A primer on the buffoonery of Simon Chapman for Australian IWT opponents (part 1)

I was recently reading about the fights over IWTs (industrial wind turbines) in Australia, and was surprised to learn that Simon Chapman -- who is a visible activist proponent of IWTs, despite apparently not understanding the relevant science -- creates a difficulty because he is considered a scientist and respected for his contributions regarding tobacco, and so has influence in halls of power.  I suspect that few people working on IWTs realize that his "contributions" to science and regarding tobacco are pretty much comical, and that he has undoubtedly done more harm than good for public health.

While I probably cannot do anything to help improve your government's willingness to trust in supposedly serious and technically-expert opinion leaders who are actually clueless hacks (if I knew how to do that, I would start here by doing something about Paul Ryan), I might be able to contribute some useful tools for fighting him.  He may well be able to leverage his supposed respect and accomplishments from tobacco to exert inappropriate influence about IWTs so long as people do not understand what he actually says in that realm, but once that is on the table he might do less damage to the world.  I think I can give you enough information to undermine Chapman's credibility as a respected international ...um... well, whatever the heck he claims to be.  I think this is up to me because I am, as far as I know, the only person I know with substantial expertise in the science and policy of both tobacco and IWTs.  I hope it becomes apparent that Chapman does not fit that description, though he works in both areas.

(For those who are not the target audience, but are interested in the tobacco politics, I expect you will find this interesting also.  As a bit of background: IWTs -- those giant bladed towers that generate electricity from wind -- cause terrible health and other problems for local residents.  While it might be possible to argue that this is a price worth paying for their benefits, the "benefits" of these monstrosities are a barely-positive net contribution to electricity generation at a cost that is ridiculously high.  But that cost-benefit argument is not the one that the industry and those working on their behalf, like Chapman, ever make; instead, they stick to the blatantly absurd claim that there are no local impacts.)

In this post I will address why Chapman does not deserve any respect for his "contributions" regarding tobacco.  In part 2 or maybe even 3, I will address how clueless he seems to be about IWTs and some of his other silliness.

First, it is not clear that anyone currently in tobacco control can claim credit for any major accomplishments; it has basically been a workaday affair for decades.  The reduction in smoking in rich countries began when 25 years of epidemiologic research finally resulted in the public health declarations of the 1960s and the education campaigns that started soon after that.  Since that time, smoking rates have steadily dropped toward their natural minimum, which they are close to now, like treacle (that is a word you use down there, right?) slowly running down a hill. 

The imposition of high taxes had some effect beyond the education.  Bans on indoor smoking in various places have reduced the impact (mostly aesthetic) of smoke on non-smokers.  But other than education, taxes, and substitution of low-risk (smoke-free) alternative products, nothing has had a measurable effect on smoking prevalence.  The substitution of smokeless tobacco or electronic cigarettes is a strategy known as "tobacco harm reduction"; it accomplishes appx 99% of the risk reduction of eliminating tobacco/nicotine use entirely, but leaves former smokers happier and allows for free choice.  Chapman is among those who oppose harm reduction; the motivation seems to be largely a desire to punish (both smokers and manufacturers) rather finding a way out of the current mess that makes everyone better off, and to exert control rather than allow free choice.

There are a few heroes of tobacco control, but they are the original researchers, who were also the core of those who did the first public health education.  Most everyone else who claims credit for reducing smoking basically just marched ahead of the treacle flow, carrying a flag, and claimed to be leading it.

Australia has among the lower rates of smoking in the world (though not nearly as low as the few places where substitution of low-risk alternatives has become popular), but it is not particularly exceptional given demographics and culture. Basically, that country just followed the lead of US, UK, and German researchers and early policy movers, and ended up just where you would expect it to be.  Nothing Chapman ever did made any substantial difference in the inexorable flow.

But "no major impact" is far too kind in this case.  I recently characterized Chapman as The Worst "Public Health" Person in the World.  He has done a lot to earn that title, but the standout contribution is that he
claims personal credit (i.e., blame) for the ban on low-risk alternatives to smoking in his country, making him the person responsible for the most pointless deaths of his countrymen since the guy who ordered the army to Gallipoli
So basically it might be that Chapman sometime contributed to raising taxes a month sooner than would have happened without him, or something of that magnitude (though, as will become apparent, if he had such an effect it must have been thanks to his skills as a bully, not as a thinker), but he also claims to have kept Australia from possibly getting the benefits of product substitution.  Since product substitution is the only proven method for getting smoking rates below about what they are now in Australia (or the US or Canada), this has to put him on the negative side of the public health ledger by a huge margin.

Of course, I realize that if you try to explain this, it will probably exceeds the attention span of anyone who thinks that listening to Chapman is a good idea.  Explaining to most people that what they thought they knew about tobacco policy is wrong is probably not a promising tactic in political rhetoric, though I think it might be helpful perspective for those who are most invested in the IWT fight.  I think much more promising approach is on the theme of "whatever he once did, now he is clearly a buffoon who spouts one false, hateful, or silly thing after another":

Recently, his public focus has been the campaign to ban branding or artwork on cigarette packages, which legally basically means abolishing even the most basic rights of free communication, confiscating brand equity, and seizing the packages as conduits for anti-smoking advertising.  This is a violation of international trade treaties, and I have seen arguments that it violates Australian law also, though I have no way to judge that (and, indeed, will bet that the court now hearing arguments will let it pass, given the national trend toward being nanny-state; the international tribunals will undoubtedly find it to be illegal).  On top of that, it is clear that this policy will lead to more counterfeiting and smuggling because it both facilitates it (generic packages are much easier to fake) and increases demand for it (if all packaging is ugly, there is one less barrier to buying the cigarettes in plastic bags off the back of a truck).  Among the effects of such smuggling are much cheaper cigarettes, sold through channels that are not too picky about ages limits and such, enriching of organized crime enterprises, and loss of tax revenue.

So it must be that the benefits of this policy are so great that it is worth the fight against law and norms, right?  Well, no.  This will not have a measurable effect on smoking.  It has never been tried before (and thus Chapman's and others' claims that they have evidence it will be effective are clearly blatant lies), so it theoretically might have some impact.  But "theoretically might", when there is absolutely no basis for believing it will happen, is not a legitimate basis for radical policies -- which the proponents must understand, or they would not lie about the impact being proven.

It will however hurt smokers (making their lives a little bit less happy due to the ugly health graphics rather than pleasant looking branding) and especially major tobacco companies (because it helps the smugglers they compete with, and also because it makes it harder for them to profit from prestige premium brands since smokers will probably shift toward the cheaper brands if they all look the same).  Since hurting smokers and hurting the industry are the goals of pseudo-public-health anti-tobacco people like Chapman, this works out just fine.  For people like him, it is not about public health, and definitely not about helping smokers.  It is about perpetuating his gravy train and punishing people who dare disobey him when he declares the Right Thing To Do.

If that sounds familiar to those in the IWT fight -- an action that does not fulfill any of its ostensible goals, and merely helps the rich get richer at others' expense, but attracts a cadre of useful idiots supporting it because they think it is good for society -- then you are catching on.

For those who are interested in digging deeper into why Australian tobacco control, even the non-buffoons in it, is pushing for an illegal move that has no apparent upside:  I speculated that those who are pulling the strings behind tobacco control are intentionally setting up this useless policy to fail so that they can claim that Evil Big Tobacco thwarted their plan that would have ended smoking once and for all, and thus ensure a continuing funding gravy train for another decade.  Chapman does not seem to have the skills to come up with a clever plan like that, nor the discipline to keep quiet about it.  So if that story is true, Chapman is probably just one of the useful idiots who is playing naive foot soldier.

So, the choices about him are either:  A leader of an activist cadre that has accomplished nothing of value, but does some really stupid things.  -or-  A dupe of the real leaders of that cadre.  Neither one is exactly a qualification to branch out and hurt people in other areas too.

But this flat assessment can never present the picture of him that you get if you look at the details of what he actually writes.  I have listed a few choice examples, and I recommend following the links to fully appreciate them.  I should note that I did not do any active research to gather this information.  I did not do a web search and I do not follow him on Twitter.  I cannot even imagine what you would come up with if you put in that effort.  Instead, these items are mostly those that came across my desk just during the few weeks since I started thinking about writing this guide (really! you would be astonished how often stupid things Simon Chapman has written come across my desk without any effort on my part), along with a few particularly amusing ones I recalled from past months.  Also, these are just the ones about tobacco -- I will include some others in a later post -- and I left out a couple of recent posts that tried to analyze him because I wanted to focus on him condemning his own intellect and integrity with his own words:
  • Here he is citing some random bravado by cigarette counterfeiters as the basis claiming that plain packaging will not facilitate counterfeiting.  Actually, the funny part is that it mis-cites the counterfeiters' claim, translating it into something that is utter nonsense -- it is a hilarious read. 
  • But don't worry, because counterfeiting is no problem: Here he is claiming that smuggling (of illegal cigarettes) cannot possibly be a problem because if customers know where to buy illegal product, then the police can easily know too, and thus stop it.  Gee, he should probably tell the drug enforcement authorities about that clever bit of sociological analysis.  Maybe he just doesn't want to make the cop dramas really boring ("Chief, we heard some people were selling crack, so we went to where it was happening and stopped it.  So can we get back to directing traffic at the construction site?"
  • And, besides, he assured us that "Smuggled tobacco is a major issue in nations with high corruption indexes and open borders. It has never been a major problem in Australia."  Apparently it is all about corrupt nations like Canada and non-island nations like Ireland (which both have enormous cigarette smuggling).  Wait, what?  You say that a major Australian newspaper reported, one week after he published that comment, that Sydney is flooded with black market cigarettes. Interesting.
  • Here he is espousing the fallacy that what is bad for industry must be good for public health, but then in the same material admitting that he really understands the truth and thus was mostly lying or such a poor thinker that he does not see the contradiction.
  • Here he declares that the many countries who are challenging the seizure of trademarks and such are all just corrupt and basket cases.  Perhaps he was reading the list from the back end of the alphabet and got as far as Zimbabwe before his limited attention span fell off; he apparently did not get to Turkey, Indonesia, Chile, and numerous other, or even as far as Zambia.
  • When a member of the UK parliament analyzed his plain packaging plan and pointed out that the costs exceed the benefits, did he respond with analysis?  Of course, not -- he does not do analysis, and does not pursue causes that are supported by analysis.  Instead, he claims that any opposition to his pet policies from the UK reflects that country's support for the slave trade.  I am not kidding.  Read here and here.
  • In response to the legal challenges about trade rules and intellectual property, he argues that it must be just fine since Islamist countries ban alcohol sales, overlooking minor points like (a) banning a product category is totally different from confiscating a brand and (b) if your argument is "this is not unacceptably illiberal; Saudi Arabia does something almost as extreme", then you have a problem.
  • But plain packaging is only the next of several steps he has planned.  His deep knowledge of sociology leads him to suggest that Australia will shortly embrace a system where smokers have to obtain a government permit that controls how much smoking they can do (more here).
  • And just in case you were under the impression that he was trying to help smokers, his hatred of them is apparent here, in his accusing them of absurd acts of bad parenting.
    That is long enough for now, because to really appreciate this message, you will need to follow the links.  And it is worth reiterating that compiling this list required no effort or searching, and I am sure it is possible to lengthen it ten-fold.

    One of the comments on one of the above-linked posts read:
    I have to admit that I love to read about Chapman fails, even though the thought of this man makes me feel ill. He’s a tyrant, using health care issues as a guise to destroy everything he does not like. ... In the fullness of the time, the world will see him as one of the most hateful beings to have lived. He deserves far more scorn than he has yet received. Although, it does feed his enormous ego when we criticise him.
    No doubt that last point is true.  The man is apparently so unaware of both himself and the world that he will probably see something like this as a tribute to his importance.  I don't really care.  I am trying to help the many people he is wantonly hurting, and the impact on him does not matter.

    So, though he can see this as a validation of his impact, I trust that others will actually understand it, and realize the message:  If he is influencing policy about IWTs by coasting on his reputation from tobacco, it might be useful to know that that reputation in that arena is as a junk scientist, a failed thinker, either a liar or incredibly clueless about what he claims expertise on (which is just another form of lying), and an international running joke.

    I will take up further spectacular Chapman fails, probably in a week or two.

    Unhealthful News 213 - More on "addiction", and understanding why NRT does not work

    This posts finishes off my recent mini-series on the nature of addiction and related concepts, in the concept of smoking and other tobacco use.  It started with a post about the implications and ethics of a "vaccine" that prevents someone from getting any effect from nicotine.  I then wrote about a new study that provided some interesting insight into the role of addiction in quitting smoking.  In those posts I introduced the notion of second-order preferences (preferences about changing your preferences) and the Chicago School definition of addiction (focused on someone having increasing marginal returns to consumption, rather than the standard diminishing marginal returns), the only candidate for a legitimate scientific definition of "addiction" that exists in the scientific literature so far as I am aware.  I then suggested that second-order preferences offer an alternative definition of addiction, or at least characterize what is often being thought of when the word is used.

    I wanted to tie this together a bit in the context of news reports about a new study that shows that use of nicotine replacement therapy causes approximately zero increase in the success of smokers who are trying to quit.  Actually, I am not sure there are such news reports right now, but since there is such a study result every few weeks, I am just going to say there are. 

    [It turns out that between the time I wrote the previous sentence and when I posted, a new example came across my desk.  I am not going to bother with details of it because the key point remains that this is a roughly semi-weekly occurrence.  I will note that the authors -- pharma industry flacks -- tried to sell the story that NRT was effective, when their results showed quite the opposite; this is typical, so it is useful to realize that most new studies that claim to have demonstrated effectiveness are really part of the long list that show so little benefit.  Honest researchers would never claim they observed any effect worth mentioning.  For more on the dishonesty of the new study, see this post by Michael Siegel.]

    So, what explains the strange combination of "NRT does not help to a measurable degree" with "people are sufficiently convinced that NRT will help that they keep trying it" and "researchers are are unwilling to accept the evidence that it does not help so keep thinking it will be different next time".  Of course, big money has a lot to do with it:  NRT is obscenely profitable, and so like everything from soda to mobile phones, it is heavily advertised with promises that it will improve your life, and most "public health" researchers I know will do any research someone offers them money to do.  But people would not be vulnerable to the advertising, and the news that it does not help would not be so interesting, if there was not some intuition that the products ought to help.  After all, there are no news stories reporting the shocking discovery that, say, wearing your underwear inside-out turns out to not make it more likely you quit smoking.

    It seems pretty clear that most would-be quitters use NRT based on the belief that it will fulfill their second-order preference, "I wish I did not want to smoke."  That is how the products are marketed, as a way to fulfill that wish.  But there is an important nuance in the sales pitch:  It talks about some immediate "urge" or temporarily "taking the edge off" because these products are not supposed to be substitutes, but only tools for making the transition to abstinence easier.  (Of course, the pharma is happy to sell most of the product to former smokers who are using it as a harm reduction substitute, just as long as they can keep pretending that is not their main market, but that is another story.)

    The nuances of the message and the wish highlight differences between the two candidate definitions for "addiction", and make it clear why it is obvious that NRT will not work.  If the reason someone has the characteristics "chooses to smoke" and "believes he would rather not smoke" is because it is too tempting to relapse before getting through some transition, then NRT or something with similar properties will help.  NRT is designed to lower that supposedly irresistible high marginal return that results from addiction (in the Chicago School sense of the term) until a few days of abstinence lowers it.  (Arguably the products are woefully bad at providing even this benefit, but that is another story still, so let's ignore that complication for now.)  But then again, most people who are really committed to quitting are quite capable of getting through that transition without aid, at least for smoking and even for the likes of heroin.  This was an implication of the Penn State study.  Still, on-label use of NRT can at least theoretically help with this.

    So NRT maybe helps the small minority who only keep smoking because they are not able to avoid starting again after a brief period of abstinence (and so benefit from the aid) but are happy to remain abstinent once they get there (really were motivated by an Chicago School addiction).

    But for many among that minority (in the West) of people who smoke, the combination of characteristics "chooses to smoke" and "believes he would rather not smoke" is something different entirely.  It really represents a realization that, all else equal, not smoking would be better, but not all else is equal.  In particular, such individuals have substantially higher utility (econ-speak for "are better off") when smoking compared to not in the medium term.  By "medium" I refer to the period that is longer than just the short weaning off period, but for which some resulting serious health problem has not occurred yet, and so is only a possibility.  For them, there is no reason to expect that NRT would help in quitting, unless it was used as a long-term substitute.  The reason they smoke again after being abstinent is not some failure to escape the short-term high marginal utility, but because of the assessment "I would be better off smoking again".  Perhaps this assessment is often made without fully considering the consequences, but often it is made in fully recognition of the health risks.  (I suspect it is seldom made with the realization that low-risk substitutes that are better nicotine source than NRT -- smokeless tobacco and electronic cigarettes -- offer the best of both worlds, but that it yet another story.)

    In other words, if we use the word "addiction" to describe this phenomenon, it is not the Chicago School definition.  The apparent difference between "willing to pay the price to consume something" and "addicted to it" is the second-order preference "I would prefer to not be willing to pay the price to consume it".  That creates the interesting situation, wherein anyone who prefers to smoke and says "I am ok with my preferences/choice" is not addicted, whereas if they change their mind about that, they are.  It also creates a situation where the dedicated quitter must either alter his preferences (as with the vaccine, that leave you no better off when using nicotine as compared to not) or forever fight them.

    The makers of NRT (and their subsidiaries in government, clinical medicine, and "charities") try to sell people on the idea that NRT will adjust their first-order preferences to better conform to their second-order preferences.  Perhaps it sort of does that in the very short run.  But it does nothing to change a person from someone who benefits substantially from nicotine to one who does not.  Medium term preferences are not changed.  Since the ANTZ who dominate the discourse like to pretend that no one benefits substantially from nicotine, and NRT merchants are happy to play along with this, understanding of this fundamental phenomenon is rare.

    If research on smoking cessation was a science, rather than being a marketing and political activity, the overwhelming evidence that NRT does not work would have led to the rejection of a hypothesis.  The hypothesis about behavior that leads to the conclusion that NRT will be helpful is something a bit more general than the Chicago School notion, though it encompasses it -- something along the lines of "people only do this because they cannot break themselves free of it, so something that aids in that breaking free should lead to substantial quitting."  But lots of people start again after a successful break, so obviously that story does not explain everyone, and indeed near-uselessness of all short-term aids suggests that it explains only a very few current smokers.

    Having proposed it as a definition, I will conclude by saying that I think a definition of addiction that is based on second-order preferences is a lousy one.  It seems to be what a lot of people mean when they use the term, but a phenomenon whose existence is determined by what someone wishes is not a very robust one.  So we return to the situation where the term, as generally used, is just noise, and the intriguing possibility that to the extent that it is well-defined, it is the addicted smokers that are most likely to successfully quit.