Monday, 30 November 2015

A tax on drinks is just the tip of Wollaston's iceberg

Today is the start of Sugar Awareness Week. If you haven't heard of it before, it's because it has just been invented by those fun-loving people at Action on Sugar (née Action on Salt). Today also sees Jamie Oliver’s delusions of grandeur reach new heights as he releases his 'crisis strategy' for obesity. Not coincidentally, there will also be the release of an anti-sugar film from one of the government's many taxpayer-funded pressure groups, Give Up Loving Pop (GULP - geddit?), and there is the launch of yet another pressure group, the Obesity Stakeholder Group, to agitate for the usual round of bans and taxes.

It is, then, a busy day for the nanny state industry, so much so that one might almost suspect a degree of collusion. This is what happens when the ‘public health’ lobby goes from flying a kite to scenting blood. But these activities are merely the hors d'oeuvres for the big events in the House of Commons: a debate on Jamie Oliver’s sugar tax petition and the release of the findings from the Health Select Committee on Childhood Obesity.

The Health Committee report is the big news, with the BBC reporting that a tax on sugary drinks has been ‘backed by MPs’. And so it has - by seven MPs to be precise. Two Conservative committee members, Andrea Jenkyns and Andrew Percy, have dissented, with the latter calling it ‘patronising nonsense’

If introduced, a 20 per cent tax on soft drinks will redistribute the best part of a billion pounds from disproportionately poor consumers to middle class bureaucrats. For those who have fallen for the bluster about sugar being the new tobacco, it is an obvious place to start, but no amount of sophistry can disguise the fact that it would be a patently regressive stealth tax. The report acknowledges concerns about disproportionately affecting low income families but brushes them aside, saying: 'We do not believe this needs to be the case because zero sugar alternatives are available which would be unaffected.' This would only be true if poor people stopped drinking sugary drinks, but that is not what happens when soft drink taxes are introduced. Sales dip little, if at all. Most people simply pay up.

Even in Mexico, which is the closest thing the anti-sugar brigade have to a success story, sales of sugary drinks are said to have declined by a mere six per cent and, as in every other country that has tried to tax itself slim, there has been no measurable effect on obesity. The committee's report doesn't mention this, nor does it mention Denmark's fat tax which was such a failure the government not only repealed it but also abolished its tax on soft drinks and abandoned its plans for a sugar tax.

Among other omissions, the report also fails to mention the awkward fact that the rise in obesity seen in Britain between 1970 and 2000 coincided with sugar consumption declining by more than a fifth. Such facts should be the bedrock of any serious discussion of obesity, but - to be blunt - Wollaston's hearings were not a serious discussion. I say this as somebody who gave evidence at them. Sitting alongside a spokesman from the food industry and a spokesman from the retail industry, it was clear that I was part of a token trio of opposition to excessive regulation. The other twelve witnesses were very much on the other side of the argument, which is to say that they were on Wollaston's side. They included two leading lights from Action on Sugar, two people from the meddling quango Public Health England, an academic who helped Jamie Oliver make his ridiculous anti-sugar documentary, a Coke-crazed campaigner from the Children's Food Fund who has been helping Jamie Oliver with his new crusade, and Mr Oliver himself. Unsurprisingly, all twelve of them are keen supporters of taxing sugar.

Although the sugar tax has been getting most of the headlines today, it is only one indecent proposal among many. If implemented in full, the committee’s recommendations would represent by far the most draconian state interference perpetrated in the name of combating obesity anywhere in the world. The committee wants to reduce sugar consumption by 50 per cent, such an impractical target as to almost be deranged. Even the folk at Public Health England acknowledge that ‘no assessment has been made of the feasibility’ of reaching it. To put it in context, per capita sugar consumption is down significantly from its 1970s peak. If it were to fall by a further 50 per cent, Britons would be eating barely half as much we did during the Second World War when sugar was tightly rationed.

Clearly, it would take an extraordinarily overbearing state to move consumption anywhere close to this target. Today's report gives the clearest indication yet of what such a state might look like. The committee wants to dictate how much sugar can be used, where it can be sold and how much it can be sold for. It wants an 'outright ban' on confectionery and other disfavoured food products being displayed at the end of supermarket aisles and check-outs. It wants non-food shops, such as WH Smith, to stop offering confectionery at the till. It wants commercials for bacon, cheese and butter to be confined to late night television. It wants the government to regulate the size of food portions in shops and restaurants. In short, it wants the world on a stick.

As if a sugary drinks tax wasn't a big enough kick in the teeth for consumers, the committee also wants to put an end to discounting, price promotions and buy one, get one free (BOGOF) offers. In a weird, pearl-clutching digression about biscuits, the report imagines a scenario in which 'a shopper might normally buy one pack of biscuits a week. When confronted with a “buy 2 for £2” deal they buy two packs instead of one (double their normal quantity). While this extra pack of biscuits might be expected to last two weeks (if still consuming one pack per week), the shopper actually buys a third packet of biscuits during the second week.' The horror! The horror!

It is a sad day for House of Commons stationery when this kind of nonsense is printed on it. As the Middle East descends into chaos and the national debt continues to spiral, there are elected politicians fretting about people eating biscuits. Not just fretting, but demanding action. Admittedly, some of the demands are cloaked in rhetoric about 'voluntary' agreements with industry, but never has the word 'voluntary' been more deserving of ironic speech marks. As the committee explicitly says, such agreements will come with the 'clear proviso that if the industry does not respond comprehensively and swiftly then regulatory action will quickly follow'.

They not only want manufacturers to halve the amount of sugar in their products, but also demand - almost as an aside - that 'the Government should also introduce a parallel programme of reformulation to reduce the overall calorie content of food, including the levels of fats'. If only it was that simple. Why do they think food companies and chefs put salt, fat and sugar in their meals in the first place? For a laugh? To get rid of surplus stock? To annoy Sarah Wollaston? In essence, the committee wants the government to put a gun to the head of food companies to force them to produce products that have no appeal to consumers.

It won't happen - not for a while, anyway. The government, like the Labour party, has never supported sin taxes on food and soft drinks. It will almost certainly thank the committee for its input and duly file the report in the waste paper basket. In response, Wollaston will do what she always does when ministers refuse to be bullied by the 'public health' lobby and accuse the government of bowing to industry. Nevertheless the report will be cited for years to come as an 'official' and 'expert' endorsement of Action on Sugar's outlandish demands. Today’s carefully planned avalanche of agitation will not be for nothing.

Cross-posted at the Spectator.

Friday, 27 November 2015

Something wicked this way comes

A remarkably large number of sugar-related events will be taking place on Monday.

Firstly, Jamie Oliver's sugar tax petition will be debated in parliament.

Secondly, 'Sugar Awareness Week' - an invention of the Action on Sugar cranks - will begin.

Thirdly, the government sock puppet lobbyists Give Up Loving Pop (GULP) will be launching a state-funded anti-sugar film. They've been letting their natural supporters know about it in advance.

Being a 100% state-funded organisation, GULP is naturally lobbying the government for a sugar tax. That's how it works in the sockpuppet state.

Last but by no means least, Sarah Wollaston's Health Committee on Childhood Obesity will be publishing the findings from the sugar-obsessed circus that masqueraded as an evidence-gathering session last month.

Taken together, along with the BBC's dishonest claim that childhood obesity is rising, it looks very much like a co-ordinated campaign to soften us up for something. You don't think, just possibly, that somebody might be about to demand a new tax, do you?

Perish the thought.

Childhood obesity is still falling

The BBC is reporting that 1 in 5 kids are leaving primary school obese (see above). This seems to be an evergreen statistic for their health 'news' (see below, from 2010).

I have no problem with the BBC reporting routine statistics every year but they also claim that child obesity rates are 'on the rise'. This is untrue, as I explain in my Spectator post today.

Do have a read of it.

Thursday, 26 November 2015

Hold on to your meat

Now it's meat-eating that has to be taxed and curtailed. Of course it is. What I find most striking about this article - from the Chatham House think tank - is how the rhetoric could come from any meddling single-issue pressure group in the last twenty years. Powerful industry, lack of awareness, bad for your health, change the default option, need for taxation, government intervention, blah, blah, blah.

Replace meat with tobacco or sugar or alcohol or gambling or fizzy drinks and it makes as much sense. There might as well be computer generated template for this kind of thing. It's not just that these people are evil and deluded, though they are both of those things, but they are so bloody dreary and unimaginative with it.

So why does meat remain off the policy agenda? Fear of backlash from the voting public and from a financially powerful industry has seen governments remain silent on the issue of unhealthy, unsustainable meat consumption. Unwilling to risk accusations of nanny state-ism, they find themselves trapped in a cycle of inertia. The assumption is that calling for dietary change is too politically sensitive, too practically difficult a policy avenue to pursue. But digging a little deeper into public opinion suggests that this assumption is unjustified.

Of course, government policies to shift meat-eating habits will not be easy. Low public awareness of the climate impact of livestock production presents a significant obstacle in the near term: campaigns that throw light on the complex and unfamiliar notion of livestock emissions cannot hope to carry the impact needed to overcome the influence of individual preference and habit, cultural customs and industry ‘nudges’ telling us to eat more meat. But there exist other levers on which governments may pull to begin a shift in attitudes and behaviour, not least the health implications of excessive meat-eating.

Policies will need to span the whole range of intervention. Soft measures to raise awareness and encourage behaviour change – through adjustments to public procurement standards, for example, and vegetarian default options in school and hospital canteens – will need to be accompanied by more interventionist measures such as taxation and subsidy reform.

But the political space is there. Public disengagement with the diet-climate relationship is not the result of active resistance; rather, it is the product of a lack of awareness that has been sustained through government inaction. Were governments to signal the urgent need for change and to initiate a public debate around the need for dietary change, this disengagement would likely dissipate.

Meat Control should not be dismissed as too laughable to happen. If the vegetarians, climate warriors and public health mob get together they would become the ultimate screeching pressure group.

Wednesday, 25 November 2015

Redefining freedom

I wrote a post for the Spectator yesterday about how the public health racket tries to redefine freedom. It was inspired by an Australian lobby group claiming that true freedom meant being ‘free from the fear that our children will be harassed by cigarette and alcohol advertising’.

It is a sure sign that a person is against freedom when they start trying to redefine it. Even politicians who espouse explicitly anti-liberal and anti-individualistic philosophies feel obliged to pay lip service to freedom from time to time. In The Doctrine of Fascism, for example, Mussolini wrote: ‘In our state the individual is not deprived of freedom. In fact, he has greater liberty than an isolated man, because the state protects him and he is part of the state.’

In this view, safety and freedom become one and the same, with true freedom coming from the state shielding its citizens from themselves. In Orwell’s Animal Farm, Squealer assures the animals that Napoleon ‘would be only too happy to let you make your decisions for yourselves. But sometimes you might make the wrong decisions, comrades, and then where should we be?’

I have mentioned before the Senate inquiry into the nanny state that is currently underway in Australia. If it does nothing else, it will at least start a dialogue about what it means to be free in a country where paternalism has been on steroids in recent years. Nobody wishes to be seen as being against freedom and yet the ‘public health’ lobby has an endless list of taxes, prohibitions and restrictions which implicitly assume that there is too much of it. The answer, as ever, is to redefine what liberty means.

Do read the rest...

Tuesday, 24 November 2015

Final thoughts on the Licensing Act

November 2005

November 2015. Plus ca change.

I've written a post for the IEA lifestyle blog about what happened after England and Wales relaxed their licensing laws ten years ago to the day. Go read that if you haven't already read Drinking, Fast and Slow.

I have one final observation to make, which is that the story of the last decade has posed a problem for the orthodoxies of the temperance/public health lobby. At the centre of their belief system is the Whole Population Approach (or Total Consumption Model) which says that reducing overall alcohol consumption invariably reduces alcohol-related health and social problems, even though those problems are caused by heavy and binge drinkers rather than the population as a whole. The theory, which was popularised by Geoffrey Rose, holds that the whole population changes its behaviour in tandem, so if moderate drinkers reduce their consumption, so will heavy consumers.

Because they are not targeting heavy consumers specifically, this means that any method of reducing per capita alcohol consumption should be effective. The three pillars of the 'public health' approach to alcohol are therefore remarkably similar to those of gospel temperance - ban advertising, restrict availability and increase price.

The fact that the increased availability that came with the Licensing Act coincided with a 20 per cent decline in alcohol consumption is therefore an inconvenient piece of information. Largely as a result of the British experience and other inconsistencies, even the WHO now accepts that the evidence linking availability to consumption is mixed.

Faced with this paradox, the pretend public health lobby could do what they often do and produce some black-is-white research claiming that all sorts of health and social problems related to alcohol are getting worse - indeed, the Institute of Alcohol Studies recently had a bash at doing this - but it would break their golden rule to admit that alcohol-related problems can increase while per capita consumption declines.

More suited to their hypothesis is the fact that alcohol-related violence and drink driving have declined while per capita consumption has declined. But it is clear that both of these trends began when alcohol consumption was rising between 1995 and 2004. Awkward.

Equally awkward is the effect of price. Alcohol became more affordable between 2004 and 2009 but then became less affordable as a result of falling real incomes and the alcohol duty escalator. And yet alcohol consumption fell at roughly the same rate in both periods. Temperance dogma says it should have risen and then fallen.

And then there are health outcomes. Alcohol-related hospital admissions have continued to rise, albeit at a slower pace than prior to 2005. Incidence of liver cirrhosis is still rising. They could claim that these increases are the result of the Licensing Act, but, again, they would have to explain why the fall in per capita consumption hasn't led to a decline in admissions.

Finally, there is alcohol-related mortality which has neither risen nor fallen since 2005. According to the Total Consumption Model, the kind of sharp decline in consumption seen in Britain in the last decade should have reduced mortality. Talk of a 'lag effect' is starting to sound a little desperate now that a decade has passed since consumption peaked. As Holmes et al. showed in 2012, the time lag between consumption falling and health outcomes improving is not supposed to take this long; much of it should be immediate.

In short, 'public health' dogma dictates that the Licensing Act should have led to more alcohol being consumed, more alcohol-related deaths and more alcohol-related crime. In fact, it has been associated with less alcohol being consumed, fewer alcohol-related crimes and the same number of alcohol-related deaths.

Time for a rethink?

Monday, 23 November 2015

Understanding the tobacco tax gap

HMRC published their latest estimates of the tobacco tax gap last month. This is the amount of tobacco smoked in Britain that is counterfeit or contraband.

The methodology of the tobacco tax gap is pretty crude. It amounts to this:

The estimate of the illicit market for tobacco is produced using a top-down methodology; that is total consumption is estimated, from which legitimate consumption is subtracted, the remainder being the illicit market.

In other words, they estimate how many smokers there are and multiply it by the estimate of how many cigarettes they each smoke. They then subtract the number of recorded sales - plus an estimate of how much is bought legally abroad - from the total and the figure that emerges is the amount of non-duty paid tobacco.

It's a cheap way of doing it (the better way - collecting discarded cigarette packs - is left to the tobacco industry) and it has been coming to increasingly unbelievable conclusions. The latest edition finds no increase in non-duty paid cigarettes in 2014/15 and a slight decline in non-duty paid rolling tobacco.

Since 2006/07, HMRC thinks the picture looks like this (albeit with wide confidence intervals)...

This suggests that the illicit trade is bigger than it was five years ago but smaller than it was before that. But is this realistic? HMRC's tobacco bulletin shows that there was a 28 per cent decline in (duty paid) cigarette sales between 2010/11 and 2014/15 (from 45.7 billion sticks to 32.7 billion sticks). That is a massive decline over a four year period. During the same period, (duty paid) rolling tobacco sales rose by only a little - from 6.2 to 6.7 million kilograms, the equivalent of half a billion sticks.

So we have legal cigarette sales falling by more than a quarter in the course of four years. What happened to smoking prevalence in that time? We don't have data for 2014/15 yet, but the ONS says that...

'Nearly one in five adults (19 per cent) aged 16 and over were smokers in 2013, a rate that although slightly less than 2012, has remained largely unchanged in recent years'

The smoking rate was 20 per cent in 2010. By 2013, it had dropped to 19 per cent. In other words, it fell by five per cent (in relative terms). If you factor in population growth, the number of smokers has declined by even less than five per cent. And yet cigarette sales fell by 21 per cent. A slight anomaly, no?

Given that legal cigarette sales have been falling at a far faster rate than has the smoking rate, how have HMRC avoided the obvious conclusion that more tobacco is being sold on the black market?

I wish I could answer that question. HMRC publish a methodological annex and I challenge anyone to read it without concluding that the whole thing is basically guesswork. A great deal depends on HMRC's assumptions, but these are rarely spelt out. As far as I can see, there are only two possibilities that could help explain why legal cigarette sales are plummeting while the smoking rate is not...

1. Smokers are smoking far fewer cigarettes
2. Smokers are buying more cigarettes on the black market

I haven't seen any evidence that smokers are smoking fewer cigarettes than they did five years ago - though they may be - and it is far from clear that HMRC have seen any such evidence either. They say they use data from the Opinions and Lifestyle Survey to estimate how many cigarettes smokers consume but I can't see any such estimate in it.

So, it's over to you, faithful reader. The number of smokers has barely dropped since 2008 and yet the number of cigarettes sold legally has dropped precipitously and the black market is - supposedly- roughly the same size. How do we square this circle?

Friday, 20 November 2015

Slides from a public health conference

It has been a theme of this blog in 2015 that commentary and satire is increasingly redundant when discussing the public health racket. All that is needed to discredit these lunatics is to repeat what they have said in their own words.

Take the Global Alcohol Policy Conference, for example. This taxpayer-funded event was held to give veteran temperance crusader Derek Rutherford a good send off and to pay homage to the Scottish National Party (which supports minimum pricing).

Most of the conference's Powerpoint presentations went online this week. I have only looked at a handful, but they drip with the kind of swivel-eyed extremism that can only come from living in an echo chamber. Anti-market, anti-individual and pro-government, the consumer is never counted as a stakeholder.

These people are obsessed with things they do not understand. Business, for one. Advertising, for another. They are obsessed not merely with the drinks industry, but with industry in general. And with so-called 'neoliberalism' (ie. anything that is not socialism).

Here are a few of the slides from the conference. As you read them, try to remember that they were put together by grown men, many of whom have letters after their name. They are academics. One of them has an OBE. These grown men doubtless spent hours preparing their presentations to ensure that the thoughts in their head were accurately and clearly transmitted to the audience. They were happy - proud, even - to stand by them in front of other educated, adult human beings. And now they want the general public to see them.

Gerard Hastings accuses a drinks company of 'grooming' teenagers.

It looks like a see-saw but is presumably meant to be a set of scales.
Oh no, free trade!
Hastings again.
A childish message amateurishly executed.

Hastings again.

This is how your taxes are spent. Good grief.

Monday, 16 November 2015

24 hour drinking - the debate

The tenth anniversary of so-called 24 hour drinking is nearly upon us. If you're in London tomorrow, do come and join us at the Institute of Economic Affairs for a debate about it. It should be lively, with the following speakers:

  • Christopher Snowdon, director of lifestyle economics at the Institute of Economic Affairs and author of Drinking, Fast and Slow
  • Jon Foster, Senior Research and Policy Officer, Institute of Alcohol Studies
  • Ian Graham, Central Licensing Unit, Metropolitan Police; Joint Chair of the National Police Chiefs Council Licensing group
  • Alan Miller, Chairman, The Night Time Industries Association
  • Stephanie Lis, Head of Communications, IEA (chair)
  • Brigid Simmonds, Chief Executive, British Beer & Pub Association

Click here for details. Please RSVP.

In the meantime, here is the video of the Maudsley debate on forcing psychiatric patients to stop smoking.

Friday, 13 November 2015

The magic of secondhand smoke

Here's another one to file under 'They Said It Would Never Happen'. The New York Times reports from the land of the free...

Smoking would be prohibited in public housing homes nationwide under a proposed federal rule announced on Thursday, a move that would affect nearly one million households and open the latest front in the long-running campaign to curb unwanted exposure to secondhand tobacco smoke.

The justification is hilarious, in a pathetic kind of way...

In moving to require the prohibitions across the country, federal officials say they are acting to protect residents from secondhand smoke, which can travel through walls and under doors

The claim that brick, plaster and cement are no match for wisps of smoke cannot be a misprint because it is repeated in a sycophantic New York Times op-ed titled 'They're coming for your cigarettes. But that's OK' (yes, it's OK, citizen, go back to sleep)...

The problem with your cigarette is that it sends secondhand smoke through your walls and doors and into your neighbors’ noses

The thing about smoke, as you cannot fail to have noticed, is that it rises due to being hotter than the air around it. You don't need to understand basic physics to know this, although it helps. Strike a match, light a candle, spark up a cigarette. Observing fire in any context demonstrates the same thing. The idea that smoke typically creeps 'under doors', down corridors, under more doors and 'into your neighbours' noses' should strike any journalist as being questionable, to say the least.

As for smoke travelling through walls, I really don't know where to begin. I'm not sure which is scarier, governments banning people from smoking in their own homes or the bizarre motivated reasoning that compels journalists to write things - in such a matter of fact way - that are not so. This is not even pseduo-science. It is anti-science.

Back in 2010, there was the guy who claimed that secondhand smoke travelled 'along plumbing and electrical lines', but he was manifestly a bit odd. This, by contrast, is the newspaper of record in the most powerful country on earth.

It's easy to laugh at the superstitions and crackpot beliefs that flourished before the Enlightenment. Increasingly, we have little to feel superior about.

Thursday, 12 November 2015

Why psychiatric patients should not be forced to quit smoking

I spoke at the Maudsley debate on banning smoking outdoors in psychiatric hospitals yesterday. This is more or less what I said...

I’ve never been in a psychiatric hospital and I don’t smoke any more. But it’s because I used to smoke that I know how enjoyable it is, what a comfort it can be, and how difficult it is to give up. Let’s be blunt about it - giving up smoking is a miserable experience. It makes you miserable even if you are fully committed and totally prepared for your quit attempt. Being forced to quit by somebody else when you least expect it must be worse. Being forced to quit when you have been taken from your home and put in unfamiliar new surroundings with total strangers must be almost unbearable. And forcing somebody through all that when they are suffering from a serious mental illness and are at the lowest point in their lives is, I will argue, vindictive and inhumane.

Why should they be put through this? According to the proposition it is because smoking is bad for their health. Smokers live shorter lives, on average, than nonsmokers. But this is true of all smokers, not just those who are suffering from mental health problems. Why, then, are they picking on them?
I think the answer is simple. It’s because they can - because they are easy targets. The medical establishment would happily ban us all from smoking if they could, but that prize is not yet in reach, and so they have turned their attention to those who are already under the government’s total control. 

In the recent BMJ head-to-head, the proposition said:

‘Some smokers with psychiatric disorders think that smoking can help them to manage their symptoms and relieve stress and don’t want to quit. We respect that view but point out that smoking has no positive effect’. 

The obviously contradicts the views of thousands of people with a mental illness who smoke, not to mention the billion or so smokers around the world who keep buying a product that supposedly has no positive effect. More to the point, it goes against the evidence that Simon and Deborah cite in their article - a 2013 report from the Royal College of Physicians which found, and I quote, that ‘nicotine can relieve symptoms of anxiety, depression, schizophrenia and ADHD’.  

Rather than attributing false consciousness to millions of people, let’s be honest and say that the problem with smoking is not that it has no positive effect, it is that it has negative effects. If smoking wasn’t bad for your health, most of you would be smokers, as you would have been if we were holding this debate in 1950. Most of you are not smokers because you are prepared to sacrifice the pleasure of smoking for the chance of better health in the future. You are making a personal trade off and psychiatric patients should be allowed to make their own trade off.

Their trade off may be different to yours, but then their circumstances are very different. It’s well known that people with mental illnesses are much more likely to smoke than the general population, with rates of up to 90% amongst people with schizophrenia. Although smoking rates have fallen in general over the years, there has not been much of a decline amongst people with mental illnesses. Perhaps the proposition think that people with mental illness are more susceptible to those colourful cigarette packs that we keep hearing about, but a more obvious conclusion to draw is that people with a mental illness get a greater benefit from smoking than the average person, and indeed there is good evidence that symptoms, particularly for schizophrenia, are alleviated by smoking. But even if smoking didn’t have particular neurobiological benefits for people with mental illnesses, it would still be a source of pleasure and comfort for them. It would still give them something to enjoy and look forward to during those long, traumatic days on the ward. And even if Simon and Deborah deny the benefits of smoking, I trust they do not deny that the existence of withdrawal symptoms which are strong enough to make 19 out of 20 quit attempts end in failure.

And so, added to the other problems that the patient suffers from, they will be forced to endure withdrawal in their new home - and never forget that this is now their home. Whether this results in the kind of violence seen repeatedly in prisons around the world when smoking bans have been introduced remains to be seen, but it will certainly lead to resentment, anger and a breakdown in trust between staff and patients before they’ve even got to know each other. The patient will know that there is a place outside where they could smoke and they will know that they are forbidden from doing so for no other reason than that their captors have decided that it’s for their own good. Not for the good of their mental health, which is the only reason they are there, but for their long term physical health - the benefits for which will be practically nil in any case because the majority of psychiatric patients resume smoking almost as soon as they are discharged.

In 2006, when the medical establishment was pushing for a ban on smoking inside psychiatric hospitals, the King’s Fund released a report supporting the ban, in which it said:

‘To those who are concerned that the proposed Health Bill infringes smokers’ rights, it is important to point out that the ban will prohibit only indoor smoking and that patients will still be able to smoke outdoors’.

How quickly we move on. How quickly these little assurances turn to dust. 

It also said:

‘The choice to smoke or to quit must ultimately be a private decision for the individual, and given that many psychiatric patients are detained compulsorily, it is right that proper consideration is given to the degree of choice that they will be able to exercise.’

That should be nothing more than an obvious truism. It is a choice for the individual. It is an abuse of power for medics to use the fact that they have custody of somebody to force them to act against their will and, in most instances, against their interests.
This is really quite simple. A psychiatric patient smoking outdoors is causing no harm to anybody. In a liberal society, that is the end of the story. A ban cannot be justified. Clearly there are people who don’t smoke, who hate smoking and apparently don’t understand anything about smoking, and they will always think that smokers are making the wrong choice, but that’s not their decision to make and it does not justify the use of coercion. Please show that you still want to live in a liberal and humane society by voting against this motion.


We lost by one vote. There should be a video of the event online soon.

Wednesday, 11 November 2015

Live stream tonight - banning smoking in psychiatric hospitals

You should be able to watch the debate about forcing psychiatric patients to stop smoking in the box below at 6.30pm GMT.

Proposing the motion is Simon Wessely and Deborah Arnott. Opposing it are myself and @Sectioned_.

Monday, 9 November 2015

No safe level

Has anyone else noticed a shift towards total abstinence in health advice this year? In October, for example, we were told that...

Go teetotal to reduce dementia risks, NHS says 

Official NHS advice on prevention of dementia warns 'there is no safe level of alcohol consumption' which does not increase risk of the condition

That advice goes against the scientific evidence, but that should no longer be surprising. In Ireland, the Royal College of Physicians explicitly denies that there are any health benefits from drinking (despite a mountain of evidence to the contrary) and also parrots the 'no safe level' line...

“People should be aware that there is no safe level of alcohol consumption and they should never drink because they believe there is a health gain from alcohol.”

This, of course, follows in the footsteps of earlier (unproven) claims that there is 'no safe level' of trans fats or secondhand smoke. It is also highly reminiscent of claims made by the crackpot prohibitionist outfit the Scientific Temperance Federation in the early twentieth century. It's rubbish, but it 'sends a clear message' to the public - and that's what counts if you are an activist.

Are we moving towards the same puritanical message for other products? A few recent headlines suggest that the momentum is building. Last week, the Telegraph reported:

Just one steak a week can increase risk of bowel cancer, study finds

Eating just one steak a week increases the risk of bowel cancer by more than two-fifths, it has been claimed.

Also last week, we were given the message that there is no safe level of, er, snacking..

Even a little is too much: One junk food snack triggers signals of metabolic disease

And today in the Mirror we were told that...

Doctors have warned that swigging just one energy drink exposes even "young, healthy" adults to an increased risk of heart disease.

We can expect some 'public health' organisation or other to claim that there is 'no safe level' of fizzy drink consumption soon. Indeed, some people are already saying it...

Soda in any amount is a brain-rotting, heart-wrecking, belly-expanding poison, and the latest science finds drinking even a little bit every day will shave nearly FIVE YEARS off your life... There is NO safe level of soda, period.

Admittedly, that comes from a bit of a crank website, but it has been widely reported elsewhere that 'Just one can of fizzy drink a day [is] linked to increased heart risk' and 'just one can of sugar-laced soda drink a day increases the risk of developing diabetes by more than a fifth'.

Is any of it true and should we care? The answer to the first question is 'possibly'. Leaving Paracelsus to one side for a moment, it is possible for a substance to pose some threat at low levels of exposure. 

Should we care? No. Studies which claim there is 'no safe level' typically find relative risks in the region of 1.10-30 (ie. a 10-30 per cent increase in risk), which can easily be explained by publication bias, data-dredging, researcher bias, poor study design, confounding and chance - which is to say, all the problems associated with junk epidemiology. Even if the risks were real, they would not be enough to concern a normal, well adjusted person. 

A product does not have to be safe. It only has to be safe enough. I, for one, welcome this avalanche of headlines claiming that everyday products are dangerous at any level of consumption. I believe that we are near the tipping point at which the general public ignores everything the 'public health' lobby says. If the quack scientists, vegan pressure groups, anti-sugar fanatics and temperance nuts can maintain their current level of activity for another twelve months, the battle may be half-won.


Just seen this from the Netherlands:

New Dutch healthy diet guidelines say don’t drink alcohol at all

This will happen everywhere eventually, as I have long predicted. Not because the evidence will evolve but because it fits the mindset of the moral crusader.

Sunday, 8 November 2015

Planet of the vapes (video)

Here's the video of last month's Battle of Ideas session on vaping. I wrote about it in this post.

Friday, 6 November 2015


The British Medical Journal seems to be on auto-destruct at the moment. More than ever, the magazine is filled with crackpots and conspiracy theorists. I don't how much tolerance its readers have for student politics and junk journalism, but some of them must be reconsidering their subscription by now.

I mentioned recently that the BMJ had refused to publish an article that they had requested for their head-to-head column about banning smoking in psychiatric hospitals. Michael Fitzpatrick stepped in to give a fine defence of patient autonomy, but the published article contains no explanation of why only one side of the forthcoming Maudsley debate has been represented in print. The magazine has not covered itself in glory this week, and it gets worse...

In September, it gave the front cover and lead story to Nina Teicholz, an Atkin's Diet crank who wrote a poorly researched book called The Big Fat Surprise. Among other peculiar beliefs, she thinks that Americans have a 'near-vegetarian diet' (the USA has the highest per capita meat consumption in the world). She is obsessed with government dietary guidelines, which she wrongly thinks Americans adhere to, and this was the subject of her BMJ article.

As often happens when low carb zealots are given column inches in journals, a factual error in the article had to be subsequently corrected (see also Aseem Malhotra and Aseem Malhotra again), but others remain and 183 scientists have now signed a letter requesting the article be retracted in full. They say it is 'so riddled with errors' that it has 'no place in the pages of a prominent scientific journal.'

So it is, but does the BMJ even want to be regarded as a 'scientific journal'? 'Activist magazine' would be more accurate given its repeated employment of Jonathan Gornall, a clown show conspiracy theorist with whom regular readers will be familiar. He's back yet again in this week's edition, this time donning his tin helmet for an 'investigation' into Public Health England's report on e-cigarettes. Clive Bates has fisked it to death in an excellent blog post so I won't go into details, suffice it to say that it is the usual mish-mash of ad hominem attacks based on binge-googling, LinkedIn profiles and quotes from anonymous sources.

One characteristic of Gornall's efforts is that he never makes any attempt to evaluate evidence or argument. He is intellectually incurious to an extraordinary degree, taking an a priori position - in this instance, that e-cigarettes are a Bad Thing - and then smearing anyone who disagrees with it (Public Health England, in this case). He did the same when he decided that the government should bring in a sugar tax and when he decided that minimum pricing was a Good Thing. As I wrote in February...

A theme is emerging in his hatchet jobs. First, he takes a policy which is controversial with the public but which has legitimate arguments for and against. He then treats the policy as a no-brainer which could only possibly be opposed by vested interests. He then looks for any kind of funding from business to civil society and the public sector; if he cannot find any he implies that it exists. Finally, he pads out his articles with quotes from activists and presents their failure to persuade government to bring in the controversial policy as being the result of 'webs of influence'.

On that occasion, he was attacking Susan Jebb, a respected food scientist, because she has 'links' to 'Big Food'. What Gornall failed to mention is that most food scientists have worked for or with the food industry. As it happens, Jebb is something of a nanny statist and she actually supports the idea of a sugar tax. Again, Gornall failed to mention this, presumably because it would undermine his conspiracy theory.

The reaction from people who know what they're talking about was a joy to behold, including these expert reactions and this response from the chief executive of the Medical Research Council (MRC)...

As I am ultimately responsible for everything MRC does, please add my name to your "tangled web". It would be an honour to stand alongside scientists such as Susan Jebb, Ann Prentice and Ian Macdonald, who are committed to improving public health through research.

Gornall made such a fool of himself with that particular smear job that I really thought it would be the end of his relationship with the BMJ. How wrong I was. To promote his latest drivel, the BMJ even tweeted an infographic which attempts to tie the authors of one of the studies cited in the Public Health England report together in one web of corruption. It nicely sums up Gornall's approach to journalism by connecting dots without saying anything.

Employing this chump once would be a mistake. Employing him again and again says a great deal about the BMJ's spiralling decline. What other conclusion can one draw than that Gornall's approach to journalism is also that of the once proud BMJ?

Thursday, 5 November 2015

£200 million down, £2.8 billion to go

From The Guardian...

If the government cut £1bn from the NHS budget, it would be on the front pages. Yet, this is in effect what it has done.

This is a reference to the government cutting the outrageously big 'public health' budget of three billion pounds by a modest 6.7 per cent* (£200 million). The Guardian is parroting the public health racket's line that taking money away from the nanny state industry will lead to bigger costs to taxpayers in the long run.

However, as I wrote at Spectator Health yesterday, this is poppycock. The government is saving the taxpayer £200 million, or not borrowing £200 million, or directing £200 million towards better uses (whichever way you want to look at it). Either way, it is a good thing. Cut deeper.

Every special interest group likes to imagine that government spending on their pet projects is an ‘investment’ that will pay off further down the line. Sometimes it is, but often it is not (hello, London Olympics). The truth about spending on ‘public health’ initiatives is that they waste money if they don’t work and they cost even more — in the long run — if they do.

Do read the whole post.

* UPDATE: Actually, just 6.2 per cent.

Wednesday, 4 November 2015

Seven teaspoons of sugar!

Oh, what now?

A diabetic MP is asking Coca-Cola not to bring its Christmas truck to Leicester, accusing the company of marketing a "real health hazard".

Keith Vaz insists he does not want to be a "killjoy", but said the truck would send the wrong message in a city where diabetes is rising and a third of children have tooth decay.

He predicts people will protest if the truck does come to the city.

 I predict they won't. Has Vaz lost his marbles?

"I know people like special things happening at Christmas, but Coca-Cola are coming to promote their product and in each can of Coke there are seven teaspoons of sugar," he said.

Seven teaspoons of sugar! SEVEN TEASPOONS OF SUGAR! The Coke lorry is coming! Run for the hills! Think of the children!

Apparently we were on the winning side of a world war seventy years ago. It's increasingly difficult to see how we pulled that off.

PS. In this week's Sunday Times, Jamie Oliver had another pop at breakfast cereals for having too much sugar in them and the presented us with a 'healthy' breakfast recipe for granola, with 32 grammes of sugar in each serving.

32 grammes is the equivalent of eight teaspoons of sugar. Will Keith Vaz be protesting against the fat-tongued one next time he visits Leicester?

Tuesday, 3 November 2015

Stop press: Campaign of hate has negative consequences

From The Times...

Scientists have investigated the unintended consequences of three decades of public policy aimed at stigmatising smokers. 

Could a state-sanctioned hate campaign possibly have any negative effects? Say it ain't so!

And they have suggested that so effective has the strategy been that, rather than pushing people away from smoking, a hardcore group of smokers now feel sufficiently depressed at being outcast from society that they lack the mental resources to do anything other than keep on with their habit.

Note that the perceived problem here is not that a group of fellow citizens has been turned into depressed outcasts, but that they have not given up smoking as a result.

Researchers from the London School of Economics (LSE) reviewed dozens of research papers related to the psychological effects of smoking. They consistently found that the habit led to self-loathing. “Participants felt shame, guilt, and embarrassment for their own smoking behaviour,” they write in the journal Social Science & Medicine. “In multiple studies, participants applied words such as ‘leper,’ ‘outcast,’ ‘bad person,’ ‘lowlife,’ and ‘pathetic’ in reference to their own smoking behaviours. “Many smokers reported feeling stigmatised for their smoking status,” the paper continued.

Tell me again how the public health mob are the good guys.

While this might seem like a positive outcome of policies designed to de-normalise smoking, Sara Evans-Lacko, from LSE, said that too little attention had been paid to whether making smokers feel like pathetic leprous lowlifes was a uniformly positive thing. 

I think you'll find that most anti-smoking fanatics think it's a thoroughly wonderful thing. Treating smokers like scum is a feature, not a bug, of their system. It is not an unintended consequence, it is the prize.
“The evidence is that it reduces and stops smoking. A lot less work has been done looking at unintended consequences. People can feel worse when they start to apply these stereotypes to themselves,” she said. This can reduce self-esteem to such an extent, that Dr Evans-Lacko suggested it might now be counterproductive. “The subsequent consequence is a reduction in self-efficacy — people are less able to quit. They feel so bad about themselves, they simply don’t have the resources to give up.”

It's hardly news if a 'public health' policy has achieved the opposite of its stated objective, nor is it surprising that it has caused collateral damage, but here's a radical thought. Regardless of whether bullying, harassing and stigmatising people 'reduces and stops smoking', maybe the government shouldn't be doing it.