E-cigarette regulation - money talks

An interesting article in the Economist tells us a lot about e-cigarettes. In China, the world's biggest cigarette market, smokers are increasingly switching to e-cigarettes. The state-owned tobacco monopoly is not happy about it.

Investor optimism derives in large part from the prospect of rapid growth in China, where just 10m people were regular users of e-cigarettes at the end of last year. But dig a little deeper and the outlook darkens. A powerful state-owned cigarette monopoly, China Tobacco, will not cede ground to a rival product without a fight.

Regulators have already intervened on behalf of China Tobacco, which paid 1.2trn yuan in taxes last year, accounting for 6% of government revenues. In November the authorities banned online sales of e-cigarettes (ostensibly to prevent minors from buying them). Now they can be bought only at physical outlets like convenience stores and karaoke bars. In recent months editorials in state-owned newspapers have claimed (falsely) that vaping is more harmful than conventional cigarettes. A spokesman for the Electronic Cigarette Industry Committee of China, a trade body, blames the online ban for a wave of bankruptcies among smaller firms.

It is obvious what China Tobacco's motivation is. They fear missing out on cigarette sales if people switch to vaping. The Chinese government, insofar as it can be distinguished from the tobacco monopoly, doesn't want to miss out on tax revenue. More vapers means fewer smokers, hence the online sales ban and scare stories.

Does this sound familiar? The United States has been awash with scare stories about e-cigarettes for several years, culminating in the 'EVALI' panic last year. A ban on online sales (disingenuously titled the Preventing Online Sales of E-Cigarettes to Children Act) passed the Senate earlier this month and will be voted on in the House any day now.

The only difference is that China Tobacco doesn't have the 'public health' lobby cheering it on.

American 'public health' campaigners argue that e-cigarettes don't help smokers quit and act as a gateway to tobacco for young people. China Tobacco obviously doesn't agree.

Who is most likely to be right - a bunch of moral entrepreneurs who have never seen a ban they didn't like, or some hard-nosed businessman who have skin the game?

Meanwhile...

Americans are smoking more during the coronavirus pandemic because they are spending less on travel and entertainment and have more opportunities to light up. They are also switching back to traditional cigarettes from vaping devices in the wake of federal restrictions on e-cigarette flavors.

Malice, corruption or unbelievable incompetence? You decide.

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Life and liberty webinar tonight at 6pm

I'm chairing an online panel discussion today at 6pm to discuss risk, wellbeing, health and wealth. The trade-off between life and liberty has been brought into stark relief by the pandemic. What lessons have we learned?

We have a great line up of speakers, so join us on YouTube at 6pm.

Julian Jessop, IEA Fellow and former IEA Chief Economist

Timandra Harkness, Broadcaster, Mathematician and Author

Professor Robin Dunbar, Emeritus Professor of Evolutionary Psychology at Oxford University

Otto Brøns-Petersen, Head of Analysis at the Danish Free Market Think Tank, Centre of Political Studies (CEPOS).

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Whatever happened to plain packaging?

With the government set to introduce all the Theresa May (previously David Cameron) nanny state policies on food, no one in government seems able to predict what success looks like. How much will obesity fall back as a result of these costly interventions? Will the government repeal the laws if obesity hasn't dropped by 2025?

You won't get any answers from MPs or 'public health'. They know and we know that the policies won't make any difference and there will be no desire to seriously evaluate them in the future. As I have said many times, 'public health' is not a results-driven business.

Take plain packaging, for example. The battle for this stupid policy involved years of screeching and millions of pounds of taxpayers money spent on self-lobbying. What happened? Where is the audit?

Australia has had plain packaging since December 2012. Anti-smoking clown Simon Chapman said it was "almost like finding a vaccine that works very well against lung cancer." But what really happened?

National smoking figures are only published every three years Down Under and this month saw the latest set of figures. Over three years, the smoking rate had fallen by just one percentage point. Since 2012, the smoking rate has fallen at half the longterm average, as Jo Furnival explains:

The Australian Institute of Health and Welfare (AIHW) released the 2019 National Drug Strategy Household Survey (NDSHS) this week. This survey has become a vital indicator of the performance of government health policies, including tobacco control. Previous surveys were carried out in 2010 before plain packaging for tobacco products was introduced, in 2013, the year following its introduction (along with other measures, including tax increases), and again in 2016.

The data shows that, prior to 2012, the per centage of daily smokers in Australia was in long-term, steady decline (a rate of 0.46 per cent annually for 20+ years). After plain packaging was introduced, this annual rate of decline slowed by almost a half to just 0.26 per cent between 2013 and 2019.

Moreover, the proportion of smokers planning to quit has not changed since plain packaging was introduced. Three in 10 smokers have no interest in quitting, the same percentage (30 per cent) as in 2010. Rather than this costly eight-year experiment, the Australian government would have been better off doing nothing at all.

Trebles all round! And it gets better...

The proportion of smokers using illicit, unbranded loose tobacco has increased by 37 per cent (10.5 per cent in 2010 to 14.4 per cent in 2019). Meanwhile, overall consumption of illegal tobacco products (including unbranded loose tobacco, along with contraband and counterfeit items) has risen by a whopping 80 per cent (from 11.5 per cent in 2012 to 20.7 per cent in 2019) and is now at a record level, according to a recent KPMG study.

Tremendous work, and all as predicted by those who opposed the policy.

Australia shows what happens when nanny state fanatics run the show. Ban e-cigarettes, introduce plain packaging and set taxes so high that buying from the black market is almost a moral duty. What could go wrong?

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A no deal Brexit is no good for smokers

An interesting piece at 1828 by Dan Pryor about an issue I had missed.

The UK is facing a tobacco tariff timebomb. Britain’s black market in cigarettes is set to boom if trade talks with the European Union fail to bear fruit by the end of the year.

The damage can be easily avoided easily if the department of international trade makes some minor changes to its post-transition period tariff regime. But so far, there is no sign that politicians are aware of the problem.

The issue stems from the UK Global Tariff – our post-Brexit replacement for the EU’s Common External Tariff. In the absence of a trade agreement, the UKGT will apply to all imported goods from 1 January 2021. At present, cigarettes imported from the EU for sale in the UK (which make up the overwhelming majority of our market) are liable for tobacco duty and VAT but are not subject to any tariff.

Presumably, though, in an unfortunate oversight (since there’s virtually no domestic tobacco industry to “protect”) the UKGT in its current form will slap an eye-watering 50 per cent tariff on cigarettes and a 70 per cent tariff on roll-your-own tobacco. That’s on top of existing charges. Even with an EU-UK trade deal, if we get our rules of origin requirements wrong, the tariff could still end up applying.

Do read it all.

The government could adjust tobacco duty downwards so that prices remain unchanged (it would get the same amount of revenue), but the anti-smokers would doubtless scream blue murder.

Or it could get a trade deal with the EU, which it should do anyway.

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Boris Johnson - is new boss same as the old boss?

Rumours abound that Boris Johnson will be making an announcement about the government's obesity strategy on Monday and that it's going to be a case of 'meet the new boss, same as the old boss'.

I tried to take a positive view of things in this article for the Spectator...

Despite my libertarian disposition, I take a perverse satisfaction in some of this. The television companies that spent years hyping the childhood obesity ‘epidemic’ and demanding tough action from government are now set to lose £200 million a year in advertising fees. Channel 4 might finally reflect on the wisdom of employing Jamie Oliver to make one-sided agitprop.

Similarly, the food industry might finally realise that the 'public health' lobby is serious in its rhetoric about ‘Big Food’ being the new Big Tobacco. Food companies went along with Public Health England’s ludicrous reformulation scheme because of the thinly veiled threat of more draconian laws if they didn’t comply. Now that the government is going to pass the laws anyway, they might awake from their slumber and stand up for themselves. Anti-smoking legislation started with a ban on television commercials before 9 p.m. – they must see which way the wind is blowing.

There is also a strange comfort in being able to abandon hope in Boris Johnson so soon into his premiership. It saves time in the long run. To be honest, his libertarianism was already in doubt when he put us all under house arrest for three months but, to be fair, that was under exceptional circumstances. However, if a Conservative government with an 80 seat majority, a liberal leader and an anti-establishment chief advisor is going to impose the kind of purse-lipped, micro-managing, finger-wagging, lemon-sucking, nanny-knows-best, censorious, anti-business, killjoy policies that even Gordon Brown never seriously entertained, then we have to conclude that nothing short of revolution is going to put the paternalistic political class out of its stride. It doesn’t matter who you vote for, Public Health England always gets in.

No paywall. read it all.

I've also written about it for the Telegraph. In this article, I argue that an advertising ban will set a runaway train of prohibitions in motion, just as it did with tobacco.

The advertising ban won’t work. How do we know? Partly because the economic evidence consistently shows that advertising affects brand preference, not aggregate demand. In other words, a Colgate advert might make people buy more Colgate toothpaste, but it doesn’t make them buy more toothpaste.

But we also have real world evidence from Britain showing that it doesn’t work. In 2008, the Labour government banned HFSS adverts during programmes which had a large proportion of viewers under 16 years old. This, along with the fact that children watch less live television than they used to, led to children’s "exposure" to HFSS ads falling by 70 per cent. The rate of childhood obesity, however, remained the same. 

Paradoxically, the failure of such policies makes further restrictions inevitable. When the watershed ban fails to reduce obesity, there will be demands for a total advertising ban. Practitioners of "public health", unlike practitioners of medicine, can get away with carrying out useless and harmful interventions ad infinitum.

It is time to demand results. When Johnson announces the latest set of bans next week, he should tell us how much rates of obesity are going to fall by and over what period of time. There should be a sunset clause. If the anti-obesity policies haven’t reduced obesity after, say, five years, they should be repealed. This is a modest request to ask of policies that claim to be evidence-based, but it will never happen because everybody involved knows, deep down, that they are nothing of the sort.

It's behind a paywall (I think), but read it if you can.

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The Observer's ignorant view of obesity

Some dog-bites-man news from Britain's least liberal Sunday newspaper, the Observer...

 

‘Junk food is the new tobacco’: experts call for restrictions to tackle obesity 

Ministers should regulate processed food as heavily as tobacco to tackle the “massive national challenge” of the UK’s obesity crisis, health experts have warned.

They have urged severe restrictions on supermarket promotions of processed foods, and bans on fast food outlets near schools, and TV adverts for pizzas, burgers and similar foods before 9pm. One campaign group even urged the government to consider plain packaging for processed food.

 

No slippery slope there then, eh?

 

The paper also carries an editorial calling for more heavy regulation from government.

The government is expected to set out a new strategy this week, aimed at reducing obesity levels both in the next few months – ahead of a possible second wave of infections – and the longer term.

 

Anyone who thinks a government strategy released next week is going to reduce obesity levels in three months is away with the fairies. 

 

There is robust evidence about what is needed to cut obesity and in recent years report after report, including from Public Health England and the former chief medical officer, have called for urgent action.

 

Public Health England is utterly incompetent and the most recent contribution to the debate from former Chief Medical Officer, Sally Davies, was laughable.

 

There is no credible evidence to support any of the proposals in the Childhood Obesity Strategy. The impact assessment is based on nothing but guesswork. The claims about the efficacy of banning so-called 'junk food' advertisements are based on extremely weak evidence. There is essentially no evidence for the idea of banning retailers from displaying certain food in certain parts of their shop. And the evidence on calorie labelling and restricting fast food outlets suggests that neither policy has any impact.

 

Yet these calls were ignored by Conservative ministers who have seemingly prioritised the food and drink industry’s financial interests over the health of the nation.

 

This is not only a false dichotomy, it is untrue. It was a Conservative government that gave us the sugar tax and a Conservative government that put forward all the proposals that the Observer supports. A public consultation on them was held last year, although a genuine public health crisis has understandably taken priority since then.

The continuing failure to act is consigning a generation of children to a lifetime of health problems. One in three leaves primary school overweight or obese, putting them at significantly greater risk of cardiovascular disease, cancer and type 2 diabetes later in life.

 

The claim that one in three 11 year olds are overweight or obese is a lie.

Poor diet has overtaken smoking and drinking to become the nation’s biggest premature killer...

 

The link provided by the Observer refers to the world, not the nation, and it is based on a basic misunderstanding of statistics.  

 

...and it brings a huge cost of around £6bn a year for the NHS...

 

That is 3.6% of the NHS budget and you need to look at the net costs to overall spending, which are lower, rather than the gross costs.

 

...as obesity-related hospital admissions continue to rise.

 

To 700,000 a year, according to the Observer's source. Which amounts to 3.4% of all admissions.

Increasing obesity levels are not the result of the nation becoming more wilfully irresponsible about its nutrition choices or parents deliberately choosing to load their children’s diets with unhealthy foods. They are primarily the result of an industry that stands to gain from packing processed foods with increasing amounts of cheap and addictive fat, sugar and salt, in a way that has reduced consumer choice by conditioning our palates to crave more over time.

 

This is an evidence-free assertion. Per capita consumption of sugar, fat and salt have all declined since the 1970s. None of them are addictive.

 

Its efforts are working: children are consuming, on average, more than twice the recommended amount of sugar each year and tooth decay is the most common reason for those aged five to nine to be admitted to hospital.

Children are consuming twice the recommended amount of sugar because the guidelines were halved in 2015 for no good reason. Rates of tooth decay have never been lower and continue to fall.

The one area where the government has taken proper action has been the introduction of a sugar levy on fizzy drinks, eventually brought in in 2018 after years of delay. This has been highly successful on its own terms – the amount of sugar in fizzy drinks has fallen by almost 30% without a corresponding fall in soft drink sales – but it is far too limited in scope to make a big enough difference on obesity. 

 

It hasn't made any difference to obesity, so it hasn't been a success, has it? 

Apart from this, the government has relied on asking for voluntary action from the food industry, which has completely failed to deliver. A more interventionist approach is required. 

 

Before 2010, the UK was a leader in nutrition policy and was the first country to successfully reduce population-level salt intakes by forcing manufacturers to gradually reduce salt levels in food, an approach that has been copied around the world with other countries applying it to sugar and fat as well as salt with great success.

 

This is incorrect. The salt reduction scheme was voluntary.

 

However, Conservative governments have ripped up this approach.

 

Quite the reverse. Via Public Health England, Conservative governments have presided over a massive expansion of the reformulation programme which now encompasses sugar, fat and calories. Why can't the Observer get these basic facts straight?

We need to see the compulsory reformulation of processed and convenience foods to reduce sugar and fat as well as salt levels...

 

 Really? I'd love to see how that legislation would be worded. 

 

...and, as the King’s Fund argues in today’s Observer, we need a comprehensive ban on junk food advertising, regulation to eliminate unhealthy food being sold as a loss leader by supermarkets and beefed-up powers to enable local authorities to maintain the area around schools as fast food-free zones.

 

The King's Fund is a pressure group whose main focus is on pressing the government to give the NHS more and more money. They have no expertise in this area. 'Unhealthy food' is not used as a 'loss leader' (on the contrary, it is quite profitable, as the Observer article seems to acknowledge a few sentences earlier). There is no legal definition of junk food and a ban on HFSS food advertising would hit advertisements for foods that Observer readers think are wholesome. A ban on fast food outlets near schools would not only be a de facto ban on fast food outlets nearly everywhere, but the evidence strongly suggests that it would have no impact on obesity.

 

So far, government briefings suggest that the new strategy, like the ones that went before, will be focused on weak measures such as public education campaigns and “nudges” such as the repositioning of unhealthy food in different parts of supermarket aisles.

A ban on positioning 'unhealthy food' at the entrance and exit of shops would not be a 'nudge' (bans are not nudges). 'Public health' campaigners have spent years screeching about the horrors of chocolate bars at the check out. They are the ones who have been demanding a ban.  

The real test for an overweight prime minister said to be shaken by his own experience of Covid is whether he is prepared to take on an industry seemingly determined to extract as much profit as it can, regardless of the cost in premature deaths.

Is the industry selling at a loss or extracting as much profit as it can? On this, as with so much else, the Observer seems confused. It doesn't even have a superficial understanding of the facts. It mentions industry no fewer than seven times, but never mentions physical activity. From a misdiagnosis of the problem, it comes up with the wrong prescription.

The Observer is always going to take a nanny state line on such issues. It is a paternalistic newspaper read by a small number of people who take a dim view of the public. The question for Boris Johnson is whether he is going to capitulate to the left-wing press, as Cameron and May did, or chart a different path.

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The staggering incompetence of Public Health England

The list of charges against Public Health England since the pandemic began is long. I am sure I have forgotten some, but off the top of my head, there is...

Rejecting the South Korean model of mass testing

Ending contact tracing in early March

Rejecting private sector laboratories and keeping diagnostic testing within the NHS's limited capacity

Assuring us that care homes were safe from COVID-19 and that staff shouldn't wear face masks in them

Making unscientific claims about the risks of smoking and COVID-19

Discouraging the public from wearing masks and advising the Advertising Standards Authority to ban adverts for them

Failing to share infection data with local authorities

The most recent PHE cock up to be revealed is not going to kill as many people, but it is perhaps the most remarkable in its cretinous stupidity.

As Yoon K Loke and Carl Heneghan (from the Centre for Evidence-Based Medicine) explained in a blog post on Thursday, PHE collects information on who tests positive for COVID-19, but they do not keep a record of who recovers. When that person dies - of any cause - it is automatically counted as a COVID-19 death.

By this PHE definition, no one with COVID in England is allowed to ever recover from their illness. A patient who has tested positive, but successfully treated and discharged from hospital, will still be counted as a COVID death even if they had a heart attack or were run over by a bus three months later.

... In summary, PHE’s definition of the daily death figures means that everyone who has ever had COVID at any time must die with COVID too. So, the COVID death toll in Britain up to July 2020 will eventually exceed 290k, if the follow-up of every test-positive patient is of long enough duration.

This helps explain why deaths from COVID-19 in hospital have been falling so much faster than overall COVID-19 deaths. It also helps explain why COVID-19 deaths in Scotland, Wales and Northern Ireland have been petering out so much quicker than they have in England. The rest of the UK counts these deaths in a sane and reasonable way.

Here's how PHE's figures differ from the Office for National Statistics. Notice to long tail on the right.

PHE vs. ONS comparison based on today's ONS week 27 report and latest PHE/DHSC all-settings date-of-death data. Numbers by positive test still seem to be tracking above death cert mentions. pic.twitter.com/rnxVxLGRQD

— Richard (RP 13) (@RP131) July 14, 2020

  

Under PHE's methodology, COVID-19 could be wiped out next week but people would still be dying from it decades from now. It's such a rudimentary error that it destroys whatever faith you may still have in the agency's competence.

The day after Loke and Heneghan published their blog post, the government announced that it will be conducting an investigation into how COVID-19 deaths are counted in England. Public Health England tweeted a pathetic half-apology...

Here's more detail from PHE Incident Director, Dr Susan Hopkins, on our method for counting #COVID19 deaths.

As we learn more, it's right that we review how #coronavirus deaths are calculated. pic.twitter.com/BJNojRGHiK

— Public Health England (@PHE_uk) July 17, 2020

In other words: 'Sorry, but this is as new to us as it is to you. You live and learn.'

The fact that COVID-19 is a 'new and emerging infection' is neither here nor there. From PHE's statement, you would think that keeping count of patients who recover was a radical new idea. Note also how they conflate miscounting and over-counting with having 'complete' data.

I have said many times over the years that these people are clowns, but I honestly didn't think they were this incompetent. In his Friday message, PHE boss Duncan Selbie sounded like a beaten man. Reading between the lines, it looks like he is expecting the chop.

The world will never be the same again following the COVID-19 pandemic but this now presents a genuine opportunity to achieve a better balance between risk and investment in the public’s health. PHE is rightly recognised for its science capability, public health expertise and national to local connectivity [no it isn't - CJS] , but resilience also requires flexibility and ability to adapt to a changing context. No public health agency has entered this pandemic thinking it will look the same afterwards. The public’s health is what matters most and whatever future decisions are to follow, the organising principle will be how we as a nation more effectively close the health gap between the rich and the poor and be better ready in capability and at scale for a future pandemic. Meantime we remain fully focused on fighting the virus.

It's telling that Selbie mentions reducing health inequalities ahead of protecting people from infectious disease as PHE's 'organising principle'. The health inequalities agenda is fundamentally political and largely amounts to trying to force everybody to adopt the lifestyles of the upper-middle class.

And on that, there was a sliver of good news for Public Health England yesterday...

Cadbury to shrink all multipack chocolate bars by 2021 - but prices will stay the same

One of the world's biggest chocolate manufacturers has announced plans to shrink all of its products to cut back on calories - but prices will stay the same when the changes come into effect.

Cadbury is shrinking the size of Double Decker and Wispa Gold bars sold in multipacks so they contain less than 200 calories in an attempt to help tackle obesity, but the smaller bars will cost the same.

This is Public Health England's so-called reformulation scheme in action. This is the stuff that Public Health England is really interested in. This is what it was doing when it should have been preparing for a pandemic. Never forget that.

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