Last week's news

I wrote a couple of posts for the IEA last week on some topics you might be interested in. I forgot to mention them here at the time.

Firstly, I responded to some complaints about the new 'anti-sockpuppet clause', pointing out that the idea is to stop taxpayers' money being used to fund political campaigns, not to stop charities giving advice to politicians.

Secondly, I assessed the Guardian's claim that 'Australians are ditching cigarettes at record levels' thanks to plain packaging. As the chart below shows, tobacco sales are falling at the usual rate. If anything, plain packaging did its best to reverse that trend.

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James Enstrom wins

When I was in Australia last year, I cited John Snow, Katherine Flegal, James Enstrom and the authors of the 'Australian paradox' study as victims of groupthink for having arrived at scientific conclusions that contradicted 'public health' dogma (article here, video here).

Of the four, James Enstrom got the worst treatment. He produced research that challenged not one, but two, political agendas. Not only was he the co-author of a study that found no association between secondhand smoke and lung cancer and heart disease in 2003, but he also found that the threshold of risk from diesel particulate matter was considerably higher than the Californian Environmental Protection Agency assumed when it introduced punitive restrictions on vehicle pollution.

A number of studies have supported Enstrom's findings, but Cal-EPA ignored them in favour of a study conducted by Dr Hien T. Tran which happened to find a serious risk from the very thing Cal-EPA wanted to ban. However, as Enstrom discovered, "Dr." Tran had bought his PhD from an online University for $1,000. Although Cal-EPA eventually accepted this, Enstrom was sacked by UCLA because—in the university's own words—his research was "not aligned with the academic mission of the Department".

Enstrom has been appealing his dismissal for the last few years. 

Dr. Enstrom not only blew the whistle on junk science driving recent proposed California diesel emissions restrictions, he discovered the state’s lead “scientist” had purchased his degree from a fictitious “Thornhill University” and that many members of the state’s Scientific Review Panel had overstayed term limits by decades. While the fake scientist received only a short suspension after Dr. Enstrom discovered his fraud, UCLA not only fired Dr. Enstrom, it also looted his research account of tens of thousands of dollars and failed to pay him any salary for more than a year.

 I'm delighted to see that Enstrom has finally prevailed...

Not only did the Regents agree to pay Dr. Enstrom $140,000, but they also have effectively rescinded the termination, agreeing to Dr. Enstrom’s use of the title “Retired Researcher” (as opposed to acknowledgment as a non-titled terminated employee) and his continued access to UCLA resources he previously enjoyed during his appointment.

This is a significant victory for academic freedom and the fight against policy-based evidence, as David French from the American Center for Law and Justice explains:

Dr. Enstrom’s victory comes at a critical time, reminding the public that the scientific establishment is hardly infallible. Indeed, it’s subject to all the same failings as any human institution, including greed, corruption, and bias. It’s worth remembering as the House once again takes up the Secret Science Reform Act, a bill that would render the EPA more transparent by requiring it to make available for public review the “scientific and technical information used in it's assessments.”

It shouldn’t take an act of job-risking courage to bring transparency and honesty to science, but in the Leftist-dominated academy, dissent from progressive orthodoxy is seen as toxic, instead of patriotic. Here’s hoping that with more victories like Dr. Enstrom’s (and Dr. Mike Adams’s jury verdict last year), universities will learn that censorship is expensive. Protecting academic freedom may lead to less scientific “consensus,” but it will certainly lead to greater integrity.

It's nice to report a bit of good news for a change. More details here and here.

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2040 vision

 

"There will be no more smoking!"

1916
Lucy Page Gaston of the Anti-Cigarette League launches the slogan 'A smokeless America by 1925'.

1984
Surgeon General Koop launches the slogan 'A smoke-free society by the year 2000'.

2015
The Lancet: 'Experts call for a tobacco-free world by 2040'

Prohibitionists are nothing if not ambitious. Maybe this time will be different. There are plenty of starry-eyed zealots goose-stepping out the universities who would like to make it so, but I doubt it. Something that has been smoked for thousands of years is not going to disappear in 25 years. It could only happen if everybody decided they didn't want to smoke but, as Dick Puddlecote illustrates with a graph that says a thousand words, that ain't the case.

It certainly isn't going to happen if the authors of the Lancet fantasy get their way. They think too much time has been spent trying to reduce demand when they should be reducing supply. Reducing supply without reducing demand, what could go wrong?

I think it's much more likely that everybody will have seen through the 'public health' scam by 2040. The very term 'public health' will be something akin to a swear word and the handful of 'public health professionals' who are not dead or in prison will have invented some new euphemism for authoritarian prodnosery. They will be treated with mixture of pity and contempt, but mainly contempt.

Now there's something to work towards.

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Denying the slippery slope while greasing the slippery slope

Marion Nestle, an American food activist, has written a very badly thought out article for New Scientist which denies the existence of a slippery slope while simultaneously calling for tobacco-style regulation of food and drink.

It's clear from the outset that she's out of her depth...

That plain wrappers will undoubtedly further reduce smoking, especially among young people, is best confirmed by the tobacco industry's vast opposition to this government measure

No. All that tells you is that the industry is worried that people will buy cigarettes with lower profit margins, as even anti-smoking activists like Luk Joosens and Simon Chapman have admitted.

...to perk up its tired and thoroughly discredited campaign, the tobacco folks have added a new argument. Requiring plain wrappers on cigarettes, they say, is a slippery slope: next will be alcohol, sugary drinks and fast food. This argument immediately raises questions. Is it serious or just a red herring? Should the public health community lobby for plain wrappers to promote healthier food choices, or just dismiss it as another tobacco industry scare tactic?

I don't know, Marion. Why don't you ask Michael Jacobson at the Center for Science in the Public Interest, who recently said:

“The ‘plain-packaging' concept is certainly appropriate for junk foods, and that’s especially the case for junk foods marketed to children. Snazzy graphics, spokes-characters, misleading health claims and other devices shouldn’t be allowed to distract from the fact that a food or beverage contributes to obesity, tooth decay, heart disease or other health problem.”

Nestle, however, doesn't think plain packaging should be rolled out to food (yet), but only for administrative reasons...

...the problem is deciding which foods and beverages might call for plain wrappers. For anything but soft drinks and confectionery, the decisions look too vexing. Rather than having to deal with such difficulties, health advocates prefer to focus on interventions that are easier to justify – scientifically and politically.

And what might these be?

If not plain packaging, then what? Studies suggest small benefits from a long list of interventions such as taxes, caps on portion size, front-of-package traffic-light labels, nutrition standards for school meals, advertising restrictions, and elimination of toys from fast food meals and cartoons from packaging. Rather than dealing with the impossible politics of plain wrappers on foods, health advocates increasingly favour warning labels.

Ah, you mean warning labels like the warning labels that first appeared on cigarettes? The warning labels that the evil tobacco industry said would end up on other products as a result of the fictitious slippery slope (which is not, by the way, a "new argument")?

You mean the warning labels that anti-smoking campaigners insisted would only be put on cigarettes and that any claim to the contrary were industry spin? Campaigners like Simon Chapman, for example, wrote an article in 2003 which read as follows:

Arguments used to avoid, delay, and dilute health warnings

Within the four strategies outlined above, the industry has used six main arguments to oppose the introduction and strengthening of warnings:

• tobacco warnings are the start of a “slippery slope”

This, he said, was a risible lie, explaining...

"Slippery slope”

In pre-warning days, when arguments could be couched in incredulity that tobacco should be singled out from other consumer products, the industry used “slippery slope” or “thin edge of the wedge” rhetoric, arguing that the policy would inexorably bleed into other product areas.

“The precedent is one which could easily come to affect other industries. For instance, a number of medical scientists claim that butter and milk are dangerous to the health of some people. It is recognised that drinking too much liquor or reckless driving are hazards to life... can we expect all these products to carry a ‘danger’ label ...?”

This argument appears to have quickly lost momentum when the dire predictions of rampant warnings never materialised.

These are the kind of warnings you want on food, right Marion? The ones that the industry—and not just the industry but many sentient people—said would be introduced once the precedent was set with tobacco?

And you are saying that there is no slippery slope while calling for a policy to be extended from tobacco to other products? You see the problem there, don't you?

She continues:

Although no warning label law has passed so far, such messages are the logical next step in promoting healthy food choices, in the same way that plain wrappers are the next logical step for all cigarette packages. Health advocates should recognise the slippery slope argument for the typical tobacco ploy that it is.

Good grief. The lack of self-awareness is staggering. If plain packaging is the 'next logical step' for tobacco, and tobacco-style warnings are the 'next logical step' for food, it is not difficult to work out what the 'next logical step' for food will be once warnings have been introduced.

How naive do these people think we are?

By the way, the image at the top of this post, like those below, has not be mocked up by industry reps or slippery slope obsessed libertarians. They've been designed by the Ontario Medical Association and they're not kidding.

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The fizzy drink tax racket

From The Guardian:

A sugary drinks tax could save the NHS up to £300m over 20 years, according to campaigners, who say costs would be slashed by the reduction in diabetes, stroke, heart disease and cancer.

No, no, no. We explained this last year when the Children's Food Campaign—for it is that state-funded pressure group again—used similar estimates to claim that Londoners would "save" £39 million over 20 years.

What they neglect to mention (but have mentioned previously) is that their sugary drinks tax would cost taxpayers £20 billion over those same 20 years. The taxes would be paid by drinkers of sugary drinks (ie. nearly everybody) rather than general taxpayers (also nearly everybody), but it would be an extra burden, not a saving.

The maths shouldn't be too much even for Guardian journalists:

Cost: £20 billion

Saving: £0.3 billion

Net cost: £19.7 billion

“Current taxes on foods are a mess, and don’t support people choosing healthier options,” said Malcolm Clark, co-ordinator of the Children’s Food Campaign.

That's not wholly true. The tax system on food and drink is a mess, but it mostly supports Malcolm Clark's aims. Fruit, vegetables and water are VAT-free. Fizzy drinks, chocolate and takeaways are not. In other words, there already is a 20 per cent tax on sugary drinks and there is a 20 per cent tax on lots of other 'unhealthy' products too.

“Using the revenue to set up a Children’s Health Fund, paying for programmes to improve children’s health and protect the environment they grow up in, would also ensure that this was a progressive measure, benefiting families in poverty and on low incomes."

This is a reference to the £1 billion a year that Malcolm and his colleagues are hoping the government will hand over to people like them to set up "an independent body" and to pay for "education".

Let's be clear, there is nothing "progressive" about using an indirect stealth tax to pick the pockets of the poor and give the spoils to middle class do-gooders and bureaucrats. Such a tax would be unambiguously regressive. To claim that families in poverty would benefit because some ball-juggling quango sticks a glossy pamphlet through their door once every five years is so ludicrous as to be borderline offensive. It is an appalling idea on every level.

Speaking of middle-class bureaucrats pissing away taxpayers' money...

“Public health directors in north-west England and in Cardiff, as well as the London Health Commission, have publicly backed a sugary drinks duty."

To paraphrase the late Mandy Rice-Davis, they would, wouldn't they? That's another good reasons why these pointless parasites should be kicked out their jobs and their quangos closed down.

"We hope this new research encourages public health directors across England to join their counterparts in calling for the government to introduce a nationwide duty.”

A state-funded sock puppet calling on other state-funded sock puppets to lobby the government for higher taxes so they can get more funding. What a sleazy little racket these people have going on.

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Jumping on the sugar bandwagon

This had to happen. Stanton Glantz has jumped on the anti-sugar bandwagon with an article that is so bad it made me laugh out loud a couple of times.

Glantz made his name in the 1990s after he was sent thousands of pages of internal tobacco industry documents which he turned into a book called The Cigarette Papers. He's been dining out on them ever since and now he is trying the same routine with the sugar industry. It's a shrewd business move which gives him something to fall back on if his $6.6 million anti-tobacco racket ever fades.

“Sugar Papers” Reveal Industry Role in 1970s NIH Dental Program ... just like Big Tobacco

Big Tobacco was involved in a dental program?

It wasn't, of course. The sugar industry was "just like Big Tobacco" in the sense that it, er, exchanged goods for money.

The archive of 319 industry documents, which were uncovered in a public collection at the University of Illinois, revealed that a sugar industry trade organization representing 30 international members had accepted the fact that sugar caused tooth decay as early as 1950, and adopted a strategy aimed at identifying alternative approaches to reducing tooth decay.

"Uncovered in a public collection", for god's sake.

The first author located these documents in 2010 in an inventory of the papers of Roger Adams housed in the University of Illinois Archives through a Google search using the terms “International Sugar Research Foundation” and “archives”. Roger Adams, Emeritus Professor of Organic Chemistry, served on the SRF [Sugar Research Foundation] and then ISRF [International Sugar Research Foundation] Scientific Advisory Board from 1959 until his death in 1971. Adams’s files contain correspondence with sugar industry executives, meeting minutes, and other relevant reports.

Wow, the sugar industry is really bad at hiding things. They put entire archives in publicly accessible libraries which can be found with a simple Google search. It's almost as if - I dunno - they feel they haven't got anything to hide.

Glantz's schtick in this 'study' is to assume that sugar should have been treated like tobacco as soon as it became apparent that it increased the risk of dental caries (tooth decay). In fact, the government worked with the sugar industry to look at ways of preventing tooth decay, such as tooth-brushing, fluoridation, product modification and research into a possible vaccine. These efforts are ludicrously portrayed by Glantz as tobacco-style 'deflection and delay'.

Jenkins saw fluoridation as “the only thoroughly well-established method of reducing caries which does not require the active (and usually reluctant) participation of the patient”.

Well, perhaps it is. Glantz doesn't seem to understand that it is very difficult to get people to stop eating sugar - even if it was the government's job to force them - and he is dismissive of those who do. People like Richard Greulich of the Nationak Institute of Dental Research, for example, whom he quotes:

One could say, on logical grounds and good evidence, that if we could eliminate the consumption of sucrose, we could eliminate the problem—because we would be denying these pathogens their primary source of nutrient. We are realists, however, and we recognize the value of sucrose to nutrition. So while it is theoretically possible to take this approach to demonstrate it, and it has been demonstrated certainly in animal models, it is not practical as a public health measure. It is like saying the maximum speed of a jet plane is the speed of light. It just is not practical to try and evolve on to that point. And so in smooth surface caries, we have a more practical goal in working on the microorganism. (emphasis added [by Glantz])

To a sane person, this is common sense. Eliminating sugar consumption is not going to happen, but tooth decay can be prevented by other means so let's do those. To Glantz, however, this is "industry deflection of attention away from limiting sugar intake".

The documents show that the sugar industry knew that sugar caused dental caries as early as 1950 and did not attempt to deny the causative role of sucrose in tooth decay. Instead, through trade associations, the sugar industry adopted a strategy to deflect attention to public health interventions that would reduce the harm of sugar consumption, rather than restricting intake.

Reducing harm is what medical science is all about. Banning sexual intercourse is not a realistic way of preventing HIV, so we have condoms. Banning cars is not a realistic way of reducing road fatalities so we have seat belts and air bags. If you want to ban sex and cars, these might look like ways to "deflect attention". To reasonable people, they are sensible, evidence-based responses to risky behaviours that cannot, and should not, be stamped out by the state. Naturally, these goes against Glantz's prohibitionist mindset.

The majority of the research priorities promoted by the sugar industry and those selected for the 1971 NCP RFC failed to lead to widespread application. By 1976, clinical studies of dextranase mouth rinses in humans had failed to duplicate the success of using dextranases to inhibit new dental caries in experimental animals. 

That's the way it goes in scientific research. Not every research avenue leads to a breakthrough. In science, unlike in 'public health', you can't guarantee you're going to get the result you want before you start doing the research.

Glantz, of course, presents the failure of some research projects as another part of the delay and deflection strategy, but even he can't pretend that it was all a waste of time.

The most successful interventions selected for funding following the 1971 NCP RFP were topical fluoride and sealants. While a 1980 prevalence survey found that the burden of dental disease in children had decreased by more than 30% since the last survey in 1971–1973, 64% of children still exhibited dental caries, far short of the NCP’s founding goal of eradicating the disease.

Glantz downplays this, but imagine his delight if his anti-smoking policies led to a 30 per cent reduction in lung cancer in less than a decade.

In fact, as the CDC confirms, the supposed period of inaction on sugar saw a very substantial decline in dental caries.

Glantz continues:

Regulatory science to support sensible and defensible policies to limit added sugar consumption was not pursued in the 1970s because of the alignment of the NIDR’s research priorities with those of the sugar industry.

So what are these "sensible and defensible policies" that would "eradicate" tooth decay? How does Glantz think the USA would have stopped kids eating sweets if it hadn't been for Big Sugar's dirty tactics?

Proposals centered on ways to limit sucrose consumption were just around the corner. In its multi-year review of foods generally recognized as safe initiated in 1969, the FDA deemed sucrose consumption at 1976 levels as unsafe for teeth. In the coming years, the FDA would consider food labels “to warn against the hazards to the teeth of consuming a particular product” and debate whether warning labels should be placed on foods based on the percentage of sugar content, or on some measure of cariogenic potential.

Warning labels. That's it. That is literally the only policy Glantz puts forward as an alternative 'public health' solution to tooth decay.

Comparison to the Tobacco Industry

The sugar industry formed SRF in 1943 to fund research that supported the industry position, 11 years before the creation of the Tobacco Industry Research Committee (TIRC) in 1954 to play a similar role for the tobacco industry. In 1954, the TIRC hired SRF’s first scientific director, Robert Hockett, to serve as the TIRC’s associate scientific director, where he was positioned to help the tobacco industry learn key science manipulation tactics from the sugar industry.

Wait, what? The tobacco industry was working from Big Sugar's playbook? Is that the narrative now? I thought it was the other way round.

Glantz then wibbles on about how the sugar industry looking for cures and vaccines for tooth decay is basically the same as the tobacco industry developing low tar cigarettes. I won't bore you with it. Only an obsessive would see a comparison. His concluding point is that his piss-poor research might help ambulance-chasing lawyers sue the sugar industry.

Litigation against tobacco companies has been a major factor in achieving meaningful policy change. Successful litigation could not have been achieved without industry documents research illuminating the strategies and tactics of tobacco companies. This analysis demonstrates that sugar industry documents research has the potential to define industry strategies and tactics, which may potentially prove useful in future litigation.

It's not going to happen, Stan. Pulling documents out of a library which show that the sugar industry funded research into tooth decay—much of which succeeded in reducing tooth decay—is not going to lead to class action suits, even in America.

Glantz's article does, however, provide a nice illustration of the interaction between science, medicine and 'public health' which I show in the Venn diagram below.
 

There is no interaction. Public health has no relationship with either medicine or science (or, if it does, it is like the relationship between a dog and a lamppost). Medical science is an inquisitive endeavour to find solutions, cures and vaccines to help people lead their life as they wish with the least practical risk. 'Public health' is a dogmatic endeavour to use the cudgel of legislation to make people live in a way that does not accord with their preferences. Medical science makes the world a better place. 'Public health' does not.

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Couch potatoes and hunter-gatherers

Further to Aseem Malhotra's absurd claims about obesity not being linked to physical activity, here he is at a recent conference last month making another of his frequent assertions—that there has been "little change in exercise levels in the past 30 years".

Ignore the silly stuff about the Big Sugar 'playbook' for a moment. (It is, incidentally, not true that the tobacco CEOs swore under oath that they didn't believe smoking caused lung cancer. They famously said they didn't believe nicotine was addictive. The bit about cancer has been added by Malhotra.)

I want to focus on the second point on the slide.

Little change in exercise levels in the past 30 years whilst obesity has rocketed

Perhaps because this is a counter-intuitive claim in an era of office drones and couch potatoes, Malhotra goes to the trouble of providing a reference. It is a reference I have come across before because Action on Sugar cited it in a briefing paper sent to politicians.

The title of the study - 'Hunter-gatherer energetics and human obesity' - provides a clue that it is not going to offer much evidence about changes in Western levels of physical obesity in the last thirty years. And it doesn't. It actually looks at a hunter-gatherer tribe in Tanzania, whose members apparently have similar levels of energy expenditure as that seen amongst a sample of Americans.

What is the relevance of this study? Presumably Malhotra's thinking goes like this.

1. The lifestyle of hunter-gatherers in Africa is similar to that of Westerners in days of yore.

2. Hunter-gatherers in Africa are no more physically active than Westerners today.

3. Levels of physical activity have not changed for thousands of years and therefore cannot have changed in the last few decades.


Hmm. This theory is problematic for a number of reasons. For a start, the study of Tanzanian bushmen actually did find higher levels of physical activity ("As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners.") It also found higher levels of physical activity amongst peasant farmers, in line with previous studies. It was only total energy expenditure after adjusting for height, weight etc. that was similar in both societies—a finding that appears to be due to physiological differences between the two groups.

(Incidentally, the authors note that "many hunter-gatherers seasonally consume a large portion of their daily calories as honey, which has high concentrations of glucose and fructose". This poses a bit of a problem for people like Malhotra who see fructose as the main cause of obesity and diabetes, both of which are vanishingly rare amongst tribesmen.)

But even if taken at face value, this is still only one study. If you look at the the evidence in the round, a rather different picture emerges... 

Most analyses of hunter-gatherer diets assume caloric intakes of approximately 3000kcal day, a surprisingly large figure that exceeds typical contemporary intakes. The level of energy expenditure necessitated by pre-agricultural lifestyles, however, was much greater than that for average modern individuals. For instance, total energy expenditure in the !Kung and Ache peoples averaged 206kJ/kg/d, compared to roughly 134kJ/kg/d for contemporary humans.

Hunter-gatherers who consume 3000 calories a day rarely, if ever, become obese. Westerners who eat 3000 calories a day frequently become obese. The difference is that hunter-gatherers burn off all those calories whereas Westerners generally don't.

What does this tell us about physical activity levels over the last 30 years? Not very much, to be honest, but it is worth noting that in the mid-twentieth century the UK government recommended people eat 2,900 calories a day, based on good evidence showing that if people consumed less than that, they lost weight. Today, the government recommends people consume 2,250 calories a day (more for men, less for women). Why, if there has been no decline in energy expenditure, has the advice changed so much?

The fact is that the average Briton who consumed 2,700 calories in the 1940s would lose weight. Today, the average Briton who consumes 2,700 calories gains weight. Conversely, if the average Brit in the mid-twentieth century followed today's guidelines they would lose weight to a rapid and dangerous extent. The only rational explanation for this—supported by masses of empirical evidence—is that physical activity has declined over the years.

As I mentioned in a previous post, the decline in physical activity in the West is acknowledged by the World Health Organisation, Public Health England, the NHS, the Harvard School of Public Health and countless other organisations. If you want to challenge that view, you'd better have some pretty compelling evidence. Malhotra's killer piece of evidence—the one study that he repeatedly cites and puts up on slides at conferences—is not only of little relevance to the claim he is supposed to be debunking, but is an outlier even within its own narrow field.

All of which is a good indication that he hasn't got much evidence at all.

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