Christopher Snowdon's Blog, page 265

Prohibition working as well as ever

From The Observer:

Mephedrone more popular since being banned – survey
The full story is here, but the following provides a summary of how well the prohibition of mephedrone (bubble, m-cat, meow meow), and prohibition generally, has worked:

"Since we carried out our first study the purity of mephedrone has fallen, the price has risen, yet the results of our second study showed both use and popularity had increased in the year since the ban.

"The results of our two studies showed that not only were club-goers undeterred by the change in law, but the drug had in fact increased in popularity among our sample."

Winning!

Readers of The Art of Suppression might be interested in this next finding...

The survey found the dance drug GHB – also known as GBL – was the second most popular drug among clubbers

GHB isn't actually the same as GBL, but that is just routine journalistic ignorance of designer drugs. Neverthless, I trust you get the point.

Sugar riposte

As a postscript to the 'toxic sugar' silliness, a spokesman for the sugar industry (Big Sugar?) has responded in a letter to Nature.

As director-general of the World Sugar Research Organisation, I wish to point out some shortcomings in the latest discussion of sugar's impact on health (Nature 482, 27–29; 2012).

Robert Lustig and colleagues incorrectly say that sugar consumption has tripled worldwide since the 1960s. The global population has more than doubled in that time, so the increase in sugar supply per head is more like 60%. [D'oh! - CJS] In fact, the United States, Canada and the United Kingdom all show only marginal changes over the past few decades in average sugar consumption as a proportion of food-energy intake.

The authors argue that sugar can kill because of its supposed influence on metabolic syndrome (itself a controversial concept), indirectly implicating a WHO Technical Report that draws no such conclusion. There is little consistent effect on the symptoms of this syndrome in people who eat up to three times more sugar than the average Western intake (A. S. Truswell Am. J. Clin. Nutr. 59, 710S–718S; 1994). Neither have any deaths been attributed to dietary sugars in an exhaustive analysis of US mortality figures (G. Danaei et al. PLoS Medicine 6, e100058; 2009).

The Food and Agriculture Organization of the United Nations, the US Food and Nutrition Board, and the European Food Standards Authority have all considered the issues now revisited by Lustig et al. and find no reliable evidence that typical sugar consumption contributes to any disease apart from dental caries. Without evidence that reducing sugar consumption would improve public health, Lustig and colleagues' policy proposals are irrelevant.

Scientific controversies should be settled by consideration of all the available evidence, not of a seemingly biased selection. Overconsumption of anything is harmful, including of water and air.

Richard C. Cottrell,
World Sugar Research Organisation,
London, UK

He makes some sound points, I think you'll agree. But why worry about facts when you can shout about 'toxins' and 'poisons' and think of the children? And why listen to the vested interests of the evil sugar industry when you can listen to the batshit opinions of Californian 'medical sociologists'? Look, it's Mary Poppins and she's killing kiddies! What more proof do you need?


Picture used to illustrate Nature's toxic sugar article

Penn and Teller explain the absurdity of Americans levying sin taxes on sugary food and drinks below.

Boozy Britain - what the BBC won't tell you

From the BBC:

Over-45s tend to drink more often, says ONS survey

Adults aged over 45 are three times as likely to drink alcohol every day as those aged under 45, results of a lifestyle survey suggest.

More than 22% of men aged 65 and over, but just 3% of men aged 16 to 24 drank almost every day - though younger adults were more likely to binge drink.

More than 13,000 people across Britain completed the Office for National Statistics survey.

Experts recommend three alcohol-free days a week.

The findings of the General Lifestyle Survey 2010 cover a range of topics including people's drinking and smoking habits.

Yadda, yadda, yadda. Alcohol Concern and Drinkaware are given ample space to say the usual stuff, but this is really a non-story. One age group is bound to drink more than the rest. It is a statistical inevitability.

There is nothing to see here, but there should be. Y'see, the General Lifestyle Survey is, as Ron Burgundy might say, kind of a big deal. It is the main source of statistics for alcohol consumption and I couldn't help but feel, as I read the Beeb's report, that there was something they weren't telling us.

Sure enough, the text of the report tells a very different story...

Between 2005 and 2010 average weekly alcohol consumption decreased from 14.3 units to 11.5 units per adult. Among men average alcohol consumption decreased from 19.9 units to 15.9 units a week and for women from 9.4 units to 7.6 units a week.

That, folks, is a twenty percent drop in the nation's alcohol consumption in just five years. Is that not newsworthy? Why wouldn't a state broadcaster think licence-payers would want to know a fact like that?

When a few medics wrote a letter to the Telegraph calling for minimum pricing, that was considered newsworthy.

When the Lancet picked a number out of the air and extrapolated it over twenty years, that was considered it newsworthy.

When alcohol-related deaths increased by a statistically insignificant amount, that was considered newsworthy.

But a twenty percent drop in alcohol consumption? Nah, who'd want to hear that? After all, it's hardly going to help the campaign for minimum pricing and a total advertising ban if people discover that the Booze Britain narrative is a myth.

The drop in drinking doesn't just apply to per capita consumption. Take the 'safe' drinking level, for example...

Since 2005 the GHS/GLF has shown a decline in the proportion of men drinking more than 21 units of alcohol a week and in the proportion of women drinking more than 14 units of alcohol a week. The proportion of men drinking more than 21 units a week fell from 31 per cent in 2005 to 26 per cent in 2010 and the proportion of women drinking more than 14 units a week fell from 21 per cent to 17 per cent over the same period.

Yes, but what about the young people—Britain's true binge-drinkers?

These changes were driven by falls in the younger age groups. Among men, the percentage drinking more than 21 units of alcohol a week decreased in the 16 to 24 age group (from 32 per cent to 21 per cent) and in the 25 to 44 age group (from 34 per cent to 27 per cent). Falls were also present among women; the percentage drinking more than 14 units of alcohol a week fell in the 25 to 44 age group from 25 per cent to 19 per cent.

Dammit! What about heavy drinking then? Surely that's gone through the roof...

When using the average weekly consumption measure, heavy drinking is defined as consuming more than 50 units a week for men and consuming more than 35 units a week for women. There have been falls in the proportions of both men and women who drink heavily since 2005. The estimates for men fell from 9 per cent to 6 per cent and for women fell from 5 per cent to 3 per cent from 2005 to 2010.

And so it goes on and on...

The proportion of men who reported drinking alcohol in the seven days before interview fell from 72 per cent in 2005 to 67 per cent in 2010. Similarly, the proportion of women who reported drinking alcohol in the seven days before interview fell from 57 per cent to 53 per cent over the same period. In addition, the proportion of men who reported drinking alcohol on at least five days in the week before interview fell from 22 per cent in 2005 to 17 per cent in 2010. The proportion of women reporting drinking alcohol on at least five days in the week before interview fell from 13 per cent to 10 per cent over the same period.

There is a downward trend in the proportions of men exceeding four units and women exceeding three units on their heaviest drinking day in the week before interview. The proportion of men exceeding four units on their heaviest drinking day was 41 per cent in 2005 and 36 per cent in 2010. The proportion of women exceeding three units was 34 per cent in 2005 and 28 per cent in 2010.

The estimates for heavy drinking follow a similar pattern. When using the heaviest drinking day in the last week measure, heavy drinking is defined as exceeding twice the Government daily benchmarks on a single day: more than 8 units of alcohol on that day for men and consuming more than 6 units on that day for women. The proportion of men drinking more than 8 units on their heaviest drinking day fell from 23 per cent in 2005 to 19 per cent in 2010. The corresponding estimates for women drinking heavily (more than 6 units) were 15 per cent in 2005 and 13 per cent in 2010.

The most pronounced changes have occurred in the 16 to 24 age group. Among men in this age group, the proportion drinking more than 4 units on their heaviest drinking day fell from 46 per cent in 2005 to 34 per cent in 2010 and the proportion drinking more than 8 units decreased from 32 per cent to 24 per cent over the same period. There have also been marked falls for women in this age group with the proportion drinking more than 3 units on their heaviest drinking day falling from 41 per cent in 2005 to 31 per cent in 2010 and the proportion drinking more than 6 units falling from 27 per cent to 17 per cent.

I think you get the picture.

Not one word of this was reported by the BBC, although they are able to find space for the dregs of junk science and thinly-veiled policy documents. I've come to expect nothing more from the BBC's health reporters, but the fact that the rest of the media have reported the findings of the General Lifestyle Survey in much the same way suggests that the Office for National Statistics press released it like this (if you want how deeply churnalism in engrained in Fleet Street compare and contrast the BBC's report with that of the Guardian ).

Pitiful.

Scottish smoking ban miracle touches the unborn

The miracles keep on coming in Scotland, soon there will be pilgrimages.

Drop in pregnancy complications after smoking ban
Complications in pregnancy have fallen as a result of the ban on smoking in public places, according to a new study.

Researchers found the ban, introduced almost six years ago, has led to a drop in the number of babies being born before they reach full term.

It has also reduced the number of infants being born underweight.

My word, this post hoc ergo propter hoc junk science sounds like the kind of rubbish Jill Pell keeps coming out with.

The research team, led by Professor Jill Pell...

Ah, Professor Pell, we meet again and under such similar circumstances. You may recall Jill "Pinocchio" Pell from her signature piece claiming that the heart rate plummeted after the Scottish smoking ban, but for sheer effrontery in the face of rock solid evidence, her subsequent article claiming that the asthma rate fell after the smoking ban takes the cake. Rarely has science met fiction so brazenly.

...looked at more than 700,000 single-baby births before and after the introduction of the ban.

The number of mothers who smoked fell from 25.4% to 18.8% after the new law was brought in, researchers discovered.

This, as you might expect from Pell, is a distortion of the truth. The 25.4% figure relates to 2001, some five years before the ban was introduced. Any honest researcher would surely use the figure for 2005 (22.5%) as the pre-ban measure. We already know from a previous Pell study that the ban had no effect on the smoking rate in the general population. Looking at the ISD figures, it is difficult to see any effect on expectant mothers as well. There is a general downward trend which continued after 2006.


The graph above might actually exaggerate the decline. I was interested to see, upon studying the ISD data, that the smoking ban coincided with (I shall not say caused as I am not a charlatan) a large increase in number of expectant mothers for whom no information on smoking status was available. In other words, more pregnant women are refusing to tell the NHS whether or not they smoke.


The likelihood is that many of these women are smokers but do not wish to be chastisted by the denormalisers of Scotland's health service. This suspicion is supported by the fact that the proportion of pregnant women who are lifelong non-smokers has barely moved for a decade.


Back to the news story...

Experts further found there was a drop of more than 10% in the overall number of babies born "pre-term", which is defined as delivery before 37 weeks' gestation.

There was also a 5% drop in the number of infants born under the expected weight, and a fall of 8% in babies born "very small for gestational size".

This is the meat of the research. As so often, the study has been press released before publication so we cannot see which statistical tricks Pell has employed, but we can use the official NHS records to see how her claims stand up. The data are available here.

The graph below shows preterm births (ie. less than 37 weeks gestation) as a percentage of all live births recorded in Scottish hospitals between 1996 and 2010 (the period that Pell claims to have studied).



The proportion of babies born prematurely in this period remained very constant (between 6.8% and 7.9%). The post-smoking ban years were unremarkable, with percentages of 7.3, 7.4, 7.6 and 7.2 (2007, 2008, 2009 and 2010 respectively). The lowest rate was in 1996. There appears to be no relationship with the general smoking rate, maternal smoking rate or the smoking ban.

I suspect what Pell has done here is taken the highest pre-ban figure (7.9%) and compared it with the lowest post-ban figure (7.2%). The difference between these figures in percentage terms is a little under 9% which, with a bit of statistical massaging, could become "a drop of more than 10% in the overall number of babies born 'pre-term'".

Since preterm births are the major driver behind low birth weights, it should be no surprise that there has been no major change in the number of babies with a low birth weight. Between 97.0% and 97.4% of all full-term pregnancies in Scotland in this period resulted in a baby of normal weight (2500 gm+). I can see no evidence of any 'smoking ban effect' in any of the ISD data. There are moderate random variations and nothing more.

Dr Pell said the research highlighted the positive health benefits which can stem from tobacco control legislation.

To paraphrase Mandy Rice-Davis, she would, wouldn't she?

She said: "These findings add to the growing evidence of the wide-ranging health benefits of smoke-free legislation and support the adoption of such legislation in other countries which have yet to implement smoking bans.

"These reductions occurred both in mothers who smoked and those who had never smoked."

Sorry, what?

"These reductions occurred both in mothers who smoked and those who had never smoked."

Doesn't that tell you something then, Pell? If you are claiming that the smoking ban reduced preterm births because it made people give up smoking, the fact that you found the same result with nonsmokers rather gives the game away, does it not? If, on the other hand, you're suggesting that reducing secondhand smoke miraculously reduces preterm births (I haven't read the study yet, but I wouldn't put it past you to indulge in such superstition), the findings for smokers strongly suggest that this is nonsense as well. Or perhaps you are going to claim that smokers somehow feel the benefit of secondhand smoke reductions as well. Nothing would surprise me at this stage.

"The potential for tobacco control legislation to have a positive effect on health is becoming increasingly clear."

Yes, yes. We understand why you keep producing this garbage. Why don't you go find yourself a street corner to shout from?

Researchers looked at data for babies born between January 1996 and December 2009, taken from the Scottish Morbidity Record, which collected information on all women discharged from Scottish maternity hospitals.

Which is exactly what I have shown above. Feel free to check the data yourself.


UPDATE: Michelle Roberts—easily the worst of the BBC's appalling health reporting team—has been suckered by this story. Her entry on Journalisted is an A-Z of pointless epidemiology. I notice the national press have ignored the story, presumably on the basis of 'once bitten'.

Pell's study has appeared on PLoS here. It's short on data but this is her killer graph...


This barely resembles the actual data from Scottish hospitals, but even so it takes a massive leap of faith to attribute the smoking ban to any part of it. The hard line represents the smoking ban, but Pell prefers to use the dotted line because "the Akaike information criterion statistics suggested that using 1 January 2006 as the breakpoint produced a marginally superior model fit than using 26 March 2006." Hey, whatever fits your a priori conclusion the best, Jill.

Even having moved that goalpost, it's plain to see that the fall in preterm births began around ten months before the smoking ban came in. In fact, it came well over a year before, because the timeline Pell is using is the date of conception, not birth. It must have been pretty galling for her to see that the largest drop in her graph preceded the ban and came to an end as soon as the ban came in. Moving the date back to January does not help her much in that respect. Furthermore, even if it had happened after the ban, it would hardly have been proof of anything. There are two little peaks in the graph (as there are in my graph above) followed by two drops. Peaks do tend to be followed by drops, y'know. Maybe Jill Pell should look up 'regression to the mean'.

Scottish smoking ban miracle touches to the unborn

The miracles keep on coming in Scotland, soon there will be pilgrimages.

Drop in pregnancy complications after smoking ban
Complications in pregnancy have fallen as a result of the ban on smoking in public places, according to a new study.

Researchers found the ban, introduced almost six years ago, has led to a drop in the number of babies being born before they reach full term.

It has also reduced the number of infants being born underweight.

My word, this post hoc ergo propter hoc junk science sounds like the kind of rubbish Jill Pell keeps coming out with.

The research team, led by Professor Jill Pell...

Ah, Professor Pell, we meet again and under such similar circumstances. You may recall Jill "Pinocchio" Pell from her signature piece claiming that the heart rate plummeted after the Scottish smoking ban, but for sheer effrontery in the face of rock solid evidence, her subsequent article claiming that the asthma rate fell after the smoking ban takes the cake. Rarely has science met fiction so brazenly.

...looked at more than 700,000 single-baby births before and after the introduction of the ban.

The number of mothers who smoked fell from 25.4% to 18.8% after the new law was brought in, researchers discovered.

This, as you might expect from Pell, is a distortion of the truth. The 25.4% figure relates to 2001, some five years before the ban was introduced. Any honest researcher would surely use the figure for 2005 (22.5%) as the pre-ban measure. We already know from a previous Pell study that the ban had no effect on the smoking rate in the general population. Looking at the ISD figures, it is difficult to see any effect on expectant mothers as well. There is a general downward trend which continued after 2006.


The graph above might actually exaggerate the decline. I was interested to see, upon studying the ISD data, that the smoking ban coincided with (I shall not say caused as I am not a charlatan) a large increase in number of expectant mothers for whom no information on smoking status was available. In other words, more pregnant women are refusing to tell the NHS whether or not they smoke.


The likelihood is that many of these women are smokers but do not wish to be chastisted by the denormalisers of Scotland's health service. This suspicion is supported by the fact that the proportion of pregnant women who are lifelong non-smokers has barely moved for a decade.


Back to the news story...

Experts further found there was a drop of more than 10% in the overall number of babies born "pre-term", which is defined as delivery before 37 weeks' gestation.

There was also a 5% drop in the number of infants born under the expected weight, and a fall of 8% in babies born "very small for gestational size".

This is the meat of the research. As so often, the study has been press released before publication so we cannot see which statistical tricks Pell has employed, but we can use the official NHS records to see how her claims stand up. The data are available here.

The graph below shows preterm births (ie. less than 37 weeks gestation) as a percentage of all live births recorded in Scottish hospitals between 1996 and 2010 (the period that Pell claims to have studied).



The proportion of babies born prematurely in this period remained very constant (between 6.8% and 7.9%). The post-smoking ban years were unremarkable, with percentages of 7.3, 7.4, 7.6 and 7.2 (2007, 2008, 2009 and 2010 respectively). The lowest rate was in 1996. There appears to be no relationship with the general smoking rate, maternal smoking rate or the smoking ban.

I suspect what Pell has done here is taken the highest pre-ban figure (7.9%) and compared it with the lowest post-ban figure (7.2%). The difference between these figures in percentage terms is a little under 9% which, with a bit of statistical massaging, could become "a drop of more than 10% in the overall number of babies born 'pre-term'".

Since preterm births are the major driver behind low birth weights, it should be no surprise that there has been no major change in the number of babies with a low birth weight. Between 97.0% and 97.4% of all full-term pregnancies in Scotland in this period resulted in a baby of normal weight (2500 gm+). I can see no evidence of any 'smoking ban effect' in any of the ISD data. There are moderate random variations and nothing more.

Dr Pell said the research highlighted the positive health benefits which can stem from tobacco control legislation.

To paraphrase Mandy Rice-Davis, she would, wouldn't she?

She said: "These findings add to the growing evidence of the wide-ranging health benefits of smoke-free legislation and support the adoption of such legislation in other countries which have yet to implement smoking bans.

"These reductions occurred both in mothers who smoked and those who had never smoked."

Sorry, what?

"These reductions occurred both in mothers who smoked and those who had never smoked."

Doesn't that tell you something then, Pell? If you are claiming that the smoking ban reduced preterm births because it made people give up smoking, the fact that you found the same result with nonsmokers rather gives the game away, does it not? If, on the other hand, you're suggesting that reducing secondhand smoke miraculously reduces preterm births (I haven't read the study yet, but I wouldn't put it past you to indulge in such superstition), the findings for smokers strongly suggest that this is nonsense as well. Or perhaps you are going to claim that smokers somehow feel the benefit of secondhand smoke reductions as well. Nothing would surprise me at this stage.

"The potential for tobacco control legislation to have a positive effect on health is becoming increasingly clear."

Yes, yes. We understand why you keep producing this garbage. Why don't you go find yourself a street corner to shout from?

Researchers looked at data for babies born between January 1996 and December 2009, taken from the Scottish Morbidity Record, which collected information on all women discharged from Scottish maternity hospitals.

Which is exactly what I have shown above. Feel free to check the data yourself.


UPDATE: Michelle Roberts—easily the worst of the BBC's appalling health reporting team—has been suckered by this story. Her entry on Journalisted is an A-Z of pointless epidemiology.

Pell's study has appeared on PLoS here. It's short on data but this is her killer graph...


This barely resembles the actual data from Scottish hospitals, but even so it takes a massive leap of faith to attribute the smoking ban to any part of it. The hard line represents the smoking ban, but Pell prefers to use the dotted line because "the Akaike information criterion statistics suggested that using 1 January 2006 as the breakpoint produced a marginally superior model fit than using 26 March 2006." Hey, whatever fits your a priori conclusion the best, Jill.

Even having moved that goalpost, it's plain to see that the fall in preterm births began around ten months before the smoking ban came in. In fact, it came well over a year before, because the timeline Pell is using is the date of conception, not birth. It must have been pretty galling for her to see that the largest drop in her graph preceded the ban and came to an end as soon as the ban came in. Moving the date back to January does not help her much in that respect. Furthermore, even if it had happened after the ban, it would hardly have been proof of anything. There are two little peaks in the graph (as there are in my graph above) followed by two drops. Peaks do tend to be followed by drops, y'know. Maybe Jill Pell should look up 'regression to the mean'.

A real scientist speaks

One of the bits of voodoo science upon which the anti-smoking extremists are pinning their hopes vis a vis plain packaging came from the pen of Linda Bauld. You may recall Bauld as the fantasist who insists that the smoking ban did no harm to England's pubs. She works at the UK Centre for Tobacco Control Studies, an organisation that the BBC correctly described as a "campaign group" over the weekend. Although she is not a scientist herself, she is the scientific advisor on tobacco control to the Department of Health.

Her study involved using eye-tracking technology to monitor how long people linger on cigarette health warnings. She claimed that non-smokers (but not smokers) look at warnings for longer on plain packets than on normal packets and concluded that: "Plain packaging will make health warnings appear more prominent and strengthen their impact." This finding was duly misreported by our cretinous media under such headlines as "Smokers ignore health warnings".

There are a couple of critical flaws in this logic. Health warnings only tell people what they have known about smoking since they were about five years old and it takes a massive leap of faith to think that people's decision to smoke will be altered by an few extra milliseconds looking at them. It is simply absurd to believe, in 2012, that people of any age start smoking without being cognisant of the risks.

More interestingly, a vision scientist at Royal Holloway, University of London, has carried out a very similar experiment but got some quite different results. Dr Timothy Holmes used eye-tracking technology on a sample of 59 students and found the following...

...we were surprised to observe two interesting results: the non-smokers looked at the warning messages much less than the other participants, and there was no difference between plain and branded package designs in the amount of time spent looking at the warning message.

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

Holmes' results are shown below. Non-smokers looked at the brand (blue) more than the warning (red) in both cases, but the type of packaging made no difference to either group.


So, on the one hand, you have a professional vision scientist who has no agenda and no axe grind finding that plain packaging won't make any difference (and giving plausible reasons to support his empirical data.) On the other hand, you have a professor of socio-management who works for an anti-smoking campaign group, using the same methods but finding that plain packaging will make a difference.

Ooh, who to trust?

Talk is cheap

"The era of big, bossy, state interference, top-down lever pulling is coming to an end."

—David Cameron, Prime Minister, 2008

"For too long, laws have taken away you freedom, interfered with your life and made it difficult for businesses to get on ... This Government is going to transform our politics so the state has far less control over you ... We'll get rid of the unnecessary laws – and once they're gone, they won't come back."

—Nick Clegg, Deputy Prime Minister, 2010

"In the past government has had a tendency to shout at the public from the sidelines rather than being down on the pitch with them."
— Anne Milton, Public Health Minister, 2010

"All our decisions must be evidence-based, and on that basis, we do not currently support an introduction of minimum pricing."

—Andrew Lansley, Health Minister, 2010

Fast forward to March 2012...

CHEAP booze is finally facing the axe as David Cameron launches a twin blitz on drinks and fags.

The PM is ready to press ahead with plans to introduce minimum pricing in an attempt to stamp out binge drinking.

Meanwhile Mr Lansley will spearhead a TV ad offensive warning smokers not to light up near children.

The campaign will be followed by a ban on tobacco displays in supermarkets starting on April 6. Smaller shops will be forced to end their displays in April 2015.

Mr Lansley will also press ahead with plans to force cigarette firms to sell every brand in plain grey packets with a big health warning to make them less attractive to kids [erm, aren't we supposed to have a public consultation on that first? -  CJS].

Whoever you vote for, the Department of Health's fake charities always win.

David Cameron: "Cheap drinks for me, but not for thee."

The easiest thing in the whole world

People say a lot of stupid things on Twitter and it's unfair to take off-the-cuff comments as definitive statements. However, if the stupid thing is then repeated twice, it seems fair to assume that it represents their sincere belief.

Last week, wrinkly rocker Simon Chapman applied himself to picking holes in my report about plain packaging. Having given due thought to the possibility that standardising the colour, shape and size of cigarette packs might just make life easier for those who counterfeit cigarettes, Chapman came back with this killer argument....



The evidence he presents is a short video clip in which an undercover journalist shows a Hong Kong counterfeiter a pack of Winfield Lights and asks him: "How close can you get to that?" The counterfeiter replies "100%". That's it. He doesn't say it's "100% easy" (even if he had, it would be a meaningless statement.) He certainly doesn't say that counterfeiting cigarette packs couldn't be made any easier. He just says that perfect replication is, in his opinion, possible. 
For Chapman, however, this statement indicates that there is a scientifically provable ranking of easiness and that counterfeiting elaborate cigarette packaging is right at the top of it. Perhaps it looks something like this...




As you can see from the graph, counterfeiting cigarettes is "100% easy". QED, there are no economies that can be made. It is literally the easiest thing in the whole world. My six month old daughter has been doing it for ages. I've counterfeited several packs whilst writing this.
Spot the logical flaw? Of course you do, and I put all this down to the early onset of senility that comes from of a life-time of wowserism and paranoia, but Chapman evidently thinks that he really has found a dazzling argument because he has pestered me about it twice since, most recently...


OK Simon, especially for you...

There isn't a Scale of Easiness that goes from 0% to 100%, and even if there was, it wouldn't be measured by the bravado of organised criminals. You have taken one idea— that it is possible to replicate a product perfectly—and confused it with a wholly different idea: that the product can be replicated with perfect ease. Having made that logical error, you then assert that it is impossible to replicate the product more easily.

That is manifestly untrue. Counterfeiting cigarettes is a complex process with significant barriers to entry and relatively high start-up costs. By asserting that barriers to entry could never be lowered, costs could never be cut, and the process could never be made more convenient or accessible, you make an absurd statement.

As with all propagandists, it is difficult to know whether Chapman is deliberately trying to mislead or is genuinely confused. If he is sincere, it demonstrates something that is common amongst cranks and conspiracy theorists. The guy in the video didn't say what Chapman wanted him to say so he changed the guy's words around in his head. He then made a basic error of logic which led to a patently ridiculous conclusion and yet, because he cannot see where his thought process went wrong—and because the conclusion matches what he wants to believe—he incorporates it into his dogma as if it were fact. Whereas other people would regard an absurd logical outcome to be the result of absurd logic, he treats the absurd as if it were rational and dismisses logic as "alchemy".

Simon Chapman edited the journal Tobacco Control for seventeen years.

Failure, failure, failure

A study published this week in Addiction reveals that the Italian smoking ban had no lasting effect on smoking prevalence and quit rates. The researchers found that there was a brief decline in the number of smokers when the ban came in, but that the smoking rate returned to pre-ban levels shortly afterwards.

Findings: Among males, smoking prevalence decreased by 2.6% (p = 0.002) and smoking cessation increased by 3.3% (p = 0.006) shortly after the ban, but both measures tended to return to pre-ban values in the following years. This occurred among both high and low-educated males. Among low-educated females, the ban was followed by a 1.6% decrease (p = 0.120) in smoking prevalence and a 4.5% increase in quit ratios (p < 0.001). However, these favourable trends reversed over the following years. Among high-educated females, trends in smoking prevalence and cessation were not altered by the ban. Among both males and females, long–term trends in the daily number of cigarettes, which were already declining well before the implementation of the policy, changed to a minor extent.

Conclusion: The impact of the Italian smoke-free policy on smoking and inequalities in smoking was short-term. Smoke-free policies may not achieve the secondary effect of reducing smoking prevalence in the long-term, and they may have limited effects on inequalities in smoking.

This study closely echoes the findings of a paper published last year in PLoS (mentioned on this blog in November) which reported a large increase in the use of nicotine replacement 'therapy' when the smoking ban was introduced in Scotland, but no long-term change in the nation's smoking prevalence. It also echoes another study published this month which found no change in the number of nurses smoking in France after smoking was banned in the workplace.

All of this runs counter to the widely held belief that smoking bans encourage smokers to quit. By contrast, new evidence continues to appear showing the efficacy of snus as a smoking cessation aid.

Among male quitters under the age of 45 years, 45.8 % of those who had used snus on their last attempt to quit were current non-smokers (OR = 1.61, CI 1.04-2.29), while 26,3 % of those who had used NRT were current non-smokers.

59.6 % of successful quitters and 19.5 % of unsuccessful quitters who had used snus as a method for quitting smoking had continued to use snus on a daily basis after quitting.

Conclusion: Norwegian men frequently use snus as a method for quitting smoking whereas women are more likely to use NRT. The findings indicate that switching to snus can be an effective method for quitting smoking.

You may also recall the study from 2010 which revealed that graphic warnings on cigarette packs had no effect on the quit rate (or initiation rate)—again, in contrast to the excitable claims made by 'tobacco control professionals'.

There were few changes post implementation of the picture health warnings in the number of health effects recalled or participant's perception of risk... There were no differences post implementation of the picture health warnings in the number of smokers reporting forgoing a cigarette when about to smoke one or stubbing out a cigarette because they thought about the health risks of smoking... Among young people, the impact of picture health warnings was negligible.

The evidence is mounting that the neo-prohibitionist approach of incremental bans is a busted flush, whereas the harm reductionist approach is not only more civilised, but is more effective in helping people who want to quit do so, rather than hassling and belittling people who don't. As I've said before, tobacco control is not a results-driven business. No one gets sacked for making the wrong call, they just move onto the next policy and hope nobody notices.

The priority for the neo-prohibitionists this year is plain packaging and the usual tired claims are being wheeled out about "overwhelming evidence"which exists only in their imagination. Will the politicians fall for it one more time or will they demand—at long last—that tobacco control be judged by past performance?


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UPDATE: In the comments, "Big" Dick Puddlecote brings my attention to yet another example of failure.

Smoking levels among adults in Northern Ireland have not reduced in the last five years, the health minister has said...

The Executive has introduced smoke-free legislation in public areas such as the workplace, bars and restaurants. It has increased age requirements and developed smoking cessation services. There are also measures to scrap vending machines and remove displays of cigarettes in shops...

Smoking prevalence among adults has remained around 24% since 2007 and for manual workers that rate is 31%.

Winning!

Mission creep

I wrote an article for the Yorkshire Post last week about plain packaging and the phenomenon of mission creep.

The tendency of pressure groups to move towards increasingly extreme positions is a familiar political phenomenon.

When the successful activist can only recapture the intoxicating feeling of victory by finding new causes to champion, the result is "mission creep".

Take the Smokefree Action Coalition, for example. Originally formed to campaign for the smoking ban, they have since lobbied for graphic warnings on cigarette packs, higher tobacco taxes, a retail display ban and a ban on vending machines. It is a tribute to their campaigning prowess that politicians have capitulated to all these demands, but this string of easy victories has left them scraping the policy barrel.

The link is here if you want to read it all.