Tuesday, December 28, 2010

Winner of 2010 Tobacco Control Lie of the Year Award: Office of the United States Surgeon General; Runner Up: Free & Clear

As the new year approaches, I am today announcing that the winner of the 2010 Tobacco Control Lie of the Year Award is ...

... the Office of the United States Surgeon General.

The Surgeon General's office takes the award for disseminating widely throughout the media the blatant lie that even brief exposure to secondhand smoke can cause cardiovascular disease and that inhaling even the smallest amount of tobacco smoke causes cancer.

Although all ten contestants, and the eight quarterfinalists, were all outstanding entries in that they all represented blatant lies, the clear sentiment of Rest of the Story readers was that the Surgeon General's office deserves the award because of the sheer magnitude of the impact of this lie. Given the influence of the Surgeon General's statements on anti-smoking groups and the prominence of the Surgeon General's statements in the media, the assertion that even a brief tobacco smoke exposure can cause heart disease and lung cancer is likely to be used successfully by anti-smoking groups to support an ever-increasingly aggressive agenda of banning smoking just about everywhere.

Second place goes to Free & Clear, for making the fraudulent claim that its smoking cessation program has a 45% six-month success rate, when its own research found only a 21% success rate using intention-to-treat analysis.

The rationale for the choice of Free & Clear as the runner-up for the 2010 Tobacco Control Lie of the Year Award is presented by John Polito, who wrote:

"Intentionally advertising a 17% quitting rate as 45% is a massive distortion that is helping Free & Clear make millions. While the other 9 misrepresentations are serious, none appear directly motivated by raw greed. The U.S. government's (Fiore's) bible on quitting rates is the 2008 Clinical Practice Guideline for Treating Tobacco Use and Dependence. The last paragraph on page 23 of the Guideline states: "All of the new meta-analyses conducted for the 2008 Guideline were based exclusively on intent-to-treat data." Guideline evidence Table 1.3 (above link at page 28) combines the results from 9 studies which examined pro-active telephone counseling. It found that six-month quitting rates ranging from 13.8% to 17.3%, producing a combined abstinence rate of 15.5%, with a rather modest 1.6 estimated odds ratio over minimal or no self-help (which would include unassisted cold turkey quitters). Now contrast that with this Free & Clear's page, which makes the following unqualified assertion: "Quit For Life Program produces an average quit rate of 45% for employers, making it 9 times more effective than quitting “cold turkey.” Two giant fibs."

"Remember, we're talking about the nation's largest telephone quit smoking service, the 90 "trained," at-home Free & Clear counselors smokers talk to when calling 1-800-QUIT-NOW, probably the most expensive telephone quit counseling service on earth. The 1-800-QUIT-NOW number also appears on the U.S. government's official quitting site. Oklahoma is paying Free & Clear more than $900,000 per year, and "on average, the program has so far cost $700 to $835 for every person who has quit smoking."

"How many smokers understand how Free & Clear calculated its "responder rate" or what a responder rate even is. Any? Where does it tell us the percentage or number of smokers who actually "responded?" Another secret? What incentive does Free & Clear have to use diligence in following up with non-responders when it knows that the reason many don't want to talk to it is because they're still smoking? None. It's why Free & Clear deserves the award. By doing less and redefining quitting it makes itself look 3 times better than all other telephone counseling studies. It knows its representation is fraudulent yet with tens of millions at stake it feels the risks are worth the reward. Unless we somehow holds Free & Clear's feet to the fire, the health lies are profitable."

The Winners

FIRST PLACE: United States Surgeon General's Office


The Lie: (1) "Even brief exposure to secondhand smoke can cause cardiovascular disease and could trigger acute cardiac events, such as heart attack."; (2) "Inhaling even the smallest amount of tobacco smoke can also damage your DNA, which can lead to cancer."

The Rest of the Story: It is simply not true that even brief exposure to secondhand smoke can cause cardiovascular disease. Luckily, it takes many years of exposure before the process of atherosclerosis (hardening of the arteries) can occur. Fortunately as well, inhaling the smallest amount of tobacco smoke does not lead to cancer. While the Surgeon General is correct in asserting that the tiniest amount of tobacco smoke can damage your DNA, it simply is not true that someone who inhales the tiniest amount of tobacco smoke may well develop cancer because of it. There is certainly no evidence to support such a statement.

SECOND PLACE: Free & Clear

The Lie: "Using an integrated mix of medication support, phone-based cognitive behavioral coaching and web-based learning and support tools the Quit For Life Program produces an average quit rate of 45% for employers, making it 9 times more effective than quitting “cold turkey.”"

The Rest of the Story: What Free & Clear does not tell the consumer is that the quit rates reported on the site are known not to be accurate, as they are based only on survey responders and ignore respondents who are lost to follow-up, who we know are most likely those who have failed to quit smoking. In my view, this is fraudulent marketing, because it the company is knowingly providing a quit rate that is invalid -- essentially by definition the true quit rate is substantially lower than that which is being advertised.

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