Monday, 29 February 2016

Plain packs review finally published

The long-awited, much-delayed plain packaging review was published in Australia last week. As Taking Liberties has noted, the most interesting thing about it is that it was slipped out on a Friday with zero fanfare and almost no media coverage.

Perhaps the Aussie government is embarrassed by it. It is a slippery report that evades the tough questions and contains only one new piece of research. The impact of plain packaging on the black market is mentioned only briefly and there is a reliance on the same weak behavioural experiments that were used to get the government to experiment with the policy in the first place. There is also a focus on a couple of studies that vaguely suggested an immediate effect on smoking rates, such as the study that claimed a surge in calls to smoking Quitlines when the policy was brought into effect.

The only new evidence comes from a regression model which claims that plain packaging reduced smoking prevalence by 0.55 per cent. If this was true it would not be much, but it would also not be nothing. The Aussie government will be hoping that it is enough for them to justify the policy to the World Trade Organisation when their case comes to court. The model is shown below...

Sinclair Davidson is not impressed by this model. His blog post about it is worth reading. I would only add one thing.

The model purports to show an acceleration in the decline of smoking prevalence after plain packaging came in. The smoking rate in almost all of the post-implementation period is below the trend line, ie. below what might be expected from the secular trend.

But look again and you will see that the smoking rate in the two years before implementation is also almost always below the trend line. That is because there was little change in the smoking rate in the first few years of this series, leading to a trend line that does not cut through the middle of the data after 2005. If you look at the evidence from the last decade, ie. since 2006, the smoking rate is falling at a consistent rate—and at a steeper rate than the regression line implies.

It is only in late 2013/early 2014 that the rate of decline seems to accelerate, albeit only very slightly. The rate of decline in the first year or so of plain packaging is actually no different to that of the previous few years.

There is a reason why the smoking rate might have dropped off slightly at the end of 2013. To the naive observer, a more impressive graph appears on page 45 of the Post-Implementation Review. The graph of (legal) tobacco sales shows a marked decline...

The problem is that the marked decline does not correlate with plain packaging's introduction. If we flag up some important dates on this graph, it becomes clear that sales rose after plain packaging and only started to fall again when a large tax rise of 12.5 per cent (plus sales tax) was introduced in September 2013. Another tax hike of the same magnitude was introduced a year later.


I have been pointing this out for some time. It is nice to have it confirmed in a government report. Or rather, it would have been nice had the government presented the data clearly. As it is, the few people who read the report will probably assume that the decline in (legal) sales correlates with plain packaging. It doesn't. It never did.

Despite all the fuss and nonsense about people calling Quitlines and telling researchers that they didn't like the new packs, sales of cigarettes rose after plain packaging was introduced and it took some hefty tax rises to bring them down again. Those are the facts. Nothing will ever change them.

Sunday, 28 February 2016

Censorious anti-smoking fanatics

This has to go straight into the top twenty of the maddest things the health zealots have ever done. Some bloke from California, supported by Stanton Glantz, has launched a lawsuit against the following organisations: the Motion Picture Association of America (MPAA), Parmount Pictures, Disney, Sony, Universal, Warner Bros., Twentieth Century Fox and the National Association of Theatre Owners.

Why? Because they have allowed smoking to be portrayed in movies that can be viewed by people under the age of 17.

I am not making this up. You can read the plaintiff's complaint here. He has swallowed every one of Glantz's ludicrous claims...

During the period 2012 through the present, defendants’ film rating system – certified and rated thousands of films featuring tobacco imagery as suitable and appropriate for children under the age of seventeen without a parent or guardian, causing over 1.1 million children under the age of seventeen to become addicted to nicotine and will cause the eventual premature death of 360,000 of such nicotine addicts from tobacco caused diseases including lung cancer, heart disease, stroke and emphysema.

As Hollywood Reporter points out, there is a First Amendment issue at stake here and the case 'could open up a whole new range of lawsuits blaming Hollywood for helping cause gun deaths and other social calamities'

The MPAA has responded, saying:

'We are confident that the courts will recognize the MPAA’s First Amendment right to provide information to parents so that they may make appropriate movie-going decisions for their children.'

That sounds about right, although it will be amusing to see Stanton Glantz's vast body of junk science tested in court.

Saturday, 27 February 2016

Opium prohibition 'didn't work out badly'

Ruth Malone, the editor of Tobacco Control, has been promoting prohibition under its latest euphemism of the 'tobacco-free generation' ie. banning anyone born this century from ever buying tobacco.


This received a predictable, but reasonable, response..


Which, in turn, received an unpredictable and rather less reasonable response...


*splutter*

What?! The prohibition of opium didn't work out too badly? For whom? The Taliban? Pfizer?


Er, Afghanistan? Y'know, the place they grow it, process it and export it to the rest of the world as heroin.


It certainly has been discussed by historians. Here's a potted history for the benefit of a twenty-first century would-be prohibitionist like Malone:

Opium was banned in the USA in the nineteenth century, leading to an upsurge is morphine consumption.

Morphine was then banned - as, indeed, was alcohol - thereby leading to an upsurge in heroin use.

Heroin was then banned and no one ever took opiates ever again. Since 1915, every generation has been an opiate-free generation. The rest of the world followed the US's lead and the global war on drugs ensued, leading to people consuming drugs safely, if at all.

No wait, that's not quite right is it?

What actually happened is that opium, morphine and heroin were banned, leading to a hundred years of heroin use because it's the strongest, most compact and most profitable opiate product.

Consumers take it in impure form in unpredictable quantities via hypodermic syringes, leading to overdoses and infection of diseases like HIV and hepatitis.

The manufacturers and retailers cannot use courts to enforce contracts and so they settle their disputes with indiscriminate violence.

So Ruth is right to say that there is very little opium smoking these days. Whether the prohibition of opium 'didn't work out badly' is more contentious, to say the least.

This has been discussed by historians. Let's read some of them before we do this all again.


Friday, 26 February 2016

The story of the new alcohol guidelines

I've been reading the minutes of the meetings held by the committee that reviewed the alcohol guidelines recently. You may recall that this was the first full review since 1995 and led to the Chief Medical Officer (CMO), Sally Davies, lowering the recommendations for men from 21 to 14 units a week. The female guidelines were left at 14 units. She also claimed that the health benefits derived from moderate drinking were an ‘old wives’ tale’ and claimed that there was ‘no safe level of alcohol’.

The most striking difference between the 1995 review and the 2016 review is the make-up of the panels. Whereas the 1995 committee was dominated by civil servants who had no obvious prejudices for or against alcohol, the meetings held from March 2013 to discuss alcohol guidance were dominated by activist academics and temperance campaigners.

The Institute of Alcohol Studies (IAS), a small but hardline anti-alcohol organisation, was heavily represented on the committee. The IAS was formed in the 1980s as a direct successor to the UK Temperance Alliance which, in turn, had been formed out of the ashes of the UK Alliance for the Suppression of the Traffic of All Intoxicating Liquors, a prohibitionist pressure group. The IAS receives 99 per cent of its income from the Alliance House Foundation whose official charitable objective is ‘to spread the principles of total abstinence from alcoholic drinks’. Its director, Katherine Brown, was on the CMO’s panel, as was its ‘expert adviser’ Gerard Hastings, although he failed to disclose his IAS role in his declaration of interests.

The IAS’s scientific adviser Petra Meier was also on the committee and was joined by her Sheffield University colleague John Holmes. Holmes and Meier are both strong advocates for minimum pricing and helped develop a computer model which has been repeatedly used to promote minimum pricing by producing estimates of the number of lives that will supposedly be saved by the policy.

Another staunch anti-alcohol campaigner, Ian Gilmore (chairman of the Alcohol Health Alliance, of which the IAS is a key member), was unable to attend the first meeting but was involved thereafter. Gilmore has campaigned for many years for higher alcohol taxes, minimum pricing and a total ban on alcohol advertising.

Other members of the committee may have been less strident than Gilmore and the IAS but there was no doubt where their biases lay. Mark Bellis wrote an article for the British Medical Journal in 2011 complaining that existing alcohol guidance was too generous and ‘read more like an alcohol promotion slogan’. Mark Petticrew and Theresa Marteau are both strong advocates of a range of heavily interventionist ‘public health’ policies, including sugar taxes, plain packaging and minimum pricing.

Of those who attended the initial meetings in 2013, only three did not explicitly advocate stricter alcohol control: the health economist Martin Buxton, the health sociologist Sally Macintyre, and the epidemiologist Valerie Beral. The latter appears to have been selected because of her research linking alcohol to breast cancer, which would become a crucial element in the ‘no safe level’ narrative.

The minutes of a meeting in June 2013 indicate that the path towards dismissing the benefits of moderate alcohol consumption was mapped out from an early stage. Mark Petticrew told his new colleagues: ‘The beneficial effects of alcohol consumption, where they are evidenced, are limited to a low consumption level of half a drink per day.’ Moreover, he said, ‘The population cohort who experiences any beneficial health effect from alcohol is very small. Given these limitations, there is an argument that beneficial effects could be considered not to be relevant in the context of an overall population message, advice or guidance.’

These bald assertions were based on private meetings held between Petticrew and two alcohol researchers, Jurgen Rehm and Tim Stockwell, a fortnight earlier. As a result of this information, the minutes of the 25 June meeting state that the group ‘agreed that a key message from the Rehm/Stockwell discussion is that the evidence shows that any amount of alcohol increases the risk of cancer. Therefore it cannot be said that there is such thing as a “safe” limit.’

Here were the two central messages that would be transmitted, almost word for word, to the British public two and half years later — that the benefits of moderate consumption had been much exaggerated and there is no safe level of drinking. This new narrative appears to have arisen from nothing more than a private meeting with two researchers. Rehm has strong views on alcohol policy (he advises governments to ‘treat alcohol like tobacco’) and he is a respected alcohol researcher but his views, as ventriloquised by Petticrew, bear little relationship to what he told the BBC after the guidelines were announced. On BBC Radio 4’s More or Less programme, he made it clear that there was good evidence that moderate alcohol consumption reduced the risk of heart disease and other diseases. Rehm’s own research concluded that the protective effect of alcohol on heart disease was ‘hard to deny’ and not just for those who consume ‘half a drink a day’, as Petticrew claimed, but for larger quantities too. Rehm’s 2012 systematic review found that heart disease risk was at its lowest for men drinking around four units a day, with a lower optimal level for women.

While Rehm’s views may have been misreported by Petticrew, those of Tim Stockwell were not. Stockwell is the world’s most persistent and prominent critic of the evidence showing that moderate alcohol consumption saves lives. His various letters, editorials and studies casting doubt on the benefits of drinking were given a hugely disproportionate prominence in the 2016 guidance. It is telling that Petticrew’s first act was to approach Stockwell and allow his controversial opinion to frame the debate.

The other striking difference between the 1995 review and the 2016 review is the range of evidence put before the respective committees. Whereas the 1995 panel received dozens of submissions, the minutes of a March 2013 meeting show Sally Davies’s team explicitly rejecting a call for evidence, preferring instead to rely on their own wisdom. Several new reports were commissioned, but all were co-authored by members of the committee.

Most of these were commissioned from the Centre for Public Health at Liverpool John Moores University and co-written by Mark Bellis. One of them, entitled ‘A summary of the evidence of the health and social impacts of alcohol consumption’, did its utmost to cast doubt on the benefits of alcohol consumption.

Sceptics such as Stockwell often claim that non-drinkers have a lower life expectancy than moderate drinkers because many of them are unhealthy former drinkers. Despite many studies showing that moderate drinkers also live longer than lifetime abstainers, this zombie argument continues to be made and it reappeared in Bellis’s report for the committee. He was, however, forced to admit that studies which have controlled for this potential confounder still found a protective effect. The draft document concedes: ‘A few meta-analyses have sought to account for such bias, and based on the extent to which this misclassification error can be accounted for, compared with lifetime abstainers a protective association appears to remain for type-2 diabetes, ischaemic heart disease, and ischaemic stroke.’

This was undoubtedly true. The Liverpool report included a summary of epidemiological studies showing that risk from several major diseases is lowest for people drinking between 1.5 and 8.5 units a day and that risk only reverts to that of an abstainer at a level of at least 4 units a day (or 28 units a week). The authors did not dwell on this evidence. Instead, they immediately suggested that there were ‘further reasons to suggest that the beneficial effects of alcohol consumption may currently be overestimated’, a vague claim for which the only citation was an opinion piece by Tim Stockwell.

The Liverpool document has since been made available to the public but the published version has been edited to further obfuscate the benefits of drinking. Whereas it previously acknowledged the evidence that moderate drinking reduces the risk of type-2 diabetes, ischaemic stroke and heart disease, it now only mentions heart disease and Stockwell’s opinion is given added prominence. The passage quoted above has been replaced by the following: ‘A few meta-analyses have sought to account for such bias; for example a recent meta-analysis, which reported that light to moderate alcohol consumption was associated with a reduced risk of cardiovascular outcomes, included lifetime abstainers as a reference category in sensitivity analyses. However, Stockwell et al question the robustness of the conclusions generated from this literature…’

By November 2013, Mark Petticrew had already drafted the committee’s conclusions. He acknowledged that many studies have found a ‘J-shaped relationship between alcohol consumption and total mortality’ but after considering evidence from Liverpool John Moores University and his conversations with Rehm and Stockwell (no other evidence was mentioned) he claimed that the ‘estimates of the size of this protective [effect] are likely to be biased’. Petticrew had no such concerns about flaws in the epidemiology of cancer, however: ‘For cancers there is clear and consistent evidence of a linear relationship. Alcohol is carcinogenic with no safe lower limit.’

The draft guidelines concluded that the benefits of alcohol consumption, such as they were, mainly affected people over the age of 50 and only related to heart disease. The latter is untrue (the evidence before the committee clearly showed a protective effect for other diseases) and the former is largely irrelevant (heart disease is rare among people under 50). Despite portraying the benefits as only applying to older people, Petticrew advised against telling them to drink alcohol. ‘Discussion at previous meetings,’ he wrote, ‘was along the lines of: if someone >65 is not currently drinking, then the evidence is not strong enough to recommend them to start; however if they are currently drinking more than the lower limit, then they should reduce their consumption.’

It was becoming clear that the bar for what constituted good evidence was being set much higher for benefits than it was for risks. The idea that the government should recommend moderate alcohol consumption to people who did not drink was regarded as unthinkable, regardless of the health benefits.

When a second draft of the guidelines was written at the end of January 2014, an even harder line was taken and a new argument had been found. Having whittled away the benefits of drinking until they applied only at a low level to a single disease among one section of the population, Petticrew explained that heart disease in Britain was not the killer it once was and, therefore, ‘irrespective of whether any protective effect is real or artefactual, any positive impact on total mortality is likely to decline as mortality from IHD [ischaemic heart disease] continues to decline’. No one seems to have raised the possibility that heart disease rates have declined in the last 50 years partly as a result of rising alcohol consumption, nor was it pointed out that heart disease — declining though it may be — still kills more people than all the ‘alcohol-related’ cancers combined.

At this stage, however, there was little to suggest that the male drinking guidelines would be reduced to bring them in line with those of women. The Liverpool report had shown clear differences in risk for men and women, and a presentation viewed by the committee on 10 September 2013 showed different J-curves for both sexes. The draft conclusions of November 2013 noted that alcohol’s ‘cardioprotective effect on total mortality is observed at a much lower level of consumption for women’ and almost every country in the world has higher guidelines for men.

This began to change after the committee, via Public Health England (PHE), commissioned some computer modelling to help formulate the final guidelines. In the minutes of a September 2014 meeting it was noted that ‘the PHE tender exercise had resulted in just one bid and that the bidder would be interviewed in early October to explore their proposals’. We must presume that the lone bidder was Petra Meier and John Holmes’s team at Sheffield University since it was they who won the contract.

It remains puzzling why a theoretical model was deemed necessary when so much epidemiological data exists to show the effect on morbidity and mortality from different levels of alcohol consumption. We may never know how the model was put together — the published Sheffield report does not provide enough data to allow independent replication — but one thing is clear: its risk curves bear no relationship to any risk curves in the published epidemiological literature. Whereas observational epidemiology shows lower rates of mortality for people drinking up to 4-8 units per day, the Sheffield model suggests that drinkers’ mortality risk is lower than abstainers only at very low intakes and exceeds that of abstainers at around two units per day. Moreover, while epidemiological studies find that men can drink more than women before assuming the same risk as a teetotaller, the Sheffield report finds similar limits for both sexes.

It is not even clear what the Sheffield report is measuring. The key criterion for gauging a safe drinking level is the risk of death, ie mortality risk, but the Sheffield report instead focuses on mortality from ‘chronic alcohol-related causes’. It is obvious that non-drinkers are less likely to die from alcohol-related causes, but it tells us nothing about overall mortality.

Moreover, the team stripped out all health benefits from drinking with the exception of heart disease. In their response to a comment from the peer-reviewer (who, interestingly, said ‘I predict that there will be very little, if any, change to the guidelines’), the team stressed that ‘excepting cardioprotective effects, the report focuses exclusively on the negative consequences of drinking’. This was certainly true and, like Petticrew and Bellis, the Sheffield team went out of their way to cast doubt on the cardiovascular benefits. In the space of two sentences, they described the protective effect on the heart as ‘disputed’, ‘overestimated’ and suggested that the scientific consensus was moving towards the view that the benefits barely existed at all. This passage contains ten references, half of which were articles or op-eds written by Tim Stockwell.

In short, the Sheffield team produced a theoretical model that was entirely divorced from the epidemiological evidence. The model appeared to show that a ‘safe’ level of drinking — if defined as carrying no more risk than abstaining from drink — was significantly lower than had been reported in a large body of epidemiological research. The model also deviated from observational epidemiology by showing this ‘safe’ level to be similar for men and women alike. Indeed, it actually reported a higher level for women. When a computer model clashes with observed reality so conspicuously, it is time to bin the model. Instead, the CMO’s committee binned the real world evidence and used the model as the basis of its recommendations.

By April 2015, the only question was how to sell the new advice to the public. Having failed to completely erase the health benefits of drinking, the group were concerned about the public being encouraged to drink even small quantities of alcohol. The group emphasised that there was ‘now no justifiable case to recommend that anyone should choose to start drinking alcohol in the interests of their health’. Their message to those who already drank below the current lower risk limit was that ‘should they wish to reduce their frequency or levels of drinking, [they] need have no health concerns in doing so’. Whatever the evidence might say, there was no doubt that the committee favoured total abstinence: ‘The message is quite clear that any level of drinking can be harmful to health’.

The statistician David Speigelhalter, who acted as an adviser to the committee in the latter stages, told them that ‘a message that “there is no safe lower limit” would risk being at odds with public opinion’, but it barely seemed to matter if the public found the new guidelines credible or realistic. A telling comment in one set of minutes indicates that the real intention was to influence policy: ‘It would be important to bear in mind that, while guidelines might have limited influence on behaviour, they could be influential as a basis for government policies, which could in turn help to alter norms.’

The new guidelines were announced on 8 January 2016. The committee had made every effort to downplay the benefits of moderate drinking, and Sally Davies delivered the final blow by dismissing those benefits as ‘an old wives’ tale’ on the Today programme. Nearly three years after cramming her committee with temperance campaigners and ‘public health’ activists, Davies went further than even Tim Stockwell could ever have hoped when he had that first chat with Mark Petticrew in June 2013. The job was done.

Cross-posted from Spectator Health

Wednesday, 24 February 2016

Sheffield University: no job too small, results guaranteed.

You will recall that the forthcoming court case about minimum pricing hinges on the question of whether the policy will be more effective than tax rises in reducing alcohol consumption amongst heavy drinkers. A few weeks ago I made a little prediction...

I don't know how long it takes to cobble together a 'public health' study and get it through the not-very-rigorous review process, but the activist-academics have now been given some extra time to get their story straight.

Minimum alcohol pricing delayed for further evidence

Scottish courts have agreed to accept further evidence before making the final decision over whether Scotland can legally introduced a minimum price for alcohol.

The inner house of the court of session met last week to consider the recent ruling of the European court of justice, and decided to hear more material. The final hearing will provisionally be June.

Five months should be enough. The only question is who'll be getting the (taxpayers') money for the commission, which journal will print it, and when. The odds on favourite has to be Sheffield University, but other runners and riders include Liverpool and Sterling, both of whom have a solid record for policy-driven research.

As for which magazine accepts it, The Lancet is always keen to help but the British Medical Journal and Addiction are also good bets. If I had to put money on it, I would go for Sheffield in the BMJ in May. Watch this space.

It seems that I overestimated the time it takes to research, write, peer-review and publish a 'public health' study. Two months to the day after the European Court of Justice threw down the gauntlet, this has appeared...

Minimum unit pricing and strength-based taxation have larger impacts on health inequalities than increasing current alcohol taxes

Introducing minimum unit pricing or alcohol-content-taxation would reduce inequalities in health more than increasing alcohol duty under the current tax system or increasing VAT on alcohol, a new report has shown.

Research from the University of Sheffield’s Alcohol Research Group (SARG) compared four policy strategies for regulating alcohol prices to estimate how changes in alcohol price would affect individual levels of alcohol consumption and the subsequent impact on illness and deaths associated with 43 alcohol-attributable conditions in England.

The study, which is the first of its kind, showed that strategies which strongly link alcohol content with the price of drinks were more suited to tackling health inequalities compared to the current duty system where wine and cider are taxed by total beverage volume regardless of strength, and duty rates per unit of alcohol vary widely between different types of drink.

And just in case the Scottish judges miss the point when the SNP's lawyers wave this piece of pseudo-scientific wishful thinking under their noses in June, the text of the study lays it on with a trowel...

Minimum unit pricing is under consideration in several EU countries. Its legality under European Union law depends in part on its ability to achieve additional advantages or fewer disadvantages for public health and free trade compared to existing policy options, particularly tax increases under the current system (volumetric taxation is not currently possible in the EU as taxation of wine and cider by ethanol content is prohibited). This study suggests that, compared to a commensurate increase in existing alcohol taxes, minimum unit pricing is more targeted to the population at greatest risk of harm (i.e., disadvantaged heavy drinkers) and is thus more effective in reducing health inequalities, a key public health goal.

Incidentally, followers of the slipery slope may be interested in this sentence from the study...

The current judgment may set legal precedent not just for minimum pricing for alcohol, but also for potential future policies relating to other commodities such as sugar and fat.

Okay, it's not May and it's not The Lancet (it's in PLoS One, which must have a quicker turnaround), but it is Sheffield University.

Does anybody else even bother putting in a tender for these contracts? Is it a closed shop?

This is the same Sheffield University team that produced multiple models purporting to show that minimum pricing reduces alcohol-related deaths. The same Sheffield University team that produced a model showing that minimum pricing isn't really very regressive after David Cameron rejected minimum pricing for being too regressive. The same Sheffield University team that produced a model showing that people shouldn't drink more than 14 units a week when the Chief Medical Officer needed evidence to show that people shouldn't drink more than 14 units a week.

Now they've produced a model showing that minimum pricing is more effective than taxation just when the Scottish National Party needs evidence that minimum pricing is more effective than taxation in order to win a crucial court case.

This is the equivalent of a murderer's mistress showing up in court to testify that she was with him on the night he killed his wife. It is hard to imagine policy-based evidence being more shameless and blatant than this.

What are the chances?


Tuesday, 23 February 2016

Mad versus madder

It's a favourite trick of the 'public health' racket to ask for the impossible and then accuse the government of bowing down to Big Industry when it refuses to capitulate. We frequently see Big Alcohol and Big Tobacco cast in this role, and British campaigners are getting ready to do the same thing with Big Food when the new obesity strategy comes out.

But this is one of the most extreme examples I've ever come across...

Tasmanian Government following tobacco industry's instructions, says anti-smoking group

What do you suppose the government is about to do? Slash tobacco tax? Repeal the smoking ban? Give free cigarettes to school children?

No...

SmokeFree Tasmania says the State Government is "following the script" of the tobacco industry with its proposed changes to the legal smoking age.

In December, Health Minister Michael Ferguson announced a five-year preventative health plan which included a proposal to lift the smoking age to as high as 25.

And according to the fruitcakes at SmokeFree Tasmania, banning people under the age of 25 from buying tobacco products is exactly what the manufacturers of tobacco products want.

But Professor Haydn Walters from SmokeFree Tasmania said while he supported the intention of the move, the Government needed to be braver "rather than serve the interests of the tobacco industry".

Professor Walters said the approach was "punitive" and would "criminalise smokers", and the emphasis should be on the "pushers and dealers".

'Pushers and dealers', for god's sake. Tasmania has a display ban, an advertising ban and plain packaging. The industry couldn't 'push' its products in a month of Sundays.

"We know it's pretty sure that it's what the tobacco industry has been telling the Government," he said.

"They've been telling the Government, 'Look, we'd be happy if you put up the age but don't do anything more dramatic'."

More dramatic than banning grown men and women from buying cigarettes? Like what? Full prohibition?!

Well, actually, yes...

SmokeFree Tasmania supports the alternative Tobacco-Free Generation (TFG) legislation, which was introduced by Windermere MLC Ivan Dean, because it does not "penalise smokers".

The TFG legislation would see tobacco products become illegal to buy for anyone born in the year 2000 or later.

You see, what these fanatics want is the total phase out of tobacco sales, with 18 year olds banned from buying tobacco in 2018, 28 year olds banned from buying it in 2028, 38 year olds banned from buying it in 2038 and so on. This, apparently, will not 'penalise smokers'. Er, except anyone born after 2000 who might feel like smoking in a few years time.

Professor Walters said big tobacco was obviously putting pressure on the State Government.

Obviously.

Lunatics.

Friday, 19 February 2016

Cancer Research jumps the proverbial

I hope Cancer Research's cancer research is better than their economic research. This is their latest press release...

SUGAR TAX COULD PREVENT 3.7 MILLION CASES OF OBESITY OVER NEXT DECADE

A 20 per cent tax on sugary drinks could reduce obesity rates in the UK by five per cent* by 2025 - equal to 3.7 million fewer obese people - according to a new report** from Cancer Research UK and the UK Health Forum published today (Friday).

The devil is in the detail of the first footnote...

*Current trends predict that obesity rates will be 34 per cent of the UK population in 2025, which will be reduced to 29 per cent by a sugary drinks tax.

So what we have here is a futuristic counterfactual. CR-UK reckon obesity is going to rise to 34 per cent without a soda tax but will 'only' be 29 per cent with a soda tax. There are some pretty basic problems with this.

Firstly, they must mean 'reduce by five percentage points' not 'reduce by five per cent'. This is a minor criticism, but if you're going to attempt a statistical analysis you should have some grasp of maths.

Secondly, if 3.7 million is five per cent of the population then the population has to be 74 million. The population is currently 65 million, so it is going to have to rise by 9 million in the next nine years for the prediction to be right. This is very unlikely.

Thirdly, it is unlikely in the extreme that obesity rates will rise to 34 per cent by 2025. The adult rate of obesity has been fairly static at around 25 per cent for the last ten years and childhood obesity has been falling. Media-driven obesity predictions have all been wildly and hilariously wrong to date and I will put money on this one—which CR-UK was pushing last month—being no different.

Let's not forget that a third of adults were supposed to be obese by 2012 and 36 per cent of men were supposed to be obese by 2015. The latest prevalence figures are 27 per cent for women and 24 per cent for men.

Fourthly, the obesity prediction CR-UK is referring to relates to adults, not the whole population. CR-UK have simply taken 34 per cent of the presumed total population of 74 million and assumed there will be 25 million obese men, women and children. Even if the prediction was right, this would be wrong. Obesity rates are always much lower amongst children.

Finally and most fundamentally, the idea that doubling VAT on sugar-sweetened drinks is going to prevent or cure 3.7 million cases of obesity is borderline insane. Sugary drinks only supply three per cent of the nation's calorie intake and a twenty per cent tax can be expected to reduce consumption of this relatively minor source of calories by no more than ten per cent.

Briggs et al. (2013) modelled a 20 per cent tax and estimated that it would reduce obesity by 180,000 persons—and Briggs et al. are ardent supporters of soda taxes and used some highly optimistic assumptions. Once brand-switching, store-switching and product-switching are taken into account, the effect would likely be negligible to nil.

The study also predicts that the tax could save the NHS about £10 million in healthcare and social care costs in 2025 alone.

That is also unlikely for the reasons above and the reasons I have discussed before, but even if there was a £10 million annual saving, the tax is going to cost £1,000 million, so that's a £990 million loss to the taxpayer.

This is shambolic, back-of-an-envelope stuff from Cancer Research. Littered with basic errors, it looks like it took about three minutes to write. They know as well as the government that a sugary drink tax is not going to be part of the 'childhood' obesity strategy, but by keeping the media blitz going they can raise expectations and pretend to be disappointed when the state starts to take control of the food supply. As I argued at Spectator Health a few days ago, that is the name of the game now.


UPDATE

The BBC has (obviously) been quick to cover this non-story.

Currently, 29% of people are obese and trends suggest that figure will reach 34% in 2025.

Rather than reverse the obesity epidemic, the forecast predicts the tax would lead to obesity rates levelling off at around 29% - preventing 3.7 million people from becoming obese.

No. Nowhere near. 25% of adults are obese, and that figure has not changed in years. An even lower proportion of people are obese. 29% is what this ridiculous model predicts if there isn't a sugar tax.

The guy from industry—the only voice of opposition in the Beeb's article—doesn't help...

The director general of the British Soft Drinks Association, Gavin Partington, said: "The hypothetical claims made in this modelling study run contrary to real-world evidence.

"In fact, the soft drinks tax in Mexico has reduced average calorie intake by six calories per person per day, with no evidence that it has reduced levels of obesity."

He added that other options such as reducing portion sizes or changing ingredients would be more effective.

D'oh! 

Thursday, 18 February 2016

Oh, America

I don't write as much about the USA as I used to. Frankly, it's just too depressing. America's retarded approach to e-cigarettes and its increasingly fascist smoking bans are not based on any form of logic so there is no argument with which to engage. Since the people who are bullying their way towards prohibition are not appealing to science, reason or principles, there is nothing to say. It is now a power struggle, pure and simple, and the fanatics have the power.

This is the kind of thing I'm talking about...

Mary Simmonds takes smoking personally.

As director of the Florida A&M University's School of Allied Health's Division of Cardiopulmonary Science, Simmons knows what smoking and tobacco use does to the heart and lungs of people, especially African-Americans. And Simmons believes FAMU should be at the forefront of discouraging smoking.
“This is something that I have been talking about with others on campus,” said Simmons, who has been at FAMU for 13 years. She oversees the four-year program that trains respiratory therapists. “Big Tobacco has always marketed to African-Americans. I have taken care of many patients affected by tobacco.

“We’ve had complaints about second-hand smoke, some faculty have asthma, and are affected. And there’s third-hand smoke from that dropped butt. I’m still getting that smoke.

Third-hand smoke?! This woman is at an institute for higher learning, for God's sake. Does she believe in pixies too?

Simmons recently secured support from the Faculty Senate in her drive to get the university designated a tobacco-free, smoke-free environment.

Because it's not enough to be 'smoke-free', the whole place - indoor and out - must also be 'tobacco-free'. No chewing tobacco. No snus. And, as we shall see, no e-cigarettes. Why? Because she can.

This kind of coercive paternalism is remarkably common on US campuses...

As of Jan. 1, there are at least 1,475 campuses that are 100 percent smoke-free, according to the Americans for Non Smokers’ Rights website, (www.no-smoke.org). Of these, according to the advocacy group, 1,128 are 100-percent tobacco-free, and 802 prohibit the use of e-cigarettes anywhere on campus.

Note that the majority also ban vaping. Tobacco control is not about tobacco. It's about control.

If approved, the FAMU policy would restrict cigarettes, pipes, cigars, and e-cigarettes from being used on campus property. It also would restrict smoking in university-owned vehicles during work hours and include everyone.

It also would extend to contractors, vendors and visitors, she said.

“Once you hit the campus, you can’t smoke,” Simmons said.

Or chew tobacco, or vape...

She said the policy also would prohibit the use of e-cigarettes (“They are just as harmful as regular cigarettes") and smoking hookah, which is popular among college students.

Again, I remind you that this person works at a university.

Simmons understands it's going to take time to change the status quo.

“Anytime you are impeding someone’s rights," she said, "you have to get all of the stakeholders involved; the entire FAMU campus.”

Except the people whose rights you are impeding. But they're in a minority so screw them.

Ottisha Torres, a freshman criminal justice major from Tampa, leans in favor of the policy change, largely because of the health risks.

Second-hand smoke is just as bad as first-hand smoke,” she said.

What kind of idiocracy is this college? This is the predictable and intended consequence of lying to people year after year. Secondhand smoke and e-cigarettes being as bad as smoking. Thirdhand smoke being a thing. This is how stupid you have to make people before they go along with the kind of tyrannical policies we are seeing in 2016.



Monday, 15 February 2016

David Cameron's useful idiots

David Cameron's on-off relationship with sugar taxes looks to be at an end. A trial separation has been announced while he plays the field of other policies.

Fair weather friends of the Prime Minister were in shock over the weekend. Tam Fry of the National Obesity Forum said: “The decision must be reversed or it will be more proof that the Government is in the thrall of the food industry and the sugar barons will have won yet again. NHS chiefs know full well that the combination of child and adult obesity could topple the UK's most cherished institution.”

A statement accusing the government of being in thrall to "sugar barons" and predicting the collapse of the NHS would normally be a shoo-in for most hysterical overreaction of the day, but Mr Fry was no match for Graham MacGregor, chairman of Action on Sugar, who is threatening to flee to South America: "Everything he [Cameron] does ends up in chaos," said MacGregor, "this was his one opportunity to achieve a legacy. He will be a Prime Minister who has achieved nothing. We won’t stop and if the UK doesn’t want to stop doing it [sic], we will go to another country like Argentina or Chile which are much better organised in terms of public health and nutrition.”

When the idea of a sugar tax was first mooted, Cameron explicitly rejected it. Then, after a sustained campaign from Jamie Oliver and Action on Sugar, it was put back on the table. It has now been taken off the table but will be considered if the food industry does not comply 'voluntarily' with the government's demands.

I am quite sure that Cameron's first reaction to the sugar tax was his gut reaction. I would wager that taxing sugar was never seriously in the frame. It would be unpopular with the Conservative grass roots and with the public at large. Although some opinion polls have shown increasing support for the idea, the government will have learned lessons from Denmark where initial support for a fat tax withered away once it was seen to be regressive, inflationary and ineffective.

If a sugar tax was never in contention, why did the government reopen this can of worms by claiming last month that it was 'back on the table'? I think there are two reasons.


The first is that the government cannot legislate for much of what it wants to do. Food labelling is an EU competence, for example. The traffic light system used on most food products is not there by law but by voluntary agreement with the industry. If the government wants to change food labelling it can only do so in practice by persuading industry.

The EU might also have something to say about Britain putting mandatory limits on how much sugar, fat and salt could go into food and drink products (as Cameron is rumoured to want), but even if Westminster could legislate for this in theory, it would be a legal nightmare in practice. Imagine the vast bureaucracy required to set mandatory limits for thousands of different products, both domestic and imported. Product reformulation cannot realistically happen by force of law. Much better to have a quasi-voluntary approach backed up with the threat of a sugar tax, but threats are only effective when they are credible.

The second reason why a sugar tax has been kept on the table is that it helps make the government's other proposals look moderate by comparison. Make no mistake, they are not. There is talk of banning discounts and price promotions, which would be as damaging to low income consumers as a tax on soft drinks, as well as banning all sorts of food and drink advertising before 9pm, which would be disastrous for commercial broadcasters. This, along with mandatory controls over sugar, salt and fat content, amounts to a degree of state control of the food supply that is unprecedented in Britain's peace-time history, but by raising the spectre of a sugar tax the government has shifted the Overton Window in the direction of greater state regulation. People are now expecting dramatic policy changes. So long as it holds back on the sugar tax, anything will seem moderate.

If this is the Cameron's public relations strategy, the likes of Jamie Oliver and Graham MacGregor are his useful idiots. Whatever appears in the forthcoming obesity strategy will seem sensible and restrained compared to the demands of the fanatics.

But this strategy can only work in the short-term. By raising - and then dashing - expectations about a tax that was never likely to be implemented, Cameron has made some permanent enemies. Despite his bizarre rant, MacGregor will probably not go to Argentina. Instead he will remain in the UK to be a thorn in the government's side, along with Tam Fry, Sarah Wollaston, Jamie Oliver, the British Medical Association, the Lancet and everybody else who has scented blood in recent months. This could sow the seeds of future problems.

On the other hand, Cameron may have realised that such people can never be appeased. He may have decided that since the 'public health' lobby are always complaining, he might as well give them something to complain about.

Sunday, 14 February 2016

Peter Hitchens and Big Dope

In the Mail on Sunday today, Peter Hitchens laments the Economist's renewed call for cannabis legalisation...

Perhaps this will at last alert the soppy vegan Fairtrade types, who bizarrely support the slick, billionaire-backed Big Dope campaign, that they are on the wrong side. The pathetic rump of the Liberal Democrats, now pursuing this greasy, irresponsible cause, should also know better.

I have always thought it odd that people who are (rightly) worried about the ruthless conglomerates who cram us with deadly hamburgers and lethal fizzy drinks, and who (reasonably) regard Big Tobacco as Satan made flesh, ally with Big Dope.

The product which Big Dope so irresponsibly promotes is increasingly correlated with irreversible mental illness, a scourge that has already scarred many families. That’s surely worse than anything a cheeseburger can do.

And Big Dope, now backed by many politicians who hope to levy heavy taxes on human greed, grief and folly, is one of the most unscrupulous and most avaricious of all the lobbies now operating on this planet. It’s no place for gentle people.

Putting the word 'big' before the name of a product you dislike is a dog whistle for the puritanical right to attract the 'liberal' left. Terms like Big Soda, Big Sugar, Big Alcohol and even - if you are into the low carb crusade - Big Grain, are all intended to convey the impression that the entire machinery of government is no match for the lobbying of a few rival companies. It says: 'This is a struggle between David and Goliath. You don't want to side with Goliath, do you? These people are making money and wearing suits. Join us in our fight against The Man.'

The tobacco and alcohol industries are dominated by a handful of global corporations and so can reasonably be given the 'Big' prefix. But 'Big Dope' simply does not exist. Anti-booze and anti-smoking campaigners can get away with the conceit that young people drink and smoke because they have been seduced by big corporations. Anti-drug campaigners patently cannot.

Marijuana is illegal almost everywhere. In the handful of US jurisdictions that have recently relegalised it, it remains a cottage industry. Big corporations have shown little interest in getting involved, but so what if they did?

The drug market could do with a bit more Big Dope and a lot less Big Government. Early twentieth century prohibitionists successfully demonised the 'liquor trust' (AKA Big Alcohol) until the American public found out what the alternative to a legitimate, law-abiding supplier looked like. After 100 years of drug prohibition, people are coming to a similar realisation about the merits of a taxed and regulated marijuana industry that can settle its disputes in court rather than on the streets.

Hitchens' mention of a 'billionaire-backed' lobby presumably refers to George Soros and/or Richard Branson, but neither of these people are in the (non-existent) marijuana industry. Their interest is entirely philanthropic as far as I can see, but even if Branson intends to market Virgin Spliffs I would rather see him take a share of the market than have it run by the smugglers, murderers, organised criminals and small time crooks who currently run the show.

Hitchens is shrewd to play up fears of Big Dope. There are plenty of people on the left and right who don't like the idea of companies making money out of drug use, which is why so many of them support the half measure of decriminalisation rather than legalisation. But if making a profit from cannabis is considered ethically questionable, it is worth remembering that there are modern day Al Capones making incredible amounts of money from cannabis and other drugs. These bootleggers are the real Big Dope and they feel even more strongly than baptists like Peter Hitchens that drugs should remain illegal.

Friday, 12 February 2016

We can no longer trust health advice

I've put a version of my speech from Tuesday's Spectator debate about the reliability (or otherwise) of health advice up at Spectator Health. Do have a read.

Wednesday, 10 February 2016

More or Less finally encounters Stanton Glantz

More or Less is on fire at the moment. Following on from its tidy analysis of the new drinking guidelines, the latest episode looks at Stanton Glantz's meta-analysis that purported to show that e-cigarettes prevent smoking cessation. Needless to say, Tim Harford is not impressed.

It's a shame it's taken so long to for the clown Glantz to cross More or Less's radar. If they went through his back catalogue of policy-based junk science they could put out an episode every day for the next few years.

Listen to it here.

James Cracknell on Coke

Ex-rower James Cracknell has become to latest rich white guy to put his weight behind the sugar tax campaign. He's being supported by the centre-right think tank Policy Exchange, thus proving once again that when it comes to nanny state interference there is no separating socialists from conservatives.

Cracknell doesn't seem very sure that a sugar tax will actually 'work' but he thinks it's worth a try. The £1 billion a year cost will fall disproportionately on the plebs, after all.

Guido has picked up on a Tweet I sent in the wee, small hours suggesting that Cracknell might not be the best chap to front a campaign against fizzy drinks. When asked by Men's Health about his vices, he said:

"I used to put ketchup on everything... Now I just drink a lot of Coke."

Cracknell's interest in 'The Real Thing' doesn't end there. Giving tips to would-be Olympic rowers, he said:


"My 'pro's secret' is to drink a flat Coke towards the end of a ride. It will perk you up no end."

And reminiscing about rowing the Atlantic, he said...


"I was so exhausted I started to hallucinate being back home with a long, tall glass of ice-cold Coca-Cola."

In his rowing days, Cracknell was consuming 6,000 calories a day and drinking Lucozade for breakfast.

"I don't limit myself, if I have a craving for something I eat it. Life's too short to worry about every mouthful."

Well said. Maybe a spot of physical activity might be a better option that trying to tax couch potatoes into submission?

Saturday, 6 February 2016

The beginning of the end of the sock puppet state

This is the best new I've heard in ages.

Charities to be banned from using public funds to lobby ministers

Revealed: A new clause to be inserted into all new and renewed grant agreements will make sure that taxpayer funds are spent on improving people's lives and good causes, rather than covering lobbying for new regulation 

Charities in receipt of Government grants will be banned from using these taxpayer funds to engage in political lobbying, The Telegraph can disclose.

A new clause to be inserted into all new and renewed grant agreements will make sure that taxpayer funds are spent on improving people's lives and good causes, rather than covering lobbying for new regulation or using taxpayers’ money to lobby for more government funding.
It will not prevent organisations from using their own privately-raised funds to campaign as they see fit. 
The Institute of Economic Affairs, a right of centre think tank, has undertaken extensive research on so-called “sock puppets”, exposing how taxpayers’ money given to pressure groups is paid to fund lobbying campaigns on policies such as a sugar tax and the environment.
Officials are hoping that the clause will ensure that freedom of speech is protected, while stopping taxpayers’ money being diverted away from good causes.
 
Matt Hancock, the Cabinet Office minister, told The Telegraph: “Taxpayers’ money must be spent on improving people’s lives and spreading opportunities, not wasted on the farce of government lobbying government. 

“The public sector never lobbies for lower taxes and less state spending, and it’s a zero sum game if Peter is robbed to pay Paul. 

“These common sense rules will protect freedom of speech – but people won’t be made to foot the bill for political campaigning and political lobbying."

“Conservatives are standing up for value for money, so we can keep taxes down and support better services that people can rely on.” 

Chris Snowden [sic - damnit!] , head of Lifestyle Economics at the IEA, said: “This is very good news for taxpayers who will no longer be forced to pay for the government to lobby itself.

“At every level - local, national and European - people have been subsidising political campaigns that they may not know about and might disagree with. 

“Campaigning is an important part of a thriving democracy but charities and pressure groups should not be doing it with taxpayers’ money.” 

The exact phrase that will be inserted into all new and renewed grant agreements reads: “The following costs are not Eligible Expenditure:- Payments that support activity intended to influence or attempt to influence Parliament, Government or political parties, or attempting to influence the awarding or renewal of contracts and grants, or attempting to influence legislative or regulatory action”.

It might seem obvious that the government shouldn't be paying for pressure groups to lobby itself, but the practice has become endemic in recent years. Hats off to Matt Hancock for doing something about it.

Ministers don't get enough credit when they do good things in politics. Hancock will doubtless receive a flurry of complaints from those who see it as their right to use taxpayers' money for their political campaigns, so if you are pleased about him chipping away at the sock-puppet state, do send him an e-mail at matthew.hancock.mp@parliament.uk. I will be doing likewise.



Friday, 5 February 2016

Goodbye and good riddance

It's always nice to see a leech being pulled off the arteries of the taxpayer...

Smokefree South West to close this summer after cuts to funding

Taking Liberties has the full details, but isn't it telling that these organisations make no attempt to carry on with private donations once the state withdraws its funding? Take away taxpayers' money and they're dead. The public don't want to know.

This 100% state-funded lobby group has burned millions of pounds of our money in recent years to harass and demonise smokers. Dishonest to the last, its final act before it had its ill-gotten gains withdrawn was to retweet a lie from one of its fellow state-funded sock puppets.

A few months ago this parasitic organisation changed its name to Public Health Action in order to do 'denormalise' alcohol (that ol' slippery slope once more). Thankfully, drinkers have been spared the attention of these bullies, but the damage they have done to smokers - and to pubs, via the smoking ban - will endure.

Let's hope the long overdue defunding of this mob is only the start.

Living in the past

"Early in life I had noticed that no event is ever 
correctly reported in a newspaper"
George Orwell


Some, er, interesting journalism from Andrew Whitaker in the Scotsman...
 
Calls for action as Scotland records highest rate of alcohol deaths in UK 

Scotland had the worst rate for alcohol-related deaths in any part of the UK, according to figures recorded over the past 20 years. 
Alcohol death rates for men in Scotland have risen dramatically, according to the figures published by the Office for National Statistics. In Scotland they stood at 31.2 per 100,000 of the population, compared to 18.1 per 100,000 in England, 20.3 in Northern Ireland and 19.9 for Wales. 

Risen dramatically, you say? Oh dear.

The latest findings from 2014 led to renewed calls for the introduction of the Scottish Government’s plan for a minimum alcohol price, aimed at tackling alcohol abuse. 

Well, there's a shock.

Dr Peter Bennie, chair of the British Medical Association (BMA) Scotland, said: “It is disappointing to see the rise in the number of alcohol-related deaths, but it does underline the importance of tackling the culture of heavy drinking in Scotland.”

Terrifying stuff, eh? Until you look at the Office for National Statistics' data that formed the basis for this report...


Scotland is the top line: the one that's been going down while all the other ones have been flat or rising; the one that saw the rate of alcohol-related deaths fall from nearly 50 per 100,000 to barely 30 per 100,000 since 2003.

Does Scotland have the highest rate of alcohol deaths in the UK? Yes. It has for decades. Has this rate 'risen dramatically'? Once upon a time, yes - as it did in all the other home nations - but the story of the last thirteen years has been steep decline, in contrast to England, Wales and Northern Ireland.

How strange that the Scotsman is still reporting a rise in alcohol-related deaths that came to an end in 2003 while ignoring the 33 per cent decline that has taken place since. Is this a newspaper or a historical journal?

It's almost as if there's a fixed narrative that no amount of facts can shift, isn't it?


Thursday, 4 February 2016

Garbage in, garbage out

Heart miracles are once more in the news. This story, for instance, is on the front page of the Telegraph...

Smoking ban sees 40 per cent cut in heart attacks in UK since 2007 law was introduced

Heart attack rates in the UK have fallen by up to 42 per cent since the 2007 smoking ban, major research suggests.

A review of 77 studies found that reduced exposure to passive smoking has caused a “significant reduction” in heart problems across the population.

The basis of the report is a literature review from the Cochrane Collaboration (not to be confused with a Cochrane Review). Smoking ban/heart attack miracles were invented by Stanton Glantz with the notorious Helena study. Glantz has since published at least three meta-analyses/literature reviews, all of which cobble together terrible studies in the hope of masking their obvious flaws and providing the illusion of strong evidence. You can do this as many times as you like but it won't stop the underlying evidence base being outrageously, hilariously and often fraudulently awful. A meta-analysis of smoking ban miracles is the ultimate garbage in, garbage out study.

Michael Siegel and myself have written about dozens of these studies over the years. For a while, it was mildly entertaining because those responsible would try audacious new tricks, but they have generally settled for relying on the simple post hoc ergo propter hoc fallacy (as in the Telegraph headline above) or by using one of two techniques I described in 2014:

Firstly, dredging the data for any town that saw a large decline (in percentage terms) in heart attacks at around the time of a smoking ban. Nobody decided to do a study of Helena, Montana or Bowling Green, Ohio before the bans took place. The decision to focus on such obscure places came about only once it was clear that they were anomalous (not unlike Derren Brown's horse-racing trick). They were then presented to the media with the implication that they had been randomly selected.

Secondly, although less frequent, studies of larger populations have portrayed rather small declines in the heart attack rate as being the result of a smoking ban, without acknowledging that that there had been a secular decline of the same magnitude long before the ban was enacted. As the authors of the above study note, the secular decline is simply ignored in such cases.

As that blog post highlighted, there is also a great deal of publication bias in this corner of quackademia.

I've pretty much exhausted the subject on this blog. There's a large archive of posts if you want to catch up, but I will leave you with a couple of graphs showing hospital admissions rates and mortality rates from heart attacks in the UK between 2002 and 2010 (click to enlarge). I trust you will notice the lack of change in the trends when the smoking ban was enacted in 2007.



These graphs come from a 2012 BMJ study which looks at trends in heart attack mortality and the reasons for them. It doesn't mention the smoking ban at all, nor does this study from Heart which looks at the epidemiology of cardiovascular disease in the UK. That's because (a) the smoking ban didn't have any effect on cardiovascular disease or rates of acute myocardial infarction, and (b) the authors are not tobacco control activists and therefore do not have the same exceptionally large incentives to make stuff up.

Wednesday, 3 February 2016

Whatever happens, we've won

Sally Davies has been giving some more advice to drinkers (at a parliamentary committee meeting yesterday):

"I would like people to make their choice knowing the issues and do as I do when I reach for my glass of wine and think, 'Do I want my glass of wine or do I want to raise my risk of breast cancer?'. And I take a decision each time I have a glass."

If that's how she wants to see out her miserable existence, she's welcome to it. I've written a piece for the Spectator in which I argue that she can throw as many taxes and bans at us as she likes. She thinks about cancer whenever she sees a glass of wine. We don't, so we win.

Do have a read.

Tuesday, 2 February 2016

The race is on

As reported just before Christmas, the European Court of Justice has ruled that minimum pricing is illegal if other anti-drinking measures would be (a) more effective and (b) less disruptive to trade. The court strongly suggested that alcohol tax rises would be more effective in achieving the Scottish government's stated aims of addressing heavy drinking and reducing alcohol consumption across the population.

The Scottish government and its front groups (eg. Alcohol Focus Scotland) are on a sticky wicket here because one of the bugs (or is a feature?) of minimum pricing is that it will have the least effect on the rich. Since the rich tend to be the heaviest drinkers, it is hard to argue that minimum pricing is more effective than alcohol duty rises in discouraging heavy drinking, nor is it the best way to reduce alcohol consumption across the whole population.

The matter has now been tossed back to the Scottish courts, leaving us in the strange situation in which the drinks industry has to claim that alcohol duty rises are reasonably effective and the neo-temperance lobby have to claim they are not as great as they had previously led us to believe.

I can imagine the frantic scenes in the 'public health' industry on December 23rd when they realised they would have to get some evidence that minimum pricing is better than taxes into the public domain before the Scottish court sat. You may recall that after David Cameron rejected minimum pricing because it would hurt the poor, a new version of the Sheffield model was published in The Lancet which concluded that, actually, y'know, it wouldn't be as regressive as previous versions had predicted. What a happy coincidence that was.

I don't know how long it takes to cobble together a 'public health' study and get it through the not-very-rigorous review process, but the activist-academics have now been given some extra time to get their story straight.

Minimum alcohol pricing delayed for further evidence

Scottish courts have agreed to accept further evidence before making the final decision over whether Scotland can legally introduced a minimum price for alcohol.

The inner house of the court of session met last week to consider the recent ruling of the European court of justice, and decided to hear more material. The final hearing will provisionally be June.

Five months should be enough. The only question is who'll be getting the (taxpayers') money for the commission, which journal will print it, and when. The odds on favourite has to be Sheffield University, but other runners and riders include Liverpool and Sterling, both of whom have a solid record for policy-driven research.

As for which magazine accepts it, The Lancet is always keen to help but the British Medical Journal and Addiction are also good bets. If I had to put money on it, I would go for Sheffield in the BMJ in May. Watch this space.

Monday, 1 February 2016

Transparent lies down under

There was a time when the 'public health' racket used a bit of imagination when they misled the public. It sometimes took a little effort to unpick their tricks. These days, however, they just lie to your face in such an flagrant and obvious way that there is no fun in debunking them.

Flat out lying has been their only option in Australia since plain packaging flopped. The latest deceit was parroted by the gullible ABC last week...

The rate of smoking among young people in Australia has dropped to a record low, and there is hope it could be the early signs of a potentially smoke-free generation...

This was based on a study of sorts in an obscure journal which claims that...

Australian adolescent smoking is at a record low, with only 3.4% of people aged 12–17 smoking daily

This immediately struck me as being suspicious because I remember seeing this graph on Dick Puddlecote's blog on several occasions:



Those figures come from the Australian government and they are correct. You can check them here.


This isn't rocket science. 3.4% is more than 2.5%. It is also more than 3.2%. Even an ABC reporter should be able to see that.

There is nothing more I can say about this without insulting your intelligence. Since youth smoking is quite obviously not at a record low, the news report and the journal article that spawned it are castles built on sand.

Needless to say, this garbage had a political purpose, as the ABC article made clear:

The data is being used to highlight the effectiveness of plain packaging laws...

And if you add an 'in' before 'effectiveness', that's exactly what it does.

h/t Catallaxy Files

More on Less on the new drinking guidelines

The BBC's excellent More or Less programme looked at the new alcohol guidelines on Friday. Although it didn't go into the statistical tricks of the Sheffield University team who devised the new 'evidence' (ie. theoretical model), it made several important observations, one of which is crucial and often overlooked.

It also included a revealing interview with alcohol researcher J├╝rgen Rehm who simply laughed when asked why the J Curve has attracted more scrutiny than any other finding in alcohol epidemiology. The answer, of course, is that it is a finding which many alcohol researchers find intolerable.

Listen here.