Friday, February 24, 2006

A Double Standard for Scientific Integrity In Tobacco Control?

I have to honestly say, that as I try to wind down from a difficult week for me (in terms of the attacks and negative comments I have received from colleagues because of my questioning of the validity of scientific claims made by an anti-smoking organization), the thing that is disturbing me most is not the fact that I feel an anti-smoking organization is using misleading public claims to support its agenda.

Instead, what's most disturbing to me is the response I have received (through emails sent directly to me) from other anti-smoking organizations and advocates (colleagues), who have, uniformly, condemned me for having the gall (?chutzpah) to suggest that something an anti-smoking organization is stating may be scientifically inaccurate.

In fact, so far I'm not aware of any anti-smoking organization which has publicly suggested that perhaps ASH is not being scientifically accurate when it claims that a 30 minute exposure to secondhand smoke increases a nonsmoker's risk of a fatal heart attack to that of a smoker's.

The impression I am left with, sadly, is that there appears to be a double standard here. When the tobacco companies, or their front groups or allies (you know who you are!), misrepresent the science, it is wrong and despicable. But when an anti-smoking group misrepresents the science, it is acceptable. The assumption is that there is a valid explanation for it, that there is some data upon which the claim is made and that I am being overly critical and not basing my own commentary on science, and that I am actually the one who is a fanatic. Or that the scientific inaccuracy is acceptable because, after all, the intentions of the anti-smoking organization are good and the ends to which it is working are noble.

The Rest of the Story

Here is an excerpt from an email from an anti-smoking colleague, sent directly to me, condemning me for questioning the scientific validity of ASH's contention that 30 minutes of exposure to secondhand smoke increases the risk of a fatal heart attack among nonsmokers to that of smokers. Following the condemnation, I have inserted my commentary:

"What is going on here? What has happened to you...? Has someone done you a bad turn? You say that all of this is in the interests and greater good of tobacco control, yet I find it hard to get away from the impression that the underlying assumption behind much of your commentary is one of ill will. ... I have begged before for mercy - please! listen!"

Well, there are a number of theories that have surfaced as to what has happened to me. One is that I am being paid off by the tobacco companies. That accusation has been made several times on my blog itself. Another is that I am being paid off by the Republican party (an accusation that was made on a tobacco list-serve). Another is that I am a civil libertarian manque (an accusation also made on a list-serve).

Actually, the truth is that nothing has happened to me. It is the tobacco control movement that I see changing. There was a day, not long ago, when it would have been unfathomable to me that an anti-smoking organization would have made a public claim so ridiculous as the one that breathing in secondhand smoke for 30 minutes increases a nonsmoker's risk of a fatal heart attack to that of a smoker's. I am not the one who made that claim. I haven't changed. The anti-smoking movement is what seems to have changed. I simply don't remember such preposterous claims being used to support our effort to promote smoke-free workplaces during the past 20 years I have been in this field.

I am sorry to hear that criticism of what anti-smoking groups are doing, even if the allegation is a complete distortion and misrepresentation of the science, means that the dissenting speaker has taken a "bad turn" and harbors "ill will." If that is your definition, then I guess - yes - I have taken a bad turn. I have taken a bad turn because I actually care about honesty and scientific integrity. I have taken a bad turn because I actually believe that the ends do not justify the means and that we must not use deception and mislead people or stretch, distort, and misrepresent the science in order to promote our policy goals. I have taken a bad turn because I am willing, and courageous enough, to step forward and speak up for the ethical principles in which I believe and which I think ought to be the pillars of the tobacco control movement. I have taken a bad turn because I don't have a two-dimensional view of the world, where everything we say is right and everything they say is wrong, and there is no need for us to provide adequate scientific documentation of our claims because our cause is a noble one. So yes, I guess in the eyes of many in the tobacco control movement, I have taken a bad turn.

As far as ill will, no. I'm trying to protect the credibility, integrity, reputation, and basic ethical and public health principles of the tobacco control movement. My aim is to improve the movement by calling attention to things that I feel need to be changed to make the movement stronger, more credible, more consistent, more compassionate, and more effective.

As far as mercy goes, I try to be a compassionate and merciful person, but if mercy is defined as squelching the expression of my opinions and asking me not to share any opinions other than those which agree with the dogma of the movement, then this is a no go.

Finally, it's interesting to me that this comment is not suggesting that I'm wrong. Nowhere does it suggest or even imply that 30 minutes of exposure to secondhand smoke does increase the risk of a fatal heart attack among someone without pre-existing coronary disease. So apparently, where I've taken a bad turn is not in the shoddiness of my science, but in my willingness to suggest that an anti-smoking organization may be making a claim that I feel is wrong.

Incidentally, the response is missing the point. After all, the only reasonable defense to my questioning would be to provide documentation that 30 minutes of secondhand smoke exposure can cause a fatal heart attack and that it in fact does increase the risk of a fatal heart attack to that of a smoker. Isn't that what the appropriate focus of discussion should be about?

The fact that a number of colleagues have shifted the discussion from the scientific issue of the risks of secondhand smoke to ad hominem attacks against me personally is unfortunate, but also very telling.

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