Tuesday, 28 July 2015

Good riddance to bad sock-puppets

I'm pleased to able to bring glad tidings for a change. DrinkWise North West, the taxpayer-funded lobby group, has had its state-funding withdrawn. Since nobody in their right mind would give it money voluntarily, this naturally means that it has been closed down with immediate effect. Its Twitter feed has already disappeared.

You may recall DrinkWise as the Department of Health front group that used public money to campaign for alcohol advertising bans and minimum unit pricing (MUP). For the latter, they set up a sock-puppet website - anonymously, at first - which made the ludicrous claim that MUP would reduce the price of some drinks. The rest of its campaign literature had a similarly uneasy relationship with the truth.

There is no doubt that DrinkWise were a lobby group (how nice it is to speak of them in the past tense). It's difficult to find any part of their website that was not devoted to encouraging people to 'join the movement', 'act now' or 'write to your MP'. Despite being 100 per cent state-funded, they were proudly and openly engaged in political campaigning.

Since most of their income came from local authorities, they would have been in breach of the Department for Communities and Local Government's new 'anti-sockpuppet clause' which states:

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.

Presumably this was a large part of the reason for its funding being withdrawn. We must also presume that DrinkWise's counterpart across the Pennines, Balance North East, will soon also be consigned to the dustbin of history. Balance North East's room-mates at FRESH should be heading for the door shortly afterwards, as should FRESH's state-funded colleagues at Smokefree South West. The recently formed Give Up Loving Pop (GULP) must also be on thin ice. There are others, of course.

It is probably too much to hope that the rinky-dink governments of Scotland and Wales will stop throwing money at the likes of Alcohol Focus Scotland and Alcohol Concern, but England is certainly ready to save a few million quid by burning some leaches off the taxpayers' skin.

It can't happen a day too soon.

Monday, 27 July 2015

Fortunately, Tesco does not have a monopoly

If the newspapers are to be believed, the people who run Tesco have taken leave of their senses.

The UK's biggest supermarket chain is axing some of the best-selling children's drinks brands as the war on sugar is stepped up in a bid to tackle childhood obesity, according to a new report.

Tesco has revealed that it is to cull an array of added-sugar soft drinks including CCE's Capri-Sun and several varieties of Suntory's Ribena as it revamps its range amid growing concerns over health and obesity.

Have these people been smoking crack? Do they really think that they will appease the 'public health' racketeers by taking Ribena and Rubicon off the shelves? Why not stop selling sweets, chocolate and fruit juice? Why not stop selling packets of sugar, if that's what the demon ingredient is? Why not stop selling cigarettes and alcohol? Above all - as the 'public health' goons were quick to shout on Twitter - why not stop selling Coca-Cola, Pepsi and Tango, all of which will still be available under the new regime? Tesco has started something it will not be able to finish without closing down several aisles.

Speaking of Twitter, I was expressing my bewilderment on there yesterday when the inevitable zinger arrived...

Obviously that is not my position. Tesco is free to bring in whatever policy it likes and I am free to shop elsewhere. The market can therefore decide whether Tesco's policy is sensible or not.

My house is pretty much equidistant between a Tesco and an Asda. I tend to go to Tesco and I won't be boycotting it on principle but when Ribena is on my shopping list - as it sometimes is - I'm damned if I'm going to Tesco for most of my shopping before going elsewhere for my soft drinks. It will be Asda for me.

Living in a free market obviously does not mean that the government forces supermarkets to sell Ribena, but nor does it mean that customers shouldn't complain when a company unnecessarily restricts choice in a doomed attempt to satisfy insatiable 'public health' quacks. Complaining might not make them change their minds, but ultimately it's their loss if people decide to vote with their feet.

Contrast this with government regulation. When the state does it, you can't go elsewhere because the state has a monopoly. What are you going to do? Emigrate? You can vote in the ballot booth, but people rarely vote on a single issue and your vote is pretty much worthless anyway. You have no choice and the government doesn't care if sales fall.

In summary...

Company stops selling something you like:

Complain. If your complaint has no effect, shop elsewhere and make the company suffer. No skin off your nose.

Government bans something you like:

No point complaining. Suck it up. You suffer, they don't.

The insanity of the 'endgame'

Clive Bates gave an outstanding speech at this year's Global Forum on Nicotine in Warsaw. He discusses the anti-smoking lobby's ludicrous 'endgame' and compares it with policies that might actually reducing smoking without creating massive costs on individuals and society. If you haven't watched the video, do.

Sunday, 26 July 2015

"No evidence"

The campaign to ban smoking in prisons is marching on thanks to the ever-gullible Observer newspaper and a sock-puppet pressure group known as the Tobacco Control Collaborating Centre. I've never heard of them and nor has The Observer judging from its description of them as "an organisation called the Tobacco Control Collaborating Centre", but its article contains this gem...

Deborah Arnott, chief executive of charity Action on Smoking and Health, said there was no evidence to support claims that depriving prisoners of tobacco could lead to riots.

No evidence! Not just a little bit of evidence, but no evidence!

Perhaps Debs has forgotten about the events in Australia that took place only a few weeks ago...

Prisoners riot at Melbourne's Ravenhall remand centre over smoking ban

Police armed with tear gas and water cannons were on Tuesday evening still attempting to contain a riot that broke out at a maximum security prison in Victoria earlier in the day, after prisoners became angered by the introduction of a smoking ban.

All staff were evacuated from the prison in Ravenhall, Victoria, after several hundred prisoners rioted.

This apparent oversight is typical of ASH's view of evidence. As with the mass closure of pubs after the smoking ban, it didn't happen unless it was written up by a tobakko kontrol mouthpiece and published in one of their favoured pal-reviewed journals like the BMJ or - if all else fails - their in-house comic Tobacco Control.

The fact that these things did happen - and have happened before in Queensland, Canada and the USA - is neither here nor there to the single-issue fanatic. They make their own reality.

Some people would call it lying.

Friday, 24 July 2015

The middle class drink epidemic

 With alcohol consumption falling every year for over a decade it is becoming increasingly difficult to sustain the myth that Britain is in the grips of a drinking epidemic, but where there’s a will there’s a way. One method is to focus on whichever group is drinking the most. Even though everybody is drinking less, some people are bound to be drinking more than others and that means scary headlines. Inconveniently for the doom-mongerers, the people who are drinking the most happen to be the middle-aged and middle class. It would be a better story if the heaviest drinkers were the tired, the poor and the huddled masses yearning to breathe free, but the evidence clearly shows that they are the white collar professionals. In Britain, people in the top social class consume an average of 15 units of alcohol per week while people in the lowest social class only consume 10.

And so, after an admittedly slow news day, several national newspapers have led with the story - such as it is - of reasonably wealthy people drinking bottles of wine. Or, as the Daily Mail’s front page put it, the ‘Middle Class Drink Epidemic’. ‘Successful middle classes suffering crisis in alcohol abuse’ was The Times’ front page headline while The Telegraph led with ‘Middle classes most at risk from drinking’.

The hook for all this is a study (in reality, a glorified survey) published in BMJ Open which found that successful, wealthy, middle class people over the age of 50 are more likely to exceed the government’s drinking guidelines than their peers. At this point it is customary to point out that you can exceed the guidelines by drinking a glass, or a glass and a half, of wine a day (for women and men respectively), and that the guidelines themselves were ‘plucked out of the air’ in the 1980s. But even if you take the guidelines seriously, exceeding them does not make you a ‘harmful drinker’ or a ‘problem drinker’, as The Times claims in its report. It makes you a mere ‘hazardous drinker’ which is below both in the ladder of risk.

Getting technical definitions wrong is the least of the problems with the reporting of this story. It is simply wrong to claim, as The Telegraph does, that middle class people are ‘most at risk from drinking’. As a class, it is true that they drink the most, but they do not suffer the greatest alcohol-related harm, not by a long shot. The harm disproportionately falls on lower socio-economic groups and they tend to drink the least.

This is what public health researchers call the Alcohol Harm Paradox. Public health researchers call everything a paradox when reality doesn’t bend to accommodate their theories and so, if boozing fails to kill affluent people despite their supposedly hazardous rates of consumption, it doesn’t demonstrate that the guidelines are worthless - heaven forfend! - it is merely a ‘paradox’ that requires more research (ie. more funding).

Alcohol Research UK published a rather inconclusive study about the paradox earlier this year and I’m told that there is more to come. I hope they get to the bottom of it, but I would be surprised if it comes down to much more than two basic problems:

Firstly, the definition of hazardous and harmful drinking is too broad to accurately capture people who are at serious risk of coming to grief. According to the government, there are over 10,000,000 hazardous drinkers and yet there are only 6,000 alcohol-related deaths each year. An annual death rate of 0.06 per cent does not represent much of a hazard.

Secondly, you cannot assume that an arbitrarily defined group of people is going to produce more death and disease than another group merely because their group average exceeds an arbitrary guideline. Why? Because averages tell you nothing about individuals. Yes, people on low incomes drink less than middle class people on average. They don’t have much money and alcohol is a heavily-taxed luxury, but within this group are some people who not only drink very heavily but also have a propensity for other risk-taking behaviours. It should therefore not be surprising that a disproportionate number of alcohol-related hospital admissions and deaths arise in the group that drinks the least. The fact that lots of other poor people bring the group average down by drinking moderately or abstaining is neither here nor there to the low income alcoholic.

We can discuss the reasons why some people at the bottom of the socio-economic ladder turn to drink - and, indeed, why some people who turn to drink end up at the bottom of the socio-economic ladder - but that is not really the point here. The point is that middle class people are not the most at risk from alcohol-related harm, despite drinking more, as a group, on average. Rates of alcohol-related mortality are many times higher in the lowest socio-economic group than in the highest.

It takes a certain amount of self-delusion to look at a group of unusually healthy people and conclude that they are suffering from an ‘epidemic’, and yet the report in The Times includes this timeless gem from a spokesman for Age UK:

‘Because this group is typically healthier than other parts of the older population, they might not realise that what they are doing is putting their health in danger.’

In other words, they might be the healthiest people but according to our calculations they shouldn’t be and so we’re going to pretend that they’re not.

To be fair, Age UK are only taking their cue from the authors of the BMJ Open study who apparently saw no paradox at all when they wrote that the ‘problem of harmful drinking’ is concentrated amongst ‘people in better health’. We are through the looking-glass here, are we not?

Imagine if the results had been different. Imagine that the people (ie. group) who were most likely to be ‘harmful drinkers’ were found to be in the worst health. In those circumstances, it would surely have been reported as proof that exceeding the drinking guidelines is very bad for you. Instead, the study showed the opposite but the band played on regardless.

Tuesday, 21 July 2015

Area man speaks out

I'm supposed to be on holiday this week, but the nanny state never sleeps so I was on Sky News earlier today speaking from my backyard (relatively speaking) in Hove about the proposal to ban smoking in parks and beaches. Deborah Arnott from ASH was on the end of a rather distorted line so I didn't catch everything that was said, but she didn't seem like she really had her heart in it to me. Who can blame her? It is a truly appalling idea on every level.

I should be debating the same issue with Brighton and Hove's director of public health tomorrow on BBC Sussex radio (at around 9.10am). If I can get him to explain what the hell a voluntary ban is, I will let you know.

Anyway, here's the video...


He was a no-show.

Those sugar guidelines are not what they seem

At The Spectator, I discuss last week's lowering of the sugar 'allowance'. Some people have said they can't access the site if they're using Chrome so here it is in full...

Like putting Dracula in charge of a blood bank’ is how Action on Sugar’s Simon Capewell described Ian MacDonald’s role as chairman of the Scientific Advisory Committee on Nutrition (SACN) last year. Professor MacDonald’s reputation as one of Britain’s leading nutritionists gave him no protection when Channel 4’s Dispatches programme devoted half an hour to attacking any scientist who receives grant funding from the food industry. Seemingly unaware that industry-government partnerships are the norm in diet research, Action on Sugar’s Aseem Malhotra accused MacDonald of being ‘in bed with the food industry’ and called for his resignation. Similar inferences and accusations were made in a British Medical Journal ‘investigation’ earlier this year.

We shall probably never know whether this smear campaign had any influence on the conclusions of the SACN report when it was released last week, but the campaigners certainly got what they wanted when MacDonald et al halved the recommended sugar intake from 10 per cent of daily calories to five per cent. A lower limit has been the holy grail for the anti-sugar movement for years (for reasons I recently discussed). The World Health Organisation let them down earlier this year when it kept the limit at ten per cent, but SACN played ball and the talk of Dracula and blood banks was conspicuous by its absence on Friday morning.

The pool of nutritional epidemiology is murky at the best of times, leading some academics to dismiss the whole field as pseudoscience, but if you are prepared to give it the benefit of the doubt, the SACN report provides a decent summary of the evidence to date. Taken together, it does not make happy reading for the anti-sugar/low-carb movement. SACN found an association, based on ‘moderate evidence’, between sugary drinks and type 2 diabetes, but it failed to support any of the other pet theories of the anti-sugar campaigners. For example, it found ‘no association’ between sugar and type 2 diabetes, ‘no association’ between sugar and blood insulin, and ‘no association’ between sugary drinks and childhood obesity. It also found no association between fructose (the bête noire of the anti-sugar lobby) and type 2 diabetes. As for the low-carb diet, SACN found ‘no association between total carbohydrate intake and body mass index or body fatness’, nor with type 2 diabetes or cardiovascular disease. By contrast, it found ‘some evidence that an energy restricted, higher carbohydrate, lower fat diet may be an effective strategy for reducing body mass index and body weight.’

You need to reach page 183 to find the only part of the 370-page report that made the headlines. SACN explained its decision to recommend reducing sugar consumption to five per cent of daily energy as follows:

‘To quantify the dietary recommendation for sugars, advice from the Calorie Reduction Expert Group was considered. It was estimated that a 418 kJ/person/day (100kcal/person/day) reduction in energy intake of the population would address energy imbalance and lead to a moderate degree of weight loss in the majority of individuals (Calorie Reduction Expert Group, 2011) … To achieve an average reduction in energy intakes of 418 kJ (100kcal/person/day) using this estimated effect size, intake of free sugars would need to be reduced by approximately five per cent of total dietary energy (418kJ/78kJ= 5.4) … A five percentage point reduction in energy from the current dietary recommendation for sugars would mean that the population average of free sugars should not exceed five per cent of total dietary energy.’

In other words, the average person consumes too many calories and if sugar consumption was reduced from 10 per cent of energy to five per cent of energy, people would eat 100 fewer calories (unless, of course, they compensated by eating more calories from other sources). This is the sole justification in the SACN report for changing the guidance on sugar. The mathematics is correct – 100 calories is roughly five per cent of an adult’s recommended intake. The logic is not wrong, it is merely trivial. If the aim of dietary advice is to get people to eat 100 fewer calories a day, similar edicts could be announced about any ingredient or food. Telling people to eat 25 fewer grammes of cheese a day would serve exactly the same purpose, but it would not tell us how much cheese it is safe to eat.

There is no difference whatsoever between saying ‘eat 100 fewer calories’ and ‘reduce your sugar consumption from 14 teaspoons a day to 7 teaspoons’. The latter, which has now been enshrined in official guidance, is merely one way of achieving the former. It is doubtful that even one person in 100 who saw last week’s headlines realises this. It is much more likely that they think scientists have found new evidence showing that consuming more than seven teaspoons a day is inherently dangerous, even toxic.

The clear implication from the new daily ‘allowance’ is that it represents the upper limit of a risk threshold, above which it is dangerous to stray. This is not what the SACN report says, and it is not their justification for changing their guidance, but it will be portrayed as the ‘safe limit’ by pressure groups forever more.