It might buy you happiness

Over Easter, the Archbishop of Canterbury (yes, him again), applauded David Cameron's Gross National Happiness project, saying "it's certainly a good thing that people have publicly acknowledged that there is more to life than the level of Gross National Product."

This is not an original thought and I don't disagree with the general sentiment. But then nor would anyone, and that is the point. The idea that anybody in the history of the world has ever believed that there is no more to life than Gross National Product is one of the great straw men of our times. Not only does no individual believe that, but there is precious little evidence that any government has ever made GNP the sole—or even main—consideration in public policy.

If we believed that there was no more to life than GNP, we would be rolling in the tax revenue brought in by the legalisation of drugs, health and safety laws would be abolished, the Department of Health would be a third of the size, the BBC would have been sold off and euthanasia for the over 65s would be not just legal, but actively promoted. The fact that they are not suggests that we, as a society, think that there are many things that are more important that GNP. A quick look at the legislation passed in the last decade shows that health and the environment—to name just two issues—are considered more important than economic growth.

What people like the Archbish and Lord Layard (of the recently formed Action on Happiness) mean when they say that GDP isn't the only important thing is that GNP really doesn't matter at all. Typically, this rhetoric comes from those demanding a 'steady-state' (ie. zero growth) economy. These are people who have grudgingly admitted that socialism isn't very good at creating growth, but still like the trappings of socialism.

Action on Happiness have so far kept quiet about what political action is needed to improve well-being, but—unless Layard's views have changed radically since he wrote his book Happiness in 2005—we can expect much higher taxes to encourage us to work less and much higher taxes to punish those who use their wealth as a negative externality.

What sets GNP apart from most of the things that make us happy in life is that it can be readily quantified and governments can do something about helping it along. This makes it a valuable measure and a legitimate target for policy action. Despite the ludicrous ambitions of David Cameron, no government is ever going to increase levels of love, nor is it going to bring us prettier sunsets or tastier sausages. If we must have a happiness policy, it should be to allow us to pursue it. For the most part, that would mean the government getting out of our way.

The "people only care about GNP" straw man exists to perpetuate the myth that modern society is obscenely materialistic. As the narrative would have it, we have been seduced into a narrow world view that makes us forget what is really important—in Williams' case, God; in Layard's case, God knows. But, as Will Wilkinson has pointed out, there is nothing in the least bit "narrow" about using GNP as one indicator of social well-being:

Many people seem to think that a government’s emphasis on measurements like GDP indicate a kind of collective affirmation of materialist goals, encouraging a narrowly materialist attitude at war with more exalted values. But this is simply a mistake. The very function of money is to serve as a neutral medium of exchange. It is a shape-shifting embodiment of almost any value. The same $100 can be spent on a prostitute or donated to an HIV/AIDS clinic.

The relative value neutrality of money is precisely why the measurement of per-capita wealth is well suited to pluralistic liberal societies; it doesn’t beg many questions about competing conceptions of the good life. Money can’t be converted into anything that someone might value, but it is of the nature of money to be convertible into a phenomenally broad range of values. Societies with high levels of average income and wealth are societies in which people have more resources at their disposal to achieve their aims, no matter what those aims might be, which is why it should be no surprise that, other things equal, people with more money are more satisfied.

Pursuing economic growth is not some niche obsession like collecting shoes or hunting Bigfoot, but if collecting shoes or hunting Bigfoot is your thing, money can help you do it. There is, of course, more to life than any of these things, but then no one ever said there wasn't.

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Cock up or conspiracy?

A little recommended reading this Sunday comes from Ep-ology, where Carl Phillips is not convinced that the Office of National Statistics got their alcohol figures wrong by accident.

Given how simple this is, and that it is probably taught in the second or maybe even first semester of any decent applied statistics program, there is no excuse for the British study. This is not something that an even slightly competent researcher could possibly fail to notice in the data even if they somehow overlooked the information about how the definition changed ("hmm, let's look at the trend from year to year: down a bit, down a bit, same, down a bit, huge increase, down a bit, down a bit – yup, it sure looks like an upward tend to me").

Either someone was intentionally trying to mislead their audience or they were in so far over their heads – and by this I mean they knew absolutely nothing about analyzing statistics, but did so anyway – that they had no excuse for claiming their analysis was worth anything. Either way, it is important to recognize the difference between honest disagreement (which this obviously was not, since the ONS retracted it), honest mistakes (which this was not because the mistake is too glaring to make honestly), and dishonesty (either in the form of lying about the world or about one's qualifications).

This, of course, is a reference to the ONS's claim (since debunked and retracted) that women's drinking is on the rise in Britain. Go read.

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Render unto Caesar, says Archbishop

Rowna Williams goes for that With The Beatles look

On Maundy Thursday each year, the Archbishop of Canterbury performs the ritual of the washing of the feet in imitation of Jesus. On Radio 4 this morning, he suggested that the rich and powerful learn about charity and humility by working with the poor for a few hours. It's a nice Easter message befitting of a vicar at this time of year, but he couldn't just leave it at that. He had to preface it with those six little words that are as sacred in modern society as anything in the scripture:

"What about having a new law..."

Ah, the great cry of our age. The words on everyone's lips. Such is the thirst for law-making you would think we were building a nation from scratch.

The quote in full:

"What about having a new law that made all cabinet members and leaders of political parties, editors of national papers and the hundred most successful financiers in the UK spend a couple of hours every year serving dinners in a primary school on a council estate? Or cleaning bathrooms in a residential home? Walking around the streets … at night as a pastor, ready to pick up and absorb something of the chaos and human mess you'll find?"

Again, there's nothing wrong with the sentiment. Certainly, there is a perception that the rich and powerful are out of touch, just as there is a perception that the wealthy could do more for charity. Whether those perceptions are correct is not always easy to tell since it is considered vulgar to boast about the work you do for charity. And rightly so. But Rowan Williams—for it is he—thinks that charitable work would be more virtuous if it was compulsory.

"Maybe having to do it, to do it in public and not to be able to make any sort of capital out of it because they had no choice?

Williams could not be wronger. Charitable acts enforced by coercion are not worthy of the name, just as charities that are funded by the state without the consent of the taxpayer are not charities. It would be more noble to make "capital" out of charitable acts than to do them because you have "no choice."

If you're a religious man—as I assume the Archbishop of Canterbury is (although it's hard to tell with the Church of England)—charity and humility are very important to your faith. There is, however, a division between Church and State; a division that Williams seems not to recognise.

It's been a while since I read the Bible but I don't remember Jesus calling for new laws to be made. I do recall him saying something about rendering unto Caesar what is Caesar's and rendering unto God what is God's. On that basis, the Archbishop of Canterbury should his beak out of politics and achieve his goals through the power of prayer.

Happy Easter.

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The vile views of Chandran Nair

Following a link on Twitter, I ended up listening to a talk at the Royal Society of Arts by Chandran Nair who claims to be some sort of environmentalist. I had not come across Mr Nair before but he has written a book called Consumptionomics, is fond of Chinese Communism, thinks we need "massive carbon taxes" and wants governments to be "draconian" so you can probably guess what kind of environmentalist he is.

Rarely have I come across a speech that makes the case for anti-human, anti-progress, anti-liberty politics as explicitly and shamelessly as this, with not a word of dissent from the audience. With people like this around, is it any wonder greens get labelled watermelons?

Here are a few choice, but entirely representative, quotes:


On the joys of collectivism:

"In Japan, the individual doesn't matter. I have a home in a small village in Japan and everything has a rule and I love it—because it's about the collective. You can't do anything without having the permission of the collective."

On whether technology has a role to play (ie. in feeding people and reducing pollution):

"The Chinese tell you how many gallons of petrol you can have a week, how many miles you can drive and when your car will stop. And it will be recorded somewhere and you'll get a huge bill for what you do. I've talked to my friends at Cisco and they say they have the technology. So technology does have a role to play."

On government:

"We will need strong governments. We will need draconian measures to stop and restrain people."

On population:

"The Chinese model [one child per family] might work better in these issues than anything else."

On car ownership:

"The Chinese have intervened in car markets and two months ago imposed restrictions on car ownership. And I've always said that if they can mess with your reproductive system, they can certainly mess with your car."

On being green:

"I refuse to go to conferences any more that talk about 'greening'. I prefer to go to conferences that talk about constraining, restricting, imposing rules."

On liberty:

"Asian governments need to reject the Western model. They need to move beyond the rhetoric of liberal democratic capitalist systems which say that individual rights are sacrosanct."

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Two films

I was able to see a few films at the MTV International Harm Reduction Film Festival while I was in Beirut. Some of them are available online so I thought I'd share them with you.

This snappy and humorous film takes a look at snus as a tobacco harm reduction strategy:






And the video below is from the splendidly named documentary Howard Marks On Drugs. The full film is not available online but this is the unedited footage of Marks' interview with our old friend David Nutt. I don't dislike Professor Nutt, really I don't. I just find it frustrating that someone can talk so much sense about drugs while talking so much rubbish about drink.

In this interview, note how many times the Nuttmeister drags the conversation back to alcohol (and, hence, onto the cutting room floor). Marvel as he claims that liver disease will be Britain's number one killer within 12 years (very unlikely indeed). Be amazed as he insists that alcohol is "wiping out the NHS" (no it's not). Splutter as he claims that alcohol is a third of the price as it was when he were a lad (utter nonsense).

Having said that, when he sticks to talking about drugs, he's on the money. Nobody's perfect.

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Steer clear of Big Pharma, says... the WHO!

From the BMJ:

The World Health Organization has warned health professionals working in tobacco control not to become too closely involved with drug companies that produce smoking cessation products.

Well, well. This is a breath of fresh air. And it looks like the WHO picked a suitable audience for this message...

The warning came last month at a meeting on smoking prevention in Madrid that was hosted by the National Committee to Prevent Smoking, which represents most Spanish anti-tobacco organisations, and which was sponsored by Pfizer, GlaxoSmithKline, and McNeil—all of which make treatments to help smoking cessation.

Let's be clear on this. I have never had a problem with businesses lobbying or funding research, including pharmaceutical and tobacco companies. In fact, I would rather the government listens to people who have worked for a living than remain in the political echo chamber passing stupid and impractical laws.

Industry primarily represents its own self-interest, of course, but they represent the interests of their customers rather better than politicians represent the interests of the electorate. If we are being charitable, we might say that Big Pharma represents the interests of smokers who want state-funded pharmaceutical nicotine. Likewise—and I realise this is not a popular view these days—the tobacco industry's desire to sell cigarettes more closely matches the desire of the millions of people who want to buy cigarettes than does the desire of the WHO to ban them.

The problem with Big Pharma's role in tobacco control is two-fold. Firstly, it is blatantly hypocritical to ignore one industry while being hand in glove with another industry. Secondly, although the interests of Big Pharma are served by policies that have long since been decided on by tobacco control (smoking bans, higher tax on cigarettes, etc.), in several instances the influence of pharmaceutical companies results not just in damage to liberty but in damage to public health. For example, I do not believe that the ridiculous ban on snus would still be in place were it not for lobbying from Big Pharma at the EU and WHO level. At a national level, I doubt that ASH would be pushing Chantix quite so vigorously if Pfizer weren't a constant presence at every conference they attend.

But more to the point, where does the World Health Organisation get off telling other people not to be too chummy with the pharmaceutical industry? Isn't this the same organisation that welcomed Big Pharma as a partner in its tobacco control program with the barely ambiguous comment that "investing in health yields high returns"? This, from the Director-General of the WHO in 1999:

Three major pharmaceutical companies have joined this partnership: Glaxo Wellcome, Novartis, and Pharmacia & Upjohn. They all manufacture treatment products against tobacco dependence. Together, these companies will support a common goal that will have a significant impact on public health.

We are facing major health challenges. There is a real scope for meeting them. It is within our grasp to drastically reduce the global burden of disease. WHO is determined to do its part. And I am happy to welcome other stakeholders - and that includes industry - to join us - because investing in health yields high returns.

In the same year, Glaxo Wellcome's director of Global Commercial Strategy explained what they wanted in return (link should be here but is broken):

We want to support and be partners in tobacco control in a number of areas. We could use help in the area of reimbursement.

By 'reimbursement', he means using taxpayers' money to hand out free pharmaceutical nicotine products and that is exactly what the pharma-funded National Committee to Prevent Smoking has been lobbying for in Spain, as the BMJ notes:

In Spain public funding of drugs for smoking cessation is only provided in two autonomous communities: Navarra and La Rioja. Attempts by the National Committee to Prevent Smoking and some political parties—the conservative Popular Party and the Catalan nationalist Convergence and Union party—to get the public funding of such drugs put into Spain's new smoking law failed. 

Rodrigo Córdoba, spokesman for the National Committee to Prevent Smoking, denied that the committee had any conflict of interest, despite the fact that drug companies contributed to funding certain events. "We have tried by all means to maintain independence," he said, in the face of pressure from the drug industry "to persuade us to support public funding [of drug therapies] in a more aggressive way."

Some of the medical societies forming part of the committee had much "stronger links" to drug companies, he said. "There may be individual cases of conflict of interest. Clearly that has occurred and will still occur to some extent," he added."

No doubt it has and no doubt it will. It is good that the WHO is at least acknowledging this conflict of interest. Can we now expect the likes of ASH, the Roy Castle Lung Foundation and John Banbanbanzhaf—who are so quick to dismiss anything which has the slightest whiff of tobacco industry funding—to turn their back on pharmaceutical industry funding?

That was a rhetorical question, by the way.


(Thanks to Eric Crampton for sending me the full article.)

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Alcohol and cancer - what's the story?

While I was away, the move towards an abstinence-only alcohol policy took a couple of steps forward. I mentioned recently the importance of Scientific Temperance Instruction (STI) in bringing about Prohibition in the USA. For 40 years, STI used pseudo-science to hammer the message that there was no safe level of alcohol consumption into American school-children. This was necessary to turn the sensible advice of temperance into the fanatical doctrine of prohibitionism.

Abstinence-only has long been hampered by the knowledge that alcohol is good for the old ticker—as confirmed in a BMJ study in February—a finding that is denied by only the most blinkered anti-drink crusaders.

The new study that came out in the BMJ last week offers hope to the zero tolerance activists and will, I expect, be cited for many years to come. It claimed that:

• alcohol is responsible for 8% of all cancers in men (UK)
• alcohol is responsible for 3% of all cancers in women (UK)
• former (male) drinkers have a 54% increase in cancer risk
• alcohol caused 16,355 cancer cases in 2008 (UK)
• risk increases by 3% for every drink (per day)

It is the last of these points that most excites the temperance lobby since it seems to support the 'no safe level' doctrine. The study does not, of course, try to calculate how many cases of heart disease are prevented by alcohol so the net cost/benefit cannot be ascertained. 

The study concludes with a paragraph on 'policy implications' which is always a bit of a red flag.

This strongly underlines the necessity to continue and to increase efforts to reduce alcohol consumption in Europe, both on the individual and the population level.

It's at times like this that I wish I didn't drink. Not because of the cancer risk but because I could better enjoy the schadenfreude as the smug non-smoking pub-goers, CAMRA members and the "drinking's different" brigade struggle to disassociate themselves from the cigarette fiends and fatties. It's no longer just about 'binge-drinkers', alcoholics and lager louts. The temperance lobby has its eye on that agreeable glass of pinot noir and they've got the science behind them.

What has been most interesting for me has been the way in which the study has been attacked by those who now see their own pleasures under threat. Much of it is very reminiscent of the weak arguments made in the 20th century against the smoking/lung cancer link. At the Telegraph, for example, Judith Potts wrote:

The story hit the headlines. However, according to Cancer Research UK’s figures published in July 2010, the total number of cancer cases in the UK is 298,000 – which covers over 200 different types of the disease. This means that 285,000 cancers are not caused by alcohol. I wonder how many of these 285,000 cases are alcohol-blamed cancers which have developed in non-drinkers?

Well, yes but this is not an argument against public health clamping down on booze. You might equally say that most cancer cases are not smoking-related. You'd be right, but some are and they are considered preventable through behaviour modification.

The Science Bit unwittingly took the traditional tobacco industry line that mere statistics do not prove anything:

Rather than establishing a causal link between alcohol consumption and cancer occurrence, the researchers conducted a study that relied on the premise that such a link exists. In other words, a causal link between alcohol and cancer is not a conclusion of the BMJ study — it is one of its assumptions.

Yes and no. Epidemiology can never prove causation. However, the study did control for a large number of confounding factors so it is not unreasonable to assume causality. Saying that an epidemiological study doesn't prove causation is asinine. You need to provide a convincing alternative explanation for the statistics or demonstrate that the statistics themselves are flawed. Otherwise, we must accept the most obvious interpretation—the one given by the researchers—is the correct one.

Instead, this was very much a “What if…?” kind of study. The basic research question was, “If alcohol consumption causes cancer, then how much cancer might it be causing?”

Actually, it wasn't. It collected the statistics like any other cohort study and derived the conclusions from the data.

...it is impossible to know for sure whether all extraneous factors have been accounted for.

It always is. This is an argument against all epidemiology and, again, was an argument used against the smoking/lung cancer link for years. Then, as now, we need to hear what these 'extraneous factors' are otherwise the hypothesis stands. I am very open to hearing criticisms of this study—I'm quite prepared to believe that much of it is wrong, exaggerated or misleading—but general criticisms of epidemiology as a whole just don't cut it.

Regular readers will know that I am no defender of junk science. This study may well be flawed and you can be sure that as more money moves towards temperance work, the quality of the research will decline and the claims will become more sensational.

Where does that leave us right now? The claim that alcohol increases cancer risk from the very first drink certainly needs to be shown in further studies before anyone outside of temperance circles takes it seriously. The claim that ex-drinkers have a 50% increase in risk that is independent of other factors also needs to be reproduced. But while there are reasons to question some of the associations (a causal link with breast cancer, in particular, has never been as well documented as if often assumed), surely we are not denying that alcohol is linked to cancer of the larynx, liver or mouth? 

This particular study may well overestimate the number of cancer cases but there is strong evidence that excessive drinking, and possibly moderate drinking, increases the risk of several forms of cancer. We've known this for a long time. Whether alcohol causes 16,000, 8,000 or even 4,000 cases of cancer, the temperance lobby will push on with its neo-prohibitionist policies. (Bear in mind that the favoured statistic is 40,000 deaths per year.)

As I've said before, a public health movement that bans smoking in all 'public' places on the basis of 3,000 hypothetical deaths from secondhand smoke—based on much weaker epidemiological evidence that the study discussed here—is not going to think twice about hammering drinkers who are allegedly responsible for tens of thousands of deaths.

The solution to the problem does not lie in quibbling over statistics, but in telling the powers that be that our lives are our own and defending personal liberty in general. As Dick Puddlecote has said time and again:

You simply cannot pick and choose which freedoms you like and which you don't. You either stand up to all of the dictatorial bullying, or you will inevitably become a target.

If the BMJ study is correct and every drink carries a risk—and that even those who give up drinking are in danger—it serves as a reminder that pretty much everything carries a risk so you might as well enjoy yourself. Whether or not the epidemiology is up to scratch, the researchers can file their 'policy implications' over a cliff while we, as grown adults who can make our own decisions, can say "Thanks for the information, I'll take my chances."

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