The tobacco prevention coordinator at the Richland County Health Department in North Dakota was quoted as saying that it doesn't reflect well on the community for people to see people smoking in that community.
According to an article in the Wahpeton Daily News (North Dakota), Richland County tobacco prevention coordinator Jason Bergstrand was at the campus of North Dakota State College of Science to promote a 100% smoke-free campus policy. Such a policy would ban smoking throughout the campus, not only indoors and in surrounding outdoors or crowded outdoors areas.
According to the article: "A timely matter continues to present itself to the North Dakota State College of Science campus. Many campuses in the state of North Dakota as well as several state universities in Minnesota have gone smoke-free or tobacco-free. Jason Bergstrand, tobacco prevention coordinator at the Richland County Health Department, presented a slideshow on campus Wednesday on the benefits of having a smoke-free or tobacco-free campus. ... Tobacco use is also the No. 1 preventable cause of death and disability in the United States. More than 430,000 die annually. "Secondhand smoke is equally dangerous," Bergstrand said. ...
"Bergstrand said more often than not, in driving by campus, students or others are standing outside smoking and 'it doesn't reflect very well on the community as a whole,' he said. Benefits of going to a tobacco-free campus include a cleaner and healthier campus, an improved social and community reputation and 'I'm almost positive you'll see a less burden to your student health service,' Bergstrand said.
"In addition, the campus would more then likely see improved student health with increased class attendance and better academic comprehension by the students. Also, because many employers are seeking workers who don't smoke, a campus that promotes no smoking would ultimately provide more marketable students to enter the workforce."
"The last of the benefits Bergstrand included, although there may be many more, was a no tobacco use policy would cause less exposure to secondhand smoke."
The Rest of the Story
If quoted correctly, what this anti-smoking advocate appears to be saying is that it doesn't reflect well on a community for people to be driving by and to see smokers.
I wonder if the same sentiment holds for people driving by and seeing fat people. Do people who are fat reflect poorly on the community as well?
Perhaps the North Dakota State College of Science could present a better front to the community if it also banned the ingestion of fatty foods and severely limited the total number of calories that could be consumed each day on campus. People driving by would be less likely to see fat people.
Seeing people using illicit drugs, having public sex, or walking around nude on campus would legitimately reflect poorly on the community (although it might increase applications to the college). But there is a major difference between public sex, drug use, and nudity on the one hand and smoking on the other. The former are seen as violating well-established public morals. It is viewed as a moral affront for people to be engaging in illicit drug use, sex, or nudity in public.
So what Bergstrand is actually saying here is that he sees smoking in public not as a health issue, but as a moral issue. Smoking in public is a moral affront to the community.
This is why it seems offensive to most of us to hear someone suggest that fat people don't reflect well on a community. Because such a statement gives moral value, not just health value, to being thin or "normal" weight. Most of us do not believe that weight carries with it any moral value. Decisions about not exercising or eating lots of high-fat foods may not be healthy; but as of yet, they are not viewed as immoral. These decisions may be poor for your health, but they are not viewed as violating community morals.
Not so, apparently, with smoking. The issue here seems clearly to be more than merely the health consequences of smoking. It is all about the moral value of not smoking. Smoking carries with it a lack of moral value. The decision to smoke is not only an unhealthy one, it is also viewed as immoral. Such a decision is not only bad for your health, but it is also viewed as violating community morals.
This is where I must jump in and vehemently take issue with the statement and perspective illustrated by that statement. Smoking is a health behavior decision -- just like not exercising, eating poorly, or not putting on sunscreen. It is not a moral issue.
To suggest otherwise is not only foolish; it is also dangerous. We do not want society to start making moral judgments based on people's lawful health behavior decisions. It will lead down the road to discrimination and intolerance.
Another part of this story that is problematic is the assertion that secondhand smoke exposure is "equally dangerous" as active smoking. There is no need to exaggerate the health effects of secondhand smoke (or downplay the health effects of active smoking, whichever you want to call it) in order to promote all-out smoking bans on college campuses.
On second thought, it is necessary to exaggerate the effects of secondhand smoke, because we all know that the effects of momentary exposures as one might encounter with a policy that restricts smoking to certain designated outdoors locations away from buildings and crowded areas are just not substantial enough to justify an all-out outdoors smoking ban. So it is no wonder that this anti-smoking advocate has to exaggerate the scientific evidence and suggest that secondhand smoke is as dangerous as active smoking.
As far as making students more marketable to enter the workforce, I would ask: "How does whether a person smokes outdoors on campus affect his or her employability?" While it is unfortunately becoming true that smoking is a factor in employment decisions, the consideration is whether or not someone smokes, not whether or not they smoke in remote outdoors locations while on a college campus.
As far as the argument that complete smoking bans will cause smokers to quit, I would first of all say that I'm not sure that is the case. These extreme policies could just as well make smokers angry and feel persecuted and not tolerated and therefore cause them to smoke more (albeit not on campus). However, even if true, this is an example of unjustified paternalism.
You don't ban smoking in order to force smokers to quit. You ban smoking in order to protect nonsmokers from exposure to secondhand smoke. If you are willing to do the former, then there is no reason not to also ban the consumption of fatty foods on campus and to limit the overall intake of calories while on campus.
Interestingly, protecting people from secondhand smoke was the last of the benefits listed by the anti-smoking advocate supporting this policy. However, it really is the only benefit that would justify the policy. And in this particular case, one would need to make the case that a ban on smoking in all indoor areas, outdoor areas near buildings, and outdoor areas which are crowded or where people congregate is not enough to protect nonsmokers from significant secondhand smoke exposure.
I don't think one can compellingly make that argument. Which I guess is all the more reason to rely upon exaggerating the science beyond recognition, calling on intrusive paternalism, and making the anti-smoking movement into an all-out moral crusade.
Tuesday, October 30, 2007
Monday, October 29, 2007
National Tobacco Control Conference Sacrifices Scientific and Moral Integrity for Money
The 2007 National Conference on Tobacco or Health was held late last week in Minneapolis. According to the conference literature, a major purpose of the conference was to "Learn the latest evidence on what works in tobacco control and how to apply current research findings." However, far from being an objective source of scientific information, the conference prostituted itself - in my opinion - by accepting sponsorship funding from Pfizer, a pharmaceutical company that manufactures a smoking cessation drug which was discussed at the meetings.
A major topic of the conference was "cessation, nicotine, and the science of addiction." In a conference sponsored by Pfizer, one cannot expect to have an objective presentation of this topic. After all, Pfizer is the manufacturer of Chantix (varenicline), which the company is heavily promoting as a smoking cessation aid.
In fact, one of the "scientific" sessions - which could better be called a "marketing" session for Pfizer - discussed the use of Chantix for smoking cessation. The acknowledged learning objective for this session was to "understand the newly-approved smoking cessation pharmacotherapy, varenicline (Chantix)."
There is nothing wrong with discussing the use of Chantix at a scientific conference. However, when that conference is sponsored by the manufacturer of Chantix, it ceases to be an objective scientific meeting and instead becomes a pharmaceutical marketing tool. Essentially, Pfizer paid for the marketing of its drug at this conference.
To make matters much worse, the financial connections between the investigators presenting the Chantix data and Big Pharma are not disclosed on the conference web site. Among the scientific presenters of the Chantix data listed on the website are Dr. Jon-Jar Zubieta, and Dr. Douglas Jorenby.
What is not revealed on the website is that:
For example, I doubt that they discussed research, such as that by Robert West and Taj Sohal at University College London and published recently in the British Medical Journal, which finds that a substantial proportion of successful quitters do not make a planned quit attempt, but quit spontaneously, a fact which suggests that the obsessive focus on pharmacotherapy is misplaced. With its pharmaceutical company sponsorship, there is simply no way that the conference could present a scientifically objective perspective on the role of pharmacotherapy as part of smoking cessation strategy.
As a Silver sponsor, here is what Pfizer also received from the National Tobacco Control Conference:
The prostitution of the tobacco control movement's national conference -- seeking money and forsaking scientific objectivity -- is just another example of the loss of scientific integrity in the tobacco control movement.
When money becomes more important than scientific integrity, that's when you leave the realm of a science-based movement and enter the realm of an all-out crusade.
A major topic of the conference was "cessation, nicotine, and the science of addiction." In a conference sponsored by Pfizer, one cannot expect to have an objective presentation of this topic. After all, Pfizer is the manufacturer of Chantix (varenicline), which the company is heavily promoting as a smoking cessation aid.
In fact, one of the "scientific" sessions - which could better be called a "marketing" session for Pfizer - discussed the use of Chantix for smoking cessation. The acknowledged learning objective for this session was to "understand the newly-approved smoking cessation pharmacotherapy, varenicline (Chantix)."
There is nothing wrong with discussing the use of Chantix at a scientific conference. However, when that conference is sponsored by the manufacturer of Chantix, it ceases to be an objective scientific meeting and instead becomes a pharmaceutical marketing tool. Essentially, Pfizer paid for the marketing of its drug at this conference.
To make matters much worse, the financial connections between the investigators presenting the Chantix data and Big Pharma are not disclosed on the conference web site. Among the scientific presenters of the Chantix data listed on the website are Dr. Jon-Jar Zubieta, and Dr. Douglas Jorenby.
What is not revealed on the website is that:
- Zubieta's research has been supported by Pfizer and Zubieta has received lecture fees from a number of other pharmaceutical companies; and
- Jorenby has received "research support from Pfizer, Nabi Biopharmaceutical, Sanofi-Aventis and consulting fees from Nabi Biopharmaceutical."
- Dr. Rigotti has received "research grant funding and consulting fees from GlaxoSmithKline, which markets smoking cessation medications, and Pfizer and Sanofi-Aventis, which are developing smoking cessation medications. Dr Rigotti also reported receiving consulting fees from Merck, which is developing smoking cessation medications;" and
- Dr. Ellerbeck has participated in research funded by Pfizer.
- Dr. Fiore has "served as a consultant for, given lectures sponsored by, or ... conducted research sponsored by Ciba-Geigy, SmithKline Beecham, Lederle Laboratories, McNeil Consumer Products, Elan Pharmaceutical, Pharmacia, and Glaxo Wellcome."
For example, I doubt that they discussed research, such as that by Robert West and Taj Sohal at University College London and published recently in the British Medical Journal, which finds that a substantial proportion of successful quitters do not make a planned quit attempt, but quit spontaneously, a fact which suggests that the obsessive focus on pharmacotherapy is misplaced. With its pharmaceutical company sponsorship, there is simply no way that the conference could present a scientifically objective perspective on the role of pharmacotherapy as part of smoking cessation strategy.
As a Silver sponsor, here is what Pfizer also received from the National Tobacco Control Conference:
- Recognition as Major Sponsor in all materials
- Recognition as Major Sponsor on Program back cover
- Recognition as Major Sponsor in Participant Directory
- One free standard exhibit booth space
- 15% discount on premium exhibit space
- Free half-page Program ad
- Highlighting of exhibit booth on Program map
- Participant mailing list (1 free use, pre- or post-conference)
- 5 free full Conference registrations
- 6 free Exhibitor passes
- Inclusion on signage in MCC [Minneapolis Convention Center]
- Web site listing as Major Sponsor with hotlink
The prostitution of the tobacco control movement's national conference -- seeking money and forsaking scientific objectivity -- is just another example of the loss of scientific integrity in the tobacco control movement.
When money becomes more important than scientific integrity, that's when you leave the realm of a science-based movement and enter the realm of an all-out crusade.
Friday, October 26, 2007
Anti-Smoking Group Claims that 390,000 Youths Die Each Year Due to Smoking in Movies
The same anti-smoking group which is publicly claiming that 340 young people die each day from smoking is also claiming that 390,000 youths die each year due to smoking in movies.
On its web site, Breathe California of Sacramento-Emigrant Trials asks: "Considering the fact that 1,070 youth die each day due to smoking in movies: Should youth be allowed to view films with excessively glamorized tobacco use?"
In other words, Breath California of Sacramento-Emigrant Trails is stating to the public that it is a "fact" that "1,070 youth die each day due to smoking in movies." That is: 390,000 youths die each year due to smoking in movies.
The Rest of the Story
This claim is obviously false. There are just over 390,000 total deaths each year attributable to smoking. This means that for the claim to be correct:
1. Every death that occurs due to smoking must occur in a youth. In other words, all 390,000 people who die each year due to smoking are youths.
AND
2. Every person who smokes must smoke because they were exposed to smoking in movies.
The claim also implies that if smoking in movies were eliminated, there would be no more deaths due to smoking.
In fact, there are only 26,000 total deaths due to all causes among youths (ages 1-19) annually in the United States. So it is mathematically impossible for smoking to be a cause of 390,000 annual deaths among youths.
The interesting question to me is whether we can write this off by stating that it is simply a mistake. I tend to think not. First of all, this mistake was pointed out to the anti-smoking group, but they still have not changed the site. Secondly, this errant "fact" is on the very same web page that states: "More than 1,000 teens will start smoking today because of what they saw on screen. 340 of them will die early from a smoking related disease."
In other words, it is very clear that the organization is aware that their claim is false. It is clear that they are aware that 340 young people do not die each day from smoking, but that 340 young people will eventually die from smoking, if the cited research is correct (and I do not believe it is anyway). But stipulating that the research is correct, the organization clearly understands that it is not youth who are dying from smoking.
Why is this important? It is important because it suggests that the organization knows that the public statement they are making is wrong. And this would turn a simple error into what I would call a lie.
To be lying, one could argue that you have to know that what you are stating is incorrect, but state it anyway. And here, we have strong evidence that Breathe California of Sacramento-Emigrant Trails knows that 390,000 youths do not die each year from seeing smoking in movies. In fact, I'm quite sure that Breathe California of Sacramento-Emigrant Trails is aware of the fact that 390,000 youths do not die each year. And I'm quite sure they are aware of the fact that the total annual mortality attributable to smoking is on the order of 390,000.
The Encarta dictionary defines lying as "deliberately saying something that is untrue." It appears unquestionable that the group is deliberately making the statement that 1,070 youths die each day from seeing smoking in movies. They put too many statistics on the website to believe that they have simply not thought this out at all. It also seems unquestionable that what they are saying is untrue. It is not true that 1,070 youths die each day from any cause, much less from seeing smoking in movies.
The Encarta dictionary also defines lying as "being deceptive" or "giving a false impression." By that definition, what Breathe California of Sacramento-Emigrant Trails is doing clearly seems to meet the definition of lying.
I am still willing to give Breathe California of Sacramento-Emigrant Trails one final benefit of the doubt. I am willing to entertain the remote possibility that somehow, this claim on the website escaped their careful scrutiny and they just made a mistake. If this is the case, however, I would expect that the mistake would be corrected immediately upon finding out about it, which is right now, since they are receiving this blog post by email.
I am willing to give them the weekend to think this over and correct it. But by Tuesday morning, if this is not corrected, I will have no choice but to conclude that this statement is a deliberate attempt to mislead the public by making a claim that the organization knows is not correct. In other words, to conclude that an anti-smoking group is lying to the public.
I have avoided jumping to such a conclusion, despite the widespread untruths being spread by many anti-smoking groups, because I don't want to believe that it is true. But honestly, I'm down to my final breath here. There's only so much that I can rationalize these actions as being some sort of innocent mistake.
Now is the time for a definitive resolution of this. I'll report back on Tuesday morning - hopefully, with the news that the organization has acknowledged and corrected the mistake and apologized for misleading the public.
(Thanks to James Austin for the tip).
Two quick additional points:
1. Because the claim is being made on the web page, and not in some sort of linked PDF document, it should be an easy matter to correct the false and misleading statement.
2. While the "definition" of "young people" may be somewhat subject to interpretation, the definition of "youth" seems far less subject to interpretation. Moreover, even if we consider anyone up to age 50 to be a "youth," which is absurd, the claim being made is still false on its face.
On its web site, Breathe California of Sacramento-Emigrant Trials asks: "Considering the fact that 1,070 youth die each day due to smoking in movies: Should youth be allowed to view films with excessively glamorized tobacco use?"
In other words, Breath California of Sacramento-Emigrant Trails is stating to the public that it is a "fact" that "1,070 youth die each day due to smoking in movies." That is: 390,000 youths die each year due to smoking in movies.
The Rest of the Story
This claim is obviously false. There are just over 390,000 total deaths each year attributable to smoking. This means that for the claim to be correct:
1. Every death that occurs due to smoking must occur in a youth. In other words, all 390,000 people who die each year due to smoking are youths.
AND
2. Every person who smokes must smoke because they were exposed to smoking in movies.
The claim also implies that if smoking in movies were eliminated, there would be no more deaths due to smoking.
In fact, there are only 26,000 total deaths due to all causes among youths (ages 1-19) annually in the United States. So it is mathematically impossible for smoking to be a cause of 390,000 annual deaths among youths.
The interesting question to me is whether we can write this off by stating that it is simply a mistake. I tend to think not. First of all, this mistake was pointed out to the anti-smoking group, but they still have not changed the site. Secondly, this errant "fact" is on the very same web page that states: "More than 1,000 teens will start smoking today because of what they saw on screen. 340 of them will die early from a smoking related disease."
In other words, it is very clear that the organization is aware that their claim is false. It is clear that they are aware that 340 young people do not die each day from smoking, but that 340 young people will eventually die from smoking, if the cited research is correct (and I do not believe it is anyway). But stipulating that the research is correct, the organization clearly understands that it is not youth who are dying from smoking.
Why is this important? It is important because it suggests that the organization knows that the public statement they are making is wrong. And this would turn a simple error into what I would call a lie.
To be lying, one could argue that you have to know that what you are stating is incorrect, but state it anyway. And here, we have strong evidence that Breathe California of Sacramento-Emigrant Trails knows that 390,000 youths do not die each year from seeing smoking in movies. In fact, I'm quite sure that Breathe California of Sacramento-Emigrant Trails is aware of the fact that 390,000 youths do not die each year. And I'm quite sure they are aware of the fact that the total annual mortality attributable to smoking is on the order of 390,000.
The Encarta dictionary defines lying as "deliberately saying something that is untrue." It appears unquestionable that the group is deliberately making the statement that 1,070 youths die each day from seeing smoking in movies. They put too many statistics on the website to believe that they have simply not thought this out at all. It also seems unquestionable that what they are saying is untrue. It is not true that 1,070 youths die each day from any cause, much less from seeing smoking in movies.
The Encarta dictionary also defines lying as "being deceptive" or "giving a false impression." By that definition, what Breathe California of Sacramento-Emigrant Trails is doing clearly seems to meet the definition of lying.
I am still willing to give Breathe California of Sacramento-Emigrant Trails one final benefit of the doubt. I am willing to entertain the remote possibility that somehow, this claim on the website escaped their careful scrutiny and they just made a mistake. If this is the case, however, I would expect that the mistake would be corrected immediately upon finding out about it, which is right now, since they are receiving this blog post by email.
I am willing to give them the weekend to think this over and correct it. But by Tuesday morning, if this is not corrected, I will have no choice but to conclude that this statement is a deliberate attempt to mislead the public by making a claim that the organization knows is not correct. In other words, to conclude that an anti-smoking group is lying to the public.
I have avoided jumping to such a conclusion, despite the widespread untruths being spread by many anti-smoking groups, because I don't want to believe that it is true. But honestly, I'm down to my final breath here. There's only so much that I can rationalize these actions as being some sort of innocent mistake.
Now is the time for a definitive resolution of this. I'll report back on Tuesday morning - hopefully, with the news that the organization has acknowledged and corrected the mistake and apologized for misleading the public.
(Thanks to James Austin for the tip).
Two quick additional points:
1. Because the claim is being made on the web page, and not in some sort of linked PDF document, it should be an easy matter to correct the false and misleading statement.
2. While the "definition" of "young people" may be somewhat subject to interpretation, the definition of "youth" seems far less subject to interpretation. Moreover, even if we consider anyone up to age 50 to be a "youth," which is absurd, the claim being made is still false on its face.
Thursday, October 25, 2007
Tobacco Control Activist Responds to Revelation of Incorrect Data on Website: I Don't Care; Anti-Smoking Group Apparently Decides to Retain Inaccuracy
An anti-smoking activist has responded to my revelation on Monday of an incorrect (and blatantly false) assertion on a tobacco control web site by admitting that he really doesn't care. My email to him on Monday alerted him to the presence of this incorrect statistic on the SceneSmoking.org web site. His response: "I don't waste my time on you and your blog any more."
The anti-smoking group which is posting the incorrect information also doesn't appear to care about its accuracy. The organization responsible for this error - Breathe California of Sacramento-Emigrant Trials - has apparently decided to retain the mistake because after reading my email and the blog post on Monday, it has failed to correct the problem. As of the writing of this post, Breathe California of Sacramento-Emigrant Trails is still maintaining that smoking in movies "kills about 340 young people a day."
Background
According to the SceneSmoking.org web site, 340 young people die every day from seeing smoking in movies. SceneSmoking.org is a web site dedicated to the effort to get smoking out of movies seen by young people, and is run by Breathe California of Sacramento-Emigrant Trails.
At the bottom left corner of the home page, you'll see a statistic given in the form of a movie ratings label. The label is "SK-340." It reads: "Viewers Strongly Cautioned. Smoking Kills About 340 Young People A Day. Smoking in Movies is Not Cool, Healthy Nor Needed."
Presumably, what the statistic intends to communicate is that 340 young people die each day from the depiction of smoking in the movies. It appears that the support for this statistic comes directly from a paper by Dr. Stanton Glantz which was published in the journal The Lancet in July 2003 ("Smoking in movies: a major problem and a real solution").
According to that article: "In the USA, about 2050 adolescents (age 12–17) start smoking every day and about 32% of these people—660 a day—will die prematurely because of smoking. Assuming that the 52·2% attributable risk observed by Dalton and colleagues applies to this whole group, smoking in movies is responsible for addicting 1080 US adolescents to tobacco every day, 340 of whom will die prematurely as a result."
So according to this paper, 340 young people become addicted to smoking each day due to seeing smoking in movies and will eventually die prematurely as a result.
On its face, the claim by this anti-smoking group is absurd. There are not 340 deaths among young people each day due to smoking, much less due to smoking that was caused by exposure to smoking in movies.
In fact, according to the CDC, there are no (ZERO) deaths attributable to smoking among persons under age 35. The reason is quite simple: it is rare for young people to die from smoking.
Now of course one could argue about what is meant by "young people." If one argues that anyone under age 65 is a "young" person (a definition that becomes increasingly appealing to me each year), then perhaps this claim is no longer absurdly false. But it would then be terribly misleading, because I doubt that anyone reading the web page is thinking of 40 and 50 and 60-year-olds when they read that "Smoking [in Movies] Kills 340 Young People A Day."
For the purposes of its smoking-attributable death calculations, the CDC defines middle-age as starting at age 35. I've never heard public health scientists referring to an age group above age 35 as representing what they mean when they talk about "young people."
Now I've already explained why I don't believe it is accurate even to claim that exposure to smoking in movies causes 340 young people to eventually die prematurely from smoking. But to state that 340 young people die each day because of exposure to smoking in movies is ludicrous. And patently false.
I really don't understand this need to lie to the public, or to stretch the truth beyond recognition, in order to make a point to the public. Forgetting about my argument that there is no valid scientific support for the claim that smoking in movies kills 120,000 people each year, if SceneSmoking.org wanted to accept this statistic from this one author, then what would the problem have been in stating that 340 young people will eventually die prematurely due to smoking in movies?
The problem, as far as I can see, is that it would not have been sensational enough. Apparently, it is no longer enough to tell the truth in tobacco control. It is not good enough to accurately represent the science.
The Rest of the Story
Today, the story gets more revealing. Based on the response of the anti-smoking activist who is largely responsible for this statistic, this is not merely a careless error. In fact, it does not appear that he, nor the group making the claim, care about the accuracy of the claim. They are neither willing to defend the claim or to remove or correct it.
There are really only two reasonable responses to my email:
1) Sorry Mike. You are wrong. And here is why; or
2) Thanks Mike. You are right. We'll fix it.
But instead, from the anti-smoking activist I get:
"I don't waste my time on you and your blog any more."
And from the group making the claim, I get:
bupkes.
It really does appear, then, that this deception by an anti-smoking group is not merely some sort of careless mistake. It certainly appears that it is a calculated decision to deceive the public. In other words, this appears to be intentional deception.
I am willing to reconsider my opinion that this anti-smoking group is willfully deceiving the public. But first, I need to see documentation of the "fact" that 340 young people die each day from smoking.
So I challenge Breathe California of Sacramento-Emigrant Trails to provide documentation that there are 120,000 young people who die each year from smoking.
Given the fact that I have been in the position of generating the nation's statistics on the age-specific mortality from smoking (as an epidemiologist at the CDC's Office on Smoking and Health), I can tell you that the annual number of deaths from smoking among young people (even if we define young as less than 40 years of age) is nowhere near 120,000. Not even close. Not remotely close.
But I am still willing to see documentation to the contrary.
I'm anxiously awaiting it.
I'll let you know tomorrow whether I get it. But I can tell you that if I don't, it's going to be very difficult to continue to maintain my position that the anti-smoking groups are not deliberately lying to the public.
The anti-smoking group which is posting the incorrect information also doesn't appear to care about its accuracy. The organization responsible for this error - Breathe California of Sacramento-Emigrant Trials - has apparently decided to retain the mistake because after reading my email and the blog post on Monday, it has failed to correct the problem. As of the writing of this post, Breathe California of Sacramento-Emigrant Trails is still maintaining that smoking in movies "kills about 340 young people a day."
Background
According to the SceneSmoking.org web site, 340 young people die every day from seeing smoking in movies. SceneSmoking.org is a web site dedicated to the effort to get smoking out of movies seen by young people, and is run by Breathe California of Sacramento-Emigrant Trails.
At the bottom left corner of the home page, you'll see a statistic given in the form of a movie ratings label. The label is "SK-340." It reads: "Viewers Strongly Cautioned. Smoking Kills About 340 Young People A Day. Smoking in Movies is Not Cool, Healthy Nor Needed."
Presumably, what the statistic intends to communicate is that 340 young people die each day from the depiction of smoking in the movies. It appears that the support for this statistic comes directly from a paper by Dr. Stanton Glantz which was published in the journal The Lancet in July 2003 ("Smoking in movies: a major problem and a real solution").
According to that article: "In the USA, about 2050 adolescents (age 12–17) start smoking every day and about 32% of these people—660 a day—will die prematurely because of smoking. Assuming that the 52·2% attributable risk observed by Dalton and colleagues applies to this whole group, smoking in movies is responsible for addicting 1080 US adolescents to tobacco every day, 340 of whom will die prematurely as a result."
So according to this paper, 340 young people become addicted to smoking each day due to seeing smoking in movies and will eventually die prematurely as a result.
On its face, the claim by this anti-smoking group is absurd. There are not 340 deaths among young people each day due to smoking, much less due to smoking that was caused by exposure to smoking in movies.
In fact, according to the CDC, there are no (ZERO) deaths attributable to smoking among persons under age 35. The reason is quite simple: it is rare for young people to die from smoking.
Now of course one could argue about what is meant by "young people." If one argues that anyone under age 65 is a "young" person (a definition that becomes increasingly appealing to me each year), then perhaps this claim is no longer absurdly false. But it would then be terribly misleading, because I doubt that anyone reading the web page is thinking of 40 and 50 and 60-year-olds when they read that "Smoking [in Movies] Kills 340 Young People A Day."
For the purposes of its smoking-attributable death calculations, the CDC defines middle-age as starting at age 35. I've never heard public health scientists referring to an age group above age 35 as representing what they mean when they talk about "young people."
Now I've already explained why I don't believe it is accurate even to claim that exposure to smoking in movies causes 340 young people to eventually die prematurely from smoking. But to state that 340 young people die each day because of exposure to smoking in movies is ludicrous. And patently false.
I really don't understand this need to lie to the public, or to stretch the truth beyond recognition, in order to make a point to the public. Forgetting about my argument that there is no valid scientific support for the claim that smoking in movies kills 120,000 people each year, if SceneSmoking.org wanted to accept this statistic from this one author, then what would the problem have been in stating that 340 young people will eventually die prematurely due to smoking in movies?
The problem, as far as I can see, is that it would not have been sensational enough. Apparently, it is no longer enough to tell the truth in tobacco control. It is not good enough to accurately represent the science.
The Rest of the Story
Today, the story gets more revealing. Based on the response of the anti-smoking activist who is largely responsible for this statistic, this is not merely a careless error. In fact, it does not appear that he, nor the group making the claim, care about the accuracy of the claim. They are neither willing to defend the claim or to remove or correct it.
There are really only two reasonable responses to my email:
1) Sorry Mike. You are wrong. And here is why; or
2) Thanks Mike. You are right. We'll fix it.
But instead, from the anti-smoking activist I get:
"I don't waste my time on you and your blog any more."
And from the group making the claim, I get:
bupkes.
It really does appear, then, that this deception by an anti-smoking group is not merely some sort of careless mistake. It certainly appears that it is a calculated decision to deceive the public. In other words, this appears to be intentional deception.
I am willing to reconsider my opinion that this anti-smoking group is willfully deceiving the public. But first, I need to see documentation of the "fact" that 340 young people die each day from smoking.
So I challenge Breathe California of Sacramento-Emigrant Trails to provide documentation that there are 120,000 young people who die each year from smoking.
Given the fact that I have been in the position of generating the nation's statistics on the age-specific mortality from smoking (as an epidemiologist at the CDC's Office on Smoking and Health), I can tell you that the annual number of deaths from smoking among young people (even if we define young as less than 40 years of age) is nowhere near 120,000. Not even close. Not remotely close.
But I am still willing to see documentation to the contrary.
I'm anxiously awaiting it.
I'll let you know tomorrow whether I get it. But I can tell you that if I don't, it's going to be very difficult to continue to maintain my position that the anti-smoking groups are not deliberately lying to the public.
Wednesday, October 24, 2007
Tobacco Control List-Serve Admits that It Expelled Rest of the Story Author Because He Was Critical of Anti-Smoking Groups and Expressed Disagreement
It is now official. McCarthyism is alive and well in the anti-smoking movement.
Yesterday, the list-serve which expelled me for what I claimed was my gall to express disagreement with the established wisdom of the tobacco control movement has publicly acknowledged that the reason I was expelled was that I had the gall to express disagreement with the established wisdom of the tobacco control movement.
Back in December 2005, I wrote - in response to my expulsion - that: "the tobacco control movement simply cannot tolerate any dissent. ... in response to speaking out to suggest that perhaps some of the things we are doing are not appropriate, the movement resorts to attacking the messenger, and now censoring that individual's free expression of opinion. ... What is really being said is that I disagreed with some of the dogmatic views of the movement. In this case, that's what interference means: disagreeing with the mentality of the movement. There clearly is no room for dissent in the tobacco control movement, and dissent is met not only with personal attacks, but now, with outright censorship."
It turns out that what I opined was exactly correct, and the list-serve has now publicly acknowledged that. In a message sent to the list-serve today, an administrator wrote that I was expelled from the list-serve for two reasons:
(1) for criticizing health organizations for misrepresenting scientific evidence about the risks of brief secondhand smoke exposure; and
(2) for criticizing health organizations for supporting various policies, such as firing all smokers at workplaces and making smoking around children a form of child abuse.
The administrator wrote: "Mike Siegel has misrepresented his expulsion from tp-talk as due solely to his criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks, when Mike's expulsion from tp-talk was also due to Mike's ad hominem attacks on health organizations for merely not agreeing with Mike's adamant opposition to:
- smokefree workplace laws that exempt even one workplace (i.e. every smokefree workplace law),
- outdoor smokefree laws for playgrounds, parks, beaches, near building entrances, etc.,
- laws and other public policies that protect children from tobacco smoke pollution exposure,
- cigarette tax hikes, and
- smokefree hiring/firing policies adopted by employers. "
The Rest of the Story
So my expulsion from the tobacco control list-serve was not only for my "criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks."
Which means that my expulsion from the tobacco control list-serve, according to the list-serve itself, was in part due to my "criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks."
So let's get this straight. You can participate on a tobacco control list-serve and take part in discussions all you want; however, you are not free to criticize any health organizations, even if they are misrepresenting scientific evidence to the public.
That bears repeating, especially because these are the admitted sentiments of the tobacco control list-serve administration, not my own: You can participate on a tobacco control list-serve and take part in discussions all you want; however, you are not free to criticize any health organizations, even if they are misrepresenting scientific evidence to the public.
The other admitted reason for my expulsion was that I expressed disagreement with and criticized health organizations for supporting certain policies, including policies by which employers fire all their smokers and refuse to hire any smokers and policies by which parents who smoke around their children are treated as child abusers.
So let's get that straight. You are not free to disagree with the policies being supported by anti-smoking groups. You have to agree with everything they do. You have to support every policy they support. Or at least keep quiet if you disagree.
That bears repeating, especially because these are the admitted sentiments of the tobacco control list-serve administration, not my own: You are not free to disagree with the policies being supported by anti-smoking groups. You have to agree with everything they do. You have to support every policy they support. Or at least keep quiet if you disagree.
Clearly, there is no room for dissent in tobacco control. Certainly not on its list-serves.
Disagreeing with anti-smoking organizations and their policies is not allowed. Criticizing tobacco control groups is not allowed.
You have no choice but either to go along with the established wisdom of the movement or to be quiet. If you express a difference of opinion, you are - in the eyes of the movement - subject to expulsion and therefore, to censorship.
The rest of the story is that the list-serve from which I was expelled has now publicly admitted that it committed outright censorship: I was kicked off the list-serve because I was expressing criticism of anti-smoking groups and opposition to certain [arguably radical] anti-smoking policies.
Interestingly, the main focus of my criticism of anti-smoking groups was that they are misrepresenting scientific information, which I view as a violation of the most basic ethical principle of public health.
The main focus of my criticism of tobacco control policies was that they represented discrimination against smokers and undue invasion of individual employee privacy. I also dared to suggest that smoking around children is not the same thing as physically or sexually abusing a child.
Apparently, if you believe that there is a major difference between exposing a child to secondhand smoke and smacking that child repeatedly so that you break his ribcage, you are simply not welcome in the tobacco control movement. You are, after all, expressing opposition to a policy intended to protect children from secondhand smoke.
Actually, the above statement is wrong. If you believe that there is a major difference between exposing a child to secondhand smoke and smacking that child repeatedly so that you break his ribcage, you are welcome in the tobacco control movement. You are welcome as long as you keep that opinion to yourself. If you express it publicly, then you are subject to censorship and expulsion from the movement.
The administrator of one of the largest and most important tobacco control list-serves has now publicly admitted to outright censorship.
This is McCarthyism in action. Quelling debate. Stifling opposition. Expelling and blacklisting anyone who dares express dissent.
No wonder the tobacco control movement has gone off the deep end in its fanaticism. Anyone who tries to stop it knows that they will be censored or expelled. You have no choice but to go along with the groupthink.
So now we know The Rest of the Story.
Yesterday, the list-serve which expelled me for what I claimed was my gall to express disagreement with the established wisdom of the tobacco control movement has publicly acknowledged that the reason I was expelled was that I had the gall to express disagreement with the established wisdom of the tobacco control movement.
Back in December 2005, I wrote - in response to my expulsion - that: "the tobacco control movement simply cannot tolerate any dissent. ... in response to speaking out to suggest that perhaps some of the things we are doing are not appropriate, the movement resorts to attacking the messenger, and now censoring that individual's free expression of opinion. ... What is really being said is that I disagreed with some of the dogmatic views of the movement. In this case, that's what interference means: disagreeing with the mentality of the movement. There clearly is no room for dissent in the tobacco control movement, and dissent is met not only with personal attacks, but now, with outright censorship."
It turns out that what I opined was exactly correct, and the list-serve has now publicly acknowledged that. In a message sent to the list-serve today, an administrator wrote that I was expelled from the list-serve for two reasons:
(1) for criticizing health organizations for misrepresenting scientific evidence about the risks of brief secondhand smoke exposure; and
(2) for criticizing health organizations for supporting various policies, such as firing all smokers at workplaces and making smoking around children a form of child abuse.
The administrator wrote: "Mike Siegel has misrepresented his expulsion from tp-talk as due solely to his criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks, when Mike's expulsion from tp-talk was also due to Mike's ad hominem attacks on health organizations for merely not agreeing with Mike's adamant opposition to:
- smokefree workplace laws that exempt even one workplace (i.e. every smokefree workplace law),
- outdoor smokefree laws for playgrounds, parks, beaches, near building entrances, etc.,
- laws and other public policies that protect children from tobacco smoke pollution exposure,
- cigarette tax hikes, and
- smokefree hiring/firing policies adopted by employers. "
The Rest of the Story
So my expulsion from the tobacco control list-serve was not only for my "criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks."
Which means that my expulsion from the tobacco control list-serve, according to the list-serve itself, was in part due to my "criticism of health organizations for misrepresenting scientific evidence about short term 2nd hand smoke risks."
So let's get this straight. You can participate on a tobacco control list-serve and take part in discussions all you want; however, you are not free to criticize any health organizations, even if they are misrepresenting scientific evidence to the public.
That bears repeating, especially because these are the admitted sentiments of the tobacco control list-serve administration, not my own: You can participate on a tobacco control list-serve and take part in discussions all you want; however, you are not free to criticize any health organizations, even if they are misrepresenting scientific evidence to the public.
The other admitted reason for my expulsion was that I expressed disagreement with and criticized health organizations for supporting certain policies, including policies by which employers fire all their smokers and refuse to hire any smokers and policies by which parents who smoke around their children are treated as child abusers.
So let's get that straight. You are not free to disagree with the policies being supported by anti-smoking groups. You have to agree with everything they do. You have to support every policy they support. Or at least keep quiet if you disagree.
That bears repeating, especially because these are the admitted sentiments of the tobacco control list-serve administration, not my own: You are not free to disagree with the policies being supported by anti-smoking groups. You have to agree with everything they do. You have to support every policy they support. Or at least keep quiet if you disagree.
Clearly, there is no room for dissent in tobacco control. Certainly not on its list-serves.
Disagreeing with anti-smoking organizations and their policies is not allowed. Criticizing tobacco control groups is not allowed.
You have no choice but either to go along with the established wisdom of the movement or to be quiet. If you express a difference of opinion, you are - in the eyes of the movement - subject to expulsion and therefore, to censorship.
The rest of the story is that the list-serve from which I was expelled has now publicly admitted that it committed outright censorship: I was kicked off the list-serve because I was expressing criticism of anti-smoking groups and opposition to certain [arguably radical] anti-smoking policies.
Interestingly, the main focus of my criticism of anti-smoking groups was that they are misrepresenting scientific information, which I view as a violation of the most basic ethical principle of public health.
The main focus of my criticism of tobacco control policies was that they represented discrimination against smokers and undue invasion of individual employee privacy. I also dared to suggest that smoking around children is not the same thing as physically or sexually abusing a child.
Apparently, if you believe that there is a major difference between exposing a child to secondhand smoke and smacking that child repeatedly so that you break his ribcage, you are simply not welcome in the tobacco control movement. You are, after all, expressing opposition to a policy intended to protect children from secondhand smoke.
Actually, the above statement is wrong. If you believe that there is a major difference between exposing a child to secondhand smoke and smacking that child repeatedly so that you break his ribcage, you are welcome in the tobacco control movement. You are welcome as long as you keep that opinion to yourself. If you express it publicly, then you are subject to censorship and expulsion from the movement.
The administrator of one of the largest and most important tobacco control list-serves has now publicly admitted to outright censorship.
This is McCarthyism in action. Quelling debate. Stifling opposition. Expelling and blacklisting anyone who dares express dissent.
No wonder the tobacco control movement has gone off the deep end in its fanaticism. Anyone who tries to stop it knows that they will be censored or expelled. You have no choice but to go along with the groupthink.
So now we know The Rest of the Story.
Tuesday, October 23, 2007
A Salvo of Articles Directing Public Attention to the Widespread Misrepresentation of Science by Anti-Smoking Groups
Today, I highlight three articles - one from a scientific journal, one from a newspaper, and one from a magazine - which expose the misrepresentation, by anti-smoking groups, of the scientific evidence about the acute cardiovascular effects of secondhand smoke.
1. POST #1: In his commentary published today in the journal Epidemiologic Perspectives & Innovations, Dr. Carl Phillips, a professor at the University of Alberta and an editor of the journal, warns that "Anti-tobacco activism may be hazardous to epidemiologic science." The commentary accompanies two pieces - one by me and one by Dr. James Enstrom - which highlight the anti-tobacco movement's attack on researchers who dared to publish findings which could be construed as unfavorable to the movement.
2. POST #2: In an article in the current issue of Skeptic magazine, Sidney Zion highlights the absurd claims that anti-smoking groups are making about the acute cardiovascular effects of secondhand smoke.
3. POST #3: In an op-ed piece published today in the New York Post, Jeff Stier - associate director of the American Council on Science and Health (ACSH) - highlights the misrepresentation of the acute effects of secondhand smoke by a large number of anti-smoking groups.
The Rest of the Story
I and The Rest of the Story blog played a substantial role in bringing this issue to media and public attention. The New York Post piece is based largely largely on my article published this week in Epidemiologic Perspectives & Innovations. The journal itself today published a commentary which highlights not only my own story, but a similar story of Dr. James Enstrom, whose character has also been attacked by anti-smoking activists because he produced results unfavorable to them. Sidney Zion's article is based heavily upon his interview with me, in which I revealed the widespread misrepresentation of the science about the acute cardiovascular effects of secondhand smoke and the fanatical agenda that has recently been adopted by many tobacco control groups.
It is exceedingly difficult to get this story out to the media and to the public. It is thus very satisfying to have such a salvo of public attention to this important issue within a single week.
While my hope would be that the tobacco control groups take a step back and re-examine the public statements they are making, I am well aware that will not happen. The end is the only thing that matters. While it is intolerable for the tobacco companies to lie to the public, it is perfectly acceptable for anti-smoking groups to mislead the public, as long as the end goal is a good one. You can't lie to sell cigarettes; but it is OK to lie if it is for the children.
1. POST #1: In his commentary published today in the journal Epidemiologic Perspectives & Innovations, Dr. Carl Phillips, a professor at the University of Alberta and an editor of the journal, warns that "Anti-tobacco activism may be hazardous to epidemiologic science." The commentary accompanies two pieces - one by me and one by Dr. James Enstrom - which highlight the anti-tobacco movement's attack on researchers who dared to publish findings which could be construed as unfavorable to the movement.
2. POST #2: In an article in the current issue of Skeptic magazine, Sidney Zion highlights the absurd claims that anti-smoking groups are making about the acute cardiovascular effects of secondhand smoke.
3. POST #3: In an op-ed piece published today in the New York Post, Jeff Stier - associate director of the American Council on Science and Health (ACSH) - highlights the misrepresentation of the acute effects of secondhand smoke by a large number of anti-smoking groups.
The Rest of the Story
I and The Rest of the Story blog played a substantial role in bringing this issue to media and public attention. The New York Post piece is based largely largely on my article published this week in Epidemiologic Perspectives & Innovations. The journal itself today published a commentary which highlights not only my own story, but a similar story of Dr. James Enstrom, whose character has also been attacked by anti-smoking activists because he produced results unfavorable to them. Sidney Zion's article is based heavily upon his interview with me, in which I revealed the widespread misrepresentation of the science about the acute cardiovascular effects of secondhand smoke and the fanatical agenda that has recently been adopted by many tobacco control groups.
It is exceedingly difficult to get this story out to the media and to the public. It is thus very satisfying to have such a salvo of public attention to this important issue within a single week.
While my hope would be that the tobacco control groups take a step back and re-examine the public statements they are making, I am well aware that will not happen. The end is the only thing that matters. While it is intolerable for the tobacco companies to lie to the public, it is perfectly acceptable for anti-smoking groups to mislead the public, as long as the end goal is a good one. You can't lie to sell cigarettes; but it is OK to lie if it is for the children.
New York Post Op-Ed Highlights Anti-Smoking Groups' Misrepresentation of the Acute Cardiovascular Effects of Secondhand Smoke
In an op-ed piece published today in the New York Post, Jeff Stier - associate director of the American Council on Science and Health (ACSH) - highlights the misrepresentation of the acute effects of secondhand smoke by a large number of anti-smoking groups. Stier's article, which was prompted by the publication of my study on this topic this week in Epidemiologic Perspectives & Innovations, argues that by overstating the case, anti-smoking groups are actually doing great harm to the larger public health movement.
In the column, entitled "Smoke & Mirrors: Butts, Lies, and Public Health," Stier writes of the irony that the days of deception about the health effects of tobacco smoke are not over, but not due to the re-emergence of tobacco industry propaganda. Instead, "it's anti-smoking advocates spreading the disinformation - overstating certain risks. But - because such deception undermines the credibility of all public-health work - they're being called on it by one of their own."
In the column, entitled "Smoke & Mirrors: Butts, Lies, and Public Health," Stier writes of the irony that the days of deception about the health effects of tobacco smoke are not over, but not due to the re-emergence of tobacco industry propaganda. Instead, "it's anti-smoking advocates spreading the disinformation - overstating certain risks. But - because such deception undermines the credibility of all public-health work - they're being called on it by one of their own."
"A startling study by Dr. Michael Siegel of Boston University's School of Public Health is pointing the finger at the well-intentioned likes of Action on Smoking and Health, the politically powerful Campaign for Tobacco-Free Kids and New York City's Department of Health. In a study published this week in the journal Epidemiologic Perspectives & Innovations, Siegel warns that these groups are wildly inflating the health risks of exposure to second-hand smoke. In doing so, they tarnish the very credibility that the public-health community must have in order to save lives."
"Siegel is no friend of Big Tobacco - he's a vocal opponent of smoking and a supporter of smoke-free workplace rules. Indeed, it was his place as a leading member of the tobacco-control community that compelled him to publish his findings that some groups are harming the movement's credibility by overstating the dangers of short-term exposure to environmental tobacco smoke (ETS)."
"There is evidence that long-term, high-dose ETS exposure increases the risk of heart disease and heart attack. And there is speculation that even short-term exposure may be unsafe to those with severe coronary artery disease. But the evidence does not support the claim that more than 100 groups are wantonly making - which is that acute, transient exposure to ETS increases heart-attack risk in healthy individuals."
"The lack of evidence hasn't stopped Commissioner Thomas Frieden at the city Health Department, which is buying ads in The New York Times claiming that "just 30 minutes of exposure to second-hand smoke produces some of the same physical reactions that would occur from long-term smoking, and increases the risk of heart disease in non-smokers."
"The "evidence" behind that assertion is so flimsy that it would be laughed at if it supported the finding that smoking is less dangerous than we once thought. The clear implication is that some anti-smoking activists have adopted an "ends justifies the means" approach in pursuit of their noble cause."
"This is what makes Siegel's report so troubling. No longer can we rely on the public-health establishment for scientifically accurate information. They'll fudge the numbers if they have to, so long as it promotes their overall agenda - in this case, the drive to outlaw smoking in all public places."
"Even more disturbing is that some in the tobacco-control community are attacking those raising questions. Siegel was banned from the primary tobacco listserv for simply sharing his dissenting views."
Stier concludes: "Cigarette smoking is the leading cause of preventable death in the United States and needs our urgent attention. Overstating the case may help the advocates win this political battle but at significant cost to the overall public-health war."
Article in Skeptic Magazine Highlights Absurd Claims of Anti-Smoking Groups
In an article in the current issue of Skeptic magazine, Sidney Zion highlights the absurd claims that anti-smoking groups are making about the acute cardiovascular effects of secondhand smoke (see: Zion S. Science and Secondhand Smoke: The Need for a Good Puff of Skepticism. Skeptic 2007; 13[3]:20-27). In doing so, Zion draws heavily upon his interview with me.
He writes: "Dr. Michael Siegel was ex-communicated in late February 2006. A momentous event in the annals of anti-smoking militancy, for Siegel was a pioneer in the long fight to bar smoking in restaurants. He's a physician and a professor in Boston University's School of Public Health. If the Movement had a College of Cardinals, he'd have been among the first to wear the red hat. These credentials availed him nothing, for he committed the Mortal Sin of Criticism against the Infallible ASH and its pontiff, John Banzhaf."
"What brought Siegel to the apostasy was his revulsion at ASH's "fanatical" positions: that outdoor smoking should be banned, that companies should fire all smokers, that cities that permitted outdoor smoking would likely be sued by nonsmokers who keeled over from heart attacks, and for boasting that they were going to break the final frontier, by banning smoking in private homes."
"The means to these ends was ASH's claim that 30 minutes of secondhand smoke could cause fatal heart attacks in otherwise healthy nonsmokers. "In science and medicine," Siegel wrote in his blog, "we have a technical term that can be used to describe such a contention: a bunch of crap."
"Since ASH was promoting this line in the context of outdoor smoking, I asked Siegel if he thought they were right about half-hour heart attacks from indoor smoking. 'Of course not,' he said. 'As for outdoor smoking, I've never seen a credible study that [it] has ever killed anybody in any amount of time. If 30 minutes can cause fatal heart attacks, we'd have noticed it. People would be dying like flies.'"
In a piece that provides somewhat of a counter-point (in terms of the effects of chronic exposure to secondhand smoke), Dr. Harriet Hall, a physician who has no connection to the anti-smoking movement (at least not that I am aware of) expresses her agreement that the anti-smoking movement is seriously overstating its case. This is an important development, because it gives some indication of what a "neutral" physician believes and how she views this debate (see: Hall H. Clearing the Air: What Does Science Really Say About Secondhand Smoke? Skeptic 2007; 13[3]:28-31).
Dr. Hall writes: "Sidney Zion is right about one thing: anti-smoking activists have overstated the evidence against secondhand smoke. ... Hysterical anti-smoking activists have gone overboard, using this uncertainty [about whether there is a threshold below which secondhand smoke is absolutely innocuous] alone to support their demands for total bans. ... Common sense tells us that a low level of exposure is innocuous enough for practical purposes. Common sense tells us that judges should not be taking children away from parents just because the parents smoke."
He writes: "Dr. Michael Siegel was ex-communicated in late February 2006. A momentous event in the annals of anti-smoking militancy, for Siegel was a pioneer in the long fight to bar smoking in restaurants. He's a physician and a professor in Boston University's School of Public Health. If the Movement had a College of Cardinals, he'd have been among the first to wear the red hat. These credentials availed him nothing, for he committed the Mortal Sin of Criticism against the Infallible ASH and its pontiff, John Banzhaf."
"What brought Siegel to the apostasy was his revulsion at ASH's "fanatical" positions: that outdoor smoking should be banned, that companies should fire all smokers, that cities that permitted outdoor smoking would likely be sued by nonsmokers who keeled over from heart attacks, and for boasting that they were going to break the final frontier, by banning smoking in private homes."
"The means to these ends was ASH's claim that 30 minutes of secondhand smoke could cause fatal heart attacks in otherwise healthy nonsmokers. "In science and medicine," Siegel wrote in his blog, "we have a technical term that can be used to describe such a contention: a bunch of crap."
"Since ASH was promoting this line in the context of outdoor smoking, I asked Siegel if he thought they were right about half-hour heart attacks from indoor smoking. 'Of course not,' he said. 'As for outdoor smoking, I've never seen a credible study that [it] has ever killed anybody in any amount of time. If 30 minutes can cause fatal heart attacks, we'd have noticed it. People would be dying like flies.'"
In a piece that provides somewhat of a counter-point (in terms of the effects of chronic exposure to secondhand smoke), Dr. Harriet Hall, a physician who has no connection to the anti-smoking movement (at least not that I am aware of) expresses her agreement that the anti-smoking movement is seriously overstating its case. This is an important development, because it gives some indication of what a "neutral" physician believes and how she views this debate (see: Hall H. Clearing the Air: What Does Science Really Say About Secondhand Smoke? Skeptic 2007; 13[3]:28-31).
Dr. Hall writes: "Sidney Zion is right about one thing: anti-smoking activists have overstated the evidence against secondhand smoke. ... Hysterical anti-smoking activists have gone overboard, using this uncertainty [about whether there is a threshold below which secondhand smoke is absolutely innocuous] alone to support their demands for total bans. ... Common sense tells us that a low level of exposure is innocuous enough for practical purposes. Common sense tells us that judges should not be taking children away from parents just because the parents smoke."
Commentary in Epidemiologic Perspectives & Innovations Highlights Threats to Science from Anti-Tobacco Activism
In his commentary published today in the journal Epidemiologic Perspectives & Innovations, Dr. Carl Phillips, a professor at the University of Alberta and an editor of the journal, warns that "Anti-tobacco activism may be hazardous to epidemiologic science." The commentary accompanies two pieces - one by me and one by Dr. James Enstrom - which highlight the anti-tobacco movement's attack on researchers who dared to publish findings which could be construed as unfavorable to the movement. Dr. Phillips adds his own story: he, too, was ex-communicated from the tobacco control movement because he suggested that a harm reduction strategy, rather than a risk elimination strategy, be considered.
Speaking about all three cases, Dr. Phillips writes: "The three cases (including my own experience, described below) involve scientists whose careers are substantially devoted to the anti-smoking cause, but who have been viciously attacked by anti-tobacco advocates for not adhering 100% to the party line. These attacks are examples of the threat to honest science by powerful organized interests, a threat to which the science of epidemiology seems particularly vulnerable [3,4]."
Importantly, my case adds an example of someone who has not received funding from tobacco companies but has been treated in the same way as those who have. As Dr. Phillips points out: "Many of the attacks against Enstrom and me, though clearly directed at the content of our research, have been rationalized based on it being partially funded by unrestricted grants from the tobacco industry. The evidence that this is a rationalization can be found in the similarly vehement attacks on those who defied the orthodoxy but have not received industry funding, including Siegel."
Speaking about my own case, Dr. Phillips writes: "The accompanying article by Michael Siegel [1] recounts a particularly egregious misrepresentation of epidemiologic research by self-styled public health advocates. This might not be considered newsworthy, except for the fact that Siegel – a respected researcher and writer, and well-known anti-smoking advocate in his own right – actively attempted to correct the misrepresentation and was attacked for this. Indeed, Siegel's defenses of epidemiologic evidence, which anti-tobacco advocates preferred to ignore or misrepresent, resulted in him being "excommunicated" (there is really no other word that captures it) from the anti-smoking activists' inner circles." ...
"Readers of the Siegel article may find his story less surprising, given how common it is for activists of various stripes to casually misconstrue epidemiologic findings to support their political ends. But the full story is really more disturbing than that: Almost no other researchers have joined Siegel in pointing out the errors in the claims he brought to light, even though the claims in question were not remotely plausible. Moreover, respected organizations that are the face of epidemiology to most of the public (in particular, the major player of the Enstrom story, the American Cancer Society (ACS)), organizations that claim scientific authority, have joined the chorus that makes the ridiculous claim that Siegel has critiqued. (Several new chapters of this story have been written since Siegel finalized this manuscript [5-7], and they can be found in his blog [8], which is the best source of honest, scientifically-sophisticated, up-to-date analysis on matters related to tobacco policy.)" ...
"Readers interested in further distortions of science relating to ETS research should read Siegel's blog entries that mention the Helena, Montana study or the recent reports from New York. It was claimed by authors who positioned themselves as epidemiologists that ETS exposure in public places causes 10%, or perhaps 40%, or maybe even 60% of all heart attacks. It is difficult to understand how such patently absurd claims can be made without an outcry from legitimate scientists."
Speaking about all three cases, Dr. Phillips writes: "The three cases (including my own experience, described below) involve scientists whose careers are substantially devoted to the anti-smoking cause, but who have been viciously attacked by anti-tobacco advocates for not adhering 100% to the party line. These attacks are examples of the threat to honest science by powerful organized interests, a threat to which the science of epidemiology seems particularly vulnerable [3,4]."
Importantly, my case adds an example of someone who has not received funding from tobacco companies but has been treated in the same way as those who have. As Dr. Phillips points out: "Many of the attacks against Enstrom and me, though clearly directed at the content of our research, have been rationalized based on it being partially funded by unrestricted grants from the tobacco industry. The evidence that this is a rationalization can be found in the similarly vehement attacks on those who defied the orthodoxy but have not received industry funding, including Siegel."
Speaking about my own case, Dr. Phillips writes: "The accompanying article by Michael Siegel [1] recounts a particularly egregious misrepresentation of epidemiologic research by self-styled public health advocates. This might not be considered newsworthy, except for the fact that Siegel – a respected researcher and writer, and well-known anti-smoking advocate in his own right – actively attempted to correct the misrepresentation and was attacked for this. Indeed, Siegel's defenses of epidemiologic evidence, which anti-tobacco advocates preferred to ignore or misrepresent, resulted in him being "excommunicated" (there is really no other word that captures it) from the anti-smoking activists' inner circles." ...
"Readers of the Siegel article may find his story less surprising, given how common it is for activists of various stripes to casually misconstrue epidemiologic findings to support their political ends. But the full story is really more disturbing than that: Almost no other researchers have joined Siegel in pointing out the errors in the claims he brought to light, even though the claims in question were not remotely plausible. Moreover, respected organizations that are the face of epidemiology to most of the public (in particular, the major player of the Enstrom story, the American Cancer Society (ACS)), organizations that claim scientific authority, have joined the chorus that makes the ridiculous claim that Siegel has critiqued. (Several new chapters of this story have been written since Siegel finalized this manuscript [5-7], and they can be found in his blog [8], which is the best source of honest, scientifically-sophisticated, up-to-date analysis on matters related to tobacco policy.)" ...
"Readers interested in further distortions of science relating to ETS research should read Siegel's blog entries that mention the Helena, Montana study or the recent reports from New York. It was claimed by authors who positioned themselves as epidemiologists that ETS exposure in public places causes 10%, or perhaps 40%, or maybe even 60% of all heart attacks. It is difficult to understand how such patently absurd claims can be made without an outcry from legitimate scientists."
Monday, October 22, 2007
Anti-Smoking Group Claims that 340 Young People Die Each Day from Seeing Smoking in Movies
According to the SceneSmoking.org web site, 340 young people die every day from seeing smoking in movies. SceneSmoking.org is a web site dedicated to the effort to get smoking out of movies seen by young people, and is run by Breathe California of Sacramento-Emigrant Trails.
At the bottom left corner of the home page, you'll see a statistic given in the form of a movie ratings label. The label is "SK-340." It reads: "Viewers Strongly Cautioned. Smoking Kills About 340 Young People A Day. Smoking in Movies is Not Cool, Healthy Nor Needed."
Presumably, what the statistic intends to communicate is that 340 young people die each day from the depiction of smoking in the movies. It appears that the support for this statistic comes directly from a paper by Dr. Stanton Glantz which was published in the journal The Lancet in July 2003 ("Smoking in movies: a major problem and a real solution").
According to that article: "In the USA, about 2050 adolescents (age 12–17) start smoking every day and about 32% of these people—660 a day—will die prematurely because of smoking. Assuming that the 52·2% attributable risk observed by Dalton and colleagues applies to this whole group, smoking in movies is responsible for addicting 1080 US adolescents to tobacco every day, 340 of whom will die prematurely as a result."
So according to this paper, 340 young people become addicted to smoking each day due to seeing smoking in movies and will eventually die prematurely as a result.
The Rest of the Story
On its face, the claim by this anti-smoking group is absurd. There are not 340 deaths among young people each day due to smoking, much less due to smoking that was caused by exposure to smoking in movies.
In fact, according to the CDC, there are no (ZERO) deaths attributable to smoking among persons under age 35. The reason is quite simple: it is rare for young people to die from smoking.
Now of course one could argue about what is meant by "young people." If one argues that anyone under age 65 is a "young" person (a definition that becomes increasingly appealing to me each year), then perhaps this claim is no longer absurdly false. But it would then be terribly misleading, because I doubt that anyone reading the web page is thinking of 40 and 50 and 60-year-olds when they read that "Smoking [in Movies] Kills 340 Young People A Day."
For the purposes of its smoking-attributable death calculations, the CDC defines middle-age as starting at age 35. I've never heard public health scientists referring to an age group above age 35 as representing what they mean when they talk about "young people."
Now I've already explained why I don't believe it is accurate even to claim that exposure to smoking in movies causes 340 young people to eventually die prematurely from smoking. But to state that 340 young people die each day because of exposure to smoking in movies is ludicrous. And patently false.
I really don't understand this need to lie to the public, or to stretch the truth beyond recognition, in order to make a point to the public. Forgetting about my argument that there is no valid scientific support for the claim that smoking in movies kills 120,000 people each year, if SceneSmoking.org wanted to accept this statistic from this one author, then what would the problem have been in stating that 340 young people will eventually die prematurely due to smoking in movies?
The problem, as far as I can see, is that it would not have been sensational enough. Apparently, it is no longer enough to tell the truth in tobacco control. It is not good enough to accurately represent the science.
You need to lie in order to sensationalize your message. You need to misrepresent the facts. Otherwise I guess you're not doing your job.
By the way, have you ever wondered what those movie theater ushers do during the ten minutes in between movie showings? They're not just cleaning up spilled popcorn and candy. They're picking up the dead bodies of the young people who died from seeing the smoking in those movies. No wonder that job never appealed to me.
(Thanks to James Austin for the tip).
At the bottom left corner of the home page, you'll see a statistic given in the form of a movie ratings label. The label is "SK-340." It reads: "Viewers Strongly Cautioned. Smoking Kills About 340 Young People A Day. Smoking in Movies is Not Cool, Healthy Nor Needed."
Presumably, what the statistic intends to communicate is that 340 young people die each day from the depiction of smoking in the movies. It appears that the support for this statistic comes directly from a paper by Dr. Stanton Glantz which was published in the journal The Lancet in July 2003 ("Smoking in movies: a major problem and a real solution").
According to that article: "In the USA, about 2050 adolescents (age 12–17) start smoking every day and about 32% of these people—660 a day—will die prematurely because of smoking. Assuming that the 52·2% attributable risk observed by Dalton and colleagues applies to this whole group, smoking in movies is responsible for addicting 1080 US adolescents to tobacco every day, 340 of whom will die prematurely as a result."
So according to this paper, 340 young people become addicted to smoking each day due to seeing smoking in movies and will eventually die prematurely as a result.
The Rest of the Story
On its face, the claim by this anti-smoking group is absurd. There are not 340 deaths among young people each day due to smoking, much less due to smoking that was caused by exposure to smoking in movies.
In fact, according to the CDC, there are no (ZERO) deaths attributable to smoking among persons under age 35. The reason is quite simple: it is rare for young people to die from smoking.
Now of course one could argue about what is meant by "young people." If one argues that anyone under age 65 is a "young" person (a definition that becomes increasingly appealing to me each year), then perhaps this claim is no longer absurdly false. But it would then be terribly misleading, because I doubt that anyone reading the web page is thinking of 40 and 50 and 60-year-olds when they read that "Smoking [in Movies] Kills 340 Young People A Day."
For the purposes of its smoking-attributable death calculations, the CDC defines middle-age as starting at age 35. I've never heard public health scientists referring to an age group above age 35 as representing what they mean when they talk about "young people."
Now I've already explained why I don't believe it is accurate even to claim that exposure to smoking in movies causes 340 young people to eventually die prematurely from smoking. But to state that 340 young people die each day because of exposure to smoking in movies is ludicrous. And patently false.
I really don't understand this need to lie to the public, or to stretch the truth beyond recognition, in order to make a point to the public. Forgetting about my argument that there is no valid scientific support for the claim that smoking in movies kills 120,000 people each year, if SceneSmoking.org wanted to accept this statistic from this one author, then what would the problem have been in stating that 340 young people will eventually die prematurely due to smoking in movies?
The problem, as far as I can see, is that it would not have been sensational enough. Apparently, it is no longer enough to tell the truth in tobacco control. It is not good enough to accurately represent the science.
You need to lie in order to sensationalize your message. You need to misrepresent the facts. Otherwise I guess you're not doing your job.
By the way, have you ever wondered what those movie theater ushers do during the ten minutes in between movie showings? They're not just cleaning up spilled popcorn and candy. They're picking up the dead bodies of the young people who died from seeing the smoking in those movies. No wonder that job never appealed to me.
(Thanks to James Austin for the tip).
Saturday, October 20, 2007
IN MY VIEW: Why Has The Tobacco Control Movement Lost Its Scientific Integrity?
In this post, I address two questions that have been asked by a number of readers and by several reporters since the publication of my article in Epidemiologic Perspectives & Innovations, which concludes that many anti-smoking groups are misrepresenting the acute cardiovascular health effects of secondhand smoke:
1. Did this misrepresentation of the science just start, or has it been going on for some time?
2. If the misrepresentation of the science has been increasing over time, why?
My answer to the first question is that while some misrepresentation of the science may have been occurring for some time, there has, without a doubt, been a dramatic increase in the amount of this misrepresentation. Without question, it is over the past six years, from 2001 forward, that I have observed a complete loss of scientific integrity within the tobacco control movement.
My answer to the second question is that the loss of scientific integrity in tobacco control coincides perfectly with the abdication by the tobacco industry of its role as a watchdog for "anti-tobacco industry" statements and communications.
In essence, the role that I am now playing is one that the tobacco industry used to play, albeit for a different reason. The tobacco industry played a watchdog role because they wanted to discredit tobacco control and undermine its public credibility. I am now playing this watchdog role because I want to restore the scientific integrity of the movement and save its public credibility. Nevertheless, the role that I am playing is very similar to what the tobacco industry used to do.
To some extent, it is surprising to me that the tobacco companies have not made more of a public display over the outright misrepresentation of science by anti-smoking groups. I suppose they feel that if they just lay back, the movement will destroy its own credibility. This may be a wise strategy, since it seems that every day, the claims get more and more absurd (wait until you read Monday's post).
First it was 30 minutes of secondhand smoke being fatal, then 20 minutes, then 5 minutes, and then basically instantaneous death from a trace of secondhand smoke.
First it was Helena, then Pueblo, then Piedmont, then Bowling Green, and now Scotland and Ireland.
First it was 120,000 deaths from exposure to smoking in movies and now it's 120,000 deaths from exposure to even a single depiction of smoking in movies.
If left to their own devices, it appears that the tobacco control movement will continue to spiral out of control in their misrepresentations of science, and eventually, they will go too far and lose public credibility. It's a good thing that somebody is trying to hold the movement accountable for its statements.
I remember, back before 2001, that whenever we wanted to make a public statement, we would quake in our boots over what the tobacco industry's reaction might be. We pored over every word of every statement we made because we were scared. We were scared of being nailed by the tobacco industry. The industry was watching every word we said and they would nail us to a tree if we took any mis-steps. So we were exceedingly careful.
Around the year 2000 or so, coinciding with the change in the public position of the tobacco companies over the health effects of smoking, the implementation of the Master Settlement Agreement, the Engle decision and the tobacco industry's attempt to portray itself to the jury in a new light, the dissolution of the Tobacco Institute, and the attempt of the tobacco industry to create a new public image in light of damaging publicity from lawsuits, it appears to me that the industry made a decision to lay off its constant vigilance over the communications of anti-smoking groups.
Gone were the days of constant FOIA requests to anti-smoking groups, which had gotten us to watch every word we said, even in non-public communications. Gone were the days of having to worry about actually being held to our public statements. Gone were the days of having to actually defend our statements publicly, and to take public responsibility for them.
This is the new era of tobacco control - sans industry oversight.
And it has truly become a free-for-all for anti-smoking organizations.
Imagine this: the anti-smoking groups can actually claim that 30 minutes of secondhand smoke exposure is enough to cause hardening of the arteries. They can actually claim that 30 minutes of secondhand smoke exposure increases your risk of a fatal heart attack to the same level as that of an active smoker. They can actually claim that 2 hours of secondhand smoke increases your risk of sudden death from a cardiac arrhythmia.
And they can get away with it.
That's why I think the anti-smoking groups have lost their scientific integrity. Because they can get away with it.
1. Did this misrepresentation of the science just start, or has it been going on for some time?
2. If the misrepresentation of the science has been increasing over time, why?
My answer to the first question is that while some misrepresentation of the science may have been occurring for some time, there has, without a doubt, been a dramatic increase in the amount of this misrepresentation. Without question, it is over the past six years, from 2001 forward, that I have observed a complete loss of scientific integrity within the tobacco control movement.
My answer to the second question is that the loss of scientific integrity in tobacco control coincides perfectly with the abdication by the tobacco industry of its role as a watchdog for "anti-tobacco industry" statements and communications.
In essence, the role that I am now playing is one that the tobacco industry used to play, albeit for a different reason. The tobacco industry played a watchdog role because they wanted to discredit tobacco control and undermine its public credibility. I am now playing this watchdog role because I want to restore the scientific integrity of the movement and save its public credibility. Nevertheless, the role that I am playing is very similar to what the tobacco industry used to do.
To some extent, it is surprising to me that the tobacco companies have not made more of a public display over the outright misrepresentation of science by anti-smoking groups. I suppose they feel that if they just lay back, the movement will destroy its own credibility. This may be a wise strategy, since it seems that every day, the claims get more and more absurd (wait until you read Monday's post).
First it was 30 minutes of secondhand smoke being fatal, then 20 minutes, then 5 minutes, and then basically instantaneous death from a trace of secondhand smoke.
First it was Helena, then Pueblo, then Piedmont, then Bowling Green, and now Scotland and Ireland.
First it was 120,000 deaths from exposure to smoking in movies and now it's 120,000 deaths from exposure to even a single depiction of smoking in movies.
If left to their own devices, it appears that the tobacco control movement will continue to spiral out of control in their misrepresentations of science, and eventually, they will go too far and lose public credibility. It's a good thing that somebody is trying to hold the movement accountable for its statements.
I remember, back before 2001, that whenever we wanted to make a public statement, we would quake in our boots over what the tobacco industry's reaction might be. We pored over every word of every statement we made because we were scared. We were scared of being nailed by the tobacco industry. The industry was watching every word we said and they would nail us to a tree if we took any mis-steps. So we were exceedingly careful.
Around the year 2000 or so, coinciding with the change in the public position of the tobacco companies over the health effects of smoking, the implementation of the Master Settlement Agreement, the Engle decision and the tobacco industry's attempt to portray itself to the jury in a new light, the dissolution of the Tobacco Institute, and the attempt of the tobacco industry to create a new public image in light of damaging publicity from lawsuits, it appears to me that the industry made a decision to lay off its constant vigilance over the communications of anti-smoking groups.
Gone were the days of constant FOIA requests to anti-smoking groups, which had gotten us to watch every word we said, even in non-public communications. Gone were the days of having to worry about actually being held to our public statements. Gone were the days of having to actually defend our statements publicly, and to take public responsibility for them.
This is the new era of tobacco control - sans industry oversight.
And it has truly become a free-for-all for anti-smoking organizations.
Imagine this: the anti-smoking groups can actually claim that 30 minutes of secondhand smoke exposure is enough to cause hardening of the arteries. They can actually claim that 30 minutes of secondhand smoke exposure increases your risk of a fatal heart attack to the same level as that of an active smoker. They can actually claim that 2 hours of secondhand smoke increases your risk of sudden death from a cardiac arrhythmia.
And they can get away with it.
That's why I think the anti-smoking groups have lost their scientific integrity. Because they can get away with it.
Thursday, October 18, 2007
Cigarette Tax Increase to Fund SCHIP Expansion is Dead
Earlier today, the U.S. House of Representatives failed (by 13 votes) to override President Bush's veto of a proposal that would have increased the federal excise cigarette tax by 61 cents per pack to fund an expansion of the SCHIP children's health insurance program.
My argument against the use of cigarette tax revenues to fund health insurance for children was highlighted by a Cybercast News Service article today. The article notes that more than 9 million new smokers would have been needed in the next 5 years in order to keep the program fully funded.
My quotes from the article:
"I don't dispute the idea that increasing the cigarette tax will reduce smoking. I don't think there's any question about that. But it doesn't make sense to me to permanently tie the financial solvency of children's health insurance to the need to continually increase the number of smokers."
"It's the most politically expedient solution. Clearly, to expand the program, you've got to get the revenue from somewhere, and I think that this is just the most politically easy target, because it's popular to go after smokers."
"Dr. Siegel disagreed [that declining cigarette consumption would not be a problem for program funding], explaining that tobacco taxes were effective when used to fund anti-smoking prevention programs, for which the need would diminish as the number of smokers decreased. But to fund a federal healthcare program, Congress was better off using another tax, he said."
"This is a situation where you're advocating a specific amount of money to a program based on cigarette revenue. So if that cigarette revenue falls, by definition, the revenue available to the program is going to fall."
My argument against the use of cigarette tax revenues to fund health insurance for children was highlighted by a Cybercast News Service article today. The article notes that more than 9 million new smokers would have been needed in the next 5 years in order to keep the program fully funded.
My quotes from the article:
"I don't dispute the idea that increasing the cigarette tax will reduce smoking. I don't think there's any question about that. But it doesn't make sense to me to permanently tie the financial solvency of children's health insurance to the need to continually increase the number of smokers."
"It's the most politically expedient solution. Clearly, to expand the program, you've got to get the revenue from somewhere, and I think that this is just the most politically easy target, because it's popular to go after smokers."
"Dr. Siegel disagreed [that declining cigarette consumption would not be a problem for program funding], explaining that tobacco taxes were effective when used to fund anti-smoking prevention programs, for which the need would diminish as the number of smokers decreased. But to fund a federal healthcare program, Congress was better off using another tax, he said."
"This is a situation where you're advocating a specific amount of money to a program based on cigarette revenue. So if that cigarette revenue falls, by definition, the revenue available to the program is going to fall."
Blowing Secondhand Smoke: New Research Uncovers False Claims Spread by Anti-Smoking Groups (Press Release Sent Out Today to Major Media Outlets)
Blowing Secondhand Smoke:
New Research Uncovers False Claims Spread by Anti-Smoking Groups
A new study published this week in the journal Epidemiologic Perspectives & Innovations reveals that many anti-smoking groups are deceiving the public by exaggerating the acute cardiovascular effects of secondhand smoke. The study’s author, Dr. Michael Siegel – a professor at Boston University School of Public Health – is a long-time anti-smoking advocate, researcher, and a supporter of workplace smoking bans who believes that many anti-smoking groups are acting unethically by misrepresenting the facts about secondhand smoke to the public and that this may harm their credibility and effectiveness in future efforts. The study, which provides a comprehensive review of the scientific evidence regarding the cardiovascular effects of brief exposure to secondhand smoke, is available on the journal’s web site at:
http://www.epi-perspectives.com/content/4/1/12/abstract.
The article provides a comprehensive review of the scientific evidence relevant to the acute cardiovascular health effects of secondhand smoke. It then evaluates claims made by at least 100 anti-smoking groups that brief exposure to secondhand smoke causes a number of severe health effects - including atherosclerosis, reduced coronary artery flow, heart damage, heart disease, heart attacks, fatal and catastrophic arrhythmias, and strokes - in otherwise healthy individuals (those without severe, pre-existing coronary artery disease).
The article concludes that: "Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness. Disseminating inaccurate information also represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed, even for a noble end such as protecting nonsmokers from secondhand smoke exposure. How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health."
Among the groups implicated in making inaccurate and/or misleading health claims are Americans for Nonsmokers' Rights (ANR), Action on Smoking and Health (ASH), Smoke-Free Ohio, the New York City Department of Health, the Montana Tobacco Advisory Board, TobaccoScam, and the Campaign for Tobacco-Free Kids (TFK).
The article goes on to explain that provision of accurate health information to the public is a core ethical principle of public health practice. The right of the public to accurate and non-misleading health information is supported by the Universal Declaration of Human Rights.
The paper's final conclusion is as follows:
"While there is ample evidence that chronic exposure to secondhand smoke increases the risk of cardiovascular disease, and therefore heart attack risk, and there is some suggestive evidence that acute exposure to secondhand smoke may present some degree of risk to individuals with existing severe coronary artery disease, there appears to be no scientific basis for claims that brief, acute, transient exposure to secondhand smoke increases heart attack risk in individuals without coronary disease, that it increases such risk to the level observed in smokers, that it can cause atherosclerosis, that it can cause fatal or catastrophic cardiac arrhythmias, or that it represents any other significant acute cardiovascular health hazard in nonsmokers."
"In light of this, the claims that are being widely disseminated by a large number of tobacco control groups appear to be scientifically unjustified and inaccurate."
"The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness."
"While anti-smoking groups may provide a utilitarian-based argument that these inaccurate and/or misleading communications are doing more good than harm in the long run because they are helping to promote smoke-free policies which will protect the public's health and save lives, the problem is that even if this were true, disseminating inaccurate information represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed. The ends do not justify the means, especially when those means are violating principles of autonomy and self-determination that form the essential bases for free societies. These are values which cannot and should not be trodden upon by public health organizations simply to promote a favored policy."
Examples of Inaccurate and Misleading Claims by Anti-Smoking Groups,
with Links to Active Websites Containing these Claims
Americans for Nonsmokers' Rights: "Even a half hour of secondhand smoke exposure causes heart damage similar to that of habitual smokers. Nonsmokers’ heart arteries showed a reduced ability to dilate, diminishing the ability of the heart to get life-giving blood." [LINK]
Coalition for a Tobacco-Free
Campaign for Tobacco-Free Kids: "as little as 30 minutes of exposure to secondhand smoke can trigger harmful cardiovascular changes, such as increased blood clotting, that increase the risk of a heart attack." [LINK]
DuPage County Health Department: "30 minutes exposure = stiffened, clogged arteries" [LINK]
Tobacco Public Policy Center: " A recent study completed by Japanese researchers concluded that just 30 minutes of exposure to secondhand smoke can lead to hardening of the arteries in nonsmokers." [LINK]
University of North Carolina Department of Family Medicine: "30 minutes of exposure = stiffened, clogged arteries" [LINK]
New York City Department of Health and Mental Hygiene: "Just 30 minutes of exposure to second-hand smoke produces some of the same physical reactions that would occur from long-term smoking, and increases the risk of heart disease in non-smokers." [LINK]
Clean Air for Everyone (C.A.F.E.)
Washington State Department of Health: "Only 30 minutes of secondhand smoke exposure may cause heart damage similar to that of regular smokers. This exposure can reduce the ability of the arteries close to the heart to expand, which reduces the ability of the heart to receive life-giving blood." [LINK]
Campaign for a Healthy and Responsible Tennessee: "The Journal of the American Medical Association reports that just 30 minutes of exposure to secondhand smoke changes blood chemistry and increases the risk of heart disease in non-smokers." [LINK]
Tobacco Free Coalitions of
Wednesday, October 17, 2007
Anti-Smoking Groups Insisting on Different Treatment of Smoking in Movies from Alcohol, Violence, and Sex
Not satisfied with the Motion Picture Association of America's (MPAA) decision to consider smoking in movies as a factor in movie ratings, anti-smoking groups, led by the SmokeFree Movies Campaign, have taken out another advertisement insisting that any non-historically correct depiction of smoking trigger an automatic R-rating.
The policy adopted by the MPAA states: "All smoking will be considered and depictions that glamorize smoking or movies that feature pervasive smoking outside of an historic or other
mitigating context may receive a higher rating...Additionally, when a film's rating is affected by the depiction of smoking, that rating will now include phrases such as 'glamorized smoking' or 'pervasive smoking'."
The policy that anti-smoking groups are calling for states that: "Any film that shows or implies tobacco should be rated 'R.' The only exceptions should be when the presentation of tobacco clearly and unambiguously reflects the dangers and consequences of tobacco use or is necessary to represent the smoking of a real historical figure."
The Rest of the Story
Two things don't make sense about the anti-smoking groups' desired policy.
First, why should smoking in movies be treated completely differently from alcohol, violence, nudity, and sex? The depiction of alcohol use in movies does not trigger an automatic R rating. The depiction of violence, nudity, or sex in movies does not trigger an automatic R rating. So why should the depiction of smoking?
I could understand the initiative better if it aimed to clear non-R movies of all smoking, alcohol use, nudity, sex, and violence (Of course, who would want to go to such a movie?). If the principle is that any depiction that could have adverse health consequences for children by demonstrating or glamorizing unhealthy behaviors should not be allowed in films that children can view on their own, then why single out smoking as the sole depiction that requires an automatic R rating? This doesn't make any sense.
Second, why should the historical correctness of smoking give it an exemption from the policy? If the depiction of smoking is going to kill 120,000 kids every year, then it is going to kill them whether the smoking is fictional or historical. Why would one exempt depictions of historically correct smoking if such depictions are going to contribute to 120,000 deaths per year? This doesn't make any sense.
Can you imagine a similar policy for violence? Any film that contains violence will receive an R rating. However, if a film contains violence that actually occurred, it may still be rated G, PG, or PG-13.
How about a similar policy for sex? The MPAA will not increase the rating of a movie that contains sex if that sex actually occurred.
I have come to the conclusion that this is all a bunch of mishegas and that the anti-smoking groups are out of touch with any semblance of reason. But as I am learning, the policies advocated by anti-smoking groups do not need to make sense. They only have to be intended to save the children.
The policy adopted by the MPAA states: "All smoking will be considered and depictions that glamorize smoking or movies that feature pervasive smoking outside of an historic or other
mitigating context may receive a higher rating...Additionally, when a film's rating is affected by the depiction of smoking, that rating will now include phrases such as 'glamorized smoking' or 'pervasive smoking'."
The policy that anti-smoking groups are calling for states that: "Any film that shows or implies tobacco should be rated 'R.' The only exceptions should be when the presentation of tobacco clearly and unambiguously reflects the dangers and consequences of tobacco use or is necessary to represent the smoking of a real historical figure."
The Rest of the Story
Two things don't make sense about the anti-smoking groups' desired policy.
First, why should smoking in movies be treated completely differently from alcohol, violence, nudity, and sex? The depiction of alcohol use in movies does not trigger an automatic R rating. The depiction of violence, nudity, or sex in movies does not trigger an automatic R rating. So why should the depiction of smoking?
I could understand the initiative better if it aimed to clear non-R movies of all smoking, alcohol use, nudity, sex, and violence (Of course, who would want to go to such a movie?). If the principle is that any depiction that could have adverse health consequences for children by demonstrating or glamorizing unhealthy behaviors should not be allowed in films that children can view on their own, then why single out smoking as the sole depiction that requires an automatic R rating? This doesn't make any sense.
Second, why should the historical correctness of smoking give it an exemption from the policy? If the depiction of smoking is going to kill 120,000 kids every year, then it is going to kill them whether the smoking is fictional or historical. Why would one exempt depictions of historically correct smoking if such depictions are going to contribute to 120,000 deaths per year? This doesn't make any sense.
Can you imagine a similar policy for violence? Any film that contains violence will receive an R rating. However, if a film contains violence that actually occurred, it may still be rated G, PG, or PG-13.
How about a similar policy for sex? The MPAA will not increase the rating of a movie that contains sex if that sex actually occurred.
I have come to the conclusion that this is all a bunch of mishegas and that the anti-smoking groups are out of touch with any semblance of reason. But as I am learning, the policies advocated by anti-smoking groups do not need to make sense. They only have to be intended to save the children.
Tuesday, October 16, 2007
More on My Epidemiologic Perspectives & Innovations Article: Highlighting the McCarthyism in the Tobacco Control Movement
While the primary conclusion of my article published yesterday in Epidemiologic Perspectives & Innovations is that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers, the article also highlights the way in which I was treated by the tobacco control movement for being willing to advance this opinion.
In the article, I write: "In response to my questioning of the validity of these types of scientific claims being made by many anti-smoking groups, I have been personally attacked, publicly condemned, accused of being a traitor, accused of being funded by tobacco companies, called a fanatic, and have had my opinions censored by a prominent tobacco control policy discussion list-serve, from which I was expelled because advocates were apparently unhappy with my expressing dissent from the established dogma of the movement [76]. In my expulsion from the tobacco policy (tp-talk) discussion list-serve, I was informed told that the list-serve “made the dictatorial (but perhaps benevolent) decision to remove Mike Siegel from tp-talk today. I felt that his posts lately have interfered with the quality of the listserv messages. I suspect I'll be the subject of a blog posting about how he's been kicked off a tobacco control listserv, but I can deal with that” [76].
What is really being said is that I disagreed with some of the dogmatic views of the movement. In this case, that's what interference with the quality of the discussion means: disagreeing with the mentality of the movement. There is apparently no room for dissent in the tobacco control movement, and dissent is met not only with personal attacks, but with outright censorship. Unfortunately, the one type of response I have not received is a scientific justification for the claims that are being made or a refutation of my scientific arguments. The general approach has been to attack ad hominem, rather than to directly confront the arguments being made. For this reason, I have come to the impression that the tobacco control movement does not allow room for any difference of opinion, and that those who dissent with any aspect of the prevailing wisdom must be discredited, attacked, and silenced. I sense a rather McCarthyistic element in the tobacco control movement. Whether the scientific arguments I have made are valid or not is up for question and debate; the unwillingness of the movement to be willing to entertain a discussion of the validity of its scientific claims, on the other hand, is a dangerous element in a public health movement.
This may be exactly the type of problem that Rothman predicted in his commentary which suggested that focusing on the scientist rather than on the merits of the science could lead to a “new McCarthyism in science.” [77] Rothman argued that every piece of scientific work and criticism should be judged solely on its scientific merit, and that any attacks on these works should be science-based, not ad hominem attacks. My experience revealed that tobacco control advocates and groups are falling into this trap; the response to my critical pieces has consisted entirely of ad hominem attacks and has been devoid of any discussion of the scientific merits (or lack thereof) of my work."
The Rest of the Story
The reason I was expelled from the tobacco control list-serve is that they were not happy with my expressing opinions that questioned the validity of claims being made about secondhand smoke, no matter how obviously absurd those claims might be. No one actually challenged the scientific validity of my statements. They were just threatened by the fact that someone would have the gall to question the dogma of what I now realize is a religious-like faith. And so they ignored the science and went straight to the personal attack.
The worst thing in the world that you can do in the tobacco control movement is to have the gall to suggest that secondhand smoke isn't as immediately deadly as the movement is suggesting. That is one piece of dogma that is not subject to debate. Once a statement is made by an anti-smoking group, it takes on a Biblical-like quality. It cannot be challenged. Doing so is heresy. Doing so makes you subject to ex-communication from the movement.
Note that I acknowledge that discussion of the lack of scientific merit of my analysis and commentary would be fair game. If anti-smoking groups were actually defending their statements by demonstrating how and why their scientific claims are correct and my assertions are wrong, there would be no problem. I've learned, however, that the point is not to actually discuss the science. The point is that the gospel-like dogma of the tobacco control movement, especially as it relates to secondhand smoke, is simply not up for discussion or challenge.
Interestingly, in the same issue of Epidemiologic Perspectives & Innovations, Dr. James Enstrom presents his own story of being accused of scientific misconduct for accepting tobacco industry funding to complete a study which reported that secondhand smoke exposure was not associated with lung cancer.
As I highlighted in The Rest of the Story, the American Cancer Society accused Dr. Enstrom of scientific misconduct, apparently because they did not like the conclusions of his study, because as it turns out, there were no grounds for an academic misconduct accusation and Enstrom was cleared by the University of California of all such charges.
In his article, Enstrom too sees an element of McCarthyism in his treatment by the tobacco control movement: "Being able to distinguish between real and implied scientific misconduct is important to the integrity of science in general and to the integrity of individual scientists in particular. Falsely accusing an honest scientist of scientific misconduct is just as wrong as scientific misconduct itself. Implying that an honest scientist has committed scientific misconduct because he has published unpopular findings or has used an unpopular funding source is wrong and falls under the category of “scientific McCarthyism” [4]."
As I argued in my blog post regarding the American Cancer Society's attack on Enstrom, it appears that the ACS was using Dr. Enstrom as a fall guy for unfavorable research findings. There were no grounds for a scientific misconduct charge. It was a false accusation, and it was based solely on Enstrom's having published unfavorable findings and using an unpopular funding source. It does, therefore, fall under the category of scientific McCarthyism.
Dr. Enstrom also notes in his paper my role in questioning the statements of anti-smoking groups about the acute cardiovascular effects of secondhand smoke: "Michael Siegel, MD, MPH, a professor of social and behavioral sciences at Boston University School of Public Health and a prominent tobacco control researcher, told JAMA "We're really risking our credibility [as public health professionals or officials] by putting out rather absurd claims that you can be exposed briefly to secondhand smoke and you are going to come down with heart disease or cancer. People are going to look at that and say that's ridiculous." Siegel’s own paper expanding on this point is published alongside the present article [84]. Furthermore, since March 2005, Siegel has posted many detailed and insightful analyses regarding ETS and tobacco control on his personal website, “The Rest of the Story: Tobacco News Analysis and Commentary” [85]. Each post includes “Comments” from readers who provide additional insights. For instance, on June 28, 2006, he posted “Surgeon General's Communications Misrepresent Findings of Report; Tobacco Control Practitioners Appear Unable to Accurately Portray the Science” [86]."
I should note that for expressing my opinions, which in this case happen to be unfavorable to the anti-smoking movement, I have forfeited a continued career in tobacco control. There is no room in the movement for someone who questions this type of dogma.
One question that may occur to readers is whether there is anyone else in the tobacco control movement who supported me and expressed agreement with my opinions. The answer is: absolutely. However, most of these individuals were only willing to express their support privately. To express their support publicly would result in their own expulsion from the movement, and in some cases, the end of their careers. This is how the McCarthyism in the tobacco control movement works.
In the article, I write: "In response to my questioning of the validity of these types of scientific claims being made by many anti-smoking groups, I have been personally attacked, publicly condemned, accused of being a traitor, accused of being funded by tobacco companies, called a fanatic, and have had my opinions censored by a prominent tobacco control policy discussion list-serve, from which I was expelled because advocates were apparently unhappy with my expressing dissent from the established dogma of the movement [76]. In my expulsion from the tobacco policy (tp-talk) discussion list-serve, I was informed told that the list-serve “made the dictatorial (but perhaps benevolent) decision to remove Mike Siegel from tp-talk today. I felt that his posts lately have interfered with the quality of the listserv messages. I suspect I'll be the subject of a blog posting about how he's been kicked off a tobacco control listserv, but I can deal with that” [76].
What is really being said is that I disagreed with some of the dogmatic views of the movement. In this case, that's what interference with the quality of the discussion means: disagreeing with the mentality of the movement. There is apparently no room for dissent in the tobacco control movement, and dissent is met not only with personal attacks, but with outright censorship. Unfortunately, the one type of response I have not received is a scientific justification for the claims that are being made or a refutation of my scientific arguments. The general approach has been to attack ad hominem, rather than to directly confront the arguments being made. For this reason, I have come to the impression that the tobacco control movement does not allow room for any difference of opinion, and that those who dissent with any aspect of the prevailing wisdom must be discredited, attacked, and silenced. I sense a rather McCarthyistic element in the tobacco control movement. Whether the scientific arguments I have made are valid or not is up for question and debate; the unwillingness of the movement to be willing to entertain a discussion of the validity of its scientific claims, on the other hand, is a dangerous element in a public health movement.
This may be exactly the type of problem that Rothman predicted in his commentary which suggested that focusing on the scientist rather than on the merits of the science could lead to a “new McCarthyism in science.” [77] Rothman argued that every piece of scientific work and criticism should be judged solely on its scientific merit, and that any attacks on these works should be science-based, not ad hominem attacks. My experience revealed that tobacco control advocates and groups are falling into this trap; the response to my critical pieces has consisted entirely of ad hominem attacks and has been devoid of any discussion of the scientific merits (or lack thereof) of my work."
The Rest of the Story
The reason I was expelled from the tobacco control list-serve is that they were not happy with my expressing opinions that questioned the validity of claims being made about secondhand smoke, no matter how obviously absurd those claims might be. No one actually challenged the scientific validity of my statements. They were just threatened by the fact that someone would have the gall to question the dogma of what I now realize is a religious-like faith. And so they ignored the science and went straight to the personal attack.
The worst thing in the world that you can do in the tobacco control movement is to have the gall to suggest that secondhand smoke isn't as immediately deadly as the movement is suggesting. That is one piece of dogma that is not subject to debate. Once a statement is made by an anti-smoking group, it takes on a Biblical-like quality. It cannot be challenged. Doing so is heresy. Doing so makes you subject to ex-communication from the movement.
Note that I acknowledge that discussion of the lack of scientific merit of my analysis and commentary would be fair game. If anti-smoking groups were actually defending their statements by demonstrating how and why their scientific claims are correct and my assertions are wrong, there would be no problem. I've learned, however, that the point is not to actually discuss the science. The point is that the gospel-like dogma of the tobacco control movement, especially as it relates to secondhand smoke, is simply not up for discussion or challenge.
Interestingly, in the same issue of Epidemiologic Perspectives & Innovations, Dr. James Enstrom presents his own story of being accused of scientific misconduct for accepting tobacco industry funding to complete a study which reported that secondhand smoke exposure was not associated with lung cancer.
As I highlighted in The Rest of the Story, the American Cancer Society accused Dr. Enstrom of scientific misconduct, apparently because they did not like the conclusions of his study, because as it turns out, there were no grounds for an academic misconduct accusation and Enstrom was cleared by the University of California of all such charges.
In his article, Enstrom too sees an element of McCarthyism in his treatment by the tobacco control movement: "Being able to distinguish between real and implied scientific misconduct is important to the integrity of science in general and to the integrity of individual scientists in particular. Falsely accusing an honest scientist of scientific misconduct is just as wrong as scientific misconduct itself. Implying that an honest scientist has committed scientific misconduct because he has published unpopular findings or has used an unpopular funding source is wrong and falls under the category of “scientific McCarthyism” [4]."
As I argued in my blog post regarding the American Cancer Society's attack on Enstrom, it appears that the ACS was using Dr. Enstrom as a fall guy for unfavorable research findings. There were no grounds for a scientific misconduct charge. It was a false accusation, and it was based solely on Enstrom's having published unfavorable findings and using an unpopular funding source. It does, therefore, fall under the category of scientific McCarthyism.
Dr. Enstrom also notes in his paper my role in questioning the statements of anti-smoking groups about the acute cardiovascular effects of secondhand smoke: "Michael Siegel, MD, MPH, a professor of social and behavioral sciences at Boston University School of Public Health and a prominent tobacco control researcher, told JAMA "We're really risking our credibility [as public health professionals or officials] by putting out rather absurd claims that you can be exposed briefly to secondhand smoke and you are going to come down with heart disease or cancer. People are going to look at that and say that's ridiculous." Siegel’s own paper expanding on this point is published alongside the present article [84]. Furthermore, since March 2005, Siegel has posted many detailed and insightful analyses regarding ETS and tobacco control on his personal website, “The Rest of the Story: Tobacco News Analysis and Commentary” [85]. Each post includes “Comments” from readers who provide additional insights. For instance, on June 28, 2006, he posted “Surgeon General's Communications Misrepresent Findings of Report; Tobacco Control Practitioners Appear Unable to Accurately Portray the Science” [86]."
I should note that for expressing my opinions, which in this case happen to be unfavorable to the anti-smoking movement, I have forfeited a continued career in tobacco control. There is no room in the movement for someone who questions this type of dogma.
One question that may occur to readers is whether there is anyone else in the tobacco control movement who supported me and expressed agreement with my opinions. The answer is: absolutely. However, most of these individuals were only willing to express their support privately. To express their support publicly would result in their own expulsion from the movement, and in some cases, the end of their careers. This is how the McCarthyism in the tobacco control movement works.
Monday, October 15, 2007
New Journal Article Demonstrates Widespread Misrepresentation of Acute Cardiovascular Health Effects of Secondhand Smoke by Anti-Smoking Groups
An article that I published today in the journal Epidemiologic Perspectives & Innovations reveals that anti-smoking groups have been widely disseminating communications which misrepresent the acute cardiovascular health effects of secondhand smoke (see: Siegel M. Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure? An analysis of the scientific evidence and commentary on the implications for tobacco control and public health practice. Epidemiologic Perspectives & Innovations 2007; 4:12).
The article provides a comprehensive review of the scientific evidence relevant to the acute cardiovascular health effects of secondhand smoke. It then evaluates claims made by at least 100 anti-smoking groups that brief exposure to secondhand smoke causes a number of severe health effects - including atherosclerosis, reduced coronary artery flow, heart damage, heart disease, heart attacks, fatal and catastrophic arrhythmias, and strokes - in otherwise healthy individuals (those without severe, pre-existing coronary artery disease).
The article concludes that: "Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness. Disseminating inaccurate information also represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed, even for a noble end such as protecting nonsmokers from secondhand smoke exposure. How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health."
Among the groups implicated in making inaccurate and/or misleading health claims are Americans for Nonsmokers' Rights (ANR), Action on Smoking and Health (ASH), Smoke-Free Ohio, the New York City Department of Health, the Montana Tobacco Advisory Board, TobaccoScam, and the Campaign for Tobacco-Free Kids (TFK).
The article goes on to explain that provision of accurate health information to the public is a core ethical principle of public health practice. The right of the public to accurate and non-misleading health information is supported by the Universal Declaration of Human Rights.
The paper's final conclusion is as follows:
"While there is ample evidence that chronic exposure to secondhand smoke increases the risk of cardiovascular disease, and therefore heart attack risk, and there is some suggestive evidence that acute exposure to secondhand smoke may present some degree of risk to individuals with existing severe coronary artery disease, there appears to be no scientific basis for claims that brief, acute, transient exposure to secondhand smoke increases heart attack risk in individuals without coronary disease, that it increases such risk to the level observed in smokers, that it can cause atherosclerosis, that it can cause fatal or catastrophic cardiac arrhythmias, or that it represents any other significant acute cardiovascular health hazard in nonsmokers."
"In light of this, the claims that are being widely disseminated by a large number of tobacco control groups appear to be scientifically unjustified and inaccurate."
"The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness."
"While anti-smoking groups may provide a utilitarian-based argument that these inaccurate and/or misleading communications are doing more good than harm in the long run because they are helping to promote smoke-free policies which will protect the public's health and save lives, the problem is that even if this were true, disseminating inaccurate information represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed. The ends do not justify the means, especially when those means are violating principles of autonomy and self-determination that form the essential bases for free societies. These are values which cannot and should not be trodden upon by public health organizations simply to promote a favored policy."
The Rest of the Story
The tobacco control movement now faces a crisis of its scientific credibility. Given the widespread misrepresentation of the science that has taken place, the public may now question even the valid aspects of the communications that the movement is disseminating.
As I stated in the article, I believe that "How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health."
It is critical that the tobacco control movement and the organizations that have been implicated in this deception respond definitively to this crisis. Otherwise, my fear is that the public may "throw out the baby with the bath water."
In other words, I fear that the public does not have the ability to discern what communications are accurate and which are misleading. Rather than retaining respect for the scientific integrity of the tobacco control movement and simply acknowledging these misrepresentations as an isolated event, the public may well dismiss all statements that tobacco control organizations make.
If the tobacco control organizations involved, especially the leading groups such as Americans for Nonsmokers' Rights, TobaccoScam, the American Cancer Society, ASH, and the Campaign for Tobacco-Free Kids, respond definitively by apologizing for these misleading statements, correcting or clarifying them, and being more careful in the future, then I believe the deception that has occurred will eventually be forgotten.
However, if the organizations do not respond definitively, I fear that the reputation of the movement will be permanently tainted.
I should emphasize, however, that the reputation and future effectiveness of the movement is not my only concern. I believe that truth itself, and the ethical responsibility to provide accurate scientific information to the public, demand that tobacco control groups respond definitively in the way I describe above. It is not a game that we are playing. We have the responsibility to adhere to a certain ethical code of conduct in public health practice. We have veered off the path and are violating those core principles. It is time to get the movement back on track. The public has the right to accurate and non-misleading health information. I do not believe that we have a choice to make. We owe it to the public to do the right thing.
The article provides a comprehensive review of the scientific evidence relevant to the acute cardiovascular health effects of secondhand smoke. It then evaluates claims made by at least 100 anti-smoking groups that brief exposure to secondhand smoke causes a number of severe health effects - including atherosclerosis, reduced coronary artery flow, heart damage, heart disease, heart attacks, fatal and catastrophic arrhythmias, and strokes - in otherwise healthy individuals (those without severe, pre-existing coronary artery disease).
The article concludes that: "Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness. Disseminating inaccurate information also represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed, even for a noble end such as protecting nonsmokers from secondhand smoke exposure. How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health."
Among the groups implicated in making inaccurate and/or misleading health claims are Americans for Nonsmokers' Rights (ANR), Action on Smoking and Health (ASH), Smoke-Free Ohio, the New York City Department of Health, the Montana Tobacco Advisory Board, TobaccoScam, and the Campaign for Tobacco-Free Kids (TFK).
The article goes on to explain that provision of accurate health information to the public is a core ethical principle of public health practice. The right of the public to accurate and non-misleading health information is supported by the Universal Declaration of Human Rights.
The paper's final conclusion is as follows:
"While there is ample evidence that chronic exposure to secondhand smoke increases the risk of cardiovascular disease, and therefore heart attack risk, and there is some suggestive evidence that acute exposure to secondhand smoke may present some degree of risk to individuals with existing severe coronary artery disease, there appears to be no scientific basis for claims that brief, acute, transient exposure to secondhand smoke increases heart attack risk in individuals without coronary disease, that it increases such risk to the level observed in smokers, that it can cause atherosclerosis, that it can cause fatal or catastrophic cardiac arrhythmias, or that it represents any other significant acute cardiovascular health hazard in nonsmokers."
"In light of this, the claims that are being widely disseminated by a large number of tobacco control groups appear to be scientifically unjustified and inaccurate."
"The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness."
"While anti-smoking groups may provide a utilitarian-based argument that these inaccurate and/or misleading communications are doing more good than harm in the long run because they are helping to promote smoke-free policies which will protect the public's health and save lives, the problem is that even if this were true, disseminating inaccurate information represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed. The ends do not justify the means, especially when those means are violating principles of autonomy and self-determination that form the essential bases for free societies. These are values which cannot and should not be trodden upon by public health organizations simply to promote a favored policy."
The Rest of the Story
The tobacco control movement now faces a crisis of its scientific credibility. Given the widespread misrepresentation of the science that has taken place, the public may now question even the valid aspects of the communications that the movement is disseminating.
As I stated in the article, I believe that "How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health."
It is critical that the tobacco control movement and the organizations that have been implicated in this deception respond definitively to this crisis. Otherwise, my fear is that the public may "throw out the baby with the bath water."
In other words, I fear that the public does not have the ability to discern what communications are accurate and which are misleading. Rather than retaining respect for the scientific integrity of the tobacco control movement and simply acknowledging these misrepresentations as an isolated event, the public may well dismiss all statements that tobacco control organizations make.
If the tobacco control organizations involved, especially the leading groups such as Americans for Nonsmokers' Rights, TobaccoScam, the American Cancer Society, ASH, and the Campaign for Tobacco-Free Kids, respond definitively by apologizing for these misleading statements, correcting or clarifying them, and being more careful in the future, then I believe the deception that has occurred will eventually be forgotten.
However, if the organizations do not respond definitively, I fear that the reputation of the movement will be permanently tainted.
I should emphasize, however, that the reputation and future effectiveness of the movement is not my only concern. I believe that truth itself, and the ethical responsibility to provide accurate scientific information to the public, demand that tobacco control groups respond definitively in the way I describe above. It is not a game that we are playing. We have the responsibility to adhere to a certain ethical code of conduct in public health practice. We have veered off the path and are violating those core principles. It is time to get the movement back on track. The public has the right to accurate and non-misleading health information. I do not believe that we have a choice to make. We owe it to the public to do the right thing.
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