47 lions

MPs voted for the Tobacco and Vapes Bill yesterday by a landslide. The Bill legislates for the gradual prohibition of all tobacco products, a total ban on e-cigarette advertising and allows Wes Streeting to do whatever he likes with vape flavours, smoking bans, vaping bans, vape packaging, etc.

Labour MPs were given questions to ask and told what to think by the leadership. Not a single one voted against prohibition. Conservative and Liberal Democrat MPs were given a free vote. 35 Tories, 7 Lib Dems and 4 Reform MPs voted against. Rishi Sunak, whose 'legacy' this was supposed to be, didn't bother to turn up to vote.

The conscience of these 47 MPs is clear. They could have gone with the crowd - they had no chance of winning - but they stood up for personal liberty. There are 72 Lib Dems so seven voting against isn't much, but it shows that liberalism hasn't been completely snuffed out in the party. 

It's been fifteen years since I published Velvet Glove, Iron Fist, the last chapters of which warned about the looming threat of prohibition and the slippery slope of regulation from tobacco to food and alcohol. I shouldn't be surprised that prohibition has returned and that the government is now planning taxes on 'junk food', but I never thought that Britain would be first out of the blocks with Prohibition 2.0. As one of the more prominent defenders of smokers' rights in the UK, this is obviously sub-optimal.

The more I think about it, the less it matters. The generational ban won't affect anybody until 2027 and won't really be noticeable until around 2030. Vaping is making cigarettes obsolete, especially among young people, but even if an 18 year old wanted to smoke, why would they buy cigarettes legally? 

I was on a night out in a city in the north-west recently when the trusty vape that I've had for two years finally packed up. I went to a shop to get a disposable vape and a pack of cigarettes in case I didn't like the disposable vape (I'm not into sweet flavours). I picked out a disposable vape, picked out a lighter and asked the guy behind the counter if he sold cigarettes. He pulled up a big plastic bag and showed me what he had - all loose packs with health warnings in a variety of different languages, obviously not legal. I chose a pack of Marlboro Touch, whatever that is, and he sold me the lot - disposable vape, lighter and a pack of premium cigarettes - for £14. The cigarettes alone are worth more than that on the legal market. The guy had never seen me before. I could have been anybody. The shop was in the middle of the city centre.

This is happening up and down the country. Tax morale among smokers is at rock bottom and the legal market is collapsing. The government has its head in the sand and no one is going to do anything about it. We know from Australia how bad this could get (it had firebombing number 150 at the weekend). Banning disposable vapes next June isn't exactly going to help. 

The point is that by the time this idiotic law starts to bite, there will be so little of the legal market left that the age at which people can legally buy tobacco will be largely academic. The de facto age at which people will be able to buy tobacco will be zero.

They can't say they haven't been warned. This is on the 415 lemmings who voted for the Tobacco and Vapes Bill. The 47 rebels can sleep soundly.

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Calorie labelling didn't work

Of all the anti-obesity policies that have been tabled in recent years, calorie labelling is the least objectionable. It is not regressive like the sugar tax or anti-competitive like the advertising ban. If it’s nannying, it is of the gentlest sort; a nudge rather than a shove. It would have been a nightmare for small businesses to implement, but they were given an exemption when the government made calorie counts mandatory in cafés, pubs and restaurants two years ago.

You could argue that the number of calories in a meal is basic information that consumers have a right to know, even if it doesn’t make any difference to what they eat. That is just as well because we now know that it doesn’t change what people eat. An evaluation funded by the National Institute for Health and Care Research was published this week and concluded that “the introduction of the mandatory kcal labelling policy in England was not associated with a significant decrease in self-reported kcals purchased”. Monitoring the behaviour of 6,578 customers in pubs, fast food outlets, cafés and restaurants before and after the introduction of mandatory calorie counts, the authors found that the number of calories consumed actually rose from 909 per meal to 983 per meal.

Read the rest at the Telegraph.

It's been another bad week for 'evidence-based' public health policies. I've written about three of them on my Substack.

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The 'intimidation' of 'public health' cranks

Anna Gilmore has been dipping into the millions of pounds she gets from Mike Bloomberg to complain about people being mean to her. Her latest 'study', titled 'Intimidation against advocates and researchers in the tobacco, alcohol and ultra-processed food spaces: a review', is the usual Google-based fluff and is a bit rich from someone who set up a fake wiki to smear her opponents and who starts her article by describing the infant formula industry as a 'vector of disease'.

What kind of intimidation do these delicate poppets have to put up with?

The most reported form of intimidation was public discreditation with advocates and researchers often portrayed as extremists, under-qualified, or a waste of taxpayer money.

Well, if the cap fits...

Gilmore and her chums then give an enjoyably long list of examples...

Researchers were publicly labelled as ‘extremists’ (Landman et al., 2002; Malone, 2002; Knight and Chapman, 2004; Yang and Malone, 2008; Avery et al., 2016; Johnson, 2020), ‘fascists’ (Smith and Malone, 2007), ‘nazis’ (Schneider and Glantz, 2008), ‘zealots’ (Daube, 2015), ‘demons of overzealous and moral righteousness’ (Knight and Chapman, 2004) and ‘prohibitionists’ (Landman and Glantz, 2009; Daube, 2015). Similarly, those producing research unfavourable to the alcohol industry were labelled ‘nannyists’ (Avery et al., 2016), those doing the same in the UPF sector were called ‘too radical’ (Mialon, 2021), ‘food fascists’ (CCF, 2010), ‘gastronomical gestapo’ (Thomson, 2009) and ‘food police’ (Heisel, 2011), while breastfeeding advocates were described as the ‘breastapo’ (Hager, 2014) and were portrayed as ‘limiting mothers’ freedom of choice’ (Baker et al., 2021). Negative religious connotations were also used across the different industry sectors, with academics referred to as the ‘anti-food jihad’ (CCF, 2004), ‘health jihadists’ (Hager, 2014) and ‘religious fundamentalists’ (Petticrew et al., 2015; RESYST, 2019).

In addition, across all sectors, researchers were criticized as lacking the relevant skills (Drope and Chapman, 2001; Landman and Glantz, 2009; RESYST, 2019), being ‘bogus’ (Landman and Glantz, 2009), ‘untrustworthy’ (Vedwan, 2007), ‘mad’ (Hager, 2014), having conflicts of interest (Ibrahim et al., 2004), being money hungry (White and Bero, 2004; Landman and Glantz, 2009; Hoe et al., 2021), ‘publicly funded troughers’ (Hager, 2014) or simply for being ‘peculiar’ (Bornhäuser et al., 2006) or for not having the right physique to criticize the food industry (Pollan, 2006).

 

Pejorative adjectives were the most common form of 'intimidation'. The second most common form of 'intimidation' was legal action. And then there is the horror of people complaining about them. For example...

 

A further six sources (9.4%) included examples where advocates and researchers working on issues affecting UPF, and in one case tobacco, received a complaint. These complaints took several forms, including a detailed critique of research and a request for the original data for ‘proper’ analyses to be conducted.

Oh no, not a detailed critique! Anything but that!

 

Some of the 'intimidation' amounts to nothing more than polite disagreement...

 

UNICEF’s Director General received complaints from a US-based lobby group working for the baby formula industry. The complaints argued that UNICEF’s Philippines country office promoting breastfeeding ‘misrepresents the available scientific evidence regarding the alleged risks of not-breastfeeding’.

 

It is probably true that 'public health' academics get more abuse online and are called names more often in the media than most other academics, but most other academics are not political activists using taxpayers' money to restrict the freedom of the individual. If you're going to get involved in politics, you have to expect some rough and tumble. What these people want is power without accountability. They explicitly seek to stigmatise ('denormalise') millions of people, make them poorer through sin taxes and ban the things they enjoy doing. They want to be seen as serious academics but normal people see them, quite rightly, as authoritarian killjoys who are making an unprovoked assault on their lifestyle (including the right of mothers who cannot breastfeed to keep their baby alive). If a few of their powerless victims are calling them 'mad' and 'peculiar' on social media, they have got off very lightly.

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The scary logic of the generational tobacco ban

As the second reading of the Tobacco and Vapes Bill approaches today, MPs on both sides of the house will be looking for something to say in their speeches after the obligatory throat-clearing of “I believe in freedom but…”. When it comes to anti-smoking legislation, the welfare of children is the usual excuse, but since the Bill’s flagship policy is a ban on adults buying tobacco products, an appeal to vulnerable minors will not cut it this time. The costs of smoking-related diseases to the NHS have often been cited in the past, but it is easy to demonstrate that the £3.1 billion smoking supposedly costs the NHS is much less than the £11 billion the government raises in tobacco taxes.

What, then, can be used to put a liberal mask on prohibition? The Department of Health and Social Care has prompted MPs with a “factsheet” which claims that smoking “costs the economy and wider society £21.8 billion a year”. Most of this — a whopping £18.3 billion — is due to “lost productivity”. This claim is derived from Action on Smoking and Health (ASH), a pressure group funded by the government, who commissioned Howard Reed of Landman Economics to do some modelling. I have a slight affection for Reed because he co-authored a report with Jonathan Portes that made some predictions about child poverty that were so wrong that I made £1,000 betting against them. 

Reed has been playing Numberwang for ASH for years and every estimate of the “cost of smoking” is higher than the last. In 2019, it was £17 billion. Now, despite smoking rates continuing to fall, it is £21.8 billion. Lost productivity due to unemployment, lower wages and early death are always the biggest component.

ASH have tapped into a rich seam of political concern about economic growth by focusing on these “costs”, but are they really costs? If they are really costs, who pays them? And can nonsmokers expect to benefit financially if smoking somehow disappears? 

Read the rest at The Critic.

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A bad time for a bad obesity prediction

All you have to do to produce an obesity forecast that will be published in a medical journal is draw a straight line through the recent past and push it forward a few decades. That is literally all there is to it and it is why such forecasts are very likely to be wrong. 

Sure enough, they are always wrong. According to past predictions, the UK's adult obesity rate should have been 33% in 2012 (it was 25%) and it should be 40% by 2030 (seems unlikely; the figure for 2022 was 29%).

Predictions for the US are even more dramatic. To be fair, obesity is significantly higher there (41%). But the prediction that "by 2048, all American adults would become overweight or obese, while black women will reach that state by 2034" remains as implausible as it did in 2008.

Nevertheless, the media lap these forecasts up and the studies that contain them invariably urge policy-makers to regulate people's diets to avoid these awful outcomes. It's never too late!

The latest effort was published in the Lancet this month. Minor aristocrat and major killjoy Jim Bethell was all over it.

This is very powerful.
Most striking, USA obesity rates are accelerating!
Our current efforts are a total failure.
I’d guess UK data similar. Anyone know for sure?
For sure, to bend the curve we need a new approach. https://t.co/sy5yEwqZ1l

— Lord Bethell (@JimBethell) November 20, 2024

The study reckons that...

 

The projected prevalence of overweight and obesity in 2050 is estimated to be 81·1% (77·9–84·5) in adult males and 82·1% (76·7–85·7) in adult females. The prevalence of obesity is projected to increase at a more rapid rate than overweight, and faster among males than females. In males, the percentage change in the prevalence of obesity from 2021 to 2050 is estimated to be 32·8% (15·7–48·0), with a prevalence of 55·3% (47·7–61·8) in 2050. For females, the percentage change in the prevalence of obesity from 2021 to 2050 is estimated to be 28·6% (13·5–39·3), with a prevalence of 58·8% (51·1–64·1) in 2050.

 

In West Virginia and Kentucky, the authors reckon at least two-thirds of the adult population will be obese by 2050! 

 

 

All this is based on the assumption that "current trends" will continue. But if you've been reading the news recently you may know that current trends have already stopped continuing. As James Burn-Murdoch reported in the FT last month...

Around the world, obesity rates have been stubbornly climbing for decades, if anything accelerating in recent years. But now newly released data finds that the US adult obesity rate fell by around two percentage points between 2020 and 2023.

 
What makes this all the more remarkable is the contrast in mechanisms behind the respective declines in smoking and obesity. The former was eventually achieved through decades of campaigning, public health warnings, tax incentives and bans. With obesity, a single pharmaceutical innovation has done what those same methods have repeatedly failed to do.

  

I guess this news came out too late for the Lancet to halt publication. Awkward.

 

 

Burn-Murdoch is confident that weight-loss drugs explain the decline in the USA. I think we need to wait another year or two to be sure. Someone on Twitter mentioned the possibility that the decline is because Covid killed off a disproportionate number of obese Americans. It's an interesting thought. After all, it should have. And yet we saw no reduction in obesity in the UK (the 2022 figure is an all time high) and I don't think any other country has seen a fall in obesity rates. Burn-Murdoch also says that the fall in obesity was largest among the better educated, which fits the drug theory but not the Covid theory.

Let's wait and see.

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Not Invented Here (2): alcohol

Doctors have been advising people to have several days without alcohol each week for decades. It is sound advice because, as the British Liver Trust says, ‘it is simple and easy to understand, reduces the overall number of units that you drink each week, helps prevent alcohol dependency and importantly for liver health gives your liver a rest and a chance to rejuvenate.’ In 2011, Ian Gilmore, the chairman of the Alcohol Health Alliance, advised drinkers to have ‘two to three alcohol-free days a week’. In 2012, the House of Commons Science and Technology Committee said that ‘people should be advised to take at least two drink-free days a week’. In 2016, the Chief Medical Officer said that ‘a good way’ for people to reduce their alcohol consumption was to have ‘several drink-free days each week’. None of this was remotely controversial until the alcohol education charity DrinkAware partnered with Public Health England (PHE) in 2018 to launch the ‘Drink Free Days’ campaign. Aimed at drinkers aged between 40 and 64, it advertised on radio and digital platforms and provided an app to help people monitor their alcohol consumption.

You might think that public health groups would be delighted to see a well known charity put its time and money into encouraging drinkers to consume less alcohol. But you would be wrong. DrinkAware is funded by donations from alcohol producers and retailers, and this was enough to make the aforementioned Ian Gilmore resign as co-chair of PHE’s alcohol leadership board and write an article titled ‘Public Health England’s capture by the alcohol industry’. An open letter opposing any collaboration between PHE and Drinkaware was signed by 332 academics, some of whom threatened to stop working with PHE if it did not part ways with the charity.

 

Read the rest at the IEA Substack.

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Not Invented Here (1): obesity

This month I'll be writing a series of articles about Not Invented Here Syndrome - when institutions reject practical solutions because they weren't part of their plan. The first is about obesity and weight loss drugs.

 

The Department of Health and Social Care says that obesity costs the NHS ‘up to £6.5 billion a year’. The health secretary Wes Streeting has claimed that it costs the NHS £11 billion a year. When wider societal costs, including lost productivity, are included, Frontier Economics estimated that obesity cost Britain £58 billion in 2020, and when they made a further estimate to include the cost of people being overweight in 2023, this rose to £98 billion, of which £19.2 billion were direct costs to the NHS.

Obesity is routinely referred to as a ‘crisis’ in the UK and elsewhere. Fifteen million adults (28 per cent) have a body mass index of 30 or more and are therefore classified as obese. The number of obese Britons has been gradually growing for decades and none of the anti-obesity policies enacted so far, such as the sugar tax and traffic light labelling on food, has made any tangible difference. Some countries have gone further. Hungary, for example, has an extensive system of taxes on food that is high in fat, salt or sugar (HFSS). Chile has had mandatory health warnings on HFSS food since 2016 and has banned the use of cartoon mascots such as Tony the Tiger. Both countries have seen obesity rates continue to rise.

Given how seriously public health campaigners take obesity as a health problem, you might think that they would be delighted to find something that makes people lose a great deal of weight in a short space of time. But you would be wrong. A new generation of pharmaceuticals that have been shown in randomised controlled trials to help people lose an average of 15 per cent to 20 per cent of their body weight have been given a cautious welcome at best by those who should be most excited by them.

 

Read the rest.

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Has vaping backfired? (No)

Has vaping backfired? That is the question asked by Sunday Times journalist Tom Calver yesterday. He claims that rising e-cigarette use has left Britain with more nicotine users than it did when the smoking ban was introduced in 2007 and that nearly 40 per cent of 16-24 year olds are “hooked” on nicotine. This, he says, “might just about be tolerable if cigarette smoking rates were quickly falling. But they are not.” He even claims that there are “some signs that the number of young cigarette smokers is ticking back up again”.

Read the rest at The Critic.

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