Tuesday, 25 October 2016

Who's to blame - journals or journalists?

In the age of 24 hour news, all the dead tree press have left are embargoed studies from journals - and, boy, do they like to make the most of them. Two front page stories caught my eye today. Both are largely rubbish. The question is who is at fault: the journalists or the journals?

First, this from the Guardian...

Women now drink as much alcohol as men, global study finds

Women have caught up with men in the amount of alcohol they drink and are doing increasing amounts of damage to their health as a result, according to a global study that looked at the consumption habits of four million people over a period of over a century.

The change is partly the result of successful marketing campaigns and the creation of sweeter products aimed at young women or girls, as well as cuts in price, say health campaigners.

These claims are not borne out by the Office for National Statistics which has consistently found that men are the bigger drinkers. In the most recent drinking survey, conducted in 2014, the ONS found:

Men were more likely than women to drink alcohol, as well as consuming higher amounts. In the week previous to the survey, 64% of men had drunk alcohol, with over half (52%) drinking more than 4.67 units on their heaviest drinking day. In comparison, 53% of women had drunk alcohol in the previous week, with only 37% of those drinking more than 4.67 units on the heaviest day. Men were 3 times more likely to have drunk over 14 units on their heaviest drinking day, 12% of men compared with 4% of women.

If that's the situation in Britain, it seems unlikely that women are out-drinking men in some of the less socially progressive in the world, but let's see what the study - published in BMJ Open - says:

Among those born in the early 1900s, males were 2.2 (95% CI 1.9 to 2.5) times more likely than females to consume alcohol, 3.0 (95% CI 1.5 to 6.0) times more likely to drink alcohol in ways suggestive of problematic use and 3.6 (95% CI 0.4 to 30.3) times more likely to experience alcohol-related harms. Among cohorts born in the late 1900s, males were 1.1 (95% CI 1.1 to 1.2) times more likely than females to consume alcohol, 1.2 (95% CI 1.1 to 1.4) times more likely to drink alcohol in ways suggestive of problematic use and 1.3 (95% CI 1.2 to 1.3) times more likely to experience alcohol-related harms.

As you can see, the authors make the infuriating mistake of using '1900s' to describe the twentieth century rather than the first decade of the twentieth century. (This is not pedantry. If this common error becomes universal, historians will have no way of describing the first decade of a century.) Assuming that by 'late 1900s' they mean 1980-1999 rather than 1907-09, the study shows that the gap between male and female drinking rates has narrowed, but has not reached parity. Men are 20 per cent more likely to drink heavily and are 30 per cent more likely to experience alcohol-related harms. The whole premise of the Guardian front page story is therefore incorrect.

The study - actually an evidence review - doesn't show the actual rates of consumption, nor does it show trends for either sex. It focuses only on the gap. As the authors acknowledge...

It is important to note that the sex ratio metric used in the current study provides information on the relative prevalence of alcohol use or related harms in males versus females. This metric does not empirically determine whether observed changes in the sex ratio are being driven by increases or decreases in male or female prevalence

However, they say that in most instances rates of drinking have risen among women. That has certainly been the case in Britain but it is also the case that drinking amongst men has fallen sharply since 1900 (and has fallen amongst both sexes since 2004). It would be possible for the gap to narrow even if both sexes drank less.

The authors do not discuss the reasons for the narrowing of the gender gap other than to mention greater equality in the labour market, but this does not prevent the Guardian from inviting the usual neo-prohibitionist talking heads from Alcohol Concern and the Institute for Alcohol Studies to spout off about marketing and the 'need' for health warnings on drinks.

You can't blame the journal for this shoddy reporting. The study is not misleading and the press release repeatedly stated that women were 'catching up', but had not caught up, with men. The press release also said that the study did not 'address whether alcohol use is falling among men or rising among women' and that the authors 'did not set out to explain the reasons behind their observed findings'.

Verdict: Bad journalism

Meanwhile, the Times led with this story...

On its face, this is a crazy idea. Doctors have very little time with patients as it is without weighing everybody who comes in to see them. Most people are not obese and you don't need to weigh somebody to tell if they are fat. Moreover, the claim that heart disease would be cut by 23 per cent and diabetes would be cut by 17 per cent if doctors sent their patients off to Weight Watchers to lose two pounds seems deeply implausible.

The study in question was published in the Lancet. It's a randomised experiment in a real world setting in which GPs said something along the following line to obese patients:

'While you’re here, I just wanted to talk about your weight. You know the best way to lose weight is to go to [Slimming World or Rosemary Conley] and that’s available free on the NHS?'

The doctors didn't weigh the patients - only obese people were selected for the study - and so the intervention only took around 30 seconds.

The take-home message from the study is that the vast majority of obese people do not mind doctors raising the issue of their weight, and most of them appreciate the offer of help. Those who were offered help lost a bit more weight than those who didn't (1.4 kg on average).

The predictions about heart disease and diabetes are contained in the study, but the figures are relative to a counter-factual of future obesity rates. As regular readers know, 'public health' forecasts of future obesity rates are worthless and so are these.

While some of the basic facts in the Times story are correct, the headline claim that 'patients should be weighed during routine GP appointments' is not being made by anybody, as far as I can see - not in the study and not in the press release. The BBC has a somewhat more accurate report of the study here.

Verdict: Mostly bad journalism

Monday, 24 October 2016

Gay cakes

From the BBC...

The Christian owners of a Northern Ireland bakery have lost their appeal against a ruling that their refusal to make a "gay cake" was discriminatory. Appeal court judges said that, under law, the bakers were not allowed to provide a service only to people who agreed with their religious beliefs.

Two years ago, the family-run firm refused to make a cake iced with the slogan: "Support Gay Marriage". The order was placed at its Belfast shop by gay rights activist Gareth Lee.

The firm argued that the cake's message was against the bakers' religious views.

Reacting to the ruling, Daniel McArthur from Ashers said he was "extremely disappointed" adding that it undermined "democratic freedom, religious freedom and free speech".

"If equality law means people can be punished for politely refusing to support other people's causes then equality law needs to change," he said.

I know there are strong view on both sides and that many people celebrating this outcome have the best intentions, but I'm with the bakers.

The government is a lumbering, cowardly bully. When the majority of Britons regarded homosexuality as immoral, irreligious or otherwise socially unacceptable, it was illegal. The lives of many gay men were ruined by imprisonment, blackmail and forced sterilisation. By 1967, attitudes had softened to the extent that homosexual acts were legalised, albeit only for men aged 21 or over, and for the next few decades, they were legally tolerated while continuing to be the subject of widespread but dwindling social disapproval.

Attitudes then swung decisively. Between 1985 and 2012, the proportion of Britons who believed that homosexuality was ‘wrong’ fell from 69 per cent to 28 per cent and it was now homophobia that became socially unacceptable.

Sensing the changing mood of the majority, the cowardly, bullying state swung to the opposite extreme and began prosecuting those who displayed prejudice against homosexuals. In 2011, a Christian couple were fined £3,600 for refusing to allow a gay couple to stay in a double room in their bed and breakfast. Three years later, the bakery involved in this dispute was fined £500 for refusing a request from a customer to bake a cake with the words ‘support gay marriage’ on it. In effect, they were being forced to promote an opinion with which they totally disagreed.

Neither the old attitude to homosexuality nor the current attitude to homophobia is recognisably liberal. Under John Stuart Mill’s harm principle, it would not matter whether it was homosexuality or homophobia that was deemed immoral by the majority. Neither would be a matter for the police.

The government has used the law to persecute first one side and then the other. It never seems to occur to these moral imbeciles that there is a third option of allowing people to voluntarily trade and associate with whomever they want, and to not persecute anybody.

Saturday, 22 October 2016

Minimum pricing, the law and the dominance of 'public health'

I wrote a piece for Spectator Health about the Scottish court ruling that sided with the government in the minimum pricing case.

Those of us who voted Leave in June understood that there is a trade-off between sovereignty and trade. The SNP are an overtly paternalistic party with authoritarian tendencies, but they have been resoundingly elected by the Scottish people. If they want to drain the pockets of the poor by putting a deadweight cost on alcohol, there is a case for respecting their sovereignty. On the other hand, they are party to a trade deal in the form of the common market which, until today, seemed to forbid such actions. 

For those of us who like free markets and oppose minimum pricing, the EU’s ban on such restrictive practices was one of the things we were going to miss after Brexit. After today, it is one less thing to worry about.

I suspect that this will now got to the Supreme Court. The judge's rationale was far from compelling and, to my mind, did not fully engage with the objections raised by the European Court of Justice. We shall see, but I don't think the lawyers are going to lose out from this saga. 

Thursday, 20 October 2016

Living in the pre-truth world

I spoke at the launch of the Orwell prize last night about 'post-truth Britain'. Here is roughly what I said...

The emblem of the post-truth society is a red bus that has come to assume rather more importance since the vote to leave the EU than it did during the referendum campaign. This bus famously claimed that we send £350 million to the EU every week and that we could be spending this cash on the NHS instead. Alas, this is physically impossible because the £350 million figure includes a rebate that never gets sent to the EU in the first place. The real figure is - depending on how you look at it - £190 million or £250 million.

This is hardly the first time a dodgy statistic has been used in a political campaign, so what was it about this particular claim that made it so offensive to those of us who care about facts?

There were other questionable claims made in the referendum campaign such as the idea that Turkey is set to join the EU. It is very, very unlikely that Turkey will join the EU in the short or medium term and yet it is not technically impossible. The EU has spent money looking into its membership. David Miliband was very keen on getting Turkey to join when he was foreign secretary, but Turkey has gone backwards since then and it would take a near-miracle for it to meet the EU’s criteria for entry. So not a total lie, perhaps, just a very implausible prediction.

The Remain side had their own implausible predictions. There would be a punishment budget if we voted to leave. There would be an immediate recession. David Cameron promised to invoke Article 50 straight away and stay on as prime minister. Instead, he resigned as prime minister straight away and Article 50 has still not been invoked. Having stepped down as prime minister he then promised to stay on as an MP, but he has since quit politics entirely. Were these lies? Did he really think he could stay on as prime minister if the country voted for Brexit? It seems unlikely, but it cannot be proven. It is therefore possible that he was sincere and later changed his mind.

It seems to me, therefore, that the ‘post-truth’ porky is something that cannot possibly be true and is uttered by someone who knows it is not true. So that's why we're in the post-truth era, because politicians never used to do things like that.

But then I thought of Harold Wilson going on television to tell the British public that devaluing the pound would not affect the value of the pound in their pockets. I thought of Ronald Reagan telling the American public that he had never traded arms for hostages. I thought of Jonathan Aitken and his “simple sword of truth" before he was jailed for perjury and perverting the course of justice.

I remembered Bill Clinton insisting that he had not had sexual relations with "that woman". I thought of Jeffrey Archer and Neil Hamilton and Richard Nixon and I’m tempted to say that the list is endless, but actually it is not. Deliberate, flat out lies are relatively rare in politics because so many people are watching and waiting to pounce on the slightest slip. As Jeremy Corbyn found out after he claimed not to be able to find a seat on a train, it is not the size of the lie that matters. The public can tolerate incompetence, but will not put up with deceit.

All of the politicians I’ve mentioned were found out. The £350 million figure was widely challenged at the time; Sarah Wollaston switched from Leave to Remain as a result. The intense scrutiny of politicians, which has only increased in the age of social media, gives them a big incentive to get their facts right, or at least to get them wrong in a way that can be defended.

In the examples of political lying I’ve just given, most involved politicians denying things from their own past when cornered, rather than inventing statistics from whole cloth. But that seems to me to be narrowing the definition of a lie down to an excessive degree and, anyway, statistics don’t need to be entirely made up in order to mislead people. They can be easily twisted in a way that will trick the public without resorting to outright fraud. Politicians - and journalists - often cite dodgy figures, but they have usually been given them by lobbyists, pressure groups and charities. And if you look at the vast pool of false claims and nonsense in society, you will find these groups more culpable than politicians.

There’s a man I know who debunks bad statistics for a living. When I told him I was looking for some good examples in advance of this event, he gave me three words of advice: ‘Beware good causes’. In the past few weeks, I have seen a headline on the front of a national newspaper asserting that e-cigarettes are as bad as smoking. No one who has studied the evidence believes this to be remotely true. I have seen The Times report the news that the Gambling Commission announced that rates of problem gambling have doubled in the last three years. The Gambling Commission has made no such claim and all the evidence shows no change in problem gambling prevalence since records began in 1999.

I’ve seen the Advertising Standards Agency condemn Friends of the Earth for making claims about fracking that can most politely be described as unsubstantiated. This comes after 107 Nobel prize winners wrote a letter to Greenpeace asking them to end their campaign against Golden Rice, a campaign they described as being ‘emotion and dogma contradicted by data’. A few weeks ago, Oxfam claimed that the UK is one of the most unequal countries in the developed world. The Office for National Statistics says income inequality is ‘close to the overall EU average’ and Credit Suisse says wealth inequality is ‘very typical for a developed country’. No media outlet challenged this claim, as far as I know, despite the data with which it could be debunked being readily available.

A list of false or misleading factoids from special interest groups really would be endless and I'm not accusing any of the people involved of being conscious liars. When the magicians Penn and Teller created a television series debunking the claims of frauds and charlatans some years ago, they called the programme ‘Bullshit!’, because accusing someone of lying is potentially actionable whereas accusing them of talking bullshit is, in legal terms, mere vulgar abuse.

Lying may be more morally objectionable, but bullshit is more common and it is just as damaging to public understanding of the world we live in. My argument is not that we are living in a truthful age. On the contrary, there is bullshit everywhere but deliberate political lies make up a very small portion of it - and that portion is not growing.

As long as people have an appetite for having their biases confirmed, newspapers will continue printing bullshit. As long as people think they can get away with it, they’re going to mislead the public. I don’t think we live in the post-truth era because I don’t think there was ever an era of truth. We are still in the pre-truth era and probably always will be.

Tuesday, 18 October 2016


ASH have produced an amusingly inept report today which has received a justifiable lack of interest from the media. The document - Counter-arguments - is designed to soften up retailers for the day when ASH push for full prohibition. It makes a ham-fisted attempt to persuade them that selling tobacco, despite all appearances, is not a good way of making money. 
The "counter-arguments" are ridiculous, bordering on dishonest...
Profits. Despite the high volume of tobacco sales in convenience stores, accounting for 25% of total sales income in our sample, small retailers make very little money from tobacco. The margin on tobacco products is around 6% compared to an average of 24% for the other products they sell.

This is a pathetic claim. 80 per cent of the price of a pack of cigarettes is tax. If 80 per cent is tax, it is impossible to make a 24 per cent margin. The main job of a tobacco retailer is to collect tax for the government. The real question is how much of the pre-tax price goes to the retailer. The answer is closer to 40 per cent. Elsewhere in the report, they mention that retailers make an average 44p profit on tobacco transactions. Given that the pre-tax price of a pack of cigarettes is barely more than £1 this is a pretty generous margin.
If ASH are so concerned about retailer margins, they should support a cut in tobacco duty. Every cut in tax would increase the margin as a percentage of the price. That won't actually make retailers any more money, though, because it is the amount earned not the percentage that matters to their livelihoods. On such a heavily taxed product, the post-tax margin is an irrelevance.
Footfall. Tobacco manufacturers claim that retailers do well from tobacco sales because smokers buy other products while they are in the shop. However, other than the money they spend on tobacco, smokers do not spend significantly more than people who do not buy tobacco.

This is a bit of a straw man. The importance of footfall is not getting smokers to spend more money than nonsmokers - though they do - it is getting them in at all. If smokers bought their cigarettes from supermarkets rather than newsagents, they are likely to buy their drinks and newspapers from supermarkets at the same time. The small shops would get nothing.
Variety of stock. Tobacco manufacturers encourage retailers to maintain the availability of their own brands and brand variants. Yet the cost to retailers of ignoring this advice is low: a few disappointed customers per week add up to a very small cut in profits.

I don't know if the cut in profits would be small or not, but it shows how little ASH know about small shopkeepers, who work incredibly long hours in a difficult trading environment, that they think they would be prepared to sacrifice any size of profit - or disappoint any customers - on the whim of an extremist single issue pressure group.
Opposition to new legislation. The claim that tobacco control measures increase the size of the illicit market does not stand up to scrutiny. In Britain, the market share of illicit tobacco has declined since 2000 despite all the changes to how tobacco is sold. The size of the illicit market is determined principally by the effort put into law enforcement.

ASH always use 2000 as their starting date for measuring the illicit trade - and it is true that the illicit trade is smaller now than it was then. What they don't mention is that 2000 saw a massive spike in cross-border shopping to the EU after successive tobacco duty rises in the 1990s. This taught the government that it could not keep hiking up taxes ad infinitum and for the next eight years, it froze tobacco duty in real terms. In the last five years, however, there have been steep tobacco duty rises and - surprise, surprise - the illicit market has grown. Even by the questionable estimates of HMRC, the share of tobacco that is non-duty paid has risen by a third since 2011/12. We shall see what effect the display ban and plain packaging have, but the news is unlikely to be good for legitimate retailers.
As a point of fact, there is a direct relationship between tobacco taxation and illicit tobacco sales. The UK, Ireland and France have the highest taxes on cigarettes and, not coincidentally, also have the largest illicit markets in Western Europe. The belief that black markets can be eliminated through enforcement is a myth dating back to the Anti-Saloon League.
A new approach. Retailers could benefit from a declining population of smokers if they reduce their stock of tobacco to core products, shift their gantries out of customers’ line of sight, and use the freed-up space to promote and sell higher margin products. They can keep regular smokers among their customers while reducing the burden of smoking on their cash flow and, potentially, increasing their profitability.

I suspect that shopkeepers know rather more about how to make a living from running a shop than an economically illiterate, state-funded, nanny state lobby group. The reason retailers keep tobacco products close at hand is that they need to be reached many times a day and need to be kept out of the way of shoplifters; thanks to the aforementioned taxes, they are worth thousands of pounds. 
ASH live in such a world of fantasy that they can make claims like 'in Australia, the introduction of standardised packaging actually increased the efficiency of retail sales' with a straight face. Their latest report will raise a hollow laugh from shopkeepers in the real world.

Saturday, 15 October 2016

New Last Orders podcast

There's a new Spiked Last Orders podcast out featuring me and Tom Slater with special guest Timandra Harkness. Lauded by Twitter communist David Colquhuon as the silliest he's ever heard, it includes our thoughts on David Nutt's synthetic alcohol, the NHS's social engineering and the claim that modern life is killing us. Subscribe on your device or click here to listen.

Friday, 14 October 2016

The WHO's Opposition to Tobacco Harm Reduction

Julian Morris has written a great report for Reason about the World Health Organisation's backwards attitude towards harm reduction. It is heavy on facts and includes an excellent primer on snus.

Here are a few samples:

On the WHO's abuse of the precautionary principle...
In general, the WHO demands an excessively high standard of evidence for new products. In Tobacco: Deadly in Any Form or Disguise it asserted: “For new products and for those under development, additional research is needed to understand more precisely whether their risks are the same as the products they would replace. Such research will take years, or even decades. Until such research is completed, the most prudent course is to assume that their health risks are extraordinarily high compared with any ordinary consumer product and to make every effort to prevent their use along with all other tobacco products.” Given that decades of data were already available on the effects of snus by the time the WHO published this, one wonders if any amount of data will ever be sufficient to persuade it of the merits of harm reduction products.

On the secretive dealing of the Framework Convention on Tobacco Control meetings...

Articles 29, 30 and 31 of the FCTC’s Rules of Procedure permit certain “Observers” to “participate without the right to vote in public or open meetings of the Conference of the Parties and of its subsidiary bodies.” The rules state that Observers are also permitted to “speak” during open or public meetings of the Conference of the Parties (COPs) and subsidiary bodies.  This gives the appearance that the FCTC is extremely participatory — more so than most other intergovernmental agreements.

But actual, permitted participation in the FCTC is extremely narrow. The FCTC currently lists only 20 NGOs as Observers on its website. By contrast, the Framework Convention on Climate Change lists over 2,000 NGOs as Observers on its website. Moreover, there is essentially no participation by representatives of many affected groups, including users of tobacco and vape products, vendors, and farmers. Participation by IGOs has also been restricted; even Interpol has been denied Observer status, despite its expertise in combating illicit trade in tobacco — a key topic covered by the Convention.

And what the WHO should do...

If the FCTC is genuinely committed to the “right to health” then it must listen to those who are taking control of the things that determine their health — and to those who are helping them to do so. In other words, it should open itself up to participation by groups representing vapers, snus users, and companies producing these and other less harmful nicotine - containing products.

A more open, participatory FCTC would not produce papers in secret and make them available only a few weeks before COPs. Instead, it might issue a call for papers and encourage all parties with an interest in the issue to submit materials. It might then allow pu blic scrutiny of those papers and form a committee, the composition of which is determined by votes from a much enlarged group of Observers, who can then review submissions and form conclusions.

At the same time, if the FCTC is genuinely concerned about avoiding conflicts of interest, then the best approach is to open itself up to scrutiny. That means, at the very least, permitting journalists to attend all sessions of COPs and technical committees. Better yet, the FCTC might livestream all its proceedings over the Web — in much the way that the Framework Convention on Climate Change livestreamed its 21 st Conference of Parties.

You can download The WHO's Opposition to Tobacco Harm Reduction here.

Washington's Taxpayer Protection Alliance has also recently put out a report on the WHO: World Health Organisation in need of intensive care: World taxpayers funding failing international organisation.