Local Government Association questions value of stop smoking services

Breaking news.

Responding to the ASH report on budget cuts to stop smoking services (see previous post), the influential Local Government Association has issued a statement:

Cllr Izzi Seccombe, Local Government Association Community Wellbeing spokesperson, said:

“Since the advent of e-cigarettes and campaigns such as Stoptober, we have seen the number of users of smoking cessation services fall, while the population of smokers left is now more challenging to get to quit.

“This means councils are re-evaluating what they do on tobacco control and how to be more effective.

“Councils remain committed to helping smokers quit, however they face significant cuts to public health budgets this year, and spending large volumes of money on a service people are not using will fast undermine the cost-effectiveness of providing it.”

In plain English, the Local Government Association doesn't believe stop smoking services offer value for money because smokers who wish to quit are increasingly embracing free market solutions such as e-cigarettes.

If the LGA is querying the point of stop smoking services, how long before local authorities start asking questions about regional anti-smoking groups such as Smokefree South West, Tobacco Free Futures and Fresh?

What, exactly, do those groups do that anti-tobacco groups such as Cancer Research, the British Heart Foundation and the British Lung Foundation don't do already?

The British Lung Foundation runs No Smoking Day, Stoptober is backed by Cancer Research and the British Heart Foundation, so there must also be question marks about the role of ASH as a quit smoking organisation.

Apart from media and political lobbying (and a 'project' paid for by central government using public money), what is the USP that justifies ASH's existence and an annual income that currently includes £150k of public money?

I'm damned if I know.


ASH begs government for money but don't call it political lobbying!

What a coincidence.

At the very moment I was writing my previous post (Fat cats in public health axe services) I received a copy of a press release from Cancer Research whose CEO pockets £240,000 a year.

Here's a taste:

Stop smoking services under threat as funding comes under pressure

Around forty per cent of local authorities in England are cutting budgets to stop smoking services according to a new Action on Smoking and Health (ASH) report published today (Wednesday) by Cancer Research UK ...

In the Spending Review 2015, the Government announced cuts to local council public health budgets of 3.9 per cent a year over the next five years. This is in addition to the £200 million extra in year cuts announced at the Budget 2015.

Stop Smoking Services are not mandatory services that councils must provide so there are fears they will be targeted and hit hard by cuts. This would then make it difficult for smokers to get the support they need to help them break their addiction.

Naturally a tobacco levy, rejected by Chancellor George Osborne last year, is back on the agenda.

George Butterworth, Cancer Research UK’s tobacco policy manager, said: “We believe the tobacco industry should pay for the damage their products cause. A levy on the tobacco industry should be used to provide sustainable funding for Stop Smoking Services and mass media campaigns to help people quit.”

And here's Hazel Cheeseman, director of policy for ASH and one of the report authors:

“Our research shows that most local councils take their responsibility to reduce smoking very seriously. But, they are facing enormous funding pressures. The services we have to support smokers to quit are world class but they are being eroded. The wider role that council’s play in tackling smoking - such as enforcing existing laws on smoking and selling tobacco - is also under threat.

“We need national action now to ensure that local authorities have the tools and the funding to do everything they can to reduce smoking rates.”

Now if that's not political lobbying by a so-called 'charity' I don't know what is.

More to follow ...


Fat cats in public health axe services not salaries

There's a minor scandal brewing in Ireland following revelations about the amount of money the Irish Cancer Society spends on staff salaries.

According to the Irish Examiner, the CEO earns €145,000 (£108,000) a year.

In addition to his salary, the society contributes 16% of Mr McCormack’s gross salary to his pension fund, pays the approximate €3,000 annual cost of his health insurance and provides him with a Toyota Avensis.

According to the Examiner:

The society’s financial statement for 2014 shows €7.4m was spent on salary, social welfare, and pension costs for 152 staff, of whom 12 were paid over €70,000.

All this came to light when the ICS decided to cut "vital financial support provided by the Irish Cancer Society to more than 2,700 patients struggling to pay household bills on after a cancer diagnosis".

The charity said it was withdrawing the financial lifeline to hardship cases on January 31 due to “unmanageable demand”, which it said was putting other vital services at risk.

The announcement prompted a proliferation of dismayed tweets and a flood of phonecalls to radio chat shows from callers expressing anger, disappointment, and disgust.

Needless to say there were no staff cuts nor were any salaries threatened.

Defending the charity’s decision, Kathleen O’Meara, the society’s head of advocacy, said they had “looked at all the possibilities” before opting to axe the scheme.

Asked on RTÉ’s Drivetime if this included looking at reducing salaries, including the CEO’s annual salary of €145,000, Ms O’Meara said it had been looked at, but “the board had passed the budget” in December.

See Anger as vital financial support for cancer patients to be cut by Irish Cancer Society (Irish Examiner)

The row is similar to that in Britain when it was revealed that "Dozens of charity bosses are pocketing six-figure salaries funded by public donations."

Nine executives at Cancer Research UK earn more than the Prime Minister, including chief executive Harpal Kumar, who pockets up to £240,000 a year.

Kumar, 50, lives in a luxury £1.6m home in north-west London and does not have a mortgage.

Peter Wanless, CEO of the NSPCC, earns a staggering £162,000 per year – £40,000 more than his predecessor Andrew Flanagan.

Other high earners include Amnesty International's Salil Shetty, who pockets a salary of up to £210,000, and Tom Wright of Age UK, who earns up to £190,000 a year.

See Outrage as charity bosses pocket six-figure salaries from generous public donations (Daily Express).

Personally I don't have a problem with people earning large salaries if they are in charge of organisations that raise large sums of money because fund-raising is a skill and if you want to raise a lot of money you need the best people to do that. It's called market forces.

Nevertheless it's good that the the salaries paid to staff working for public health organisations and the services they provide are coming under greater scrutiny because salaries should be proportionate to income raised.

This is especially true of organisations that receive public money. According to O'Meara the Irish Cancer Society "are not State supported". The ICS did however receive a grant from the Department of Health of €600,000 in 2015/2016 for a programme to help people travel for treatment.

In the UK Action on Smoking and Health enjoys a very similar relationship with our own Department of Health.

This year ASH will receive £150,000 from the DH for a specific project. (In previous years it was £200k.) Exactly how the money is spent isn't yet clear but I hope to find out.

Update: Stop smoking services under threat as funding comes under pressure says ASH. More to follow in my next post.

Update: I'm hearing that the Irish Cancer Society has reversed its decision. Watch this space.


The politics of public health

The announcement on Friday of new alcohol guidelines prompted this response from Forest's Action on Consumer Choice campaign:

New guidelines on alcohol consumption will cause unnecessary alarm and will be used to justify more nanny state policies, say campaigners.

The new advice, issued by the UK's chief medical officers, reduces the recommended level of alcohol consumption to just 14 units per week for men and women - equivalent to one pint of fairly weak beer per night - and suggests that pregnant women should not drink at all.

Action on Consumer Choice, which campaigns against excessive regulations on smoking, drinking and eating, argues the new guidelines lack evidence and are based on the idea that all risk should be removed from our everyday lives.

Rob Lyons, campaigns manager for Action on Consumer Choice, said: "The claim that there is no safe level of drinking flies in the face of the weight of studies showing that those who drink moderately have better or similar health outcomes to teetotallers.

"These guidelines seem devoid of common sense. They will be widely ignored by most drinkers but will cause unnecessary alarm for others.

"They seem designed to suggest that drinking alcohol in more than tiny quantities is abnormal and risky.

"The real danger is they will be used to justify more nanny state policies, from higher prices and alarmist health warnings to further restrictions on the sale of alcohol."

Rob was quoted by several newspapers, including the Mail (Health chief attacked over 'nanny state' alcohol guide that says a single glass of wine a day raises cancer risk).

He also appeared on the BBC News Channel and 13 local radio stations including BBC Cambridgeshire and BBC Merseyside. (You can listen to the interviews here and here.)

H/T too to Chris Snowdon who has been the most consistent and outspoken commentator on this issue for some time now.

Chris did a fine job on the Today programme (and elsewhere) and has posted several pieces on his blog including 'The Chief Medical Officer is misleading the public'.

There's not much more to add, apart from the following links:

Alcohol puritans: drunk on power? (Action on Consumer Choice)
The state needs to butt out of Britain’s drinking habits (Guardian)
Don’t let the public health zealots demonise us innocent drinkers (Telegraph)
Why those killjoy new alcohol rules are just plain wrong (Daily Mail)

One issue I will come back to, though, is this. In an otherwise impeccable article, Charles Moore (Daily Telegraph) contrasted alcohol with tobacco and wrote:

Unlike smoking which is – though people should be free to do it – unambiguously bad for you, drinking is subtle. It has its benefits and its dangers. It is a joy of civilisation, and a threat to it. It is like human life, in fact, and therefore peculiarly unsuited to policies of repression.

Is smoking really "unambiguously bad for you"? That's what we're led to believe, certainly, but it does seem odd that while many are (rightly) questioning the evidence on the ill effects of a moderate consumption of alcohol, sugar and smokeless tobacco, there is an almost unanimous consensus that smoking has no redeeming benefits and can only lead to ill health or moral turpitude.

Common sense – supported by some statistical evidence – suggests heavy smokers are putting their health at far greater risk than moderate drinkers, for example. But what about those who smoke moderately, take regular exercise, enjoy a healthy diet and don't drink to excess? Is smoking "unambiguously bad" for them too?

Eating, drinking, smoking and lack of exercise are all potential factors in ill health, as are poverty, loneliness and, inevitably, old age. In other words, health is a complicated issue and everyone is different.

Another problem is the term 'public health'. In Victorian times it meant solving problems caused by toxic drinking water, for example. In the 21st century it should mean tackling things like winter flu, sanitation problems caused by flooding, health scares such as ebola, or the threat of the MRSA bug in hospitals.

Instead the 'public' health industry has been commandeered by those who want to control our private habits. Individal health has been politicised and the evidence of the last two weeks shows just how powerful, oppressive and relentless the public health industry has become.

So if you enjoy drinking, smoking, vaping or eating whatever you please, remember this. There's no appeasing the public health lobby. They have no interest in choice or personal responsibility. It's all about money and control.

Prohibition – be it nicotine, alcohol or sugar – is their long-term goal because that will keep them in business long into the next century.

Does anyone really believe they will settle for a guideline of 14 units of alcohol per week? Or a 'smokefree' nation that allows five per cent of adults to light up without censure, with millions allowed to vape in peace?

With regard to vaping, btw, there are two types of public health campaigner. The first believes e-cigarettes renormalise the act of smoking and must be severely restricted or banned.

The second believes they are a useful tool that will help consign smoking to history. Once they have achieved that aim they will turn on e-cigs and other recreational nicotine products with the same evangelical fervour they brought to the war on tobacco.

Anyone who doesn't understand that doesn't understand the politics of public health. ('Useful idiots' is the expression that comes to mind.)

Thankfully the UK's chief medical officers have been called out on their latest 'guidelines' but that won't stop them demanding further regulations. They work in a bubble, surrounded by other public health campaigners who have bought into the new Jersulalem and won't tolerate dissent.

What's needed is a genuine coalition of consumers who will fight the public health industry tooth and nail – and not appease them because it suits the narrow self interest of one particular group or product.

Did I mention Action on Consumer Choice? To register your support click here!


Spare us from the sanctimonious puritans who would have us all live risk free lives

I've just seen an email sent to Forest.

Subject heading: 'David Bowie'.

It reads:

Keep up your good work :(

Oddly enough someone with the same name wrote to the Guardian in 2001 following the death of George Harrison.

The original letter doesn't seem to be online but it generated this response:

I think x will find it is beagles who are forced to smoke, not Beatles.

There may be a gap of 15 years but I'm guessing the email and letter were written by the same person.

It says everything about the anti-smoking mindset that there are people who instead of celebrating the life of a remarkable showman/artist can't wait to comment – indirectly – on that person's lifestyle and attack those who believe everyone should have the freedom to make informed choices.

I don't know what caused the cancer that killed Bowie – perhaps he was just unlucky – and on this of all days it seems inappropriate and distasteful to even speculate.

But I do know this. Bowie made the most of his 69 years and if that included a tendency to take risks (personally and professionally) without harming anyone else then it was no-one's business but his own.

If you celebrate someone's life you have to celebrate everything about them because that's who they were.

Meanwhile spare us from the sanctimonious puritans who would have us all live 'healthy' risk free lives.


Squeezing out sparks

Got every album, seen them live many times.

So it was weird to see Squeeze hailed as heroic agitprop protestors following today's appearance on the Andrew Marr Show.

Very briefly, David Cameron had been interviewed by Marr and at the end of the programme Squeeze played the title track of their new album 'From the Cradle to the Grave'.

However the third verse was changed to:

I grew up in council housing,
Part of what made Britain great,
There are some here who are hellbent,
On the destruction of the welfare state.

As I write the band is still trending on Twitter and the story has been among the most popular on the BBC website all day.

Elsewhere a typical headline and report is this one from the Independent – David Cameron condemned live on TV by Andrew Marr Show band Squeeze as group change lyrics to target Tories.

The last time I saw the band was in October in Harrogate, one of the safest Tory seats in the country. It was a full house, naturally.

Two tickets cost £118 via a secondary ticketing agency. Capitalism at its best, you might say.

Poor old David Cameron is getting pelters for applauding the band when they finished their 'protest'.

I can't imagine he was listening to the lyrics and if he was what was he meant to do? He was merely showing good manners. I'm sure they had a laugh about it afterwards. (Or perhaps not.)

Meanwhile some people (I assume they are Tories) have taken to Twitter and have called for Andrew Marr's producer to be sacked for allowing Squeeze to make a "political statement".

For heaven's sake. I don't agree with the sentiments but, as someone else tweeted, if other guests (including the PM) are making political statements on the programme, why can't the band?

Freedom of speech (remember that?). It's a wonderful thing.

Anyway, whatever the merits of the song, the performance or the political message it took some nerve to do that with the PM sitting no more than a few feet away.

To echo another tweet, 'Bravo!'.


Controversial law firm also acted for ...

The name was familiar but it took a while for the connection to sink in.

According to the Telegraph yesterday:

Labour's new shadow defence secretary Emily Thornberry received donations from a law firm which was condemned over false claims British soldiers were involved in torture and murder in Iraq.

Jeremy Corbyn's new frontbench appointment accepted £14,500 from Leigh Day & Co, which is now facing disciplinary action after allegations it made were found to be "wholly and entirely without merit" by the Al-Sweady inquiry.

See New defence shadow minister Emily Thornberry accepted £14,500 from law firm which sued British troops.

The Tories, naturally, smelled blood. Addressing the PM Conservative MP Stewart Jackson said:

"Will my Right Honourable Friend agree with me that it's more than a matter of regret that the new shadow secretary of state for defence has seen fit to take a donation from the immoral, thieving and ambulance chasing lawyers Leigh Day, who together with public interest lawyers specialise in hounding our brave service personal in Iraq on spurious claims."

Speaking in the House of Commons Mr Cameron responded that Mr Corbyn has questions to answer over the appointment. He said: "I do think this organisation Leigh Day does have some questions to answer, not least because they were deeply involved in the al-Sweady inquiry.

Leigh Day. The name rang a bell but I couldn't quite place it.

I turned to the Mail for more details:

Solicitors from a law firm hounding British soldiers over their actions in the Iraq War could be struck off, it was revealed yesterday.

A year-long investigation into Leigh Day's alleged dodgy practices concluded the claims were serious enough to pass on to a disciplinary tribunal.

It was launched after it emerged the firm shredded a key document which could have stopped the Al-Sweady inquiry into Iraqi allegations of torture by British troops – and saved taxpayers £31million.

Leigh Day. Leigh Day.

I was sure I'd heard the name before. But where, and when?

I Googled the firm. According to the Mail (in December):

Labour has received tens of thousands of pounds in donations from one of the law firms criticised over false claims British soldiers were involved in torture and murder in Iraq.

Leigh Day and Co gave the party or its MPs a total of £33,000 over two years, official records show.

Interesting, but that wasn't it.

And then I remembered. (I even wrote about it here.)

Leigh Day acting for ASH in High Court tobacco plain packaging case:

Law firm Leigh Day is representing the campaigning public health charity ASH who are intervening in a High Court case, beginning today (10 December 2015), which has been brought by the four major manufacturers of tobacco products against the UK Government’s decision to introduce regulations on pack design for cigarettes and hand rolled tobacco ...

Sean Humber, head of the human rights team at Leigh Day and who is representing ASH, said: “ASH are intervening in this important legal challenge in support of the Government’s proposals to introduce plain packaging on the basis that these proposals are clearly a justified and proportionate response to the extreme harm caused by cigarette smoking and the need to protect public health, in particular the health of children and young people."

Truly, it's a small world.


Bauld as brass: an uncomfortable truth about some vaping advocates

I'm a bit late to this but it warrants a quick post.

According to reports – widely published last week – a new study suggests that 'E-cigarettes are no safer than smoking tobacco, scientists warn'.

I haven't read it yet but I understand this is a serious misreading of the study. You can see where the headlines have come from though because in the press release the lead scientist stated, "Based on the evidence to date I believe they are no better than smoking regular cigarettes."

In other words, and not for the first time, hard-pressed journalists have simply lifted the copy from the press release without bothering to do any further research or invite comment from third parties.

Naturally social media exploded with vapers and anti-smoking vaping advocates united in condemning the reports. Chief target of their ire was Sarah Knapton, science editor at the Telegraph, who posted one or two inadvisable tweets of her own.

To be honest, I'm not sure swarming around journalists like angry bees is the best way to make friends and influence people. I understand the anger and frustration people feel when they read these reports and compare them with the actual study, but journalists are not, in general, the enemy. With a handful of exceptions they're ordinary people trying to do what can be a high pressure job to the best of their ability.

In the case of health correspondents it's quite simple. Journalism is a competitive industry and in order to do their job they need their sources. The public health/tobacco control industry knows this and if health correspondents are perceived to give too much weight to contrary opinions they risk being exiled from the inner circle.

In practise that means they won't receive embargoed press releases and other information, putting them at a serious disadvantage to their colleagues and potentially threatening their jobs and livelihoods.

(Ironically Knapton has just been punished in exactly this way, not for filing an inaccurate report but for breaking an embargo, the ultimate sin. Apparently she will lose access to embargoed content to Nature magazine for three months after breaking an embargo on a study about stem cells.)

Other journalists are not so cowed and it's to their enormous credit that other parties do get a chance to comment, but don't underestimate the pressure they're under to ignore us.

Despite Knapton's subsequent tweets she must know her report was lacking in balance. Nevertheless, even if I knew I was in the wrong I know how I'd feel if I was targeted by scores of irate people calling for my dismissal.

Embattled people tend to react negatively to excessive and sometimes personal criticism. Rightly or wrongly they feel they're being bullied. Far from changing my mindset I might actively go looking for anything that would support or justify my earlier report. It's human nature not to allow yourself to be browbeaten, whatever the rights and wrongs of an argument.

What stood out last week however was not Knapton's article (which was no different to most other reports about the San Diego study), but the identities of some of the leading complainants.

The reaction of vapers, I can understand. Some of the loudest voices though were those of anti-smoking campaigners who for a decade or more have made careers on the back of some very dubious claims about the threat of passive smoking, the 'success' of the smoking ban, or even the impact of smoking itself.

The hypocrisy is staggering but because they are advocates of e-cigarettes (as a quit smoking aid) many vapers willingly ignore this uncomfortable truth.

A case in point is Professor Linda Bauld of Stirling University. I like Linda but I've read enough to take with a pinch of salt anything she says on the impact of smoking bans, for example.

If you're interested I recommend The Bauld Truth, a very good rebuttal to The Impact of Smokefree Legislation in England: An Impact Review written by Bauld when she was at the University of Bath.

The Bauld Truth was published by Imperial Tobacco but don't let that put you off. It's a very well written document that should be read in tandem with Bauld's review. Read them both and draw your own conclusions. Chris Snowdon did and in July 2011 he commented:

And this brings me back to Linda Bauld's abomination. I didn't write about her effort when it came out because it didn't get much media coverage and everything in it had been debunked long before the document was published.

Imperial Tobacco, on the other hand, have now decided to tackle it. They've released a report (PDF) which shows very clearly how Bauld misrepresents the truth and ignores evidence that doesn't suit her case. Its conclusions are refreshingly forthright:

We have become used to the public health community and the anti-tobacco lobby groups churning out made-to-measure studies to suit their objectives. Bauld’s review should be submitted to public scrutiny. Without such transparency how can anyone have confidence in Government policy going forward?

The report is of interest because it comes directly from the tobacco industry, whose campaign of doubt regarding smoking and lung cancer in the twentieth century has been well documented. There is, then, good reason to treat what they say with scepticism. And on the opposing side, we have an anti-tobacco industry with a dreadful record of using misleading data and junk science in the twenty-first century. Each side have obvious partisan interests — one is financial, the other is ideological.

Who to trust? The answer, surely, is to trust no one and instead trust the evidence—a pretty good rule of thumb in general. You can make up your own mind. Imperial's report is here. The Bauld report is here. From where I'm sitting it looks like a slam-dunk for Imperial.

See Direct from the ASH bunker (Velvet Glove Iron Fist).

On July 1, 2012 Chris added, for good measure:

We then move onto Linda Bauld of the state-funded Tobacco Control Research Group who wangled the job of assessing the smoking ban for the Department of Health despite having no relevant qualifications in the fields of health, economics or statistics (she is a professor of socio-management, whatever that is).

Prof Bauld's report concluded: "The law has had a significant impact … Results show benefits for health, changes in attitudes and behaviour and no clear adverse impact on the hospitality industry."

No clear adverse impact on the hospitality industry. Truly, these people have no shame.

Now, three and a half years later, Linda is the go to person on anything to do with vaping. She addresses conferences. She gives evidence to parliamentary committees. She's on radio and TV. Her comments appear in newspapers and on Twitter where the vaping community treats her like their best friend.

I loved the way, on Twitter, Linda softly admonished Sarah Knapton and promised to take the matter further. It's absurd but glorious.

She isn't alone, of course. There are lots of anti-smoking campaigners who are eager to berate journalists for misleading the public about the risks of vaping but have no qualms when it comes to misleading the public about the risks of second or third-hand smoke – even smoking itself.

Likewise there are thousands of ex-smoking vapers who seem to believe all the scaremongering about smoking but go berserk when some public health 'expert' questions the long-term safety of e-cigarettes.

"Don't believe the propaganda" they tweet, ignoring the fact that many pro-vaping advocates are happy to promote public health propaganda about tobacco. (A Billion Lives, anyone?)

Anyway, before any vapers have a go at me, here's my latest comment about e-cigarettes, published on the BBC News website on Christmas Day:

"E-cigarettes appeal to smokers because they mimic the act of smoking. There is no evidence they are harmful to the user so if the goal is smoking cessation, banning their use is completely counter-productive.

"If NHS boards are genuinely interested in harm reduction there should be no restrictions on the use of e-cigarettes on hospital grounds. Why discourage the use of a potentially game-changing device?"

And before any smokers have a pop, I did emphasise that Forest remains strongly against smoking bans on hospital grounds too!

See Five Scottish health boards review e-cigarette policy (BBC News).

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