Friday 31 August 2012

Towards zero

For the last couple of years I have been predicting that the time will come when the recommended drinking guidelines (colloquially known as "limits") will fall to zero. One day we will be told that the daily/weekly units system is too confusing for the plebs and that there is no safe level of alcohol consumption. The best advice, the experts will say, is to not drink at all.

Gradually, the evidence is being gathered for this zero tolerance line. Most recent was this, reported in the Independent:

Even light drinking increases cancer risk

New study indicates that it's not just heavy drinkers who need to worry about the health implications of alcohol

Just one alcoholic drink a day may increase the risk of cancer, according to a new study, which estimates that light drinking is responsible for 34,000 deaths a year worldwide.

This is based on a study—or, more likely, a meta-analysis—the results of which have been extrapolated. The relative risks that the 34,000 figure have been extrapolated from are things like this...

One drink a day increased the risk of cancer of the oesophagus by almost a third, according to the study being reported in the Annals of Oncology, which analysed data from more than 200 research projects. Low alcohol intake increased the risk of oral cavity and pharynx cancer by 17 per cent, and breast cancer in women by 5 per cent.

Let's leave aside the unlikelihood of questionnaire-based epidemiology being able to identify one risk to two decimal points (until relatively recently, if you'd have told an epidemiologist that x increases risk by 5% (ie. a relative risk of 1.05), he would have laughed in your face).

Instead, and for the sake of argument, let's assume that these risks are accurate. What do they mean for the individual? I have not been able to find the mortality rate for oesophageal cancer, but there were 1,975 deaths from cancer of the oral cavity & pharynx in England & Wales in 2010. Since there were 493,242 deaths altogether, we can say as a rough but useable estimate that the risk of dying from those diseases is about 0.4%.

In the same year, 10,290 women died from breast cancer, out of a total of 255,326 female deaths. The chance of a British woman dying from breast cancer is therefore roughly 4%.

The absolute risk of mortality from the former, and possibly the latter, cancer will be somewhat lower for teetotallers, but we shall be conservative and stick with the figures above as being the baseline risks.

If having a drink a day raises the individual's risk of dying from oral cavity & pharynx by 17%, then the absolute lifetime risk rises from 0.40% to 0.47%. If having a drink a day increases the risk of breast cancer by 5%, then the absolute lifetime risk rises from 4% to 4.2%.

I wonder if this information—if given in relevant, rather than relative terms, as I have above—would make anyone think it was worth living a life of self-denial in order to reduce their risk by a fraction of one percent. Considering that the lifetime risk of dying from all cancers combined is somewhere between a quarter and a third, I doubt it would.

Risks of this order simply have no practical relevance to human beings. The relative risks are so tiny—even if we assume them to be real—that it is irrational to worry about them. The only way they can be made to sound scary is by doing what the authors of this study have done, ie...

(a) only give relative risk and hope the public mistakes it for absolute risk (a common error)

(b) extrapolate your numbers across the largest population you can think of. In this instance, they've gone for the nuclear option of using the population of the entire world—this should always ring alarm bells

If you do both of these things, you can then use the old line about the risks not being very high, but that "in terms of public health" they are of great significance. This get-out clause is often to be found in the text of epidemiological studies when the findings are of negligible significance for a person's health, and we see it again here:

"Alcohol increases the risk of cancer even at low doses," say the researchers. "Given the high proportion of light drinkers in the population, and the high prevalence of these tumours, especially of breast cancer, even small increases in cancer risk are of great public health relevance."

No matter how many times this line gets used, it never gains any meaning. A risk that has no practical significance to an individual should be of equally little significance to public health. The public, after all, is no more than a collection of individuals. Spouting variations of "many a mickle makes a muckle" does not alter that fact. If the public health industry considers risks which are of no significance to people to be of great importance to them, it only shows how irrelevant the public health industry is to the lives of normal men and women.

Professor Peter Johnson, Cancer Research UK's chief clinician, said: "This study adds to the evidence linking alcohol consumption to several types of cancer, and confirms that even light drinkers have a small but definite increase in the risk, particularly for those parts of the body, such as the throat and oesophagus, that come into direct contact with alcohol.

"People who wish to minimise their risk of cancer can help by cutting down on their drinking."

This thinly-veiled plea for abstinence is not justified by the scientific evidence. Only this week we have seen the latest in a long line of epidemiological research concluding that moderate drinking is very good for health, and not just for rare diseases. As Crampton mentions, a study in the European Heart Journal found a statistically significant reduction in the risk of total mortality of 22 per cent and a 42 per cent reduction in mortality from heart disease. It also looked at the "sick quitter" hypothesis so beloved of Ben Goldacre and David Nutt and found that it did not explain the results. There is now masses of evidence that there is a U-shaped curve for drinking and mortality, and especially heart disease (which is the single biggest cause of death in the UK).

That study did not get reported in the Independent and we continue to wait for a study to be published showing how many people are being "killed" worldwide through teetotalism. Don't hold your breath.




Thursday 30 August 2012

Countering e-cigarette lies

There is a dreadful woman in Kentucky called Ellen Hahn. Dick Puddlecote mentioned her earlier this year. Having no clue about science and health, she naturally gravitated towards the payroll of tobacco control and has become Director of the Kentucky for Smoke-free Policy.

If this non-job means anything, it must involve helping smokers who want to quit. Hahn, however, takes a very different view and has instead gone to war with e-cigarettes (which she mistakenly believes are "tobacco products"). This has led to her hounding people at a 'Vape Meet' round her neck of the woods and spreading deceitful information about the products.

So I was pleased to hear that Consumer Advocates for Smoke-free Alternatives Association (CASAA) have decided not to take it any more...



Tobacco harm reduction advocacy organization fights back against Hahn's disinformation

The Consumer Advocates for Smoke-free Alternatives Association (CASAA) has begun a new initiative to expose false and otherwise misleading information that is distributed by opponents of tobacco harm reduction (THR). As part of that initiative, CASAA recently filed a formal complaint with the President of the University of Kentucky (UKY) and with the Kentucky State Attorney General asking for an investigation into UKY faculty member Ellen J. Hahn's dissemination of disinformation, including a recent attempt to trick a hotel into breaking a legal contract for hosting a THR gathering.

THR is the public health strategy of encouraging smokers to switch to low-risk alternatives like smokeless tobacco and electronic cigarettes ("e-cigarettes"). It is the only strategy that has proven able to reduce smoking rates below about one-fifth of the population once smoking has become popular in a population, and appears to be responsible for most of the reduction in smoking in the US for the last decade. Despite this, there is a small, but vocal and lavishly funded, group of extremist activists who oppose THR and whose strategy focuses on lying about it.

"I have been studying and promoting THR for more than a decade," said Carl V. Phillips, PhD, CASAA's Scientific Director, "and during that time, the truth about THR has been buried by a well-funded and orchestrated campaign of lies. Our simple truth-telling could never break through the noise. But THR advocates are finally numerous and organized enough that we can fight back directly."

In its 26-page letter of complaint about Hahn (available at http://casaa.org/HahnUKYletter.html), CASAA shows how Hahn presented herself as an official representative of the University and made false claims in an attempt to intimidate a Lexington, Kentucky hotel manager into canceling a scheduled conference of e-cigarette users, supporters, and merchants. The conference was eventually allowed to proceed thanks to the efforts of the local CASAA member who organized it, though Hahn was almost successful and her efforts resulted in substantial harms.

Most important, from the perspective of public health and academic integrity, the CASAA letter details how Hahn apparently violated UKY research ethics rules by making numerous false and otherwise misleading scientific claims about the risks posed by e-cigarettes. E-cigarettes have never been definitively linked to any health risk and are generally estimated to be about 99% less harmful than smoking. Anyone reading Hahn's claims, however, would believe that they are a proven serious hazard, comparable to cigarettes.

Some of Hahn's other claims that were not addressed in the formal complaint are the focus of a series of posts at CASAA's new "Anti-THR Lie of the Day" blog (antiTHRlies.wordpress.com). "We launched the anti-THR lies blog to coincide with the start of our new strategy," says Phillips, "and it should evolve into a catalog of the lies and liars, and provide a starting point for future formal complaints like the one to the University of Kentucky." Information about why there is opposition to THR, a question which often baffles people who are new to the topic, can be found in the first post on the blog.


Notice the new blog, AntiTHRlies.wordpress.com. Get it bookmarked.

Wednesday 29 August 2012

With the prohibitionists

I've got an article up at the Adam Smith Institute blog on the subject of tobacco prohibitionists.

Contrary to some excitable headlines, Tasmania has not banned the sale of cigarettes to anyone born in the 21st century. Such a move has been proposed, but it is most unlikely that the Australian state’s Lower House will allow it to become law. Nevertheless, it is another sign that anti-smoking campaigners are ready to come out of the closet and admit that they are prohibitionists. For decades, any suggestion that advocates for a ‘smoke-free world’ secretly wanted to criminalise the sale of tobacco were met with denial and protestation. This was not a witch-hunt against smokers, they said, only a campaign for better education, or restricting advertising, or protecting bar-staff, or saving the children.

The Tasmanian ruse, which was first mooted in Singapore, retains a ‘think-of-the-children’ element by forbidding those born after the year 2000 from purchasing tobacco products. Since the eldest of these people are currently twelve years old, this is not immediately controversial, but in a few years time it will mean prohibition for the first wave of adult consumers. This crucial fact seemed to escape some Tasmanians, like the gentleman who told ABC News that the proposal "definitely has my support mate because I believe that children shouldn't be smoking." This sentiment is, of course, besides the point. The real question is whether future generations should be treated like children forevermore; the Peter Pans of tobacco control.


Do go have a read...

Food and alcohol next, says The Lancet

Time to pull those quotes out again...

Simon Chapman, August 2012:

Look, if the slope is slippery, it's the most unslippery slippery dip I've ever seen in my life. We started banning tobacco advertising in 1976 and there has been no other commodity where there has been anything like a serious move to do what we've done with tobacco.


Deborah Arnott, February 2012

...the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false. The same argument was used against the ban on tobacco advertising, but 9 years after the tobacco ban in the UK, alcohol advertising is still permitted with no sign of it being prohibited.


So imagine my surprise, dear reader, when I found an editorial in this week's Lancet which celebrated the plain packs campaign in Australia and said...

Like many other milestone tobacco-control legislations such as pictorial warnings on tobacco packets, first adopted by Canada in 2001, and workplace smoking bans, first introduced in Ireland in 2004, Australia's lead in plain packaging will inevitably be followed by many other countries. Indeed, the UK, Norway, New Zealand, Canada, India, and South Africa are already considering taking such measures. Furthermore, the valuable lessons learnt in the fight against tobacco can be taken on board in countering the rampant marketing of alcohol and fast food.

Yessir, it's the most unslippery slippery dip you'll ever see in your life.

Monday 27 August 2012

Simple Simon's slippery slope

Dick Puddlecote has had endless fun with (ASH Director) Deborah Arnott's hostage-to-fortune refusal to accept what she calls...

"the “domino theory” i.e. that once a measure has been applied to tobacco it will be applied to other products is patently false." 

Barely a day passes without some anti-alcohol or anti-lemonade zealot paying homage to the anti-smoking crusade as they walk down the furrow ploughed by tobacco control, and yet the likes of Arnott still defiantly—some would say dishonestly—insist that there is no slippery slope.

As I mentioned last week, talk Down Under has turned to full-on prohibition but even that is not enough to make the champions of non-smoking sections on aeroplanes admit that we have been sold a lemon.

Interviewed on that very subject, protester-turned-quackademic Simon Fenton Chapman said:

Look, if the slope is slippery, it's the most unslippery slippery dip I've ever seen in my life. We started banning tobacco advertising in 1976 and there has been no other commodity where there has been anything like a serious move to do what we've done with tobacco. And that's because there are great big differences between tobacco and all other commodities.

So, you know, the comparisons with hamburgers and chocolate bars and alcohol and such with like that, they're just really don't stack up.

Presumably Chapman has never heard of the Australian government's own Preventative Health Taskforce, which has, since 2009, been calling for...

Advertising bans on junk food and alcohol

I guess that doesn't count as a "serious move to do what we've done with tobacco" and we should also ignore ABC News when it says that the plan to ban alcohol advertising in sporting venues is "similar to the method used for tobacco laws more than 20 years ago". And when a national medical journal calls for a total ban on alcohol advertising, saying: "Surely the time has come to treat alcohol in the same way as tobacco products?" we must turn a blind eye. After all, the great man has told us for years that the slippery slope is a myth. In an article written in 2003 he said:

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”

Elaborating on the first of those six arguments, Chapman wrote:

”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.

No danger of alcohol being given a "danger label" under Chapman's watch, then. Why, that's crazy tobacco industry "thin end of the wedge" rhetoric! So we should definitely ignore the sounds coming from the Network of Alcohol and other Drug Agencies this month:

"DEMON drink" is the new health battle-ground, with higher taxes, drinking ages and graphic warnings similar to those on tobacco products touted as ways to fight alcohol-related birth defects and other issues.

But perhaps we should not condemn Chapman for the sins of others. He can't help it if a few of his 'public health' colleagues speak out of turn and he was still on diplomatically defensive form when he spoke to the Guardian earlier this year. On that occasion he was insistent that his latest ruse—plain packaging—would definitely not be the start of another slippery slope:

He derides any idea of plain packaging for alcohol, because it would antagonise people unnecessarily...

He "derides" it, you will note, not because he thinks it is wrong, illiberal, authoritarian or excessive, but because it would be politically unacceptable in the current environment. A little more softening-up required before the public will fall for that one, I fancy.

There is, however, less softening-up required to push some of his other erstwhile "unique-to-tobacco" policies down the slope...

...but backs restricted opening times for pubs and clubs, graphic warnings on labels and tougher controls on licensing.

Didn't take long, did it? Graphic warnings were first used on cigarette packs in Australia in 2006 and then, as now, we were told that there was no slippery slope that would lead to other products (eg. alcohol) getting the same treatment. If six years is considered a reasonable interlude, we can expect the sociopathic sociologist to be calling for plain packaged alcohol in 2018. The way things are going, it could well be sooner.

Here's a guy who squeals in indignation at the suggestion that his latest anti-smoking ruse will be rolled out to other products while simultaneously calling for his last anti-smoking ruse to be rolled out to other products. What kind of collective amnesia is the media suffering from to take such a fellow at face value?

Meanwhile, the news that Tasmania is contemplating Simple Si's next-but-one anti-smoking ruse of total prohibition had him rushing to Google to find any sliver of evidence to show that prohibition could be anything other than the fiasco...



Of course you're not supporting prohibition, Simon. Perish the thought. That would be a "myth", just like the slippery slope.


UPDATE

You can watch Chapman defending Prohibition on Australian TV here. James Patterson of the IPA makes the counter-argument. After five minutes, Chapman realises he's losing the argument and so does the usual trick of playing the man instead of the ball. Viva academia!




Saturday 25 August 2012

That GCSE scandal in full

A typical schoolgirl awaits her GCSE results.
(Picture courtesy of the Daily Telegraph)

The teaching profession has gone into hysterics about so-called 'grade fixing' in this year's GCSE results. British readers will be familiar with the annual farce of semi-literate teenagers celebrating ever-improving exam results. Everybody knows that GCSEs, like A-Levels, have been systematically dumbed-down for political reasons and only the teaching unions seriously suggest otherwise. Last week—for the first time in 24 years (which is to say, ever since GCSEs were created)—records failed to be broken.

The teachers' response has been absolutely mind-boggling. Without a hint of irony, they have suggested that the rigour of examinations has been altered for political ends. They seem to genuinely believe that each new batch of pupils has a legal right to be awarded better exam results than any generation in history and they are prepared to sue the government on the basis of equality legislation.

The Association of School and College Leaders (ASCL) says it may take legal action against exam boards over grading reforms which appear to have denied thousands a C grade in the core exam.

Malcolm Trobe, of the ASCL, which represents most secondary head teachers, said it was currently gathering information on the situation at schools where there were large numbers of pupils on the boundary between a C and D grade.

"We're examining whether this is hitting any particular groups of young people that are covered by the equal opportunities legislation," he said.

"We are not afraid of taking legal action if that is the appropriate step."

Words fail me.

A statement on the Leeds City Council website by Councillor Judith Blake said: "We do not feel this basic principle of fairness has been adhered to in this case and will be looking with colleagues nationally at the possibility of raising a legal challenge to ensure Ofqual and the government put this right."

Quite extraordinary.

Labour called for the Commons education select committee to conduct an official inquiry into the affair and the Welsh Assembly Government launched its own probe.

Good God almighty. Let's look at the facts for a second. The graph below shows the last ten years of GCSE results. Since 2003, the number of A-C grades (de facto passes in an age in which no one is allowed to fail) has risen from 58.1% to 69.4%. The proportion of As and A*s rose from 17.4% to 22.4%.


The alleged scandal of tougher marking led to the class of 2012 doing very slightly worse than the class of 2011, but there were still more A-Cs dished out than in any year prior to 2011 and more As and A*s awarded than in any year prior to 2010.

So, if this year's pupils have a legal right to have their exam results upgraded on the basis of "fairness" and "equality", it seems to me that everybody who took GCSEs between 1988 and 2009 should also raise a "legal challenge". I passed mine in 1992 and I demand an enquiry.




Friday 24 August 2012

The war on motorists?

Yesterday, a report was published by the left-wing think tank IPPR, claiming that there was no 'war on motorists'. They provided an eye-catching piece of evidence for this, but as I dug around I found some even more interesting statistics.

I've written about it at the Adam Smith Institute blog.

Thursday 23 August 2012

Does giving antibiotics to animals cause obesity in humans?

This sounds like a load of nonsense to me, but who knows?

Livestock drugs 'link' to obesity epidemic

Farmers may have fuelled the obesity epidemic by using antibiotics to fatten up livestock, a new study suggests.

This is based on a study published in Nature. I haven't read it because it's behind a paywall and I don't really care, but the salient points seem to as follows...

For decades since the 1950s, farmers have used low non-therapeutic doses of antibiotics to increase the body weight of cows, sheep, pigs and chickens.

They have indeed, although the EU banned the practice in 2006.

"The rise of obesity around the world is coincident with widespread antibiotic use, and our studies provide an experimental linkage," said lead researcher Professor Martin Blaser, from New York University School of Medicine in the US.

Hmm. Not the most compelling start. Correlation/causation and all that. Quite a lot of things coincided with the rise of obesity. Falling smoking rates and rising alcohol consumption fit pretty well, to take just two examples off the top of my head.

"It is possible that early exposure to antibiotics primes children for obesity later in life."

Anything's possible, Professor. So what is this research of which you speak?

The scientists administered common antibiotics such as penicillin and vancomycin to weaning mice at similar doses as those used in agriculture.

The treatment altered the composition of gut bacteria in the mice which in turn led to metabolic changes, such as increased production of fatty acids. After about six weeks the mice had gained about 10% to 15% more fat mass than untreated mice.

That's what one would expect to happen since the antibiotics are known to produce weight gain. What happened next? Were human subjects given a diet of these mice and carefully monitored for years to track changes in their body mass index?

They were not. It seems that fattening up the mice was the start and end of the experiment. So what does that tell us?

"By using antibiotics, we found we can actually manipulate the population of bacteria and alter how they metabolise certain nutrients," said co-author Dr Ilseung Cho, also from New York University.

Although it was known that antibiotics could fatten up animals, previously the mechanism involved was unclear.

Well, that's great and all, but identifying the biological mechanism behind a known effect is a little different from saying that antibiotics fed to livestock caused an international epidemic of human obesity.

All that's been shown here is that if you give certain drugs—which we know make large animals fatter—to small animals, then those animals will also put on weight. From this, you might speculate that if the same drugs were given to humans in equivalent quantities, they would also put on weight. That would depend on the doses, the type of antibiotics used and the length of time they were used for. It also relies on the assumption that humans will react to the drug in the same way as cows and mice.

If you were a reckless person—such as a Telegraph or Independent journalist—you could go out on a limb and imagine that eating slices of these animals might involve trace chemicals from the antibiotics entering the body and somehow having the same effect on weight gain, but that would be to indulge in wild speculation that is not supported by the study.

To repeat, I have not read the study, although this video of the author summarising its findings suggests that my description is fair. In it, he raises the possibility of antibiotics used in childhood being a possible explanation for childhood obesity. Essentially, he thinks that bacteria in the gut help prevent weight gain. That is a very tentative theory (although that doesn't stop the ever-irresponsible Daily Mail calling it "another very good reason for avoiding antibiotics") but it is not incompatible with the available evidence. What he does not do is suggest that there is some "passive" effect flowing from animals to humans. That appears to be an invention of the media and it should not be taken seriously.

Besides, everybody knows that obesity is caused by advertising. Didn't this guy get the memo?



Wednesday 22 August 2012

Plain packaging first, prohibition next

As Australia prepares for plain packaging in December, things are really starting to move towards the endgame that the anti-smoking crusaders always vehemently denied was their true goal. In Tasmania, the Green Party produced a press release saying:

Tobacco Plain Packaging is Only First Step

Isn't it always? And it turns out the Tasmanians aren't kidding...

Move to ban cigarette sales

Tasmania's Health Minister is under pressure to decide whether she will act on an Upper House motion which could result in an eventual ban on tobacco sales.

My, my. Don't things move quickly these days?

The Independent Member for Windermere, Ivan Dean, wants to make it illegal for people born after the year 2000 to buy tobacco once they turn 18.

Hardly seems worth it, really. After all, we know that people only start smoking because of those, ahem, "glitzy" packs. With those out of the way, smoking's finished, right?

Mr Dean says something has to be done.

Behold, the klaxon of every curtain-twitching, authoritarian busybody in history.

"It would be easier for retailers to enforce because when they ask for ID, all they would need to see if the person was born after the year 2000."

Sorry, what?! You mean it would be easier than knowing what year 18 year olds were born in, something that bar staff, newsagents, policemen and many other workers have no trouble at all remembering each and every day of their lives? By God, I've heard some lame justifications for prohibition in my time, but this one takes the jammy dodger.

While the vote was unanimous...

Urgh.

...the Independent Member for Murchison, Ruth Forrest, foresees problems.

Good for Ruth Forrest. It's heartening to know that amongst this crowd of illiberal cretins, at least one Tasmanian politician understands that prohibition creates what we can coyly be described as "problems".

Or so you might think until she opens her mouth. Here's what she sees as one of the main problem:

"These children born post-2000 will still be exposed to passive smoking because the reality is there will still be people who'll continue to smoke and even now the restrictions push people away from doors and buildings like that," she said.

[slams face on keyboard]

This Toytown politician thinks the problem with incrementally outlawing a very widely use consumer product is that older people might still smoke in doorways. In other words, the problem is that this insane proposal does not go far enough.

Seriously, is this a joke? These people cannot really exist, can they?

Health Minister Michelle O'Byrne believes a smoking ban is worthy of serious consideration.

But Tasmania has had a smoking ban since 2006. There are no exemptions to it. What can this lady possibly mean? Does she suffer from amnesia? Has she taken a blow to the head?

Oh, I see. 'Smoking ban' now means a ban on the sale of all tobacco products to people born before a certain year. How quickly the goalposts shift.

The Cancer Council's Simon Barnsley welcomes the move and is urging the Tasmanian Government to act.

"We believe it'd be exciting for the Government to explore radical new ideas that might set the pace for the rest of the country," he said.

This is what it really comes down to, isn't it? As with Ireland's smoking ban and Australia's plain packaging law, the real motivation is for undistinguished politicians and lobbyists to make a name for themselves by being "exciting" and bullying a minority in the knowledge that their only financed opposition is a demonised industry.

Nowhere in this article is there any suggestion that grown adults—now or in the future—might have the right to buy and smoke tobacco if they want to. It's a sort of "think of the children even when they are no longer children" argument, which is fitting since Australian politicians clearly see the whole population as children and themselves as—what other word can there be?—nannies.

I have increasingly come to believe that the worst thing about Australia is that it is not far enough away.

Tuesday 21 August 2012

Australia's alcopop tax folly: A lesson in unintended consequences

Reading this little post reminded me of Australia's doomed attempt to stop binge-drinking by taxing the hell out of alcopops. It serves as a classic example of big promises from public health hucksters being followed by abject failure. With the UK seemingly set on minimum pricing and Australia set on... well, literally any idea the wowsers come up with, it is a good time to reflect on the woeful track record of the neo-prohibitionists.

At the end of April 2008, Australia increased the tax on alcopops by 70 per cent. A familiar cast of characters claimed that there was "overwhelming evidence" that price influences consumption (as if that was not Econ 101) and that a high tax would slash rates of teen binge-drinking. Foremost amongst them was that pitiful simpleton Nicola Roxon in her days before she fell for the plain packaging nonsense...

Health minister Nicola Roxon said: "We've got research showing that young people are price sensitive and, if that means this is a deterrent, then this will be a really successful measure."

There were plenty of speculation dressed up as fact from the mouths of professional campaigners:

John Rogerson, the Australian Drug Foundation chief executive, said: "It's going to help reduce binge drinking, it's going to reduce violence and it's going to reduce damage."

Within days, the British Conservative Party decided to ride the band-wagon, with the usual sock puppet charity in tow.

A 50p tax would be imposed on alcopops such as Bacardi Breezers by a Conservative government as part of a drive to cut the consumption of "problematic alcoholic drinks" by half...

Don Shenker, director of policy at Alcohol Concern, said the drinks targeted were some of the most problematic, adding: "There's no doubt that measures of this kind will put a dent in teenagers' ability to drink these products excessively."

But it wasn't long before the unintended consequences appeared Down Under...

Alcopop thefts soar since tax jump

Vel Tanaskoski, the co-owner of Glenfield Cellars, calculated that thefts of individual alcopops had run into several cases over the past few days, not including some cans that were recovered from individuals as they tried to leave the store.

"As soon as the price went up the stealing went up dramatically," he said. "It's pointless to report it to the police. It's like the law's on their side."

And, in a sign of things to come...

Rex Newaz, of Prestons Village Liquor, said he too had noticed a sudden change in his younger customers' buying patterns.

"The [ready-to-drink products] have slowed down a bit, but they're just buying more spirits," he said.

So it proved...

Alcopop sales plunge, spirits soar in tax wake

SALES of pre-mixed alcoholic drinks have plunged dramatically in the wake of the Federal Government's 70 per cent tax hike on the popular drinks.

The peak industry body also says there has been a "staggering" 20 per cent jump in the sales of full-strength spirits such as vodka, gin, and whisky over the same period.

This has been confirmed in subsequent reports, like this...

THE contentious tax on alcopops has failed to influence teenage drinkers and done nothing to curb binge drinking, according to the first survey of underage alcohol use since the federal government introduced the excise hike.

A Health Department survey found that "risky underage drinking continued unabated".

"These figures are an absolute disaster," said Professor John Toumbourou, who holds the chair in health psychology at Deakin University, commenting on girls' risky drinking.

And this...

Young binge drinkers have simply switched to cheaper booze to beat the Federal Government's controversial "alcopop" tax.

New research shows 15 to 29-year-olds have dodged the 70 per cent tax on popular pre-mixed drinks by changing their drink of choice.

The University of Queensland study found no significant reduction in binge drinking-related hospital admissions since the tax was introduced in 2008.

And—bearing in mind that Nicola Roxon had previously opined that, according to ABC News, "the large increase in tax on pre-mixed alcoholic drinks will not force teenagers onto stronger drinks or drugs"—the icing on the cake was this...

Alcohol price spike fuels switch to ecstasy

A NEW phenomenon of young people "switching" to the increasingly cheap party drug ecstasy has been fuelled by rising alcohol prices, according to drug researchers, nightclub owners and the people themselves - the nightclubbers.

The rise in alcohol prices was in part fed by federal Labor's 2009 alcopops tax. "It is cheaper and convenient to use pills," said Professor Jake Najman, director of the University of Queensland's Alcohol and Drug Research and Education Centre.

This is a text-book example of government folly that could have been prevented had anyone in the government been in touch with the real world. It is a story as old as the hills and never does it change whether the target is drink, drugs or cigarettes. If these imbecile politicians moved beyond Econ 101 they might come across such concepts as price elasticity. If they had any knowledge of history, they would know that people switch from one stimulant to another. If they had any understanding of human beings, they would know that the desire for pleasure and intoxication is innate.

This could have been a lesson learnt. The hapless politicians and wide-eyed reformers could have realised that increasing the price of alcohol has consequences which rarely match their intentions. But what did they come up with instead?


Call for minimum alcohol price as alcopop tax fails to stop Australia's young binge drinkers








Monday 20 August 2012

More plain pack news

A little more plain packaging news...

According to the Tobacco Manufacturers Association, an estimated 500,000 people have told the Department of Health not to go ahead with the policy. This includes the 235,000 who have signed the Hands Off Our Packs petition.

This unprecedented response represents views from thousands of members of the public as well as retailers, packaging companies, marketing and design firms, manufacturers, wholesalers, politicians, employers, employees, business groups, trade unions, the Intellectual Property community, international business, trade associations and the law enforcement community.

Meanwhile, a survey for Marketing Week found that only 28% of Brits think that plain packaging will help deter young people from smoking.

Just a quarter of people in the UK (28 per cent) think that selling cigarettes in plain packaging would discourage younger people from taking up smoking, the stance that health organisations are currently taking to push the law in this territory. Only 25 per cent of smokers agree that plain packs would put children off trying cigarettes.

It's also interesting to see the effect that last week's Australian High Court decision had on Philip Morris's share price, ie. next-to-none.

While this is a negative headwind for Philip Morris, we don't believe that it is the end of the world for the company. For one thing, this litigation wasn't even discussed at the Q2 2012 Earnings Call between Philip Morris and its analysts. Secondly, the market did not make that big of a deal about it on August 15th (which was the first trading day after the news was announced), because Philip Morris's stock only closed down 17 cents (.18%) during the day's trading and PM's stock only saw slightly below average trading volume. And third, despite the fact that over 50 countries have mandated pictorial health warnings since 2001, Philip Morris's revenue has tripled since 2001.

Still, what do the markets know about business, eh?

And finally, Carl Phillips has a couple of posts up at Ep-ology about plain packs and the black market which are worth a read—see here and here.



Wednesday 15 August 2012

Australia lights the fuse, prepares for a price war

Australia has moved a step closer to implementing plain packaging after the High Court rejected Japan Tobacco's complaint that the government was stealing its trademarks. In a nutshell, the court ruled that the government is not taking the trademarks to use itself, only preventing the tobacco companies from using them on their packs.

This has naturally induced squeals of delight from antipodean crusaders and "Simple" Simon Chapman was quick off the block to celebrate Australia's lurch towards the black market. In his excitement, he even told the truth about what will happen when plain packaging comes in...

First, we will see dramatic price falls in the retail price of tobacco. Many will think “these [famous name brand] cigarettes are costing me $3 to $4 a pack more than cheap unknown brands in exactly the same packaging except for the small brand name. They taste pretty much the same as cheap brands, so why should I pay out all the extra?”

Er, yes. I told you that would happen back in January when I wrote the following...

Plain packaging will result in people paying less for their cigarettes for other reasons. The first is that manufacturers operating in a completely “dark market”—ie. one in which they have no communication with their customers—are only able to compete on price. The second is that many consumers will drift towards cheaper brands when the premium brands lose their identity.

The bug-eyed sociologist continues...

Tobacco companies today chase the “value market” because they know that total sales volume is steady and the margins on high-end brands is where they profit most.

That's right. Again, I said all this in my paper for the Adam Smith Institute...

Knowing the power of packaging to imply quality, companies often produce two barely distinguishable versions of the same product and give the budget brand a consciously inexpensive-looking package, even though it would cost no more to make it look glitzier. The same is true of cigarettes which are branded and packaged according to the price point. One in two smokers cannot distinguish between similar cigarettes in blind trials and it is reasonable to expect many of them to downgrade to cheaper brands under a regime of plain packaging. This is the main reason the tobacco industry is so vehemently opposed to plain packaging: its top brands are worth billions of pounds and any government which misappropriates them can expect to be sued, as is already happening in Australia.

... It is the profitability of premium brands which is at stake in the plain packaging issue, not cigarette consumption per se.

This is all quite obvious stuff to anyone who has ever dabbled in logic, but throughout the whole campaign for this ridiculous policy, Chapman has continually claimed that Big Bad Tobacco objects to plain packaging not because it values its trademarks (as any industry would) nor because it wants to protect its more profitable premium brands, but because it's going to reduce the number of smokers. To take just a handful of his many tweets on the subject:








But now the truth can be told. The money is in the premium brands. The premium brands are about to lose much of their appeal and so people are going to turn to cheaper cigarettes. Pushing people onto cheaper cigarettes is not generally considered to be best practice in public health. But fear not, because Chapman has the solution...

But the Australian government can simply raise tobacco tax overnight as often as it needs to effectively maintain a floor price for cigarettes that will deter smokers from buying more than they could have afforded previously.

The man's a genius! Make cigarettes more expensive and fewer people will buy them. Why has no one thought of this before?!

Since this is such a cunning plan, why not double the price of cigarettes? In fact, why not triple it?

Oh, that's right. Because higher prices give massive incentives for people to buy cigarettes on the black market and it gives black marketeers further incentives to increase supply. That would explain why Ireland—the home of Europe's most expensive cigarettes—has an illicit tobacco market which is off the frickin' scale. Add plain packaging into the mix and you have cigarettes that are easier to counterfeit, combined with bigger profit margins from escalating tobacco duty. And, of course, organised criminals don't care how old their customers are. Jeez, what could possibly go wrong?

None of this will worry our Simon because he has what can most charitably be described as a simplistic view of how the black market can be policed. You may recall this gem from last year, a classic example of why people who have no sense of irony should not attempt sarcasm:

So while one in six smokers apparently know where they can repeatedly buy illegal tobacco, strangely, with more than a billion dollars supposedly being lost, the gormless Federal Police with all their intelligence and resources and impressive history of major smuggling busts cannot find any of these same retail outlets and prosecute.

I can only repeat what I said at the time about this stupefyingly dim-witted comment:

It's a measure of Chapman's immense talent that he can solve the centuries old problem of smuggling in one throwaway sentence, but this is a true Eureka moment, is it not? If the public can get hold of illicit substances, so can the authorities. Like all the best ideas, the beauty lies in its simplicity. All the police have to do is go undercover, find out where people are getting illicit goods and then find out who supplied them to them, and so on until you get to the top of the chain. Then make a few arrests and—ta-da!—the problem is solved. If only the DEA and the FBI had thought of this 100 years ago, we could have made a success of Prohibition and the War on Drugs. I look forward to reading this guy's next webitorial when he will solve the Palestinian problem and the common cold.

When this policy comes in it will be open season between the tobacco industry and the anti-smoking crusaders, with the black marketeers waiting in the wings. BAT's press release shows that they expect the government to jack up prices to bring about a reduction in smoking prevalence which it can then attribute to plain packaging:

As there’s no proof that plain packaging will actually work we expect the Federal Government to impose [on] the industry a large excise increase alongside plain packs to try and get more people to quit so it can say ‘look green packs worked’.

Chapman, meanwhile, expects the tobacco industry to reduce prices to maintain smoking prevalence for the same reason:

Australia is a tiny market for Big Tobacco, and it may well be willing to treat us in the way as when supermarkets place drastically reduced “loss leader” items on special to get customers into the store. The industry will be so desperate to demonstrate to watching nations that plain packs “don’t work” that it might even be prepared to wear local losses for a year or so.

Time to get out the popcorn. It's war!

Tuesday 14 August 2012

A few plain pack articles

If you can stand to read any more about plain packaging, there are a few articles of note...

I was asked to write a piece for Public Service Europe which is here.

Is the anti-smoking movement addicted to legislation? If so, is it possible to wean these people off silly laws and return them into the community? I ask the question because every year the crusaders fire up their formidable PR machine and every year their policies become more surreal. Cigarette prices sky high? Make a pack cost £100. Graphic health warnings did not work? Put the cigarettes behind shutters. Shutters fail to do the trick? Make all cigarette packs brown. Perhaps the whole enterprise is a Situationist prank designed to see if there is any policy too preposterous to be enshrined in law under the pretext of protecting kiddies.

Mr Eugenides also has his two penneth at Think Scotland...

Under these plans, cigarettes could be sold only in plain packaging without logos or identifying marks of any kind; apparently the bright primary colours attract children and adults who otherwise wouldn’t dream of going near them, though I can’t help noticing that it doesn’t seem to work with Scottish people and fruit salads.

And at The Commentator, Dave Atherton covers the prohibitionists' desperate last ditch (and, it seems, futile) attempts to get more more supporters than the Hands Off Our Packs campaign.

Friday 10 August 2012

A timely plain packaging study

As the plain packaging consultation finally grinds to a halt, I was interviewed by the Voice of Russia for a comment about where the whole thing is likely to lead. The link's here—do listen to the audio as the transcript is inaccurate.

Also speaking was Olivia Maynard, one of Linda Bauld's postgraduate students from Bristol University, who has produced another chunk of quasi-science claiming to show that plain packaging "encourages young smokers to heed health warnings". It does not nothing of the sort, of course. The research—which was barely reported in the media—was merely the latest in a series of studies which use eye-tracking technology to show that plain packs might make people look at health warnings for fractionally longer than normal packs do.

The glaring problem with this as a "plain packaging will reduce smoking" argument is that it does not actually show that people will "heed" the warnings even if they do look at them for 0.1 second longer. In the interview, Maynard makes the puerile claim that "when you look at something more, you understand it more", as if the phrase 'Smoking Kills' was an enigmatic riddle requiring deep meditation. In truth, knowledge about the hazards of smoking is universal and is well-engrained by the age of about seven. People don't start smoking because they think cigarettes have got vitamin C in them.

For the record, Dr Tim Holmes, of Royal Holloway (University of London) happens to be an expert in eye-tracking experiments and has no ties to either the tobacco industry or the anti-tobacco industry. When he conducted a similar experiment, his research found...

...the non-smokers looked at the warning messages much less than the other participants, and there was no difference between plain and branded package designs in the amount of time spent looking at the warning message.

Now, it’s great that the right people are looking more at the warning message, but if this doesn’t result in an increased risk perception then surely the messages aren’t doing their job! Moreover, if removing the brand identity doesn’t change the way people look at the packets then maybe plain packaging, which will be costly to implement, isn’t the best of ideas.

As far as I know, Dr Holmes has yet to publish his research and one can hardly blame him from wanting to avoid the smears and slurs that will inevitably come his way if he does. As for Bauld's team at the University of Bristol, it is quite shameless that this sort of "science" is being press released at such a politically convenient time and that the "scientist" responsible is an overt advocate for the policy in question. As it happens, I remember Ms Maynard as one of the starry-eyed true believers who sat front and centre at the debate I spoke at in Bristol on the same subject. Whilst I cannot blame her for walking the gold-plated path of tobakko kontrol in this challenging job market, neither her interview nor her background are suggestive of a disinterested academic.

Meanwhile, after the Hands Off Our Packs campaign announced that they had 235,000 signatories, the pro-plain campaign announced they had... [drum roll] ... 235,000 signatories. What a coincidence, eh?





Thursday 9 August 2012

235,000 voices of sanity

Finally, a bit of good news...

235,000 sign petition against plain tobacco packs

A petition against controversial plans for plain tobacco packaging signed by 235,000 people has today been handed to the Department of Health.

The petition, organised by the Hands Off Our Packs campaign, has been presented two days ahead of the deadline for responses to a public consultation on Friday.

This is a quite phenomenal result, particularly when you consider the government's expectations...

Based on past consultation exercises, we expect to receive around 100,000 responses to the consultation.

It is notoriously difficult to get people to put pen to paper in favour of the status quo, especially when you're dealing with a 'denormalised', minority habit such as smoking. It is therefore very encouraging to see that so many people have spoken out against this ridiculous scheme. This, remember, is in addition to opposition from the country's biggest trade union, nine out of ten police officers and members of Parliament.

It should go without saying that this massive petition does not guarantee success in post-democratic Britain. We know that the Department of Health is firmly behind the idea (why else would it spend millions of pounds campaigning for it?). We also know that the Department of Health are past masters when it comes to sexing up public consultations until they get the 'right' result. And we know that ASH, Smokefree South-West and all the other state-funded sock-puppets have been given the resources to gather many signatories themselves.

But even if the liberal side had no more than 235,000 supporters—and there will be many more on paper by the time the consultation is published—it will be a significant and irksome thorn in the prohibitionist's side. The government might start to ask itself, finally, why on earth it is pursuing this obscure policy. Where are the votes in it? And then perhaps we can see a return to some semblance of sanity and perspective from the mother of all parliaments.

Wednesday 8 August 2012

What is home advantage worth at the Olympics?

Regular readers will know that I am not the biggest fan of the Olympics, but I am keen on statistics and so I wondered how much of an advantage hosting the event provides in terms of medals.

I took the average number of medals won by each host in the years before their Olympics and compared this to the number won when they were the host. Thanks to the cold war boycotting of the 1980 and 1984 games, the USA and South Korea were excluded because they missed a preceding Olympics and the USSR is excluded because its success at the 1980 Moscow games was at least partly due to the absence of the other superpower. West Germany was excluded because it did not compete under that name until 1968.

Here are the results. Click to enlarge. Each nation's home performance is shown in the middle. Figures to the left show preceding Olympic performances going back up to seven Olympics.



As you can see, every host nation wins significantly more medals when they are playing at home. Plausible explanations include increased investment in athletics prior to the the games, favourable climatic conditions, psychological advantages from crowd support and judges being influenced by partisan crowds.

The win rate increases from 41% (Australia, 2000) to 756% (Spain, 1992). This, of course, is a large margin, but the average increase in medal tallies is 222%. Therefore, if 'Team GB' benefits from an average home advantage, we would expect them to win 64 medals this year.





Tuesday 7 August 2012

Dr Aseem Malhotra: quackery's buddy

Dr Aseem "we must demonise junk food for the sake of our children" Malhotra has been getting his face around recently, popping up on Newsnight and in the pages of The Guardian bemoaning the existence of 'junk food' advertising. He is a cardiologist and therefore—in the eyes of the bovine media—a scientist and food expert.

But, as I never tire of pointing out, he repeatedly gets basic facts wrong and will take any junk statistic on trust if it furthers his vendetta against Ronald McDonald (and, more worrying, against physical exercise).

Today, he directed his Twitter followers towards the website of one Dr Joseph Mercola, which promises us "the truth about fast food".




The "article" in question begins thusly...

Ever wonder what goes on behind the scenes at fast food restaurants? Fast-food insiders (i.e. former employees) reveal a slew of nasty secrets that may make you think twice about ever eating in one of these restaurants again …

I like the idea that anyone who has ever worked at a burger joint is a "fast-food insider". This sets the bar rather low for the reliability of the information to come (it's not as if burger chains ever have any disgruntled, stupid or deceitful staff, obviously).

And the bar needs to be set low, for what follows is a load of tommy rot.

Most Fast Food is a Mixture of Chemicals, Sugar, Flavoring and Salt

More precisely and succinctly, one could simply say "Food is a Mixture of Chemicals". As is the whole Universe, of course, but then this webpage is full of chemophobia, organic-worshipping, aversion to genetic modification and other tell-tale quackery. "Additives" and "preservatives" are assumed to be evil without any explanation of what they are or why they should be malign. Equivocation and speculation abounds. Chicken nuggets contain "corn-derived fillers and additives (most likely genetically modified chemicals)". Hamburger buns "allegedly contain" artificial flavours.

It is, in short, two-a-penny tree-hugging anti-science from a rinky-dink website written by an alternative medicine chancer who happens to sell various "natural remedies" and "dietary supplements". It would not be considered a reliable source by a stoned teenager, let alone Wikipedia.

Business Week says that Dr Mercola's huckstering comes from "an unfortunate tradition made famous by the old-time snake oil salesmen of the 1800s". He has been thrice warned by the FDA for making false claims and violating federal law. He thinks microwaves are dangerous because they supposedly alter the chemistry of food. He doesn't think HIV causes AIDS. Instead he thinks that "the severe, acute psychological stress of being diagnosed "HIV Positive" is quickly transformed into a severe, chronic psychological stress of living with a prediction of a horrifying decline that could start at any time. This causes a dangerous suppression of the immune system."

We've gone beyond 'free thinker' and 'maverick' here, I think, and entered 'fruitcake' and 'dangerous crank' territory.

I don't suggest that Aseem Malhotra necessarily shares any of Mercola's other wacky beliefs, but I do find it troubling that a man who is presented by Newsnight as an expert—a man of science, no less—could go to the website of a notorious quack and not smell the bullshit, let alone laud it as "the truth". It's no surprise that the Guardian's go-to man comes out with the whoppers he does if he gets his facts from this sort of lazy, indiscriminate googling, but if I were in public health I would be muzzling this guy because he's an ill-informed accident waiting to happen.

Monday 6 August 2012

In case it's not mentioned in Dispatches...

This evening Channel 4 will be broadcasting a programme about the bookmaking industry. I would like to think that this will be a fair and balanced look at British gambling habits, but the trailer suggests that it will be an anti-gambling polemic designed to make the viewer believe that the country is being flooded with betting shops.

Just in case Dispatches doesn't bother to mention them, here are the facts. The number of betting shops peaked in 1973 at over 15,000. In 2003, the Department for Media, Culture and Sport published a document showing what happened between 1987 and 2003. What happened was numbers continued to fall gradually...





In 2003, there were 8,804 bookies in operation. I can't find the figures for 2004-2008, but in 2009 there were 8,862. Today, in 2012, there are 9,128. The number of bookmakers has therefore risen by less than 4 per cent in the last ten years (broadly in line with population growth) and remains lower than at any time between the 1960 legalisation and 1996.

If there is a perception that betting shop numbers have rocketed in recent years, it is because the recession has caused the rent on commercial property to fall and so betting shops have been able to move from the side street to the high street.

I understand that Dispatches will focus on fixed odds betting terminals—the new bogeyman of the anti-gambling movement. There are valid questions to ask about where these devices should sit in the regulatory ladder, but do not be fooled into thinking the country is awash with betting shops.




Thursday 2 August 2012

Another sock puppet?

The Children's Rights Alliance for England is a lobby group which campaigns against things like parental smacking and lobbies for things like lowering the voting age to 16. Their agenda isn't of great interest to me, but this claim—on the 'Our Key Supporters' page of their website—is...

CRAE receives no Government funds.

Fairly ambiguous, that. So why does a quick check on the Charity Commission website suggest otherwise?




Their single biggest donor in 2010/11 was the European Commission. Their third biggest donor—with £61,919—is the Equality and Human Rights Commission. Unless I've missed a meeting, these both fall under the umbrella of 'government'. 

So, is it right for a pressure group that gets more than a third of its grant income from statutory sources to say that it "receives no Government funds"?

I've written to CRAE to ask them about this discrepancy but—whadya know?—no reply.




Wednesday 1 August 2012

Reponse to HoC committee on alcohol

On behalf of the Institute of Economic Affairs, I responded to the House of Commons Health Select Committee regarding the government's alcohol strategy. This is the consultation which asked about minimum pricing and plain packaging, amongst other things. A sample...

As regards raising the drinking age, lowering the strength of alcoholic drinks, banning advertising and mandating plain packaging, these are all policies entirely at odds with the principles of a free society. Drinking alcohol is an adult pastime and those who are 18 and over should not be prohibited from engaging in it and have a right to know which products are available. Plain packaging, like minimum pricing, would be a serious infringement of commercial freedom which would likely violate a number of free trade agreements to which the UK is a signatory. We find it troubling and scarcely believable that the government is contemplating creating a country in which bureaucrats not only set the price of products but also design their packaging.

If you're interested, you can read it in full here. The list of all respondents is here.