Friday, 20 November 2009

Football nonsense and xmas gift tips


I'm going away for a few days, so I will say cheerio and leave you with spurious piece of research:

Man Utd fans 'most keen to quit smoking'

Manchester United fans have been the keenest to sign up for Smokefree United - a virtual club of quitters that supports fans to give up smoking.

New figures show that 274 Manchester United fans have signed up to the initiative, which was launched in October by the NHS.

Far be it from me to question the veracity of this research, but could this finding - just possibly - be because Manchester United have the most fans? Having the most fans is a bit different to having fans who are 'most keen to quit'. And calling the programme 'Smokefree United' is hardly going to have Man City fans rushing to sign up, is it?

Liverpool are in second place with 182 quitters, while Arsenal are third-placed with 138 members.

I rest my case.


Also, since Amazon are selling my book at a generous discount, I hope you'll forgive me for making a shameless pre-Christmas plug for Velvet Glove, Iron Fist which comes complete with a festive red cover and could just about be squeezed into a stocking. 

Why not buy one for a loved one, work colleague or family pet? Nothing says 'I love you' quite like a comprehensive history of the anti-smoking movement. Available for £11.50 on amazon.co.uk and $16.50 on amazon.com, unless they've whacked the price up between me writing this and you reading it. 




Thursday, 19 November 2009

Fruit cakes


Dick Puddlecote has written a great post, inspired by efforts to demonise fruit juice. His conclusion is short and to the point, but it encapsulates the frustration of many people who - after a decade of junk science and scare stories - must be wondering what on earth they can eat or drink.

The article Dick links to is fascinating in the way it illustrates the cul de sac that debased epidemiology and food faddism have left us in. Please read it. Weeping is optional. 

At its heart is a study which found that children who drank more than 12 ounces of fruit juice were 3 and a half times (or 350%) more likely to be fat that those who didn't. The study only involved 168 children and the obvious explanation - that gluttons who eat a lot tend to drink a lot as well - is never entertained. 

Furthermore, the article admits:

The link between juice and weight gain isn't always found, however. In a 2008 review of 21 studies, six supported the connection and 15 did not.

None of which deters Kimber Stanhope of the (surprise, surprise) University of California, who says there is no difference between fruit juice and soda.

"Both are going to promote equal weight gain," she said, adding that she's perplexed by the fixation on the evils of sugar-sweetened beverages: "Why are they the only culprit?"

The thing is, she has a point. Once calories were identified as evil, there was never any reason to end the obesity crusade with less-fashionable items like burgers, pizza, soda. 

The tone is set near the beginning of the article with this statement:

There's also evidence that high consumption increases the risk of obesity, especially among kids.

This is a meaningless statement. It's like saying that "too much of x is harmful." It is self-evident. "High consumption" of anything containing calories could increase the "risk" of obesity. As ever, it is the quantity that matters. The poison is in the dose. 

We can laugh at such stories but one thing we cannot do is accuse those behind them of inconsistency. If we are to tax fizzy drinks because of their calorie content, it is perfectly logical to tax fruit juice, bread, potatoes - indeed everything except water and celery. There is a faultless internal logic at work here which can only be undermined by challenging the whole rotten edifice on which it stands. 

Is a tax on fruit juice likely? No, not for the time being. But only because the self-appointed guardians of public health dare not attack something that is so popular with so many. This is an important point. They have no ethical objections to such measures. It is doubtful whether issues of liberty even cross their mind. But they are pragmatists, as the reporter explains:

It's uncomfortable for advocates of a junk-food tax who say they can't afford to target juice and alienate its legions of fans.
 
Even the porky obesity zealot Kelly Brownell agrees that it is too much, too soon (Jacob Sullum has written entertainingly about Brownell here - recommended):

Brownell of Yale has waged a high-profile campaign to fight obesity with "sin" taxes on soda and other sugary drinks. It's already an uphill battle, and he said he's loath to provoke the tens of millions of Americans who consider their morning juice sacrosanct.

Dr. Frank Greer, who spent 10 years on the American Academy of Pediatrics' nutrition committee, said he "can't imagine" the group would ever downgrade juice to the status of soda.

"It's such a normal part of the American diet," Greer said. "A glass of fresh-squeezed orange juice for breakfast, my goodness!"

Fruit juice gets a stay of execution, then, only because it has not yet been denormalised. In a few years, thanks to articles like this, that may change. 




Wednesday, 18 November 2009

Wisdom of the ancients


From the BBC:

Ancients 'had heart disease too'

Hardening of the arteries has been found in Egyptian mummies - suggesting that the risk factors for heart disease may be ancient, researchers say.

Who really thought otherwise? It shows how engrained the 'Social Theory' of disease (© James Le Fanu) has become that anyone would be surprised by this finding. It's one thing to say that modern lifestyle choices are responsible for some cases of coronary heart disease, but quite another to blame them for all cases (thereby assuming that heart disease is a purely modern phenomenon).

Dr Gregory Thomas, from the University of California, said: "While we do not know whether atherosclerosis caused the demise of any of the mummies in the study, we can confirm that the disease was present in many.

"So humans in ancient times had the genetic predisposition and environment to promote the development of heart disease.

"The findings suggest that we may have to look beyond modern risk factors to fully understand the disease."

Good news, if true. However, the BBC report suggests that they're not going to be looking too far beyond them.

The researchers said that while ancient Egyptians did not smoke tobacco, eat processed food or lead sedentary lives, they were not hunter-gatherers.

So, let's see now...

Tobacco

Passive smoking

Processed foods

Sedentary lifestyles

That only leaves one thing...

All the mummies were of high socio-economic status and would have had a rich diet.

Agriculture was well-established and meat consumption appears to have been common among those of high social status.

Of course. Meat!

Thank you, social theory. Biology would be so much more complicated without you.




Tuesday, 17 November 2009

Beating up smokers


The folks at Freedom2Choose have been successful in getting Birmingham NHS to withdraw a particularly obnoxious anti-smoking commercial (also reported here). If you haven't seen it yet, click to play (it shouldn't be online much longer).




Freedom2Choose objected to it on the basis that it could encourage violence towards smokers. This does not seem to me to be an unreasonable objection. I've written before about the fine line between 'denormalisation' and hate-mongering. In recent years there have been too many incidents of what we might call smoking-related violence. Freedom2Choose presented a list to Birmingham NHS, including:

A non-smoker was jailed for two years yesterday for attacking a “deaf and mute” man who refused to stub out a cigarette.


Wales Online March 19 2008

A 17-year-old student was burned with a home-made flame thrower during a horrifying four-hour torture ordeal, a court heard.

Aerosol cans of air freshener and furniture polish were squirted at Katy James and the jets set alight with a naked flame. She was attacked by a gang of teenagers at the flat they shared in Burcot Lane, Bromsgrove, after her smoking was blamed for Hayley Kirby's miscarriage.

Her hair was set alight and she had to beat out the flames with her bare hands. Perfume was sprayed onto her stomach and also set on fire.

She was battered with a chair until its leg broke, punched, kicked and forced to drink a cocktail of coca-cola, cigarette ends and urine while her tormentors laughed, Worcester Crown Court was told.

Miss James, a vulnerable girl with learning problems, was lured home on March 23 where she was attacked by Kirby, her boyfriend Robert Hart, Wynette Darkes and her boyfriend James Smale. Kirby claimed that on that day she was told by a hospital that smoke in her body had caused her to lose the child, said Nicolas Cartwright, prosecuting. 

Bromgrove Advertiser 18 December 2006

A drinker has taken offence to a fellow drinker lighting up a cigarette in a pub and went to extreme measures to stop him - he shot the smoker in the head, killing him.

The dispute between the 50-year-old gunman and the 35-year-old smoker broke out at the Flash Road Bar in Kwartel Street, Birch Acres, Kempton Park, on Saturday night.

Independent Online 7 December 2004


Authorities allege an argument over smoking led a Brooklyn Center man to slash his wife's throat, severing her tongue and windpipe.

Authorities say Meg Lundeen and her husband, Randy Aaser, visited a couple bars with friends and colleagues to celebrate her 30th birthday Friday night. According to the complaint, she told a friend she wanted to buy cigarettes, but that she had quit smoking and that her husband would be mad if he found out.

Authorities say Lundeen was attacked later at the couple's house.

Associated Press June 13 2007


The case of the 17 year old girl is particularly troubling, since the doctor had no evidence to support his claim that secondhand smoke led to her assailant's miscarriage. This seems to be a case of 'if in doubt, blame tobacco'. Many white lies told about secondhand smoke are justified on the basis that anything that discourages smoking can't be a bad thing. "What harm can it do?", they say. This case shows the harm it can do.

Let's be clear. The responsibility for all of these horrific crimes lies with the people who committed them. But since tobacco control is set on 'denormalision', it must at least recognise the dangers of such state-sponsored stigmatisation and behave responsibly. That means erring on the side of caution and this particular campaign, in my view, oversteps the mark.

Yes, I understand the subtext of this advert, but ultimately it shows someone lighting a cigarette and then being beaten half to death as a result. For some disturbed people lurking in the darker reaches of the internet (I won't link to the sites I have in mind) this video represents some sort of wish-fulfillment. It should have been forseeable that certain individuals would get a frisson of excitement from it. The Department of Health should not be doing anything that might encourage denormalisation to spill over into violence.

I'm not suggesting that people in the public health movement want to personally assault smokers. I wouldn't even suggest that this advert alone could necessarily lead to smokers being assaulted. But it adds to a growing culture of aggression towards people who smoke. 

Above all, I'd like to know what was going through the head of the person who came up with the advert and ask why public money was spent producing it.


[Thanks for Dave and Brenda at F2C for the news reports]



Sunday, 15 November 2009

Soft drinks, tough laws



Sugary soft drinks should be taxed to raise money for hospitals and to tackle obesity, a leading doctor has urged.

Of course he has. Can we spell 'slippery-slope' yet?

Small charge added to fattening, sugary drinks 'could slow UK's weight gain and raise billions for NHS'

Spot the inherent contradiction here? Since nearly everyone consumes these drinks, it is important to stress that it will only be a "small charge". The neo-temperance campaigners face the same dilemma with their minimum-price-per-unit-of-alcohol ruse. On the one hand, they assure "responsible drinkers" that the price rise will be so low they won't notice it. On the other hand, they say that it will big enough to transform the nation's drinking culture.

But, as with booze, how will a "small charge" deter people from drinking fizzy drinks? How, for that matter, will a small charge raise "billions"? It could only raise billions if people keep drinking these drinks - if, in other words, the policy fails to do what it is supposed to do. And, like most neo-prohibitionist measures, it will fail to do what it is supposed to do.

[Dr] Chand said drinks that contained up to 17 teaspoons of sugar were fuelling the UK's obesity epidemic: "The amount of sugar that goes into some of these drinks is staggering and it has a double whammy, increasing obesity and rotting teeth."

Speaking of rotting teeth, I'm always intrigued by how we rarely, if ever, hear dentists calling for higher taxes and suchlike. I've never heard a dentist call for gobstoppers or pork scratchings to be banned, although I'm sure they could easily produce evidence to link them to nasty dental injuries. Perhaps they haven't developed a sufficiently effective PR machine, or maybe they just don't have the God complex that afflicts so many doctors.

Chand said he was talking about fizzy drinks such as high calorie colas and lemonades, as well as fruit squashes and energy drinks.

The clue is in the name "energy drinks", surely? It's pretty difficult to have an energy drink without calories and whilst the public health movement imagines us all to be catatonic in front of the television, there are plenty of us who play sports and do activities which require more than a diet of bread and water. 

Recently, the Scientific Advisory Committee on Nutrition seem to have (sort of) woken up to the fact that different lifestyles require different calorie intakes.

The calorie counts used as the foundation for diet plans and healthy-eating guidance for the past 18 years may be wrong, a report suggests.

The recommended daily intake of calories could be increased by up to 16%, a draft report by the Scientific Advisory Committee on Nutrition said.

This raises several points:

1. Public health frequently issues advice which turns out to be based on poor data and is wrong, sometimes even life-threateningly wrong (see the rethink on aspirin).

2. Apart from a few hypochondriacs, politicians and public health professionals, no one really pays attention to these daily limits. It is a huge vanity to believe that people will adjust their diet regardless of whether the Scientific Advisory Committee on Nutrition increases the daily limit by 16% or not.

3. There can be no one-size-fits-all approach to diet, calories or water consumption. People are different sizes, live in different climates and do different jobs. 2,500 calories and 8 glasses of water a day is not enough for a labourer working in the sun and is too much for an administrator in an office. The only sensible advice is - and has always been - don't take in more energy than you use up. 

But I suppose that kind of advice won't raise "billions" and - heaven forfend - people would be free to ignore it.






Friday, 13 November 2009

US smoking rate rises for the first time since 1994


Now that more than half of America is covered by smoking bans, could it be that the US is experiencing the curse of the smoking ban? From The Washington Times:

Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials' hopes that the U.S. smoking rate had moved permanently below 20 percent.

As with Ireland, where smoking rates have soared despite being the "world-leader" in tobacco control, advocates are putting their faith in still higher cigarette taxes.

Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. Perhaps the recession will have an impact, too.

"In general, when people have less money, they smoke less," Dr. Frieden said. "Time will tell."


So it is often said, but where is the evidence? Is it not the case that the poor smoke more than the rich? Even if it were true that people smoke less during recessions, it is not the amount people smoke that matters here, but the number of people smoking. The economic depression of the 1930s didn't see a fall in smoking prevalence. It saw quite the reverse. 

Evidence that recessions significantly affect smoking prevalence is thin on the ground, as is evidence that tax hikes make a major difference. There are examples of tax rises reducing prevalence (England in the 1940s, America in the early 1980s) but there are more examples of them making no difference or backfiring (America in the early 1990s, Ireland recently).

It's too early to say whether this (small) rise in US smoking prevalence is the start of an upward trend. It may be that the 2007 decline (from 21% to 19.8%) was a blip and that smoking rates have essentially been static in America for the last 5 years.

More interesting, I think, is how these statistics are generated. Always based on surveys, the figures very much depend on what questions are asked. The European journal Public Health has recently published a ground-breaking study which compares the Centers for Disease Control's surveys with those of the National Survey on Drug Use and Health. As co-author Brad Rodu explains on his excellent blog, there is a very significant discrepancy between the two.

In contrast to the decline reported by the CDC, we found evidence from another federal source that the number of adult smokers in the U.S. has been stable for about a decade. In 2005, for example, the CDC estimate was 45.1 million smokers; our analysis revealed that number could be as high as 54.2 million.

You would think that collating data for smoking prevalence would be fairly simple, wouldn't you? A simple yes/no question. But as Brad shows, nothing in tobacco control is ever simple and if the National Survey on Drug Use and Health is correct, the smoking rate has not fallen at all since 1998. Go read.



Tuesday, 10 November 2009

John Banzhaf's slippery slope


Further to yesterday's post on John Banzhaf, here's an article I wrote about the man earlier this year...


But he seemed so reasonable!


For many years the anti-smoking movement has been accused of creating a 'slippery slope' that will lead to a puritanical crusade against any product deemed to be unhealthy. The anti-smoking movement has always denied this. As Stanton Glantz (founder of Americans for Nonsmokers' Rights) said in 2006:

"The whole slippery slope argument is fallacious. It says that intelligent people aren't capable of making decisions."

In actual fact, Stanton Glantz is quite right in what he says. It is a logical fallacy to claim that just because A leads to B, that B will inevitably lead to C, and that C will lead to Z. Lawmakers can draw the line at any time. Circumstances can change. What is deemed appropriate remedial action in one case might be deemed inappropriate in another case.

And yet, history shows that the slippery slope is no myth. Those who warn that prohibitions in one area will lead to prohibitions in other areas are portrayed as fear-mongerers in their own time but, with hindsight, have often been shown to be right. The slippery slope may be a logical fallacy but it is also a political reality. Politics is not always logical.

The career of John Banzhaf III provides a classic illustration of the slippery slope in action. Banzhaf founded Action on Smoking and Health in 1968 as - to quote Richard Kluger - "an extension of a not inconsiderable ego" (Ashes to Ashes, p. 506) and has appeared on television and radio enough times in the last 40 years for us to see how he has slowly taken off the velvet glove to reveal the iron fist.

Back in 1968, ASH ostensibly existed as a pressure group to resist cigarette advertising on television to protect children. When the Los Angeles Times interviewed him in that year, he was insistent that he was anti-smoking, not anti-smoker, as their reporter explained:

"Banzhaf doesn't smoke but he denies his crusade is based on an antipathy for smokers and smoking. "You can smoke," he said. "That's all right. I just don't want children brainwashed into it."

Fast forward to 2009 and Banzhaf has a very different attitude. He now describes ASH as "a national organization leading the fight to protect nonsmokers from thirdhand smoke." ('Thirdhand smoke' being an ill-defined chimera based on a telephone survey which has no credibilty amongst serious scientists). For several years, he has been a leading voice in the campaign for smokers to be discriminated against in custody battles. Not only has he called for the children of divorced couples to be given to the nonsmoking parent, but he now believes that the smoking parent should be compelled by law to "change clothing and use a mouthwash before the child visits." Last year, he appeared on television to explain why it was "legal and profitable" for companies to "fire smokers and employ only nonsmokers."

It is safe to say that Banzhaf would have never been taken seriously had he proposed even one of these policies in the 1970s. Instead he has taken baby steps to win a long series of small victories, all the while calling for compromise and reasonable accommodation. This article documents a few examples of how he has achieved this.


Banzhaf on outdoor smoking bans


The first example comes from 1977, when Banzhaf debated with the Tobacco Institute's Walter Merryman on the Joel Spivak Show. In a lively debate, an audience member said she believed that any attempt to ban smoking in the street would be unreasonable and unenforceable. Banzhaf whole-heartedly agreed:


(Skip to part 3 - 5.55 minutes in)


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."


Of course, no one was seriously suggesting that smoking be banned in the street in 1977. It was not until 2006 that an outdoor ban was mooted in Calabasas, California. When this law was debated, Banzhaf gave testimony in support of it, now claiming that "even the small amounts of tobacco smoke hovering over a sidewalk CAN be enough to trigger an asthmatic attack".

In his testimony, Banzhaf explicitly addressed the issue of enforcement, now with a very different point of view:

John Banzhaf, 2006: 

"Equally unavailing is the argument that outdoor smoking bans may be difficult to enforce. Exactly the same argument has always been made for indoor smoking bans, but time after time - from elevators to airplanes to office buildings - they have been proven to be dead wrong as they are now being proven wrong regarding other outdoor smoking bans on beaches, in parks, and around building entrances."

Banzhaf on smoking/nonsmoking sections


In another television appearance (in 1986), Banzhaf said he wanted smoking banned in hospitals "with the exception of smoking sections". When another guest - Bob Greene - complained that anti-smoking groups were trying to make it illegal for him to smoke in a private room of a hospital, Banzhaf accused him of "creating a straw man".

The ASH director was a picture of sincerity when he put forward his compromise:




Banzhaf, 1986: 

Banzhaf: Most of the anti-smoking organisations are not against Bob smoking in his private room in a hospital, smoking in his office, smoking outdoors or smoking anywhere where it's away from nonsmokers."

Bob Greene: What about a domed stadium where professional football is being played?

Banzhaf: Then you have separate smoking and nonsmoking sections. You wouldn't object to that would you?!


But seven years later, in 1993, Banzhaf gave a very different reply. Having spent 25 years campaigning for no-smoking sections, he now flatly dismissed them:

"A non-smoking section? There ain't no such thing. Tobacco smoke drifts, it is recirculated."

Banzhaf has since gone much further, saying:

"The ultimate goal is to have a smoke-free society, by which we don't mean that nobody will smoke, but it will be something like spitting which is not done politely in public. We will not be tolerating it on public places, streets, outdoors or anywhere else."


Smoking in bars


Throughout the 1970s and 1980s, John Banzhaf would accuse many other people of constructing "straw men" when they suggested that his ultimate aim was to have smoking banned in all public places and workplaces. He made this very point to Tobacco Institute spokesman Bill Dwyer when they debated on a radio show in 1979:

Banzhaf, 1979:

"Bill, this isn't prohibition. You know it and I know it. We have no objection whatsoever if you and the other folks who want to smoke want to go into smokeasies and smoke all day long. We just object that you do it around us."


But when, more recently, Washington DC discussed exempting some bars from its smoking ban because they were losing money, Banzhaf sung a very different tune:

Banzhaf, 2007:

"I don't think there should be any exemptions at all," adding that: "The idea that we have to accommodate smokers is changing." 


Smoking bans on aeroplanes


A further example of Banzhaf insisting that he only wanted to meet smokers half way comes from 1984, when he debated with the Tobacco Institute's Anne Browder on television. The subject was banning smoking on flights of two hours or less:


(8.10 minutes in)

John Banzhaf, 1984:

"What we are talking about here is not a prohibition of smoking on airplanes. Rather it is in the nature of a compromise... We are asking for a ban only on flights of two hours or less because we feel this is a reasonable compromise based upon the needs of the smoker and the requirements of the smoker and social justice."


In 1988, bowing to the request for a 'reasonable compromise', the House of Representatives voted for a bill to ban smoking on flights of up to two hours by the narrow margin of 198 votes to 193. With it ended any further talk of a 'reasonable compromise.' The anti-smoking lobby immediately complained about the inherent inconsistency of the legislation and talked about the "loophole" that exempted longer flights. In 1990, the ban was extended to all flights.

Looking back in 2003, Banzhaf admitted that the piecemeal approach had all been part of the plan:

"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."

The slippery slope 'fallacy'


Despite such admissions, the anti-smoking movement has always resisted the slippery slope argument. Stanton Glantz, for example, has written (pdf):


"The 'slippery slope' argument is one that the tobacco industry has routinely raised to oppose policies against its interests, including smokefree policies, decisions by arts and cultural organizations not to accept tobacco money, advertising restrictions, and other policies. These predicted subsequent problems simply have not materialized"


The idea that these "subsequent problems" have "not materialized" is risible when one considers the 'sin taxes' and advertising bans currently being enacted against various drinks and food products around the world. The possibility of the anti-smoking campaign being extended to food and drink was often raised by Banzhaf's critics in the 1990s, but the notion was given short shrift by the ASH founder. In 1991, for example, he said:

"They use the 'slippery slope' argument. 'My God, if they can do this to smokers today they can do this to people who eat Haagen-Dazs ice cream or whatever.'"


Of all the hostages to fortune that Banzhaf has left in his 40 year career, this is the most ironic. Today, Banzhaf is at the forefront of the food wars. Just thirteen years after scoffing at the idea of Haagen Dazs coming under attack, he referred to ice-cream as a "coronary in a cone" and sent a letter to six ice-cream manufacturers telling them that they had been "put on legal notice that they may be sued if they don't begin disclosing just how much artery-clogging fat and calories their offerings contain."

These companies included Baskin-Robbins, Ben & Jerry's, Cold Stone Creamery, Friendly's, TCBY and - of course - Haagen-Dazs.


*Videos come courtesy of the superb archive.org and forces.org.