Christopher Snowdon's Blog, page 276

Somebody's lying

They say you're entitled to your own opinions, but not your own facts.

Wise words, but that's not how it works in tobacco control. Spot the difference between these two BBC news stories taken three months apart.

25 March 2011

Scotland's smoking ban hailed as anniversary approaches
Sally Haw, senior scientific adviser for the Scottish Collaboration for Public Health and Policy, said: "The ban really has been one of Scotland's big public health success stories.

"This bold step has really paid off."

Ms Haw cited a study by Glasgow University which showed a 15% reduction in the number of children with asthma being admitted to hospital in the three years after the ban came into force.

27 June 2011

Scottish health boards 'complacent' over asthma care
Research into the care of young people with asthma has exposed "shocking" complacency by some Scottish health boards, according to charity Asthma UK.

Asthma UK said the number of emergency admissions had remained unchanged for a decade - suggesting the asthma of many young people was still being badly managed.

Asthma UK Scotland's national director Gordon Brown said: "This report makes shocking reading - especially when you consider Scotland has one of the highest rates of childhood asthma in the world.

"Some health boards are doing some things very well - and this is down to the excellent staff within managed clinical networks.

"However, it seems that at a strategic level some complacency has crept in - that asthma has somehow been 'fixed' and priorities have now changed.

"This is borne out by the fact there has been no noticeable change in the unacceptably high emergency hospital admissions for children and young people with asthma in the last decade."

It is impossible for both these statements to be true. Either emergency hospital admissions for children with asthma fell by 15% after the smoking ban or they have remained unchanged for a decade. Someone's not telling the truth. Is is the "study by Glasgow University" or Asthma UK?

You can probably guess the answer. If I told you that the Glasgow study was penned by the infamous Jill Pell, you would be in no doubt at all.

Readers with a long memory will recall that Pell's study was the sheerest junk science. There was no effect from the smoking ban on asthma admissions. In fact, the first year of the Scottish smoking ban saw the largest number of childhood asthma admissions of the decade. Asthma UK is correct. Pell is wrong. Again.

Here we have two 'facts' which are totally at odds with each other appearing on the same news website in the same year. One fact is the number of children who actually went to hospital with asthma. The other is a piece of statistical jiggery-pokery created for political ends. And yet only one of them is true. The other is a fraud which has taken the place of the truth thanks to repetition and the appeal to authority (it was published in the prestigious, peer-reviewed  New England Journal of Medicine ). The real truth, meanwhile, appears almost by accident in a different context and no one at the BBC makes the connection.

This is the parallel universe created by the charlatans of the anti-smoking industry. They are entitled to their own facts. Whether or not they are true is of no consequence. They want them to be true and that is all that matters.

It is ridiculously easy to see through this garbage. The real hospital admissions data for asthma are available online, just as the heart attack data are. It takes a matter of minutes to distinguish fact from fiction and yet there is only silence and tumbleweed. If the mainstream media do not feel inclined to expose blatant policy-based evidence when it is in its crudest form, what hope is there of more subtle scientific abuses coming to light?

[Thanks to Ivan for spotting the two stories above.]

The situation in Europe

A bit of news from Spain:

First smokers' club opens
Smokers are free to light up behind the closed doors of a new 'members only' club in Alicante.

The club – believed to be the first legally registered smokers' club in the Valencia region –has attracted more than 200 members, all aged over 18.

Meanwhile in Greece:

Smoking will be once again permitted in Greece given the country's poor financial situation [but smoking bans are good for business! ASH says so]. The new measure will allow smokers to smoke inside casinos and big nightclubs exceeding 300m2.

According to the decision of Finance and Health Ministers, Mr. Venizelos and Mr. Loverdos, casino and big nightclub owners will be authorized to set up a smoking area, which could cover 50% of the total acreage of their business.

Meanwhile in France:

Gentleman's smoking lounge makes Parisian comeback
While most people are obliged to freeze on the pavement to keep up their cigarette habit, since the ban was introduced three years ago, a growing number of nightspots are offering exclusive and law-abiding shelter for smokers, complete with pianos, leather armchairs, and cigar lockers.

French law still allows indoor smoking spaces provided they have state-of-the-art ventilation and that no staff operate inside.

Consenting adults making grown up decisions for themselves — could this radical idea ever catch on?

This all comes after the Netherlands, Germany, Croatia, Portugal, Belgium, Denmark, Macedonia, Poland, the Czech Republic and several other countries relaxed their smoking bans (or introduced limited bans from the outset). The British media continues put out the message that the whole world is adopting the "comprehensive" smoking ban. The truth is that, along with the Irish, we have a ban that is exceptionally draconian, uncompromising and intolerant.

The lights are coming back on all over Europe. If you haven't signed the petition to review the English smoking ban, do it now.

Panic on a Plate by Rob Lyons: A review

In the last eighty years, the proportion of household income spent on food has dropped from a third to less than a tenth. Fruit and vegetables from around the world are on the shelves all year round. Women are no longer chained to a life of domestic drudgery. Malnutrition and rickets are a distant memory. For the first time in history, we who are lucky enough to live in the West do not have to worry about food.

But worry we do – about genetic modification, fast food, BSE, childhood obesity, adult obesity, salt, margarine, cholesterol, fat, pesticides, red meat, food miles, carbon footprints and school dinners. At the very moment when we should be most relaxed about the food supply, we are bombarded with fears. Fast food is "addictive", so we are told, and the food industry is trying to kill us for profit. Unless we take drastic action, most Britons will be obese by 2030.

As Rob Lyons patiently explains in this splendid plea for sanity, these beliefs owe more to ignorance and prejudice than fact. Take the humble hamburger, which obesity crusaders have chosen as their very own Moby Dick. On the face of it, it is bewildering why "two all beef patties, special sauce, lettuce, cheese, pickles, onions on a sesame seed bun"—to quote the old Big Mac slogan—should be the embodiment of evil. A burger is only bread, meat and salad. Each Big Mac contains 500 calories – a fifth of a man's daily 'limit' - and you wouldn't want to copy Morgan Spurlock's silly experiment of eating nothing else, but it is no more fattening than the supposedly more wholesome alternatives. Ketchup is rich in vitamin C and so are fries - surprisingly, a portion of fries contains between a quarter and a third of an adult's daily recommended vitamin C intake. There are better candidates for demonization in every middle class kitchen. "Cheese is roughly one third fat. Parmesan is also pretty salty. Olive oil is pure fat. Butter must be, by law, 80 per cent fat," writes Lyons. "Honey and raisins – usually regarded as 'good' – are practically pure sugar. Orange juice is 87 per cent water, almost all the rest is sugar."

Although equally calorific, pasta is 'good', chips are 'bad'. Fizzy drinks are out, but fruit juice – though more sugary – is in. Whether measured by salt, sugar, fat or calorie content, there is little to distinguish 'junk food' from haute cuisine. Our perception of good and bad food has less to do with nutrition than it does with class. The dominant view of diet in modern Britain, Lyons argues, "has more to do with a combination of middle-class angst and plain old-fashioned snobbery than anything else." If you are what you eat then junk food is for junk people. Oh, how we sneered at those ghastly common folk in Rotherham when they shoved fish and chips at their offspring through the school railings. Except that these 'junk food mums' - these 'sinner ladies' - were actually delivering meals, including sandwiches and jacket potatoes, which any adult would remember from their own school-days, and were only doing so because the school had operated a lunchtime lockdown to force the hapless children to eat Jamie Oliver's low-fat fodder.

The Rotherham 'sinner ladies'
Jamie Oliver is the proverbial bad smell in Panic on a Plate, popping up with depressing regularity as the voice of the diet police. After making the transition from Sainsbury's shill (catchphrase: "none of that low fat malarkey") to canteen crusader, the TV chef turned a reasonable campaign for better school dinners into a witch-hunt against the "tossers" and "arseholes" who dared to give their offspring a packed lunch. Few images sum up the absurdity of the obesity panic than the stocky mockney berating stick-thin kids for eating chips. If you watched it with the sound turned off, Jamie's School Dinners was an hour long illustration of how few school children are overweight. Turn the sound up, however, and Oliver was saving these young 'uns from certain death.

Sausage, beans and chips might not be the most adventurous dish, but it is a perfectly nutritious lunch for active teenagers. With their boundless energy and growing bones, children burn off more calories than stout celebrity chefs. They also have naturally conservative palates, hence the nosedive in school dinners being served after the government capitulated to Oliver's demands and substituted the much-despised Turkey Twizzlers for broccoli.

There is little that can be usefully said about food beyond the common sense observation that calories consumed should be roughly commensurate with energy expended. For the food faddists, it is not a question of excess versus exercise, but of wholesome food versus killer junk. Despairing of the "numpties" of Rotherham, Oliver could only sigh in exasperation: "If these mums want to effectively shorten the lives of their kids and others' kids, then that's down to them." Like many a culinary campaigner, Oliver is fond of repeating the grotesque lie that today's children will die before their parents. Even when put in its less misleading form of 'this generation will die at a younger age than their parents', this reference to the 'obesity timebomb' remains unlikely and is belied by ever-increasing life expectancy estimates. Obesity is not going to bankrupt the NHS. Centenarians might.

The inevitability of parents burying their children in extra-large coffins is one of several oft-repeated 'facts' parroted by dietary dogmatists which do not stack up. Campaigners rarely acknowledge that obesity rates levelled off on both sides of the Atlantic ten years ago, and the claim that fast food is 'addictive' requires a definition of addiction that is so broad it would include any activity people find enjoyable. The claim that it is cheaper to buy 'junk food' than cook a meal at home is demonstrably untrue and the sainted Mediterranean diet has proved to be less healthful than was believed thirty years ago, while fears of salt, GM crops, BSE and manmade fertilisers have been shown to be greatly exaggerated when not utterly groundless.

The middle classes have been susceptible to food faddism since the Victorian era, when the 'back to the land' movement ignited the first stirrings of popular vegetarianism and organic farming. As the urban population began to outnumber that of the countryside, a romantic, idealised view of nature emerged which can be seen to this day in such eccentric organisations as the Soil Association and the Center for Science in the Public Interest. "The underlying temper of our times," writes Lyons, "is that anything processed or industrialised can be seen as adulterated and harmful, while anything that appears to be natural or close to nature can be regarded as pure and uncorrupted."

Jamie Oliver and his chins
The fetish for organic vegetables epitomizes this foodie flim flam. Study after study has found no health benefits from eating organic produce and even organic devotees are unable to distinguish one from the other in blind trials. Far from being led by the evidence, the organic movement is deeply suspicious of science. Fearful of the slightest trace of 'chemicals' and suspicious of industry, the organic/anti-GM crowd is backward looking and elitist (hello, Prince Charles). Over-priced and over-rated, organic food is little more than a tax on the credulous.

Just as Oliver yearned to return to the Golden Age of school dinners (no soggy semolina or concrete chips in his recollection), nostalgia for a bygone age of wholesome grub figures heavily in the modern war on fast and/or convenient food. "Don't eat anything your great-great-grandmother wouldn't recognize as food," says the writer Michael Pollan. Mmm, all those handpicked vegetables and buxom maidens toiling over churns of butter. Jumpers for goalposts. Marvellous.

Or perhaps not. Your grandmother would probably not recognize spaghetti, hummus or kiwi fruits as food, but she would certainly be familiar with bread and dripping, gruel, fried everything and the early symptoms of scurvy. The range and quality of British food has improved immeasurably since the turn of the last century and supermarkets have broadened our horizons considerably. An illustration of this came when Delia Smith updated her 1970s cook books in 1995 and found that: "Almost everyone now has access to good olive oil, fresh herbs, imported cheese. I found myself over and over again deleting the words 'or if you can't get it…'" More choice, lower prices, less toil. What's not to like?

What the food faddists don't like is the modern world. After decades of lingering on the fringes of public life, lentil-munching hypochondriacs have now found an audience at a time when the micromanagement of private behavior is the raison d'etre of British politics. The public health establishment is gearing up for a legislative crusade of tax rises and advertising bans on food which is overtly based on the anti-smoking campaign. Big Food is already being wheeled out as the new Big Tobacco, and politicians who lack bigger ideas are happy to lead the assault against what they are told is a new 'epidemic'. The food on our table will be targeted by law-makers and single-issue campaigners for many years to come. The myths and half-truths discussed in Panic on a Plate will be echoed often and loudly. Prepare yourself by reading this excellent book.


Buy Panic on a Plate from Amazon (UK) or Amazon (USA)

Stanton Glantz: Clueless clown

"..and then divide by the number you first thought of..."
It is a rare month when Stanton Glantz, doctor of mechanical engineering and professor of something-or-other at the University of San Francisco, does not publish some advocacy-based junk in a low-grade public health journal. The old fellow has many imitators these days, but efforts like this from the forthcoming issue of Tobacco Control show that he will not give up his crown without a fight.

Movies with smoking make less money

Stanton A Glantz, Jonathan R Polansky

Objective: To determine the relationship between presence of smoking in films and total box office receipts.

The conclusion of this study is rather given away by the title. By reviewing a whole load of films, Glantz found that movies which depicted smoking made l3% less money than those which didn't. The methodology was as follows:

...we compared the reported box office gross receipts (in 2010 dollars) of the 1316 films, with and without tobacco imagery, that ranked among the top 10 in ticket sales in any given week of their 'domestic' (USA and Canada) theatrical release between 2002 and 2010.

What a pitiful thought it is that someone in California has been paid to watch over a thousand movies to look out for a glimpse of tobacco smoke. And how tragic it is that Glantz keeps the resulting dossier in his office to be whipped out for studies like this. Nevertheless, the methodology is not unreasonable and we shall assume—possibly naively—that the basic conclusion is sound.

The question is: So what? No one has ever claimed that directors portray smoking to boost sales. It is an artistic decision which reflects a real world in which 1 in 5 people smoke. Surely Glantz is not going to insist—as he does with smoking bans—that cow-towing to tobacco controllers is going to be good for business?

Fear not, dear reader. Even Stan is not prepared to mistake correlation and causation so grievously (although it surely won't be long before advocates use this study to tell Hollywood: "Get rid of smoking in your films and you'll boost sales by 13%"). He does not claim that smoking in films is the cause of lower revenues. He does not explore what the actual reasons may be, but it seems likely that smoking is more common in indie films, gritty dramas, European releases and other movies which tend to make less money than big budget cartoons and family blockbusters.

Since there is no cause-and-effect here, what is the point of the study? For Stan, the point is that Hollywood has nothing to fear from his SmokeFree Movies ruse because a lack of smoking on the screen does not put off punters.

One hypothesis to explain the persistence of high levels of smoking in US films is that smoking pays off at the box office.

Er, no it isn't. As far as I'm aware, nobody has ever made such an argument and it is telling that Glantz does not provide a reference for this claim. Nobody seriously believes that people are specifically attracted to films which show smoking, nor is anyone deterred from seeing films which do show smoking. It's irrelevant at the business end. This is purely an issue of artistic freedom versus censorship.

Having constructed his straw man, Glantz demonstrates that it is false. Well done him. However, while he shows that tobacco imagery has no effect on box office takings, he inadvertently manages to show that his SmokeFree Movies scheme would financially damage the movie industry.

This study shows why movie studios tend to push for a PG-13 rating: such movies make 18% more at the box office compared ones with an R rating.

This is the real point of SmokeFree Movies. The purpose is not merely to restrict smoking in the movies to R rated films. The purpose is to coerce movie studios into getting rid of all smoking from their films for fear of losing their PG rating and, therefore, a significant proportion of their audience.

Under Glantz's regime, the makers of The Simpsons Movie or Avatar would have to think very carefully about whether they wished to maintain their artistic vision or maintain their PG rating. If they say "screw these cranks, the film stays as it is" then they will lose their PG rating and, therefore, will lose money—to the tune of 18%, according to Glantz, although this gap may not be entirely due the classification status.

What Glantz demonstrates in this study is that the presence or absence of smoking has no effect on box office takings (no one ever thought it did), but that the SmokeFree Movies plan will lead to a significant loss in box office takings if directors choose not to capitulate to the anti-tobacco fanatics.

Glantz, however, comes to exactly the opposite conclusion in his new study:

...implementing an R rating for smoking to remove it from youth-rated films will not conflict with the economic selfinterest of producer-distributors.

Garbage. R ratings have a negative effect on sales. The SmokeFree Movies plan will lead to more films being given an R rating. Therefore, the SmokeFree Movies plan will very much "conflict with the economic self-interest of producer-directors."

The only way to escape this financial damage will be for film-makers to remove every hint of smoking from their films. That is what Glantz wants, of course, but if they refuse—as they have every right to do—they will be penalised at the box office. This is blackmail, pure and simple. Comply or die. If directors refuse to cleanse their films to suit the zealots they risk losing millions of dollars. No wonder Hollywood has consistently told them to sod off.

While I was out

Back from Manchester now and what good fun it was. If you've e-mailed me or ordered a book while I was away I will catch up today. In the meantime, a few links that have caught my eye in the last few days.


More blatant temperance propaganda from Auntie Beeb

Full link here. It's woefully unbalanced. Amongst the lowlights is this attempt to make people believe there is "no safe level of alcohol consumption" (a message you will be hearing very often in the years ahead).

Katherine Brown, head of research at the Institute of Alcohol Studies, says the current guidelines and how they are communicated may be giving the public misleading information.

"We need to be very careful when suggesting there is a 'safe' level of drinking for the population. Rather, we need to explain that there are risks associated with alcohol consumption, and that the less you drink the lower your risk is of developing health problems.

"We hope the government use this as an opportunity to help change perceptions about regular drinking being a normal, risk-free practice."

No mention of the Institute of Alcohol Studies being almost entirely funded by the Alliance House Foundation. Nothing special about that, you may think, except that the Alliance House Foundation used to be called the United Kingdom Alliance for the Suppression of the Traffic of all Intoxicating Liquors. As readers of The Art of Suppression will know, they led the charge to bring Prohibition to Britain in the nineteenth century. Don't you think that BBC readers would be interested to know that the oh-so impartial sounding Institute of Alcohol Studies is the modern incarnation of the Quaker teetotal movement?


If in doubt, blame it on smoking

As I write this, the big health story on the BBC is a rewritten British Medical Journal editorial. Rather unusually, it deals with a genuine public health issue: Tuberculosis. Rather less unusually, it finds a familiar culprit.

TB smoking toll 'could reach 40m'

A lung charity said global efforts to fight TB are being undermined by the tobacco industry's "aggressive promotion" of smoking in some places.

TB is an infectious disease which has a cheap and effective vaccine. Far be it from me to suggest that 'public health professionals' are too lazy, thick and/or incompetent to use medicine to prevent epidemic diseases, but...

He said: "It is nearly 20 years since the World Health Organization declared tuberculosis to be a 'global health emergency'.

"Since that time rates have risen rather than fallen, and smoking increases the risk of getting - and dying from - TB..."

What a pathetic indictment of the WHO and all the other vastly funded international 'public health' organisations this is. But don't blame them, blame BIG TOBACCO.

"...and smoking increases the risk of getting - and dying from - TB. Concerted international efforts are now under way to try and turn the tide of TB, but this important research shows that all these efforts may be undermined by the tobacco industry's continuing aggressive promotion of smoking in many parts of the world."

The NHS and the Center for Disease Control both have webpages listing risk factors for TB and neither of them mention smoking at all, so I wonder how big a factor it is. Whatever the case, TB remains an entirely preventable disease brought about by infection. If 'public health' spent as much time dishing out TB jabs to the poor of the world as it does fretting about secondhand smoke and alcohol units, the epidemic would be under control by now.


Alcohol Research UK

The newly founded Alcohol Research UK (formerly the Alcohol Education and Research Council) has a different funding issue and has just set out what seems to be a clear stance on taking money from industry.

Receiving Funds from the Alcohol Industry

Alcohol Research UK will not accept funds, in cash or in kind, from the alcohol industry

Really? That would represent a bit of a change on AERC's last year in operation when it was heavily funded by Drinkaware...




The Drinkaware Trust is entirely funded by drinks industry, so are we to assume that AERC will be rejecting these donations under its new name of Alcohol Research UK? A little clarification is in order...



Seems unambiguous to me. Leaving aside the baffling question of why the drinks industry is funding the temperance lobby, why is Alcohol Research UK denying that such funding takes place?

Anybody?


Thirdhand woo continues to be used to hassle smokers in the USA

Christus St. Frances Cabrini Hospital in Alexandria will implement an anti-tobacco policy for its entire campus starting July 1 of next year, expanding the policy put in place two years ago for employees of the women's and children's areas. The policy will prohibit the use of tobacco products by employees while on their shifts, including when they are on breaks. It also will not allow employees to work if their clothing smells like smoke. "About a month or two ago we sent a letter to all of our associates to their homes," hospital administrator Lisa R. Lauve said. "We sent a letter notifying them that they had a year to make whatever adjustments they needed to make to be able to comply with the policy that would not allow them to smoke during the hours that they work." Hospital officials are aiming to reduce patients' and employees' exposure to toxins that linger in fabrics from a recently burned cigarette, also known as third-hand smoke, Lauve said. Such toxins present a special danger for the developing brains of infants and small children.

It's like the Enlightenment never happened. If the intellectual climate continues to decline at the current rate we'll be building wicker men and having dung for dinner by 2020.


And finally, a glimmer of sanity

...from a surprising quarter. Dr Harry Burns is Scotland's Chief Medical Officer. It turns out there's one issue on which we see eye-to-eye (from obscure committee hearing)...

Dr Burns: I feel very strongly about this. Over the past year or two, since a number of us who have been carrying out research internationally in this area pretty much agreed the fundamental psychosocial drivers of health inequalities, I have been looking quite closely at the kinds of interventions that seem to correct some of that imbalance. At this point, I should say in response to Mike Brown's point that this is all down to inequality in society, that that is not the case. That fallacy comes from a epidemiologically very flawed book called "The Spirit Level", but that is another point.

Good for him.

More later.

Out and about in October

Should you be in or around Manchester or London in the next few weeks, you might feel inclined to pop along to one of the events I'll be speaking at.

The first is a fringe meeting at the Conservative conference in Manchester this very Sunday. Hosted by the Adam Smith Institute:

The Individual v The State - The battle for lifestyle freedom

Other panelists:

Philip Davies MP
Daniel Hamilton, Director – Big Brother Watch
Alex Massie, freelance journalist – Spectator blogger

Date: 2nd October 2011
Time: 5.00pm to 7.00pm
Location: Radisson Edwardian, Stanley / Livingstone Suite, 38-40 Peter Street, Manchester, M2 5GP (outside the security zone)

RSVP: sally@adamsmith.org
Food and drinks will be provided

The second is also a fringe event in Manchester and will be something of a rematch of this summer's Voices of Freedom debate in which Peter Hitchens defended the authoritarian argument against smokers (and drinkers, and motorists, and...). Should be lively.

Civil Liberties Up in Smoke: what rights do smokers have in a free society?

Venue: Barbirolli Room, Bridgewater Hall, Lower Mosley Street

Other participants:

Mark Littlewood, Institute of Economic Affairs
Peter Hitchens, Mail on Sunday
Dan Hamilton, Big Brother Watch

Monday 3 October, 4.30-5.30pm

Towards the end of the month I will be back in London for the Battle of Ideas for 'Seduced by Stats?', a discussion of how statistics are misused and misrepresented by special interest groups. Or, at least, that's what I'll be discussing.

Speakers:

Timandra Harkness
—journalist and writer; co-writer and performer, Edinburgh Festival Fringe smash hit Your Days Are Numbered: the maths of death

Bryan Joseph
—actuarial partner, London, PwC

Chris Snowdon
—author, Velvet Glove, Iron Fist and The Spirit Level Delusion: fact-checking the Left's new theory of everything

Chair:
Hilary Salt
—founder, First Actuarial plc; chair, Manchester Salon

Saturday 29 October, 12.15pm until 1.15pm, Lecture Theatre 2, Royal College of Arts

Full blurb here.

Scotland prepares for failure

Tomorrow sees the start of new temperance laws in Scotland which will ban two-for-one offers and group discounts. The putative 'health' lobby has been blaming such offers for 'binge-drinking' for years. At midnight tonight, they will have a sudden change of heart and declare that these cheap deals were never the real problem and that much tougher action is needed to stem the mythical alcohol epidemic.

This is how it works. You might recall that selling alcohol below cost price was the Great Evil until the British government announced plans to stamp out the practice. At that point, the temperance lobby admitted that below cost sales were incredibly rare and demanded tougher action.

Prof Ian Gilmore, of the Royal College of Physicians, said in practice it was a "small step" with "no effect at all on the health of this nation". "If you go round the supermarket shops today, even where they're heavily discounted, they will not fall below this level."

Today, an editorial in The Scotsman accepts that Scotland's new laws will probably have no effect and opens the door to the inevitable tougher action.

It was a sound idea in theory, stopping an obvious economic incentive to over-indulge, but like so many ideas it appears it will not work in practice. As we report today, the supermarkets have already found a way around it by the devastatingly simple device of reducing the price of a bottle of wine, or packs of beer.

Public health professionals outwitted by the devastatingly simple? Say it ain't so!

Alas, it is so, and the BBC has noticed that Scotland borders a country that is marginally less of a nanny state.

Online deals are being used to get round new laws banning discounted promotions on alcohol in Scotland.

The legislation, which comes into force on Saturday, will stop deals such as two-for-the price-of one and group discounts on wine.

Tesco has emailed customers to say they can still get wine discounts because cases will be dispatched from a depot in England.

Damn you, open borders! Curse you, worldwide web! A plague of your house, free trade!

Those of you who have been dipping into my new book The Art of Suppression (reviewed by Dick Puddlecote here) might recognise the old 'cross border sales' problem from America's attempts to introduce statewide prohibition. In came the rum-runners and the mail order delivery companies.

Since it was not illegal for drinkers in dry regions to order alcohol by mail order from wet regions, local prohibition was primarily a problem for the poor who depended on the saloon. For the middle class, as Towne recalled, "it was mighty easy to give a dinner party with plenty of liquid refreshment. All one had to do, it seemed, was to lift the telephone receiver in Bangor, and ask that Boston send over a supply of whatever one desired."

American politicians, under heavy pressure from the dry forces, responded to this 'loophole' by banning cross-border sales with the Webb-Kenyon Act in 1913. That Act ultimately pathed the way for national Prohibition seven years later. The Scots cannot do the same since it would certainly be viewed as a restraint of trade by the European Union.

And speaking of things the European Union won't allow...

The SNP will, of course, argue that the way to deal with this is for their flagship policy of a minimum price per unit of alcohol to be re-introduced, as it has promised to do in this session of Holyrood. In this the Nationalists are, again, right in theory - a minimum price, if set high enough, would probably reduce alcohol consumption.

"If set high enough" is the key phrase. The proposed 40p or 50p limit would make everyone a little poorer but it is very unlikely to lower overall consumption. The rich (doctors, politicians etc.) would not be affected at all and chronic alcoholics will never be put off by higher prices. Possibly a few moderate consumers might reduce their intake somewhat, but that would be a pyrrhic victory.

But there are two problems. The first, is the extra money goes to the retailers, mainly the big supermarkets...

When businessmen and politicians collude to screw the citizen, we should expect nothing less. But whilst it would be annoying to see supermarkets (or anyone) profit from an illiberal law, who makes the money is not the problem per se. The problem is that minimum pricing is a highly regressive policy that takes money from the poorest people in society.

Besides which, it won't work.

...and the second is that it is unlikely to stop those who crave alcohol from purchasing it.

Indeed. This is not a trifling flaw in a scheme that seeks to reduce alcohol-related harm. Why are we even talking about a policy that can't be introduced under EU law and, even it is could, won't bloody work?

The answer, I suppose, is that failure is the lifeblood of the neo-prohibitionists. They have to introduce laws that won't work. They'd be out of a job if the perceived crisis disappeared. Their motto is: "That didn't work, let's do it again." Same number of people smoking after the smoking ban as before it? Let's extend the ban. Graphic warnings had no effect? Try plain packaging. Higher prices lead to more smuggling? Make 'em even higher. Banning below-cost selling made no difference? Let's ban two-for-one deals. Banning discounts failed? Introduce minimum pricing.

This pattern is so familiar that The Scotsman can predict the response to the discount ban's failure before the law has even come into effect.

If these two measures, one coming into effect tomorrow, the other to be legisated for soon, do not succeed, the SNP might further its case for Scotland having powers over taxes levied on alcohol as a more logical, and fairer solution since the money raised would go to government

And so it continues.

The Art of Suppression

10 October 2011 sees the publication of my new book The Art of Suppression: Pleasure, Panic and Prohibition since 1800. This is the baby I've been working on since finishing Velvet Glove, Iron Fist more than two years ago and I consider it to be my best work yet. I hope you'll agree.


The Art of Suppression: With thanks to the
ever-glorious Devil's Kitchen for the jacket design
The idea was to create a biography of The Prohibitionist and seek an explanation for why bans begin. I wanted to see how substances—which is to say 'drugs' in the modern sense of the word, including narcotics, alcohol and tobacco—go from being benign and acceptable to becoming demonised and illegal. How does this happen? More importantly, who makes it happen?

The result is a panoramic study of prohibitions around the world, from opium-smoking in China and the crusade against alcohol in the USA to the more recent European ban on snus and the ongoing war on designer drugs. This is a story of religious zealots, vested interests, political opportunists and social deviants. Above all, it is the story of moral panics. If there is a single characteristic that unites The Prohibitionist wherever and whenever he (or she) surfaces, it is the reliance on fear over hope.

Some of the subject matter has been covered before, notably America's 'Noble Experiment' with alcohol suppression and the War on Drugs, but I hope that I have found enough fresh material to hold the interest of those who are already familiar with these wretched tales of failure. Other stories, such as the ban on snus, the attempt to ban alcohol worldwide, and Britain's quixotic battle against the likes of mephedrone ('Meow Meow') are told for the first time in this book.

The chapters are divided as follows:

1. Bone dry forever: Alcohol suppression in the USA

2. Prohibition averted: The campaign for a dry world

3. Opium: The dawn of the War on Drugs

4. Snus: If you can, ban

5. Narcotic moonshine: Designer drugs and the media

6. The Art of Suppression

The breadth of the subject matter meant that the research was exhausting at times and I wondered if I would ever get it finished, but reading it now, The Art of Suppression is what I wanted it to be—a lively, amusing and (hopefully) thought-provoking collection of stories which highlight a subject that is more relevant than ever in these prohibitionist times. This is a true labour of love and I'm very proud of it. You can read the introduction here.

The RRP is £11.99 (UK) or $19.99 (US). If you would like to receive a copy before it is officially released (signed, if you like), I can offer the book to readers of this blog at the discounted rate of £9.99 or $17.99 each—and that includes free postage.

For readers in the UK:

UK and Europe (£)Signed copy £9.99Unsigned copy £9.99
For readers in the rest of the world:

Rest of the world (US$)Signed copy $17.99Unsigned copy $17.99
Because Utopia is only ever one ban away...

Puritans then and now

I'm grateful to Michael McFadden for alerting me to an article in the New York Times (City's Battle Against Smoking Goes Back Centuries). In particular, this reference to the Woman's Christian Temperance Union caught my eye. When not fighting for Prohibition, this band of puritans spent a great deal of time battling tobacco, as readers of Velvet Glove, Iron Fist will recall.

In 1907, the Woman's Christian Temperance Union in Manhattan began inspecting library books to eliminate smoking heroes and heroines from modern novels.

A bunch of zealots vandalising artistic work to further an obsessive political agenda? This sounds rather familiar. I suppose 1907 was a bit early to go after smoking in the movies, but their ideological descendants have got that base covered and, as mentioned in a recent post, the latter-day temperance movement will no doubt soon demand that booze be banished from our screens (for the sake of the children, natch).

How strange it is that we have 20/20 vision when it comes to identifying cranks and puritans in earlier times but are so blind to them in the present day.

Some real research into alcohol

In August, former British Medical Journal editor Richard Smith discussed an encounter with two sociologists. The topic of discussion was 'binge-drinking' and the role of parents. One of the sociologists was his daughter. She was unsurprisingly against "tough love" from parents. The other was this person:

A much older sociologist at the lunch said that it was fashionable to blame parents for everything and that there wasn't good evidence of the influence of parenting.

This sentence tells you quite a lot about sociologists. It might help explain why sociology is treated with such disdain by a large section of the public (unfairly, IMHO). It is, I think, blindingly obvious that the people who raise you have a profound influence on your character, prospects and behaviour. If "older sociologists" dispute this it is perhaps because their horizons have never extended much beyond school and university. (There is an amusing video of a sociologist describing her experience of going to Las Vegas after the American Sociological Association accidentally held their annual convention there.)

More importantly, ideological axe-grinders—of whom there are many in sociology—like to blame problems on things that they can change by force of law. Why focus on important but complex issues like parenting and education when you can focus on simple but trivial issues like advertising and pricing?

Activists, neo-prohibitionists and anti-capitalists are much happier blaming the corporations and the institutions, man, than looking at the real factors behind excessive drinking and alcoholism.

I dislike and distrust 'alcohol control' partly because I put a high value on freedom but also because I strongly believe that their broadbrush stategy is ineffective, costly and harmful, since it ignores the real issues. It is a neo-prohibitionist population-level response when it should be a targeted response to the minority who need help.

Considering how implausible it is that corporations could mould minds in ways that friends and family cannot, it is remarkable how entrenched is the view that parenting has only a minor influence on behaviour. Both nature (genetics) and nurture (parenting) have been downplayed in academia since the 1960s to such an extent that when the Joseph Rowntree Foundation (JRF) found that family and friends are the biggest influence on drinking behaviour, they described it as an "inconvenient truth".

JRF have produced successive reports showing the same thing, most recently in June when they reported that "family and friends have a strong influence on teenagers' drinking patterns, and are stronger influences than some other factors – such as individual well-being, celebrity figures and the media."

Well, duh, you may say. Even so, the temperance lobby managed to harness the findings for their own ends (as the Quaker teetotaller Joseph Rowntree would no doubt have wished). The ubiquitous Don Shenker said...

"Government ministers must also look at some of the causes of why it is so easy for children to obtain alcohol, usually from the home.

"Government should look to see if they've done everything they can to stop the large supermarkets from continuing to heavily promote cheap alcohol which incentivises more alcohol purchases and therefore results in more alcohol being stored in the home, blah, blah, blah..."

Note how he takes a report that discusses a deep-rooted social factor and turns it into an issue about access and pricing. It's no accident that this guy is in the lobbying business. He's good at it.

Since then, the think-tank Demos has produced a report which broadly echoes JRF's findings, but using a more sophisticated methodology and coming to a more sophisticated conclusion. JRF found a link between parent's drinking habits and those of their offspring, whereas Demos found the link with the particular types of parenting. 'Tough love', they say, is the best way to bring up a child. 'Disengaged' is the worse.

None of this should be a great surprise, as one of its authors, Jamie Bartlett, said:

This is quite intuitive. It does not mean parenting is the 'cause' of binge-drinking, as some reports have put it, or that it is the only factor. But it is important.

Note that Bartlett, unlike certain advocacy groups, has the integrity not to shout 'causation' here, even though the associations being reported are stronger than any epidemiological finding you'll read about this month.

The risk of excessive drinking at age 16 is 8.36 (836 per cent) times higher if a child's parent has a 'disengaged' parenting style rather than one of 'tough love'.

The whole report, which is now available to download, exhibits a degree of academic rigour that is rarely displayed by partisan groups and is frequently absent in the peer-reviewed literature (sadly, these two elements frequently merge together). This is a credit to Demos—and a vindication of think-tanks, which George Monbiot ludicrously believes are "crushing democracy" (because democracy would be so much better served if the people George doesn't like were silenced)—but it is also an indictment of the state of research into this, and other, contentious topics. There is a refreshing absence of an a priori conclusion in this report and, almost uniquely amongst the current literature, there are no policy demands. It's difficult to imagine now, but there was a time when ending an academic study with a political call-to-arms would have been viewed as crass and unprofessional. Demos's report takes us back to those good old days when there was a division between science and politics.

What is striking is how many unspoken facts are laid out openly from the start. Many of them are the kind of things I've been saying on this blog and elsewhere for some time. They are the facts that do not get aired on Panorama or in the newspapers.

On alcohol consumption, for example:

In strictly medical terms, binge-drinking in the UK – as measured as more than twice the recommended daily allowance of alcohol consumed in a single episode – has been falling for at least five years in a row, and is not significantly higher than in other European countries.

Indeed it has. And, as I have said before, alcohol consumption in Britain today is unexceptional both in historical terms and in relation to other wealthy nations...

UK per capita alcohol consumption is unremarkable by comparison with other countries of a comparable size and income level, and well below historic levels in the eighteenth or very early twentieth century. Moreover, the majority of the population either do not drink, or do it within the government's lower risk limit.

There are a couple of points with which I disagree. For example...

Unfortunately, there has been a marked increase in the number of people who are unconcerned by the long-term health effects of their behaviour – and even their immediate personal safety.

I have not heard this claim before and I am not at all convinced that it is true. The reference they give does not seem to support the assertion that people are less concerned about their health and safety than previous generations. There may be research elsewhere showing this, but my own, admittedly jaded and anecdotal, view is that the people are more obsessed with long-term health and safety than ever before.
I also think the following statistic could have been treated with greater scepticism: 

There has been a steady increase in reported alcohol-related hospital admissions over the last decade. In 2009/10 there were 1.1 million admissions related to alcohol, which was an increase of 12 per cent on the previous year and around double the number in 2002/03, when there were 510,200 admissions. However, it is to be noted that the majority of alcohol-related admissions were older people, likely to be suffering from long-term alcohol misuse.

It is certainly true that the majority were old, and often very old, people. Whether they were suffering from long-term alcohol misuse is more questionable. As this eye-opening article by Nigel Hawkes explained, 'alcohol-related' hospital admissions are estimates of the crudest variety. Admissions figures are added up and then large percentages are hived off and designated 'alcohol-related'. More than half of the so-called 'alcohol-related admissions' are for hypertension and heart palpitations, and the definition of 'alcohol-related' has been expanded to such an extent in the last decade that I see the figures as being essentially useless. What we are seeing is an increase in old people going to hospital for various reasons. Tellingly, the proportion of admissions that are 'alcohol-related' has barely changed over this period. The very fact that alcohol-related hospital admissions have doubled in a decade, at a time when alcohol consumption has been falling should make us ask serious questions about the reliability of these data.

What, then, is the problem with British drinking habits? It is not one of overall alcohol consumption in the general population, but of the behavior of a minority.

However, the last decade has seen changes to the way people drink. A small, but possibly growing, number of young adults in the UK is drinking to extreme excess, often in an intentionally reckless and very public way, putting themselves and others at risk of harm – and causing considerable social and financial cost.

How much this has changed in the last decade, it is difficult to say. As the authors indicate, it is not clear whether the number of people drinking to "extreme excess" has risen at all. There is more than a hint that our recent obsession with 'binge-drinking' falls under that most useful of sociological terms, the moral panic.

With more people going to university, more disposable income, people marrying later and having children later, there are very plausible socio-economic reasons for drinking and 'binge-drinking' to be on the rise. Alcohol consumption is undoubtedly higher now than it was fifty years ago, though not higher than 100 years ago. There is also evidence of greater drunkenness than in most other countries.

The UK consumption average for a single drinking episode is the highest in Europe, and the drinkers in the UK have the fourth highest average number of drinks per day overall.

I suspect it was always thus. Northern European drinking habits and all that. But, again, this is not a question of overall alcohol consumption so much as patterns of alcohol consumption. It would be helpful if we could ditch the silly term 'binge-drinking' and return to calling it drunkenness. Or at least tipsiness, for that is all you need to be to meet the ludicrous modern definition of 'binge-drinking'.

That being the case, we believe the task at hand, and the proportionate and liberal response to binge-drinking, is to help create an environment in which people are free to drink alcohol – but behave in a responsible manner when they do.

But what, if anything, can be done? I have always maintained that pricing has the least effect on the people who most need to be targeted. (Exhibit one: the homeless.) This seems to be borne out by the data.

One study by the Centre for Economics and Business Research (CEBR) found that heavy drinkers are in fact likely to be the least responsive to changes in price, meaning a minimum unit price of 50 pence per unit would reduce alcohol consumption by harmful drinkers by a very small amount: around two pints of beer per week.

Sin taxes are highly regressive. It is always fascinating to see supposed left-wingers supporting regressive taxation when 'vices' are concerned, despite conclusive evidence that they widen inequality and exacerbate poverty.

The distributional impacts of minimum pricing are heavily contested, and have been questioned by a recent report by the CEBR, which argues that minimum pricing is a regressive measure because people on lower incomes typically pay more as a proportion of their income on alcohol, and will therefore be the most affected.

And if pricing really made a difference, we would expect countries which have the highest alcohol taxes—such as the UK—to have the lowest rates of binge-drinking.

The evidence on how minimum pricing would affect binge-drinking is not conclusive. Countries where excise tax on alcohol is very high also have very high levels of consumption.

In other words, the real-life evidence suggests that minimum pricing would be a futile and counterproductive endeavour. The real drivers of hazardous drinking are not price or advertising, but factors which are beyond the reach of government, and therefore of little interest to those who demand remedial legislation.

It appears that although not the only determinant of drinking behaviour among young people, parenting can and does have a dramatic effect on it. Good parenting has positive effects on young people's drinking behaviour and there is indirect evidence that it builds the kinds of personal qualities and relationships that guard against risky behaviour in general. If there is an optimal parenting style for reducing the risks of early and excessive binge-drinking, it is the tough love, authoritative style cited above.

There is more to this report than a message of 'blame the parents'. It is rather more nuanced than that—go read the rest to see why—but nurture is clearly very important and should not be a surprise to those of us who are not "older sociologists".




Insofar as alcohol is a problem in society, it is a problem of public order and—for a small minority—an issue of addiction and health. In my experience, people who behave like idiots when drunk are idiots when sober. Drunkenness may bring this to the fore, but it is the underlying lack of respect and self-restraint that is the real problem. The nanny state panders to, and encourages, the irresponsibility and indiscipline that is at the heart of the problem. Don't blame the drug (alcohol) for these people. Blame them and, if you wish, blame their parents. As Frank Zappa once said: "A drug is not bad. A drug is a chemical compound. The problem comes in when people who take drugs treat them like a license to behave like an asshole."

Britain has more than its fair share of assholes (these are now my views, not those of Demos, BTW). From my travels to other countries, I regard this as an incontrovertible fact. You can argue about why this is so until the cows come home. As the wildly differing reactions to the London riots demonstrated, your opinion will probably be coloured by your political views. Whatever they are, you would probably agree that the causes are complex and deep-rooted. The temperance lobby, however, portray the problem as simple, political and easy to remedy through legislation. Most of what is written about alcohol is designed to further this legislative agenda, whether on the Alcohol Concern website or in the pages of The Lancet. Politically motivated junk science takes us further from the truth and further from real answers. Demos has produced a report which looks at the issue more thoughtfully and, though it will probably be ignored by the public health lobby, it is a valuable contribution to serious discussion.