Sunday, 4 October 2015

The useful and the true

Propaganda requires inconvenient truths to be replaced by useful lies. For the purposes of public relations, a bald assertion made often enough is as good as a fact. For the issues covered in this blog, I've characterised this as 'we're public health, we say what we want'. So long as people believe it, that's all that matters.

There was a small example of this on the BBC website yesterday when it was reported that 'Surrey County Council has been accused of hypocrisy after running stop smoking campaigns while investing in tobacco companies.'

Although it was on the front page of the Beeb's news site, this wasn't much of a story. All that had happened was a Green party councillor had complained about the local council investing in tobacco stock, presumably for its pensions.

Mr Essex said it was hypocritical for the council to invest in the tobacco industry.

He called for it to "show some leadership and take our money out of an industry that does so much harm and costs the NHS so much".

This fellow clearly has a moral objection to certain industries and doesn't want the council associated with them. This kind of virtue signalling is central to the divestment crusade.

Fair enough, he has his view, but moral ickiness is not enough to persuade people to sacrifice money for self-righteousness (which is the trade-off required by divestment). His moral indignation is the true motivation, but it is not sufficiently useful to win the argument.

Since people invest in shares to make a profit, it would be more useful if it could be shown that tobacco stock was not very profitable. To that end, the BBC (or the press release it was working from) quoted somebody from the UK Sustainable Investment and Finance Association. I've never heard of her or her organisation but this is what she said...

"Over the long term, tobacco companies do not provide significantly higher returns than other companies."

This is the very opposite of the truth, as any serious investor will tell you. This graph from Credit Suisse shows how wrong she is...

As Credit Suisse say, every decade since the 1960s (when the health effects of smoking became well known) has seen 'tobacco companies outperforming comparable firms by over +3 percent per year.'

This - obviously - is the reason councils, universities and pension funds invest in tobacco. They pay good dividends and the share price outperforms that of nearly every other industry. Between 2000 and 2012, for example, British American Tobacco yielded a return of +669%, making it the fifth most profitable FTSE 100 company. BAT, like Imperial and the other big tobacco firms, produce 'above-average yields, and good records and prospects of dividend growth.' They have been 'some of the most reliable income generators for many years'. They are 'cash machines'.

If the BBC had approached almost any other financial analyst, this is what they would have said. It is, after all, a simple, verifiable fact that tobacco shares have been amongst the best in the world over virtually any time frame you choose to look at it. Instead, they managed to find somebody to say something that was useful but totally untrue.

Job done.

Saturday, 3 October 2015

My Manchester schedule

If you're going to the Conservative party conference and will be in the secure zone, you can come and see me speaking at the following debates:

Monday 8 am: What works in reducing obesity? Next steps in public health with Maggie Throup MP (Health Select Committee), Chris Askew (Diabetes UK), Sarah Kershaw (2020 Health). Exchange 8.

Monday 3.45 pm: E-cigarettes: setting the regulatory bar - how high is too high? with Clive Bates (Counterfactual), Christian May (City AM), David Morris MP. Techcentral.

Tuesday 11.15 am: Sock puppets: Should the state be funding pressure groups? with Paul Staines (Guido Fawkes), Sir Stuart Etherington (NCVO), Daniel Hannan (MEP). Think Tent.

Tuesday 5.45 pm: Can wellbeing usurp economic indications of success? with Dame Jil Matheson (ex-ONS), Juliet Michaelson (New Economics Foundation), Nigel Keohane (Social Market Foundation). Exchange 4-5.

Thursday, 1 October 2015

Smoking, cars and quack science

Anti-smoking fanatics are celebrating today because it's now a crime to smoke around people under the age of 18 in cars. The issue of secondhand smoke in vehicles is utterly trivial and the immense effort that has gone into this political campaign only makes sense when you understand that it is about setting a precedent for banning smoking in private, domestic environments.

Obviously, the 'public health' charlatans don't care about children any more than they care about bar-workers. All they care about is using state force to stop people smoking. Equally obviously, it won't end here.

It's worth remembering that this is Labour legislation and Labour's shadow health secretary is quite rightly taking the credit for it. Ten years after they last won an election, the Labour party is still passing legislation through the unelected House of Lords. They did exactly the same thing with plain packaging. A tax on plastic bags in coming into effect next week. Labour, Tory, it makes no difference. Nanny always wins.

From the outset, the campaign to ban smoking in cars has required Lysenko science. At one point it got so bad that even the British Meddling Association had to retract a sciency claim. And the junk keeps on coming. Take this factoid from the useful idiots at the BBC, for example...

Smoke can stay in the air for up to two and a half hours even with a window open

You have to wonder what the BBC defines as "smoke" and whether they've ever been in a moving vehicle. Or a stationary vehicle, for that matter.

It seems that people will believe in anything when it comes to secondhand smoke. Newcastle University put out a press release today which contains this gem...

“People think that by opening the window they are clearing the air, but what actually happens is the air is sucked in from outside and pushes the smoke backwards, straight towards the passengers in the back seat."

Don't you love the way cars defy the laws of physics by sucking air in without blowing air out? What are they, black holes?

The manner in which academics are prepared to degrade themselves in the pursuit of money and ideology is pathetic, but expect more of the same in the future. Who knows what new magical properties secondhand smoke will be found to have. Perhaps they'll even try to revive the 'thirdhand smoke' scam? As the political objectives become more and more draconian, there are always new depths to plunge.

Saturday, 26 September 2015

The stupidest thing I've read all week...

Possibly all year, in fact. From the Independent...

Efforts to discredit claims that Alzheimer's is infectious is similar to how the mad cow disease scandal was handled

The suggestion that Alzheimer’s may be a transmissible disease, and the reluctance of government science advisers to countenance the idea, has parallels with what happened over “mad cow” disease in the late 1980s and early 1990s.

At the time, science advisers to the government took the cautious approach that there was “no evidence” mad cow disease was a threat to human health, although they privately admitted that did not mean there was “no risk”.

The “no evidence” line is similar to that adopted by the Department of Health in relation to the possible transmission of Alzheimer’s disease.

Ooh, uncanny! What a spooky coincidence. Makes you think, huh?

The whole article is here, but its entire 'argument' is presented above. There really is nothing more to it than claming that if there is no evidence for something, there are "parallels" with the mad cow disease situation twenty years ago.

There are also parallels with millions of instances when there was no evidence because there was no relationship, but that doesn't seem to have occurred to the author.

Words almost fail me. I've seen comments on the David Icke forum that have more intellectual weight than this.


Tuesday, 22 September 2015

The Institute of Alcohol Studies' response to Alcohol and the Public Purse

The UK Temperance Alliance, which these days prefers to be known as the Institute of Alcohol Studies (IAS), has responded to my IEA report about the cost of alcohol to the English taxpayer. In the report I showed that the financial, out-of-pocket costs to the government of alcohol-related crime, ill health and worklessness were unlikely to be higher than £3.9 billion a year, which is about a third of what drinkers pay in alcohol duty.

The IAS reply seems to have been written in reasonably good faith so I'll try to be equally constructive in my reply. They begin...

The most important point about the IEA paper is that it deliberately addresses only a very limited question – what the impact of alcohol is on the government’s fiscal balance. By design, it does not look at broader social or economic costs.

That's right. It looks at the cost to the government and therefore the taxpayer. Why? There are two reasons. Firstly, because I think that is what people are most interested in. Secondly, because the wider societal cost of £21 billion that includes intangible costs (such as emotional distress) and private costs (such as lost productivity) is routinely portrayed as being a direct cost to the taxpayer. For example, this is how the figure is typically presented in the media...

The government is seeking to reduce irresponsible drinking that costs the taxpayer 21 billion pounds a year in police and medical bills

Here is Theresa May on a government website:

'Alcohol-fuelled harm costs taxpayers £21 billion a year.'

Here is the Alcohol Health Alliance explicitly comparing a figure dominated by private and emotional costs with financial tax revenues:

And here is Katherine Brown, director of the IAS, describing the £21 billion as a cost to the economy while at the same time saying that it is a direct cost to the taxpayer.

“This government’s failure to keep its promise to come down hard on cheap alcohol has let everybody down except the drinks industry. It’s let the NHS down, the police down, but most of all it lets every taxpayer down. We are all footing the £21 billion bill of alcohol harm to our economy each year.”

Back to the IAS response...

This restriction inevitably limits the force of the IEA’s argument. Most people who are concerned about the level of alcohol harm in the UK are not primarily motivated by a desire to balance the government’s budget. Rather, they are concerned by the damage to public health, crime, social disorder and wider economic costs caused by excessive drinking.

I'm not sure that is true, otherwise temperance groups wouldn't go to such lengths to make the public think that wider societal costs are costs to the taxpayer. At the very least, people are more interested in the financial costs to the state in the context of discussions around alcohol taxes which are supposed to compensate for those costs.

The fact remains that somebody needs to pay these costs – whether it’s protecting themselves against crime, replacing goods that are stolen or vandalised, or functioning less productively at work. The IEA argue that it is misleading to balance these costs against revenue from taxation. But in that case, we need to acknowledge that there is no compensatory mechanism for the billions of pounds of harm suffered by private individuals and businesses.

But there is no compensatory mechanism and the IAS is not suggesting one. To be clear, putting more tax on alcohol will not compensate employers for hungover workers, nor will it pay to have someone's garden fence repaired. Tax goes to government. If alcohol duty is about compensation, it should therefore only meet the costs incurred by government.

(This is separate from the argument about Pigouvian taxation which the Alcohol Health Alliance is vaguely alluding to in the tweet above. The temperance lobby seems to think that alcohol duty should be equal to the gross negative externalities associated with alcohol. This, however, is a misunderstanding of what a Pigouvian tax is. Pigou's aim was not to raise an amount of tax equal to the gross externalities but to use tax to increase the private cost of a product to meet the net externalities. The private cost includes the price of the product before tax. People in Britain spend more than £30 billion on alcohol. That is the private cost, not just the £12 billion or so they spend on alcohol duty.)

The report has performed a valuable service in bringing to light the limitations of previous data/analysis and the confusion they have caused

Hear, hear!

The IEA is also correct in identifying the dangers of conflating social costs, economic costs and fiscal costs. ‘Alcohol and the Public Purse’ should encourage all sides of the debate to be more careful in the language they use. It is vitally important to be clear about the difference between different types of costs, and just as important to clarify who bears these costs – the government, the drinker, other people or businesses.

If it achieves that, I will be very happy (and surprised).

Much of the coverage and interpretation of the IEA’s findings has been misleading

While the IEA’s report criticises public health campaigners for confusing costs to the economy with costs to the Treasury, it is disappointing to see newspaper reports of the paper making the very same error:

“Boozers are subsidising teetotallers as research shows how much they pour into the economy”10 (The Mirror)

“Britain’s drinkers are helping to boost the economy by £6.5 billion a year”11 (The Express)

As discussed above, the IEA’s report says nothing about the cost to the economy, but only refers to the cost to the government.

Yes, it's very frustrating, but we can't control the headlines and nothing in the IEA's press release encouraged this sort of misreporting. The newspapers have been reporting broader economic costs as costs to the taxpayer for years (without being chastised by the IAS) so it is perhaps no surprise that they made a similar mistake this time. I commented on this at the time, both on Twitter and on this blog, saying...

Quite a few of the headlines failed to distinguish between the economy and the treasury - to be clear, taxing people does not 'boost the economy' - but Rome wasn't built in a day.

Back to the IAS...

While these headlines are ultimately the responsibility of the newspapers that publish them, it is notable that the IEA’s official twitter account made the same mistake, tweeting: “Britain's drinkers are helping to boost the economy by £6.5 billion a year”.

Ah, come on, they were tweeting coverage of the report all day and that was the headline in the Daily Express. They read the Express story, pressed the little Twitter button and that's what came out. People do this all the time. It doesn't mean they endorse every word of the article.

The idea of a ‘subsidy’ from drinkers to non-drinkers, which was central to both the IEA’s press release and many of the press reports, is misleading in a more subtle way. This implies that non-drinkers are better off for the fact that other people drink, because this (according to the IEA) reduces their tax burden. But if we are comparing the balance of costs and benefits between drinkers and non-drinkers, it is no longer appropriate to ignore private costs. Therefore, it does not follow that drinkers subsidise non-drinkers, unless the IEA can show that the tax ‘subsidy’ (if it exists) is greater than the private costs to non-drinkers.

The point is that non-drinkers are able to pay less tax as a result of other people drinking. I take the point that there may be other private costs (and, indeed, benefits) from other people drinking that are not reflected in the tax system, but - as mentioned above - they would not be compensated by taxation paid to government anyway.

Moreover, even in narrow fiscal terms, this ‘subsidy’ will be significantly smaller than the widely claimed £6.5bn. The IEA does not account for the fact that drinkers also use public services that are not directly related to their drinking – they still send their children to state schools, they are still treated for non-alcohol related ailments on the NHS, they still have their rubbish bins collected. If we accept the IEA’s numbers, alcohol raises £6.5bn for the Treasury, which is presumably spent on public services. But 79% of this £6.5bn will be spent on drinkers, since drinkers comprise 79% of the population (assuming that drinkers and non-drinkers are equally likely to use public services not related to drinking). This would imply that the subsidy is in fact closer to £1.4bn (21% of £6.5bn).

I applaud the creativity of this argument. It raises an interesting question. Let's say you had a tax on women that brought in £10 billion. Would you say that women are subsidising men to the tune of £10 billion or would you say that the subsidy is only £5 billion because women use half of the public services paid for by the tax? It seems to me that the former would be the normal way of describing it whereas the latter has the whiff of sophistry, but I take the point.

However, if you want to chop off 79 per cent of the benefit (the 'subsidy') because the money will ultimately be spent on drinkers then you must equally chop off 79 per cent of the cost (eg. spending on alcohol-related harm) because it would be paid by drinkers in the absence of a specific duty. By this logic, 79 per cent of the 'cost of alcohol' is not an externality at all because it is paid by people who drink.

If the costs of alcohol to public services came out of general taxation, drinkers would pay 79 per cent of them. So, by the IAS's logic, the cost to the taxpayer is not £3.9 billion but just £819 million. You can't have it both ways.

In ‘Alcohol and the Public Purse’, there are a number of costs that are omitted from the IEA’s analysis. Most significantly, the IEA do not attribute any social care costs to alcohol, despite the evidence that alcohol is often related to child neglect and mistreatment. This has been estimated to cost the government between £1bn- £2.5bn, so on its own could add 50% the IEA’s estimate of alcohol costs.

My report was explicitly modelled on the Cabinet Office report and the subsequent (thinner) documents that were the source of the £21 billion figure. None of them mentioned social care and I have not heard them criticised for ignoring it.

Whilst there may be costs to be found in social care, it is hardly surprising that it has been ignored to date. The data are practically non-existent. The reference given by the IAS is a report about the economic and social costs of alcohol in Leeds. It includes a page and a half about social care with some back-of-an-envelope estimates about the costs associated with alcohol. The estimates are not based on evidence from Leeds. Instead, they are based on a survey which found that parental alcohol misuse was a factor in 14 per cent of child care cases in four London boroughs. The authors assume causation and attribute 14 per cent of total child care social work spending in Leeds to 'alcohol-related expenditure'. It then adds in an estimate for adult social work, but because 'it is not clear what proportion of this expenditure was spent in relation to alcohol misuse' they just assume 25-50 per cent.

Presumably, IAS have extrapolated this guesstimate from Leeds across the whole country to reach their estimate of £1-2.5 billion. It is exactly the kind of guesswork that IAS said I 'performed a valuable service in bringing to light' and is nowhere near robust enough for an IEA report. 

Additionally, despite the IEA’s claim that they “err towards generosity rather than conservatism when compiling the estimates”, there are a few assumptions that appear to understate the cost of alcohol. First, the IEA ignore hospital admissions where alcohol is a secondary diagnosis (except where these are classified as an ‘external cause’).

This was explained at length in the report. It is ridiculous to assume that a secondary diagnosis was the primary cause for a hospital visit. Public Health England and the Department of Health both now agree that only primary diagnoses should be counted.

Second, the IEA assume that 14% of A&E visits are attributable to alcohol. While they acknowledge that there is significant uncertainty around this figure, it is worth noting that this is towards the lower end of the 2-40% range that is sometimes cited.

This was also dealt with in depth in the report. It should be obvious that if one estimate says that 2 per cent of A & E admissions are alcohol-related and another says 40 per cent then one of them is totally wrong. IAS are implying that you should split the difference and assume the real figure is at the midpoint between the two but that means using a figure that you know is totally wrong to come up with an average.

A better approach is to look at the estimates and see which one looks totally wrong. As I explain in the report, figures of 30-40 per cent are simply not credible whereas there are quite a few studies - that's studies, not surveys - of A & E admissions which arrive at single figure estimates. I went with 14 per cent because it was at the high end of the credible range. I strongly suspect that the real figure is quite a bit lower than this.

The IAS has promised to publish some of its own research on A & E admissions soon and I believe that government is working on a new economic assessment on the total cost of alcohol. Hopefully the government will at least bear in mind the point on which the IAS and myself are agreed - that the differences between difference types of cost should be made clear.

Monday, 21 September 2015

E-cigarettes and the EU: a user's guide

From May next year, the e-cigarette industry will have to abide by new EU laws that were agreed behind closed doors under the Tobacco Products Directive. If you use second or third generation e-cigarette - as most vapers in the UK do - these laws will have a major (negative) impact on you.

I've written a short briefing paper for the Epicenter Network (a group of European think tanks) explaining what the EU laws say and what it will mean for vapers and the e-cigarette industry. It's not pretty and national governments have limited ability to implement it sensibly. They do, however, have some latitude so you should encourage lawmakers to use common sense and - above all - not to gold-plate it with yet more meddlesome legislation.

If you're reading this, you probably have an above-average interest in these matters but I would guess that nine out of ten vapers have no idea that the quality of products is about to be radically degraded from next year so please read the briefing paper and share it widely.

I've had a few comments by e-mail about other issues with the EU legislation. If you have others, please leave them below and I'll blog about this again tomorrow.

Saturday, 19 September 2015

Trans fats - a pointless prohibition

It was reported in the week that a ban on trans fats would save 7,000 lives over five years.

Professor Simon Capewell [yes, it's him again], said: “There should be no place in our society for trans fats and a total ban would clearly improve the health of the nation.”

I won't go into the question of how dangerous trans fats are, suffice to say that the epidemiological evidence against them is similar to the evidence against saturated fats which many people now consider to be weak. It should also not be forgotten that the increased use of trans fats in the late twentieth century was largely due to the 'public health' lobby agitating against sat fats. Since then, the food industry has responded to public concerns about trans fats by greatly reducing their use.

For most food products, trans fats can be replaced fairly easily (although it can be costly), but you have to replace them with something and that often means more sugar or more saturated fat. Moreover, there are a few products which really do need trans fats for flavour or storage.

The bottom line is that trans fats are hardly used in Britain these days except in a few products that need them and a few others which contain them naturally. Their presence in the British food supply has fallen from a fairly trivial level to a very trivial level. Average consumption is well within the recommended limit. 

That is not enough for 'public health' zealots who hate it when voluntary agreements with industry successfully address a problem and are more comfortable with 'no safe level' dogma than evidence-based policy. As ever, their attitude is 'if it moves, ban it' and banning trans fats has been one of the top 12 targets of the public health racket since the start of the decade. This week's claim that 7,000 lives would be saved if the UK introduced a full ban came from a study co-authored by Simon 'Caps Lock' Capewell in the British Medical Journal.

As is becoming the norm whenever Capewell opens his mouth, scientists who actually understand the issue, including nutritionists at Public Health England, have raised criticisms. You can read a few of them in this article. For a fuller explanation, I recommend this post by Tom Sanders, professor of nutrition at King's College.

The changes made by industry mean that artificial trans fats are virtually absent from food consumed in the UK, something corroborated by studies measuring levels of TFAs in blood or adipose (fat) tissue. To my knowledge, no partially hydrogenated vegetable oils are currently manufactured in the UK. The main sources of TFAs left are the natural ones.

As such, banning trans fats as suggested by the new report would seemingly involve banning not just the industrial trans fats that are no longer present but also milk, butter, cheese and ruminant meats.

In other words, it would be another pointless and costly ban to make industry-hating public health chancers feel good about themselves.