Saturday, 22 October 2016

Minimum pricing, the law and the dominance of 'public health'

I wrote a piece for Spectator Health about the Scottish court ruling that sided with the government in the minimum pricing case.

Those of us who voted Leave in June understood that there is a trade-off between sovereignty and trade. The SNP are an overtly paternalistic party with authoritarian tendencies, but they have been resoundingly elected by the Scottish people. If they want to drain the pockets of the poor by putting a deadweight cost on alcohol, there is a case for respecting their sovereignty. On the other hand, they are party to a trade deal in the form of the common market which, until today, seemed to forbid such actions. 

For those of us who like free markets and oppose minimum pricing, the EU’s ban on such restrictive practices was one of the things we were going to miss after Brexit. After today, it is one less thing to worry about.

I suspect that this will now got to the Supreme Court. The judge's rationale was far from compelling and, to my mind, did not fully engage with the objections raised by the European Court of Justice. We shall see, but I don't think the lawyers are going to lose out from this saga. 

Thursday, 20 October 2016

Living in the pre-truth world

I spoke at the launch of the Orwell prize last night about 'post-truth Britain'. Here is roughly what I said...

The emblem of the post-truth society is a red bus that has come to assume rather more importance since the vote to leave the EU than it did during the referendum campaign. This bus famously claimed that we send £350 million to the EU every week and that we could be spending this cash on the NHS instead. Alas, this is physically impossible because the £350 million figure includes a rebate that never gets sent to the EU in the first place. The real figure is - depending on how you look at it - £190 million or £250 million.

This is hardly the first time a dodgy statistic has been used in a political campaign, so what was it about this particular claim that made it so offensive to those of us who care about facts?

There were other questionable claims made in the referendum campaign such as the idea that Turkey is set to join the EU. It is very, very unlikely that Turkey will join the EU in the short or medium term and yet it is not technically impossible. The EU has spent money looking into its membership. David Miliband was very keen on getting Turkey to join when he was foreign secretary, but Turkey has gone backwards since then and it would take a near-miracle for it to meet the EU’s criteria for entry. So not a total lie, perhaps, just a very implausible prediction.

The Remain side had their own implausible predictions. There would be a punishment budget if we voted to leave. There would be an immediate recession. David Cameron promised to invoke Article 50 straight away and stay on as prime minister. Instead, he resigned as prime minister straight away and Article 50 has still not been invoked. Having stepped down as prime minister he then promised to stay on as an MP, but he has since quit politics entirely. Were these lies? Did he really think he could stay on as prime minister if the country voted for Brexit? It seems unlikely, but it cannot be proven. It is therefore possible that he was sincere and later changed his mind.

It seems to me, therefore, that the ‘post-truth’ porky is something that cannot possibly be true and is uttered by someone who knows it is not true. So that's why we're in the post-truth era, because politicians never used to do things like that.

But then I thought of Harold Wilson going on television to tell the British public that devaluing the pound would not affect the value of the pound in their pockets. I thought of Ronald Reagan telling the American public that he had never traded arms for hostages. I thought of Jonathan Aitken and his “simple sword of truth" before he was jailed for perjury and perverting the course of justice.

I remembered Bill Clinton insisting that he had not had sexual relations with "that woman". I thought of Jeffrey Archer and Neil Hamilton and Richard Nixon and I’m tempted to say that the list is endless, but actually it is not. Deliberate, flat out lies are relatively rare in politics because so many people are watching and waiting to pounce on the slightest slip. As Jeremy Corbyn found out after he claimed not to be able to find a seat on a train, it is not the size of the lie that matters. The public can tolerate incompetence, but will not put up with deceit.

All of the politicians I’ve mentioned were found out. The £350 million figure was widely challenged at the time; Sarah Wollaston switched from Leave to Remain as a result. The intense scrutiny of politicians, which has only increased in the age of social media, gives them a big incentive to get their facts right, or at least to get them wrong in a way that can be defended.

In the examples of political lying I’ve just given, most involved politicians denying things from their own past when cornered, rather than inventing statistics from whole cloth. But that seems to me to be narrowing the definition of a lie down to an excessive degree and, anyway, statistics don’t need to be entirely made up in order to mislead people. They can be easily twisted in a way that will trick the public without resorting to outright fraud. Politicians - and journalists - often cite dodgy figures, but they have usually been given them by lobbyists, pressure groups and charities. And if you look at the vast pool of false claims and nonsense in society, you will find these groups more culpable than politicians.

There’s a man I know who debunks bad statistics for a living. When I told him I was looking for some good examples in advance of this event, he gave me three words of advice: ‘Beware good causes’. In the past few weeks, I have seen a headline on the front of a national newspaper asserting that e-cigarettes are as bad as smoking. No one who has studied the evidence believes this to be remotely true. I have seen The Times report the news that the Gambling Commission announced that rates of problem gambling have doubled in the last three years. The Gambling Commission has made no such claim and all the evidence shows no change in problem gambling prevalence since records began in 1999.

I’ve seen the Advertising Standards Agency condemn Friends of the Earth for making claims about fracking that can most politely be described as unsubstantiated. This comes after 107 Nobel prize winners wrote a letter to Greenpeace asking them to end their campaign against Golden Rice, a campaign they described as being ‘emotion and dogma contradicted by data’. A few weeks ago, Oxfam claimed that the UK is one of the most unequal countries in the developed world. The Office for National Statistics says income inequality is ‘close to the overall EU average’ and Credit Suisse says wealth inequality is ‘very typical for a developed country’. No media outlet challenged this claim, as far as I know, despite the data with which it could be debunked being readily available.

A list of false or misleading factoids from special interest groups really would be endless and I'm not accusing any of the people involved of being conscious liars. When the magicians Penn and Teller created a television series debunking the claims of frauds and charlatans some years ago, they called the programme ‘Bullshit!’, because accusing someone of lying is potentially actionable whereas accusing them of talking bullshit is, in legal terms, mere vulgar abuse.

Lying may be more morally objectionable, but bullshit is more common and it is just as damaging to public understanding of the world we live in. My argument is not that we are living in a truthful age. On the contrary, there is bullshit everywhere but deliberate political lies make up a very small portion of it - and that portion is not growing.

As long as people have an appetite for having their biases confirmed, newspapers will continue printing bullshit. As long as people think they can get away with it, they’re going to mislead the public. I don’t think we live in the post-truth era because I don’t think there was ever an era of truth. We are still in the pre-truth era and probably always will be.

Tuesday, 18 October 2016


ASH have produced an amusingly inept report today which has received a justifiable lack of interest from the media. The document - Counter-arguments - is designed to soften up retailers for the day when ASH push for full prohibition. It makes a ham-fisted attempt to persuade them that selling tobacco, despite all appearances, is not a good way of making money. 
The "counter-arguments" are ridiculous, bordering on dishonest...
Profits. Despite the high volume of tobacco sales in convenience stores, accounting for 25% of total sales income in our sample, small retailers make very little money from tobacco. The margin on tobacco products is around 6% compared to an average of 24% for the other products they sell.

This is a pathetic claim. 80 per cent of the price of a pack of cigarettes is tax. If 80 per cent is tax, it is impossible to make a 24 per cent margin. The main job of a tobacco retailer is to collect tax for the government. The real question is how much of the pre-tax price goes to the retailer. The answer is closer to 40 per cent. Elsewhere in the report, they mention that retailers make an average 44p profit on tobacco transactions. Given that the pre-tax price of a pack of cigarettes is barely more than £1 this is a pretty generous margin.
If ASH are so concerned about retailer margins, they should support a cut in tobacco duty. Every cut in tax would increase the margin as a percentage of the price. That won't actually make retailers any more money, though, because it is the amount earned not the percentage that matters to their livelihoods. On such a heavily taxed product, the post-tax margin is an irrelevance.
Footfall. Tobacco manufacturers claim that retailers do well from tobacco sales because smokers buy other products while they are in the shop. However, other than the money they spend on tobacco, smokers do not spend significantly more than people who do not buy tobacco.

This is a bit of a straw man. The importance of footfall is not getting smokers to spend more money than nonsmokers - though they do - it is getting them in at all. If smokers bought their cigarettes from supermarkets rather than newsagents, they are likely to buy their drinks and newspapers from supermarkets at the same time. The small shops would get nothing.
Variety of stock. Tobacco manufacturers encourage retailers to maintain the availability of their own brands and brand variants. Yet the cost to retailers of ignoring this advice is low: a few disappointed customers per week add up to a very small cut in profits.

I don't know if the cut in profits would be small or not, but it shows how little ASH know about small shopkeepers, who work incredibly long hours in a difficult trading environment, that they think they would be prepared to sacrifice any size of profit - or disappoint any customers - on the whim of an extremist single issue pressure group.
Opposition to new legislation. The claim that tobacco control measures increase the size of the illicit market does not stand up to scrutiny. In Britain, the market share of illicit tobacco has declined since 2000 despite all the changes to how tobacco is sold. The size of the illicit market is determined principally by the effort put into law enforcement.

ASH always use 2000 as their starting date for measuring the illicit trade - and it is true that the illicit trade is smaller now than it was then. What they don't mention is that 2000 saw a massive spike in cross-border shopping to the EU after successive tobacco duty rises in the 1990s. This taught the government that it could not keep hiking up taxes ad infinitum and for the next eight years, it froze tobacco duty in real terms. In the last five years, however, there have been steep tobacco duty rises and - surprise, surprise - the illicit market has grown. Even by the questionable estimates of HMRC, the share of tobacco that is non-duty paid has risen by a third since 2011/12. We shall see what effect the display ban and plain packaging have, but the news is unlikely to be good for legitimate retailers.
As a point of fact, there is a direct relationship between tobacco taxation and illicit tobacco sales. The UK, Ireland and France have the highest taxes on cigarettes and, not coincidentally, also have the largest illicit markets in Western Europe. The belief that black markets can be eliminated through enforcement is a myth dating back to the Anti-Saloon League.
A new approach. Retailers could benefit from a declining population of smokers if they reduce their stock of tobacco to core products, shift their gantries out of customers’ line of sight, and use the freed-up space to promote and sell higher margin products. They can keep regular smokers among their customers while reducing the burden of smoking on their cash flow and, potentially, increasing their profitability.

I suspect that shopkeepers know rather more about how to make a living from running a shop than an economically illiterate, state-funded, nanny state lobby group. The reason retailers keep tobacco products close at hand is that they need to be reached many times a day and need to be kept out of the way of shoplifters; thanks to the aforementioned taxes, they are worth thousands of pounds. 
ASH live in such a world of fantasy that they can make claims like 'in Australia, the introduction of standardised packaging actually increased the efficiency of retail sales' with a straight face. Their latest report will raise a hollow laugh from shopkeepers in the real world.

Saturday, 15 October 2016

New Last Orders podcast

There's a new Spiked Last Orders podcast out featuring me and Tom Slater with special guest Timandra Harkness. Lauded by Twitter communist David Colquhuon as the silliest he's ever heard, it includes our thoughts on David Nutt's synthetic alcohol, the NHS's social engineering and the claim that modern life is killing us. Subscribe on your device or click here to listen.

Friday, 14 October 2016

The WHO's Opposition to Tobacco Harm Reduction

Julian Morris has written a great report for Reason about the World Health Organisation's backwards attitude towards harm reduction. It is heavy on facts and includes an excellent primer on snus.

Here are a few samples:

On the WHO's abuse of the precautionary principle...
In general, the WHO demands an excessively high standard of evidence for new products. In Tobacco: Deadly in Any Form or Disguise it asserted: “For new products and for those under development, additional research is needed to understand more precisely whether their risks are the same as the products they would replace. Such research will take years, or even decades. Until such research is completed, the most prudent course is to assume that their health risks are extraordinarily high compared with any ordinary consumer product and to make every effort to prevent their use along with all other tobacco products.” Given that decades of data were already available on the effects of snus by the time the WHO published this, one wonders if any amount of data will ever be sufficient to persuade it of the merits of harm reduction products.

On the secretive dealing of the Framework Convention on Tobacco Control meetings...

Articles 29, 30 and 31 of the FCTC’s Rules of Procedure permit certain “Observers” to “participate without the right to vote in public or open meetings of the Conference of the Parties and of its subsidiary bodies.” The rules state that Observers are also permitted to “speak” during open or public meetings of the Conference of the Parties (COPs) and subsidiary bodies.  This gives the appearance that the FCTC is extremely participatory — more so than most other intergovernmental agreements.

But actual, permitted participation in the FCTC is extremely narrow. The FCTC currently lists only 20 NGOs as Observers on its website. By contrast, the Framework Convention on Climate Change lists over 2,000 NGOs as Observers on its website. Moreover, there is essentially no participation by representatives of many affected groups, including users of tobacco and vape products, vendors, and farmers. Participation by IGOs has also been restricted; even Interpol has been denied Observer status, despite its expertise in combating illicit trade in tobacco — a key topic covered by the Convention.

And what the WHO should do...

If the FCTC is genuinely committed to the “right to health” then it must listen to those who are taking control of the things that determine their health — and to those who are helping them to do so. In other words, it should open itself up to participation by groups representing vapers, snus users, and companies producing these and other less harmful nicotine - containing products.

A more open, participatory FCTC would not produce papers in secret and make them available only a few weeks before COPs. Instead, it might issue a call for papers and encourage all parties with an interest in the issue to submit materials. It might then allow pu blic scrutiny of those papers and form a committee, the composition of which is determined by votes from a much enlarged group of Observers, who can then review submissions and form conclusions.

At the same time, if the FCTC is genuinely concerned about avoiding conflicts of interest, then the best approach is to open itself up to scrutiny. That means, at the very least, permitting journalists to attend all sessions of COPs and technical committees. Better yet, the FCTC might livestream all its proceedings over the Web — in much the way that the Framework Convention on Climate Change livestreamed its 21 st Conference of Parties.

You can download The WHO's Opposition to Tobacco Harm Reduction here.

Washington's Taxpayer Protection Alliance has also recently put out a report on the WHO: World Health Organisation in need of intensive care: World taxpayers funding failing international organisation.

Thursday, 13 October 2016

E-cigarettes and the Nudge Unit

I mentioned in a recent article the role of the Nudge Unit in keeping e-cigarettes on the market in Britain. According to David Halpern in his book Inside the Nudge Unit, his team were instrumental in lobbying for light touch regulation after he came across an e-cigarette by chance in 2010. Here are a few excerpts....

At some point, Rory [Sutherland] produced an 'e-cigarette'. Back in 2010, these were still very rare. I think he'd got his own on a recent trip to Japan. Almost as an aide, he waved his e-cig and proclaimed that maybe these were a good thing.

In the same year, the question of how to regulate vaping was raised in government...

It wasn't a clear call. Policy decisions are often like this. Prime Ministers and Ministers, with the aid of their advisors, often have to make decisions in the face of incomplete evidence. We looked hard at the evidence and made a call: we minuted the PM and urged that the UK should move against banning e-cigs. Indeed, we went further. We argued that we should deliberately seek to make e-cigs widely available, and to use regulation not to ban them but to improve their quality and reliability.

Enter the MHRA...

We deliberated whether we could regulate e-cigs like foodstuffs or electronics, but eventually concluded that our best route might be a 'light-touch' medical route to regulation. The inverted commas are appropriate because, as anyone who deals with regulation will know, 'light-touch' is not necessarily the default instinct of regulators. Nonetheless, we asked the body that regulated medicines in the UK, the Medicines and Healthcare Products Regulatory Authority (MHRA), to develop as light a touch regulation as they could - just enough to make sure e-cigs didn't have other toxins, and that they had enough nicotine in them to be effective.

And then the 'public health' industry came bumbling out...

The public health sector might have been caught unaware by e-cigs and our rapid action in 2010. But through 2011-12, significant sections of the policy community, and particularly the public health sector, started to turn against e-cigs in earnest. The Chief Medical Officer moved from being on the positive side of neutral to firmly against. Pharmaceutical companies that made nicotine patches and gum weren't too pleased about the new competition, and started lobbying against e-cigs. The argument wasn't helped by big tobacco companies, who moved from being bemused and slightly hostile observers, to becoming actively interested in the products and even, it was rumoured, buying up some of the e-cig companies.

Meanwhile, government regulators had decided - surprise, surprise - to over-regulate...

By the time the proposals came back from the MHRA, they didn't look quite like the light-touch regulation we had in mind. The issue was also becoming a European matter, with many countries arguing for a ban, or at least very heavy regulation. Faced with a backlash in the public health sector, one of the UK's largest retailers withdrew e-cigs from its shelves. Despite our early efforts, we were losing the battle. We were heading towards heavy restriction of e-cigs in Europe, where they might only be available on prescription. Some wanted to go further still, and to follow the Australians towards an outright ban, or availability only possible under tight medical supervision. Even the MHRA was concerned that the European position would go too far.

Halpern and his team then looked at the evidence and found that e-cigarettes were clearly helping people quit smoking and were not acting a 'gateway' to smoking for nonsmokers....

We took the evidence back to the PM and the Cabinet Secretary. As it happens, David Cameron was one of the only people in No. 10 who had been a smoker [and still it, it seems - CJS], and had even tried an e-cig (he wasn't especially impressed). We took the decision to stick to our line: to ensure that, for now at least, e-cigs should be widely available; to push for light-touch regulation to ensure that they were free of other toxins but had enough nicotine to satisfy smokers' cravings; and to legislate to ensure that they were not to be sold to the under-18s. Available, but safe, was to be our line.

Based on behavioural and other evidence, and with the help of a new Public Health Minister and our European and Global Issues Secretariat (EGIS), this is the line we took and pushed and more or less secured in the UK and Europe. It is a situation we continue to watch.

Nobody could seriously describe the EU's Tobacco Products Directive as light-touch regulation, but never mind. There's an even greater threat in the WHO...

As with much of policy, this is an unfinished story. In July 2014, the World Health Organisation published a report concluding that countries should pursue a 'two-pronged regulatory strategy - regulating ENDS [e-cigs] as both a tobacco product, in accordance with the provisions of the WHO Framework Convention on Tobacco Control, and as a medical product. They did not recommend a ban, but for many countries regulating e-cigs in this way would dramatically curtail their availability.

He concludes:

Though time will tell, the initial indications are that by helping people quit - and possibly opening the door to a future outright ban on smoking - e-cigs may prove to be the biggest boost to public health in a generation. Even more extraordinarily, much of the public health bodies [sic] would have blocked them.

Not so extraordinary when you consider that it's never really been about health. It's about control.

In some respects, it's a good news story that the Nudge Unit helped to get a relatively liberal regulatory regime in Britain, but it is also worrying that so many big decisions come down to the right people being in the right place at the right time. What would have happened if Halpern had not come across a friend using an e-cigarette in 2010? If the dice had fallen differently, we could have ended up with the mendacious 'public health' industry winning the battle and securing a ban, as has happened in other countries. Our liberties shouldn't really be in the hands of random people like this.

You can buy Inside the Nudge Unit here.

Wednesday, 12 October 2016

The WHO is lying about food and drink taxes

The WHO's excrucitaing decline continued yesterday when it published a document calling for fiscal measures in the food supply, ie. taxes and subsidies. Written anonymously, as is their style, its report - Fiscal Policies for Diet and Prevention of Noncommunicable Diseases - makes a number of unsupported claims, such as this...

There is increasingly clear evidence that taxes and subsidies influence purchasing behaviour, notably when applied to sugar-sweetened beverages and this contributes significantly towards addressing the obesity and diabetes epidemic, especially when part of comprehensive multisectoral population-based interventions.

It is a statement of the bleeding obvious that price influences consumption and it is equally obvious that taxes and subsidies affect price. But where does the belief that taxing sugary drinks 'contributes significantly towards addressing the obesity and diabetes epidemic' come from? No country has ever reduced the prevalence of these health conditions with taxation. There is not a jot of real world evidence to support this claim, and the WHO does not offer any.

The authors continue...

Estimates from recent economic research show that the prices of foods and beverages effect [sic] purchase and consumption significantly.

Well, duh.

As taxes increase, the purchase price of certain foods increases and consumers thus reduce their purchases. As a consequence, industry may produce less of the food in question.

I love the use of the word 'may' here. In fact, it's safe to say that if people buy less of a product, the industry will produce less of it.

The fundamentals to the effect of fiscal policies on diet and the basics of price elasticities include:

a) demand for SSBs [sugar-sweetened beverages] is generally elastic, with price elasticities around -0.9 to -1.3

No, demand for sugary drinks is generally inelastic.

Growing evidence shows that appropriately designed fiscal policies, when implemented with other policy actions, have considerable potential for promoting healthier diets.

Really? And where is this growing evidence?

These will improve weight outcomes and other diet-related risk factors, and will contribute, ultimately, both to the prevention of NCDs and to the reduction of the NCD health and economic burden.

Note the switch from talking about the 'potential' of these policies to the certainty that they 'will' work.

A meta-review of 11 recent systematic reviews on the effectiveness of fiscal policy interventions for improving diets and preventing NCDs (6) showed that the evidence was strongest and most consistent for the effectiveness of SSB taxes in the range of 20–50% in reducing consumption, and of fruit and vegetable subsidies in the range of 10–30% in increasing consumption.

Finally, some evidence! Let's have a look at reference (6) shall we?

(6) Fiscal policy options with potential for improving diets for the prevention of noncommunicable diseases (NCDs) (draft). Geneva: World Health Organization; 2015.

The report is citing itself! I've never seen that before.

Whatever evidence the FIFA of Health claims to have in mind can only be based on theoretical models. No country taxes sugary drinks at 20-50% (excluding sales taxes such as VAT). Even Mexico and Berkeley only tax them at 10%. Nor do any countries subsidise fruit and vegetables at 10-30%. It is simply dishonest to pretend that these policies have been shown to work. They haven't even been tried - and with good reason.

There is also growing evidence for the likely effectiveness of combinations of taxes and subsidies, particularly as a mechanism to reduce potential substitution with unhealthy foods.

Sheer bullshit again. No one has tried this.

The WHO goes on to discuss eleven countries that have dabbled with policies of this kind. Perhaps this is the 'meta-review of 11 systematic reviews on the effectiveness of fiscal policy interventions' that they mention when referencing themselves. It must be because it's the nearest thing to evidence that appears in the report. If so, it is mendacious.

Denmark’s tax on saturated fat – implemented on 1 October 2011 and abolished on 1 January 2013 – proved to be efficient in reducing the intake of saturated fat as well as in improving other dietary measures and reducing mortality from NCDs.

Unevidenced, unmitigated tripe. There is no evidence - none - that a short-lived tax on saturated fat reduced mortality from non-communicable diseases.

The WHO then mentions Ecuador where a tax on soft drinks and some food 'faced challenges which made the tax difficult to implement'. It mentions Egypt where 'the government has not adopted taxes on unhealthy food as a tool to reduce consumption. On the contrary, it has imposed low tax rates on some unhealthy foods, such as sugar'. Great success!

Then there is Finland which 'has a long history of using price policies to influence food consumption'. Has it reduced obesity or improved health? We don't know because it 'has not been formally evaluated'.

And so it goes on. A soda tax in Mauritius 'has not been assessed'. A bill to introduce a soft drink tax in the Philippines (a despotic country admired by the WHO) has not been passed but a computer model reckons that 'a tax that would increase the price of SSBs by 20% would reduce overall consumption by 24%'. Hungary has lots of food and drink taxes but there's no evidence of any improvements in health. France has a small tax on fizzy drinks, but it applies to sugary and non-sugary drinks alike. Thailand taxes sugary drinks at a lower rate than non-sugary drinks but gets a mention anyway. Mexico saw soda sales drop after a tax was introduced if you compare it to a 'public health' counterfactual but sales didn't actually drop. Finally, the USA gets a mention because most of its states have a soda tax of some sort but the WHO neglects to mention all the studies showing that they have had no impact on obesity because of substitution effects.

That, apparently, is the 'growing evidence' for taxing food and soft drinks. This unelected, secretive agency is pushing governments to introduce regressive taxes that it does not understand and willfully misrepresents.

In most cases, however, the demand for foods and beverages is typically inelastic (i.e. consumers are not very responsive to price changes). This should not be viewed, per se, as hindering the pursuit of public health goals. It simply means that the tax rate will have to be high enough to reduce the consumption of the taxed products to an extent that will generate meaningful health effects.

Be afraid.