make it very likely that it will loose control of a growing share of vape sales too. Australia’s neo-prohibitionist approach to vaping has been an absolute fiasco. There are lessons to learn from that benighted country if politicians had the eyes to see.

9. Are there any other factors concerning home production/blending that should be considered?

Yes. It will encourage the sale of pure nicotine which will be mixed ineptly by enthusiastic amateurs and any harm that results from this will be your fault.

58. Do you believe the introduction of the new duty would lead to consumers switching to alternative nicotine containing products?

Yes. Cigarettes.

59. Unless already covered in your responses to other questions within this document, is there anything else you would like us to note about the impact of the duty?

There are legitimate concerns about underage vaping in the UK, rates of which have increased sharply in the last three years. Those concerns should not lead to a knee-jerk reaction that throws the baby out with the bathwater. There are no Pigouvian grounds for a tax on e-cigarettes and no non-trivial negative externalities to be addressed. A vape tax would amount to a tax on smoking cessation and would take hundreds of pounds from those who can least afford it. These are people who have already done what the government demanded and given up smoking. They are now to be punished for it in an attempt to prevent those who are already forbidden from buying vapes from doing so.

The public at large would like something to be done about underage vaping. So do I. But the laws already exist to make an sizeable impact on the problem. Illegal vapes are being sold illegally to children up and down the country. The laws are simply not being enforced. Further legislation and taxation will not address this problem.



References

Cotti, C., Courtemanche, C., MacLean, J. C., Nesson, E., Pesko, M. and Tefft, N. (2022) The effects of e-cigarette taxes on e-cigarette prices and tobacco product sales: Evidence from retail panel data. Journal of Health Economics 86: 102676.

Hartmann-Boyce, J., Lindon, N., Butler, A. et al. (2022) Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews Issue 11.

McNeill, A., Simonavičius, E., Brose, L., Taylor, E., East, K., Zuikova, E., Calder, R. and Robson, D. (2022) Nicotine vaping in England: an evidence update including health risks and perceptions. Office for Health Improvement and Disparities. 29 September.

Pesko, M. F., Courtemanche, C. J. and MacLean, J. C. (2020) The effects of traditional cigarette and e-cigarette tax rates on adult tobacco product use. Journal of Risk and Uncertainty 60: 229-58.

Saffer, H., Dench, D., Grossman, M. and Dave, D. (2020) E-cigarettes and adult smoking: Evidence from Minnesota. Journal of Risk and Uncertainty 60: 207-28.



Wednesday 22 May 2024

Does alcohol misuse cost England £27 billion a year?

The UK Temperance Alliance Institute of Alcohol Studies has had a go at updating a 2003 Cabinet Office estimate of the societal cost of alcohol in England. It's new figure is £27 billion. There are many problems with this, as I explain at Conservative Home...
 

It’s a mark of how much the currency has been debased that £20 billion in 2001 would, if it kept pace with inflation, be worth £36 billion today.

That £20bn was the “societal cost” of alcohol to England in 2001, according to an economic analysis from the Cabinet Office. That estimate has never been officially revisited.

However, the neo-temperance Institute of Alcohol Studies (IAS) put out an unofficial update on Monday to coincide with a Health and Social Care Select Committee on the subject. IAS’s estimate is £27.4bn – and this is being touted as a 40 per cent increase; the Guardian ran with “alcohol abuse costs soar to £27bn a year” on its front page.

But this ignores inflation. In real terms, the costs have fallen by around 25 per cent, and both the Cabinet Office estimate and the new estimate are gross overestimates.

When I calculated the cost of alcohol misuse to the government in 2015, I arrived at a figure of £3.9bn. Updating my estimates with fresh data last week, it became clear that the total is still below £5 billion and is less than half of the amount the government rakes in from alcohol duty every year.

Why are my figures so different to those of the IAS?
 



Tuesday 21 May 2024

Ultra-Processed People revisited



I picked up a copy of Ultra-Processed People in paperback to see what Chris van Tulleken has been up to and he seems to be gettng worse.
 
Van Tulleken does not only judge people by the motivations they are presumed to have. He also judges food by the supposed motives of the people who make it. In the Frequently Asked Questions section of the new chapter we find the following enquiry:
 

If you cook at home with xanthan gum, are you making UPF?

 
I am surprised that this question is frequently asked but I suppose Chris and I move in different circles. I am even more surprised by the answer:
 

No. UPF is industrially produced for profit. This is part of the definition. If you make food because you love someone and you want to nourish them, then you’re not ultra-processing.

 
Earlier in the book, van Tulleken describes xanthan gum as “revoltingly, a bacterial exudate: slime that bacteria produce to allow them to cling to surfaces” and suggests that consuming it may have “profound effects on immune system development”. How fortunate, then, that there is an ingredient that acts as an antidote to this “disgusting” emulsifier. The name of that ingredient? Love. 

This raises more questions than it answers. What if you ultra-process food for someone you love but make a profit? What if you ultra-process food for someone you hate but give it to them for free?

Read the rest at The Critic.



Friday 17 May 2024

A swift half with Lord Frost

The final episode of the second series of The Swift Half came out yesterday. It features Lord (David) Frost who, amongst other things, negotiated Brexit under Boris Johnson.



Thursday 16 May 2024

Gambling suicides - another junk statistic

 A new article from me at The Critic...

There is one gambling-related suicide in the UK every day. There are up to 496 gambling-related suicides a year. Ten per cent of all the suicides in England are caused by gambling. 

These statistics, and other iterations of them, have become mantras for the anti-gambling lobby since January 2023 when the Office for Health Improvement and Disparities (OHID) published a report claiming that there are “between 117 and 496 suicides associated with problem gambling” in England. Activists naturally focused on the larger of these two numbers and started putting it on billboards. The monetised value of years of life supposedly lost to suicide make up most of the “up to” £1.77 billion that gambling is said to cost “wider society” each year.

It turns out that these figures are based on nothing. They are a will o’ the wisp. A mirage. They exist only on a laptop in Whitehall. They are worthless.

 
This is an important story about OHID's statistical incompetence/corruption. Do read the rest.



Tuesday 14 May 2024

Could the Tobacco and Vapes Bill be any worse? MPs hope so.

No matter how bad things get in neo-puritan Britain, they can always get worse.
 
The Labour MP Rachael Maskell has put forward an amendment to the Tobacco and Vapes Bill to extend Sunak's prohibition to all nicotine products, including vapes and pouches. The only difference is that the ban on tobacco sales will be for those born after 2008 whereas the ban on nicotine will be for those born after 2014.
 

To move the following Clause—

“Sale of vaping products and nicotine products

(1) The Secretary of State may by regulations prevent the sale of to anyone born
after 1 January 2015—

(a) vaping products; or
(b) nicotine products.

(2) Regulations made under subsection (1) must specify an exemption for products prescribed by a clinician

(3) Regulations under this section:
(a) shall be made by statutory instrument; and
(b) may not be made unless a draft has been laid and approved by
resolution of both Houses of Parliament.

(4) Prior to making any regulations under subsection (1), and within 12 months of this Act coming into force, the Secretary of State must commission an independent evaluation of the health impacts of the matters under subsection (1) and must lay the report of the evaluation before Parliament.”

Member's explanatory statement:

This new clause would allow the Secretary of State, by regulations, to prevent the sale of vaping and nicotine products to anyone born after 1 January 2015 after having laid before Parliament an independent evaluation report on the health impact of doing so.


The final destination is the total prohibition of nicotine. In the long run, the aim is to make it a controlled substance and fully drag nicotine into the war on drugs. There is no ethical or health justification for this, but Sunak has given them more than an inch so they are taking more than a mile.

I don't know what chance this amendment has of passing, but it raises the question of what Labour will do when in power to prove that they are even more prohibitionist than the Conservative Party. The answer will certainly not be nothing.

Even Jacinda Ardern's legislation (now repealed) only included cigarettes. Cigars, hookah, snuff, heated tobacco, rolling papers, etc. were all exempt. Sunak has already gone much further than the New Zealand Labour Party. 

The full list of amendments is here (Maskell has put her name to 25 of them). They are mostly uber-prohibitionist, gathering up the loose ends of various ASH demands over the years, such as banning what's left of e-cig advertising, putting health warnings on cigarette papers, introducing a tobacco levy, etc. There is also an amendment (N14) signed by 11 MPs to ban vaping everywhere smoking is banned. Why? Because they can.

It's sickening.


Monday 13 May 2024

Obesity and worklessness

It's European Congress on Obesity week so expect non-stop, unpublished obesity research to be in the media regularly. The Times has put some of it on its front page today. The study seems OK but the interpretation is way off. I've written about it for The Spectator...
 

There has certainly been a rise in worklessness since the pandemic. The number of people of working age who are economically inactive has risen from 8.5 million to 9.4 million. This includes 2.8 million people who say they are too sick to work. Almost all of the increase in economic inactivity is explained by this rise in long-term sickness. 

Is obesity the ‘root cause’ of the problem? It seems unlikely. Despite obesity rates rising for several decades, there had been no increase in the number of people off work with long-term illness since the 1990s. Between 2000 and 2019, the number actually fell – from 2.3 million to 2 million, but since 2020 another 800,000 people have suddenly joined their ranks.



Friday 10 May 2024

Rampant misinformation at the Tobacco and Vapes Bill committee

 

The UK Vaping Industry Association has written to MPs to raise concerns about the  ‘misleading, incomplete, unsubstantiated, or incorrect’ information presented to the Tobacco and Vapes Bill Committee last week. The UKVIA should have been invited to give evidence to the committee (it has no links to the tobacco industry and therefore could not be disqualified on the usual McCarthyite grounds) but it wasn't. Instead, the floor was given to rabid anti-vapers, mendacious fanatics and hopeless ignoramuses. 

The UKVIA has compiled a little document with a handful of the worst lies told by committee members and their guests during the two day hearing. They include... 
 

Sheila Duffy, Chief Executive of Action on Smoking and Health (ASH): “There is a link between regular vaping and moving onto smoking..."  

Laura Young, PhD Researcher from the Centre for Water Law, Policy and Science at the University of Dundee: “The first thing to remember is that vaping is not good for you. It is slightly better than smoking...”

 
Steve Turner, President of the Royal College of Paediatrics and Child Health, was a repeat offender, claiming that vaping causes popcorn lung and that "nicotine addiction is smoking". 
 
Dr Rob Branston, one of Anna Gilmore's cronies at her Bloomberg-funded pressure group, left a massive hostage to fortune when he said “we can be reasonably confident that there will not be a big wave of illicit products in the future.” Cut that one out and keep it.

The UKVIA letter reads, in part:
 

“Because the evidence was mainly given by those who have spoken out against vaping in the past, it presented a very skewed message which often conflated the legal compliant vape industry with the black market and frequently made no distinction between the tobacco and vaping industries.

“We recognise there are illegal traders in our industry who will sell to children, and criminal gangs who import black market devices, which can contain illegal and dangerous substances. The legitimate and majority side of the sector want to rid the country of this scourge on society and see them prosecuted, punished and driven out of business. To equate the illegal and legal vaping sectors is as unfair as saying that illegal immigrant smugglers and the Dover to Calais ferry do the same thing. One is illegal and needs to be stopped, the other performs a helpful and beneficial service.

“We are also not trying to water down, delay or circumvent the legislation but we do want to ensure that when MPs scrutinise this Bill they are doing so from an informed perspective which comes from fact not fiction. In scrutinising this Bill, MPs must balance the rights and needs of adult smokers to have access to the very best products to help them quit, with those of young people to be protected from age-restricted products, including vaping.

“This by no means is an easy path to navigate and it will be made even more treacherous whenever evidence presented to the Committee is so misleading that it does more harm than good. Not only does the underhand management of the Bill Committee’s oral evidence session risk the Bill not facing proper scrutiny prior to its third reading, but the selection process across the board was fundamentally undemocratic, with the people this Bill will impact the most not being able to provide evidence on how it can be improved.

“It is another example of the growing list of decisions by the Department of Health and Social Care to exclude the UKVIA and wider industry from any meaningful collaboration with the Department."

 
It won't make any difference, obviously. The government has made up its mind and is not interested in facts.


Thursday 9 May 2024

Everything is displacement

I've written about the Tories 14 wasted years for The Critic... 

In 2018, Dr Lisa Cameron, an MP from the Scottish National Party, called for the consumption of dog meat to be banned in the United Kingdom. There was no evidence that anyone in Britain was eating dogs and she was surely correct when she said that “I do not believe the general public would approve of the practice at all”. The sale of dog meat has been banned for many years, but Dr Cameron was concerned about a loophole that allows people to eat their own dog if the animal has been humanely killed. Appalled at the prospect of this hypothetical problem, she urged the government to “take action to nip it in the bud”. The Conservative minister Sir Alan Duncan immediately rallied to the cause, saying: “There is no need in the modern world for this disgusting habit.” Like Dr Cameron, he said the government “should nip it in the bud”. 

Somewhat surprisingly, the campaign gathered steam. Jim Shannon MP said that “it is obscene, gross and immoral that someone could, technically speaking, cook a dog and eat it”. Following such newspaper headlines as “Horror of DOG EATING in the UK – Theresa May urged to act” (Daily Express), questions were asked in both Houses of Parliament and the House of Commons library prepared a 13 page briefing on the issue in advance of an hour long debate in the House of Commons. The debate was triggered by a Ten-minute Rule Bill from the Conservative MP Bill Wiggin who admitted that “there is no evidence that dogs are eaten in the UK” but that Britain should be “setting an example to the world”. By the summer of 2019, Michael Gove had reportedly drafted legislation to make the possession of dog meat a criminal offence. Alas, the clampdown on theoretical dog-eating fizzled out when civil servants decided that a ban would be “culturally insensitive”

In its small way, this episode sums up the last 14 years of government. The sheer inanity of it, the entanglement in trivia, the virtue signalling, the use of legislation to “send a message”, the inevitable involvement of Michael Gove and the whole thing falling apart for fear of seeming racist. It is a canned version of the whole era. Unserious politicians in serious times will do anything to avoid grasping the nettle. Everything is displacement.


Do read it all.



Tuesday 7 May 2024

Ultra-processed food - my comments to the House of Lords

The House of Lords Food, Diet and Obesity Committee started its pointless proceedings in February and is still slogging on. It has managed to avoid asking anybody who is sceptical of the ultra-processed food panic from appearing (last week it heard from three 'ambassadors' from the Food Foundation and three 'ambassadors' from Jamie Oliver's BiteBack front group). The committee did, however, ask for written submissions so this is what I sent them back in February after Dimbleby, Spector and Coco Pops guy kicked things off....


I was concerned to see that six out of the seven people who appeared at your first three oral evidence sessions were activists and/or authors who subscribe to a particular view of the food system and favour heavy regulation. Whilst I am sure you plan to invite some mainstream scientists, economists and consumers to future sessions, I felt it might be of use to respond to some of the questions in your call for written evidence below.

The definition of a) ultra-processed food (UPF) and b) foods high in fat, sugar and salt (HFSS) and their usefulness as terminologies for describing and assessing such products.

The official HFSS definition, which campaigners use as the implicit definition of ‘junk food’, creates many absurdities, partly because the limits laid out in the Nutrient Profiling Model (NPM) are so low. HFSS food includes raisins, sultanas, most tinned fruit, most yoghurts, two-thirds of morning goods, nearly all cheese, cream crackers, tomato soup, hummus, ham, pesto, cereal bars, olive bread and salami. Whether these foods are ‘high’ in fat, sugar and/or salt is a matter of opinion, but few people would view all of them as ‘junk food’ and want to ban them from being advertised. It is doubtful whether the general public considers even very high sugar foods like jam or very high fat foods like butter to be ‘junk food’.

Campaigners such as Jamie Oliver have exploited the confusion about what ‘junk food’ is (it has no scientific definition and is legally meaningless) to push for legislation against the much broader category of HFSS food. Having capitulated to these campaigners in 2020, the government has tacitly acknowledged that it bought a pig in a poke by exempting a number of HFSS foods from its list of ‘less healthy’ food in the Health and Care Act (2022). There is no scientific justification for exempting these foods - the NPM has the virtue of at least being consistent - but they are so far removed from the popular idea of junk food that the government would look ridiculous if it included them.

‘Ultra-processed food’ is an even broader category which demonises the vast majority of food that isn’t eaten raw or prepared by hand in a domestic kitchen. As a phrase, it was never uttered in the House of Lords until 2020 but there has been a flurry of mentions and several specific debates in the chamber since Chris van Tulleken published his book Ultra-Processed People in April 2023. Van Tulleken is responsible for introducing many people to the concept of UPFs. He makes many claims in his book and in his media appearances that are at best contentious and at worst demonstrably false. For example, based on a misreading of an academic study, he falsely claims in Ultra-Processed People that Chilean miners burn the same number of calories as sedentary office workers and that exercise therefore does not help people lose weight. He has falsely claimed on Twitter/X that the very idea that exercise assists weight loss was invented by the Coca-Cola company.

UPF is an even worse classification system than HFSS because whereas fat, salt and sugar are known to be harmful to health when consumed in large quantities, UPF portrays all but the most basic ingredients as harmful. UPF is characterised by the presence of emulsifiers, preservatives, artificial flavourings and additives, all of which are generally recognised as safe by scientists but which are portrayed as somehow dangerous (carcinogenic or obesity-causing) when used in industrial food processing. Anti-UPF activists have been unable to show that any of these ingredients - let alone all of them - are individually harmful. Their evidence comes from observational studies in which people who eat UPFs appear to have worse health outcomes than people who do not. Leaving aside the well known weaknesses of nutritional epidemiology, the use of such a broad category as UPF limits what can be learned from such research. It zooms out when we need to zoom in. As a category, UPF may include foods that have a causal relationship with certain diseases, but lumping them together with everything made in a factory does not help us tease out which ones or why. Critiquing a recent study which claimed that UPF consumption causes cancer and heart disease, Visioli et al. (2024) say:
 

‘the association between UPF consumption and the risk of multimorbidity would disappear if the data were adjusted not only for the consumption of sugary or artificially sweetened beverages, but also for foods of animal origin at the same time. Indeed, in our opinion, the article underlines the absolute need to return to the evaluation of foods on the basis of their nutritional role (including their nutrient composition, quantities consumed, metabolic effects, etc.) and not on the basis of their degree of processing.’

 
I agree.

One peculiarity about the UPF system is that some of the few ingredients that are not portrayed as inherently dangerous are fat, sugar and salt. So long as they are used to make cakes, biscuits, etc. in a domestic kitchen, they are de facto healthy. It is the industrial processing, not the nutrients, that somehow creates the risk. This not only turns the scientific consensus of recent decades on its head but is palpable nonsense and it is a sign of how quickly the West is retreating from Enlightenment values that anyone is taking it seriously.

Growing fanaticism from certain policy entrepreneurs would lead us to portray a large number of food products as inherently dangerous and urge us to abstain from them all. This is not only unscientific but useless in terms of practical public policy because people are never going to abstain from eating chocolate and bacon let alone sliced bread.

The cost and availability of a) UPF and b) HFSS foods and their impact on health outcomes.

Processed/HFSS/UPF food is typically more expensive than what the government defines as healthy food (fruit, vegetables, starchy carbohydrates, white meat, etc.). Campaigners often claim the opposite by comparing food prices using the cost-per-calorie method. This turns the virtue of being low in calories into a vice since the cost-per-calorie naturally rises as the number of calories in the product declines. A better method is to measure the cost per meal or the cost per kilogram. Under these measures, the cost of healthy eating is relatively low and is far lower than the cost of eating takeaways and fast food (Snowdon 2017).

The impact on heath of HFSS and UPF has been partially addressed in the previous answer, but it is worth mentioning the study by Kevin Hall et al. (2019) which will doubtless be cited a lot in the written and oral evidence to your inquiry. By the low standards of nutritional science, this was a well conducted randomised controlled trial. It found that the people who ate the UPF diets consumed significantly more calories than those on the non-UPF diet and that the former gained weight while the later lost weight. Unfortunately, due to cost pressures, the researchers were not able to offer UPF and non-UPF versions of the same meal. Instead, the UPF group was given a diet that differed more fundamentally than in the way it was processed. For example, one lunch consisted of burger and fries for the UPF group while the non-UPF group got salmon and green beans. The non-UPF food was not merely non-UPF, but was minimally processed which perhaps explains why those who ate it lost weight. As a control group, it would have been more useful (and more realistic) to give them processed (but not ultra-processed) food. The hypothesis that ultra-processing causes over-eating/obesity can only really be tested by giving people processed and ultra-processed versions of the same meal, but no RCT has yet done this to my knowledge.

Lessons learned from international policy and practice, and from the devolved administrations, on diet-related obesity prevention.

I am aware of no country that has reduced obesity rates through deliberate government action (although a few socialist countries have done so as an unintended consequence of its economic policies, e.g. Venezuela). An obvious approach would be to look at comparable countries that have significantly lower rates of obesity than the UK and emulate their policies. This is rarely suggested by ‘public health’ campaigners, presumably because countries with lower obesity rates do not have the kind of taxes and bans they support.

The impact of recent policy tools and legislative measures intended to prevent obesity.

The most significant measure in recent years has been the sugar tax which plainly had no impact on childhood obesity (rates of which rose for three successive years after it was introduced). The ban on HFSS food advertising on television during children’s programmes also failed to have any impact on rates of obesity. Food reformulation didn’t work because consumers couldn’t be forced to eat the reformulated products. It is highly doubtful that forthcoming bans on advertising and promotion will lead to a decline in obesity. Even the government’s own Impact Assessment, based on a starry-eyed interpretation of weak and biased research, only predicts a trivial effect on calorie consumption.

The persistent failure of anti-obesity policies to reduce obesity never leads to any apologies or resignations from the activists and academics who campaign for them. Rather than repealing unsuccessful policies, governments tend to double down with further restrictions, thereby creating a runaway train of regressive, anti-competitive policies that logically leads to some form of prohibition (as we are now seeing with tobacco). Policy entrepreneurs who seek to regulate the food supply are in the privileged position of never having to show that their policies work. This sets them apart from doctors and nurses who cannot, in the modern era, get away with conducting unnecessary and harmful operations or prescribing useless drugs.

No one expects a single policy to reduce obesity rates to zero, but it should not be too much to ask for them to reduce them by a little bit, even if only a fraction of one per cent. This, however, has so far been beyond the purported experts of Britain’s lavishly funded ‘public health’ institutions. To disguise their failings, they have invented something called the ‘whole systems approach’ to obesity which amounts to throwing as many untested and unproven policies at the problem as possible, regardless of cost and unintended consequences, in the hope that one or more of them might work. When each of them predictably fails to move the dial, they mutter something about there being ‘no silver bullet’ and move on to the next idea. This, I submit, is neither a wise nor evidence-based approach to policy-making.



Saturday 4 May 2024

A swift half with Erik Matson

A new episode of The Swift Half dropped this week. I spoke to Erik Matson, an American academic who is an expert on Adam Smith and David Hume, to discuss the lessons of those great thinkers in relation to the new paternalism (i.e. nudge theory). You can read his IEA book New Paternalism Meets Older Wisdom for free.



Friday 3 May 2024

Tobacco and Vapes Bill committee: day two

 

On Wednesday I gave you some representative quotes from the hand-picked 'experts' who were asked to speak to the Tobacco and Vapes Bill committee. With every MP on the committee in favour of tobacco prohibition, it turned into something of a circle jerk. On day two, there was an equally solid consensus, as the transcript shows...
 

Chris Whitty (chief medical officer for England): "I think I speak on behalf of all the chief medical officers when I say we enormously welcome the Bill, which I think the overwhelming majority of doctors, nurses and other healthcare workers fully support. It is an extraordinarily important public health measure."

Francis Atherton (chief medical officer for Wales): "To echo what Sir Chris has said, it is rare to achieve such a high degree of consensus across the medical community as there is around this Bill."

Gregor Ian Smith (chief medical officer for Scotland): "I would reiterate every word that Sir Frank has just said. The consensus across the medical profession, as far as I can see, is absolute."

Michael McBride (chief medical officer in Northern Ireland): "I would echo all that has been said. To add to Sir Gregor’s point about the weight of professional opinion, in Northern Ireland we also have the weight of a huge majority of the public. They are hugely supportive of the smoke-free generation and of measures on displays, point of sale and flavours of vapes."

Stephen Powis (national medical director of NHS England): "Seventy-eight years ago, Parliament passed the National Health Service Act 1946, which led to the formation of the NHS on 5 July 1948. In my view, the legislation that you are considering here today is one of the most important—possibly the most important—pieces of legislation since the passage of that Act."

Kate Brintworth (chief midwifery officer for NHS England): "... all the chief nursing and midwifery officers across the four countries are united in support of the Bill, as our medical colleagues are, because we see the damage wrought across families and generations. We are 100% behind it."

Kamila Hawthorne (a GP in south Wales): "I see a smoke-free generation as the logical next step, and I really think we have to take it."

Steve Turner (president of the College of Paediatrics and Child Health): "...we believe this Bill is splendid. We would be happy for the version that we have seen to be approved unamended."

Sanjay Agrawal (Royal College of Physicians): "The RCP supports the Bill. It is really well balanced. As a clinician in the medical profession, I, along with the RCP, which represents at least 30 different medical specialties, support the Bill. We know it will prevent ill health for future generations and reduce poverty and disparity."

Tim Mitchell (president of the Royal College of Surgeons): "We as a college fully support the Bill and, as my colleague said, we very much hope that it will pass through smoothly and get on to the statute book."

Mark Rowland (chief executive of the Mental Health Foundation): "... this Government should be applauded for introducing this progressive, bold and far-sighted piece of legislation."

Dr Laura Squire (Medicines and Healthcare products Regulatory Agency): "... anything that introduces more controls over consumer vapes has to be a good thing."

Ann McNeill (King’s College London): "I welcome the Bill... It is really important, moving forward, that the Bill is in the context of a comprehensive tobacco control strategy".

Robert West (Diet Sage communist): "...there is widespread support for what some in years gone past might have seen as quite a draconian Bill that phases out smoking. That is testimony to how far we have come with the policies we have adopted, with credit to successive Governments".


The Bloomberg-funded quackademic Anna Gilmore also appeared alongside two of her colleagues. None of them explicitly paid homage to the generational ban because they were too busy talking about how ghastly capitalism is and attacking vaping. Mary Kelly Foy, vice-chair of ASH's APPG, went off topic by asking them if they support a levy on the tobacco industry (a favourite ASH policy) which of course they did.

The overall standard of discussion was beyond woeful. Both Hawthorne and Turner falsely told the committee that vaping can cause popcorn lung. At one point, Andrea Leadsom started spouting some nonsense about nicotine-addicted babies. Anna Gilmore claimed that nicotine "rewires the brain". Ann McNeill pushed back a little on some of this, but it mostly went unchallenged because the committee had gone out of its way to avoid hearing from anyone who wasn't a full-on prohibitionist/nutter.

Only David Lawson (director of Inter Scientific Ltd.) came out of it with any credit. Although he did not oppose the generational ban, he did point out that the problems the committee had with vaping could be dealt with by enforcing the many laws that already exist. Naturally, he was the only witness to get the 'who funds you?' treatment.

 

Don't stop clapping

 



Wednesday 1 May 2024

Tobacco and Vapes Bill committee: day one

The farcical committee on the Tobacco and Vapes Bill has concluded its pointless proceedings, with its cherry-picked MPs and guests. The transcript of the first day's hearing has been published. I couldn't read it all because it made me bilious - the MPs seemed mainly interested in banning e-cigarettes next - but it was very much as expected. Here's a flavour of it... 

Deborah Arnott (ASH): "I have been around for a lot of tobacco legislation, and it is really impressive to see where successive Governments have brought us."

Sheila Duffy (ASH Scotland): "We very much welcome this proposed legislation"

Charmaine Griffiths (chief executive of the British Heart Foundation): "We, as the BHF, would urge for the Bill to be pushed through in full."

Sarah Sleet (chief executive officer of Asthma and Lung UK): "Asthma and Lung UK very much support this bill".

Patrick Roach (general secretary of the NASUWT): "We believe that this is a strong Bill"

Paul Farmer (chief executive of Age UK): "Age UK fully supports the proposed legislation".

Greg Fell (moron): "...all DPH strongly support the Bill—I have yet to find a public health professional who does not, as I do not think that one exists" 

David Fothergill (Local Government Association): "On the whole, we are supportive of the Bill, and that will be the thrust of the evidence I give... we fully support the Bill".

Ailsa Rutter (FRESH): "I am absolutely privileged to be here with you this afternoon, speaking on behalf of the north-east and the many partners in the region who will give you their overwhelming support for this absolutely crucial, complete once-in-a-lifetime opportunity to have the single biggest impact in addressing the biggest cause of cancer."

Adrian Simpson (British Retail Consortium): "Yes, the large retail sector, which we represent, is broadly in favour of the Bill... but we feel that, for all this to be successful, there needs to be strong and robust enforcement behind it all."

John Herriman (Trading Standards Institute): "One of the things that I think is really good about the Bill, and the work that DHSC and other Departments have been doing, is the taking of a strategic view.... We have not seen this level of strategic approach to resourcing and tackling a problem in many other areas, so it is quite welcome."

Laura Young (random PhD student): "I very much welcome this Bill and support a lot of what has been said, but I also think there is room for taking more action".

 
It's a bit of an amen corner, isn't? Still, I'm sure it doesn't matter. After all, it's only prohibition that's being proposed - a policy that has always worked in the past and has never had any negative side effects - so there's no need for any scrutiny or serious thought. It'll be fine!

 



Last Orders with Mark Birbeck

Check out the new episode of Last Orders with Mark Birbeck, co-founder of the Our Fight campaign, as we discuss why we shouldn't be banning smoking or pro-Palestine marches. If you still haven't subscribed, you can listen here, but this is episode 83 so you really should have subscribed by now.