Christopher Snowdon's Blog, page 272

Over yonder

A couple of blog posts are knocking around with my byline at the moment. In case you haven't seen them...

One is on the subject of the Dutch government finally giving smokers smoke respite.

The other is about the OECD apparently swallowing The Spirit Level's quack science. (And there's more on The Spirit Level authors' silly claims here.)

We warned you about people like this

"Bring on the nanny state"Is it Hate Week or something? Just two days after Jonathan Waxman's demand for diet policing, The Independent on Sunday publishes an opinion piece by Joan Smith entitled...

Filling your face with popcorn is not a human right

Funny that, because I'm a human and I thought I had the right to fill my face with popcorn. It's my popcorn, my money and my body, and, in any case, popcorn can be a nutritious, low-fat, low-calorie food.

What are these human rights of which you speak? Is filling your face with celery a human right? Is reading a book a human right? Is going for a walk a human right? For that matter, is writing ignorant, bigoted columns for loss-making Sunday newspapers a human right? If not, according to the logic of the bilge that follows, the state should put a stop to it.

As a breed, Conservative politicians hate the nanny state. So do right-wing columnists, some of whom are still whining about the fact that they can't smoke in public places.

Any suggestion that the principles behind the smoking ban be extended to junk food prompts near-apoplexy, as though we have an inalienable right to consume as much high-fat, sugary rubbish as we wish.

At least Jonathan Waxman had the good grace to wait a few paragraphs before throwing in the 'we did it to smokers, now let's do it to them?' argument. Smith, on the other hand, dives straight in there. I'm sure you can guess where this is heading.

I've never been convinced that eating popcorn is a human right...

As in the UN Declaration of Human Rights, you mean? What straw man is this? Nobody has ever said that eating popcorn, or anything else, is a right enshrined in international law, but in civilised countries we have this convention that says that people have a right to do something unless it is specifically proscribed by law. Perhaps Smith would prefer to live in a society in which everything is proscribed by law unless specifically permitted. If so, I will happily pay for a one-way flight for her to emigrate to such a nation on the condition that she promises to never return.

...and the argument that governments shouldn't intervene in the nation's eating habits looks shakier than ever. According to an analysis carried out at the Wolfson Institute of Preventive Medicine and published last week, around 40 per cent of cancers could be avoided by a change in lifestyle blah, blah, blah...

This is the same study that Waxman was citing on Friday as his excuse for having the state decide what people eat and drink. Amongst other problems, this study assumes that someone who gets lung cancer, for example, would otherwise not have got any form of cancer had they not smoked. Since the biggest risk factor for cancer is age, this is quite a major flaw. I refer you to Nigel Hawkes' analysis of it over at Straight Statistics. Hawkes points out that more than 60% of the 'lifestyle-related' cancers are due to smoking—a risk factor which has hardly been under-publicised in recent years—but that for nonsmokers, "adopting a perfect diet, drinking no alcohol, eating no red or processed meat, and maintaining a body mass index of less than 25 would actually reduce total cancer incidence by 13.3 per cent. Many people might think the sacrifice scarcely worth the reward."

Indeed. Particularly since, as he also notes, the majority of cancer deaths registered in England and Wales last year involved people over the age of 75. Unless Joan Smith believes that the alternative to cancer is eternal life, what is it that she thinks people should die of?

That figure is bound to rise as more people exceed sensible weight limits, with one study published in The Lancet predicting that half the population could be obese by 2030.

That study, frankly, is bullshit in a ball gown. A glance at recent trends in obesity indicate that it is highly unlikely that half the population will be obese in 19 years time. On the contrary, the rate seems to be flattening out. Actual figures are shown on the left of the graph below. The Lancet's projection is on the right. As with the '40% of cancers' study, The Lancet's fanciful prediction was designed purely to inspire half-witted busy-bodies to write half-witted opinion pieces in which they demand authoritarian policies from half-witted politicians. Joan Smith has not disappointed.

The cost in extra health care alone would be about £2bn a year...

No it wouldn't.

Last week, cancer charities were keen not to blame individuals for habits that raise their risk...

Of course they were, you fool. The whole idea is to place the blame on the government because what these campaigners want is 'tough action' from the government. Everybody knows that the individual is responsible for what he eats, drinks and smokes, but the lobbyists are hardly like to say that, are they now? Do try to keep up.

...it's clear that many people find it hard to resist fatty food and cheap alcohol, which leaves government intervention the only serious option.

Well, let's not be so hasty. Are we sure that all the other possibilities have been exhausted? Have you, for example, considered the option of fucking off and leaving us alone?

It's worked with smoking, which used to be enjoyed by more than half the male population and has now dropped to a fifth. The success of campaigns against tobacco, from graphic health warnings on cigarette packets to high rates of tax and an advertising ban, provides an optimistic model of how self-destructive behaviour can be altered. 

Ah yes, the "model". The anti-tobacco blueprint. The tobacco control template. The start of that slippery slope which we were told for years was a figment of our imagination.

How the drinkers scoffed when we told them that they were next. How the nonsmokers chuckled when they were warned that pizza would one day be equated with cigarettes.

Seems like only yesterday, does it not? These complacent souls now find themselves with no leg to stand on. How can they argue with Smith's prescription—graphic warnings, high taxes, advertising bans? Presumably she agrees with plain packaging, retail display bans and denormalisation as well.

And why not? The provide an "optimistic model".

Where do we draw the line between smoking and drinking? Where do we draw the line between drinking alcohol and drinking Pepsi? We cannot. Once we have accepted the healthist world view, no principled and logically consistent objection can be made against photos of rotten teeth on soft drinks. Those who welcomed the 85% sales tax on cigarettes are in no position to oppose an 85% sales tax on bacon. They can only wriggle and squirm and hope the puritans tackle their pleasures last.

And so, in a sense, I welcome the likes of Joan Smith and Jonathan Waxman for finally coming clean and alerting us all about what is afoot.

Unless it wants to look criminally irresponsible, the Government should tackle weight and alcohol problems with the same ferocity. Bring on the nanny state, and ignore the predictable protests.

The lines are drawn. We tried to warn you, we really did. Now whose side are you on?

A nasty piece of work

This man must be denormalisedThe endless slurry of stupidity in modern life makes it easy to become numbed to even the vilest viewpoints, but every now and again you encounter somebody whose worldview is so revolting that you wonder whether you can be of the same species. Such an individual is one Dr Jonathan Waxman who has an article in The Times (£) today under the headline...

To avoid cancer, let the State dictate your diet

Oh dearie, dearie me. Not a good start at all. However, writers don't get to pick their own headline, so let's give him a chance to explain himself.

This week, a Cancer Research UK study revealed that about 40 per cent of cancers could be prevented by changing the way we live. This caused a lot of headlines, but we have known for centuries that cancer is related to lifestyle. In the 16th century, Italian barber-surgeons observed that breast cancer occurred at an increased rate in nuns and concluded that the increased risk might be due to the nuns' apparent virginity — or rather that they had no children.

An interesting example to give, because breast cancer is indeed very strongly associated with childlessness. If doctors were to suggest that women who wanted to avoid breast cancer have as many children as possible as young as possible, that would be very sound advice. Strangely, I didn't see any mention of this in the Cancer Research report, but I did see a great deal about the much weaker association with drinking alcohol, which makes me wonder if there is a tendency to focus on certain 'lifestyles' while sweeping over 'lifestyles' under the carpet.

Inevitably, it is not long before we get to the anti-smoking blueprint...

The fight against tobacco shows that public health cannot be left to the individual...

No, it shows that it has not been left to the individual. It easily could be. And, by the way, there is no such thing as public health. There is my health and your health and their health. There is no communal pot of health.

Twenty-five years ago, about half the population smoked. Now that figure is 20 per cent.

Twenty-five years ago it was 1986, if I'm not much mistaken. In 1986, 33% of the population smoked. Maybe "about half" and "about a third" count as the same thing in the 'evidence-based' world of public health.

That shift would not have happened without powerful government intervention that took on the tobacco companies (and ignored the lamentations of the pension funds). Changing lifestyles not only needed information campaigns; it required mandatory and gory warnings on packets, an ever-increasing vice tax on cigarettes, advertising bans and forcing smokers out of pubs and offices and on to the streets with their habit.

Hang on, I thought the smoking ban was about 'protecting' all those poor bar-workers from being 'exposed' to secondhand smoke? That was the line in 2005-06 when ASH were campaigning for it. We were explicitly told that it wasn't a witch-hunt against smokers.

But now the truth can be revealed, as if we hadn't already guessed. It was about "changing lifestyles" by "forcing smokers out of pubs and offices and on to the streets with their habit."

Only with this "nannying" did the message begin to stick and the mindset and individual choices of the population begin to change.

Cobblers. The smoking rate began falling in the early 1950s and has been gradually declining ever since. The smoking ban, the graphic warnings and the denormalisation began in 2007 and the rate of decline has slowed or—by some estimates—halted in the years since.

We need the same strength of public campaigning to prevent the coming cancer epidemic caused by obesity. Already a quarter of Britons are overweight — and the figure is rising.

You mean 'obese', not 'overweight', right? They are two very different things, as a doctor might be expected to know. The obesity rate is close to a quarter, yes. But whether one looks at the number of people who are overweight or obese, it is straining the truth to say that that figure is "rising". It is too early to say that the rate is declining after the large rise of the late twentieth century, but certainly "flat-lining" would be the only honest assessment of the recent trend.



I'll warn you now, dear reader, that you may need a stiff drink for this next bit...

So should the State dictate how many sausage butties I have for breakfast? Should the Health Minister be e-mailing me about my five-a-day broccoli and bananas? Yes and yes. 

Sorry, but is this a wind up? "The State" should dictate how many sausage butties I have for breakfast?

Because my "freedom" has repercussions, not just on my health but on the rest of us. Private lifestyle choices have a tremendous effect on the public purse.

It's interesting that Waxman capitalises the word 'State', but puts the word 'freedom' in scare quotes, is it not? Gives you an idea of the value he places on the two.

As for smokers and the obese having a "tremendous effect on the public purse", not according to the vast majority of economic studies of the subject, it doesn't. Unless by "tremendous effect on the public purse" you mean saving money in pensions, benefits and healthcare costs. The table below shows the net lifetime healthcare costs of smokers, the obese and the 'healthy-living'. The smokers cost 220,000 euros, the obese cost 250,000 euros and the 'healthy-living' cohort cost 281,000 euros. Make your case on the basis on naked paternalism, by all means, but do not make it on economic grounds.

Some will argue that this is an affront to personal freedom. 

Jeez, d'ya think?

But the people with the least ability to make informed choices are the poor, who happen also to be more likely to smoke or be fat. 

Because the poor are so stupid and uninformed that they need the übermenchen of the public health establishment to force them to do what's right for them, is that it? They couldn't possible be rational actors like everybody else, could they? Here's an idea—since the poor are irrational and ignorant, why don't we stop them voting and form a coalition of doctors to preside over us? Then you lot could send us food parcels and 14 units of alcohol a week. Would that be enough control for you? Probably not.

Y'know, back in 1994, the tobacco company RJ Reynolds published an advertisement titled 'Today it's cigarettes. Tomorrow?' accompanied with photos of people eating burgers and drinking alcohol and coffee.



The text reads, in part:

Let's understand exactly what they're trying to do. They're pursuing a new era of prohibition, and in the process are ignoring the individual rights of not just the 45 million Americans who smoke but non-smokers as well. But the most threatening aspect of their program is their intention to force their views on the whole country. If they are successful in their bid to abolish cigarettes will they pursue other targets? Will alcohol be next? Will caffeine and cholesterol "addicts' need to be protected from themselves? Will books, movies and music get the treatment?

Not many people took this warning seriously, partly because it came from an industry which had an obvious vested interest and partly because the scenario seemed so outlandish. Who in 1994 could seriously envisage a campaign to ban smoking in the movies?! Who could imagine that people who eat high fat foods would ever be classed as addicts?! In all likelihood, RJ Reynolds never fully believed it themselves.

Three years later, ASH published a paper that addressed the slippery slope issue in relation to the ban on tobacco advertising. It read, in part:

Not a precedent for wider restriction

A ban on the promotion of tobacco is occasionally portrayed as the harbinger of wider restrictions and an authoritarian 'nanny state'.

Often this is made into a reductio ad absurdem [sic] argument in which the government is portrayed as regulating everything. This is false: the case for action against tobacco is based on its unique characteristics and enormous toll of death and disease even when used as intended. No other product comes close to matching this.

Contrast that with Waxman's article today, riddled with factual errors though it is...

Not only do we need to ramp up the public health campaigns that encourage us to ditch the doughnuts. But we will have to go further and ban adverts for high-fat foods.

Sure we do, and the rest. A reductio ad absurdum argument, huh? Who looks absurd now?

Stanton Glantz: How to deceive without actually lying

Last year, the Netherlands relaxed its smoking ban after a campaign by small bar owners and their customers. It came after a battle between the Dutch and EU governments' lavishly-funded NGOs and fake charities who masqueraded as nonsmokers' rights groups against Wiel Maessan and others gave their time for free to undo the worst of the ban's damage to small bars. 
This is how things work these days. State funded astro-turf groups create the illusion of support for draconian laws. Ordinary people fight against them. Usually the astro-turf groups win. Sometimes, as in the Netherlands, ordinary people claim a scalp.
Anti-smoking dinosaurs like Simon Chapman and Stanton Glantz (pictured left) try to maintain the facade of it being a battle between the whole of humanity—made up of people who don't smoke and people who do smoke but want tobacco control to save them—versus the big, bad, evil, all-controlling tobacco industry.

Stanton Glantz knows that the tobacco industry weren't involved in the campaign to relax the smoking ban in the Netherlands. He knows because he interviewed Wiel Maessan personally several months ago and got it from the horse's mouth. If that weren't enough, he's failed to uncover a scintilla of evidence of industry involvement with the campaign despite looking under every stone. It was a grass-roots campaign by people who believed in property rights, individual freedom and—in the case of bar-owners—self-interest. End of story.

This is mind-blowing information to someone like Glantz who is so far down the rabbit hole of delusional self-righteousness that he probably believes his own studies. So when he writes up his account of what happened in the Netherlands, he can't bring himself to tell the truth, but he can't lie either. Instead, he uses innuendo and suggestion to give the reader the impression that Big Tobacco was at work, while never risking libel by stating it up front.

The introduction of his latest article (from the European Journal of Public Health ) gives the flavour of what is to come...

Introduction

The tobacco industry has made maintaining smoking in hospitality venues a priority worldwide by organizing and sometimes financing hospitality and 'smokers' rights' groups to oppose smoking restrictions. Bars are particularly important to the tobacco industry because they are adult only venues where young adults can be targeted [what on earth does this mean? - CJS]. As claims of adverse economic effects on restaurants have lost credibility, the tobacco industry has focused on bars as a wedge to undermine 100% smoke-free laws, including in the Netherlands.

Get the picture? It's the tobacco industry who want people to smoke in bars, not smokers or the people who own the bars.

It carries on in much the same vein, with Stan always talking about the kind of things the tobacco industry might do, while being careful to never say that they actually did them.

Echoing tobacco industry messaging, opponents accused the government of violating individual freedom, and called Minister Klink a 'nanny'.

Perhaps, because of the dominance of the pro-industry messaging in the media, the health groups did not gain much traction.

And then finally, on page 5 of this 7 page article, we get a glimpse of the truth.

While the tobacco companies did not play an open public role in these events...

They didn't play any role in these events—open or covert, public or private—and Glantz knows it. If he had any evidence to the contrary he would present it. Instead, he continues with the same innuendo.

...the strategies and rhetoric deployed to oppose the smoking restrictions parallels tobacco industry global strategies, including arguing that smoke-free laws represent a form of intolerance and extremism [they do—CJS], and that, despite consistent evidence to the contrary, smoke-free laws harm bars [they do; it's basic economics—CJS]. Other industry tactics are to encourage and publicize venues flouting the law to create the perception of widespread noncompliance [I went to Amsterdam when the ban was in force and there was widespread noncompliance—CJS], to encourage (and fund) hospitality venues to challenge the law in court, and to promote ventilation.

And just in case you haven't taken the nudge and the wink, he finishes with this...

Conclusion

Owner-run bars in the Netherlands have been used by tobacco industry allies as a wedge to undermine public perception of and encourage noncompliance with smoke-free regulations. (Compliance remained high in other hospitality venues). The reversal in the Netherlands was the result of a failure to present and defend the law as a way to protect non-smokers, together with continuing to allow smoking rooms. There is a danger that the Netherlands may be cited by the tobacco industry and its allies as evidence that 100% smoke-free bar laws are unpopular and unenforceable and that tobacco control best practices embodied in the FCTC do not work.

"Allies", "parallels", "tactics", "pro-tobacco messaging". What weasel words these are. Misleading but never quite libellous; untrue but never quite lies. Using the same techniques, I will say this about the great mechanical engineer...

There is no direct evidence that Stanton Glantz is a criminally insane fraudster. That said, his refusal to acknowledge facts which clash with his delusions is a common phenomenon often observed in psychiatric patients. Although never officially certified with a mental illness, Glantz's constant references to dark conspiracies for which there is no evidence is a classic symptom of paranoid schizophrenia, as is the belief that ordinary people are working for sinister organisations. Asylums are filled with people with delusions of grandeur who obsessively repeat the same words over and over as if they had a profound meaning.

Glantz has recently written an article that was published in The Lancet, the same journal that published the notorious study on autism and MMR which has been described as "deliberate fraud" involving "clear evidence of falsification of data." Glantz has also worked with Prof. Anna Gilmore.

Glantz has written a book in which he explains his beliefs, thereby mirroring the strategies and rhetoric deployed by the suspected murderer O. J. Simpson, the disgraced politician Jeffrey Archer and the genocidal dictator Adolf Hitler whose book, Mein Kampf, was written whilst in prison in Germany. Like many of the most evil men in history, Glantz uses the Latin alphabet and owns a pen.

On the ninth of September 2001, two passenger aircraft were flown into the twin towers of the World Trade Centre. Glantz did not play an open public role in these events, although he has never publicly denied involvement. Nor has he denied involvement in the disappearance of Madeleine McCann, the schoolgirl who went missing in Portugal six years later. Some eye-witness reports suggested that the kidnapper was a white male.

Stanton Glantz, a white male, has ever been formally charged with racially motivated violence. He lives in the United States of America, where lynchings of ethnic minorities were common until quite recently. His home state of California endorsed eugenics and carried out an extensive sterilisation programme which did not end until 1979, at which point Glantz was working at the University of California, San Francisco.

You see how easy it is? Glantz has long since scraped through the barrel and at this rate will each the core of the Earth by 2019. It's garbage. The truth is—as his study tells you if you can cut through the guff—that the tobacco industry only appears twice in this story. On the first occasion, they were invited by the government to attend a meeting as a stakeholder. The industry's lobbying at this meeting was ignored and a total ban was introduced. On the second occasion, a law firm working on behalf of the hospitality industry allegedly approached the Dutch Cigarette Manufacturers Association to ask for funding so that bar-owners could sue the government. The Dutch Cigarette Manufacturers Association turned them down.

That's yer conspiracy, right there. Scary, huh? If you want to hear what really went on, I suggest you listen to the conversation between Wiel Maessan and Stanton Glantz (listen here).

Warped minds

"WTF is this?" you may well ask. Pop over to Carl Philips' place and find out.

McDonalds 1 - Food Fascists 0

Ronald McDonald: He's lovin' it
The story of San Francisco's ban on Happy Meals has come to an amusing conclusion. The city of killjoys has just enforced a prohibition on restaurants giving away toys with "unhealthy" food—a law that has only one intended target (the red-nosed fellow above). Needless to say, the law was passed for the chiiildren.

The politicians bragged that they had instituted a de facto ban on the Happy Meal when they passed the law. Their assumption was that the crafty corporate types had programmed kids to incessantly nag their parents to buy meals that the nanny state had decreed unhealthy by dangling a plastic toy in front of impressionable youngsters.

McDonalds' response has been beautiful in its simplicity: sell the food and the toys separately, charging 10 cents for the toy. Unlike the bone-headed prohibitionists, McDonalds understands that the toys have a value in themselves and parents are continuing to buy them—and the Happy Meals—in abundance.

A shrewd move by McDonalds, then, but these are Californian politicians we're talking about here; they could be outwitted by a bag of sand. The really smart part of Maccy D's counter-offensive is to give the 10 cents to charity. Not just any charity, mind, but the Ronald McDonald House charity which supports seriously ill and injured children.

So, think of the chiiiildren and buy a McDonalds toy. And while you're here, why not enjoy a Happy Meal?

Happy Meal sales haven't slowed down, McDonald's is making even more money, and parents are now spending an extra 10 cents per kid every time they stop by the golden arches.

Touché.

The Points interview

Some readers may be familiar with Points —the blog of the Alcohol and Drugs History Society — which has been on my blog roll for most of the year. As you might imagine, it is right up my street and so I was more than happy to participate in the Points interview to discuss my latest book The Art of Suppression.

Read the interview here.

A little taste of prohibition

Dec. 1920: Prohibition agents show off 89 confiscated stills.
(From here)

From The Morning Advertiser:

Five men who masterminded a major counterfeit vodka manufacturing and bottling plant in Leicestershire, were sentenced to a total of 17 years and ten months on Friday at Hull Crown Court.

The plot was uncovered in an industrial unit by HM Revenue & Customs (HMRC) when they carried out raids in September 2009. They seized 9,000 bottles of fake vodka, branded as Glen's, manufacturing equipment, bottles and counterfeit packaging – labels and cardboard boxes, at the remote industrial unit at Moscow Farm near Great Dalby, Leicestershire.

The court heard there was a complete lack of any fire safety measures which posed a serious and life threatening hazard. The alcohol vapour alone could have triggered a major explosion if the lights had been switched on or a naked flame or cigarette had been lit.

It certainly could. You may recall what happened back in July...

Boston fire blast unit producing illegal vodka
An industrial unit in Lincolnshire, where five men were killed in an explosion, was being used to produce illegal vodka, police have confirmed.

This happened in Boston, England in 2011, by the way, not Boston, Massachusetts in 1921. Easy mistake to make.

This is part of a growing trend, as the UK's sky-high alcohol taxes combine with economic hardship to fuel demand for the black market. Half of all rolling tobacco is smuggled into the country. Counterfeit cigarettes are openly sold in the streets. We've got the smoke-easies (last week I was in a pub in central London where the landlord told people to light up and leave their cigarette stubs on the floor). Now we have criminal gangs producing poisonous moonshine and blowing themselves up with illegal stills. All we need now is Elliott Ness dancing the Charleston and we can have a full-blown 1920s revival.

The neo-prohibitionist fools believe they can avoid the consequences of prohibition so long as society falls short of a total ban. That's now how it works. It's a sliding scale. In The Art of Suppression I write about 'little prohibitions'—bans, price hikes, excessive regulations—which cause the same problems, only on a smaller scale. After all, as John Stuart Mill said: "Every increase of cost is a prohibition, to those whose means do not come up to the augmented price."

Still, at least people aren't getting literally blinded by moonshine like they did during Prohibition.

No, wait. They are.

25p vodka made me go blind
Christmas partygoers have been warned off bargain booze that can leave you blind. Eastern European gangs are flooding corner stores and even going door to door selling illicit drink in a £1billion- a-year trade.

Last night trainee accountant Dale Shaw, 27, told how he nearly lost his sight drinking the dodgy liquor. After being invited to a family party, Dale bought a bottle of Drop Vodka from an off-licence in Bradford, West Yorkshire.

He said: "I'd never heard of the brand before but it was £4 cheaper than the others. After downing a quarter of the bottle, Dale began to feel more drunk than usual and his vision began to blur.

But by the next morning he could not see at all and was suffering excruciating pains in the lower half of his body. "As soon as I woke I knew there was something wrong," he said. "I was in agony and my sight was almost completely gone."

Dale was taken by a relative to Bradford Royal Infirmary where a doctor immediately recognised he was being poisoned by the bootleg spirits. The cut-price vodka contained methanol – alcohol used in explosives, anti-freeze and racing car fuel – and not the safe ethanol found in legal booze.

Expect much more of this if Alcohol Concern and the BMA get their way.

Velvet Glove, Iron Fist review

The journal Social History of Medicine has recently (well, two months ago) reviewed my first book Velvet Glove, Iron Fist: A History of Anti-Smoking . The review is behind a pay-wall, but as it is fairly short I trust they won't mind me reproducing it here.

Velvet Glove, Iron Fist is a fast-paced critique of the late twentieth- and early twenty-first-century public health focus on lifestyle behaviours. The book centres on smoking, which Snowdon, in common with anti-smoking activists, sees as the blueprint for increased regulation of individual health behaviour for the common good. Snowdon traces the history of anti-smoking campaigns from the early seventeenth century through to the present day, via campaigners such as Lucy Page Gaston in early twentieth-century USA and the National Socialist regime in 1930s and early 1940s Germany. Rather than making the simplistic argument that current regulations on smoking exceed anything the Nazis hoped to implement (although he makes this point), Snowdon's aim is to unveil the financial interests which have grown around the tobacco control movement and the spurious epidemiology used to back up some of its claims, particularly in relation to passive smoking and 'third-hand smoke' (that is, the residual nicotine that remains on surfaces after a cigarette has been smoked).

Much of the material in Snowdon's early chapters is re-worked from existing historical accounts of smoking, but he presents the material in an interesting and accessible manner. The more substantive part of Snowdon's argument comes in the later chapters, where he follows the development of the tobacco control movement from local initiatives to its global position today, a development which has gathered pace in the last decade and a half. In 1994, leaked documents acknowledging that the tobacco industry had been aware of the addictive nature of cigarettes and 'had deliberately misled the public for decades' (p. 191) undermined the notion of the smoker's right to choose. At the same time, concerns about passive smoking legitimated moving the debate beyond individual rights towards a raft of measures justified as within the public interest, such as increased taxation and restrictions on smoking in public places. These measures went beyond previous approaches, such as educating and informing the public about the dangers of smoking, to health and offering advice on how to quit.

This shift in the direction of anti-smoking campaigns has been chronicled elsewhere, most notably by historian Virginia Berridge (Marketing Health, Oxford University Press, 2007). However, Snowdon argues that the case against passive smoking was (and crucially for his argument, remains) scientifically unfounded, epidemiologically dubious and manifestly overstated. He seeks to call the tobacco control movement to account for unsubstantiated statements such as '[j]ust thirty seconds of exposure [to smoke] can make coronary heart function indistinguishable from smokers' (Snowdon's emphasis; p. 332). He cites comments from Sir Richard Doll, one of the epidemiologists who established the causal connection between smoking and lung cancer, that 'the effects of other people smoking in my presence is [sic] so small it doesn't worry me'. But such views went against the tide: Doll was obliged to later state he had been speaking in a personal capacity (p. 248).

While Snowdon is correct to highlight questionable tactics which go beyond sound public health, and to highlight the dangers to individual liberties which arise from those tactics being applied to other lifestyle behaviours, he undermines his case by downplaying the risks of smoking to individual health. He states that 'some people might become addicted and some of those might then become ill and die' (emphasis in original, p. 323), a statement which flies in the face of medical evidence.* 'Will' would surely be more appropriate. Similarly, to dismiss concerns about excessive alcohol consumption as 'panic' fails to take into account the very real social, as well as medical, harm caused by alcoholism.** Snowdon's attack on the health inequalities agenda (pp. 296–300) ignores the differences in longevity and mortality experienced in different social groups within the developed world. Further, although there is a detailed summary of the epidemiological evidence relating to passive smoking, there is a frustrating lack of referencing in other parts of the book. Regarding passive smoking, Snowdon by-passes the influence of Roy Castle in the UK context, a popular musician and television personality who died of lung cancer in the early 1990s despite being a non-smoker, and did much to bring the subject to public attention.

These criticisms notwithstanding, Velvet Fist, Iron Glove is an enjoyable read which surely proves that smoking has not lost its ability to provoke debate and reaction in over four centuries. It remains to be seen whether the pendulum will continue to swing towards prohibition, or whether smokers will enjoy a renaissance.

* 'Will' would probably have been a better choice of word, although in the context of the paragraph (which is about degrees of risk from cholera to gambling), it makes more sense. On the whole, I don't think the book downplays the risks of smoking at all.

** Alcoholism is always with us. Panics aren't. The hysteria about 24 hour drinking and 'binge-drinking' can fairly be described as a moral panic - see, for example, this study.

Almost half

I nearly missed this little story in the Daily Mail...

Tobacco firm gave thousands of pounds worth of hospitality to nine MPs who opposed smoking bill
MPs who received thousands of pounds worth of hospitality from one of the world's largest tobacco companies opposed a new law banning smoking in cars.

The parliamentary register of members' interests shows Japan Tobacco International, which produces Benson & Hedges, Silk Cut and Camel cigarettes, spent £23,000 entertaining 20 MPs in the past six months.

Almost half of them voted against a Private Member's Bill banning smoking in cars carrying children.

"Almost half of them" means "less than half of them" — which doesn't sound like much of a return for sending 20 fat cat MPs to the Chelsea Flower Show (for that is what happened). So how does that compare to the MPs who were not treated to corporate hospitality?

The vote went in favour of the bill by 78 votes to 66. If we exclude the 20 votes of the MPs above, it leaves a vote of 67 to 57. Therefore 46% voted against the bill—or, if you are the Daily Mail, "almost half of them".

Amongst the MPs who accepted tickets to the flower show, 11 voted for and 9 voted against. Therefore 45% of them voted against the bill.

Behold the power of Big Tobacco!