Thursday, February 19, 2009

Sir Richard Peto - Powerful and Renowned Anti-Smoking Scientist - Would Be Considered Denialist According to Diethelm and McKee

Dr. Geoffrey Kabat Describes "The New McCarthyism in Science" in his New Book

According to the reasoning in the article by anti-smoking advocates Pascal Diethelm and Martin McKee, which was published last week in the European Journal of Public Health, the renowned and highly-esteemed anti-smoking researcher - Sir Richard Peto - would be considered a denialist, on par with those who deny that the Holocaust occurred and unfit to participate in scientific discourse.

Sir Richard Peto was one of the most respected epidemiologists in the world and his research contributed heavily to what we know about the hazardous effects of cigarette smoking. He was a professor of Medical Statistics and Epidemiology at the University of Oxford and a Fellow of the Royal Society, recognized for his contributions to the field of meta-analysis. So he was widely recognized as an expert on the issue of causation.

As Dr. Geoffrey Kabat notes in his new book - Hyping Health Risks: Environmental Hazards in Daily Life and the Science of Epidemiology (New York: Columbia University Press, 2008) - Sir Richard Peto, in testimony before the House of Commons, argued that the risks of secondhand smoke are small and difficult to quantify. Because of this, he refused in his testimony to support the policy of banning smoking in public places.

This position, according to the argument provided by Diethelm and McKee, places Peto in the category of being a denialist, comparable to a Holocaust denier.

I had the opportunity to meet Sir Richard when I was working at the Office on Smoking and Health at CDC. I can assure you that he was an ardent anti-tobacco researcher who was adamant in his commitment to reducing tobacco-related diseases. He was hardly someone who would fit being called a denialist.

The Rest of the Story

In his book, Dr. Kabat explains what he calls "the new McCarthyism in science." He writes: "In this climate, in which so much as at stake -- both in terms of funding and professional advancement, as well as in terms of ideology and public health goals -- anyone who takes the science seriously and wants to assess its strengths and weaknesses is viewed as a threat to be neutralized. This situation has given rise to extraordinary attacks on the integrity of established scientists whose only documentable fault is to report findings in peer-reviewed journals and bring a critical (i.e., scientific) attitude to bear on the question of the long-term health effects of ETS exposure. What is most extraordinary is that these attacks on established and respected researchers rely exclusively on the imputation of guilt by association and on alleged conflicts of interest. Because of the highly polarized climate and the self-proclaimed righteousness of the tobacco control position, those who engage in such attacks are not required to supply any evidence of wrongdoing or fraud."

Dr. Kabat's description of the climate in tobacco control is accurate, based on my own experience. I have experienced exactly those extraordinary attacks that are based solely on the imputation of guilt by virtue of the direction, not the scientific merit, of my position on some issues. Because anti-smoking advocates have not been able to malign my character based on any proven association with the tobacco industry, they have resorted either to defamation (falsely accusing me of taking tobacco money or of simply lying) or to various insults and attacks (including accusations of having become mentally deranged).

In fact, Dr. Kabat discusses the tobacco control movement's reaction to some of my commentaries in his book. He writes: "Another figure who has taken an independent view of the reigning discourse concerning tobacco is Michael Siegel, a physician specializing in preventive medicine and a professor at Boston University. Siegel was a student of one of the prime movers behind the antismoking and clean air movements, Stanton Glantz of the University of California at San Francisco, and he has remained committed to the goal of protecting workers and others from exposure to tobacco smoke. However, a couple of years ago he decided that he had to speak out against what he saw as the increasingly objectionable tactics of the antismoking movement. These include misrepresenting the science on specific topics and an increasingly demagogic treatment of anyone who disagrees with their point of view. For the past two years, Siegel has written a blog entitled "The Rest of the Story: Tobacco News Analysis and Commentary," in which he tirelessly documents specific incidents of abuse or distortion and fills in the aspects of the question that have been ignored. His blog is a model of clarity and devotion to laying out all of the relevant evidence rather than citing selected or distorted facts to cudgel the "enemy." Some of the topics that Siegel has dealt with at length are the overstated claims of effects of smoking bans, the widely disseminated claim that as little as 30 minutes exposure to ETS can induce a heart attack in a nonsmoker, and the American Cancer Society's attack on Enstrom."

It is perhaps important to point out that Dr. Kabat is not approaching the issue as someone who does not believe that secondhand smoke has any adverse health effects or that smoking bans in public places are unjustified. He makes it clear that "my account of the ETS story has nothing to do with questioning whether exposure to secondhand tobacco smoke could cause some additional cases of lung cancer and other diseases in people who never smoked. ETS contains many of the same carcinogens and toxins present in mainstream tobacco smoke, and it is entirely biologically plausible that nonsmokers who are chronically exposed to high levels of ETS and those who have a constitutional susceptibility are at increased risk. In addition, secondhand tobacco smoke is associated with increased incidence of lower respiratory infections in infants and children, exacerbation of preexisting asthma, and other effects. Nor do I have any objection to the most stringent restrictions on smoking -- to my mind they are entirely justified and should have been enacted long ago. The only question at issue here is whether on a topic as important and as sensitive as ETS all of the science should be allowed to be heard, or whether it is acceptable to select and slant the science in order to justify a particular policy."

Dr. Kabat provides a very nice treatment of the issue of scientific McCarthyism in tobacco control and unfortunately, based on my experience, his insights and accounts ring true.

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