Do you know how sometimes when you're doing something that you're pretty sure is the right thing, you have second thoughts and begin to doubt yourself? Early on in the history of this blog, I found myself in such a situation. It struck me that a lot of what I was observing in the anti-smoking movement seemed quite inappropriate and deserving of public comment. However, part of me wasn't sure. I viewed this blog as something of an experiment. I would write about some of these issues and see what happened. I certainly had no intention that the blog would grow and develop and even be in existence 15 months after it began.
Over the past months, something has happened which has convinced me that this is real, that these things are really going on, that there is a need to bring them to public attention, and that there are really some things that need to be exposed.
What happened was that a large number of tobacco control practitioners (including many colleagues) began imploring me not to express my opinions about the tactics, actions, statements, and agenda of the movement publicly. I was instructed that it was acceptable to complain (i.e., "whine") internally, directly with the relevant groups, but that it was not acceptable or appropriate for me to share my opinions beyond the closed ranks of the tobacco control community.
The Rest of the Story
This reaction is one reason I now know that what I'm doing is needed. The very fact that my expressing my opinions to "outsiders" was viewed as so threatening to the movement convinced me that there must really be some terrible things going on that the movement doesn't want the public to find out about. If nothing inappropriate was going on, then there shouldn't have been any concerns.
This reaction always struck me as somewhat odd. After all, we are public health practitioners. I view myself and others in my profession as public servants. It is the public that we are trying to serve. How could it be somehow inappropriate to preclude the public from being aware of what we are thinking and what we are doing. In fact, if anything, my impression was that we should actually be inviting the public more into the discussion.
I don't view public health as something that we do "to" the public, but as something that we do "with" the public.
In fact, as I have discussed previously on this blog, public health ethical standards clearly indicate that our deliberations about potential public health interventions and policies should be transparent to the public - we should be willing to provide the public with information about the policies we are considering and the factors that are going into our decisions. So if I feel that the science behind our policies or actions are questionable, or that interventions we are proposing our inappropriate or unjustified, isn't it reasonable, if not my responsibility, to share these concerns publicly?
I remember vividly an email I received from a colleague shortly after my post in which I suggested that Americans for Nonsmokers' Rights (ANR) had misled the public by claiming that Associate Attorney General Robert McCallum was a former tobacco industry lawyer. The note chastised me for having expressed this opinion publicly, rather then simply having shared my thoughts with ANR itself (something which I had already done, but to no avail, except to get balled out by them).
Of most interest to me was the fact that the note did not take any issue with my contention that ANR had misled the public. Apparently, that wasn't the issue of concern. The issue of concern was that I had "betrayed" the tobacco control "inner circle" by expressing a criticism of our actions to the public.
Well I believe that the public is a pretty good judge and people should be able to judge for themselves. If ANR's actions were appropriate, then the public could read my commentary, disagree, and think that ANR was correct in its public attack on McCallum and that my argument was not particularly compelling. If there was no harm done, then there should have been nothing to fear.
What I began to realize is that there was harm done, and tobacco control groups knew it. They were worried about the public finding out about it, it became clear to me, specifically because there was something that they preferred to keep hidden.
I didn't come to this realization right away. My first thought, from the very beginning, was that if I just brought these issues to the attention of the relevant organizations, they would simply correct the problems. But my experience did not bear that out. For no less than two years, I went along with this approach, keeping my thoughts confined to the internal tobacco control community and relaying my concerns to the relevant organizations. To my dismay, I received not a single positive response. Instead, what I received were personal attacks and attempts to discredit me and defame my character and reputation and harm my career.
Believe me: if I had seen any response by organizations to my internal pleas, I would never have needed to even initiate this blog. The anti-smoking groups were eagerly anxious for me to share my concerns with them, but completely uninterested in doing anything about those concerns.
So I had two choices: keep my thoughts to myself or share them.
Frankly, it was really all the admonitions and pleadings to keep quiet that convinced me that there really was a "rest" of the story to be told - that I was really on to something.
In retrospect, I realize that entreating me to keep quiet and keep it all to myself and attacking me for betraying the movement and being "un-collegial" by sharing my opinions with the public who we are supposed to be serving was simply a technique to try to silence me and to quell the dissent that was becoming apparent inside the movement.
I think the silencers and quellers would have a more compelling point if one - even one - organization had changed its misleading communication about the acute cardiovascular effects of secondhand smoke. Out of a sample of more than 80 groups, if even one had responded to the concerns I expressed about misleading the public, then the dissent terminators might have had a point. Perhaps it could have been true that what was going on was simply careless mistakes by anti-smoking groups in their reporting of the science, and they would be thrilled to have the corrected information so that they could fix their web sites. It could have been true.
But unfortunately, that's not the rest of the story.