Monthly Archives: August 2012

I do not have too much to say about this or too much time, but since I have been following this issue here, I thought I would make a brief mention of this story about the New York Attorney General investigating energy drinks.

A few random observations:

The state investigators are also examining whether some additives, like black tea extract and guarana, may contain additional caffeine that is not reflected when the drinks are labeled. 

It is really hard to complain about that.  I know that there are some people who think that even informational labeling mandates are anti-liberty.  But as an economist, I have to say that providing accurate information, and trying to provide as much decision-relevant information as possible, even if that involves mandates, is necessary for real informed autonomy (i.e., liberty).

However, once again (as I have pointed out numerous times), what makes these drinks unique in the human experience is the other active ingredients, other than the caffeine (which is often quite modest in quantity).  But, hey, investigating the full picture would be hard, and the newspapers would not give the politicians free press for doing it because the health reporters would have to try to understand something, so never mind.

This, however, is rather unfortunate:

The attorney general…is also looking at whether the companies…violated federal law in promoting the drinks as dietary supplements rather than as foods, which are regulated more strictly.

It is pretty difficult to think of these concoctions as food.  The only reason to define them that way would be to be able to ban them as “adulterated”.  (That silly word, in itself, makes the case:  How does it make any sense at all to refer to an engineered, completely artificial product as “adulterated”?  It is what it is.)

[Amelia M. Arria, an epidemiologist who serves as director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health] added. “The term ‘energy drink’ is misleading. Energy should come from calories — this is more about stimulation.”

I like that point.  That is the kind of simple truth in labeling that could nudge people into making better decisions without needless restrictions or manipulative games.  A refreshingly rational and non-doctrinaire point, given the title of the speaker.  Oh, but wait…

“A person who co-ingests an energy drink and alcohol doesn’t understand how drunk they are,” Ms. Arria said. “Caffeine keeps you awake so you can keep drinking, and high levels of caffeine can mask intoxication.”

Huh?  One of the effects of being drunk, for some people, is drowsiness and the like.  Caffeine and other drugs can eliminate (not “mask”) that particular effect, but certainly not the other effects.  Perhaps she is arguing that getting groggy and falling asleep is a feature of drunkenness, rather than a bug.  But, funny, you never hear “public health” people arguing that this is a good self-correction built into drinking, even though they are happy to implicitly evoke it when condemning some other product.

Finally, there is this:

The amount of caffeine differs widely among drinks but can range from about 80 milligrams to more than 500 milligrams. By comparison, a 12-ounce cola contains about 50 milligrams of caffeine, while a 5-ounce coffee has about 100 milligrams.

The 80 mg is more typical, so that range is rather misleading.  But more important, why did they not just compare, say, 20 ml of coffee, if they were going to report an absurdly small quantity.  Who pours only  5 oz. of coffee?

This week’s apparent final surrender of Lance Armstrong to those who want to charge him with doping and strip him of his most important cycling awards is interesting to me at so many levels.  I so much enjoyed cheering for him during his glory days (at a time when I was cycling myself).  I am not really one to idolize a performance entertainer, as you might guess, but I enjoy and value the entertainment as much as the next guy.  So this is disappointing to me (though since I, like most people, do not really care what the official records say, it is not like I feel like those great Tours have vanished from memory).

On the other hand, Armstrong’s LIVESTRONG cancer charity used to be a particularly high-profile source of disinformation designed to discourage tobacco harm reduction, with its erroneous claims about the risks from smokeless tobacco.  These lies were a pale shadow of the American Cancer Society, who was one of the leaders in producing anti-THR junk science and disinformation, but they were bad enough.  With that in mind, I always saw a bit of a bright spot as the news kept trickling out over the years about Armstrong’s increasingly losing battle with his accusers.

But notice the use of past tense in the previous paragraph.  I just checked the livestrong.org website, and most of the anti-THR disinformation has quietly disappeared since THR.o last looked at it (a few years ago).  I found only one paragraph in one document that really parroted the standard anti-THR party line from the anti-tobacco extremists, and a few random mild anti-smokeless-tobacco bits.  So sometime in the last few years, someone at Livestrong must have learned something about THR and stopped repeating the lies from ACS and their ilk.  So much for the schadenfreude.  Livestrong did not go so far as to endorse tobacco harm reduction, though, which leaves them on the wrong side of the most promising way to reduce cancer in the US today

So what about the science of this?  One of the most absurd things about the whole matter is that the best evidence in support of stripping Armstrong of his Tour de France (etc.) victories is that he won the Tour de France.  How is that for Catch-22? 

To win that and other major bike races requires that someone be near the top, among the entirely population of people who have ever tried to ride fast, in each of:  useful genetic freakishness, practice, choice of the right strategy (short and long term), getting in with the right people, luck, etc.  This is true for coming out on top of any highly competitive activity, be it a sport, politics, entrepreneurship, or whatever.  It is not good enough to be near or at the top in one or two factors because there are too many other people who also do quite well at those one or two, and if they are way ahead of you in the others, then they will come out ahead.  (Those familiar with statistics or economics will recognize this is the same phenomenon that creates regression toward the mean, when luck of the moment is one of the factors.)

The catch is that one of the elements of the “etc.” — a big one in cycling during Armstrong’s glory days, according to the evidence — is using banned performance enhancing drugs.  This means that the most likely way to win was to be a freak of nature and train hard with a good team, and also to dope.  (Or at least this is the way it was a decade or so ago.  There are claims that drug detection has temporarily moved ahead of drug hiding in the arms race between them — though if it were the other way around, would we know?)

So, the logic goes, since there were other people out there who had great genetics, training, teams, etc. and who were, in addition, using great drugs, then even they were a bit inferior to Mighty Lance in most ways, if he did not use drugs also, he still would not have been able to dominate them.  This is perfectly valid scientific reasoning.  The scientifically sensible prediction from this information is that he doped. 

But such logic is not generally acceptable for making rules-based decisions.  Armstrong’s statement this week complained, quite reasonably, about the lack of due process, in particular the fact that he (supposedly) passed all of his drug tests — the accepted definitive measure.  Therefore he should be off the hook.  Indeed, in some sense, passing the drug tests (however one manages to do that) can be considered part of the game.  It is kind of like a hand-ball that is not seen by the official or an umpire calling a dubious out at the plate.  The results are based on whatever was called, which becomes the only truth that matters for the game.  There are no appeals.

The really disturbing part of the due process, though, (even worse than the double/triple/quadruple jeopardy, or the question of how a US organization can strip someone of his French victories) is the power of a few unsubstantiated claims by people with serious conflicts of interest.  As Armstrong observed:

any begrudged ex-teammate can open a USADA case out of spite or for personal gain or a cheating cyclist can cut a sweetheart deal for themselves

A great point.  Unfortunately, this observation will likely not generate concern about the countless people who are convicted of street crimes in the U.S. based on similar “evidence”?  For most of them, the testimony that the cops extract from some convenient “witness” does not leave them as a millionaire living a life of leisure, of course, but utterly ruins their lives.

In sum, I will not be wasting any sympathy on Lance Armstrong, and I really don’t feel like this diminishes the great Tour memories…  winning a time trial looking like a salt lick for lack of a water bottle, surviving 30 meters down through the grass after coming off the road on a switchback, and most of all, blowing past Ullrich and Kloden in 2004, after they refused Armstrong’s attempt to give a deserved stage win to his teammate and, ironically, his eventual primary accuser.

There is a lot to complain about regarding the FDA’s tobacco regulation unit.  The really important bits involve complicated legal and scientific questions, and in a few places even some room for legitimate debate (though you might not be able to dig through the muck to find it).  Someone might even say that in many cases they are doing what they have been assigned to do, and could even be doing about as well as can be expected, given the conflicting legal constraints and the plethora of bad advice they are getting.  The same cannot be said for their communications to the general public, which are both inappropriate (not in keeping with the legitimate mission of the FDA) and so embarrassing and amateurish that it makes the entire operation look worse than it really is.

I have previously pointed out: (a) FDA has no business trying to do consumer manipulation “education” since, even to the extent that someone might argue that such Big Brother-ism is a legitimate mission of CDC, it is clearly not a legitimate mission for FDA.  (b) This is especially true given how bad at it they are; their material reads like it is coming from some third-rate  county health department or non-scientific activist group — indeed, that it pretty clearly where they are copying some of it from.  (c) The @FDATobacco twitter feed is especially pathetic, with a large portion of its traffic consisting of thanking people by name for following and retweeting, and much of the rest being material that could have come from the aforementioned third-rate departments or non-scientific charities, rather than a scientific arm of our national government.  It is truly a national embarrassment.

I was reminded of this when @FDATobacco “favorited” a tweet from Jeff Stier (s/o to Jeff for alerting me to this), in which he ridiculed them for offering advice on how to talk to your teen that recommended being honest and open — two things that FDA Tobacco is very much not known for.  Apparently they did not recognize that it was sarcasm, which is about par for their general savvy. 

But what really prompted me to even bother to comment was running into this silly little quiz, put out by the FDA tobacco unit, so that the kiddies (who the FDA has neither the mandate nor the skill to communicate with) can test their knowledge about tobacco.  To give you a picture of its content:

True or False:  Tobacco use is the leading cause of preventable death in the United States.

The details of this are probably a little complicated for the kids, but this statement is, and has always been and is well documented as being, nonsense.  I am not just talking about the built-in implicit lying about low-risk products by referring to “smoking” as “tobacco”, though that is probably the most harmful aspect of it.  The problem is that if it is “preventable”, why are we not preventing it?  Because we actually do not know how to do so,  of course.  Then why is it “preventable”?  Because they are quite sure it can be prevented just as soon as they figure out how to do it.  But by that definition, cancer or apoptosis is a preventable cause of death too.

Of course, this nonsense statement is a convoluted way of trying to avoid making the true statement, “of all the things that people choose to do, smoking is the one that kills the most”.  But then they would have to admit that people are choosing to do it, and admitting that would be very hard on their self-identity and job security.

True or False: In order to purchase tobacco products in the United States, an individual must be at least 16 years of age.

When I answered True, it told me I was wrong and that individuals must be at least 18 years of age.  Which, of course, means that they also must be at least 16 years of age, so the correct answer is indeed True.  False would mean that you could buy at younger than 16.  Numeracy is not the strong point of these people.

True or False: Youth are sensitive to nicotine and can feel dependent sooner than adults.

The first bit of that conjunction is rather odd to even ask (does anyone really think that young people are immune to nicotine?) so the truth value hinges on the latter part.  They assert “the younger they are when they begin using tobacco, the more likely they are to become addicted to nicotine and the more heavily addicted they will become.”  Since there is no scientific definition of “addicted”, let alone “more heavily addicted” this is a little hard to judge.  It turns out there is remarkably little solid evidence on this topic (once you replace the dramatic words with something scientific), given the huge confounding problem.

True or False: Smokeless tobacco is addictive and can lead to dependence.

Of course they say True, which is not an absurd claim if you are not bothered by the pesky little problem of their being no accepted meaningful definition for “addictive”.  But their answer is still clearly wrong, reading:  “True. Smokeless tobacco contains 28 cancer-causing agents. Adolescents who use smokeless tobacco are more likely to become cigarette smokers.” 

Wow, wasn’t that sneaky of them?  They ask a question that while somewhat fuzzy and misleading (trying to demonize smokeless tobacco without actually declaring it to be harmful), but that is not completely outlandish.  And then they provide an answer that is all lie.  28?  A better estimate would be 1000, which is also a good estimate for any plant or animal matter we eat (though I suppose in the spirit of “at least 16”, above, I gotta give that one to them).  Of course, when you say something “contains cancer-causing agents” you are communicating that it causes cancer to some measurable degree, which is a lie according to the evidence about the smokeless products that the target audience is likely to be using.  As for “more likely to become smokers”, this is either false (if you interpret it to mean “more likely than they would have been had they never used smokeless”, which is how most readers will interpret it) or a lie via literal truth (if you interpret it to mean “almost everyone who chooses to use smokeless tobacco is someone who is also more inclined than average to smoke, and thus more likely than average to become a smoker”).

True or False: Tobacco smoke contains about 70 chemicals that can cause cancer.

If they had said “at least 70”, then in the spirit of “at least 16” they would have been literally correct.  Of course, since so many chemicals can cause cancer in the right dosage and location, and you can never conclude that a particular chemical never causes cancer, this is pretty unscientific phrasing from people that are supposed to be a scientific organization.  But that is not the worst of it.  The answer (True, of course) goes on to say “Therefore, it’s no surprise, then, that smoking causes about one in three of all cancer deaths in the United States.”  Huh???  Even setting aside the accuracy of the statistic, how they hell do they translate “contains 70” to “causes 1/3”?  It is bad enough that they are so scientifically illiterate that they think that makes sense.  But should they really trying to keep American youth ranked so low in math and science literacy?

True or False: Youth who are exposed to images of smoking in movies are more likely to smoke.

[Insert your own joke about not understanding the difference between inevitable social correlations and causation here — I have run out of energy.]

Anyone feeling good about the fact that we are being looked over by the beneficent and honest scientific experts at FDA?