There's fat and then there's "public interest" fat cats

Nice one in Spiked about yet another pseudo-scientific bandwagon:

‘Obesity crusaders’ are what we call the individuals who manufactured the obesity-epidemic story in the first place and continue, through application of inherently flawed instruments, such as BMI and apple-body shapes, to misinform the public. They are a relatively small group of public-health officials in the US, the UK, the EU, and the World Health Organization, assorted academics (very many with close ties to the weight-loss and pharmaceutical industry), the International Obesity Task Force, and a collection of so-called public-interest science groups.

It's "Care in the Community" again

In future the drug addicts and mentally dysfunctional people that crowd our prisons will not be put away but will be offered "voluntary treatment" in hospitals. So says Fatty Clarke on the heels of announcing the closure of six prisons to meet the cost-cutting target he irresponsibly agreed after taking over at Justice.

The most shameful episode during the Thatcher regime was its cynical adoption of community care for the mentally ill as a pure cost-cutting exercise. They emptied the asylums that - as their name implied - were supposed to be refuges for those mentally unable to cope with independent living, but did not transfer the funding without which "care in the community" was a loathsome euphemism for abandonment.

So Clarke's latest wheeze is Tory "cleverness" at work, once more. They seize on "progressive" criticism of an existing programme to justify closing it down, and put nothing in its place. With a self-righteous smirk.

In terms of party politics, the smirk appears to be justified. In 1998 Blair's Health Secretary, Frank Dobson, denounced Tory "care in the community" as a totally failed initiative; but his party did nothing to change it.

Let's hear it for a society where the abandonment of the most wretched and helpless is good politics.

EU - vee haff vays of making you conform

"Commission preparing pan-European smoking ban" reports EUobserver.

While partial or total smoking bans have been introduced in many European countries ending patrons' ability to smoke in bars, cafes and other public venues, it is still relatively easy in some states to find a bolt-hole where smokers are welcome, whether due to exceptions to such laws or owners flouting the bans. Health commissioner John Dalli has said he wants to put a stop to this. "We need a complete ban on smoking in all public spaces, transport and the workplace," he said in an interview on Monday with German daily Die Welt.

The commission will furthermore try to win agreement on rules making tobacco products no longer visible to customers and make packaging as unattractive as possible. The packets are to be made identical in appearance and to bear colourful warning pictures, such as of diseased lungs, as well as more information on the toxins the product contains. "The more uniform and bland packaging the cigarettes are, the better," said the commissioner.

I gave up smoking eleven years ago, but these mother-fuckers are making it a moral imperative to start again.

Addiction

Three articles on addiction in the Guardian in one day. Strange serendipity.

By far the most interesting is by Antonio Maria Costa (Wikipedia entry), the executive director of the UN Office on Drugs and Crime. An Italian by birth but a life-long UN bureaucrat, he holds degrees in Pol Sci from Turin, in Mathematical Economics from Moscow State (!) and a Ph.D. in economics from Berkeley. He also, clearly, has people on his staff who can work language very skillfully.

"Legalise drugs and a worldwide epidemic of addiction will follow" is Costa's title, and he lays out his stall in the first two paragraphs. He argues that the dispute between prohibition and legalisation should be focused on the "appropriate degree of regulation" for all addictive substances, including alcohol and tobacco.

Current international agreements are hard to change. All nations, with no exception, agree that illicit drugs are a threat to health and that their production, trade and use should be regulated. In fact, adherence to the UN's drug conventions is virtually universal and no statutory changes are possible unless the majority of states agree – quite unlikely, in the foreseeable future. Yet important improvements to today's system are needed and achievable, especially in areas where current controls have produced serious collateral damage.

Neat little verbal trick there. He uses "illicit" instead of the accurate "illegal" to blur the line, because of course addictive drugs are not "regulated" - they are banned. Costa creates the straw man of a totally free market in dope to undermine, very subtly, the opposing case for outright prohibition. It has to be subtle, because the biggest donors to Costa's office have made it very plain to him that he can kiss his funding goodbye if he even thinks about supporting harm reduction policies such as needle exchanges and diamorphine substitution (that is to say, regulated addiction).

All in all, as neat a piece of high-grade polemical sleight of hand as you are likely to read. Most people think French bureaucrats are the masters of indirection, but the Italians taught them all they know - but not all the Italians know. Not for nothing is the Roman Curia the most successful international bureaucracy in history.

Sadly, the two articles on alcoholism, much the greatest public health issue in Britain, are brutally unsubtle, betraying the usual British refusal to think things through, for fear of reaching an unpalatable conclusion. It is a society in denial on a number of fronts, but I suspect the refusal to accept the prevalence of the genetic predisposition to alcoholism (in common with other northern European societies) may be the most adamant.  

"Britain is on an almighty bender and only by raising drink prices can we lower consumption", says Luisa Dillner. "We have desocialised drinking and taken it into the privacy and unregulated arena of our homes", she says, because booze is so much cheaper at supermarkets. She does not argue that pubs should receive a special dispensation from the general price increase she advocates, so all a further price rise will achieve is to kill off the pubs for once and for all, while increasing the profits from smuggling.

"Only when you tackle the alienation of people living in extreme deprivation will you begin to tackle the problems with alcohol", says Kevin McKenna. No, you stupid lefty. Quite a lot of people living in "extreme deprivation" are there because they were born predisposed to substance dependency. Unadmitted and indulged, it is the most assured means of social demotion to living squalor and early death; and it is hereditary, so the children of addicted parents are doubly handicapped.

The most startling thing about the insolently intrusive British nanny state is that it frigs around at the margins, seeking to reduce risks without a thought of cost-effectiveness, while leaving by far the biggest cause of crime, accidents, domestic strife, preventable illness and lingering death unaddressed.

There are no programmes to educate the population about this lurking danger, and not even the justice system finds it appropriate to impose compulsory Antabuse treatment as a condition of probation for individuals convicted of offences while under the influence of alcohol.

There is a simple metabolic test to establish whether someone is predisposed to alcoholism. If administered in the context of a no-nonsense public awareness programme alongside sex education in schools, it would at least equip the predisposed with the necessary information to manage their condition.

Many would choose not to do so, just as many choose to fuck without protecting themselves or their partners from STDs and pregnancy. But in terms of cost-effectiveness such a programme must surely have an order of magnitude better claim to public money than 'elf 'n' safety wheezes like bumping gravestones to see which ones, if climbed upon by thoughtless youths, might collapse and hurt the little dears.

A nation in denial

What is the biggest public health problem in Britain? Smoking? AIDS? Obesity? Heart disease? 

Nope - it's alcoholism. It costs society more than all the rest put together.Which makes it astonishing that British officialdom never mentions the 'A' word. No TV ads to raise public awareness, no government programmes to provide support for alcoholics, no funding for research into the condition. Nada.

If the word is used at all, it is to describe youthful drunkenness - which is less usual among alcoholics, because one of the characteristics of the condition is a very high tolerance until, after indulging the condition for a number of years, a tipping point is reached.

Actually - what a surprise in Britain - such official attention as is paid to the condition is deeply classist, concentrating on the cheaper end of the market for alcoholic drinks.  

It is abundantly established that the proportion of people genetically predisposed to substance dependency varies among ethnic groups. Almost nonexistent among Orthodox Jews, approaching universality among the Amerindians. Much more prevalent in Nordic than in Mediterranean societies.

I have no idea what proportion of the British population is predisposed - yet there is a simple diagnostic test, which could be administered as a prophylactic to all young people to alert those who simply cannot permit themselves to go 'on the piss' with their friends. Because, for them, it is very likely to lead to dependency.

Why is it not done? Well, one of the characteristics of the alcoholic is a deep sense of shame, which leads to denial. I suspect that there are far more alcoholics in denial than there are latent or closet homosexuals among British officials and politicians, and that it explains a great deal about how Britain is governed.