Tuesday, October 11, 2005

Challenging Dogma (Post #5): Anyone who Questions the Party Line is A Discredit to the Tobacco Control Movement

Over the past few months, it has become clear to me that part of the dogma of the anti-smoking movement is that the movement is always correct and that any questioning of the movement's positions or of the organizations that make up the movement is basically "heresy" and is not to be tolerated.

Interestingly, and disturbingly, I have found out that the approach to dealing with such dissent is not to argue the point at hand and try to provide evidence that the arguments I have presented are wrong, but instead, to attack the dissenter and to try to malign his objectives, his character, and the effect of his dissenting opinion.

Here are some typical examples of the response of the anti-smoking community to my daring to challenge some of the "orthodoxy," and my commentary on these responses:

1. "I ask you to cease your behavior immediately. You are discrediting the whole tobacco control movement and creating great PR grist for the tobacco companies. Your blog is playing right in to the hands of the tobacco industry. I suggest that you take a month off until the dust settles."

Here, instead of attempting to argue why my opinion is wrong, the anti-smoking advocate has attacked me personally. The logic here is that because I have an opinion that differs from that of the tobacco control "establishment," I am ipso facto discrediting the whole tobacco control movement. In addition, the concern expressed here is not that I am wrong in my opinions, but that by expressing them, it might somehow help the tobacco companies. And finally, the public request being made is censorship. Because the advocate apparently does not like my views (it is apparently immaterial whether he or she agrees with them or not), I must be censored and therefore must stop expressing my views, at least for one month. This is outright censorship at its very worst.

2. "Since this blog exposes cases of hypocrisy by public health advocates, its important to point out that someone who rails against the most effective smoking reduction intervention is hypocritical for calling himself a public health advocate."

The reasoning here is that if you oppose any particular opinion of the anti-smoking establishment, then you are, by definition, no longer a public health advocate. The comment basically represents my "ex-communication" from the anti-smoking movement. It demonstrates that there is no room for dissent. You dissent - and boom - you're no longer considered to be a part of the movement. In this way, the movement can maintain its unanimity of opinion.

3. "I think that you have completely gone off the deep end on this. Your behavior has consistently acted to compromise the DOJs case and efforts to get meaningful remedies, as well as the good work by many people to protect it."

Here, the attack is not on my opinions or the suggestion that perhaps they are wrong, but instead, on my behavior. But the only behavior that I conducted was to express my opinion about the merit of the proposed remedies in the DOJ case and the reasons for the government's change in its remedies request. In this way, the anti-smoking advocate has conflated my opinions with behavior. Expressing one's dissenting opinion, by his or her reasoning, is in fact, inappropriate behavior.

4. "Like I have said a bunch of times ... you seem ready to accept the most outrageous claims of people and organizations like Mike McFadden, Gian Turci and FORCES while assuming the worst of almost anyone you perceive to be part of the "tobacco control movement" -- be it ANR or TFK. And I'm sorry, but I have to ask -- towards what end? It's fair enough to debate the strategies and tactics of people and organizations, but when you look at the people who are gobbling this up you might want to think about taking a long, deep look in the mirror and asking yourself what useful, public health purpose this forum serves."

After long and serious contemplation about this comment, I realized that it really demonstrates the dogma of the movement. If you disagree with the "orthodoxy," you are a discredit to the movement and cannot possibly be working toward any good end. To what good end could one possibly be contributing to be questioning the party line?

And even more disturbing, the concern here is not that my opinions might be wrong (no argument is made that anything I have said is wrong). Instead, the concern is that my opinions sometimes do, in some way, coincide with those of Mike McFadden, Gian Turci, and FORCES. This is exactly the mindset I observed when I served on the ANR Board. You cannot ever dare to have any agreement whatsoever with the evil "enemy," even if it is a well-researched, well-argued, and sincerely-held opinion.

In fact, the commenter agrees that it is appropriate for me to be questioning the strategies and tactics of organizations that I feel are unethical or inappropriate. However, doing so apparently hurts the "public health purpose." In other words, the truth hurts, so let's not go there.

But perhaps most disturbing of all is the assertion that because of the nature of the people reading these comments (those who are "gobbling" it up), it somehow changes the merit of the arguments in such a way that it no longer serves a useful public health purpose. But why should the nature of the readers dictate the value of these comments? They either are or are not of merit - their merit does not depend on what this particular commenter happens to think of the people who are reading these comments.

5. "This constant bashing of basically good, caring and responsible organizations is irrational and reprehensible."

Here, again, the rationale is that it is reprehensible to criticize an organization that is doing good things. Because the anti-smoking groups are basically good and caring organizations, there should be no criticism of these groups and any such criticism is reprehensible, and will not be tolerated. This is censorship. This is suppression of free speech. This is apparently the dogma of the tobacco control movement.

6. "You insist on picking on Campaign [for Tobacco-Free Kids]."
"You have something against Campaign for Tobacco-Free Kids."
"Your disdain for Tobacco Free Kids..."

These comments (made by 3 different individuals) reveal that any criticism of the anti-smoking establishment is, indeed, viewed as "heresy." Here, what is apparently wrong is not the arguments that I made, but rather, the very fact that I dared to criticize the establishment. The ethical concerns that I have expressed cannot possibly be viewed as legitimate ethical concerns. Instead, it must be the case that I am simply picking on these organizations because for some reason I don't like them.

There's no need for me to defend myself, to explain to readers how difficult it is for me to criticize organizations with which I have worked closely for much of my career, organizations at which many of my good friends and colleagues for years and years are employed, and how much courage I have to summon up every day to speak out for what I believe to be right even though it is critical of many of the groups with which I have worked for the better part of (or in some cases, my entire) career, and knowing that I am going to get personally attacked for daring to express my opinion.

Frankly, if I indeed had a grudge against all the organizations I have criticized on this blog, why would I have been a dedicated and committed tobacco control practitioner, working with all of these organizations, for more than 21 years? I have, in fact, been critical of myself at times on this blog. Does that mean that I have a grudge against myself? I guess I must hate myself since I've been critical of some things I have done.

Here again, the truth hurts. It cannot possibly be the case that the establishment has done anything wrong. So rather than seriously consider the allegations or ponder for a moment the possibility that a good-natured, noble-intended anti-smoking organization could have perhaps done something wrong, my comments must be immediately dismissed outright because I must have a personal grudge against these organizations.

Look - I understand why these ethical concerns are so hard for anti-smoking advocates to take. It does hurt to ponder the fact that maybe, just maybe, some of the things we are doing are wrong. And therefore, it is hard to accept that the criticism is being made. And the immediate reaction is to attack the dissenter and question his motives, rather than to critically analyze the allegations and consider whether or not the dissenter is correct or not. So I understand why this seems to be the response.

However, the sum total of all these individual responses is that the movement as a whole, as I have learned, simply cannot and will not tolerate dissent.

I am sorry that my criticism of public health organizations for what I believe to be unethical, irresponsible, or inappropriate behavior is viewed by anti-smoking advocates as being "heretical," reprehensible, a discredit to the whole movement, inconsistent with being a public health advocate, off the deep end, and towards no possible useful public health purpose.

But you know what - I think there is a critical public health purpose to which the commentary on this blog may be contributing - and that is, to the restoration of ethics and integrity in the tobacco control movement.

I'll be honest - I believe that because of the degradation of the movement because of the inappropriate actions of its leading organizations, the entire credibility of the movement is threatened. The only way I can see salvaging the movement is to reform it - to restore ethics and integrity to it. If this blog can play even a small role in that, then it will have indeed served a useful public health purpose. Because it is only through the restoration of the credibility of, and appropriate leadership in the tobacco control movement that we will be successful in continuing to reduce the burden of tobacco-related morbidity and mortality in this country.

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