Diethelm and McKee argue that the paper by Drs. James Enstrom and Geoffrey Kabat - which failed to find evidence of a causal relationship between secondhand smoke and lung cancer or heart disease - and its use by various groups is comparable to Holocaust denial.
As they write: "Another [example of denialism] is a paper published by the British Medical Journal in 2003, later shown to suffer from major flaws, including a failure to report competing interests, that concluded that exposure to tobacco smoke does not increase the risk of lung cancer and heart disease. This paper has been cited extensively by those who deny that passive smoking has any health effects, with the company Japan Tobacco International still quoting it as justification for rejecting ‘the claim that ETS is a cause of lung cancer, heart disease and chronic pulmonary diseases in non-smokers’ as late as the end of 2008. Denialists are usually not deterred by the extreme isolation of their theories, but rather see it as the indication of their intellectual courage against the dominant orthodoxy and the accompanying political correctness, often comparing themselves to Galileo."
Today, the European Journal of Public Health published my response to the article, which I entitled "Danger: Public Health Could Become a Religious Movement."
In the response, I write: "Diethelm and McKee have endangered the integrity of public health by comparing those who challenge the conclusion that secondhand smoke causes heart disease and lung cancer with those who deny the Holocaust. As a primarily science-based movement, public health is supposed to have room for those who dissent from consensus opinions based on reasonable scientific grounds. To argue that those who fail to conclude that the small relative risk for lung cancer of 1.3 among persons exposed to secondhand smoke is indicative of a causal connection are comparable to Holocaust deniers is to turn public health into a religion, where the doctrines must be accepted on blind faith to avoid being branded as a heretic." ...
"Diethelm and McKee appear to be basing their assessment that secondhand smoke "dissenters" are "denialists" not on the reasonableness of the scientific arguments, but on the position of these arguments. This is a dangerous proposition which threatens the integrity of public health by turning it into a purely ideological movement, rather than a scientific one. Clearly, no dissent is allowable from the doctrines of tobacco control in Diethelm's and McKee's perspective. This perspective brands hundreds of reputable scientists throughout the world as denialists, no different from Holocaust deniers. While I disagree wholeheartedly with these scientists, I will stand up for their right to express their dissenting opinions without having their characters assassinated because of the direction, rather than the scientific reasonableness, of their positions."
The Rest of the Story
There are many reputable scientists who have challenged the conclusion that secondhand smoke causes heart disease and lung cancer. While I disagree with their interpretation of the scientific evidence, I would never suggest that their opposing opinion is denialism and that it is comparable to Holocaust denial.
Apparently, Diethelm and McKee view the anti-smoking movement as a religion. You have to accept the claims on blind faith and if you don't, you are guilty of heresy. Even worse, you will be publicly attacked and have your character maligned in an attempt to silence you by blacklisting you out of public discourse on the issue.
Diethelm and McKee criticize the paper by Enstrom and Kabat on the basis that it suffers from major flaws. This is hardly grounds for calling the authors denialists. If we used that criterion to define denialism, most researchers would be considered denialists. Most of us - including myself - have from time to time used flawed methodology in a study. By this criterion, I would have to argue that many anti-smoking researchers are denialists.
The loss of reason and perspective among many in tobacco control is striking to me. It appears that there are no shades of grey in the movement any more. Everything is black and white. Either you support the conclusion that secondhand smoke causes chronic disease or you are a denialist, akin to those who deny the Holocaust. Either you agree that smoking bans result in a dramatic decrease in heart attacks or you are akin to those who deny that AIDS is caused by the HIV virus.
No dissent is allowed. Even reasonable (though possibly incorrect) scientific arguments cannot be brought to bear to challenge scientific conclusions that are favorable to tobacco control.
Tobacco control is becoming a religious-like movement which is guided by ideology and not science. Hopefully, this trend will not spread to other areas of public health.