Pell and asthma again

Pellbuster-in-chief Chris Snowdon compares Professor Jill Pell's asthma claims with official figures on asthma hospital admissions in children since the Scottish smoking ban.

You can hear Jill Pell in Edinburgh at the Scottish Smoking Cessation Conference 2011 – free of charge (unless you fail to show after registering). The programme is here.

One of Chris's readers suggests sending the link to the New England Journal of Medicine (publisher of both Jill Pell's asthma study last year and her notorious heart attack study in 2008), to Professor Pell and to BBC Radio 4's More or Less programme. I've done all three this evening.

Too little too late: Duffy answers Waterson

The response, when it came, was barely audible. Sheila Duffy's retaliation to Paul Waterson's suggestion that perhaps we should review the smoking ban came five days later, and somewhat tepidly reiterating the same tired points that we have been hearing for years now.

The smoking ban reduced heart attack admissions by 17 per cent in the year following implementation. Except they didn't, as was blindingly obvious from the moment Jill Pell's study was announced to the world (nine months before the actual study was published).

Asthma attacks in children declined by 18 per cent (the smoking ban did not affect child venues) – this was not true either.

Duffy also remarks on the state of the hospitality sector, remarking that it has not suffered overall. However, certain sections have suffered, namely pubs, clubs and bingo halls. The licensed trade association would not be calling for a review if its members were not suffering.

Duffy finally asks 'who would compromise or roll back on these health gains'? The problem has been that she and her like have lost much credibility over these supposed health gains. Consider ASH Scotland's next project: extending the smoking ban to prisons and mental institutions and intervening to stop people from smoking with children at home. It's the issue of children that exposes the poverty of the secondary smoking claims. It is an article of faith among anti-smoking activists that smoking bans do not increase children's exposure to secondary smoke. But the smoking ban inevitably involved at least the risk to children of considerably more exposure to secondary smoke. Since the strategy was denormalising smoking, the politically acceptable route was to prohibit smoking in public places and then conduct a very thorough 're-education' to persuade parents not to smoke at home. (Coming soon to a town near you.) It might have been more credible simply to have made some very strong statements about secondary smoke to encourage parents to smoke away from home, but left adult venues alone, with perhaps some encouragement to use extraction systems. That would have both reinforced smoking as an adult activity and protected children further from exposure to smoke – but of course would not have 'denormalised' smoking or made smokers an object of public vilification.

As a rebuttal of Paul Waterson's piece, Sheila Duffy's fails: Mr Waterson's is better researched and more reasonable. I would not agree with his recommendation of separate smoking rooms, unless he wants bars hit with rules from licensing boards about when staff may enter specific rooms in pub premises. An indoor air quality standard and extraction systems could do the job, clear the air of  all the stale air as well as the smoke, and open up pubs for business to their core punters again.

Duffy celebrates smoking ban in Scotland

The fifth anniversary of the smoking ban in Scotland falls tomorrow. ASH Scotland celebrates, even if 'she' has to rely on Jill Pell's accounts of drops in heart attack admissions and childhood asthma. Sheila Duffy looks forward to more of the same after the Scottish elections in order to protect children from second hand smoke exposure in the home. As usual, no comments are allowed on the ASH Scotland blog, but you can of course comment here and on Taking Liberties, linked below. 

More on the campaign undertaken by Forest and the Scottish Licensed Trade Association here. Much of Europe allows limited smoking in bars, and their campaign is to bring Scotland into line with this. (I would love to see the line-up of Scottish parliamentarians that would act on this, but I won't hold my breath.)  

Professor Pell: tribute from Snowdon, Blastland and Dockrell

Chris Snowdon's blog has this, reproduced from early 2009, to amuse us while he's away. Since Professor Jill Pell recently came back into the news with her asthma-drops-by-18-percent story, I decided to link to it here.

Michael Blastland's critique of Jill Pell's 17-percent-heart-attack study dates from November 2007: although not the first criticism, it was probably the first dedicated thumbs-down to emerge from the BBC, but this did not prevent the study's findings going three times round the solar system and back before the study itself was published in the New England Journal of Medicine the following summer.

It's quite incredible (or ought to be) that representatives of the UK Centre for Tobacco Control Studies seriously considered Pell's study has any foundation in sound science when a comparable English study found only a 2.4 percent drop in heart attacks – and even this study was not borne out by statistics. The researchers guessed that there were 'already' smoke-free venues in England, and this accounted for a lower drop in heart attacks in England than in Scotland. A considerably lower drop, in fact. Actually the English tried for a 10 percent drop before they settled for 2.4 percent, but even though 2.4 sounds more believable and carefully calculated, it still doesn't rely on the data.

The third party in this story is ASH (UK)'s policy officer.

Lodging motions on Pell in the Scottish Parliament

Actually some of them really believe what she came out with: 

*S3M-7054 Kenneth Gibson: A Reduction in Smoking Means Fewer Asthma Attacks—That the Parliament welcomes the findings of recent research by the University of Glasgow concluding that the admission of children with asthma-related problems to hospital has dropped by more than 18% since the introduction of the ban on smoking in public places in 2006, a reduction equivalent to three fewer children being admitted each day; recognises that, prior to the ban, the admission of children with asthma was increasing at a rate of over 5% per year; notes that the researchers also discovered that, since the ban, there had been a 17% year-on-year drop in hospital admissions from heart attacks and a significant decline in respiratory problems among bar staff; considers that the smoking ban has resulted in a massive step being taken toward shedding Scotland’s image of being the sick man of Europe, and believes that this legislation has greatly improved the health and wellbeing of the Scottish people.

Chris Snowdon crunches the numbers on this by helpfully breaking down the figures supplied on Pell's graph for each year under study and breaking them down into daily averages: 


2000: 2391/366 = 6.53 per day

2001: 2142/365 = 5.87 per day (drop)

2002: 2034/365 = 5.57 per day (another drop)

2003: 1803/365 = 4.94 per day (another drop!)

2004: 2621/366 = 7.16 per day (rise)

2005: 2103/365 = 5.76 per day (drop)

2006: 2633/365 = 7.21 per day (rise)

2007: 2056/365 = 5.63 per day (drop)

2008: 2235/366 = 6.11 per day (rise)

2009: 1397/304 = 4.59 per day (drop) (ten months only of this year counted)


(I added the 'rise' and 'drop' indicators for additional clarity!) Kenneth Gibson also applauds the 17 per cent figure that Pell came out with in 2007 with respect to heart attacks. I didn't know anyone took that figure seriously any more, especially since the drop in England was 'found' to be only 2.4 per cent: a figure that was also not corroborated by routine statistics.


Isn't it reassuring that Scottish leaders believe what they want to believe, rather than looking squarely at the evidence in front of them?