Five years of junk in one place

As the fifth anniversary of the English smoking ban approaches, there was always going to be a lot of bollocks talked about it, so it's nice of The Guardian to put all the fish in one barrel ready for shooting.

This could very well be the most factually inaccurate newspaper article of the year, based as it is on the scribblings of Stanton Glantz, Anna Gilmore and Jill Pell. Our credulous scribe begins as follows...

Five years after the smoking ban drove nicotine addicts out of pubs and into huddles on the pavements, the fug-filled restaurants and bars are little more than a hazy memory. But it is not just our clothes that smell better – evidence is accumulating to show that the UK population is in better health too.

Strap yourself in.

The ban did not, as opponents warned, drive people out of pubs and into their homes to smoke.

Since the smoking rate didn't go down and 11,000 pubs went bust, it would be interesting to know where the smokers are smoking now. Have they all decided to start smoking in their gardens?

Whatever their domestic smoking arrangements, there can be no argument that smokers were driven from pubs and that pubs have been literally decimated by the ban:

Ban Damage

ASH: Hopeless liars

Pub share prices

Pete Robinson unleashed

A final word on ban damage

The big worry was that an increase in smoking at home would harm children, who were not subjected to so much secondhand smoke in restaurants and pubs. But a study carried out in Scotland, published in the New England Journal of Medicine in 2010, suggested their health has improved. Fewer have been admitted to hospital with asthma attacks since the Scottish ban on 26 March 2006, more than a year before the English ban.

The researchers looked at more than 21,000 asthma admissions between 2000 and 2009 for children under 15 years. Before the legislation, admissions among preschoolers were rising by more than 9% a year, while for older children they were stable. After the ban, they dropped by 18.4% for preschool children and 20.8% for those aged five to 14.

Utter bilge from the pen of Jill Pell and easily debunked by looking at the actual hospital admissions data. If that isn't good enough for you, compare and contrast these two statements made three months apart in 2011:

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

Asthma UK said the number of emergency admissions had remained unchanged for a decade - suggesting the asthma of many young people was still being badly managed... "there has been no noticeable change in the unacceptably high emergency hospital admissions for children and young people with asthma in the last decade."

The first statement is based on the work of Ms. Pell. The second is from an asthma charity and is based on actual hospital admissions. They both refer to the same country and the same time. Who do you believe? More details here.

The biggest health impact has been a drop in heart attack emergency admissions – the "Montana effect", which has since been identified in many other places that have brought in smoking bans. Helena, in Montana, brought in a smoking ban in June 2002, but it was scrapped that December. During those six months, however, researchers publishing in the British Medical Journal found a drop in heart attack admissions to hospital.

The Helena miracle? Is that zombie study still walking?! The BMJ's decision to publish Stanton Glantz's innumerate masterpiece of cherry-picking shames the journal forever more. Details here. There is also the small matter that, no matter how you juggle the figures, a reduction in heart attacks of 40%, or even 4%, is mathematically impossible.

Anna Gilmore and her colleagues, at Bath's school for health, analysed heart attack hospital admissions for England between July 2002 and September 2008 and found a small but significant drop of 2.4% after the July 2007 ban. It was the equivalent of 1,200 fewer heart attack patients, they said in their paper in the BMJ.

Anna Gilmore's study was pure junk science.

But overall, it is pretty clear that smoking bans have made a difference to heart health. A Cochrane review, which scrutinised the data from 10 studies from North America, Italy and Scotland, found a drop in hospital heart attack admissions in all of them and a drop in the numbers of deaths in two.

Garbage in, garbage out. The Scotland study ignored the actual hospital admissions and was debunked by the BBC five years ago in addition to being included in The Times' Top 10 Junk Stats of 2007 (now behind a paywall). The Italian study was beyond a joke. And the biggest study conducted in America found no association whatsoever between smoking bans and heart attack reductions.

I hope you enjoyed that walk down memory lane. Here's to the next five years!

Meanwhile, back on planet Earth, the police are still raiding pubs and arresting landladies to enforce that "popular" smoking ban of ours.

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The Causeway Cannibal, Zombie Apocalypse and the same old pattern of misinformation

I'm sure you've heard about the case of Rudy Eugene, AKA the 'Causeway Cannibal' who, on May 26th, attacked a homeless man in the streets of Florida, biting off part of his face. Eugene, who was mysteriously naked at the time, was shot to death by policeman at the scene of the crime. This bizarre and horrific case was immediately blamed on Eugene's alleged use of 'bath salts', an amphetamine-like legal high that has become mildly popular in the last two years.

This story created two moral panics at once. Firstly, that the world is heading towards a Zombie Apocalypse, and secondly that 'bath salts' are sending people loopy around the world and that something must be done.

The Zombie Apocalypse nonsense is too silly to discuss. As Dan Gardner says in his excellent book Risk, when one extraordinary event has been reported, journalists are eager to cover similar stories—even if they really aren't that similar—thus creating the illusion of a wider trend and a mounting crisis.

If someone is killed by a shark, for instance, all other shark attacks and near-misses are also reported, thereby giving the impression that the original event was part of a spate of attacks (a shark apocalypse). In truth, the subsequent non-fatal bites and sightings would not normally have been reported at all. Similarly, a woman biting a bit of her husband's face during a fight or a man eating his dog would not normally be regarded as cannibalism, but the Causeway Cannibal story is still fresh in our minds so let's pretend it's all part of the same picture.

The 'bath salts' aspect also follows a tried-and-tested model which I outlined in The Art of Suppression. The typical scenario runs like this: someone dies or nearly dies; the police/family/friends claim that the legal high du jour was involved; politicians and the media clamour to have the drug banned; toxicological evidence subsequently shows that the victim had not taken the drug; the drug is banned anyway.

This sequence of events has been repeated with only the slightest variations over the last twenty years, most recently when mephedrone was blamed for the deaths of two lads in Scunthorpe. The drug—known in the media, but not to users, as 'miaow miaow'—was swiftly banned in the UK. Only later did the coroner's report find that they had not taken mephedrone at all. They had taken the similarly named—but very different—drug methadone.

But waiting a few weeks for toxicological reports to provide some actual evidence is not what prohibitionist politicians do. As the Sun Sentinel reported back in May...

It'll be weeks before anyone knows for sure whether Rudy Eugene was even on drugs — traditional or synthetic — when he mauled Ronald Poppo on the MacArthur Causeway last Saturday. But some South Florida cities aren't waiting for the coroner's report. Horrified by the attack, they are adding bath salts to their previously announced plans to ban the sale of synthetic marijuana...

A week later, in Canada...

The Canadian Government announced Tuesday it will issue a ban on the street drug known as "bath salts" following the gruesome face-eating attack in Miami, Florida.

In Britain, the Daily Mail gave the story repeated coverage, such as this from June 24th...

British dealers are supplying America with the drug behind wave of horrific cannibal attacks feared to be 'zombie apocalypse'

The drug being blamed for a spate of cannibal attacks in the U.S. is entering the country from the UK.

Horrific assaults in which users of a substance known as 'bath salts' have eaten victims' flesh have given rise to speculation that America is in the throes of a 'zombie apocalypse'.

Proof that the whole world has gone insane can be found in the last paragraph of that report...

The Center for Disease Control even felt it necessary to address these fears, saying: "CDC does not know of a virus or condition that would reanimate the dead (or one that would present zombie-like symptoms)".

And then yesterday in America...

The Zombie Apocalypse phenomenon has entered presidential politics as Sen. Rob Portman (R-Oh.), one of Mitt Romney’s potential picks for VP, introduced an amendment to a Senate FDA bill that would implement a federal ban on the substance, helping the bill pass (92-4) and sending it on its way to President Obama’s desk.

“This ban can’t come quickly enough,” Grassley said. “Just about every day, there’s a new tragedy related to bath salts. The sooner this poison is off the store shelves, the better. I hope the president will sign this measure into law very quickly.”

Ever since the gruesome Miami cannibalistic attack stunned the nation during Memorial Weekend, bath salts have become a concern for recession-hit communities across the country that have been terrorized by zombie-like synthetic drug users that seem to follow a now familiar pattern of stripping naked, growling and trying to bite or eat their victims. The latest casualty, a family dog which was eaten alive by a Waco, Texas, man allegedly high on the deadly substance.

From day one, I have been very sceptical about the claim that this man was on 'bath salts'. This is partly because I have seen this pattern of events before and partly because—as I have been repeatedly saying on Twitter for the last month—there was no evidence that he had ever taken the drug, let alone was under its influence at the time of the attack. There was not even circumstantial evidence, such as his girlfriend (who also seems to be slightly odd) or family saying that he had a taste for legal highs. Nothing.

And so it has proved today...

The medical examiner's toxicology report of the "causeway cannibal" is back. Surprisingly, no "bath salts" or other strong street drugs were in his system.

Only surprising if you believed the unsubstantiated rumours to begin with.

Police immediately said "bath salts," synthetic drugs sold at convenience stores, were to blame.

They did indeed, but why? According to the Daily Mail...

The results were released weeks after a Miami police union official had speculated that because Eugene's behavior had been so bizarre he was probably under the influence of bath salts.

That's it?! Speculation from a single policeman who lacks the imagination to attribute bizarre behaviour to anything other than legal highs?! That's the evidence upon which hundreds of news stories and several pieces of proposed legislation has been based?!

It is. There was never anything more to it than that.

In the typical prohibitionist scenario I outlined in The Art of Suppression, toxicological reports usually get a fraction of the column inches given to the original false rumours. Because the Causeway Cannibal case has been such a big story, in this instance the facts of the matter are now getting out there but, as Maia Szalavitz writes in Time, the damage has been done...

Despite the fact that Eugene had no synthetic drugs in his system, it’s likely that his case will still be used for years as an example of what bath salts can make people do. If our history of wrong-headed beliefs about drugs is any indication, the association between bath salts and dangerous behavior will stick simply because it surfaced early. Since bath salts just arrived on the illegal market and remain untested and mysterious to many people, they will cling in ignorance to the horror stories about them.

I make no claims for or against 'balt salts'. I've never taken it, nor do I feel any urge to do so. It may be the worst drug to ever hit the market, or it may be an unlikely panacea.

I do know this, however. The publicity given to this drug since the Florida attack has made it world famous and more people will take it as a result ("It's legal! You can buy it online!", as the newspapers repeatedly tell us.) Furthermore, the drug will now be banned in many jurisdictions (in Britain, where it is known as Ivory Wave, it was banned last year) and new drugs will immediately come on the market to replace it—just as 'bath salts' replaced mephedrone. We will know even less about these new substances than we did about 'bath salts', and the pattern of tragedy, rumour, misinformation and prohibition will be repeated again. And again.

As for the Causeway Cannibal, new information has been released which apparently no one thought relevant to mention earlier.

Mental illness has always been a possibility. WPLG in Miami has confirmed that Rudy Eugene was diagnosed with schizophrenia. After this new toxicology report, that becomes the likeliest reason behind this unexplainable attack.

It looks as if the truth has finally put its shoes on in the Causeway Cannibal case. We will learn our lesson this time?

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ASH's funding: Who's been lying?

I note from Taking Liberties that the government is preparing to give taxpayers' money to ASH for the 42nd successive year. I discussed ASH's 2008 funding application in Sock Puppets, saying:

Contrary to the DH’s claim that it does not fund external research, ASH promised to provide “policy development research, research and analysis for DH, and for other government departments”.

Contrary to ministerial assurances that “none of this funding is to be used for lobbying purposes”, ASH specifically pledged to use part of this Section 64 grant for “media advocacy and lobbying”.

It is worth putting a little flesh on this information since the implications are potentially scandalous. Department of Health guidelines are quite explicit in ruling out the provision of Section 64 grants for research, with only a few specific exemptions...

The Department’s policy is not to award grants if:

- the grant will support research – we define research as ‘creative work carried out systematically to increase knowledge’. There are some instances where the Department may award grants, including for development projects, information services, routine surveillance or data-collection activities.

With regards to lobbying, successive ministers have stated in parliament that DoH grants to ASH are not, and cannot, be used for lobbying. Here is Dawn Primarolo, then Minister for Public Health, speaking in 2008:

Action on Smoking and Health (ASH) received funding from the Department in the current financial year in accordance with the 'Section 64 General Scheme of Grants to voluntary and Community Organisations'. The standard conditions attached to these grants including audit procedures are published on the Department's website.

ASH has received this grant specifically to carry out a defined project entitled "Capitalising on Smokefree: the way forward". None of this funding is to be used for lobbying purposes.

And here is Anne Milton, the current Minister for Public Health, speaking in 2011:

Action on Smoking and Health (ASH) has received funding from the Department in the past, through the Department's ‘Section 64 General Scheme of Grants to voluntary and Community Organisations’. ASH received these grants specifically to carry out defined projects.

None of this funding was, or could be used, for lobbying purposes.

Seems pretty unambiguous, no? But...

ASH's Section 64 funding request of 2008 tells a rather different story. Thanks to a Freedom of Information request made by Richard Puddlecote, we can see that ASH explicitly told the Department of Health that their "methods for achieving our objectives" included...

"Media advocacy and lobbying" (point 2 below)

and

"Policy development research, research and analysis both for DH, and for other government departments" (point 4).

ASH were duly awarded £600,000 over three years, as they had asked for. This raises a couple of thorny questions which require answers.

Were ASH lying when they told the DoH that they would spend the money on lobbying and research? It seems most unlikely that they would do so.

If they weren't lying and in fact did use part of the money for lobbying and research, then successive government ministers have misled the House when they said that grants to ASH were not used for these purposes.

Were the ministers lying, or had they been lied to by ASH or the DoH? In either case, why were these grants awarded in the first place when the application made it clear that at least part of the money would be used in ways which broke Department of Health rules?

I think we should be told.

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The shocking rise of non-communicable diseases

This nice little graph from The Atlantic tells a big story. Note how the annual mortality rate has nearly halved in the last 110 years and how the infectious diseases have been replaced by 'non-communicable diseases', especially heart disease and cancer, but also diabetes and respiratory disease.

Earlier this month, I wrote about the coalition of NGOs who have persuaded the World Health Organisation to pledge to reduce premature deaths from non-communicable diseases by 25% by 2025.

On Saturday at the sixty-fifth World Health Assembly - a meeting of the 194 member countries of the World Health Organisation – ‘delegates approved the development of a global monitoring framework for the prevention and control of NCDs, including indicators and a set of global targets. Member States agreed to adopt a global target of a 25 per cent reduction in premature mortality from non-communicable diseases such as cardiovascular disease, cancer, diabetes and chronic respiratory diseases by 2025.’

As you can see from the graph above, such a promise is little different to pledging to reduce total mortality by a quarter within thirteen years. To state the obvious, that is not going to happen.

What do these people think we should die of? If you exclude the infectious diseases and the 'non-communicable diseases', there isn't a whole lot left. You'll note that 'dying in a perfect state of health' is not an option. Presumably they want us to either die in an accident or commit suicide.

Or maybe they're planning to reintroduce tuberculosis and pneumonia. As the graph shows, that's the only proven way to keep non-communicables diseases under control.

I will leave the last word to the estimable Dan Gardner...

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A 21st century temperance manifesto

In Sock Puppets, I mentioned a lobby group called Active Europe which is funded by the European Commission and the Council of Europe. Also known as Active Sobriety Friendship and Peace, its vision is "a world free from alcohol". It is a direct descendant of the International Order of Good Templars, the nineteenth century temperance outfit, and it continues to preach the virtues of teetotallism.

These people want an EU-wide alcohol strategy and, judging by a meeting to be held next week, the EU agrees.

What might such a strategy involve? If Active Europe get their way, it will involve a very great deal. They have published a list of "demands" (their word) based on the increasingly popular concept of "passive drinking" which, as you will see, is not the only piece of rhetoric they have borrowed from the anti-smokers.

Active demands that:

Direct and indirect alcohol marketing should be prohibited all over Europe

I'm not sure what indirect advertising is. Point of sale perhaps?

Alcoholic beverages should be clearly marked with content labels and labels warning the consumers about the risks connected with alcohol consumption. The warning text should cover at least 40% of the label.

Gee, I wonder where they got that idea from?

Alcoholic beverages targeting young people should be banned

Alcopops? Cider? Rum and Coke?

Alcohol product packaging and labeling should not be allowed to create a misleading impression about the content of the beverage, about the effects of the alcoholic beverage and they must not appeal to minors

That sounds like a recipe for plain packaging.

Alcohol should neither be sold in multiple packages nor offered at quantity discounts

Fine. I'll buy it by the barrel then.

The media should be cautious about consequences of alcohol consumption and avoid glamorization of alcohol consumption and alcohol products.

State control of the media. Why not?

European countries should adopt the model of retail monopolies for selling alcoholic beverages

State control of the alcohol retail industry. Why not?

Municipalities and local authorities should reduce the density of outlets

Notice that they give no ideal number of outlets. This is classic temperance stuff. However many outlets there are, there should be fewer. However high alcohol duty is, it should be higher.

Speaking of which...

All countries should increase minimum taxes on alcohol

Of course they should. Without end.

Non alcoholic beverages should be always more available than alcoholic beverages

What does "more available" mean? Pubs should stock more soft drinks than alcoholic drinks?

Alcohol should not be sold in packages

Plain packaging again?

Minimum prices for alcoholic beverages be introduced in all countries

That would break EU law, but never mind. It hasn't stopped the English and the Scots having a go.

Producing and selling home-made alcoholic beverages should require a license

Seriously?! That wasn't the law even during Prohibition.

All traffic, on the streets and highways, in the air and on the seas should be alcohol free.

Just to remind you, we—as taxpayers—are paying for this group to spout this stuff.

The alcohol industry should not be included in policy making on the alcohol field

Following the anti-tobacco blueprint to the letter.

Research financed by the alcohol industry should be discredited and ignored in the policy making processes

Ha! It should "be discredited and ignored" purely because of the funding source. How very enlightened.

Alcohol consumption has the consequences that the user escapes from reality instead of solving the problem. Obviously this creates obstacles for human beings to participate in the democratic processes. This amounts to political harm because in a well-functioning society everybody is empowered and engaged and nobody is influenced by drugs.

Do you know what I think "creates obstacles for human beings to participate in the democratic processes"? Governments funding special interests groups to lobby it while the rest of civil society is left out in the cold, that's what.

This group of neo-prohibitionists not only receive large sums of money from the EU (they list no other funding source). They are classed as "stakeholders" and they regularly "engage" with EU decision-makers. This system of patronage is endemic in the EU and has been a growing problem in the UK in the last decade. Welcome to the post-democratic world of state-funded activists and phony consultations.

Everyone is entitled to their opinion. I just don't want to pay for it.

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A word from a cynical career politician

Hands Off Our Packs have produced a quality video which gives a nod to Yes, Minister and mocks the vacuity of modern politics, the power of bureaucrats and the nonsense of plain packaging all at the same time. Enjoy.






The government's consultation about this is drawing closer. It ends on July 10th so if you haven't registered your displeasure, go to the HOOPS site and add your name to the list. If you want to respond in detail, you can go to the Department of Health website.

The DoH is spending vast sums of money promoting this policy, despite this 'impartial' public consultation being run by the, er, DoH. Speak up now or allow the government's sock puppets to speak for you.

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It's official: Soda is new tobacco

Having spent years explaining that the anti-smoking crusade is merely Phase One in a wider assault on liberty, it seems my work may soon be at an end. As the EU prepares itself for a Framework Convention on Alcohol, an article has appeared in PLoS which removes any doubt about the slippery slope. Directly comparing the soda industry with the tobacco industry, a bunch of social scientists from—you guessed it—California bludgeon the reader over the head with the news that Coca-Cola and its customers are next in line for denormalisation and extortion.

The hook for their argument is the soda industry's 'corporate social responsibility' programmes, ie. various anti-obesity campaigns, multi-million dollar philanthropy and community involvement. The authors note that the tobacco industry has also given money to the community in this way and therefore, by this tenuous association, the soda industry is EVIL.

Many other businesses also have corporate social responsibility programmes, of course, but they don't get mentioned because it would spoil their already paper-thin argument. Instead, they focus on Pepsi's Refresh project and Coca-Cola's Live Positively campaign.

As exposés go, I've seen better.

They use educational campaigns such as “Balanced Living” or “Exercise is Medicine” to urge individual consumers to achieve healthy lifestyles;

Shocking.

... [they] support charitable projects, such as the $2 million Spark Your Park (also called Sprite Spark Parks) initiative to refurbish basketball courts and school athletic fields in underserved communities;

The swine! Their businesses should be closed down, their factories razed to the ground and salt poured on the land so nothing can ever grow there again.

...and develop initiatives to improve the company's own business practices, e.g. reducing its water consumption.

Disgraceful stuff, I'm sure you'll agree. Just like Big Tobacco, only worse...

Soda CSR differs from tobacco in its explicit appeals to youth and in the aggressive launch of comprehensive campaigns soon after soda was linked to obesity.

It seems to be an iron rule that when governments spend large sums of money on public health campaigns, the advertisements are "innovative" and "hard-hitting", whereas even the most modest industry advertising campaign is "aggressive". Elsewhere in this article you can read about how the soda industry "has aggressively lobbied against taxes" and is "explicitly and aggressively profit-seeking". I wonder who the real aggressors are—the businesses trying to defend themselves or the fanatics who would impose their beliefs on others using state force?

Even from these brief descriptions it appears that the soda CSR campaigns reinforce the idea that obesity is caused by customers' “bad” behavior

If by 'bad behaviour' you mean choosing to consume more calories than you burn off, then yes, obesity is caused by bad behaviour.

Such tactics redirect the responsibility for health outcomes from corporations onto its consumers...

Beyond having to comply with basic safety requirements, corporations are in no way responsible for your health. You are. Never in history have we had more choice about what we eat and drink. Even within the soda industry, there exists a huge range of low- and zero-calorie products for you to choose from. What you decide to eat and drink is entirely a matter for you. Few choices are more personal and less public.

...and externalize the negative effects of increased obesity to the public

That sentence makes no sense. The soda industry is in no way responsible for someone becoming obese, but even if it were, the effect could only ever be internal to that person.

The overall goal for the tobacco industry's CSR strategy has been to normalize its products and its corporate image, but it has struggled as public health advocates have denormalized tobacco use and challenged tobacco companies trying to rehabilitate their images. Historically, advocates countered such campaigns by stigmatizing smoking. Now, denormalization characterizes the corporation's activities as a disease vector, and highlights the disingenuous use of CSR.

...The soda industry appears to be improving upon Big Tobacco's CSR strategy by acting sooner.

Sooner before what? Before "advocates" denormalise soda drinking, stigmatise soda drinkers and portray the soda industry as a disease vector, presumably. Well, yes. And who can blame them? They have the advantage of having seen the anti-tobacco blueprint. They know what's coming. They know that "advocates" will not stop with warning labels and sin taxes. They know that "advocates" will never be satisfied until the targeted product is illegal. Damn right they need to act. It's a shame that this action is limited to setting up charitable trusts.

While soda companies may not face the level of social stigmatization or regulatory pressure that now confronts Big Tobacco, concern over soda and the obesity epidemic is growing.

You don't need to read too far between the lines to see that social stigmatisation is on the horizon.

Unlike tobacco, at the first signs of soda denormalization soda companies quickly launched comprehensive, well-funded, international CSR campaigns that take advantage of social media.

Soda denormalisation, eh? How quickly things progress. For the "advocates", of course, this denormalisation is both essential and urgent.

Without sustained denormalization of soda, it will be harder for public health advocates to see why partnering with industry may further the companies' goals more than their own.

So what next? Having set our sights on the soda industry, all we need is a bit of junk science to decorate the crusade.

Research on the health harms of sugary beverages can help advocates name these products as one of the “biggest culprits” behind the obesity crisis. Emerging science on the addictiveness and toxicity of sugar, especially when combined with the known addictive properties of caffeine found in many sugary beverages, should further heighten awareness of the product's public health threat similar to the understanding about the addictiveness of tobacco products.

And there you have it. Addiction, toxicity, 'public health' and an evil industry that is copying Big Tobacco. I think we can say that Phase Two has officially begun.

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