Sunday, 30 May 2021
Happy World Vape Day!
Wednesday, 26 May 2021
Another dumb idea from tobacco control: e-cigarette flavour bans
A study published in JAMA Pediatrics this week looked a ban on e-cigarette flavours implemented in San Francisco on 1 January 2019. The ban was supposed to make e-cigarettes less appealing to young people. And so it did, but with the unintended consequence that high school students smoked more instead. After the ban came into effect, the youth of San Francisco were more than twice as likely to smoke than their counterparts in other districts. As the author noted: “This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking.”
This finding did not come as a big surprise to anyone familiar with the academic literature. Cigarettes and e-cigarettes are clearly substitute products, as studies have shown in both the USA and the European Union. Last year, a study by Yang et al. found that the ban on e-cigarette flavours in San Francisco led to increased smoking prevalence among 18-24-year-olds. Cigarette sales in the USA overall rose in 2020, partly as a result of federal restrictions on flavours used in certain e-cigarette products.
The observation that e-cigarettes are a substitute for combustible cigarettes might seem obvious, but it has crucial implications for policy because it means that efforts to suppress e-cigarette use are likely to lead to greater use of traditional cigarettes.
Tuesday, 25 May 2021
The nanny state we're in - interview
I recently had a good chat with Gary Kavanagh of the Edmund Burke Institute. Gary is based in Ireland so he knows all about the nanny state. We talked about the Nanny State Index, vaping, smoking, sugar taxes, Minimum Unit Pricing (MUP) for alcohol, the drive towards increased nanny statism coming from NGOs, and what consumers can do to fight back.
Sunday, 23 May 2021
There's one born every minute - the Ivor Cummins story
The thing I find most fascinating about this story is that Popoff is still in business. Despite being caught bang to rights on video tape, Peter Popoff Ministries is today producing 'Miracle Spring Water' and broadcasting on several TV networks (including Faith TV in Britain).
All you have to do is Google the guy's name to find out what he's been up to in the past and yet he still finds a willing and paying audience.
In January, I mentioned a man called Ivor Cummins in an article about 'coronavirus cranks'. At the time, I thought the jig was up for him and his fellow Covid entrepreneurs. I even made a Downfall video about it. But he's still going. After a brief drop in Patreon subscribers and Twitter followers, he now has more of both than he did before. He's raised another £5,000 for his long-delayed feature film.
This is a guy who could not have been more wrong over the course of the pandemic. He might just be the wrongest man who ever lived. And yet there is still a paying audience for what he does. With 1,742 subscribers paying a minimum of £3 a month (+VAT), he's making at least £75,000 a year from that revenue stream alone.
His business model relies on people having a very short memory, so let's look back on his record.
No masks probably a simple but very unfortunate mistake with Swedish strategy Andreas
— Ivor Cummins (@FatEmperor) March 27, 2020
- such an easy measure in principal (with availability of course)
- thread here discussing same: https://t.co/PInfXfvSNX
...one would think it was a no-brainer to help in a big way
— Ivor Cummins (@FatEmperor) March 26, 2020
Agreed - Ireland did great job and the people engaged - only major gap was lack of mask use earlier on (even homemade would have helped)
— Ivor Cummins (@FatEmperor) March 31, 2020
During the first lockdown, Cummins developed his own theory about COVID-19. It has undergone several modifications over time, but the basic premise is that the virus is like flu, seasonal and not particularly dangerous. Most people are immune to it because they've had a respiratory virus in the past and the first wave would have subsided with or without lockdowns. Indeed, he believes the first wave was the only real epidemic because "de facto herd immunity" was quickly achieved. This meant that there could be no second wave. There might be a "winter resurgence", but this would be mild and would be little different to what we see in an average flu season.
So around 80% are already de facto immune through cross-immunity, T-cells, prior coronaviruses. Around 1 in 5 people will be less immune, they're the ones it has to go through... Then the virus stumbles over immune people."
Since only 20 per cent of the population needed to get COVID-19 for everybody to be immune, Cummins reckoned that any country that had a significant first wave had achieved herd immunity.
'Wave' is a word that doesn't really have a scientific definition, but with COVID-19, you know one when you see it. Since Cummins thought that herd immunity had been achieved, he thought there could be no second wave unless there was a second virus. He thinks this is what happened with the Spanish Flu although, to my knowledge, it didn't. Either way, he repeated this claim ad nauseam.
As case numbers began to tick up again in the summer of 2020, Cummins endorsed the idea that it was an artifact of mass testing, false positives and asymptomatic cases. He maintained that the pandemic was over in the UK and most of Europe and declared a 'casedemic'.
Scientists didn't know enough about the virus when it first emerged. We know much more now. Most countries have had a second or third wave and they have often been bigger than the first. We have seen major outbreaks in winter, spring, summer and autumn in various countries. It is clearly not true that 80 per cent of the population acquired natural immunity without being infected or vaccinated.
Most of his ideas didn't stack up even at the time.
If herd immunity had been achieved by June, as he claimed, how could
there be any resurgence and how could the government get the virus to spread in summer, particularly if it was seasonal? And how do you achieve the "safe spread" of a virus which, contrary to Cummins' claims, has an infection fatality rate of around one per cent in rich countries?
But this was all in the future in September when he began making concrete predictions.
When challenged, he made it clear what he would accept as evidence that he was wrong.
In October he provided another testable proposition.
He also made a video titled 'The Tiger Horn Deceit' which accused the public of mistaking correlation for causation when they saw case rates fall during lockdowns. It was just a coincidence, he said, but governments would whip up fear again and introduce lockdowns in response to a mythical threat in order to convince people that lockdowns work. (I know it doesn't make a lot of sense.)
In it, he said...
"But then the question, recently, the cases are through the roof, but the deaths are still really low, and it looks like the winter is not going to be much different than a normal winter [...] so you gotta shut all this down, big time, and then the deceit, you have to double down on your lockdown, so when the winter ends up being pretty normal you can end up saying the lockdown made it so."
You know what happened next. By the end of December, the UK had 8 people per million dying of COVID-19 each day, four times what Cummins predicted. This rose in January to a peak of 18 per million, nine times higher. Between 1 November 2020 and 28 February 2021, 76,000 people died "with positive PCR for SARS-CoV-2", significantly more than had died in the first wave.
There were far more excess deaths than in the winter of 2015 and 2018 (both of which had quite bad flu seasons).
As cases and deaths mounted in December, he continued to claim that the second wave was nothing more than a "muted" winter resurgence.
On January 4th, Cummins released a video (now deleted) in which he admitted that hospitals in the UK were "filling up here and there" while claiming that mortality was "way, way lower" than in the first wave because of "community immunity".
In the same video, recorded just 11 days, he assures the English that everything’s going to be fine, community immunity, low mortality etc. pic.twitter.com/Cf6SroeD9q
— Christopher Snowdon (@cjsnowdon) January 15, 2021
On January 6th, with the UK back in lockdown and with Covid deaths close to a thousand per day, he put out a video claiming that what was happening was "exactly what we predicted" and that "excess mortality is as per prior years". He claimed that anyone who said otherwise was "lying". In fact, there were thousands of excess deaths that week in England and Wales. In England alone, there would be 15,685 excess deaths in January, 30 per cent more than normal.
He started ignoring this series of reports once they had outlived their usefulness.
As shown above, he was very much not correct.
At around the same time, he suddenly backtracked on his claims about the second wave, insisting that he had "foretold" a second wave all along.
At this point he shifted his rhetoric, claiming that the people who had predicted a "Spanish Flu second wave" would be proved wrong. I am not aware of anyone predicting such a thing. I'm not even sure what it means.
As late as mid-January, when over 1,200 people were dying every day in the UK from COVID-19, he was still insisting that there was no second wave.
You know what happened next. India became the global epicentre of the pandemic. Officially, there are more than 4,000 Covid deaths a day, but testing capacity is limited and experts believe the real figure could be ten times higher.
Then there was Croatia which had not locked down in 2021 and seemed to be doing OK.
Alas, the infection rate in Croatia had been rising for three weeks when he tweeted this. Inevitably, deaths followed.
I could go on, but it would be exhausting. This has been a long post because Cummins is wrong about a great deal. To return to my original point, it does seem - as Abe Lincoln said - that you can fool some of the people all of the time. Cummins doesn't delete his tweets and he tweets a lot. It's all out there for anyone who wants to check his track record. And yet he inspires such trust and devotion among certain people that they will give him money.
Truly, there is one born every minute.
Friday, 21 May 2021
Prince’s death at 57 was no music industry average
First published by Spectator Health in April 2016
After the tragic and untimely death of Prince, an internet meme took flight claiming that the singer died ‘at the average age of death for American pop stars’. This is not really true and, insofar as it contains a germ of truth, it is not useful.
The origin of the claim can be traced back to an article from 2014 in which an Australian professor of psychology and music compared the ages at which pop stars died in each decade from 1950 onwards and compared them to the average age of death of the general population. As the graph below shows, there is a big gap, albeit one that has been closing over time.
Prince died at the average age of death for American male pop stars. @Wonkblog chart pic.twitter.com/IiWQkyBvr7
— Paul Kirby (@paul1kirby) April 22, 2016
There is a fundamental problem with this methodology which renders the results meaningless. Pop stars usually start their careers at a young age and pop music didn’t exist until the 1950s. The oldest of the bunch was arguably Bill Haley who rocked around the clock in 1955 at the grand old age of 30. He was born in 1925, a year before Chuck Berry, seven years before Little Richard and ten years before Elvis Presley.
Haley died in 1981 at the age of 55 and Elvis died four years earlier at the age of 42, but Chuck Berry and Little Richard are still rocking at the age of 89 and 83 respectively. We won’t know what the life expectancy of a 1950s pop star is until they are all dead and it will be many years before we know the average age of death of a 1960s, 1970s or 1980s pop star.
You can take any decade and compare the age at which pop stars die and compare it to that of the general population, but it doesn’t tell you anything meaningful. The general population can be born at any time whereas no pop star was born before 1925. It is quite possible that a pop star will live until the age of 100 but it is a mathematical impossibility for them to have already done so.
It appears that the definition of pop music used in the 2014 article is broader than mere rock and roll because the average age of a pop star’s death in the 1950s is shown as a little over 50 years. Presumably, then, we are including practitioners of ragtime, big band and other forms of music who were born as early as the 19th century. But whatever genre we look at, the point still holds. The sheer number of pop stars has risen exponentially in the last 50 years. All the punk rockers, rappers and grunge artists who have passed away have died relatively young, but this could hardly be otherwise given how recently these genres were created. It will be a long time before geriatric boy bands pass away and we begin to see the full picture.
There is, then, a basic sampling bias at work which guarantees that the group being studied will have a lower life expectancy than the general population. There are lots of reasons why drug-taking rockers and gun-toting rappers are more likely to die young, and it would be silly to pretend that there is no difference in life expectancy, but this is not the way to measure it.
A better way would be to compare people who were born in the same year, but you could only do that once they were all dead. Prince was born in 1958 and died at the age of 57. Barring an outbreak of bubonic plague or an unusually methodical serial killer, it is most unlikely that the average age of death for musicians born in 1958 will turn out to be 57. Other pop stars born in 1958 include Ice-T, Madonna, Thurston Moore (Sonic Youth), Neil Finn (Crowded House), Nikki Sixx (Motley Crue), Toyah, Simon Le Bon, Joan Jett, Bruce Dickinson (Iron Maiden), Nik Kershaw, Belinda Carlisle, Paul Weller, Bill Berry (REM), Mark King (Level 42), Michael Jackson and Andy Gibb (Bee Gees). Of these, only Jackson and Gibb are not still with us. In fact, nearly all of the celebrities born in 1958 are still alive.
Sadly, Prince did not have a good innings even by the standards of the music industry.
Thursday, 20 May 2021
The Truth Initiative versus the truth
Increasingly popular oral nicotine products are frequently marketed as tobacco-free alternatives to smoking, claims that could imply lower-risk and are not authorized by the Food and Drug Administration, according to a recent Truth Initiative analysis of direct mail advertisements.
The Truth Initiative study, which was published in Tobacco Control and is one of the first to examine marketing claims used to promote oral nicotine products to U.S. consumers, found that the majority of mailed ads for oral nicotine pouches or lozenges claimed that they did not contain tobacco leaf (55%) and that they were an alternative to other tobacco products (69%). Most advertisements (84%) also featured claims that the product could be used anywhere.
Oral nicotine pouches and lozenges are a new category of tobacco product that includes brands such as Zyn, On! and Velo and come in many flavors. They are similar to snus – a type of smokeless tobacco pouch that does not produce saliva, making it spit-less – but, unlike snus, they do not contain leaf tobacco.
The products are still derived from tobacco and contain nicotine, which is harmful to young people in any form, but due to the absence of tobacco leaf, the FDA does not classify it is a smokeless tobacco product.
Some types of oral nicotine products are using synthetic nicotine that isn’t derived from tobacco leaf...
... raising additional concerns about misleading consumers who may assume that nicotine that doesn’t come from tobacco is somehow safer than tobacco-derived nicotine.
Until now, there has been little insight into how tobacco companies market oral nicotine products like nicotine pouches or lozenges to consumers, including whether they use claims that could imply reduced harm.
To address the issue, researchers coded a sample of 50 direct-mail ads for the claims that oral nicotine products were an alternative to other tobacco products, could be used anywhere, were spit- or smoke-free, or that the product did not contain tobacco leaf.
... terms like “tobacco-free” in oral nicotine marketing could suggest products are healthier and lower risk to consumers.
Using language that signals a tobacco product is “free of a substance” may meet one criteria of an unauthorized modified risk claim under FDA rules.
Researchers found that direct-mail advertising positioned oral nicotine products as alternatives to existing tobacco products, including traditional smokeless products, cigarettes, and e-cigarettes.
About half (52%) of the direct mail pieces included claims that oral nicotine was “spit-free,” appearing to position oral nicotine products as an alternative to traditional smokeless products.
About one-third (31%) described the product as “smoke-free,” implying that it is an alternative to cigarettes.
Many ads contrasted oral nicotine pouches and lozenges to e-cigarettes, urging consumers to “forget about the chargers,” for example, potentially promoting oral nicotine as a product to use in combination with existing tobacco products or as a substitute for other tobacco products.
The availability of increasingly popular oral nicotine products in flavors coupled with evidence of marketing the products as alternatives to existing tobacco products calls for greater attention and regulation from the FDA.
Wednesday, 19 May 2021
Is the European Commission about to crack down on vaping (again)?
Reading it is like taking a step back in time, or being in Australia.
The authors of the SCHEER report appear to be biased against e-cigarettes and harm reduction. The report reheats several arguments, such as the ‘gateway effect’ and the ‘renormalisation’ hypothesis, which are now a decade old and have been contradicted by real world evidence. While it downplays strong evidence showing that e-cigarettes have been a gateway from smoking for millions of people, it amplifies speculation about hypothetical risks. When the authors are unable to find adequate evidence for anti-vaping claims, they quote from organisations which share the same prejudice. Much of the evidence is treated selectively and some of the conclusions made about the strength of evidence are baffling.
This is a worry for consumers because the SCHEER report is designed to alert the European Commission to the ‘potential need for legislative amendments’ to the Tobacco Products Directive.
It wanted to regulate e-cigarettes as medical devices in the last Tobacco Products Directive, which came into force in 2016. Its plans were derailed by the European Parliament, but it may soon try again. The European Commission seems particularly interested in banning flavours in e-cigarette products, a policy copied from American prohibitionists which would make vaping much less appealing to smokers who are thinking of switching to a product that could save their lives.
In reality, the SCHEER report does not compel the Commission to do anything. The only evidence for health risks which the SCHEER report rates as ‘strong’ in the final opinion relates to poisoning and injuries due to burns and explosions. These hazards have already been dealt with in the existing Tobacco Products Directive and do not require further legislation.
However, while the report does not explicitly call for any new laws, it gives the European Commission ammunition if it wishes to table some. As the evidence that e-cigarettes are relatively harmless and effective smoking cessation devices continues to grow, the SCHEER report will be used as a crutch for those who continue to lobby against them.
The tobacco industry has continuously attempted to subvert these life-saving public health measures. Over the last decade, the tobacco industry has promoted e-cigarettes as cessation aids under the guises of contributing to global tobacco control. Meanwhile, they have employed strategic marketing tactics to hook children on this same portfolio of products, making them available in over 15,000 attractive flavours.
The scientific evidence on e-cigarettes as cessation aids is inconclusive and there is a lack of clarity as to whether these products have any role to play in smoking cessation. Switching from conventional tobacco products to e-cigarettes is not quitting.
"We must be guided by science and evidence, not the marketing campaigns of the tobacco industry – the same industry that has engaged in decades of lies and deceit to sell products that have killed hundreds of millions of people”, said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “E-cigarettes generate toxic chemicals, which have been linked to harmful health effects such as cardiovascular disease & lung disorders."









