"Is that so much to ask?"

From Santa Cruz, where the smoking ban just became a little bit more "comprehensive":

Click on the photo to make it larger. Amongst the places in which it is now illegal to smoke are "within 25 feet of any door or open window". So, in effect, pretty much everywhere, indoors and outdoors. The law was passed unanimously by the City Council. 

And all they wanted was non-smoking sections.

John Banzhaf, 1977: 

"Where you try to ban it entirely on a street or something like that, obviously you're going to have problems. But what we have found is if you have a law, if you provide separate smoking sections, if the restrictions are not onerous or whatever, if you don't have large fines or make it a major criminal problem it a then you have reasonable compliance."

John Banzhaf, 2003: 

"When we started to fight for nonsmokers, we started with airplanes. No one then thought we'd be successful at banning smoking in bars, banning smoking outdoors. We took the easier ones first. Each step builds on the one that comes before."

Thanks to Becky for the photo.

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Smoking ban 'cuts suicide rate'

It didn't really, of course, but that headline wouldn't be any more silly than the one the BBC went with today:

Smoking ban 'cuts heart attacks'

The number of people suffering heart attacks has reduced since the smoking ban in Wales began, a report by the chief medical officer has found.

I can't argue with that. To two events undeniably coincided. Of course, the heart attack rate also fell consistently for six years before the smoking ban, but the BBC omits to mention that. 

So if the smoking ban was responsible for that, it must also be responsible for this:

Figures also showed fewer children were being injured by cars, with Wales three years ahead of a target reduction.

And this:

Suicide rates across all age groups have also fallen.

These things happened at the same time and, therefore, must have happened as a result. Post hoc ergo propter hoc - the source of all superstition. An old woman moved to the village and the crops failed, therefore she is a witch. I walked under a ladder and later lost my job. I took my lucky heather to the football and my team won.

Pathetic. And if the smoking ban 'cut heart attacks' in 2007/08, what sorcery is responsible for the rate rising in 2008/09?

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The Welsh miracle is not dead. It just smells bad.

When it comes to heart attack miracles, it's difficult to pick the most preposterous. Heart miracles constitute a sub-genre of pseudo-science which is so comically ill-considered it almost makes other quackery seem reasonable. 

At the moment, only a relatively small number of people are in on the joke (including Dr Siegel, who has just exposed yet another), but we can console ourselves that many of these studies have appeared in print, thereby leaving a paper trail for future historians to follow when they rake over the coals of this decade's exodus from rational thought.

One of the silliest heart miracles was reported last year. It concerned the case of Wales, which saw a rise in heart attacks in the five months following the Welsh smoking ban and no significant fall in the post-ban year overall. This - you might think - would be enough for tobacco controllers to turn a blind eye to the green, green hills of Wales, but no. 

With a sneakiness that bordered on the heroic, a Welsh politician named Chris Franks spotted that the 4th quarter of the post-ban year saw fewer heart attacks than the same period of 2006. He used his influence to get the "story" into Wales' Daily Post, where he found a willing accomplice in the form of journalist Tom Bodden who wrote an article headlined: 'Fewer Heart Attacks in Wake Of Smoking Ban'.

This was all back in June 2008. It got a little coverage elsewhere but not very much. ASH and the Department of Health didn't want to touch it because they knew that it was all a scam. I explained why it was a scam on my website and at Spiked. Dr Siegel did likewise. So did Reason.

Now, via Jacob Grier, I see that this ancient corpse has been exhumed and Tom Bodden (for it is he again) is trying to breathe new life into it:

Smoking ban ‘sees fall in heart attacks’ in Wales

NEW figures this week are expected to reveal how the first full year of the public smoking ban in Wales heralded a steep decline in heart attacks.

The findings will be contained in the Chief Medical Officer for Wales’ annual report showing hospital admissions have fallen since the ban came into force.

I will be intrigued if the Chief Medical Officer does make such a claim, because it is completely untrue. Not only is it untrue, it has become even less true - if such a thing is possible - since I last wrote about it.

You see, reading all again this inspired me to return to the NHS Wales hospital admissions data (available at Health Solutions Wales). Since I last discussed the Welsh miracle, another year's data have become available. And - wouldn't you know it? - heart attacks increased last year. (Some readers may recall a similar phenomenon in Scotland).

As you can see from the graph below, there was no "steep decline" in the heart attack rate in Wales after the smoking ban. The rate of decline followed the exact same trend of the previous two years. But you will also notice a rise in heart attacks in the second year of the ban - the first rise for seven years. 

To put it in precise terms, the number of Welsh residents rushed to hospital with acute myocardial infarction rose from 3,999 (2007/08) to 4,126 (2008/09)*. Even if you add in emergency admissions for angina and subsequent acute myocardial infarction, there is a rise from 9,783 to 9,851. It doesn't matter whether you look at Welsh residents or Welsh hospitals (there are different statistics for both), the story is always the same. 

So what does Welsh Health Minister Edwina Hart have to say in the face of this unequivocal evidence that hospital admissions for heart attacks went up last year?

"The Chief Medical Officer’s annual report to be published later this week will show that hospital admissions for heart attacks were reduced last year."

This would appear to be from the horse's mouth, which is worrying. If the Health Minister is correct and the Chief Medical Officer does indeed announce that "hospital admissions for heart attacks were reduced last year" there will only be one explanation. 

The Chief Medical Officer must be a liar.

*Emergency admissions for acute myocardial infarction (Welsh residents):

2000/01: 4891

2001/02: 5398

2002/03: 5374

2003/04: 5263

2004/05: 4719

2005/06: 4425

2006/07: 4180

2007/08: 3999

2008/09: 4126

The Welsh smoking ban was enacted on April 2 2007. There were no exemptions.

Health Solutions Wales

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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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Bullies and Banzhaf

I haven't yet mentioned Brian Monteith's book The Bully State, which is a rollicking good read. I reviewed it in the current Spiked Review of Books:

Readers who have not visited Britain for several years may be shocked by the lurch towards authoritarianism described in this book. Those who have witnessed the creep of the bully state first hand will be enraged, amused and informed in equal measure. Californian politicians can simply use it as an instruction manual.

Go have a look. And speaking of bullies...

Chubby ambulance-chaser John Banzhaf has called on e-cigarette users to sue e-cigarette makers. In a typically narcissistic press release, the ASH founder invites vapers to "possibly share in any damages awarded to users of this new product which the Food and Drug Administration (FDA) has declared 'illegal'."

Smokles provides an accurate character assessment of the litigious lard-ass:

I can think of no other example where the signatory of the letter refers to himself in the third person so many times and so magnificently. (In nine out of the thirteen paragraphs of his release, he refers to himself at least once, and even bestows upon himself a title: the Dean of Public Interest Lawyers).

You just have to wonder how this blowhard survived grade school.

Since nearly all e-cigarette users are very happy to be vaping rather than smoking, Banzhaf is once again displaying a certain detachment from reality with this press release. Judging by some of the comments at the e-cigarette forum, the ASH founder is going to struggle to find many takers:

Yeah, i'm sure we are going to turn on the hand that feeds us ... not.

That may be in his repetoire, being the disgusting turncoat sell-out pork belly that he obviously is, but it sure as diddly isn't in the most decent people's plans.

Similar sentiments are on display on the Tobacco Facts website which hosts the press release:

I wish these anti-smoking fanatics realized that by attacking e-cigarettes they’re actually supporting big tobacco.

They might be supporting big tobacco. They're certainly supporting the pharmaceutical industry, as Michael Siegel points out:

Interestingly, ASH is not promoting lawsuits against the pharmaceutical companies who market nicotine replacement products without informing their customers that these products contain detectable levels of carcinogens. Why this double standard?

Perhaps the answer lies in the fact that ASH is heavily funded by Big Pharma.

ASH is funded heavily by Big Pharma (specifically, by Pfizer - the maker of Chantix). If e-cigarettes really take off, they represent a huge threat to the profits of pharmaceutical companies, and in turn, they represent a threat to future funding of ASH. This conflict of interest is significant, but ASH has failed to disclose it in any of its statements about the dangers of electronic cigarettes, or in its propaganda designed to encourage vapers to sue e-cigarette companies.

Indeed ASH is funded by Pfizer (makers of Chantix, Nicorette etc.). It received $50,000 from the company in 2006 and is currently sharing the spoils of a $47 million grant made to various anti-smoking organisations. 

Banzhaf himself does very nicely as head of his charity, pocketing $226,000 in the last year their accounts were published. And although the FDA has concluded that Pfizer's stop-smoking drug Chantix is linked to suicide, Banzhaf is not involved in any of the lawsuits against Pfizer, nor will you find the word Chantix anywhere on ASH's website. 

Funny, that.

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Where do these numbers come from?

The last time I commented on a Radio 5 show, the presenter read it and left a comment, so I shall be careful what I say about Richard Bacon's debate about outdoor smoking bans last night. I have no idea where Bacon stands on the smoking issue. Like most people, he probably has no strong view either way. Still, he makes quite the devil's advocate, generally making the opposing view rather more forcefully than the person invited to do it themselves.

You can listen to the show here for 7 days if you're in the UK. A few things struck me about it...

Firstly, of all the people who called in, only two supported banning smoking outdoors, and they were both tobacco control professionals. One worked for a charity which, I must confess, I have never heard of - Heart Research UK - and the second only owned up to working in tobacco control after he had been on the line for several minutes. 

Secondly, the passive smoking theory has been well and truly discarded in favour of overt paternalism and the tyranny of the majority. The Heart Research UK spokeswoman was openly prohibitionist in a way that no one would have dared before July 2007.

Thirdly, the BBC have titled this show 'Should smoking be banned in all public places?' How quickly definitions of 'public places' shift and slide.

Finally, and most importantly, I was amazed by the mangling of the basic facts. Perhaps those of us who follow these issues closely assume too much of the media but it was repeatedly said - by the presenter - that the smoking ban has made a million people give up smoking. I have never heard this figure even from ASH or the Department of Health. 

I read this in The Independent in June 2008:

The nationwide smoking ban has triggered the biggest fall in smoking ever seen in England, a report says today.

More than two billion fewer cigarettes were smoked and 400,000 people quit the habit since the ban was introduced a year ago, which researchers say will prevent 40,000 deaths over the next 10 years.

But then I read this in the Daily Mail earlier this year:

The ban on smoking in public has failed to increase the number of people quitting, a report revealed yesterday.

And then earlier this year:

The number of smokers giving up has barely increased since the ban, despite a hike in the amount spent by the NHS on quitting services.

Figures show that nearly a quarter fewer smokers gave up the habit between April and September last year compared to 2007 - the year the ban on smoking in public places was brought in.

I don't know how many people have stopped smoking since the ban but it certainly isn't anything like a million. The most reliable source is usually the Office of National Statistics, which said - in March 2009 - that adult smoking prevalence was 21%, down from 22% before the ban. Since there were 9.5 million smokers before the ban (although estimates differ) that reduction equates to around 432,000 successful quitters. 

A 1% drop in smoking prevalence over two years is very much in line with the long-term decline so it is tenuous to say that this drop was attributable to the smoking ban at all. In time, we may even see the Irish phenomenon happen here and have many more people smoking.

The other statistic cited was that smokers cost the NHS £10 billion. Again, I've never heard this figure before. I've remember the old £1.5 billion well. I'm aware that there is now a £2.7 billion figure being bandied around (which began circulating, strangely enough, after the anti-alcohol lobby started saying that booze was costing The Health £2.7 billion). But never £10 billion. Even a Google search failed to unearth a single internet crank giving that number, so where on earth did it come from?

I ask this as a serious question. The number of people who check their facts on government websites and medical journals is tiny compared to the listenership of the average radio show. Regular readers will know that I quibble with official statistics from time to time - and I realise that I'm whistling in the wind by doing so - but even the official sources must wonder why they bother when they hear numbers being plucked out of thin air on national radio.

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Leeches

Via the Tobacco Harm Reduction blog, Smokles, I find an article of glorious common sense written by the editor of the irreplaceable STATS.org, Trevor Butterworth.

For two millennia, leeches were used to balance the humors--or to drain the patient of "excess" blood and other substances thought to be the cause of most of humanity's physical and mental ailments. 

In a similar vein, some doctors and public health advocates are turning to a modern equivalent of the leech--taxes--in order to draw "excess" money from going to "unhealthy" activities, thereby reducing disease and balancing health care spending.

Regular readers will greet the latest public health ruse with a familiar sigh:

Now the latest advice for "leeching" America comes from Dr. Lloyd I. Sederer, medical director for the New York State Office of Mental Health, and Dr. Eric Goplerud, director of the Center for Integrated Behavioral Health Policy at George Washington University. 

Writing in the Washington Post, they argue that imposing heavy taxes on alcohol would both reduce the harmful effects of heavy drinking and help pay for health reform. The logic is that if teens drink less, they'll have less unprotected sex, reducing their exposure to sexually transmitted diseases.

These people are deadly serious and - behold! - they come clutching research and a spurious statistic:

They claim that a tax increase of "3 cents per beer would cut youth gonorrhea by 9%"

So why not raise tax by 33 cents and reduce gonorrhea by 99%? Hell, why not go the extra cent and eradicate it entirely? Because, as Butterworth shows in delicious detail, this statistic is completely bogus. It comes from a 2000 paper published in the Journal of Law and Economics which noted that cases of gonorrhea fell between 1981 and 1991, at a time when beer tax had doubled.

What more evidence could anyone ask for?! Why, it's almost as compelling as the well known association between rock music and oil production:

Using the classic junk science tactic of cherry-picking, and making the classic mistake of confusing correlation with causation, the authors stated that this association is "consistent with the assertion that alcohol tax increases can reduce STD rates". 

Consistent, perhaps, but utterly wrong. Rates of STDs had been falling before the tax rise and they continued to fall afterwards. Between 1992 and 1996 - with no rise in beer tax - there was a decline in rates of STDs that was almost as sharp as that seen in the previous years.

So what really happened? A far more convincing reason for the fall in STD rates during the late 1980s and early 1990s is AIDS awareness and the corresponding upsurge in condom use. 

It is far from unreasonable to conclude that the steepest decline in gonorrhea rates between 1991 and 1993 had more to do with increased awareness of the dangers of unprotected sex than the sobering effects of an extra 2.7 cents on 12 ounces of beer.

This, surely, is the real reason. But this logical explanation offers no excuse for the forces of public health to tax, tax and tax. Consequently, it is ignored and replaced with junk science. The only wonder is that it has taken them nearly ten years to catch on to the potential for extortion that lay dormant in the 2000 study.

Will it ever end? And as Smokles says, wouldn't it be simpler if we just gave the state all our disposable income and let the politicians and health groups decide what it gets spent on? 

*Thanks to Dick Puddlecote for the graph.

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