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Plain Packs – This week’s non-story

By Guest
July 30th, 2013 at 12:02 pm | 6 Comments | Posted in Uncategorized

The government’s decision not to go ahead with “plain” packaging for cigarettes was welcomed by most sane reasonable people as an indication that we may finally be seeing a beginning of an end to the madness that is government by pressure group.

Only true public health disciples believe that the campaign is anything more than a vanity project intended to bash “big tobacco” and show just how powerful the activists have become. There is no credible evidence of any likely health impact whatsoever and one can be forgiven for concluding that some activists are so wrapped up with winning their “war” with big tobacco that they view health as a peripheral objective.  Others seem more interested in topping some sort of public health competition to determine which nation can be the most authoritarian.

Arnott chris oakleyThe response of the public health industry to the plain packs setback has been predictable and sad. Refusing to even acknowledge the public or its opinion, it has responded with a wave of unpleasant speculation and conspiracy theories based on the now very tired claim that the only opponents of the activists are in the pay of “big tobacco”.

This is not even remotely true but the strategy that it underpins has nonetheless been amazingly successful over the years because it has proved much easier to undermine opponents and demonize the tobacco industry than it has to rationally justify most of what tobacco control has campaigned for. It has in fact been so successful that we now live in a society in which a person’s research or opinion however valid in its own right can be effectively dismissed by any association, however tangential with the tobacco industry.  Although we do need to be alert to the influence of vested interests, the current state of affairs is lamentable and should be a source of shame to those who have created it.

The media has played a major role in the growth of what can be termed censorship by association as a result of monumental ignorance and the love of a “good smear story”. The Guardian is particularly enthusiastic when it comes to bashing industries that try to turn a profit and being staffed, for the most part, by people who would prefer not to do anything quite so vulgar themselves, provides many natural allies for public health activists.

The latest mouthpiece for Deborah Arnott’s ASH is Jamie Doward who treated us to a major scoop in this weekend’s Observer by exposing a “sophisticated lobbying campaign” by Philip Morris Industries (PMI) apparently intended to prevent plain packs being adopted in the UK.  It appears that someone leaked some 2011 PMI files intended for internal use only and from those files the intrepid Doward has managed to concoct a deeply dishonest and frankly ridiculous conspiracy theory in which organisations such as the IEA, TPA and UNITE are mere pawns in the hands of Machiavellian tobacco company executives.

In Doward’s fantasy, dissident smokers are unthinking recruits of “big tobacco” and absolutely no grass roots opposition to anything the tobacco control lobbyists have to say exists at all anywhere. The hundreds of thousands of signatures opposed to plain packaging don’t exist or are the product of manipulation by “big tobacco”. Lynton Crosby of course appears complete with photograph despite not apparently being directly involved in the leak.

It is of course entirely unsurprising that PMI analysed the politics surrounding the plain packs proposal in some depth but I would like to see the justification for Doward’s claim that the tobacco lobby has “spent millions” trying to derail the proposal in the UK.  Having waded through his nonsense in search of anything that represented fact rather than fantasy I was struck by a section in which he reveals that those dastardly executives at PMI actually resorted to canvassing public opinion in their efforts to thwart plain packs. Apparently they used their endless resources to commission a small poll of a thousand people from marginal Tory constituencies and found that only 3% of people thought that action on smoking was a top priority for the government. I hope that the 30 are a sampling artefact for the sake of mankind. When it came to proposed smoking reduction measures 24% mentioned plain packs but 62% preferred education.  Apparently Doward thinks that it is extremely naughty of PMI to expose the lack of public support for plain packs. I am trying to work out why.

Doward leaves the last word to Arnott who rarely fails to oblige with a manipulative meaningless sound bite. The Observer article is of a laughable standard but the underlying behaviour and the societal sickness of which it is but a symptom is no laughing matter. I look forward to next week’s instalment.

By Chris Oakley. Chris’ previous posts on Liberal Vision include: Minimum pricing – policy based evidenceAlcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth Lies, damn lies, statistics &… , The Department of Health is Watching You! , New bounty on smokers helps GPs balance their books, Smoking ban health miracles , Public health idealogues don’t come cheap

 

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Lies, damn lies, statistics & meta-analysis – their contribution to the weak case for minimum pricing

By Guest
October 3rd, 2012 at 4:57 pm | 10 Comments | Posted in pseudo science

Few days go by without the public being subjected to some health scare or miracle cure delivered to them by an ill-informed but very enthusiastic media. Generally, these stories refer to “a new study” or “latest research” implying that “scientists”, “doctors” or “experts” have actually performed a novel experiment that has scientifically demonstrated something new and potentially useful.

In the vast majority of cases, this isn’t true. What has often happened is that a special interest group has reviewed some historical data, re-analysed it, applied a bit of spin in support of their case, published it somewhere not over insistent on scientific rigour such as a medical journal and issued a press release usually full of impressive sounding numbers.

These reviews appear in many formats but all suffer from the fundamental problem that they tend to conclude whatever the authors want them to. The most advanced form of this data manipulation epidemic is the meta-analysis, which can be viewed as a sort of amplifier. The idea is to take a number of studies that may be individually insignificant or even contradictory and combine them in a way that enhances consistencies.

Two major limitations of the approach as identified by numerous academic sources are publication bias and agenda bias. These factors are especially problematic in public health which is observably doctrinaire.

Publication bias normally refers to the tendency for positive results to be more likely to be published than those that support the null hypothesis thus distorting collective analysis of outcomes. Public health publications are often policy driven rather than objective or evidence based and the dogmatic nature of this approach fuels a more extreme form of publication bias caused by suppression of non-conformist ideas.

The depth of this problem was exposed in 2003 when the BMJ published Enstrom and Kabat whose work suggested that passive smoking appeared to be less lethal than previously claimed. The authors were set upon by the public health industry and The BMJ itself was subject to attack for its heretical challenge to public health orthodoxy. The vast majority of critics didn’t even address the content of the paper. The unsavoury incident led Ungar and Bray to write Silencing Science in which they conclude that an intelligent debate on the effects of passive smoke has become impossible. Irrespective of the debate over its content, the reception of the BMJ paper serves to illustrate the extreme extent of publication bias in public health.

Public health also suffers from agenda bias. The bedrock of science is sceptical objectivity and this is particularly important with meta-analysis because freedom to choose which studies to include, how to weight them and how to interpret the results introduces a degree of subjectivity.  In science the tendency to use this freedom to engineer favourable outcomes is usually offset by the value placed on scientific /academic integrity. Such ethical considerations are less restraining in public health where the discourse is dominated by policy driven orthodoxy rather than a desire for genuine discovery and the adversarial exploration of competing hypotheses.

In public health the authors of meta-analyses are all too often wishful thinking medics or public health activists who exhibit a depressing tendency to make the data fit the theory. Attempts to justify smoking bans by claiming dramatic post-ban falls in heart attacks have unsurprisingly produced some of the most unconvincing meta-analyses including this from Stanton Glantz a man obsessed by his personal war against tobacco and this produced by a cardiologist from Kansas

The outcomes of these meta-analyses are pre-determined by biased study selection. The authors chose to ignore the poor quality, methodological weaknesses and arguably fraudulent nature of the selected studies highlighting another weakness of meta-analysis. The authors should have been exposed by the “success” of their efforts which imply that 15-20% of heart attacks are caused by passive smoking. This is implausible to the point of being ridiculous but amazingly, their output is still referenced.

The dubious use of meta-analysis is not confined to tobacco control. Many of us have been left scratching our heads by claims made for minimum alcohol pricing. The notion that a modest financial measure that would not inconvenience the majority could have a significant impact on problem drinking and youth drinking appears counterintuitive and depends on some odd assumptions about price elasticity and behaviour.

The politician’s claims are based on the work of Petra Meier who derives much of her theory from meta-analyses. Based on Gallet’s 2007 interpretation of 132 studies dating back to 1945 she concludes “if the price of beer is raised by 10%, beer consumption would fall by 3.5%; if the price of wine was increased by 10%, wine consumption would fall by 6.8%; and if the price of spirits increased by 10%, spirits consumption would fall by 9.8%.”

In some ivory towered fairyland perhaps but in real life here in the UK, the leap from Gallet’s findings to “A 50p limit should cut alcohol consumption among moderate drinkers by about 3.5%, or half a unit for women and two-thirds of a unit for men” together with rest of the hyperbolic nonsense in this fabulously biased BBC article is hard to understand or justify.

I can imagine the Scottish government falling for this on the basis that any data however ridiculous is an improvement when you are used to your health secretary simply making up the numbers to support her agenda, but surely David Cameron should be better advised than this?

Reading Craig Gallet’s 2007 paper on which Meier relies heavily and being mindful of her claims with respect to targeting young drinkers, I was struck by a line in the conclusion:

“… if we are particularly concerned with teenage drinking, since we find that teens are least responsive to price, then perhaps the best approach to reducing teen alcohol consumption should involve alternatives to taxation, such as education campaigns.”

This is not the only inconsistency in this classic case of torturing the numbers to fit pre-determined policy.

By Chris Oakley. Chris has previously posted on Liberal Vision:  Smokers-State Aprroved hate and Intolerance is UK policy,   Alcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth , A Liberal Tolerant nation?What hope is there for liberty if truth becomes the plaything of political lobbyists and Public Health Success?

Note from Editor

You might also find the following posts interesting:

BBC And Guardian Played Like Fools On Minimum Alcohol Pricing by Dick Puddlecote 3/10/2012

A black market in booze fearmongering by Chris Snowdon for Spiked! 3/10/12012

Lies, Damn lies and Sheffield University by The Pub Curmudgeon 3/10/2012

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Orange Bookers Vs Social Democrats : the movie part 2

By Angela Harbutt
October 2nd, 2012 at 2:36 pm | 1 Comment | Posted in Liberal Democrats

Apologies to all you folks wanting to see the second part of the IEA/LV fringe event at Lib Dem Conference. Technical glitches have now been sorted. Enjoy.

00023 from Institute of Economic Affairs on Vimeo.

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Orange Bookers vs Social Democrats: the movie

By Angela Harbutt
September 25th, 2012 at 10:54 am | 3 Comments | Posted in Liberal Democrats

As promised – here is part one of the video from the LV/IEA fringe.

Part 2 will follow asap.

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About that fringe event last night…

By Editor
September 24th, 2012 at 11:38 am | 3 Comments | Posted in Liberal Democrats

We had a full, and as to be expected, quite lively time of it at our fringe event “Orange Bookers vs Social Democrats: What does the future hold for Lib Dems” last night.  If you were there, thanks for coming along.

For those unable to make it, we’ve already been asked by a lot of folks if we recorded the session and when they can get to see it.The answer is yes, the session was videoed (thanks to the IEA, our co-hosts, for that) and will be posted up as soon as available. In the meantime, here is a taster of what each of the speakers had to say. It’s not complete by any means, and few jokes etc missed out plus the questions/contributions from the audience not listed here. We hope it will give you a flavour of the session – and encourage you to come back and see the video as soon as it’s up.

Jeremy Brown

Jeremy confirmed that he did regard himself as an Orange Book liberal – and to be an Orange Booker was not to be a Tory as some people suggest but to be a liberal. He reminded us of the four strands of liberalism: political, personal, social and economic, and said that it was important that the weight given to each of these was equitably loaded. He stated that the Lib Dems had a way to go on personal liberalism – and that the party was in danger of proposing that “people do have the right to do what they want, as long as it conforms to Lib Dem policy”. He would not want to tell people not to drink fizzy drinks.

Most of his speech addressed economic liberalism. He said that Orange Bookers were not arguing that in all circumstances the private sector is good and the state, bad, but that they seek to avoid “excessive faith in the state”. He said he was suspicious of monopolies – private as well as state. He acknowledged that the private sector is not always perfect, but as a rule the private sector is preferable, because in markets poor performing companies go to the wall. He said that he believed in choice for the individual – e.g. there used to be only choice in education for the rich (sending children to a private school or moving house to a catchment area with a better state school) and that Orange Bookers wanted choice in education for every parent.

Evan Harris

As has already been noted by several others elsewhere, parts of Evan’s speech were attacks/assertions about other members of the panel and/or their organisations. Possibly cowardly, but we have left those bits out from our summary for fear of misrepresentation (perhaps he was being ironic?). So you’ll have to wait for the video where you can see exactly what he said in his own words.

The substance of Evan’s speech was that we cannot go into the next election after having attacked one party for five years and one party for one month. He said that would not make the Lib Dems credible as an independent party. He stated that he thought that differentiation was now coming through and that he wished it had happened sooner.

Referring to Jeremy Browne’s point on choice, he said that you can’t compare an informed consumer choosing their bread and margarine with a patient, who knows next to nothing about what medical treatment they should be given. He said that we should not let markets rip in areas such as healthcare or education . He believed that academies and free schools create two-tierism, and that the mantra of choice goes against creating effective public services.

Paul Marshall

Paul was co-editor of the Orange Book eight years ago and kicked off with an apology for only printing 3,200 copies of the book. He said that the limited print run meant the book was much more talked about than read. He said the Orange Book was not new – but was rather an attempt to reclaim liberalism. He said that the party had been neglecting one of the four pillars of liberalism (specifically economic liberalism) and that neglect of it had made the party unbalanced and irrelevant.

Specifically he listed that the lack of this pillar back in 2004/5 – he cited the extraordinary list of pledges made before the election (21,000 extra teachers, 10,000 more police officers and an extra £100 a month pension for the over 75s etc) – a combination, he said of unrealistically high spending commitments and “bribes” to constituencies (eg pensioners, students etc).

He argued that the Orange Book had made it possible for Lib Dems to get into power. At the 2010 election the Lib Dems had abandoned this kind of “oppositionitis”, he said, with one exception: the promise not to raise tuition fees. He noted that we have since discovered that Nick Clegg, Vince Cable and Danny Alexander all believed the policy unaffordable.

Nick Watt

Nick from the Guardian was absent from the start of the fringe filing his copy for the paper. He apologised and kept his remarks brief. His key point was that the Orange Book vs Social Democrat division was a false one.

He pointed out that both some of those described as the Continuity SDP were actually contributors to the Orange Book. Vince Cable and Chris Huhne both had essays in the Orange Book and that Vince led on the tuition fees U-turn and that Chris Huhne pushed the party to back an extreme deficit reduction strategy. (He revealed he was, in fact Chris Huhne’s step brother).

That’s it for now. Our thanks to all the panelists (and Mark for chairing) and the IEA. We’ll post the video as soon as possible.

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