Thursday, 5 May 2011

Obesity, smoking, class and everything else

We do keep going on about the slippery slope on this blog, don't we? Still, it's called Velvet Glove, Iron Fist for a reason and I intend to go on about the slippery slope until someone learns the lessons of history.

I've written various pieces about how anti-tobacconists used to swear on a stack of Bibles that the crusade against their bête noir wouldn't lead to an attack on others (eg. this). While nonsmokers cherished their status as first class citizens, I've been giving countless examples of zealots setting their sights on those who, like Jaws in the Moonraker shuttle, are less-than-perfect themselves (eg. this, this and this).

Let's take the case of food. In relative terms, we're not even at the "let's have nonsmoking sections on planes" stage yet, but things are moving rapidly. This quote from the Journal of Public Health Policy doesn't require any comment but I'll add some black ink for any young children reading who might not have got the point yet.

The food industry's ultimately anti-social behavior—whether conscious or inadvertent—is spreading globally.... Signs of marketing efforts by multi-national food corporations are appearing everywhere in developing countries....

The tobacco analogy: this industry, which deliberately encouraged children to become addicted to cigarettes as early as possible, then continued to market cigarettes even once well aware of the health dangers. We now know the health dangers of obesity, but the epidemic continues. To protect the public, perhaps we can learn from anti-smoking efforts about means to constrain the food industry.

This editorial turned up in the same week that the Canadian Medical Association Journal published an article called 'Legislative approaches to tackling the obesity epidemic' that recommended anti-obesity policies which come straight out of the anti-smoking textbook. You know, the textbook that was designed to tackle the "unique danger" of smoking...

Government-level interventions

Taxing junk food

A proposed intervention for reducing the consumption of energy-dense and high-fat drinks and foods is to implement a “sin” or “junk food” tax. It has been highly debated in the Canadian media, notably in Ontario and Quebec. The rationale stems from the success of cigarette taxes, a proven and effective intervention to combat smoking.


School- and youth-level interventions

Banning advertisements for unhealthy foods

An early antitobacco strategy used by the government was to outlaw cigarette advertisements in the media, on billboards and at sporting events. Based on the success of these interventions, the 2006 obesity guidelines recommend limiting the “screen time” of children (i.e., television, video and computer games) to reduce their exposure to food advertisements.


Do you see what they did there?

Let's get down to brass tacks. The obesity situation isn't a real public health problem, it isn't very complicated and it has nothing to do with smoking. Most of what is said about obesity is bullshit anyway because it depends on a BMI measure that has been downgraded to create a crisis in the first place. The idea that obese people place a cost on the economy is debatable (unlike with smokers, where the idea is simply absurd). In any case, I've always found it strange that left-wingers are the first to complain about having to pay for other people's problems. Isn't that what socialists are supposed to do?

What is undeniable is that there has been a rise in the number of fat people. That's due to people (a) being able to afford to be fat, (b) the decline of manual labour, and (c) people being too lazy to cook themselves decent meals. It has absolutely nothing to do with cycle lanes or television commercials.

On the subject of (c), don't even think of saying that we're all too busy to cook these days. Working hours have fallen sharply in the last fifty years and no country which sees dross like Eastenders regularly get ten million viewers can claim to be pressed for time. We're either lazy, incapable or choosing to do something we find more rewarding. No taxes or advertising bans are going to do anything about the indolence and stupidity of the British public. What will change things is that most people don't want to be fat and are prepared to do something about it.

There is a simple epidemiological transition going on which doesn't get anywhere near enough attention. Fifty years ago it was the middle classes who were fat and suffering heart attacks. Today, obesity is seen as a working class problem and it is certainly more prevalent amongst lower socio-economic groups. Why? The simple answer is that the middle class got richer and took office jobs first and the working class followed them a few decades later.

That simple answer is half-right, but it doesn't explain why the middle-classes haven't got even fatter as they got even richer. The answer to that, I think, is that they got accustomed to being able to afford whatever food they wanted and stopped eating the high calorie foods their fathers and grandfathers did—the food they grew up with—and changed their diets over time. Their children, now fully grown, have a completely different diet to their grandfathers and are less fat than their fathers. Their grandchildren—may God curse them into eternal damnation—have grown up, joined a gym and want to force everybody else to be like them. That is a natural, if regrettable, transition made by observation, self-improvement and insufferable self-satisfaction. The government played no part in it.

It is short-sighted, patronising and plain prejudiced to believe that the same transition won't take place through the rest of society in the fullness of time. The crucial difference between being fat and being a smoker is that smokers feel great right up until the moment they get the cancer diagnosis. Fat people—with the exception of the fat acceptance movement and my uncle Malcolm—generally don't want to be fat; not because they might get diabetes in 30 years time but because it's not a good look.

If you'll excuse me for going all Karl Marx here for a second, there is a class issue at work. Fat people didn't get any grief when fat was a predominantly middle class problem, just as smokers were treated with education rather than coercion when smoking was a classless habit. I'll even up the ante here and say that flying abroad and driving cars wasn't considered a problem until us proles had the money to do it.

Coincidence? Maybe. But what do these overwhelmingly middle-class reformers propose as the cure-all solution to these supposed problems? Make them more expensive. Apply the most regressive policies imaginable. Tax the lower orders out of the market.

But let's get back to the slippery slope. It is, I think, indisputable that the same tactics that were once used only against smokers are being deployed against the general population. It is likely that the targeted groups will end up being denormalised in the same way as smokers are today. And it is highly probable that if the general population had been aware circa 1980, or even circa 2000, that anti-smoking policies would be directed at nonsmokers there would have been a general revulsion against the whole concept of top-down public health.

If you had told the average person in 1980 that meals should be taxed to deter purchase or that food advertising should be restricted to prevent obesity, he would have laughed in your face. That would be true even if the average person was a member of the British Medical Association.

How did things change? They changed, in no small part, because the campaign against tobacco crowbarred open a door that allowed the regulation of any human behaviour that might have the slightest impact on their or anybody else's health. Once opened, it is a door that is very difficult to close. I don't expect it to close in my lifetime.

And I'm only 34.

13 comments:

Anonymous said...

"I don't expect it to close in my lifetime."

Wow, Chris! That's very depressing. I really, really hope that you're wrong.

Jean Granville said...

I don't know why you now have to be thin to be good looking, while the opposite used to be more or less true, and still is in many places (some Afghans told me they like fat women over there).
Does it have something to do with class warfare too? The fat capitalist with a cigar against the thin but fit proletarian, as the fat aristocrat is no longer respected as he used to be?

Anonymous said...

That's a great post, Chris. And from the heart it seems.

I'll add a short note about class and prominence.

Many on the Left give praise to the idea of an inclusive society. I don't think that they're lying. Yes, they actually want you to be included, but you also must be behaving properly.

So, the individual thinks, "Well, if those are the conditions, I'm not interested in being included."

That's not an option in the minds of such people. Like the song says, "you can check in anytime you want, but you can never leave". The options aren't choosing between attending the party and following the rules, and leaving if you don't want to follow the rules. Rather, you both MUST attend and MUST follow the rules, and any other thinking is just aberrant, wrong, unthinkable, distorted, and meaningless for consideration.

Curmudgeon said...

Excellent post, Chris, especially the bit about things never becoming a problem until the proles started doing them. There's plenty of evidence that measures against non politically correct activities often disappoint their proponents by failing to have the desired effect, but it's hard not to share your pessimism that it is difficult to see any change in officially expressed attitudes in the coming decades.

Woodsy42 said...

I agree with you. I'll even add a (d) to the reasons for more obese people - that they have given up smoking!
When I stopped smoking 10+ years ago I added a stone in weight almost immediately, and no I wasn't stuffing Polo mints as an alternative. After years of reduced calories, regular gym sessions etc which made no real difference I decided to restart smoking. Guess what? I have lost a stone in 3 months.

Mr A said...

@woodsy42

I'm inclined to agree with you. Let's face it most social ills can be traced back to the anti-smokers.

1) Social inequalities? Not an issue if fags are a pound a pack as they would be if they were cost plus profit plus normal tax. It's the antis' urging for disproportionate tax hikes that have caused this issue.

2) Illegal smuggling financing terror groups and organised crime? See answer to 1.

3) Litter? Not an issue pre-ban as we had things called ash trays in enclosed, defined areas called pubs.

4) Noise pollution? See number 3.

5) Stalled cessation rates/climbing cessation rates - again, prior to professional anti-smoking groups getting involved there was a steady and gradual decrease in the numbers of people smoking. Since they got "heavy" in 2006 or so, smoking cessation rates have stalled and are even increasing. There is a great deal of research to show that haranguing and hectoring just entrenches attitudes and behaviours so it's not surprising that that's what has happened when that is the approach adopted by the antis.

5) Binge drinking - despite the evidence that drinking rates are falling, even if you accept their arguments that there is a problem, why might this be? Removing drinking from pubs as no-one wants to go there as you can't smoke therefore means drinking at home or in public. This means no landlord to supervise you and no older drinkers / people you don't know to "socialise" you in drinking responsibly. As you are not in the pub, your booze has therefore come from a shop, where it is cheaper and more plentiful. Therefore, wilder, less controlled drinking.

So yes, giving up cigarettes causes weight gain = obesity problem hardly seems inconceivable. I long ago accepted that everything the antis say is not only wrong but is also going to have negative consequences, even according to their own goals. (Using MY goals I could add social denormalisation, bastardisation of science, infringement of property rights etc). But as I say, even using their own definitions, they fuck up at every turn.

DaveA said...

Chris, I alas agree with you that there is little hope the tide will turn. I think the other reason why people are fat is that it has lost its social stigma, but some are keen for it to return.

However as they turn the heat up on probably the sizable minority/majority of the population they may have overreached themselves. I hope a back lash begins.

Dr Dan Holdsworth said...

All the evidence here points to the inescapable conclusion that banning things simply doesn't work, especially not if they're pleasurable or addictive (or both). Banning drugs of all varieties has to have been the most ineffective public health measure ever enacted; regressive taxes of various things aren't far behind (ever wonder why tobacco smuggling is so rife?).

The main problem is that the bansturbation crowd think that a ban means a problem goes away; they really need their noses rubbing in the fact that satisfying as it was to declare a ban, the ban DID NOT WORK. Make their utter failure public knowledge, humiliate them, decry their stupidity and with a bit of luck they'll simply bugger off and sulk somewhere.

Anonymous said...

Adding to Mr. A's comment.
Now that the 'action' is outside the pub where the smokers gather, it is also the place where the Landlord has NO control over the age group of the people standing around in the street and garden.
Therefore any young kid doesn't have to be 18 to be with the crowd drinking whatever he/she decided to bring along from the supermarket in their bag or pocket flask etc.
Before the ban when everyone was in the pub, the Landlord could keep an eye on very young kids inside the pub drinking.
So the smoking ban is encouraging under age drinking.

Curmudgeon said...

Also, so I'm told, encouraging cannabis smoking in pub gardens.

Frank Davis said...

There's another almost-possible thermodynamic explanation for obesity 'epidemic'. And that is that it's both convenient and fashionable to wear a lot fewer clothes these days than it was 50 or 100 years ago. Particularly in the case of women.

The consequence of this is that, given a stable body core temperature of 37 degrees C, heat is lost more rapidly, and more food has to be eaten to compensate the increased energy expenditure. At the same time, the increased food consumption results in the deposition of layers of insulating fat which increase for the body's external insulation back to an optimum level.

You either wear lots of clothes, or you get fat. It's simple physics.

Junican said...

"I don't expect it to close in my lifetime."

The Berlin Wall was in good health and accepted by everyone - compliance was complete. Woopst!

Communism in Poland was in good health. Compliance was complete. Everyone loved it. Woopst!

Communism in Russia was loved by all. Compliance was complete. Woopst!

Prohibition in the US was the greatest contribution to public health and morals ever! Compliance was complete. Woopst!

Prohibition in the US only lasted for 13 years, and that was without the Internet capability for communication.

Actually, when I saw that infamous video of Clegg saying that 'of course, we will not amend the smoking ban or restore capital punishment', I knew that it was only a matter of time.

It may be that the amendment to the ban will come from a surprising direction. It seems to me to be likely that communities which have lost their local pub (and that does not necessarily mean only in the countryside) will start to agitate for a replacement. But the replacement envisaged would not be 'a magnificent edifice' - perhaps a small bar on the Spanish model - small, lock up, low overheads, sufficient to provide a decent living for the owner - but UTTERLY POINTLESS unless clients can relax and enjoy. Relax and enjoy must mean drink, eat, smoke, watch footie on TV, etc. Relax and enjoy without government interference. In other words, a re-awaking of the idea of 'the public house'.

We shall see.

dunhillbabe said...

'It is, I think, indisputable that the same tactics that were once used only against smokers are being deployed against the general population.'

GOOD... because the more people who don't smoke and didn't think anyone was going to pick on 'them' are targeted, the better chance of a backlash.