2016 – Another year of nonsense on stilts

As part of running London Skeptics in the Pub, I like to collect stories for our members. These are some from this year that caught my attention. They cover three main areas: health, diet and random nonsense.

Let’s start with the health-related stories.

HEALTH
Antibacterial soaps are often sold with scare tactics – buy this or your children will be eaten by bacteria and you will be a Bad Parent. But there is mounting evidence that they are no more effective than regular soap and water and they may be driving antibiotic resistance.

Glucosamine has become a popular remedy for joint pain but it looks like it’s no better than placebo. This means that it may work – because placebos work, especially in pain management – but it’s not cheap and you might well be better off using exercise. I wrote about glucosamine six years ago and back in 2001 the BMJ found that it doesn’t work, yet it’s still a huge money-spinner.

Staying with pain management, we’ve all used paracetamol but again there is mounting evidence that it’s no better than placebo.

So-called alternative medicine has had a fair few stories in the news this year as well, some more worrying than others.

Cupping was popular with some athletes at the Olympics. It’s done by setting fire to a flammable liquid in a glass cup. The flame burns away the oxygen, creating a vacuum. Once the flame goes out, the vacuum creates suction that sticks the cup to the body.

Along with the drop in temperature, this sucks the skin up and draws blood to the surface. There is also a version that doesn’t involve fire but it’s much less dramatic and so lacks the theatricality that witchdoctors and quacks often use to convince their ‘patients’ they’re actually doing something other than fleecing them.

The red spots last a few days and are caused by ruptured capillaries beneath the skin. It’s claimed to cure muscle problems and pain, arthritis, insomnia, fertility issues, and cellulite. Needless to say, there is absolutely no evidence for any of these claims and it will make you look like a twat. Stalwart skeptic Dr David Colquhoon was on TV explaining why it doesn’t work.

On the upside, yet more trials find homeopathy doesn’t work and NHS Wirral has stopped funding it.

The US government has ruled that homeopathy treatments will now be held to the same advertising standards as other products claiming health benefits. This means that all homeopathic products will have to include the statements ‘There is no scientific evidence backing homeopathic health claims’ and ‘Homeopathic claims are based only on theories from the 1700s that are not accepted by modern medical experts’ if they are to be stocked in chemist shops. So that’s at least one good thing America has done this year.

Many vets are calling for homeopathy to be banned, too. Of course, some people will see this as a victory for Big Pharma and carry on buying it. Because there’s no cure for stupidity.

Vets have increasingly been offering a range of ‘alternative treatments’ including chiropractic and acupuncture; the cost of them has pushed up pet insurance by 9% according to the Association of British Insurers. Of the 370 policies on the market, 96% include alternative therapies. It’s hard to tell whether vets are offering these treatments because people want them or whether people want them because vets are pushing them. Either way, this cat looks really pissed off its owner is so dumb.

Back to humans and there is no evidence that brain training helps prevent dementia. As the population ages, the various forms of dementia are on the increase and the race is on to find a treatment, especially as the NHS may not be around much longer.

Staying with the brain, the term ‘brain plasticity’ (or neuro-plasticity) gets bandied about a lot but means pretty much nothing. It’s one of those terms that people who don’t know much about science use to make it sound like they do.

It could be argued that it’s up to adults what they do to themselves but it’s different when they force children to take alt med. In October this year, a four year old boy nearly died after being given supplements from a naturopath to treat autism.

DIET FADS
This year has seen the usual crop of diet fads. Our appetite for them is equalled only by our appetite for fat and sugar (well, my appetite for sugar, certainly).

Superfoods are claimed to have all sorts of miracle powers. There is no good evidence that pomegranates have any particular benefits, goji berries are no better than any other fruit, there is little evidence for chia seeds, beetroot juice does seem to lower blood pressure slightly but if you have high pressure, get to the doctor, change your diet and do some exercise rather than looking for a quick fix. Eating too much seaweed can be bad for you and kale has no magic powers. It doesn’t seem to matter how often the antioxidant myth is debunked, people keep buying into it.

The idea that you need to drink eight glasses of water a day just won’t die despite the total lack of evidence.

Another thriving fad is clean eating. Spiralised vegetables, kale and pomegranate (again) and NO EVIL CARBS. Bread and pasta are evil and ‘full of chemicals’. Apparently fruit and veg contain no chemicals at all. That’s because they are made from fairies’ breath. The supermarkets are increasingly stocking cauliflower ‘rice’ and butternut squash or courgette ‘noodles’. And of course they are not cheap.

There’s a serious demonizing of sugar but a lot of the ‘clean’ recipes that claim to avoid sugar are still sweetened with honey, dates, coconut sugar, agave syrup and so on. I’m sorry to tell you that these are all still sugars. Paying a lot more for something with virtuous-looking packaging won’t change that.

Yes, it’s mostly another dumb middle class fad but it has repercussions for people with eating disorders, assigning some foods to the ‘dirty’ category, making food a moral choice and piling on the body shaming if you stray from the straight and narrow. Don’t you want to Get The Glow? Like a lot of cult members, clean eating converts really don’t like it when confronted with evidence.

Another dumb idea from this year was that activity icons on food packaging would help combat obesity by showing how long it would take to exercise off the calories. They won’t. As ever, the truth is boring: eat a balanced diet and get some exercise.

Finally, this story suggests that eating chocolate can make you smarter. I don’t care if it’s good science or not, I just want it to be true.

December 26. A late entry is the protein supplement. Even most athletes don't need extra protein. According to Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London,“There’s been a lot of hype in gyms pushing high-protein shakes, there’s also a need to get rid of a waste product from the dairy industry, which is whey protein,” he said. “It’s a lot of crap, a way of selling a cheap product at a high price.” Excess protein is excreted through urine so you're basically paying for expensive pee pee.



RANDOM NONSENSE
OK, we’ve done the serious stuff, now here’s the fun.

During the run-up to the Brexit referendum, there was much talk about an EU cabbage regulation that runs to 26,911 words. This myth has been around since the 1940s in one guise or another. There are some lengthy British guidelines but EU regulation contains precisely none that are specific to cabbages.

The idea that it takes 10,000 hours to get really good at something has been endlessly repeated. Malcolm Gladwell conveniently or willfully misunderstood the research his claim is based on and made a lot of money from it. But it’s nice and sound-bitey so expect to see more of it.

If you’re tempted to get your DNA checked to find out who your ancestors were, you may well be paying for what scientist Dr Adam Rutherford has described as ‘mostly total bollocks’. What’s more, a general misunderstanding of how genes work has led to some people thinking their ancestors give them some sort of ‘pedigree’ or explain their behaviour. One of my great-grandfathers was a convicted bigamist. What does that say about me? Absolutely bugger all.

This year there was a story that went on far longer than it should have about an eight foot werewolf terrorizing people in Yorkshire. According to one ‘expert’ it’s our ‘collective guilt’ about exterminating wolves that keeps these myths going. So not horror movies, alcohol and attention-seeking, then?

Oh, and apparently Uri Geller predicted that Theresa May would become Prime Minister. Of course he did.

There are three main threads running through all these stories. Firstly, desperately ill people will try anything – and who can blame them? They are often vulnerable to exploitation. There is always money to be made from intractable pain and incurable conditions.

Secondly, many of us want a quick fix to lose weight. With the increasing incidence of obesity, diabetes and other health consequences, the market is ripe for exploitation and there is no money to be made from common sense.

Finally, some people will believe any old nonsense if it makes a good story, suits their prejudices or requires a bit of effort to check out.

Come and join us at London Skeptics and watch us sort crap from Christmas for another year. You can find the stories I collect on our Facebook page and on Twitter @LondonSkeptics. Thanks to my right hand woman Carmen, to all our speakers, our audiences and the Monarch for hosting us.

The truth is out there. Keep ‘em peeled.

Pulling the wool over your eyes

Pat Ashforth and Steve Plummer have been knitting and crocheting mathematical images and objects for over twenty years. They’ve given demonstrations at science festivals, schools and craft exhibitions to ‘teach maths in an unconventional way’.

Some of the pieces have taken many thousands of hours to create and some have been bought by the Science Museum. Anything that engages young people with maths or science is laudable but is this anything new or interesting or artistic, worthy of a place in the Science Museum? Why is the Guardian getting so excited about them?

Firstly, does making these pieces out of yarn add anything to them? I spoke to Elaine Jones, a professional crafter, who said:

Most of their blanket designs would be equally interesting (and maybe clearer) as designs on paper. The craft aspect adds nothing, whereas hyperbolic crochet, for example, is a really good way of creating 3D shapes that are not easily made in other ways.

Hyperbolic crochet is something I did and wrote about here quite some time ago.

It started as a teaching aid and has developed from there. There has been a travelling exhibition of coral reefs made from hyperbolic crochet. They are both beautiful and have a scientific purpose – two, in fact. One is solving a problem of three-dimensional mathematical representation, the other is ecological. This is something that would be very hard to do in any other media.

For many craftspeople, maths is a tool, not an end in itself. Elaine continues:

It also made me consider how much maths/geometry there is in traditional pattern design anyway. The article totally overlooks this, making it sound as though using mathematical sequences to create patterns is 'amazing', instead of being something that craftspeople have always done. The difference is that craftspeople are concerned about aesthetics, whereas these people are not (as evidenced by some of their minging colour choices!)

This really is not special at all:

Elaine then says
I have a bit of a bee in my bonnet about science in art/craft. Some of it is great, but some of it is not. Despite that, if someone creates work based on something 'scientific' it immediately attracts more kudos than purely aesthetic work, regardless of its merit. It's an interesting idea, but to be really good, the execution and visual appeal should be good too. Otherwise, it's just mathematicians knitting stuff.

She is absolutely right. Part of the problem for me is that people who don't craft are impressed by any old bit of hand-made crap (which works in your favour if it's a birthday gift). Etsy is full of lumpy ugly stuff that people are charging money for. The fact these pieces are hand-made doesn’t make them ipso facto special. People have been making complex carpets and wall hangings for over a thousand years by instinctively using maths – and many of them were innumerate.

Anyone who has designed a crocheted blanket has spent time thinking about proportion, the relation of one section to another, fractions, how shapes intersect and so on. One of Ashforth and Plummer’s pieces is basically just a bunch of knitted mitred squares with a mathematical gloss.

I did a cushion using the same technique without even realising I was doing maths.

Lots of people make Fibonacci scarves. Craft web site Ravelry has over a hundred designs using the Fibonacci sequence, from scarves to stuffed animals. They also have hyperbolic crochet, pseudospheres, algebraic socks and a Lorenz manifold, which is pretty damn cool.

Many quilters use geometry in their designs. The Canadian quilter Libs Elliott goes further and uses coding to generate random formations of geometric quilts.

And of course, in the Arab world, geometric patterns have been used for around a thousand years in carpets, tiles and hangings.

Fractals are another maths thing widely used in art and craft, like this fractal necklace by Marc Newson.

I could go on but you get the picture. Or the quilt. Or the scarf.

How interested are kids in something crafted anyway? Does a six year old really care about afghan technique or how many hours went into making it?

The couple run school workshops teaching kids to knit just enough to collaborate on their own craft project for a wall hanging in the school, with a bit of added maths. This is the core of their teaching work and, judging by their website, seems to be successful in helping kids to work together and learn social skills. Making something yourself is always satisfying, especially for children. But there’s no metric for gauging how much maths the children learn or whether the workshops benefit them in their studies. Judging from this teacher’s report, they learnt far more about knitting and teamwork than maths.

The pieces the couple produce themselves are nothing special as craft or as mathematically produced objects. They sell patterns for many of their pieces and also other things like knitted toilet roll covers, dolls and puppets which are, frankly, the kind of thing that’s left over after a village hall bazaar.

They are not some amazing novelty act, they are a very small part of a long and varied tradition of using maths to create a wide range of arts and crafts. Treating them as something special ignores this tradition and the people, amateur and professional, who do it every day, as well as the work of professional maths communicators.

So, to Cast Off, putting a maths or science gloss on a piece of craft does not make it unique or wonderful. If you can find a simpler way to make maths accessible, don’t spend thousands of hours on it. Crafters have been using maths for generations. There are far better teaching aids and examples of maths-based crafts available. The Science Museum is surprisingly easy to impress. It's all a bit Emperor's New Clothes.

Quit It Part 2

The continuing saga of My Adventures in The Land Without Fags **

(Part 1 is here)

TWO MONTHS
The monkey on my back is no longer a mandrill, more of a vervet.

I still want to smoke, sometimes A LOT, but it’s slowly becoming more an emotional and mental need, a kind of nostalgia. I miss it like Wendy missing Neverland.

For the first time, smoke smells bad to me. A friend was smoking Rothmans, admittedly one of the stinkiest fags, and I didn’t like it. Up until now, I’ve stood next to friends while they smoked and even followed people in the street a couple of times (yes, I know).

The IBS has mostly calmed down. For the first month, my digestion was seriously messed up and sometimes I looked five months pregnant, not because of the stress of quitting but because of physical withdrawal from chemicals that have controlled appetite and digestion for over 30 years. It takes a while for that to normalise (and it pisses me off when people assume IBS is caused solely by stress and, by implication, that I’m a feeble, neurotic woman).

The weight gain is holding steady at around 3kg. I’m exercising like buggery to get rid of it but so far, no dice. I haven’t noticed any difference at the gym with the weights but I can go harder on the cardio and being really out of breath at the end feels good, an endorphin rush I haven’t had for years. My knees aren’t so keen though.

I spoke to my dentist about whether the inhalator is having an effect on my oral health and he said that as long as my mouth isn’t permanently dry, it should be OK long term. On the upside, circulation to my gums is greatly improved already. On the downside, the fast recovery means they are much more sensitive so a session with the hygienist was nasty even with painkilling gel.

I’ve discovered that when someone kisses you, they can’t taste the nicotine from the inhalator, so that’s a bonus.

I’ve noticed that inhalators are sold in the pharmacy section of my supermarket whereas vaping equipment is sold with smoking products.

The rage has mostly gone although there are still moments. I haven’t done anyone actual harm but I’ve come very close a couple of times. They deserved it. I can now see the appeal of being a vigilante superhero – judge, jury and executioner. I may have to work on that. Or buy a cape and mask.

Things not to say 1: If I say I want to smoke, don’t say ‘No you don’t’ and think you’re being helpful because I really do. Acknowledge the craving and help me deal with it by distracting me – make me laugh, do a little dance, whatever.

Things not to say 2: ‘What, still?’ Yes, still. Just because smoking doesn’t cause extreme and obvious behavioural changes like some drugs and alcohol can doesn’t make it any less powerful an addiction. I’m bored with it too, with how much attention it takes up - even when I’m thinking about something else at the same time. I want it to be over and done with. So kindly take your short attention span elsewhere.

Things not to say (or think) 3: Stop making a fuss and get on with it, you shouldn’t have been smoking in the first place. There’s a moral judgement attached to some people’s response to addiction, even if they don’t admit it. It’s based on ignorance about genetics, personality, environment, whether the people you most closely identified with did it, changing social acceptance, legality, and smugness. A lot of smugness. No one factor makes anyone a victim destined to be an addict but it’s a complex, multi-factorial thing and judging from your moral high ground really doesn’t help.

THREE MONTHS
The vervet has shrunk to a pygmy marmoset. I’ve decided to give her a name – Sparky. ***

Do I still want to smoke? Yes, every day, mostly in the evenings. But not for as long or as intensely as before, and it’s not making me miserable that I can’t.

I’m having regular dreams where I light up, then realise what I’ve done and wake up really angry with myself, so it looks like my unconscious is rooting for me too. Shame it can’t have a word with my metabolism.

From a 3kg peak, weight gain is now 1.5kg. I’m eating a bit less than I was before I quit but there really wasn’t much I could trim off my diet and now I’m hungry a lot of the time, which is miserable. The Nicotine Replacement Therapy is supposed to help with metabolism, hunger and weight gain. Maybe I’d have gained a lot more without it, there’s no way of knowing.

Public health and other advice websites assume that all smokers are fat bone-idle slugs so their weight gain advice is mostly just to be more active and avoid snacking, which is no use to me at all.

I’m trying HIIT as part of my regular workout (High Intensity Interval Training – basically doing sprints). There are many variations and I’m doing a 2:1 ratio: 20 second sprints then 10 seconds slower on the bike, repeated for four minutes, at the end of every workout (two weights, two cardio per week) plus an extra cardio session with HIIT, plus a lot of walking. Research shows HIIT is better for weight loss than longer periods of less intense cardio. I don’t know if I’ll be able to go back to my normal gym routine once I’ve lost the weight or if I’ll have to keep up this level of intensity forever to keep it off. I bloody hope not. I’ve had knee problems since I was a kid and compartment syndrome in both legs about six years ago so I don’t want to push my luck. My knees hate me right now.

Things I have learned 1: Nicotine is the third most addictive substance known, after heroine and cocaine, then alcohol and barbiturates. There is also an individual factor that makes some people more susceptible to some substances than others - I’ve used four out of those five and only become addicted to one.

Things I have learned 2: Smokers tend to have more visceral fat – the one that sits round the organs and causes serious health problems. It’s a stealth fat that even people who don’t look overweight can have. Because of chemical changes in the body, weight-gain after quitting is more likely to be subcutaneous fat (under the skin), which is less harmful, especially short-term. And it will be short term, if it kills me.

Things I have learned 3: Nicotine is not all bad. This shouldn’t be a surprise as poisonous plants like deadly nightshade have medical uses.

It has been found to protect against Parkinson’s disease. A small study has found that it may also protect against the early stages of Alzheimer’s disease.

There isn’t even much of a problem with addiction in its therapeutic use because, according to an article in Scientific American, other ingredients in tobacco smoke are necessary to amp up nicotine’s addictiveness. Those other chemical ingredients—things like acetaldehyde, anabasine, nornicotine, anatabine, cotinine, and myosmine—help to keep people hooked on tobacco. On its own, nicotine isn’t enough.

Another benefit is as a cognitive enhancer. According to Jennifer Rusted, professor of experimental psychology at Sussex University: “To my knowledge, nicotine is the most reliable cognitive enhancer that we currently have, bizarrely.” Many other studies back her up.

According to another article in Scientific American: Psychologists and tobacco-addiction specialists think it's now time to distinguish clearly between nicotine and smoking; the evidence shows smoking is the killer, not nicotine.

"We need to de-demonize nicotine," said Ann McNeill, professor of tobacco addiction at the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

Things I have learned 4: There’s a lot of disagreement over whether addiction is a disease or a learned pattern of behaviour, whether addicts are helpless victims and should be treated as such or whether this view disempowers people and makes them less likely to try to take control and change. The term ‘brain plasticity’ gets bandied about a lot in terms of learning or unlearning behaviour, including addictive behaviour, but it’s pretty much empty of meaning and should be regarded with skeptical caution.

What next?
This is the point where I should think about stopping the NRT according to some guidance but I’m in no rush. One Everest at a time. And according to the research I’ve mentioned, it’s not doing me any lasting harm and may even have some benefits.

For the first time since I was a teenager I will have to deal with life’s vicissitudes without the comfort blanket of nicotine, which could be interesting. But Sparky and I will keep plodding down the long and winding road. Maybe I can train her to wear a little hat and bang cymbals.

** That's English fags, not American fags, obviously.
*** Monkey notes: the mandrill is the largest monkey, the pygmy marmoset the smallest and the vervet (not surprisingly) somewhere in between.

SIX MONTH UPDATE

Still not smoking. Still wanting to smoke or at least wanting the comfort of it. Still using the inhalator. Still haven’t lost all the weight.

For the last two months I’ve been constantly ill with colds, laryngitis, three day flu (despite having the jab), more colds. There are endless forums where quitters talk about how many times they’ve been ill since stopping. None of the public health advice sites warn you that the immune system can take a long time to recalibrate itself and, while it does, you’re vulnerable to every passing invader. Also, nerve cells in the respiratory tract are beginning to work normally again, which means you’ll feel pain and irritation that smoking damped down, and the cilia take time to regrow to help repel the invaders.

It really does feel like a kind of penance. I would very much appreciate it if everyone would just stop breathing on me.

SEVEN MONTHS

I seem to have emerged from the tunnel of germs. My knees no longer hate me and have adjusted to the extra cardio, and I've lost two of the three kilos I gained.

I've had some very difficult personal stuff to deal with, including a funeral and my first response was to reach for a cigarette. An actual physical reach for a pack that wasn't there. Someone said that it would be understandable and not a failure if I just had one, if that helped me cope. I explained that I can't just have one. Ever.

2016 was probably not the best year to quit, given what's been happening in my world. But then, there never is a best year. If not now - when?

NINE MONTHS

More colds and viruses.  I may not live any longer now but it sure as hell will feel like it. I need a way to surround myself with a cloud of smoke to keep the germs at bay without doing myself harm. Basically, I need to become a dragon.

Still haven't lost the extra weight, damn it.

And yes, I do still have nostalgia pangs for smoking, especially the lighting up part. But not nearly as often and the smugness helps keep them to a minimum, especially as the cost of a pack has now gone up to over £10.

One of my younger relatives told me that of the ten people on his course, he's the only one who doesn't vape. Not one of them were previously smokers. That's a worrying trend even if they never move onto cigarettes as there is increasing evidence of harm.  Tobacco companies are aiming to double their vaping sales  as fewer and fewer adults smoke. Profit has to come from somewhere and young people are a prime target because they think they'll live forever whatever they do.

Some smokers I know are starting to get defensive around me, which can be difficult.  "I know I should give up, but ...". I'm not making you feel bad, that's all on you. I know you'd feel better if I started again but I won't. Sorry about that.

On the upside, I’ve been keeping my hands busy.

Quit it

There’s a lot of advice about how to give up smoking but, as with many public health initiatives, much of it is one-size-fits-all and so not very helpful to anyone who isn’t a mythical average.

This is my experience after 23 days of not smoking. None of what follows is setting myself up to fail, it’s being realistic about the task ahead and preparing myself for it. As the Boy Scouts say: Be Prepared. As far as I can see, thinking it will be easy is the best way to fail. Forewarned is forearmed.

What they don’t tell you
It will be fucking awful. No one tells you quite how awful it will be because all the health advice givers want you to stop.

Mood swings. I expected to be a bit grumpy. I didn’t expect to want to punch people, to burst into tears and to be bouncing around like Tigger all in the same day. Things and people that would normally mildly irritate you will make you go postal. It’s a bit like the worst PMS - for weeks on end.

If you live in a city and/or use public transport getting your sense of smell back is not a bonus. London and Londoners do not smell good.

You may never stop wanting to smoke. People have told me that even 30 years on they would go back to it if it was safe.

Cravings feel like a monster has taken over your body. Advice says that they get weaker and less frequent after about 14 days. They should last just a few minutes and then pass. Not so far. I still want to smoke just as much and just as often. My cravings can last up to half an hour.

Most people fail. Some research shows that around a third of smokers try to quit each year and that ‘fewer than one in eight former smokers who had abstained for a month or less at baseline were continuously abstinent over the next 2 years’. Other research has varying percentages for cold turkey and assisted quitting but in all cases, the percentage who succeed is very small.

What not to say
Do not say ‘I decided to give up and just did it. It was easy’. I will slap you. Hard.

Do not say ‘It doesn’t matter if you put on a bit of weight’. It clearly does matter or it wouldn’t have been mentioned. Stick to making sympathetic noises.

Do not say ‘Think of all the money you’re saving’. If that was a reason for giving up, no one would smoke. See also comments about not smelling like an ash-tray, not dying etc etc. I gave up because I just wasn’t enjoying it any more. I didn’t want to smoke. As simple as that. This doesn’t mean I don’t want a cigarette. Because I’m an addict.

ETA: Do not say 'Try to avoid triggers'. For me these are: waking up, going to the gym, eating, drinking and, it turns out, being with one of my closest friends (a non-smoker).

Do not talk about being a chocoholic or being really grumpy before you have your morning coffee. If you haven’t been a smoker, you won’t get it.

This may sound harsh and ungrateful but I reserve the right to be Oscar the Grouch verging on She Hulk for the next few months.

Nicotine Replacement Therapy
NRT covers products like patches, nicotine gum, inhalators and e-cigarettes. In theory it helps break the habit of smoking (as opposed to the addiction) while still getting some nicotine to lessen the cravings, and it doubles the chances of success.

The problem is that it’s aimed at a theoretical average smoker of 20 full-strength cigarettes a day who would get about 15mg of nicotine. I was smoking 10-12 of what used to be called ultra-low cigarettes which meant that I was getting about 1mg of nicotine a day. So I would have to use about 6% of a nicotine patch – not exactly practical. There are products with less nicotine for phased quitting but even these would give me a lot more than I was previously getting.

You’d think this would mean quitting was easier, but no. I know this because I tried to give up about 20 years ago when I was smoking 20 full-strength a day.

I opted for an inhalator and worked out from the information given that about 15 seconds of sucking on it would give me about the same nicotine as a cigarette. But there is no precise information about how nicotine absorption from cessation products compares with smoking other than the fact that it’s slower and less effective. Advice tells you to suck until you feel satisfied but as it takes longer to feel the effect you can end up getting a lot more nicotine than you actually want or need. So I’m very probably getting more than I was - although in a safer form.
ETA Day 32: I've done a bit more research and concluded that I was possibly under-dosing with the inhalator, which is why the first few weeks were so rough. I wasn't quite going cold turkey but certainly lukewarm turkey.

Some people I know used vaping and e-cigs as a way to give up and it worked for them. But if you go into vaping shops and talk to staff (as I did), it’s clear that vaping is becoming a hobby in itself with accessories, flavourings and associated products. I did consider it but I didn’t want to look like Puff the Magic Dragon billowing out clouds of vapour. Most of the flavourings smell disgusting to me. Many places don’t allow it indoors now so I’d have to go outside to do it and I want to break that association. It’s a lot more involved than lighting a cigarette (flavoured liquids, replacing coils at regular intervals, charging batteries and so on) and I just wanted to get the nicotine into me in the simplest and least twattish way.

Weight gain
This is a big one for me. When I gave up about 20 years ago I put on about 30lbs/13.5kg. I couldn’t lose it after a year and got so miserable that I went back to smoking. At the moment, my weight is about 4.5lb/2kg above where it should be and it’s a battle royal to stop it going any higher. Nicotine is an appetite suppressant and metabolism stimulant, which is why you gain weight when you stop smoking. If you’re using NRT this shouldn’t happen. But it has.

Your digestion will get messed up and your metabolism may well slow down so even if you resist the urge to snack you’ll gain weight. It also kicked off my Irritable Bowel Syndrome. Oh joy.

The advice web sites say to exercise more. I already go to the gym four times a week and walk a lot. I’m trying to walk more but it’s killing my knees. Being atypical sucks.

Getting help
One big difference between giving up now and my failed attempt 20+ years ago is social media. It didn’t exist then. Telling everyone on Twitter and Facebook that I’d given up meant that backing down was a lot harder but, more importantly for me, it means that I can get support and encouragement, especially if I'm having a bad day.

The downside is that giving up takes months and months and people will lose interest in daily updates. I don’t blame them, I would too. So I’ve picked a couple of close friends for long-term support, people who won’t get sympathy fatigue. Lucky them.

The next step
The advice is to use NRT for at least 12 weeks as in theory this is how long it takes to break the habit or at least the psychological addiction. Again, this is a one-size-fits-all guestimate. Some people take a lot longer. I’m not expecting to get over 30 years of smoking in a couple of months. And I am not a patient person. This is the long, slow, tedious bloody haul.

Nicotine itself isn’t that bad for you so getting off the NRT isn’t such a pressure. It’s generally considered no worse than caffeine – not totally without negative effects but way safer than smoking. So I may still be using it this time next year. We’ll see.

I haven’t fallen off the wagon yet. The important thing is to take responsibility for quitting. I’ve decided that if I do have a smoke, I won’t blame anyone or anything else. I am not a victim, I have had a lapse of willpower. It happens. Get back on the wagon.

After smoking for so long I accept that there may be some damage that will never be reversed.

Someone asked me if I now see myself as a non-smoker. I see myself as someone who is not smoking right now. That’s not giving myself an escape route, that’s focussing on the present because it’s in the present that I want to smoke.

So that’s where I am now. It’s early days. Watch this space.

PART TWO IS HERE

PART THREE IS HERE

…. For I Have Sinned

Why exercise is not an act of contrition

Shirley Cramer, chief executive of the Royal Society for Public Health thinks activity icons on food packaging will help combat obesity. The idea is to use stick people to show how long it would take to run or walk off the calories you’re about to eat.

The RSPH think that people are suffering from information overload in food packaging and that this will help – by giving them even more information as there is no proposal to replace the current labelling. Their research has found that 63% of people would support its introduction, with 53% saying it would cause them to make positive behaviour changes such as choosing healthier products, eating smaller portions or doing more physical exercise.

There are several problems with this approach. Firstly, who are the times based on? Everyone has a different metabolism and burns calories at a different rate depending on gender, height, age, build, lifestyle and so on.

The recommended calorie intake is 2500 a day for men and 2000 for women, based on some mythical average human. Averages can be useful as guidelines but it should be made clear that pretty much no one is ‘average’. I’m certainly not and nor is anyone I know.

Judging by the comments on the BBC article about this initiative, people don’t even understand what calories do. Someone commented on how long they’d have to run to work off 2500 a day, for example. We need calories to survive, they are not the enemy. It makes a big difference what constitutes those calories though – fats, sugars and so on. Eating 2000 a day is not going to keep you healthy if they’re made up of pizza and chocolate no matter how much you exercise.

You don’t just burn off calories while exercising. People who exercise regularly have a higher resting metabolic rate, which means that they burn off more even when they’re doing nothing just to sustain the extra muscle. What’s more, exercise is not just for calorie or weight control. There are many other health benefits, both physical and psychological.

The RSPH press release says that ‘it is hoped that ‘activity equivalent’ calorie labelling would help promote and normalise physical activity’. This is my biggest problem with the proposal – the intention may be to get people to be more active but it very strongly promotes the idea of exercise as punishment or penance rather than ‘normalising’ activity.

It’s like a Catholic approach to health – commit the sin and then do penance. Exercise is not an act of contrition and framing it as such helps no one. If guilt is your motivation and you hate every minute of your workout, you’re much less likely to keep up the exercise. Or, if you think you can exercise away the muffin, you have no reason to stop eating them in a cycle of sin and do penance, sin and do penance. As one woman told me, this approach is ‘reinforcing the notions that food has a moral value based on its calorific content, and that exercise is some kind of punishment for making arbitrarily-determined ‘poor’ nutritional choices’. Exercise does not wash away your sin and restore your moral balance.

A woman at my gym once said to me ‘When I’m as thin as you I can stop coming’. She wasn’t happy when I pointed out that the only reason I stay fit is that I keep coming. Forever. And ever. Amen.

There’s another worrying aspect to this proposed initiative. As a friend has pointed out, ‘This promotes an inherently disordered framing of what food and exercise are ‘for’. The whole idea of exercising simply to compensate for the food you've eaten is so triggering to people in eating disorder recovery who need to unlearn this bullshit in order to have a healthy and moderate relationship with food. This is so harmful, in the sense that it might actually trigger restriction and a return to disordered eating behaviours’.

This proposal comes from a good intention to help empower consumers to make healthier choices and to tackle the obesity crisis. But we already know that some foods are healthier than others. People over-eat for many different and complex reasons. If you buy crisps or chocolate, you know they are not health food. Who looks at how many calories are in a bar of chocolate and then puts it back? No one.

Making people feel guilty about their choices is not going to solve underlying psychological problems, nor is promoting exercise just to balance the scales. It’s not going to change anyone’s relationship with what they put in their mouth or with their bodies. When it comes to obesity, no one-size-fits-all approach is going to work.

As to the 63% who support the introduction of the activity icons – the road to hell is paved with good intentions. Also, the road to gyms making a profit is paved with people who join and then stop going after a couple of months. People often answer health questions based on how they would like to see themselves, how they would like to be, rather than on a realistic self-appraisal.

There is also the issue of practicality. Legislation on the mandatory labelling of food and drink is currently decided at the European level. Even if the political will existed and the food and drink industry was on board, it could take several years to happen. The industry is generally not so keen on ideas that discourage people from eating their products – unless they can sell us other products to counteract their effect. Maybe they should start investing in gyms.

Finally, why is it that articles like this so often have a food porn image at the top? Does the BBC (for example) think that we’ll read anything if there’s a picture of a heap of chocolate at the top? And, as all chocolate-lovers know, there is no such thing as a standard chocolate bar.

Pray for us sinners.

Cultural Copyright

The debate about cultural appropriation keep flaring up, much like the recently active Popacatapetl, and it does seem to be generating more heat than light. I’m surprised and disappointed that any of this still needs saying, but from what I hear and read on a regular basis, it seems it does.

Is cultural appropriation a useful or even correct term?

Ethnicities are not monocultures. Cultures are not monocultures. Typifying Indian culture (for example) by Southern Indian Hindu cuisine and then saying that cooking this food at home is cultural appropriation is in itself a kind of ignorant colonialism – they’re all the same over there. That’s like saying that all white people are Goths. If you’re going to talk about a particular culture, you need to define exactly what it is you’re talking about.

No culture is historically ‘pure’ even if some people like to think theirs is. It’s impossible to eradicate all elements of the Other. There is always cross-pollination. All cultures are an amalgamation of historical influxes and absorption. Even isolated jungle tribes have contact with each other and adopt elements of each others’ culture that suit them, while maintaining a sense of their own. The zero was adopted in the West because it made maths and trade easier. Better kinds of agriculture, metal working and medicine were acquired without asking permission. Not all of what could be called cultural appropriation is bad.

Historically, some markers of cultural identity were visible – clothes, food, music, for example. Others were less so – stories, private rituals, language. A shibboleth is defined as ‘a custom, principle, or belief distinguishing a particular class or group of people’. It comes from the Hebrew word shibbólet and its pronunciation was used to distinguish Ephraimites, whose dialect lacked a /ʃ/ phoneme (as in shoe), from the people of Gilead whose dialect did have it. In Mediaeval France, people separated themselves into Langue D’Oc and Langue D’Oil. It was a geographical separation that became a marker of custom, community and allegiance based on different ways of pronouncing the word for Yes.

Markers like this are rarely appropriated, mainly because they have no commercial or aesthetic value.

Nations and individuals have no problem selling aspects of their culture to outsiders. This can be to tourists in their own country or it can be by moving abroad and selling it to the natives – for example, by running a restaurant, selling carpets or holding classes in yoga or martial arts. That’s the foundation of export, after all. The people selling the culture decide which aspects of it to sell and may modify it for foreign tastes. They are in control of the dissemination and profitability of their own culture.

Claiming appropriation in this context denies individuals and cultures any agency of their own. They’re not capable of deciding what to do with their culture and can’t protect it so white, middle class Westerners have to do it for them. Then they can feel all virtuous by getting outraged on someone else’s behalf without actually stopping to ask that someone else if they’re offended.

Is it only appropriation if your culture has a history of exploiting or abusing the culture you’re accessorising? Is it appropriation if, for example, a Jamaican wears a bindi? Or is it not because it’s much harder for white Westerners to decide which group to side with?

There’s also an element of cultural protection. We don’t like to surrender aspects of our culture that make us different from Others. No one likes to see markers of their In group go mainstream. A degree of this is inevitable in an increasingly global culture but it’s not a new thing. In the distant past when groups were more isolated, each developed its own identity like speciation in isolated locations. As people began to mix more, often through trade or war, it became more important to be able to distinguish Us and Them, especially if one group was exploited or threatened. We’re an Us and Them kind of species, no different from many others. When resources are limited, it’s important to know who to share them with and who you’re competing with.

Refugees or immigrants often try to maintain their cultural identity as a distinct entity. It’s not a refusal to ‘assimilate’, it’s a survival instinct. It can bind them together in a difficult time and may give them a sense of comfort, strength and value. It gives them history, context and identity even though they benefit from and contribute to the culture they find themselves in. Don’t forget who you are, where you came from or what you have suffered.

What this all boils down to is power. Who is in control of the cultural copyright and who is benefiting from it? Are value, history and meaning lost or is it a fair exchange?

But any time a dominant culture discriminates against or exploits a minority or tries to impose their culture as the only valid one, establishing a cultural hierarchy while cherry-picking and commercialising the bits that are ‘acceptable’, that’s not cultural appropriation. Racism is the problem, not shopping. And that’s much harder to admit to or tackle than pointing the finger at a white woman in a cheongsam.

Dangerous Curves Ahead

Barbie now comes in three different shapes: tall, petite and curvy – and her new incarnations have sparked some debate. There have been complaints that curvy Barbie is still thinner than the average woman in the UK and the US. But is this a bad thing?

Scaled up, curvy Barbie would be 167.6cm or 5’6” (slightly taller than average) with a waist measurement of 63cm (24.8in) and hips 91.2cm (35.9in) whereas the average British woman measures 79.5cm (31.3in) and 105cm (41.3in) according to the 2012 Health Survey of England.

In that year, 67% of men and 57% of women were overweight or obese. Overweight and obesity are defined as ‘abnormal or excessive fat accumulation that may impair health’. Being overweight/obese is associated with an increased risk for some common causes of disease and death including diabetes, cardiovascular disease and some cancers.

The cost to the NHS of obesity and obesity-related disease was £2.3 billion in 2007 and is projected to be £7.1 billion by 2050 (assuming we still have an NHS by then). Costs attributed to overweight and obesity taken together are £4.2bn in 2007, projected to be £9.7bn in 2050. This compares with the current cost of smoking-related disease at approximately £2bn (and smokers are heavily taxed).

For some time, Body Mass Index (BMI) has been used as an indicator of obesity but it’s a pretty blunt instrument as it doesn’t distinguish between fat and muscle or take account of how the fat is distributed (fat in the core area or around the organs is worse for health than fat lower down the body, for example). Waist to hip ratio or waist measurement are now considered more accurate with a waist measurement over 102cm (40.2in) in men and 88cm (34.6in) in women taken as the threshold for health concerns. This metric still works best for people of average height and Western ethnicity though.

By these measurements, Curvy Barbie is clearly thinner than the average UK woman. This may not be a bad thing.

Original skinny Barbie has taken a lot of flak over the years for causing girls and young women to be unhappy with their body shape. For example, research done in 2006 found that girls aged between 5.5 years and 7.5 years old were less satisfied with their own body shape after reading a book with pictures of original Barbie. The research was done by Helga Dittmar of Sussex University who found that "The girls said they wanted a thinner body shape than they had. They had lower body-esteems after seeing pictures of Barbie. If we show an effect with a single exposure study it stands to reason that the impact increases as time moves on."

The media is full of images of very thin people that cause a lot of pressure, misery and body dysmorphia in women (and of course, men too). Diet books and products are huge earners. Barbie is just a tiny contributor but even with falling sales, she is a presence in the lives of many young people.

Fat shaming is hateful behaviour. There was a recent case of people handing cards to overweight women on the Tube in London to humiliate them, reducing women (yet again) to just a body to be judged.

Women are of course used to being judged by their appearance – and found wanting both by companies trying to sell products and by society in general. But should Barbie reflect the average woman? If she had a scaled-down version of the average waist and hip size would this make young women feel better about themselves or would it normalise obesity? Even while acknowledging the flaws of BMI, the Health Survey of England found that ‘there was a significant discrepancy between participants’ own assessment and their BMI category, which was greater among men than women. This lends support to the idea that a high prevalence of overweight and obesity in the population has led to a greater bodyweight/size becoming the norm’.

There’s a fine line to be walked here. While it is in no way acceptable to judge anyone by their size, promoting healthy body shape through a balanced diet and exercise can only be a good thing. The message is too complex for some: obesity is not good for health but if fat is bad, it’s too easy to jump to the assumption that fat people are bad/weak/stupid. It’s important that children understand the distinction. There’s also a class/income element to obesity as people in lower income groups are more prevalent in overweight groups.

Children have little or no control over what they eat so education is essential to ensure that, as soon as they have a choice, they make it a healthy one. The recent proposal to tax sugary drinks has its heart in the right place but even if campaigners succeed in getting it done, it won’t work without education and healthy bodies as role models.

Prevention is easier than cure. It’s hard to lose weight and exercise regularly. Evolution has geared us to seek out fats and sugars as they were once in short supply. Now they’re everywhere. The time of food scarcity when a fat baby was thought to be a healthy baby is long gone.

Children don’t know what dress size Curvy Barbie takes, they don’t know that it’s less than the average, they just see that she’s not skinny as a stick. Yes, she is just a doll and is only a tiny part of the way children are influenced. But if Curvy Barbie helps just a little bit to stop children feeling as bad about themselves while at the same time it normalises a healthier shape, that could be a step in the right direction.

Perhaps toy maker Mattel is being more realistic about the shape we’re in or perhaps this is an attempt to boost profits, which are reported to have fallen by 59% with a 14% drop in sales of Barbie.

It seems unlikely that Mattel is being altruistic. The tall and petite versions only look different heights compared with standard Barbie. In isolation, they just look like any other doll – and are still unnaturally thin. Tall Barbie would be 180cm (5ft 11in tall) with a waist measurement of 56.4cm (22.2in) and 78cm (30.7in) hips. Just for comparison with Lanky Barbie, I am 185cm (73in) with a waist of 76cm (30”) and hips 99cm (39”). I weigh 66.5kg (146lb) with more muscle than average. If I were any thinner, I’d be ill.