BBC in cahoots with Big Tobacco, suspects raving lunatic

I have always feared for Stanton Glantz's mental health, but it's only since he started blogging that I've realised that the guy is genuinely certifiable. His latest post is an absolute belter. It seems that the Welsh government is consulting on whether to allow television and film actors to smoke in the studio. This is because the BBC has opened a production centre in Cardiff—there is already an exemption for actors in England—and the corporation has kept some productions in England as a result of the über-draconian favoured by the sheep-worriers.

The exemption is ridiculously narrow. No children can be present (as ever, I urge you to think of the children) and no members of the public are allowed to watch the scene being filmed. The exemption will only apply if "the artistic integrity of the performance makes it appropriate for the performer to smoke."

The swivel-eyed professor of nowt has, of course, gone ballistic.

BBC lobbying to weaken Welsh smokefree regulations: Yes, this is real.

From Glantz's vantage point way down the rabbit hole, the BBC is a pro-smoking organisation.

...one wonders what else is going on in the shadows. After all, there is a long history of collaboration between Big Tobacco and the movie industry.

Nurse!

There is absolutely no evidence that any movie production moved from one place to another because they couldn't smoke.

But the BBC is saying exactly that, Stanton, and that definitely counts as evidence. As the consultation document states...

The exemption for performers ... would make Wales a more attractive place for programme making and would remove current costs involved with taking smoking scenes on productions being filmed in Wales to England. The smoking ban has been a major issue for a number of productions that have been filmed in Wales, especially period dramas set in a time when smoking was commonplace.

This means that you can believe one of two things. Either the Welsh Assembly and the BBC are lying because they're engaged in some kind of pro-tobacco industry plot to undermine the smoking ban, or they are telling the truth and the smoking ban is deterring the Beeb from filming more shows in Wales. If you look at the output of both the BBC and the Welsh Assembly in recent years, I think it's pretty clear that if they are are engaged in a pro-smoking conspiracy, it has been phenomenally well-camouflaged.

Glantz continues to rant on about his theories in his usual illiterate style...

Are we really to believe that the BBC has ignore [sic] the fact that it just opened a major new production center in Cardiff, Wales to take advantage of lower labor costs that exist in London just so they can favor actors [sic] generate secondhand smoke? I think not.

A prize to anyone who can explain what the hell he's babbling about.

It gets better...

Moreover, there would be nothing to stop BBC [sic] from having an actor wave around an unlit cigarette, cigar or pipe, then put the smoke in with CGI.

Yes, that's a much simpler solution, Stan, you old fruitcake.

The only beneficiary of this change would be the tobacco industry.

That's not quite true, is it now? If the BBC is lobbying for this unutterably trivial amendment, it would strongly suggest that they stand to benefit from it—by, for example, not having to spend hours pissing around with CGI. Companies don't generally lobby for policies that won't benefit them, y'see. The tobacco industry, on the other hand, is not lobbying for it and stands to gain—at best—the sale of a couple of packs of cigarettes to be smoked in some god awful period drama.

If the BBC wants to lobby to get smoking laws changed, they should be lobbying the government in London to remove the exemption that allows actors and other film makers to be poisoned by secondhand smoke at BBC studios in London.

Yes, yes. But as I've just explained, they're not going to do that because (a) they would not benefit from it; au contraire, they would be damaged by it, and (b) if they wanted to stop actors being, ahem, "poisoned by secondhand smoke at BBC studios", they would do so voluntarily. I know, Stan, that you struggle to comprehend the difference between public and private action, but not everything in life needs to be dealt with through repressive legislation.

I do hope someone at the BBC comes across Stan's blog. It might give them an idea of the type of crack-pots they've been giving such credulous coverage to all these years.

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Somebody's lying

They say you're entitled to your own opinions, but not your own facts.

Wise words, but that's not how it works in tobacco control. Spot the difference between these two BBC news stories taken three months apart.

25 March 2011

Scotland's smoking ban hailed as anniversary approaches

Sally Haw, senior scientific adviser for the Scottish Collaboration for Public Health and Policy, said: "The ban really has been one of Scotland's big public health success stories.

"This bold step has really paid off."

Ms Haw cited a study by Glasgow University which showed a 15% reduction in the number of children with asthma being admitted to hospital in the three years after the ban came into force.

27 June 2011

Scottish health boards 'complacent' over asthma care

Research into the care of young people with asthma has exposed "shocking" complacency by some Scottish health boards, according to charity Asthma UK.

Asthma UK said the number of emergency admissions had remained unchanged for a decade - suggesting the asthma of many young people was still being badly managed.

Asthma UK Scotland's national director Gordon Brown said: "This report makes shocking reading - especially when you consider Scotland has one of the highest rates of childhood asthma in the world.

"Some health boards are doing some things very well - and this is down to the excellent staff within managed clinical networks.

"However, it seems that at a strategic level some complacency has crept in - that asthma has somehow been 'fixed' and priorities have now changed.

"This is borne out by the fact there has been no noticeable change in the unacceptably high emergency hospital admissions for children and young people with asthma in the last decade."

It is impossible for both these statements to be true. Either emergency hospital admissions for children with asthma fell by 15% after the smoking ban or they have remained unchanged for a decade. Someone's not telling the truth. Is is the "study by Glasgow University" or Asthma UK?

You can probably guess the answer. If I told you that the Glasgow study was penned by the infamous Jill Pell, you would be in no doubt at all.

Readers with a long memory will recall that Pell's study was the sheerest junk science. There was no effect from the smoking ban on asthma admissions. In fact, the first year of the Scottish smoking ban saw the largest number of childhood asthma admissions of the decade. Asthma UK is correct. Pell is wrong. Again.

Here we have two 'facts' which are totally at odds with each other appearing on the same news website in the same year. One fact is the number of children who actually went to hospital with asthma. The other is a piece of statistical jiggery-pokery created for political ends. And yet only one of them is true. The other is a fraud which has taken the place of the truth thanks to repetition and the appeal to authority (it was published in the prestigious, peer-reviewed New England Journal of Medicine). The real truth, meanwhile, appears almost by accident in a different context and no one at the BBC makes the connection.

This is the parallel universe created by the charlatans of the anti-smoking industry. They are entitled to their own facts. Whether or not they are true is of no consequence. They want them to be true and that is all that matters.

It is ridiculously easy to see through this garbage. The real hospital admissions data for asthma are available online, just as the heart attack data are. It takes a matter of minutes to distinguish fact from fiction and yet there is only silence and tumbleweed. If the mainstream media do not feel inclined to expose blatant policy-based evidence when it is in its crudest form, what hope is there of more subtle scientific abuses coming to light?

[Thanks to Ivan for spotting the two stories above.]

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The BBC's drink problem

Yet more pitiful health reporting from the nation's state broadcaster:

Children aged four in Wales' A & Es for drink and drugs

Children as young as four have been treated in accident and emergency departments in Wales for the effects of alcohol, research shows.

What research would that be?

Figures obtained by BBC Wales suggest at least 1,200 children attend casualty each year because of drink and drugs.

As you will gather, this is not just some rewritten press release from the British Medical Association (BMA). Instead, the Beeb has decided to do some low-grade investigative journalism of its own.

Naturally, however, the BMA takes centre stage:

Dr Richard Lewis, Welsh secretary of the British Medical Association, said the issue was "increasingly worrying".

"I think it's pretty well recognised by health services and health professionals that there's an increasing problem with both alcohol and drug-related incidents with younger and younger people," said Dr Lewis.

"We see year-on-year increases with attendances at A & E departments, particularly for alcohol."

And that is where the BBC's figures come in, which they present in the chart below.

As you can see, alcohol-related hospital admissions for the 12-17 age group have increased from 605 to 833 in five years, thus giving partial support to the claim that...

Clive Wolfendale, chief executive of north Wales drug and alcohol agency Cais, said the problem of children regularly drinking to such extremes had taken off around five years ago.

But, as anyone with the slightest facility for critical thinking can see, there hasn't been a rise in admissions in the last five years. The only reason it looks like there has, is that the BBC wasn't able to get hold of the figures for Cardiff and Vale—which typically make up a quarter of the total—for 2006 and 2007. The national totals the BBC gives for those years cannot, therefore, be compared with the later years. No responsible statistician would think of comparing, or even showing, these totals, but this is the BBC and it's amateur night again.

For the three years which are comparable, there has been no significant change in admissions (818, 809 and 833), and in the four areas which do have full data, three of them saw a fall in admissions. And for the '11 and under' age group (shown on the Beeb's website), the numbers are very small but have not risen (14, 5, 10, 12 and 12 per annum). Oh, and the number of admissions for drugs has fallen.

What, then, is left of the idea that we are seeing "year-on-year increases with attendances at A & E departments" for "younger and younger people"? Nothing at all, and the BBC has the figures to prove it, if it was so inclined.

But it isn't inclined. Instead, it allows various temperance campaigners to make unfounded and unchallenged assertions. Like this, from the anti-alcohol 'charity' Cais (which receives 99.8% of its income from the government):

"Where kids go first for what might be described as a high is drink, rather than cannabis or opiates or ecstasy or legal highs. The substance of choice is alcohol," he said.

"The reasons for that are two-fold. First of all it's the cheapness and availability because, in real terms, it's cheaper that [sic] it's ever been."

[sigh]

Okay, one more time for the world. Alcohol is not cheaper in real terms than it has ever been. Alcohol is more expensive in real terms than it has ever been.

From the Office of National Statistics:

Between 1980 and 2008, the price of alcohol increased by 283.3%. After considering inflation (at 21.3%), alcohol prices increased by 19.3% over the period.

And this is how the price of a pint of bitter changed in the last century:

I wouldn't expect temperance groups to admit to the fact that alcohol has never been pricier, but I would have hoped that the BBC would know this by now—God knows, they write enough stories about alcohol. If they had interviewed someone from the other side of the debate, they would have been told this. But, in defiance of the most basic standards of journalism, they didn't bother to solicit opposing views, nor did they bother with simple fact-checking.

"The second reason [for alcohol's popularity] is the general thrust of marketing," he added.

"The drink companies are on social networking sites and there's still a lot of direct advertising going on through sports sponsorship and so on."

How seamlessly we move from Friday's scare du jour to Monday's nonsense. As I mentioned in the previous post, Alcohol Concern's moral panic about online drinks marketing is silly season stuff. Alcohol marketing has never been more strictly regulated. If you are going to claim that underage drinking is on the rise (which it isn't), you need also to show that alcohol marketing is on the rise (which it isn't), otherwise you do not even have correlation, let alone causation. The only reason this fake charity is harping on about price and advertising is that the temperance movement's current political objectives are to increase prices and ban advertising.

This is reprehensible reporting from the BBC once again. Having gone to the trouble of getting the hospital statistics for Wales, their reporter—Kevin Leonard—sees that alcohol-related admissions for young people have been static or falling, but nevertheless decides to report that admissions are rising (albeit through quotes from interested parties). None of the quotes are challenged and no opposing views are allowed to be aired.

This kind of propaganda is now so common at the BBC that it is becoming difficult to believe that there is not an agenda at work. Whilst the BBC is not (quite) the worst offender when it comes to bad reporting of health issues, its coverage of alcohol issues is consistently biased and, unlike the Daily Mail, it cannot make the excuse that it needs to resort to sensationalism to attract customers.

This rubbish virtually fisks itself, but the facts are now peripheral. A narrative has been set in place that cheap alcohol and rampant drinks advertising has led to an epidemic of drinking, and the truth is not going to get in the way. We have unprecedentedly high prices, less drinks advertising than ever and a ten-year decline in drinking rates, but none of it matters. The temperance movement has stuck to their line and the BBC is right behind them come hell or high water.


UPDATE: Dick Puddlecote has spotted a cracking quote from the author of this tripe, Kevin Leonard, extolling the benefits of the NCTJ journalism course that turned him from geography graduate to BBC reporter.

“Whatever job you end up doing - I work on the BBC News website in Cardiff - you'll never regret getting those key journalism skills hammered home on an NCTJ course.”

He should demand a refund.

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The BBC stands by its junk journalism

Seven days after sending an e-mail to the BBC about its story which falsely claimed that obesity, drinking and smoking are the three biggest risk factors for breast cancer, I received a short and anonymous reply.

The original BBC story stated:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

This is arrant nonsense for several reasons, as I said in my e-mail to the Beeb (see here for the details). In summary, there is not a scientist in the galaxy who believes that obesity and drinking are the main "drivers" of breast cancer and only a handful of certifiable anti-smoking maniacs like Stanton Glantz believe that smoking is a risk factor for breast cancer AT ALL.

The BBC's reply:

Dear Chris

Many thanks for getting in touch and raising your concerns.

You are correct that it is important to stress that the findings mean that obesity affects the levels of sex hormones. The article does this. We were mindful of this and discussed this point and the wording with cancer research uk before publication of the article. We explain that it applies only to hormone sensitive breast cancer in postmenopausal women and that the link suggests obesity drives up hormone levels.

Thanks again for contacting us. We value your feedback.

Kind regards

Since this ignores every point I raised in my earlier e-mail, I replied:

Sir/Madam,

I don't take issue with the bulk of the story in question, which reflects the study accurately in some respects. The main problem is the headline and the first two paragraphs, ie:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

Every word of this is demonstrably untrue. It is not a matter of interpretation or wording. Obesity is NOT the biggest driver of breast cancer - as with all cancers, age is the biggest driving force. Between the age of 29 and 69, a woman's odds of developing breast cancer increases from 1 in 2000 to 1 in 13. As Cancer Research UK's website says: "The strongest risk factor for breast cancer (after gender) is age"

After that, there is reproductive history. Childless women have twice the risk as women with large families (who breast-fed).

Family history of the disease also doubled the risk.

These are the true driving forces of breast cancer. Way down the list is overweight and obesity, with a 10-30% increase in breast cancer risk. Again, from CRUK: "Compared to lean (BMI 22.5-24.9) women, overweight post-menopausal women have a 10-20% increased risk of breast cancer, and obese post-menopausal women a 30% increase in risk."

Alcohol is also a risk factor, varying on consumption, but generally is considered to form a 10-50% increase in risk. (eg. http://aje.oxfordjournals.org/content/165/6/667).

Smoking is not generally considered a risk for breast cancer AT ALL, despite efforts by the BBC and the Daily Mail to tell the public otherwise. To claim that it is the third biggest driver of the disease is ignorant and inexcusable.

Sex hormones are undoubtedly a risk factor, and a major one. The study you reported on shows that obesity is a risk factor for higher sex hormones and that drinking and smoking may be "moderate" risk factors for higher sex hormones. The crucial points - which I hoped I explained in the previous e-mail, but perhaps not - is that (a) the authors of the study NEVER claimed that obesity, drinking and smoking are the main risk factors for higher sex hormones, let alone breast cancer, and (b) even if these 3 factors were the main risk factors for higher sex hormones, it does not follow that they are the main risk factors - or the 'leading drivers' - for breast cancer itself. Indeed, we know with as much certainty as is possible to have in science that they are NOT.

Your article did not "stress" that obesity affects sex hormones. On the contrary, it stressed, quite wrongly, in the headline and opening sentences that obesity is "the biggest driving force behind the most common form of breast cancer in older women". This is untrue. It then stressed that drinking and smoking were the next biggest drivers of breast cancer. This is untrue. You say that: "This latest work, published in the British Journal of Cancer, suggests obesity should go at the top of this list [of risk factors for breast cancer]". This is untrue. The author of the study said, in the press release you were doubtless sent:

“Our study shows that changes in hormone levels might explain the association of established risk factors such as obesity with breast cancer risk. Other studies have found that weight and alcohol can affect hormone levels and this research confirms and adds to these findings and provides more information about how breast cancer develops.”

Nothing in the CRUK press release or the study itself in any way supports the premise of your article. Are you prepared to stand by your claim that obesity, drinking and smoking are the "biggest driving forces" for breast cancer? If not, the article should be changed. It is too late to avoid misleading the bulk of its readers, but it would at least be an acknowledgement that the BBC knows when it has made a mistake.

Regards,

Chris Snowdon

Their reply...

Thank you for your comments, which have been noted.

BBC News website

Translation: 'Piss off and leave us to report Cancer Research UK press releases in anyway we see fit.' Needless to say, the article in question remains unchanged, so any woman who has recently been diagnosed with breast cancer can read it and blame herself for the disease.

I should say that my interest in pursuing this—as I will continue to do—is not because it is the worst example of BBC reporting I have ever seen. Far from it. It is because it is an open and shut case. Their reporting of this particular story is wrong in essence and in fact. To publish such garbage in the first place is lamentable, if forgivable, but to stand by it is appalling.

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More awful reporting from the BBC about breast cancer

Michelle Roberts of the BBC has produced a wholly misleading report about a study of sex hormones and breast cancer risk based on a press release from Cancer Research UK. It's a 38% cut and 45% paste job according to churnalism.com. It's a shame it's not 100% cut 'n' pasted because although CRUK rather glorified the study, their press release was at least factually accurate.

The Beeb's version is this:

Obesity 'leading driver' of breast cancer

Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers.

Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK.

This follows the well-worn path of blaming food, alcohol and tobacco for every disease known to man, which is presumably why the Beeb reported it. But this conclusion is in no way borne out by the study itself or even Cancer Research UK's press release. Obesity and drinking are moderate risk factors for breast cancer and the balance of evidence suggests that smoking is not a risk factor for breast cancer at all.

The best advice that could be given to women to avoid breast cancer is to have children early in life and have lots of them. This, however, doesn't fit into the sin = death narrative of our times and so the usual lifestyle factors must be trotted out.

If you look at CRUK's list of risk factors for breast cancer, you will see that obesity and alcohol feature a long way down and that the charity concedes that the weight of evidence, including an IARC monograph, shows that smoking is not a factor.

How then, does the BBC conclude that obesity is the number one 'driving force' for breast cancer, closely followed by alcohol and smoking? The answer is that, once again—and in common with the Daily Mail—Beeb reporters simply can't read a scientific study properly.

The paper in question looked at risk factors for high concentrations of sex hormones in postmenopausal women which, in turn, is one risk factor—though not the main one—for breast cancer. They found a reasonably strong correlation with weight and rather more modest correlations with drinking and smoking. The researchers don't claim that these factors are the main cause of sex hormone concentrations, let alone of breast cancer itself. The researchers also note that most studies have found no link between smoking and breast cancer.

In other words, the BBC has completely misinterpreted the study. It's not the worst health reporting I've ever seen, it's just routine incompetence that will mislead many thousands of women.

I wrote to the BBC earlier today about this, but as I entertain no hope of receiving a reply, I'll reprint what I said here:

Dear Michelle,

Your report today about sex hormone concentrations fundamentally misrepresents the study in question. It begins:

"Obesity is the biggest driving force behind the most common form of breast cancer in older women, say researchers. Alcohol and then cigarettes are the next largest culprits, according to Cancer Research UK."

This is not what the study says at all, nor is it what the Cancer Research UK press release says:

"Weight is the biggest factor affecting the level of sex hormones that increase breast cancer risk in post menopausal women, according to new research published in the British Journal of Cancer today (Wednesday)."

There is a crucial difference between these two statements. Sex hormone concentrations are one risk factor, though not the main one, for breast cancer. The study in question looks at three possible risk factors for higher sex hormone concentrations and finds a reasonably strong relationship with weight and more modest relationships with alcohol and smoking. The study does not say that these three factors are the main contributors to sex hormone concentrations and it certainly does not say that they are the three main risk factors for (or 'driving forces' of) breast cancer itself.

The main risk factors for breast cancer, as stated on Cancer Research UK's website, are age and reproductive history. There are moderate associations with obesity and alcohol, but the weight of evidence shows that smoking is not a risk factor at all. In reference to smoking, CRUK states: "In 2004, the International Agency for Research on Cancer concluded on the basis of the existing evidence that smoking and secondhand smoke do not cause breast cancer". This is also stated in the study you reported on today:

"Most epidemiological studies have suggested that smoking has little or no effect on breast cancer risk (Collaborative Group on Hormonal Factors in Breast Cancer, 2002; International Agency for Research on Cancer, 2004)" (p. 11)

Both sources mention that a minority of studies have found a link between smoking and breast cancer in certain instances and that - as ever - more research is needed, but as the evidence stands, there is not a convincing link.

Any lay person reading your report cannot fail to conclude that obesity is the main driver of breast cancer, closely followed by drinking and smoking. This is untrue and should be corrected.

All the best,

Chris Snowdon

And, while we're at it, here's the unanswered e-mail I sent to the BBC last time Michelle Roberts misled women about breast cancer risks ('Passive smoking 'raises breast cancer risk'- 02.03.11)

Sir/Madam,

The story that appeared on the health section of your website today titled "Passive smoking 'raises breast cancer risk'" is inaccurate and misleading. Your use of quotation marks seeks to distance yourself from the claim that passive smoking raises breast cancer risk but the authors of the study you reference make no such claim either.

Even a cursory reading of the study reveals that the researchers say that "extensive exposure to passive smoking *may* increase breast cancer risk." They add that "the association with passive smoking should be considered suggestive only." Your headline does not reflect these doubts, nor does your report mention that the results found were statistically insignificant. You also focus on the highest relative risk (32%) when the overall relative risk was just 8%. You compound this by prefacing it with the words 'for example', thereby implying this was a typical finding rather than the most extreme scenario. Using the same study I could equally say that 'for example' women who are exposed to passive smoke in the home are 11% *less* likely to get breast cancer.

Finally, you claim that this study is the largest yet undertaken. This is untrue. Several studies have been larger including Peto et al (see below).

Before scaring and misleading your readers, you should make it clear that decades of research have shown that neither smoking nor passive smoking increases the risk of breast cancer. A 2002 review in the British Journal of Cancer, for example, looked at 53 studies and concluded that "smoking has little or no independent effect on the risk of developing breast cancer." An extensive review by Richard Peto in 2008 concluded: "incidence of breast cancer is similar in women who did and did not report passive exposure to tobacco smoke either as a child or as an adult."

There is no reason to report today's highly equivocal study as proof when you have not, to my knowledge, reported any of the dozens - possibly hundreds - of studies showing no effect.

Lax reporting of health stories seem to be endemic at the BBC of late. I appreciate the press releases you receive may sensationalise the findings in epidemiological studies, but it is time the BBC realised that medical journals are magazines like any other and rely on news coverage to maintain their profile, readership and advertising income. Press releases from these journals should be treated with the same caution as would press releases from any other business. If there is no one at the BBC who can (a) understand statistics and (b) make themselves familiar with the scientific literature, then you should either find someone who can or stop reporting these stories entirely.

Where do they find these bloody people?

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A sincere apology to drinkers from the BBC

From the BBC:

In recent years, along with all other media, we at the BBC may have implied that an unstoppable tide of rising alcohol consumption posed a threat to the very fabric of British society. Headlines such as Rising alcohol addiction costs 'could cripple the NHS', Alcohol abuse 'becoming epidemic and Alcohol abuse 'epidemic' warning may have given some readers the impression that there was there was some sort of epidemic of alcohol use.

It is also possible that news stories such as 'Licensing Act to cause mayhem' '24 hour drinking - are you mad?' and 'Please Gordon, reverse this crazy law' may have given some licence-fee payers the impression that the country was going to hell in a handcart thanks to round-the-clock bingeing.

Having finally got round to checking the facts, we now recognise that heavy drinking is falling, abstinence is rising, and young people are leading the drive towards healthier drinking. Contrary to what you may have heard every day for several years, alcohol consumption has been falling since 2002, with drinking by young men falling most dramatically—from 26 units a week in 1999 to 15 units in 2009. Even changing the way consumption is measured can't disguise the fact that drinking has been on the decline for a decade.

Furthermore, what we have been laughably referring to as '24 hour drinking' has resulted in the average pub opening for an extra 24 minutes a day, hardly enough time to have a swift half. We also recognise that 'binge-drinking' is a scare-mongering and virtually meaningless phrase popularised by the tabloid media and is unworthy of the world's most respected news organisation.

We would like to distance ourselves from everything we have ever said and point out that we did not write any of these stories ourselves. They came from press releases from seemingly disinterested and trustworthy parties such as Alcohol Concern and the Alliance House Foundation. At the time, we had no idea that an organisation that used to be called the UK Alliance for the Suppression of the Traffic in all Intoxicating Liquors could have any prohibitionist leanings.

We now acknowledge that these temperance types will say and do anything to further their goals. Why, only yesterday we presented wild guesstimates from Alcohol Concern about the supposedly escalating costs of treating drinkers as a legitimate news story. We now see that the only reason for this story's existence was to encourage more funding for Don Shenker and his colleagues. The person responsible for this has been dismissed and from now on we will only be asking representatives from the Portman Group to comments on our news stories.

Henceforth, instead of illustrating all drink-related articles with this picture of a fat lager-guzzling wreck...

...we will be using this:

We sincerely apologise for any confusion caused in the past and will work hard to regain your trust. Cheers!

Slightly adapted from this.

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The ban and the Beeb

A very busy day of smoking ban-related items at the BBC yesterday, evidently inspired by the Dutch rolling back its smoking ban. Belinda has the run-down and sound clips at F2C Scotland.

Nicky Campbell had a spirit-sapping phone-in on Radio 5 (all phone-ins are spirit-sapping). The usual suspects called up: people who gave up smoking and think everyone else should too, people who believe that bar-workers have no choice but to work in pubs, people asking why we don't ban drinking as well, etc. etc.

Points of interest included Rosemary Gillespie from the Roy Castle Lung Cancer Foundation twice refusing to answer the question of whether Roy Castle smoked. Since the whole organisation is built on the idea that he got lung cancer despite not smoking, this is hardly a intrusive line of enquiry and her silence does make me wonder.

And a call from a gentleman who is happy that he can now enjoy a smokefree pint of real ale (CAMRA member?) crystallised the inherent snobbery and contemptuousness of the whole public health movement:

"Can I just say, quite a lot of the pubs that have closed down, to be honest I'm quite grateful they have. I think they were the most awful places which were actually just big smoking dens and had the most dubious clientele in them and they were just asking to be closed down."

I also find it very hypocritical for Cecilia Farren to talk (on Radio 4) about the "vested interests of the tobacco industry" when she is the director of GASP (UK). Aside from the fact that the tobacco industry had no hand in the grass-roots Dutch campaign, GASP is not just any ordinary anti-smoking group. It's not a volunteers' group, of course—hardly any of them are—but it is more explicitly commercial than most. It is a limited company that sells no-smoking paraphernalia and is therefore dependent on smoking bans for much of its business. Aren't conflicts of interests like that worth mentioning?

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Overkill

The big news today is that secondhand smoke causes 600,000 deaths a year worldwide. Anyone tempted to take this figure remotely seriously should bear in mind that the authors of the associated study also believe that "smoke-free laws banning smoking in indoor workplaces rapidly reduce numbers of acute coronary events" and "fully smoke-free policies have a net positive effect on businesses." And, interestingly in the light of the Moral Maze the other night, they consider the main aim of smoking bans to be denormalisation:

Above all, [smoke-free] policies contribute decisively to denormalise smoking, and help with the approval and implementation of other policies that reduce tobacco demand, such as increased tobacco taxes and a comprehensive ban of tobacco advertising, promotion, and sponsorship.

Still, you can't fault their impeccable methodology:

To identify national data for second-hand smoke, the keywords “second hand smoke”, “environmental tobacco smoke”, and “passive smoking” were combined with names of countries or regions, by searching Google and the PubMed database

The spirit of Newton and Darwin lives on, does it not?

What can be said of the 600,000 estimate? Obviously if you extrapolate a relative risk over a larger population, you will get a larger number. That doesn't make the study or studies you are extrapolating from any better, but I won't risk waking this blog's resident troll by going into all that again.

It's interesting that this study appeared in the Lancet because back in the 1990s, Lancet columnist Petr Skrabanek* remarked on the tendency of public health campaigners to use larger and larger populations to get scarier and scarier death counts. He called them "jumbo-jet numbers" because talking about the equivalent number of jumbo-jets that would have to crash for the same death toll sounds more dramatic than explaining that you have to die of something and that most of the people being "killed" were very old. This, from a collection his articles [PDF]:

The intoxication with numbers is another characteristic of the modern crusaders against smoking. They typically use big population blocks as denominators to obtain bigger and bigger numbers. Richard Peto, a leading anti-smoking exponent and a statistician, announced that 'of all children alive today in China under the age of 20 years, 50 million will eventually be killed by tobacco.' This would put the hecatombs of the Second World War in the shade. The British Medical Journal referring to another such statistic, 'typical of the Oxford epidemiologist Richard Peto', quoted that 'about 20 million children now living in Europe will be killed by tobacco in their middle age.' And The Times reported on January 1, 1988, that according to Mrs Risk-factor Epidemiology: Science or Non-science?

Edwina Currie, 'more than a million schoolchildren and 60,000 babies born this year will die of smoking-related diseases such as lung cancer.' Surprisingly, no-one has yet used the population of the whole world as a denominator: this would produce numbers of babies, toddlers, schoolchildren, and other children, killed by tobacco in truly phenomenal ranges. Perhaps the reason for this reticence is the fear of overkill.

Well, now they have. In fact, they've missed a trick by not using the other PR tool of multiplying by years (eg. here). So, to save someone the trouble, here's my study:

'A quantitative, longitudinal assessment of worldwide mortality from environmental tobacco smoke'

Christopher J. Snowdon

Methodology: Google and PubMed of course. I'm a professional.

Results: 600,000 x 10 = 6,000,000

Conclusion: Secondhand smoke will kill 6 million people over the next ten years. Where's my cheque?

[*nb. Petr Skrabanek was a skeptic about—amongst many other things—secondhand smoke. You can probably guess what the anti-smokers' response was. That's right, they accused him of working for the tobacco industry. Which was a lie. He died of a non-smoking related disease in 1994.]

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Final thoughts on Nudge

The subject of Wednesday's Moral Maze was Nudge by Thaler and Sunstein. They argue (compellingly) that it would be nice if we could set society up so the things that 99% of people want to do were the default setting, but if you don't want to do them, it would be a piece of cake to opt out. For example, companies in the US (the authors are from America—this is important) might offer free health insurance but you have to opt in to claim it. Thaler and Sunstein suggest changing things round so you're automatically given the insurance but can opt out if you want.

Who could complain? Pretty much nobody, right? And who could complain at the idea of having sunbeds switch themselves off after 10 minutes in case you fall asleep under them, or driving license renewal forms that ask you if you would like to give your organs to someone who needs them should you perish prematurely?

I consider myself to be basically a libertarian and I can't muster up any arguments against these things, and this really is as far as Nudge (the book) goes. The authors spend several page fretting over whether governments have the right to force motorcyclists to wear crash helmets, for God's sake. These people would be considered virtually anarchists in Britain.

All this seems to have passed a lot of people by. It nearly passed me by. As I mentioned in my review of it in August, the very fact that 'nudging' has been adopted by the likes of Julian Le Grand was sufficient to put me off it for several years. I'm very pleased I finally relented since it's a good addition to the library of behavioural economics. It's also 95% libertarian and only 5% paternalism.

Whilst I would never be so indelicate as to suggest that not everybody involved with the Moral Maze on Wednesday night had read the book, the whole format did rather hinge on its co-author Richard Thaler being an authoritarian wolf in libertarian sheep's clothing.

This was apparent from the choice of guests. With the panel broadly splitting in half, with Portillo and Phillips roughly in the libertarian camp (yes, very roughly - don't write in) and Taylor and Longley roughly in the paternalism camp. Since Delingpole and I are fairly obviously with the libs, and the lady from the Roy Castle Foundation with the paternalists, to even up the numbers the other witness would have to be a paternalist.

The trouble was that the other guest was Thaler himself and—as very quickly became apparent—he is anything but. Accused of trying to change people's goals, he said:

"I don't think we could have possibly been any more clear that that's completely wrong." 

Lest that still not be clear enough, the sublimely incredulous Thaler responded to further insinuations of social engineering by saying:

"Absolutely not. There is nothing that could be wronger than that." 

Listening in the green room, I said to James Delingpole that I didn't think they were quite going to get the argument they wanted out of this discussion. (Towards the end of the show, Michael Portillo drily noted that Thaler "didn't stand for some of the things we thought he stood for.") Thaler went on to strongly deny wanting presumed consent for organ donation, and when asked about plain-packaging, explained once more that he didn't approve of bans at all.

There may be tea-partying parts of America where this sort of talk is considered paternalistic, but then Americans take their liberties a bit more seriously than we do. By the standards of British politics, let alone European politics, Thaler would be classed a loony libertarian. Nevertheless, the format of the show assumed that Delingpole and I would violently disagree with him and his supposedly authoritarian-by-the-back-door ways. This we could not do. Delingpole praised Thaler's sensible book and lamented the way it had been perverted by politicians. He also quite rightly picked Matthew Taylor up on his elitist assumption that the world is divided up into "sophisticated and intelligent" people who are capable of making informed decisions and a lumpen mass of imbeciles who are constantly manipulated by malign institutions for profit.

When it was my turn to be interrogated, Longley wondered with exasperation why I was so opposed to Nudge. I wasn't, I said, although by this time I was tempted to add "... but I can pretend to be if it would help things." Some readers of this blog noticed that I was interrupted quite a bit by Longley and Taylor (the latter chaired The Spirit Level debate at the RSA), something which is more apparent to me listening back than it was at the time. I can't say that I thought the questioning was any more aggressive than in the average Moral Maze. The whole point is to have a bit of an argument and for all three of us, this was more than a rhetorical contest.

Longley believed that the government had decided that smoking was abnormal and anti-social and was going to do something about it. Essentially, he espoused absolute democracy, in which once a government had been elected, it had a mandate to do whatever it wants. Obviously I disagree, since I believe in liberal democracy, which accepts that since democracy is imperfect, elected governments should work within limits (eg. unwritten limits in Britain, written limits in the USA). In any case, using the absolute democracy argument is particularly weak when talking about contemporary Britain where you have a government nobody voted for, made up of two parties which promised less regulation and the overturn of the tobacco display ban.

Anyway, you don't need me to explain what was said as you can listen here, but I hope that the message came over on Wednesday night that Nudge does not in any way justify the kind of lifestyle policies that all the main British political parties have been going along with in recent decades. The Nudge philosophy is totally at odds with every public health initiative that goes beyond giving accurate advice and information to people who want it.

'Nudging' is not a cute name for 'do what we say'. As Thaler and Sunstein consistently stress, any nudging must have a cost to liberty that is close to zero and a financial cost that is close to zero. In other words, goodbye smoking ban, farewell minimum pricing and adios fat tax.

If the coalition is serious about cutting regulation, adopting Nudge would be a sound textbook to work from. But as we have already seen from plain-packaging and the farce of the YourFreedom website, they have no intention whatsoever of doing that. So, if anyone in politics ever gets round to actually reading the bloody book, it much more likely to be farewell Nudge.

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Hire me

Thanks to all who listened to and commented on last night's show, which can be listened to here for 7 days. I'll have some final thoughts on libertarian paternalism later today but first I have a broken boiler to attend to.

As a quick aside, however, I see the BBC has described me on its website as:

Chris Snowdon: Smoker and author of 'Velvet Glove Iron Fist; A History of Anti-Smoking'

Does this suggest that smoking is now so rare and exotic that it's worth calling attention to? (There are only 1.2 billion of us after all.)

Or is smoking now classed as an occupation? If so, I'd just like to say that I'm available for work, I have my own lighter and I'm prepared to travel.

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Nudge and the Moral Maze

Tomorrow evening I'll be appearing on BBC Radio 4's Moral Maze programme which will be discussing 'libertarian paternalism' and the so-called 'Nudge agenda'. Details are here:

How far should we go to stop people doing something that's bad for them?

We know cigarettes are very likely to cause you serious illness and could even kill you. The tricky thing is many people find them extremely enjoyable and they're perfectly legal. The government, frustrated that some people still persist in choosing to exercise their right to pursue a perfectly legal activity, despite decades of health education, bans on advertising and smoking in public places, are looking at forcing tobacco manufacturers to sell cigarettes in plain packaging.

The problem is that all those people exercising their freedom to smoke are then clogging up the NHS demanding that the rest of us pay for the treatment of their self inflicted illnesses. It's a question not just for smokers. How do you feel about a fat tax, or a minimum price for alcohol?

Tax is a bit of a blunt instrument and unpopular with voters, so it's not surprising that politicians have latched on to "nudge economics". Behind the doors of Number 10 there's a unit called The Behavioural Insight Team that talks about finding intelligent ways to encourage people to make better choices for themselves.

Is this an example of paternalist libertarianism - preserving people's freedoms while at the same time minimising their impact on the wider society? Or a worrying Orwellian development where politicians have given up trying to win the political argument and have instead just resorted to employing teams of psychologists and marketing executives to manipulate our behaviour?

If we're too stupid for our own good, why should we worry if politics becomes the equivalent of potty training? How far should we go to stop people doing something that's bad for them?

Expect plain packaging, smoking bans, temperance crusaders and other frequent offenders from this blog to get a mention.

I discussed libertarian paternalism in Chapter 14 of Velvet Glove, Iron Fist and also in the review of Nudge I wrote back in August. From the latter:

If politicians stuck to both the spirit and the letter of Thaler and Sunstein's philosophy, the nudge agenda would be largely benign and almost certainly beneficial. Far from supporting the kind of policies being pursued by the UK Faculty of Health, any British government that was genuinely committed to the Nudge agenda would have no choice but to repeal whole swaths of legislation that already cross the line between libertarianism and paternalism.

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That's one way of putting it

One for Biased BBC?

Life expectancy for everyone in England improved under Labour, and now stands at almost 78 years for men and 82 years for women.

That's one way of putting it. Another way of putting it would be to say that life expectancy has improved for, ooh, let's see, the last hundred years.

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The real history of binge-drinking

The BBC has struggled to find a way of promoting the temperance movement today, so it has resorted to a little quiz...

It's not actually a quiz about 'binge-drinking history'. It's a quiz about alcohol control with such leading questions as this:

If you want to swot up on the history of binge-drinking, I thoroughly recommend Virginia Berridge's article  'The normalisation of binge drinking? An historical and cross cultural investigation with implications for action' (available as a PDF). But if you can't be bothered, here's the first line which tells you gives you the gist:

Binge drinking is nothing new in British society and has not always attracted disapproval.

Binge drinking is, of course, what we used to call simply 'drinking'. Berridge shows how the use of the more scary-sounding 'binge-drinking' has spread in a short period of time, first by the media:

And then by politicians:

The time-lag between the term being used by The Times and it being used in Parliament indicates that the moral panic over binge-drinking is largely an invention of the media. In his article 'Binge drinking and moral panics: historical parallels?', Peter Borsay compares today's feeding frenzy with that of the early-18th century 'Gin Crisis', and concludes:

Both are driven by pressure groups and an expanding media industry, focus primarily on the role of women, are urban based, and are underpinned by public perceptions of government complacency and an element of xenophobia.

Both could be categorized as a form of 'moral panic', that is, an event constructed in the media that draws its power not primarily from its inherent features but from its capacity to mediate a package of wider social anxieties.

There is nothing new under the sun. It's just a pity there aren't a few more historians in Parliament. Or at the BBC for that matter.

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A conscious act of cultural vandalism

After much searching, I have found one person who agrees with Richard Bacon's figure of one million fewer smokers since the ban. And it's another BBC man, Mark Easton:

Since the ban on smoking in public places swept across Britain in 2006 and 2007, the number of adults who smoke has fallen by about one million.

As I said in the last post, this is sheer wishful thinking. But since no one else is quoting this figure - not ASH, not the Daily Mail, not the Department of Health - perhaps the source of this figure is some BBC memo?

In any case, Mark Easton has form for viewing the smoking ban in a rather idiosyncratic fashion, not least in this mind-boggling piece of doublethink from July 2009:

Pubs aren't dying - they are evolving

The great British boozer, we are told, is dying. But the widely reported news that 52 pubs are closing every week is not what it seems. In fact, it is probable that there are more places to enjoy a drink now than a couple of years ago.

This is quite a statement in the face of overwhelming evidence from the British Beer and Pub Association (BBPA), which shows a massive increase in pub closures since 2007. To quote one of Easton's readers:

I agree they are evolving, they are evolving into blocks of flats and they are evolving into building sites. Some (few) evolve into restaurants and other family orientated places. When a pub closes it is becoming rare for it to reopen as a place where adults can meet and have a sociable drink.

So what is Easton's evidence for saying that pubs are not dying?

Last week's press release from the BBPA reveals that of the 52 weekly closures the CGA research identifies, 51 are "wet-led" establishments. It also notes that "branded pubs and café style bars are actually opening at a rate of two a week".

Feel free to check my maths here, but surely that amounts to a total of 50 fewer pubs/bars a week?

The pubs that are closing, overwhelmingly, are those that existed to serve customers who came to drink and to smoke.

Isn't that the very definition of pub? The kind of pub beloved of the Pub Curmudgeon? As opposed to licensed restaurants and 'fun pubs', or - to borrow a phrase from the Spiked - 'anti-pubs'. 

Of all the anti-pub chains, JD Wetherspoon is the most successful. Readers from outside the UK who are not familiar with this organisation should read Natalie Rothschild's wonderfully acerbic piece 'A place where nobody knows your name' which describes it with uncanny accuracy:

Here's a taster:

Wetherspoon is, in fact, not a chain of public houses at all - it is a chain of public control houses. It is the anti-pub, a health department official’s dream local, a place where you go not to get a break from your everyday worries but to be told we’re eating and drinking ourselves to death. Wetherspoon is careful to remind customers that they should eat and drink ‘responsibly’, not overstep the officially-recommended daily units of alcohol and calories, and be sure to consume at least five fruit and veg a day.

A Wetherspoon pub is not a place for drowning your sorrows, whiling away time or spending hard-earned cash on simple pleasures like a game of pool with your mates or choosing silly songs on the jukebox for you and your friends to sing along to. It’s not a place where anybody is likely to know your name, because, here, we are discouraged even from talking to one another.

The rise of the anti-pub is an undoubted consequence of the UK's smoking ban. As real pubs close down, the pub chains have taken market share. Perhaps that's why the big pub chains accepted the smoking ban with barely a whimper. JD Wetherspoon even lobbied for it.

Will politicians and public health professionals mourn the loss of the traditional boozer? I doubt it. More likely, they will view the emergence of "public control houses" as an unexpected bonus.

Or maybe not so unexpected. As Mark Easton suggested in his article, the assault on working-class culture by the metropolitan elite may have always been part of the plan.

You may disagree with the new licensing laws, the taxes on alcohol and the smoking ban. You may mourn the demise of old-fashioned tobacco-stained drinking dens. But you could equally argue that the legislation is doing exactly what it was intended to do.

Quite.

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It's a small world

I recently mentioned a study that is being cited as evidence to support the case for the plain packaging of cigarettes. It suggested, to no one's great surprise, that some people could still recognise low tar cigarettes from the colour of the packs.

The study was warmly welcomed by ASH, who have been lobbying for the plain packaging policy for some time. In September 2008, ASH's Chief Executive Deborah Arnott described plain packaging as "an idea whose time has come". In March this year, she said: "the ultimate challenge is to get rid of tobacco advertising completely by requiring tobacco products to be sold in plain packaging"

Martin Dockrell, ASH's campaigns manager, is also a long-time fan of this idea. He was advocating it in July of last year and was promoting it again in February this year, saying:

"The health community is only beginning to understand what tobacco manufacturers have known for decades: the package matters more than the product, especially when you are pitching to children."

No wonder, then, that ASH were so quick to endorse the new study. Deborah Arnott was quoted by various news sources, including the BBC, saying: 

"This research shows that the only sure way of putting an end to this misleading marketing is to require all tobacco products to be sold in plain packaging," said Deborah Arnott, chief executive of Ash, an anti-smoking group.

"That would remove false beliefs about different brands and communicate the message that all cigarettes are dangerous.

"This matter has been discussed by parliament and there is now a perfect opportunity to include a requirement for plain packaging of tobacco products to be included in the health bill."

ASH's Deborah Arnott and Martin Dockrell clearly have much to thank the authors of the new study for. So who are they? Step forward...er...Deborah Arnott and Martin Dockrell.

No one in the media saw fit to mention that the person welcoming the report (Arnott) also happened to be one of its authors. Nor did they mention that she is the Chief Executive of one of the organisations that paid for it:

Surely, it is in the public interest to mention these little facts?

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More shisha madness

Over at Sp!ked, Patrick Hayes discusses the BBC's hysterical report about shisha smoking. As Hayes points out, the widely reported claim that shisha is "400 to 450 times worse than having a cigarette" is only the latest in a series of ever-escaltaing projections.

At worst, Dr Wareing claimed, ‘shisha was 400 to 450 times worse than having a cigarette’.

Wareing’s shock must have come from the finding that shishas are even more dangerous than believed following a 2007 study suggesting it was ‘200 times worse than a cigarette’, or 100 times worse, depending on who reported the study’s findings. The Department of Health is now working hard on ‘how best to get the message - that it is dangerous - across to the consumer’, grappling with the fact that it’s not easy to slap a warning sticker on a shisha pipe.

The research, however, has come under fire from some quarters, notably Dr Kamal Chaouachi, a tobacco expert from Paris IX University, who criticises the fact that the data has not yet been ‘peer reviewed or published’. Dr Chaouachi points out that shisha smoking is typically not ‘chronic’, with users usually partaking only one-to-three times a week, and criticises the way the study singles out carbon monoxide, which is relatively quickly flushed out of the body, for study: ‘Carbon monoxide is only one chemical out of thousands in cigarettes, so one cannot compare. But even if we look only at that chemical, shisha is not “worse” than cigarette smoking. The BBC should apologise [for its report on these findings].’

Dr Chaouachi knows of what he speaks and it's good to see at least a few news sources reporting his comments (see also here and here). But he's still waiting for a full reply from the BBC. 

His comments about the shisha report can be read here, and an interview we conducted earlier in the year can be read here.

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