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.

Monday 29 April 2024

The Tobacco and Vapes Bill echo chamber

When I mentioned the ludicrously one-sided Tobacco and Vapes Bill committee last week, I speculated about who would be called to give 'evidence'...
 

We shall see who gives oral evidence next week. I would guess it'll be Debs from ASH plus someone from the Department of Health, a local public health director and one of the other sockpuppet NGOs like FRESH.

 
The list has now been published. Sure enough, Debs will be first up to speak tomorrow morning alongside Sheila Duffy (ASH Scotland) and someone from Cancer Research UK (which funds ASH). Ailsa Rutter (CEO of FRESH) will appear in the afternoon alongside local public health director half-wit Greg Fell and a host of prohibitionist academics including Robert West, Linda Bauld and Ann McNeill.

On Wednesday, the MPs will be treated to the thoughts of England's chief medical officer Chris Whitty plus the chief medical officers from Wales, Scotland and Northern Ireland. A couple of NHS mandarins are also on the bill. Anna Gilmore will make her inevitable appearance in the afternoon.

It doesn't stop there. They've also got someone from the godawful Local Government Association and various representatives from big charities, including Age UK for some reason (perhaps they will be talking about what happens when only pensioners are allowed to buy tobacco). The general secretary of the teachers' union NASWUT will also be making an appearance. 

The only person who vaguely represents the private sector is Adrian Simpson of the British Retail Consortium. He is also among the small handful of speakers who are not funded by the state. There will be no one representing smokers and no one making the case for personal freedom, although they have found space for an obscure PhD student, Laura Young, who wants to ban disposable vapes.

 
You just have to laugh, really. The Chinese Communist Party makes more of an effort to appear pluralist than this government. The only consolation is that the prohibitionist MPs will be stuck in this echo chamber listening to the same clichés for two solid days. I hope it feels like a lifetime.

 

Friday 26 April 2024

Tobacco and Vapes Bill - another stitch up

Desperate to rush the Tobacco and Vapes Bill through Parliament before anyone can think about it too carefully, the government is taking it to the committee stage next week. There is no chance of anyone asking awkward questions because none of the 17 MPs on the committee voted against it. 

As Guido reports...
 

16 of the 17 committee members voted for the bill and the one who didn’t, Labour MP Mary Kelly Foy, is vice-chairman of the APPG on Smoking and Health which has been pushing the ban constantly. Almost a quarter of the committee members are from the APPG, which is run by the anti-smoking lobby group ASH. Sorry news for MPs who hoped amendments might be considered fairly…

Simon Clark, director of smokers’ rights group Forest tells Guido: “Committees don’t need to be balanced but this is such an obvious stitch-up it’s embarrassing. The make-up of the Tobacco and Vapes Bill Committee is effectively a f*ck you to every MP who voted against the Bill, and every member of the public who opposes the generational smoking ban.” It wouldn’t be the first time the government has deployed smoke and mirrors for this bill…

 
Four of the 17 MPs are on ASH's APPG (which was originally called the All-Party Group on Action on Smoking and Health), including its chairman Bob Blackman. I can only assume that Mary Kelly Foy didn't vote for the Bill because she wasn't in London at the time.

This is obviously a stitch up. Everyone knows the Bill is going to be rammed through on a tide of virtue-signalling from political pygmies, but they don't need to make it this obvious. Is the government so fearful of opposition that it won't allow a single dissenting or sceptical voice?

We shall see who gives oral evidence next week. I would guess it'll be Debs from ASH plus someone from the Department of Health, a local public health director and one of the other sockpuppet NGOs like FRESH. 

The House of Lords Food, Diet and Obesity Committee recently held its 'evidence sessions' and kicked off with Chris van Tulleken, Henry Dimbleby and Tim Spector, all of whom will be familiar with anyone who is up to speed with modern diet entrepreneurs. Also in the first sessions were Katharine Jenner (Food Foundation/Action on Sugar), Anna Taylor (Obesity Health Alliance), Fran Bernhard (Sustain), Rob Percival (Soil Association) and a host of lesser known academics whose bias is obvious from their tweets, such as...

Nikita Sinclair (Imperial College)

 
Wendy Wills (University of Hertfordshire)
 
Amelia A Lake, (Teesside University)

 
The difference is that the House of Lords committee is essentially a vanity project in the second chamber whereas the Tobacco and Vapes Bill committee is responsible for crafting good legislation. What a joke.

Thursday 25 April 2024

More useless alcohol modelling

The 'public health' lobby has been spinning plates this week, trying to exploit the UK's rise in alcohol-specific deaths while claiming that minimum pricing is saving lives. Meanwhile, Colin Angus has admitted that a model he produced in 2022 completely failed to predict what was about to happen.

I've written about all this for The Critic...
 

The increase in deaths in 2022 is more of a puzzle. Although there were no Covid restrictions, higher rates of consumption among some drinkers continued. There is some evidence that the figure for 2023 will be lower, but there is no sign of it coming down to pre-Covid levels. The number of people drinking a dangerous amount of alcohol (not just exceeding the Chief Medical Officer’s ridiculous guidelines, but actually drinking more than is good for them) is still higher than in 2019.

The neo-temperance lobby has reacted in predictable fashion. Richard Piper, CEO of Alcohol Change UK, called for “proper regulation of alcohol marketing, clearer alcohol labelling, and a minimum price for a unit of alcohol”. In Scotland, where the alcohol-specific death rate is 56 per cent higher than in England, the state-funded pressure group Scottish Health Action on Alcohol Problems demanded “a package of measures which tackle pricing, marketing and availability of alcohol on a population-wide scale”. 

When all you have is a hammer, everything looks like a nail. You can’t blame campaigners for not letting a crisis go to waste, but there are some glaring problems with both the diagnosis and the prescription here.

Firstly, Scotland already has a minimum price for alcohol...
 
An interesting sidenote is that Angus's model assumed that alcohol consumption rose during the pandemic. In fact, it fell. So why did he think it had risen? Because the number of problem drinkers had risen. It's circular logic based on blind faith in the single distribution theory. He and his team then modelled every conceivable scenario, including everybody returning to their pre-pandemic levels of drinking, nobody returning to their pre-pandemic levels of drinking, everybody drinking more than they did in 2020 and everybody drinking less than they did in 2019. Every model has been shown to be completely, hopelessly wrong. The proverbial dart-throwing chimp could have done a better job.
 

This garbage was funded by the supposedly cash-strapped NHS. As I say in the article, what was the point? Even if its predictions had been accurate, it wouldn't have helped in any way.

Do read it all.

 

Thursday 18 April 2024

Libertarian prohibitionists - you've heard it all now

I wasn't going to write about the tobacco ban again for a while, but the ludicrous spectacle of prohibitionists purporting to be champions of liberty has set me off. 

Their logic is that smoking is so addictive that it restricts freedom. They claim that smokers do not actually want to smoke, but were foolish enough to get hooked in childhood and are now unable to quit. And so, despite the evidence of your eyes and ears, it is the people who keep banning things who are standing up for freedom while libertarians support enslavement. 

This was the message of a slightly Orwellian editorial in The Times yesterday which explicitly described smoking as “enslavement” and described the right to smoke as “a fake freedom”. It was the message of Deborah Arnott, the CEO of the Department of Health’s sockpuppet pressure group Action on Smoking and Health (ASH), who said: “Smoking is not a free choice. It is an addiction.” And it was the message of public health minister Andrea Leadsom who told the House of Commons that “this is not about freedom to choose; it is about freedom from addiction.” The words ‘addiction’ and ‘addicted’ were mentioned 83 times in that parliamentary debate.

I have already conceded that giving up nicotine is more difficult than giving up cupcakes (although Chris van Tulleken may disagree). But the rhetoric around addiction this week has reached a different level. We have been told that smoking is not  only a difficult habit for some people to break, but is almost impossible, so much so that smokers “face a lifetime of addiction”, as Bob Blackman MP put it, and that while smokers might say that they want to purchase tobacco, they actually do not.

It is difficult to reconcile this with figures from the Office for National Statistics which show that 69 per cent of all the people in England who have ever smoked are now non-smokers. Andrea Leadsom is one of them. Despite claiming in her speech that people who take up smoking can look forward to “a life of addiction to nicotine”, she also mentioned that she gave up a 40-a-day habit when she was 21. Deborah Arnott is also an ex-smoker. She only gave up after she got the job at ASH. I suppose it wouldn’t have been a good look.

 
Read the rest at The Critic.
 
Regarding that Orwellian Times editorial. Let's remember what they say about banning tobacco sales completely for when they inevitably support total prohibition in a few years' time. 
 
 
And let's give a shout out to Peter Hitchens who doesn't think nicotine (or anything else) is addictive, but wants to ban smoking anyway because he doesn't like it and he thinks he knows best. At least he's honest about it.
 

 

A swift half with Adrian Chiles

You won't want to miss the new episode of The Swift Half in which I talk to broadcaster and Guardian super-columnist Adrian Chiles about drinking.

Tuesday 16 April 2024

The hazards of unopened cigarette packs

Proving that there is no end to 'public health' hysteria, some quackademics in South Korea are warning that unopened cigarette packs put nicotine into the atmosphere and need to be regulated. I wish I was making this up. See my Substack for more. 
 

Our findings indicate that packaged, unopened, and uncombusted cigarettes in cigarette racks at tobacco retailers emits airborne nicotine, which is a previously unrecognized source of nicotine exposure. This result has implications for policy considerations, such as the potential installation of ventilation systems on cigarette racks or the exploration of alternative packaging methods.

 
Also, check out the new episode of Last Orders.

Sunak's legacy

Rishi Sunak wants tobacco prohibition it to be his legacy. As I say in Spiked, I hope that's what it becomes.
 

Today, MPs will vote on the Tobacco and Vapes Bill. The result is a foregone conclusion since Labour has promised to support it and their members will comfortably outnumber the handful of Conservative MPs who didn’t get into politics to ban things. The flagship policy in the bill is a ban on anyone born after 2008 from ever legally buying a tobacco product. This will gradually extend the war on drugs to include tobacco, but nearly everybody in Westminster seems to be relaxed about that. In an insult to the public’s intelligence that diminishes us all, the latest health secretary, Victoria Atkins, has claimed that Winston Churchill would approve of his party banning cigars (Churchill’s grandson disagrees).

After spending 14 years achieving so little, this Tory government is using its last few months in office rushing through a policy borrowed from the New Zealand Labour Party, one which the British Labour Party would otherwise push through parliament when it wins the next election. It all seems perverse. The ban will not have any effect until 2027 so there is no need for haste, but it is in keeping with the Tories’ longstanding approach of owning the lefties by introducing Labour policies before Labour gets the chance to do so itself.

 

 


Monday 15 April 2024

Tim Stockwell's relationship with evidence

Tim Stockwell, who has been running a one man crusade against the benefits of moderate drinking for 20 years, has been on a bit of a media tour recently. He got a feature in the New York Times two weeks ago and is currently in Scotland where he is gearing up for a talk at the Royal College of Physicians on Wednesday. The talk has been organised by the state-funded Scottish Health Action on Alcohol Problems (SHAAP) and the anti-alcohol Institute of Alcohol Studies. As the Herald reports...
 

Prof Stockwell's talk in Edinburgh on Wednesday is also expected to coincide with MSPs voting on a motion to increase Scotland's minimum unit price (MUP) levy from 50 to 65 pence.

 
How fortuitous! 

Stockwell's longstanding approach has been to clog up the search engines with meta-analyses that either cherry-pick the data or retrospectively adjust it to diminish the benefits of moderate drinking - I wrote about his most recent effort last year. In an interview with the Herald this weekend, he was still banging on about the sick quitter hypothesis which has repeatedly been shown to not explain the alcohol J-Curve

He then turns to minimum pricing, which he keenly supports. You may recall that Stockwell conjured up some evidence for this policy back in the day, claiming that a 10% increase in the minimum price of alcohol in a Canadian province led to a 32% reduction in alcohol-related deaths. This would be a remarkably large effect if true but, as data from his own research group showed, it was not remotely true.

Stockwell's approach to matters related to alcohol is refreshingly simple. If he wants something to be true, he says it is true, regardless of what the evidence says. Since most journalists are not familiar with the evidence and trust anyone who sounds like they might be a doctor (Stockwell's degree was in psychology and philosophy), this is more effective than you might think.

For example, there is good evidence from both the official evaluation and independent research that minimum pricing in Scotland did not make heavy drinkers reduce their alcohol consumption. A study in BMJ Open found that the heaviest drinking 5% of men drank more after minimum pricing was introduced. Even the people at Sheffield University who did the modelling for minimum pricing in the first place had to admit that "the introduction of MUP in Scotland did not lead to a decline in the proportion of adult drinkers consuming alcohol at harmful levels".
 
Stockwell doesn't believe this therefore he says that it ain't so.

He said he is confident that MUP has made a difference to heavy drinkers, despite some surveys suggesting they had not cut down. 

He said: "If you look at total sales data: 50% of the alcohol sold is consumed by heavy drinkers.

"You don't get population level reductions - a 3% total reduction in consumption compared to England and Wales - unless heavy drinkers are cutting down. It's mathematically impossible."

 
I don't wish to insult your intelligence, dear reader, but it is definitely not mathematically impossible.  
 

"All the surveys done, however good they seem, are observational studies - not control studies."


Control studies? Does he mean randomised controlled trials? How could you even design an RCT to measure this? Nearly everything we know about the risks of drinking comes from observational studies. Isn't it funny how Stockwell accepts these when they show risks but not benefits and demands an impossible burden of proof when the results don't suit his agenda.

"So it really has worked, especially in people with heavy alcohol use."

 
OK, bud.



Friday 12 April 2024

The Tobacco and Vapes Bill

The Impact Assessment for the Tobacco and Vapes Bill is laughable, relying on nonsense figures from ASH and ignoring the impact on the illicit trade. I've written about it for The Critic where I also ask for an ethical justification for stopping informed adults engaging in risky but self-regarding behaviour.
 

Last week, the Regulatory Policy Committee gave its verdict on the Impact Assessment. It expressed concern about the “over-reliance on evidence from ASH” and spotted the obvious problem that ASH’s productivity estimates “do not control for other factors that may affect a person’s earnings”. It suggested rethinking the assumption that the prohibition was “unlikely to have substantial impacts on tourism” since smokers may be reluctant to visit a country where they can’t even buy cigarette papers, let alone tobacco. And it politely recommended that more consideration be given to “the continued likelihood of some people buying cigarettes illegally for others”, an issue that is given astonishingly little attention in the Impact Assessment. 

Legislating for prohibition without considering the effect on the black market is almost comically negligent, but there is one other aspect of this policy worth mentioning that is ignored in both the Impact Assessment and the RPC’s opinion. A lot of people enjoy smoking and, if this policy works as intended, that enjoyment will be denied them. This is not a popular thing to say and the anti-smoking lobby goes to great lengths to deny it. They claim that people only smoke because they started in childhood and got hooked. The government claims that “most smokers want to quit”. But do they? There is enormous social pressure on smokers to say that they don’t want to smoke, but in the last Public Health England survey, only 20 per cent of smokers expressed a strong desire to quit and even among this minority, most did not intend to quit in the next three months. Moreover, it is no longer true that most smokers start in childhood. The majority of people who start smoking today have their first cigarette between the age of 18 and 24.

 

Thursday 11 April 2024

Big Tobacco meets Big Food

I've seen a few posts like this recently, claiming that 'Big Tobacco' used its mysterious, fiendish tricks to manipulate food when some of them bought food companies in the 1980s. 
 

 

So why say it? Presumably because it advances the goal of applying tobacco-style regulation to the food your eat.

Wednesday 10 April 2024

A swift half with Simon Clark

I had your friend and mine Simon Clark, the indefatigable leader of FOREST, on the Swift Half last week. We talked about his career fighting for liberty. Check it out.

Monday 1 April 2024

Why is alcohol regulated differently to tobacco?


Why is alcohol advertised openly in the UK, without pictures on the packaging highlighting the medical effects, for example, when tobacco is treated so differently? John Fisher, by email


Yesterday, the Observer published the replies, a mixed bag mostly harvested from the comments section. There are one or two nutters but also a few sensible souls. 

Nobody mentioned the official reason that was repeated for decades by the anti-smoking lobby and which is gradually fading from the popular memory as we slide down the slippery slope.

The official argument for regulating tobacco differently to alcohol is that cigarettes are a “unique product”. The WHO says that tobacco “is the only legal consumer product that kills when used exactly as intended by the manufacturer." This was the explanation given by anti-smoking campaigners for decades whenever it was suggested that tobacco regulation creates a "slippery slope”. For example, when campaigning for plain packaging in 2012, Deborah Arnott of Action on Smoking and Health (ASH) said:

“...the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false. The same argument was used against the ban on tobacco advertising, but 9 years after the tobacco ban in the UK, alcohol advertising is still permitted with no sign of it being prohibited. Tobacco is a uniquely dangerous consumer product which is why there is a WHO health treaty (the Framework Convention on Tobacco Control) to regulate tobacco use.”


The American anti-smoking activist and academic Stanton Glantz wrote in 2003:

"The 'slippery slope' argument is one that the tobacco industry has routinely raised to oppose policies against its interests, including smokefree policies, decisions by arts and cultural organizations not to accept tobacco money, advertising restrictions, and other policies. These predicted subsequent problems simply have not materialized"


In the same year, with reference to warning labels on cigarettes, the Australian anti-smoking activist and academic Simon Chapman wrote:

"In pre-warning days, when arguments could be couched in incredulity that tobacco should be singled out from other consumer products, the industry used “slippery slope” or “thin edge of the wedge” rhetoric, arguing that the policy would inexorably bleed into other product areas. 'The precedent is one which could easily come to affect other industries. For instance, a number of medical scientists claim that butter and milk are dangerous to the health of some people. It is recognised that drinking too much liquor or reckless driving are hazards to life... can we expect all these products to carry a ‘danger’ label …?' This argument appears to have quickly lost momentum when the dire predictions of rampant warnings never materialised.”


More recently, however, public health campaigners have cited the precedent of graphic warnings, advertising bans and plain packaging for tobacco as a justification for applying the same regulations to other products, including alcohol. It is far too early to say that the “dire predictions” were wrong.

Saturday 30 March 2024

The nanny state trough

If you told me that there was a massive pile of cash to be dished out to 'public health' academics and asked me to guess which two people would be first in line for it, I would say Anna Gilmore and Petra Meier. And sure enough, they were. This week it was announced that they're getting £15 million between them to build yet another little empire, on top of SIPHER, SPECTRUM and the rest. It is, as I say on my Substack, a racket. 
 

Anna Gilmore has her finger in so many pies that it is difficult to keep up. She made her name back in the day by pretending that England’s smoking ban reduced the number of hospital admissions for heart attacks. Having demonstrated that she will say anything for money, she was made a professor and spent the 2010s in a flurry of activity, displaying an extraordinary degree of ineptitude in a range of disciplines, including economics. She became director of the Tobacco Control Research Group at the UK Centre for Tobacco Control Studies, an organisation that received millions of pounds from the (state-funded) UK Clinical Research Collaboration despite doing no clinical research. Spotting new funding opportunities, the UK Centre for Tobacco Control Studies became the UK Centre for Tobacco and Alcohol Studies in 2013. She has since branched out into ‘research’ on fossil fuels which she says, not unpredictably, should be subject to ‘tobacco control style regulation’.

In 2018, she got $20 million from Mike Bloomberg to set up an ‘industry watchdog’ and in 2019 she got a grant from SPECTRUM to research ‘unhealthy commodity industries’. SPECTRUM is the preposterous acronym for Shaping Public hEalth poliCies To Reduce ineqUalities and harM. It was funded to the tune of £5.9 million by the UK Prevention Research Partnership, a largely taxpayer-funded body created in 2017 to provide yet another source of cash for nanny state quackademics.

Gilmore is also the co-director of something called the Centre for 21st Century Public Health which doesn’t have much to say about itself but is more than likely paid for by you and me.

 

Also, there's a new Last Orders to listen to.

Happy Easter!

Tuesday 26 March 2024

Looking back on the WHO and looking forward to prohibition

I caught up with Martin Cullip and Lindsey Stroud on their podcast Across the Pond last week. I was with them in Panama in February to shadow the big WHO anti-nicotine conference. We looked back on events over there and discussed Rishi Sunak's looming crackdown on vapes and tobacco.

Monday 25 March 2024

Temperance 2.0

There's a good article in the wine trade press titled 'How Neo-Prohibitionists Came to Shape Alcohol Policy' by Felicity Carter looking at temperance groups masquerading as 'public health' NGOs. Give it a read. 
 

Movendi International describes itself as "the largest independent global movement for development through alcohol prevention."

Founded in upstate New York in 1851, it began as a temperance group that was heavily influenced by the Freemasons-complete with regalia and rituals. Originally called the Independent Order of Good Templars (I.O.G.T.), it spread rapidly across the U.S., Canada, and England. By 1900 there were groups in places as far-flung as Sri Lanka, Burma, Nigeria, and Panama. Everywhere the I.O.G.T. went, it inspired the founding of other temperance groups.

The efforts of such groups culminated, of course, during Prohibition, yet the unpopularity of Prohibition caused membership to fall, while the rise of Alcoholics Anonymous made such groups less relevant. After World War II, the I.O.G.T. turned to southeast Asia and sub-Saharan Africa.

It dispensed with the regalia in the 1970s and rebranded as Movendi International in 2020. Movendi is a portmanteau of 'modus vivendi,' meaning 'way of living;' it presents itself as a human rights, "heart-led" organization and says it is not against alcohol12. Instead, "...we advocate for every person's right to choose to live free from alcohol." Yet anyone who joins must agree13 that "I lead a lifestyle free from the use of alcohol and other drugs."

Movendi's worldview is simple: There are no artisans, small producers, or vignerons connected to land and history. There is only 'Big Alcohol,' which uses propaganda words like "moderation" and "craft" to conceal its true nature.

And Big Alcohol is an ally of Big Tobacco14Movendi links alcohol to tobacco whenever it can.

But while Movendi and other groups are busy mischaracterizing the alcohol industry as one united group, they go out of their way to hide their own origins.

Take Movendi's Swedish branch, the IOGT-NTO15, which presents itself as an anti-poverty organization-solving poverty by solving alcohol. It was formed in 1970 after the Swedish branch of I.O.G.T. merged with a Christian temperance group.

Ironically, the Swedish branch is partly funded by a lottery16; in 2018 they were taken to court17 and threatened with a fine of 3 million kroner (about $260,000) if they didn't stop using deceptive practices. Specialists have long recognized that gambling is an addiction, making this a curious choice of funding for a temperance movement.

Other temperance groups use similar tactics. Take the Institute of Alcohol Studies18 in London, for example, which has a stellar line-up of doctors and scientists advising it, but which is funded by Alliance House19, a temperance group headed by religious figures.

 

 

Friday 22 March 2024

Dan Malleck on drink, drugs and prohibition

I forgot to mention that we've started a new series of The Swift Half with Snowdon. Check out the entertaining episode with the anarcho-capitalist Charlie Amos here.

The Canadian historian Dan Malleck was in London recently so I got him to come on The Swift Half again. Dan is one of the few people to have publicly spoken out about the zany new alcohol guidelines that have been proposed in Canada. We discussed how that was going and talked about drink, drugs and prohibition generally. Give it a watch.




Wednesday 20 March 2024

Greg Fell - Britain's most pointless man?

Our old fiend Greg Fell has been busy getting billboards banned in Sheffield in what even he admits is a pointless endeavour. 
 

There are over 130 directors of public health in England and it is nice work if you can get it. The job comes with a six figure salary and you don’t need a medical degree. So long as you can turn up to meetings and drop phrases like “health inequalities” and “commercial determinants of health” into conversation, you’re in clover. Not knowing much about infectious diseases proved to be a handicap when COVID-19 emerged in 2020 and public health directors were left twiddling their thumbs while they waited for instructions from central government, but Greg Fell spotted an opportunity. When Boris Johnson closed the pubs on 20 March, he suggested that “whilst we are implementing emergency legislation why not go really far and ban tobacco sales”. Exactly four years later, the government brought forward legislation to do precisely that.

With COVID-19 in the rearview mirror, there is a palpable sense of relief among directors of public health that they can get back to lobbying for petty interventions in private lifestyles. Last December, Wakefield’s public health director complained that legal action from Kentucky Fried Chicken was “thwarting efforts to stop fast-food outlets near schools” in his area. There was happier news in Sunderland where the council managed to prevent a Mexican takeaway shop from opening and the public health director’s annual report focused exclusively on the “commercial determinants of health”. They are so back!

 

Tuesday 19 March 2024

Same old ASH

Last week, former public health minister Steve Brine wrote in support of Sunak’s tobacco ban for Conservative Home. Like nearly everyone who goes to the Department of Health, Brine went native and has never recovered. His article is the usual blinkered prohibitionist nonsense - he even denies that the ban will boost the illicit trade - but he starts with a statistic that sounds credible.
 

Two-thirds of adults in Britain back the Government’s smoking ban plan, including nearly three-quarters of Conservative voters, in a representative poll carried out by YouGov for ASH.

 
He returns to this poll in his closing paragraph.
 

The public understand that the Government’s smoking ban will save lives and improve the health and wellbeing not just of individuals and their families but also of our economy. That is why the overwhelming majority of the public and parliamentarians support the legislation.

 
Since 87% of Britons do not smoke and the UK has become an oppresively intolerant country in recent years, this claim wouldn’t surprise me. But I know better than to trust an ASH survey. Before the smoking ban, they conducted several polls claiming that most people wanted a total ban on smoking in pubs. They achieved this by giving people a binary option between smoking everywhere versus smoking nowhere. But when other polls gave people the option of allowing separate smoking rooms, most people were happy with that (and remained so for years after the ban was introduced).
 
The question ASH used in their latest survey is almost unbelievable:
 

How strongly, if at all, do you support or oppose a goal to make Britain a country where no one smokes?”

 
You will have noticed that there is no mention of ban there. There is no mention of any policy, coercive or liberal, let alone the gradual prohibition of all cigarettes, cigars, heated tobacco, shisha and cigarette packs. It doesn’t show that ‘the overwhelming majority’ ‘support the legislation’. It is just an aspiration, a ‘goal’. It would be quite possible for a liberal who supports tobacco harm reduction but hates the nanny state to agree with this ambition.

Read the rest on my Substack (free). And I have replied on Conservative Home today.

Monday 18 March 2024

Prohibition, problem gambling and playing with words

Australia's umpteenth attempt to ban e-cigarettes has been warmly applauded by the renowned wowser and imbecile Simon Chapman. Nicotine-containing vapes have always been illegal in Australia. Importation of these products for personal use was banned a few years ago and now the government is banning all e-cigarettes regardless of whether they contain nicotine or not. 

As dozens of tobacconists are being literally firebombed, the devastating yet predictable consequences of prohibition (for vapes) and neo-prohibitionist sin taxes (on cigarettes) could not be more obvious to Australians. (There's an excellent article by two criminologists in The Conversation that is well worth reading.) But Simple Simon not only refuses to take any share of the blame for the consequences of the policies he spent his life lobbying for, he refuses to accept that what is happening to vapes is prohibition. Why? Because vapers will (in theory) be allowed to get e-cigarettes on prescription.
 


Note the way in which he portrays those who think e-cigarettes should be sold as consumer products like they are in normal countries as 'extremists'. Note also that he is using a photo of an anti-Prohibition rally taken during Prohibition in the USA. This is, of course, the example that comes most readily to mind when people hear the word 'prohibition'. Chapman is keen to distance himself from that kind of prohibition because it was such a notorious fiasco.

However, if he weren't such an ignoramus and didn't suffer from Dunning-Kruger syndrome, he would know that alcohol was available on prescription during Prohibition (Winston Churchill famously got a doctor's note when he visited the USA). Indeed, the Volstead Act was softer on drink than the Aussie government is on vapes. Ordinary people were never arrested for mere possession of alcohol whereas people are already being arrested for the possession of vapes and vape juice in Australia.

So if Chapman doesn't think the ban on vapes is prohibition, he must think that Prohibition wasn't prohibition either.

Back in Britain, the anti-gambling lobby's rising star Matt Gaskell has also been playing with words.
 

The problem here is that most of these phrases are technical terms with scientific definitions. The exception is 'addict', but the only people who use that word about problem gamblers are anti-gambling activists and the media. Problem gambling does not necessary involve addiction, but problem gambling is definitely a thing. It is recognised by clinicians and researchers around the world and is diagnosed with the PGSI test. PGSI stands for Problem Gambling Severity Index.

A similar but distinct test is the DSM-V. This refers to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. It is the diagnostic test for the recognised condition of 'gambling disorder' which, in the previous (fourth) edition, was called 'pathological gambling'.
 
Matt Gaskell is the Clinical Lead for the NHS Northern Gambling Service which is part of the NHS's National Problem Gambling Clinic . When it opened in 2020, he said:
 

"Gambling addiction is a new public health crisis. It’s causing serious harm to thousands of people across the UK. This includes mental health problems, serious debt, breakdown of relationships, loss of employment, crime, homelessness and, tragically, sometimes suicide.

"Through my work in mental health and addictions treatment over the years I’ve seen the harms that problem gambling can cause people. However the chances of recovery from addictions like problem gambling can be very good with proper treatment." 
 
Running a problem gambling clinic without uses terms like 'problem gambling' and 'gambling disorder' is like being an oncologist and banning the terms 'cancer' and 'tumour'. So why this sudden retreat from recognised scientific terminology that no one has had a problem with in the past? It all comes back to what I was writing about last year - the 'public health' takeover of gambling policy and research. Under the new ideology, everyone is at risk from gambling, every gambler is harmed and gambling is inherently dangerous. 

Put simply, the existing literature correctly sees problem gambling as a complex mental disorder (“gambling disorder”) that is best dealt with by clinicians and augmented by harm reduction policies. By contrast, the “public health” approach is to stigmatise gambling, demonise the gambling industry and use tobacco-style regulation to deter as many people from gambling as possible. The difference between the two approaches is that the former is based on evidence and works whereas the latter is based on wilful ignorance, creates negative unintended consequences and fails.
 
The new wave of anti-gambling activists take issue with anything that implies that the psychological condition of gambling disorder only affects a relative handful of people (which it does) or implies that individuals can do anything about it (which they can). It's going to be difficult for people who treat problem gamblers to maintain this conceit because the first step to recovery is getting people to admit that they are responsible for their actions and can change their behaviour, but I'm sure they'll manage it.
 
 

Thursday 14 March 2024

The menthol cigarette ban - another 'public health' win!

Menthol cigarettes were banned in the EU in May 2020 and, as usual, the UK government decided against using its new freedoms outside of the bloc to allow more freedom to people in the UK.

A study in the junk journal Tobacco Control by the usual career anti-smokers (Linda Bauld etc.) now claims victory because...
 

The current study shows no increase in illicit purchasing 3 years after the ban in GB and is an important contribution to the literature assessing the longer-term impact of menthol cigarette bans; it is another example of how the industry’s oft-predicted surge in illicit cigarette purchases as a result of tobacco control measures did not materialise.

 
Big Tobacco in the mud! Take that!

However...

Despite being banned in 2020, one million adults continue to smoke menthol cigarettes in GB. The prevalence of menthol cigarette smoking only decreased slightly and non-significantly among adults who smoke, from 16% at the end of 2020 to 14% at the beginning of 2023.
 
Oh dear. Still, let's not allow the total and utter failure of the policy to achieve its goal distract us from Big Tobacco being wrong about the illicit trade. They're in the mud!
 
According to the authors, people who smoke menthol cigarettes were no more likely to buy from illicit sources than those who smoke normal cigarettes, although that's not what their own data shows (see table below).
 
 
Nevertheless, it is clear that a lot of people have been buying menthol (or menthol-ish) cigarettes from legal sources. The authors explain various ways in which this can be done, all of which could have been predicted by someone who is a genuine expert on the tobacco market rather than a rent-a-gob prohibitionist.
 
There are several reasons why people in the UK may continue to smoke menthol cigarettes despite the ban. First, it is possible to buy factory-made cigarettes or roll-your-own tobacco with menthol flavour in countries without a ban and bring them back to the UK either within the legal limits for personal use or through illicit means. Second, people can purchase menthol accessories, such as filters or capsules inserted in a hole in filters of factory-made cigarettes, infusion cards for cigarette packs to spread menthol aroma and flavour or menthol-flavoured filters for use with roll-your-own tobacco. These accessories are not covered by the ban and some of them seem to have been placed on the UK market in direct response to the ban. Another tactic that the tobacco industry used to circumvent the ban is to produce cigarettes that may be perceived as mentholated, while the manufacturers claim that the flavours are not characterising and are therefore allowed.

So the reason there has not been a booming black market in menthol cigarettes is that the legislation was so badly drafted that a black market wasn't necessary. And this is supposed to be a win??
 
Incidentally, all the data used in this study starts in October 2020 and ends in March 2023, despite the ban taking effect in May 2020, so it doesn't tell you anything about what happened when the ban was introduced. Tobacco Control really will publish any old rubbish.