Friday, 31 October 2025

Desperate gamblers?

  
I'm not sure why the Lords were talking about gambling this week, but it seems that they were because Natalie "brain fade" Bennett treated the House to her thoughts.
 
 
Bennett is appalled that the most common reason given by gamblers for their gambling is to win a lot of money. She interprets this as a sign of "desperation" and describes gambling - which the state is "allowing"[!] - as a "tax on desperation". For some reason she failed to mention the second most common reason reported in the Gambling Survey for Great Britain...
 

Gambling ‘for the chance to win big money’ and ‘because it’s fun’ remain the most popular reasons given as to why respondents gambled.

 
The same survey found that 48% of Brits gambled in the past 4 weeks, two-thirds of whom played the National Lottery. What other reason could someone have to play the lottery than winning big money? That is the whole point of lotteries. It is how the government markets the lottery (other forms of gambling cannot induce punters with the explicit promise of big wins but the state exempts itself from this restriction, as it does from so many other rules). It is the hope of a big win that makes the National Lottery fun, despite it having the worst odds you'll ever come across.
 
 
Meanwhile, left-wing think tanks in Derek Webb's orbit are demanding higher taxes on gambling in the full knowledge that this will lead to punters being given "poorer odds" and a "poorer deal". And yet somehow this will not damage the gambling industry and won't draw gamblers to the black market.  I've written about them for The Critic.
 
 



Wednesday, 29 October 2025

Look Back in Anger: The Conservatives and the nanny state

I was on a panel at the Tory conference earlier this month discussing the nanny state with two (pretty sound) Conservative MPs. Much of it was given over to how dreadful the Tories were in office, and why not? Now let the healing begin. 

 



Sunday, 26 October 2025

Tobacco prohibition and public opinion

FOREST have released the results of a survey they commissioned to gauge support for the generational tobacco ban that is the centrepiece of the Tobacco and Vapes Bill. The majority of respondents are, quite sensibly, against it. 59% of respondents said that people aged 18 or over should be allowed to buy tobacco.

Opinion polls are notorious for using leading questions, and people who respond to surveys are (a) easily swayed (b) afflicted by social desirability bias and (c) unlikely to think about second order consequences. It could be argued that the question above primes people to agree with adults being able to do things by listing some other things adults can do. But the survey also asked a question that is about as neutral as it could be. It describes what the government is planning and asked if they agree with it. Only 35% of respondents did, although note that support for people being allowed to buy tobacco at the age of 18 drops to 25% when they are offered the alternative of a 21 year age limit. 
 
 
People also understand that prohibition, even if introduced gradually, fuels the black market.
 

 And they can understand why smokers' tax morale is at rock bottom.
 
 
When the state-funded prohibitionists at ASH commission studies, they find majority support for the generational ban. How do they do it? Actually, it's not clear how they do it because they don't always publish the wording of their surveys. In May, they announced that their YouGov survey found "overwhelming public support for a bold smokefree future" and that "two-thirds of the public (68%) back the ‘Smokefree Generation’ policy". 
 
But the report ASH published did not give the wording of the question. All it said was that people "support the Smokefree Generation". If all they were asked was whether they supported the "Smokefree Generation", I suppose that's unsurprising. Were they told what that meant? 
 
We may never know. The survey is not available on the YouGov website, which doesn't seem like best practice to me. The media shouldn't give any coverage to opinion polls unless it is clear what questions have been asked.
  


Monday, 20 October 2025

The battle for the gambling levy millions

Last month the gambling journalist Zak Thomas-Akoo revealed that the UK Research and Innovation (UKRI) has been changing the terms of its grant applications under pressure from anti-gambling academics and campaigners. 

Thanks to the mandatory gambling industry level, the UKRI has £10 million to distribute to anyone who wants to research "gambling and gambling-related harm". It's a huge amount of money for a niche academic area and "public health" researchers are fighting like rats in a sack to get hold of it. This is why people who have never written about gambling before have suddenly taken an interest in the topic. A slew of articles about why gambling should be treated as a "public health" issue have appeared in medical journals in the last couple of years, all of which have been characterised by ignorance about problem gambling as a psychological disorder and robotic incantations about treating it like tobacco (this is a particularly comic example). 

The UKRI doesn't give researchers much of a steer on what kind of research it wants or which specific areas it thinks need studying, but it does make some stipulations. When it created its webpage to attract researchers in June 2025, it originally said:
 

Applications must be consortia based and must bring together diverse people, institutions, expertise, experiences, places, and wider stakeholders. This includes people with lived and learned experience from gambling and gambling related harms.

By lived experience, we mean people with direct experience of gambling related harms. Partnerships with non-HEI [higher education institution] organisations and people across the third sector, community groups, industry, and the public sector are essential.

 
If you're a regular reader, you can probably guess which word triggered "public health" academics. Industry. It is one of the ten commandments of "public health" that industry does not get a seat at the table, and yet here was the UKRI saying that partnerships with industry are essential.
 
If researchers want data on how people gamble and how the sector is evolving, some co-operation with industry is clearly necessary, but the UKRI was flooded with complaints from moral busybodies. According to Thomas-Akoo, the webpage was changed three days later "to define industry far more broadly than was previously implied, meaning “any enterprise that places goods or services on a market and whose commercial activities constitute more than 20% of its annual operations.”" This means that researchers can form partnerships with all sorts of pressure groups, non-profit organisations and charities that are not part of the gambling industry and may be extremely anti-gambling. But they could do that anyway, so it seemed odd that the UKRI felt the need to change the small print like this. It looks like they were trying to appease to anti-gambling lobby, which is never easy.
 
In September, Private Eye (which repeats anything the anti-gambling coalition tells it) reported that "a group of gambling reform campaigners" had written to Peter Kyle - who was the Secretary of State for Science, Innovation and Technology until recently - to moan about the UKRI being insufficiently ideological. The UKRI had even had the nerve to talk about "individual risk factors" for problem gambling! For shame!
 

I have now seen some of these letters (released under FOI). What they reveal above all is a sense of entitlement. The activists and academics simply assume that the only way to look at gambling is as a tobacco-adjacent commercial determinant of health and that the only suitable framework is the relatively novel, untested and ill-defined "public health" approach to "gambling harm". 
 
A letter from some unnamed academics is a case in point. They assert that the very idea of gambling "harm" being a "product of individual vulnerabilities" has been "discredited" and that because OHID and the NHS "follow a public health approach to preventing gambling harm", everybody else should do the same. 
 
OHID and the NHS are, of course, health agencies so it is hardly surprising that they have endorsed the "public health" approach, but that doesn't justify ignoring decades of research showing that problem gambling is a complex psychological disorder that is often associated with other psychological disorders and can be treated by psychologists (which is what the NHS gambling clinics actually do). The UKRI doesn't need to spend £10 million a year for a bunch of nanny state blowhards to produce "research" which concludes that gambling advertising should be banned and gamblers should be given deposit limits (which is what they mean by "upstream prevention" and "plugging policy gaps"). These people are so predictable that their studies write themselves, but they do not extend the field of human knowledge.
 
The fact is that the "public health framing" is just one way to look at the issue and not a very fruitful one. When they talk about "the structural drivers of harm at a population level", they mean the legal gambling industry. It has always been odds on that the levy money would be used by activist-academics to provide a scientific fig leaf for bone-headed prohibitions that have already been decided upon. This is Year Zero for them and it is why they want any academic who is "linked to industry" excluded. Gambling research has traditionally been funded by industry, albeit usually through arm's length bodies like GambleAware. If the academics who have done gambling research in the past - most of which is more serious and nuanced than the junk that will be produced from now on - are "excluded from bidding for funds", the new wave of ideologues can start with a clean slate. It's not about conflicts of interest, it's about getting rid of the old guard.
 
 
Who will decide who the "industry actors and their intermediaries" are? They will, of course, and over time the scope will be expanded to the point where anyone who disagrees with them becomes "industry" by definition (as had happened with smoking and vaping). 
 
The APPG on Gambling Harm wrote a letter along similar lines and using the same buzzwords. Like the academics, they assert that there is only one way to look at gambling and that is by embracing the "public health approach".
 

A common rhetorical trick used by anti-gambling campaigners these days is to portray the traditional approach of focusing on individuals as "stigmatising" while at the same time stigmatising gambling and demonising gambling companies. A typical example of this is in the APPG letter.
 

These groups are essentially trying to bully the UKRI into excluding anyone who disagrees with them by pretending that the "public health approach" is the only game in town and that treating gambling disorder as a problem for individuals is socially unacceptable.
 
The letter from Peers for Gambling Reform is more or less a carbon copy of the APPG's letter. It complains that the UKRI has "overlooked ... commercial practices and products". This is only true insofar as the UKRI doesn't specify any particular research agenda or framework, i.e. it "overlooks" everything and researchers can propose any research project they like. What really bugs their lordships is that the UKRI hasn't focused obsessively on specific games and commercial practices which supposedly have specific risks attached to them.
 

Gambling With Lives wrote a similar letter and I daresay several other people did too. This is the "swarm effect". If they repeat something often enough, they think it will become an established fact.
 
The response of the UKRI was to change its webpage again by adding a whole load of provisos and caveats. Below the passages I quoted at the top of this post, it has now added the following (emphasis mine) 
 

Partnerships with non-HEI organisations and people across the third sector, community groups, the public sector, and industry are essential and can contribute to diverse, innovative and cutting edge research, particularly in respect of the provision of industry data and commercial insights for the furtherance of research endeavours. By ‘industry’ we mean any enterprise that places goods or services on a market and whose commercial activities constitute more than 20% of its annual operations. This definition applies across all sectors and is not limited to organisations within the gambling industry. However, we absolutely recognise the sensitivities in respect of partnerships or collaboration with businesses, the gambling industry or otherwise.

That is why we are clear that any engagement with industry partners, especially those from the gambling sector, must be demonstrably independent, evidence-based, research-led, and aligned with the programme’s public interest objectives to further understanding of gambling and gambling-related harm.

Further, all proposals will be subject to robust scrutiny through our peer review and governance processes, with particular attention paid to the independence and integrity of the research, the source and independence of the findings, and the potential for real-world impact in understanding gambling behaviour and reducing gambling harms.

UKRI wishes to clarify that, as well as not being permitted to host awards, under the Research Programme on Gambling UKRI does not permit funding to be provided to Gambling Commission licence holders who are subject to the levy. We have also placed restrictions on co-funding from such organisations. Furthermore, UKRI would not expect individual researchers to concurrently hold funding from licence holders subject to the levy while receiving funding from the Research Programme on Gambling.

UKRI does not permit engagement with industries whose core business can be associated with harm to public health or societal wellbeing, in line with our ethical standards and harms-based exclusion principles.

Exceptions may be made for time-limited, purpose-specific interactions deemed essential to achieving legitimate and high-quality research objectives (for example, access to proprietary datasets or materials), provided that:

  • there is no direct funding or co-authorship from the excluded entity
  • the interaction is subject to robust ethical review and declared transparently
  • appropriate safeguards are in place to prevent undue influence, reputational risk, or conflicts of interest
  • the public benefit of the research demonstrably outweighs the risks of engagement
... Partnerships can take different forms including project partners or collaborating organisations. You must demonstrate how the partnerships within your consortium are equitable, have contributed to the development of your application including its conceptualisation, are not compromised by non-compliance with our conflict of interest policy, and will help the centre achieve its aims.

 
It's difficult to know how this will work in practice. On the face of it, it is incoherent. On the one hand, the UKRI is encouraging researchers to form partnerships with the gambling industry and it still says that whoever runs the Gambling Harms Research Coordination Centre should "ensure that the Centre includes representation from industry." On the other hand, it says that it "does not permit engagement with industries whose core business can be associated with harm to public health or societal wellbeing". But harm to public health and societal wellbeing is exactly what "public health" academics think the gambling industry is all about and since the UKRI is giving grants for people to study gambling "harm", it would seem that the UKRI thinks the same. 
 
The whole webpage is now a bit of a muddle, but since the UKRI keeps changing it every time they get an indignant letter from a wowser, that is hardly surprising.

 



Saturday, 18 October 2025

Good COP 11

The WHO's Framework Convention on Tobacco Control Conference of the Parties (FCTC COP) will be held in Geneva next month. The media will be banned as usual so I'll be there for the Good COP conference down the road to offer a more enlightened view along with a stellar line up of experts. You can attend or watch online. Details here.



Friday, 17 October 2025

Banning cigarette filters?

Some further thoughts on this at my Substack.
 

Smokers would have to greatly overestimate the benefits of filters for a ban to provide a net benefit in public health terms, and I doubt they do. I expect most of them think they provide no protection at all. Most smokers have only ever known filtered cigarettes and they know that they are highly dangerous. In any case, making a product more dangerous in order to scare people off using it has got to be ethically questionable.

The anti-smoking lobby’s approach to this issue is all over the place. They were all in favour of the development of low tar cigarettes in the 1970s. They now say that was a mistake. Fair enough, but if it was a mistake why did they lobby for the EU to set limits on tar yields in the 1990s and then fight to lower those limits in the 2000s? They then successfully lobbied the EU to ban tobacco companies from putting the tar and nicotine content on packs because this information was (supposedly) misleading. Which is it? Either all cigarettes are as bad as each other, in which case get rid of the limits on tar and nicotine, or low tar cigarettes are safer than high tar cigarettes, in which case consumers should be informed.

Their current position seems to be that all cigarettes are as bad as each other and that filters should be banned because they give the opposite impression. If so, the EU’s limits on tar and nicotine serve no purpose and should be abolished. Indeed, they will have to be abolished if filters are banned because there is no such thing as a low-tar unfiltered cigarette. This is an issue that the authors of the Addiction article, who include ASH’s Hazel Cheeseman, never address. They can’t be dumb enough to think that the EU will accidentally ban cigarettes by banning filters and leaving the tar limits in place so they must think - if they have thought about it at all - that the EU will allow high tar cigarettes to be sold again. That would be fine with me. It’s just be a bit surprising that it’s also fine with an anti-smoking group.

 



Tuesday, 14 October 2025

Prohibitionists for human rights!

Not a spoof

 
Tobacco Control has published an hilarious article by a lawyer from ASH (USA) and a social scientist from Mike Bloomberg's Tobacco Control Research Group (Bath University). It is titled Tobacco control advocates as human rights defenders: a call for recognition. and is every bit as ridiculous as it sounds. 
  

Tobacco control advocacy is not without risks. Increasingly, advocates have spoken out about the threats, harassment and attacks they face when confronting powerful corporate interests.

 
This "harassment" mostly consists being called things like 'nicotine Nazis', 'health fascists' and 'killjoys'. It turns out that if you stigmatise people, extort money from them through sin taxes and ruin their social lives, they will dislike you. Who knew? And yet, despite working tirelessly to make the lives of nicotine users miserable, I have never heard of any anti-smoking campaigner in the modern era being physically attacked by a smoker. When you think about it, that is quite remarkable. 
 

This commentary argues that tobacco control advocates should be recognised as human rights defenders (HRDs) under international frameworks.  

 
Hahaha! 
 

The Office of the High Commissioner on Human Rights (OHCHR) defines HRDs as individuals who, individually or with others, act to promote or protect human rights in a peaceful manner.

 
You know who isn't defined as a human rights defender? Ambulance-chasing lawyers and pointless academics who sit around on fat salaries thinking up ways to take away people's right to enjoy themselves. There are lots of names for people like that but 'human rights defender' is definitely not one of them.
 

This definition is based on actions, not positions or titles. By this standard, tobacco control advocates—who work to protect and advance the right to health (and other rights) and challenge harmful corporate practices—clearly fall within the scope of HRDs.

 
Anti-smoking lobbyists do not advance the right to health. Insofar as not smoking is synonymous with health, people can choose to do it or choose not to do it. Having the right to something does not mean that a person should be compelled by others to maximise it at the expense of everything else they hold dear. People have the right to a family life but that doesn't mean they should be forced to have children. 
 
What difference would it make if we go along with this gaslighting and pretend that prohibitionists are champions of human rights?
 

... much of the practical, frontline support for HRDs comes from civil society. For example, a civil society-led initiative based in Europe offers a variety of support mechanisms, including a hotline for urgent protection and visits in detention. 

 
The initiative they are referring to has been supporting women living in Afghanistan under the Taliban and libertarians fighting political oppression in Georgia. Surely even the most deluded 'tobacco control' nutter can see that the plight of these people has nothing in common with single-issue campaigners being called nanny statists on Facebook? 
 

Tobacco control has always been about defending the right to health, life, and dignity. 

 
No, it has always been a prohibitionist crusade run by neurotics, bigots and grifters. As the campaign against e-cigarettes and nicotine pouches shows, it was never really about health and it certainly isn't about dignity.  
 

 A moral crusade explicitly grounded in 'denormalisation' was never going to advance human dignity.
 

Yet the advocates who lead this work often face threats without the recognition or protection afforded to other defenders of human rights. 

 
The authors helpfully link to a website that might otherwise have escaped me. Paid for by two of Bloomberg's front groups, Courage Against Tobacco tells the heart-rending stories of brave of anti-smoking careerists who have suffered at the hands of the tobacco industry. The 'tobacco industry' is very broadly defined, including not just companies who make and sell tobacco products but also "all related corporate entities connected to tobacco manufacturing companies", "research institutions accepting tobacco funding", "third-party allies" and "lobbyists advancing industry positions". And, as if that were not enough, it also includes: 
 
  • Organizations promoting "reduced-harm" products while opposing evidence-based measures aligned with the WHO FCTC
  • Entities that consistently advance tobacco industry policy positions 
 
In other words, it includes literally everybody who disagrees with them. 

The website tells the story of a French anti-smoking campaigner who was "allegedly insulted online" by somebody from an organisation called 'Angry Tobacconists'. It tells the tale of ASH Scotland's Sheila Duffy being called a "health Nazi" by FOREST and of a former Detective Chief Inspector threatening to take her to court over something (the details are not clear). And we hear about some anti-smoking activist in southeast Asia who received a 36 page letter of complaint from somebody who is apparently vaguely connected to the tobacco industry.

It certainly puts the situation in Gaza and Ukraine into perspective, doesn't it? Nobody has ever suffered like a professional tobacco control lobbyist has suffered - and all to protect human rights! (i.e. their right to tell other people how to live their lives.)
 

Recognising tobacco control advocates as HRDs is not symbolic—it is a necessary step to close a serious protection gap. It would align the field more explicitly with global justice efforts, unlock underused legal and institutional resources...

 
And there we have it. Is that the sound of a cash register I can hear? 
 

... and send a clear message that defending health is defending human rights. As pressure from commercial actors intensifies, the global tobacco control community must act—not only to advance policy, but to safeguard those advancing it.

 
These people are deluded beyond belief. Clive Bates puts it well in a rapid response...
 

Tobacco control advocates are not defending human rights, but rather promoting controls and limitations on the rights of others. The threats to the safety of tobacco control activists are minimal in practice, but the threats to millions of others from adopting a prohibitionist, war-on-drugs posture towards safer forms of nicotine are significant.

 

 


Monday, 13 October 2025

Towards prohibition

I was spoke to Brent Stafford at Regulator Watch when I was at the Global Nicotine Forum in June. We discussed vaping, prohibition and why things will get worse before they get better. Here's the video.



Thursday, 9 October 2025

Has the ultra-processed food panic peaked?

 

Remember Joe Wicks, the chirpy gym bunny whose YouTube channel got children exercising during lockdown? He was quite famous in the spring of 2020 but was rather less famous five years later. In 2021, at the peak of its success, Joe Wicks Ltd. had £2,181,299 in the bank. By 2024, it had just £78,758. 

Whether the fading fame and fortune of Mr Wicks had anything to do with his decision to get onboard the bandwagon against ultra-processed food (UPF), we may never know, but it has certainly got him back on prime time TV. He has been on the breakfast sofa with Ed Balls and Susanna Reid, and viewers were treated to a whole hour of him on Channel 4 this week (Joe Wicks: Licensed to Kill). His promotional device is the “Killer” protein bar which he has created and is portraying as “the most dangerous health bar” ever. It supposedly causes cancer, stroke and heart disease — and yet it is legal! Why won’t the government do something?!

Inevitably, the documentary involves Wicks going on a poorly scripted “journey” to discover the truth about what is really going on in our food environment, blah, blah, blah. Equally inevitably, his tutelage leans heavily on the opinions of Chris van Tulleken who has recently been made a professor and is beginning to look as crazy as he sounds. For cinematic reasons, van Tulleken is portrayed as living in a dimly lit, underground laboratory surrounded by bottles of dangerous chemicals. The vibe is that of a strange but brilliant scientist who has accidentally unleashed the zombie apocalypse and is humanity’s only hope of ending it. Once Wicks gets to work manufacturing his unhealthy snack, van Tulleken occasionally surfaces with an intense stare, urging his youngish protégé to see it through to the end.

Read the rest at The Critic



Wednesday, 1 October 2025

Dewi Evans' response to the latest Letby documentary

Dewi Evans has sent a response to journalists following the broadcast of Conviction (AKA Lucy Letby: Murder or Mistake) which I reviewed last week. He says it's free to be shared so here it is for anyone who might be interested... 

Danny Bogado, Rosy Milner and the Channel 4 team took on a challenging documentary (Murder or Mistake, Channel 4, 29 September 2025). Producing a 2 hours' documentary from evidence that took Cheshire Police several years to collect and led to the longest criminal trial in English legal history is in itself remarkable. 

It was a privilege to be considered the chief prosecution witness in a trial that has led to the lifelong incarceration of England’s worst female killer. Her conviction would not have succeeded without Cheshire Police’s diligence and attention to detail, and the evidence of my fellow independent witnesses and the numerous nurses and doctors from the Countess of Chester Hospital. The evidence of all the witnesses was crucial. 

Lucy Letby’s new barrister has broken new ground in launching an appeal via press and media, providing of course a very selective version of events. Mark McDonald helpfully summarised 6 issues on his agenda; the rota, the experts, air embolus, insulin, the neonatal unit, and the media. Despite his natural thespian skills and his considerable bravado Mr McDonald and his supporters failed to offer any evidence not disclosed at Letby’s trial, or would stand scrutiny at a clinical or scientific presentation or the rigours of cross examination. 

The relevance, or not, of the rota, and Letby’s presence, has been flogged to death. Peter Elston, statistician and investment manager, just could not understand the difference between information that is statistically significant and that which is clinically significant. Statistics will point you in a certain direction. It does not prove that something took place. It’s why statistics did not play a part in the prosecution’s case. Presumably it’s why the Defence did not seek a statistical explanation either. 

Private Eye’s Dr Phil Hammond claims credit for exposing the concerns regarding what became the Bristol Heart Scandal. He conveniently overlooks the fact that the same magazine took over 10 years to admit it got it wrong in relation to discredited medic Andrew Wakefield and his flawed MMR / autism claims. His claim that my diagnosis of air embolus was because I “couldn’t think of anything else” reflects his clinical limitations, not unexpected given he is best known as a comedian who writes for The Eye. My diagnosis of air embolus was supported by my fellow independent witnesses, belatedly by the Chester paediatricians, and backed up by 18 publications. 

Shoo Lee may well be an eminent epidemiologist. His experience of air embolus is limited to reporting 3 cases from the 1980s. More tellingly he has no background of medicolegal matters because “I don’t do medico-legal cases. I don’t like them”. Bogado's programme did not have time to include my detailed critique of his 2 published papers.  If his most recent paper (published in December 2024) had been available before the trial its content would have been very useful - for the prosecution. His criticisms of my role, disclosed at the press conference, were all factually incorrect. Summaries from other members of the Panel were awash with errors, some of the weakest reports I have seen during my career.

Given the time constraints it was inevitable that the documentary concentrated on just a couple of cases. The timing of Baby C’s collapse created confusion. In my very first report (7 November 2017) I raised concerns regarding the event late on Saturday 13 June 2015 that led to his collapse and death. Over the next 5 years the dates seem to have become confused, leading to the prosecution alleging that the assault took place the previous day. I recognised the confusion at the Trial, reaffirming my original concern that the fatal assault was late on 13 June. I believe that Cheshire Police, the CPS, and the Prosecution team should set the record straight. 

Back in 2017, when I first raised concerns regarding Baby C’s demise, I was unaware of Letby’s presence on the unit, let alone that she was up close to Baby C at the time of his collapse. There is nothing in Baby C’s clinical records to confirm Lucy Letby’s presence. 

Baby O’s demise was given considerable attention, and we were presented with some extraordinary explanations from British Columbia based neonatologist Richard Taylor and the Brighton duo of Neil Aiton and Svilena Dimitrova. According to them Baby O’s death was due to a cannula inserted into the baby’s abdomen 20 - 30 minutes before he died. This fails to explain why the baby was moribund, sadly at death’s door, before the cannula was inserted. For good measure Aiton claimed that the ventilator pressures used to resuscitate the baby were too high. This does not explain why the baby required resuscitation in the first place. He had never required resuscitation following his birth, and his collapse took place when in Lucy Letby’s care. The Taylor, Aiton, Dimitrova hypothesis has been widely condemned by others, including a pathologist who gave his opinion on a recent Panorama programme. Their opinion should be confined to the Donald Trump School of Evidential Science. 

The controversy regarding insulin poisoning has been widely explored. Professor John Gregory recently endorsed (on the same Panorama programme) the opinion of his fellow paediatric endocrinologist Prof Peter Hindmarsh, stating that baby F and baby M were both poisoned with insulin. Insulin poisoning had been accepted by Letby’s Defence team at the trial, and indeed by Lucy Letby herself. 

Criticism of the neonatal unit building was reasonable, and the unit has long moved to more suitable premises. Alleging that the department was “failing” or unsatisfactory is unfair and unreasonable. Survival rates, the best quality control of any neonatal unit, were as good in Chester as the ONS [Office of National Statistics] figures for England & Wales, even for the smallest babies. The Thirlwall Inquiry confirmed that staffing was similar to other units in the North West of England. 

Mark McDonald and his team failed to show any new evidence that would justify another appeal. Unhelpfully for him, this week’s Law Society Gazette article by Bianca Castro (26 September) states: “Conviction did not uncover anything new, a potential problem if the CCRC [Criminal Cases Review Commission] are to refer the case back to the Court of Appeal.”  

The victims in the Letby Trial are the babies harmed and murdered by Lucy Letby, and their families. A campaign to release England’s worst female serial killer is beyond my understanding. It adds to the hurt and grief the families have suffered for the past decade. 


Tuesday, 30 September 2025

"Nicotine control" and the WHO

I wrote about the WHO for the Telegraph over the weekend. One of its Regional Directors has said that he wants to "erase" alcohol. In the article I discuss the malign influence of "Movendi" - the temperance group formerly known as the International Order of Good Templars - who are official partners of the WHO (fun fact: they are funded by the Swedish lottery).
 

Movendi is one of the “civil society” groups that Dr Piukala described as “essential” in his speech this week. Drinkers everywhere should be worried about a gospel temperance society collaborating with the world’s biggest health agency, although the WHO has become so puritanical and dogmatic in recent years that it is hard to know which of them is more extreme.

They both want to denormalise alcohol through advertising bans, licensing restrictions and sin taxes. They both claim that drinking is harmful at any level. They both compare alcohol to tobacco and equate the alcohol industry with the tobacco industry. This is no small thing when WHO Europe explicitly says that its goal is to create a society that is not just “tobacco-free” but “nicotine-free”.

 
More fool anyone who isn't worried about the direction of travel. The WHO didn't always want to eradicate tobacco. At one time, it would have accused anyone who suggested that it had prohibitionist intentions of being hysterical. They now explicitly want to eradicate not just tobacco but nicotine. If you don't think they would like to eradicate alcohol, even as a WHO Regional Director essentially says as much, then I am afraid that you are gullible.
 
On the point of erasing nicotine, Clive Bates points out that the UN's snappily titled Political declaration of the fourth high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases and the promotion of mental health and well-being has been made worse since it was first drafted. In the first draft, there was "only one asinine reference to nicotine" (a reference to electronic nicotine delivery systems), but now member states are urged to focus on "nicotine control".
 
This is supposed to be a statement about NCDs (i.e. cancer, cardiovascular disease, COPD, etc) finalised after a lengthy deliberative process. It is intended to focus on UN SDG Target 3.4, which aims to reduce mortality in adults aged 30-70 from major NCDs by one-third by 2030. The target that is likely to be missed by some distance. Yet, the text refers throughout to “tobacco and nicotine control” even though the primary driver of NCDs is not tobacco per se or nicotine, but smoke, including tobacco smoke.

  
The good news is that the UN was forced to water down some of the messaging in the final draft. For example, member states were told to "Increase taxation on tobacco, alcohol and sugar-sweetened beverages" in the first draft, but in the final draft this has been changed to "Consider introducing or increasing taxes on tobacco and alcohol to support health objectives, in line with national circumstances".
 
But its crusade against nicotine has been ramped up, with member states encouraged to:
 
(a) significantly reduce tobacco and nicotine use by: (i) implementing health warnings on all tobacco and nicotine packages; (ii) restricting tobacco and nicotine advertising
 
A nicotine-free world isn't going to happen. It is a pie in the sky prohibitionist fantasy. But, as I say in the Telegraph article, people can do a lot of damage reaching for Utopia. 
 
The irony is that, even if you think that using state coercion to create a smoke-free world is an ethical objective, it is made much more difficult if you fight a parallel war against nicotine, firstly because you will be using scarce resources on multiple targets and secondly - most importantly - because people are more likely to stop smoking if they can use a safer form of nicotine.


Thursday, 25 September 2025

Plain packs for vapes

The one-club golfers in 'public health' want plain packaging for vapes because of course they do. I've written about it for The Critic...
 

The epidemic of misinformation about the risks of vaping is one of the great public health disasters of the century and is all the more shameful for having been driven by people who have words “public health” in their job titles. The “popcorn lung” myth, the EVALI hoax and an endless series of tabloid scare stories — combined with the enduring misconception that nicotine causes cancer — have turned public understanding on its head. As the graph below shows, twice as many Britons think that vaping is as dangerous as smoking, if not worse, than correctly believe that it is far less harmful.

If vaccines or paracetamol were subjected to the same level of misinformation, public health professionals would be working frantically to move the public’s perceptions towards reality. Insanely, they are doing the opposite. The government’s Tobacco and Vapes Bill will give the health secretary Henry VIII powers to regulate vapes like cigarettes, thereby cementing the notion in the public’s mind that the health risks are comparable. The government is being cheered on by a motley assortment of fork-tongued “public health” academics and activists who pay lip service to the benefits of e-cigarettes while doing everything they can to suppress demand for them. 

A particularly egregious example of this was reported by the Independent this week. Members of the tiny, state-funded, prohibitionist pressure group Action on Smoking and Health have teamed up with researchers from King’s College to demand plain packaging for e-cigarettes. There is, of course, only one other product that comes in plain packaging: combustible tobacco. 

 
Do read it all. As an aside, one of the authors of the study is Deborah Arnott who memorably claimed that 'the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false'. She was campaigning for plain packaging at the time.

 

 

 

 



Tuesday, 23 September 2025

A ban on lying

A new law is going through Parliament to ban public officials from misleading the public. It sounds like a good idea, but it has the potential to spiral out of control very quickly. I've written about it for The Critic.
 

The bear trap in the Public Office (Accountability) Bill is the unprecedented creation of a new criminal offence, punishable with up to two years in prison, of “misleading the public”. Section 11 of the Bill reads as follows:

A public authority or public official commits an offence if, in their capacity

as such an authority or official—

(a) they act with the intention of misleading the public or are reckless as

to whether their act will do so, and

(b) they know, or ought to know, that their act is seriously improper.

The reason journalists prefer to use cumbersome words such as “falsehood” and “untruth” rather than the more direct “lie” is that it is inherently difficult to prove that a person has deliberately fabricated something rather than made a simple mistake. The Bill attempts to swerve this problem by making it a crime to be “reckless” about misinformation, but this is so vague as to give lawyers a ludicrous degree of latitude. If the person knows – or “ought to know”! – that their untruth is “seriously improper”, they could face jail, but what is “seriously improper”? According to the Bill, it is anything that “a reasonable person would consider … to be seriously improper”. So that clears that up. It is also anything that “caused, or contributed to causing, harm to one or more other persons”. But what is “harm”? The Bill defines it as “physical harm, psychological harm (including distress) and economic loss”. This, again, seems rather broad.

On the face of it, this appears to mean that if any of the state’s six million employees says something untrue which someone else finds upsetting, they have committed a crime. Whether they are convicted will depend on a jury believing, firstly, that the individual knew that what they were saying was untrue — or were “reckless” in not checking whether it was true — and, secondly, that they knew that it would cause “psychological harm”. 

This example might seem a bit reductio ad absurdum, but assuming the worst is not a bad way to test legislation in the current year. Section 11 takes up barely a page of the 66 page Bill and leaves so much open to subjective judgement that it is impossible to predict how it will be used, but it is not difficult to see how it could be weaponised for political reasons. The most obvious targets will be politicians themselves. In the future, when you see an MP on Question Time claiming that Liz Truss crashed the economy or that the Tories spent £37 billion on an app, instead of complaining about it on Twitter, you can call the police, citing emotional distress.

 



Friday, 19 September 2025

The lifestyle medicine of Aseem Malhotra


 
Taking a rare break from trying to free Lucy Letby, Private Eye's Phil Hammond has written a justified excoriation of the star turn at Reform UK's recent conference, Aseem Malhotra. I agree with most of it and I have said same much the same myself, but I was struck by this sentence...
 

Malhotra is particularly dangerous because he talks sense in some areas (eg. lifestyle medicine) while spouting scaremongering conspiracies with no credible evidence base.

 
When, exactly, did Malhotra ever talk sense about "lifestyle medicine" or anything else? When he said that saturated fat was good for you? When he said that exercising won't help you lose weight? When he said that Italians have a low carb diet? 
 
Perhaps Hammond is thinking about the time when he claimed that sugar was the new tobacco, but that's not really based on "credible evidence", is it? 
 
Or perhaps he's thinking about when he claimed - in a journal article that had to be corrected - that the food industry has been “buying the loyalty of bent scientists". Doesn't that sound like a scaremongering conspiracy theory?
 
Maybe he's thinking about the time he said that people who have high cholesterol live longer than people who don't, and that Big Pharma doesn't want you to know that? Again, that sounds like a bit of a scaremongering conspiracy with no credible evidence base to me.
 
You can go back as far as you want but you will not find Malhotra "talking sense" about anything. All that has happened is that he has swapped high status conspiracy theories for low status conspiracy theories. 
 
What makes Malhotra dangerous is not that he talks sense but that he abuses the trust that people have in doctors by cherry-picking evidence to suit a particular narrative. He's been doing it from the start. That is why he was able to hide in plain sight among 'public health' campaigners for so long.

 

 



Wednesday, 17 September 2025

Are problem gamblers four times more likely to attempt suicide?

As reported in the Independent... 
 

Problem gamblers four times more at risk of suicide attempt by age 24 – study

 
This is exactly how the press release that was e-mailed out yesterday was headlined although the online version has a slightly different wording...
 

Pioneering research reveals problem gambling quadruples the risk of suicide among young people four years later

 
Curiously, this claim does not appear in the study itself. Nor does the following claim from the press release...
 

Lead author Olly Bastiani, PhD researcher at the University of Bristol Translational and Applied Research Group, said: “This study tracked people from birth, meaning we could look at the long term impacts of problem gambling, and could rule out alternative explanations that hinder previous studies, such as that people might be drawn to problem gambling as a way of escaping pre-existing suicidal feelings.”

 
There is, in fact, no way for such a study to rule out other factors for an attempted suicide. 
 
So what does the study really show? It is based on 15,645 people born in the 1990s in the Avon Longitudinal Study of Parents and Children. "Tracked from birth" is an exaggeration, but it does include survey evidence about whether they had ever attempted suicide at the ages of 16, 24 and 25, and it has survey evidence showing their PGSI (problem gambling) scores at the age of 20 and 24. A PGSI score of 8 or more out of 27 is the conventional threshold for problem gambling.
 
The idea behind the study is to see whether suicide attempts are preceded by problem gambling, thereby strengthening the correlation and reducing the risk of erroneous reverse causation (i.e. that suicidal feelings lead to problem gambling). The researchers also control for other factors that could lead to suicide attempts, such as alcoholism.
 
To cut a long story short, they find associations. They find that people who are problem gamblers aged 24 are 15% more likely to have made a suicide attempt in the last twelve months at the age of 25. They also find that people who are problem gamblers aged 20 are 20% more likely to have made a suicide attempt in the last twelve months at the age of 24. The latter finding is a relative risk of 1.20 and is after controlling for other factors. 
 
Although it is not made clear in the study, the press release says that... 
 
The future suicidality link was most stark among 20-year-olds, where there was a 20% increase in suicide attempts for every increment on the PGSI meaning that those scoring eight and above experienced quadruple the rate of suicide attempts four years later. 
 
This seems to be saying that someone who scores 1 out of 27 in the PGSI test is 20% more likely to kill themselves. That sounds unlikely. To get 1 out of 27, all you have to have done is "bet more than you can really afford to lose" or "gone back to try to win back money you had lost" in the last twelve months. It is hard to see how this could drive anyone to suicide. The researchers have then multiplied 20% by something to get a figure of 400% for people who are actually problem gamblers (i.e. score 8 or more). That suggests 20% x 20, but it is unclear where the 20 comes from. 20% x 8 seems more logical, but that only produces 160%. I confess that I am rather baffled by how they came up with the claim that "problem gambling quadruples the risk of suicide".
 
None of this stuff is in the study, so we can only guess where it came from. Did the authors find an association between attempted suicide and low PGSI scores and draw a linear line upwards or did they find an association with high PGSI scores and draw a linear line backwards? One thing is for sure: there were not enough attempted suicides for them to confidently draw conclusions about people with low, moderate and high PGSI scores.
 
The study seems to be 95% maths and 5% data, and the most important data is not presented. A lot of data simply doesn't exist and had to be "imputed" (i.e. guesstimated). Of the 15,645 people born into the study, 10,528 did not answer any questions about suicide attempts. That is 67%. Of the 4,331 people who answered the suicide questions, 2,616 (60%) did not answer the gambling questions. There were only 729 people who answered all the relevant questions and only 11 of them had attempted suicide in the past year. These are very small numbers of self-selecting people to be drawing bald conclusions about.
 
Moreover, the authors chose not to control for several co-morbidities that seem relevant. They controlled for alcohol use disorders, socio-economic status and hyperactivity (all of which are strongly correlated with suicide attempts), but not illicit drug use or - surprisingly - mental health disorders. Although they give reasons for this, they acknowledge that it may be a weakness:
 
Our selection of covariates was parsimonious. Other studies with greater power should include additional covariates such as depression, anxiety and illicit drug use to investigate whether these influence the relationship between PGSI and suicidality.
 
The study itself is quite cautiously written and heavily caveated. At the end, the authors say:
 
In conclusion, the present study found evidence of positive associations between harmful gambling and current and future suicide attempts among young UK adults, which was unlikely to be confounded by pre-existing suicidality. 
 
That is a reasonable summary, as is the statement in the abstract that "this association may be more complex long-term, and increases in harmful gambling during adulthood may not be an important factor", but it is in contrast to the press release which claims the study was able to "rule out alternative explanations" (implying that all alternative explanations were ruled out, not just pre-existing suicidality). No such claim can be reasonably made. It is perfectly possible for someone who was neither a problem gambler nor suicidal at the age of 20 to have gone down a dark path by the age of 24 in which symptoms of problem gambling feature but are not terribly important. 
 
It is fairly obvious that suicidal people typically have a number of different problems in their lives. A study published a few weeks ago found that problem gamblers in a Swedish hospital had a wide range of co-morbidities and were more likely than the average person to kill themselves, but that problem gambling per se  was not a risk factor for suicide. Despite the grandiose claim that the people in the new study have been tracked since birth, the authors do not have enough knowledge about their circumstances to be able to claim a causal link between "harmful gambling" and attempted suicide and, to be fair, they do not make such a claim explicitly in the study.
 
The press release is a different beast, however. The press release seems designed to get the factoid that problem gamblers are four times more likely to attempt suicide into circulation. It also includes the red flag of a call to political action.... 
 

Dr Newall said: “Gambling is a part of the government’s suicide prevention strategy, and these results help underscore the need for additional population-wide measures to prevent gambling harms, such as meaningful restrictions on gambling advertising.”

 
The study has nothing to do with advertising or any other "population-wide measure". This is pure editorialising. 
 
Incidentally, if we want to know what effect an advertising ban would have, we can look at what the problem gambling prevalence was in the first major gambling survey in 1999 - 8 years before gambling ads were legalised. The figure was 0.6%, statistically indistinguishable from the 0.4% reported in the most recent survey of this kind. 
 
(Still more incidentally, the authors claim in the study that the "latest official Great Britain statistics have noted a significant increase in estimated prevalence rates for harmful gambling". This must be a reference to the new Gambling Commission online survey which gives a figure of 2.5%. The flaws of this survey are well understood, but even its supporters acknowledge that its figures can't be compared to figures from different surveys. The Gambling Commission has explicitly told people not to make such apples and oranges comparisons.)
 
The claim that problem gambling is a major cause of suicide is central to the argument that gambling is a "public health" issue. The aforementioned Swedish study should put an end to the zombie claim that "up to" 496 suicides are linked to gambling every year in Britain (since it was an earlier version of the Swedish study that Public Health England used to make its foolish extrapolation), but there is a palpable urge on the part of anti-gambling campaigners and 'public health' academics to quantify something that probably cannot be quantified. Now that the gambling research field is awash with cash, expect to see much more of this. 


Tuesday, 16 September 2025

RIP Graham "mad dog" MacGregor

I was sadder than you might expect to read that Graham MacGregor has died, aged 84. The Telegraph focuses on his anti-salt advocacy, but you probably know him better for setting up Action on Sugar.

We sparred on TV and radio many times and I was always happy to let him talk because he was so zealous in his campaigning and so extreme in his demands that it could only put the median voter off. He was a fanatic and he didn't try to hide it. I don't mind that. I prefer a sincere crank to a fanatic who pretends to be a moderate. You knew where you were with Graham. Most of what he said was deranged and he told some outright lies, but he was upfront about his longterm goals, such as plain packaging for chocolate and halving the amount of sugar in all foods.

He was also, I think, an eccentric, and at least eccentrics are colourful. He said something to me once that gave me the strong impression that he was right-wing, which would certainly make him an eccentric in 'public health' circles. His accent and appearance were more military than medical, but he was a proper medical doctor and, as far I can tell, he never profited personally from Action on Sugar. 

In 2014, we both appeared on 'Alan's Ding Dong', a Partridge-esque feature of the Alan Titchmarsh Show, to debate the merits of a sugar tax in front of an audience of pensioners who had been bussed in from middle England. It went to a public vote in which the audience were invited to hold up a yellow paddle if they were opposed to the idea. As you can see from the photo below, you should never get between OAPs and their sugar.

I also remember MacGregor and fellow nanny statist Susan Jebb shouting at each other at the 2015 Sugar Summit. I couldn't hear exactly what was being said but it started after Jebb accused him of using "loose words" and "factual inaccuracies" on stage.


I only had a private conversation with him a couple of times, but when we were chatting before doing the Spectator podcast in 2017, he told me with some reluctance that he had agreed with every word of an article I had recently written (unfortunately I can't remember which one). When I asked him about the departure of Aseem Malhotra from Action on Sugar, MacGregor called him "bonkers" and was just getting into his stride when he stopped himself said "Anyway, I'm not going to talk about Aseem - especially to you!"

I met him again at a small conference held by the sugar industry in a London hotel. MacGregor was only required for a panel on public health late in the afternoon but he turned up for the whole thing and ended up listening to industry folk talking about things like fertilisers, the climate and other issues that affect sugar farmers. After a dry and detailed discussion of the global sugar market from an American speaker via videolink, MacGregor raised his hand to talk about how sugar taxes and food reformulation were sweeping the world and asked how the industry was going to cope with the inevitable downturn in sales. The American looked rather baffled and said that he was not projecting any decline in sugar consumption.

His legacy was mostly malign and a lot of what he said was objectively wrong, but I could never bring myself to hate the old boy. At least he was a character. RIP.



Monday, 15 September 2025

Drink driving and the bootleggers

I've written for the Morning Advertiser about the drink-drive limit after receiving a press release from a company called AlcoSense. You'll never guess what they sell...
 

I received a press release the other day from an organisation called AlcoSense applauding the government for proposing a lower drink-drive limit. Labour will soon be consulting on whether to cut the limit from 80mg of alcohol per 100ml of blood to 50mg, bringing it in line with Scotland and the EU. AlcoSense says that this is “a welcome and overdue move”, although they would ideally like it to drop to the zero-tolerance level of just 20mg.

I had never heard of AlcoSense before. My first thought was that it must yet another neo-temperance lobby group funded by the government. In fact, it is a company that makes breathalysers. Its managing director, Hunter Abbott, says that “only” 37% of drivers are breathalysed after a collision. He thinks the figure should be 100%. He also thinks there should be more random breath testing. It is not hard to see why.  

 
Free to read. 

 



Friday, 12 September 2025

Mario Rizzo on behavioural economics

I was delighted to share a stage with Prof Mario Rizzo, co-author of Escaping Paternalism and other fine works, at the IEA earlier this year. I never got around to posting the video, but here it is. Mario is an articulate critique of behavioural economics and "nudge" policies. I also mentioned his work on the slippery slope in my introduction, in particular The Camel's Nose is in the Tent which is well worth a read.

 



Thursday, 11 September 2025

Gambling disorder does not cause suicide - study

Gambling with lies
 

Loyal readers may recall that Public Health England misused a study of Swedish hospital patients to make the claim that 409 suicides a year are linked to problem gambling. The science was so shoddy that the claim was shelved by its successor, the Office for Health Improvement and Disparities, who then used the same study and made the same mistakes to claim that "up to 496" suicides are linked to gambling. Although government agencies have been careful to use terms like "linked to" and "associated with", campaigners and journalists have been less careful with their language.

 


But, as I mentioned last year, one of the authors of the Swedish study used the same dataset for her PhD thesis and concluded that gambling disorder was not an independent risk factor for suicide among the hospital patients. It turns out that people in hospital with a range of psychiatric problems suffer from a lot of issues associated with premature mortality and that you can't use an inherently high-risk group to extrapolate across the entire population of a different country. Who knew?

Along with the co-author of the original study, she has now published a new study which comes to the same conclusion: people with gambling disorder are more likely to commit suicide but this is because of various co-morbidities, not gambling disorder.  
 

Individuals with gambling disorder had an increase in levels of mortality and suicide mortality compared to age, gender and municipality-matched controls. However, gambling disorder itself was not at the 0.05 alpha-level statistically associated with neither suicide nor general mortality when controlling for somatic and psychiatric comorbidities, gender, age and socioeconomic status. Thus individuals with gambling disorder suffer from increased mortality and suicide mortality and reasons for these appear to be multifactorial motivating careful suicide risk assessment and screening for somatic comorbidities in individuals with gambling disorder.

 
Or, to put it another way... 
 
In the regression model gambling disorder was not significantly associated with mortality, this was predicted by socioeconomic status, increasing age, low education level, somatic comorbidity, substance use disorder and previous intentional self-harm in men and for women by increasing age and somatic comorbidity. 
 
Of course, this is only one study and one cohort of people. But it is the same cohort of people that PHE and OHID used to come up with their spurious statistics (and those spurious statistics were then used to come up with equally useless claims about the cost of gambling to the health service). 
 
If you extrapolate the findings from this study, you get the result that no suicides are causally linked to problem gambling in the UK. Stick that on a t-shirt.