I am today issuing a challenge to anti-smoking organizations and advocates that are claiming FORCES is a tobacco industry front group to document their claim by providing evidence that FORCES is funded by the tobacco companies.
Several anti-smoking groups and a number of advocates are continuing to make this claim (see ANR's website for example), and I'm frankly fed up with it. I'm fed up because these are inappropriate, undocumented claims and as such, are unbefitting for a public health organization. It's time to either provide the evidence or discontinue these unwarranted and undocumented public claims.
As an added incentive, I am throwing in a fabulous prize. I will make a $100 donation to any anti-smoking organization that is able, by close of business on Wednesday, to document that FORCES is funded by tobacco companies.
Since several anti-smoking organizations are making this claim, they surely must have documentation of it, so a deadline of tomorrow at the end of the day seems quite reasonable. And since I don't have a lot of money, I will limit the prize to the first organization that is able to provide the documentation, since I assume that there must be a lot of documentation out there to support a number of organizations and advocates making this claim.
Good luck to all contestants!
...Providing the whole story behind tobacco and alcohol news.
Tuesday, February 28, 2006
Action on Smoking and Health Defends Employment Discrimination Against Smokers
Action on Smoking and Health (ASH) yesterday issued a press release which defends discriminatory employment policies by which employers refuse to consider job applications from smokers and fire existing smokers even if the smoking takes place off-the-job and in the privacy of the employees' own homes.
According to the press release, which mentions that ASH sent a letter to Washington State legislators urging them to reject a proposed bill that would outlaw this type of discrimination:
"In summary, ASH argues that, to permit people who insist on smoking, even at the expense of their jobs, to continue doing so without paying any of the added health costs, the bill would:
* force companies and their nonsmoking employees to unfairly bear the huge and totally unnecessary health care, premature disability, and other costs of smoking;
* place companies in this state at a significant disadvantage compared with competitors in other states where the companies can slash their health care costs by not hiring smokers;
* deter companies from locating plants, offices, etc. in this state because they must then bear the huge and totally unnecessary costs of employee smoking."
* deter companies from firing workers who happen to be smokers and who deserve to be fired simply because the company is afraid of law suits if the workers are smokers;
* open the door to purely frivolous law suits by any smoker who was not hired, or who was not promoted as he had hoped or expected;
* permit law suits based upon pure statistics whenever the percentage of smokers – for whatever reason, including valid business reasons – happens to be lower than expected."
The Rest of the Story
To see the fallacy in ASH's argument in support of policies that discriminate against smokers, let's reiterate their arguments, except first let's substitute the phrase "pregnant women" for smokers and consider how these arguments would fare against a bill intended to prevent employment discrimination against women of childbearing age:
"In summary, ASH argues that, to permit people who insist on being pregnant, even at the expense of their jobs, to continue doing so without paying any of the added health costs, the bill would:
* force companies and their male and non-pregnant female employees to unfairly bear the huge and totally unnecessary health care and other costs of pregnancy;
* place companies in this state at a significant disadvantage compared with competitors in other states where the companies can slash their health care costs by not hiring women of childbearing age;
* deter companies from locating plants, offices, etc. in this state because they must then bear the huge and totally unnecessary costs of pregnancy among female employees."
* deter companies from firing workers who happen to be young women and who deserve to be fired simply because the company is afraid of law suits if the workers are young women of childbearing age;
* open the door to purely frivolous law suits by any young woman who was not hired, or who was not promoted as she had hoped or expected;
* permit law suits based upon pure statistics whenever the percentage of young women – for whatever reason, including valid business reasons – happens to be lower than expected."
I hope it is clear that the precise reasoning that ASH uses to defend employment discrimination against smokers could also be used, in an identical fashion, to defend employment discrimination against women of childbearing age and to argue against laws that would prohibit discrimination on the basis of sex.
There may be valid reasons to support and promote discrimination against smokers in the workplace like ASH is doing, but these are certainly not them.
ASH is going to have to do a lot better than this to convince me that employment discrimination against smokers is reasonable and to stop me from supporting and promoting Washington's House Bill 2614.
According to the press release, which mentions that ASH sent a letter to Washington State legislators urging them to reject a proposed bill that would outlaw this type of discrimination:
"In summary, ASH argues that, to permit people who insist on smoking, even at the expense of their jobs, to continue doing so without paying any of the added health costs, the bill would:
* force companies and their nonsmoking employees to unfairly bear the huge and totally unnecessary health care, premature disability, and other costs of smoking;
* place companies in this state at a significant disadvantage compared with competitors in other states where the companies can slash their health care costs by not hiring smokers;
* deter companies from locating plants, offices, etc. in this state because they must then bear the huge and totally unnecessary costs of employee smoking."
* deter companies from firing workers who happen to be smokers and who deserve to be fired simply because the company is afraid of law suits if the workers are smokers;
* open the door to purely frivolous law suits by any smoker who was not hired, or who was not promoted as he had hoped or expected;
* permit law suits based upon pure statistics whenever the percentage of smokers – for whatever reason, including valid business reasons – happens to be lower than expected."
The Rest of the Story
To see the fallacy in ASH's argument in support of policies that discriminate against smokers, let's reiterate their arguments, except first let's substitute the phrase "pregnant women" for smokers and consider how these arguments would fare against a bill intended to prevent employment discrimination against women of childbearing age:
"In summary, ASH argues that, to permit people who insist on being pregnant, even at the expense of their jobs, to continue doing so without paying any of the added health costs, the bill would:
* force companies and their male and non-pregnant female employees to unfairly bear the huge and totally unnecessary health care and other costs of pregnancy;
* place companies in this state at a significant disadvantage compared with competitors in other states where the companies can slash their health care costs by not hiring women of childbearing age;
* deter companies from locating plants, offices, etc. in this state because they must then bear the huge and totally unnecessary costs of pregnancy among female employees."
* deter companies from firing workers who happen to be young women and who deserve to be fired simply because the company is afraid of law suits if the workers are young women of childbearing age;
* open the door to purely frivolous law suits by any young woman who was not hired, or who was not promoted as she had hoped or expected;
* permit law suits based upon pure statistics whenever the percentage of young women – for whatever reason, including valid business reasons – happens to be lower than expected."
I hope it is clear that the precise reasoning that ASH uses to defend employment discrimination against smokers could also be used, in an identical fashion, to defend employment discrimination against women of childbearing age and to argue against laws that would prohibit discrimination on the basis of sex.
There may be valid reasons to support and promote discrimination against smokers in the workplace like ASH is doing, but these are certainly not them.
ASH is going to have to do a lot better than this to convince me that employment discrimination against smokers is reasonable and to stop me from supporting and promoting Washington's House Bill 2614.
Monday, February 27, 2006
Eating a High-Fat Meal Found to Cause Endothelial Dysfunction in Healthy Nonsmokers; Eating Tater Tots for 30 Minutes May Cause Heart Attacks
Researchers from the Second University of Naples, Italy have demonstrated that eating a high-fat meal causes endothelial dysfunction, as measured by increases in intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). These are common markers used to measure endothelial dysfunction.
Based on information provided by Action on Smoking and Health (ASH), I have inferred that since a 30-minute exposure that causes endothelial dysfunction (passive smoking) can cause fatal heart attacks in otherwise healthy individuals, eating a high-fat meal can therefore trigger fatal heart attacks in healthy adults.
In addition, I have inferred from ASH's information that since a 30-minute exposure that causes endothelial dysfunction increases the risk of a fatal heart attack to the level observed in smokers, the risk of dropping dead from a heart attack after eating tater tots for 30 minutes is equal to the risk among smokers.
Therefore, as much as it pains me to do so, I am today calling for a nationwide ban on tater tots.
This is a serious problem, not only because of the fatal heart attack risk posed by this food product, but also because of the threat of student riots over a lack of tater tots. According to the Center for Emergency Health and Safety for Schools (CEHSS), this represents a serious threat of an emergency school situation:
"A coalition of respondents is prepared to handle the threat of terrorism in the Pewaukee School District. The group can control the chaos which could result if the Pewaukee High School cafeteria should become a target of an enraged faction of militant students urging for more tater tots."
The Rest of the Story
The serious aspect of this post is that the most important detail that ASH fails to provide its readers is that endothelial dysfunction is reversible.
This is the precise reason why eating a high-fat meal does not cause heart attacks in otherwise healthy people. Sure, after the meal you experience endothelial dysfunction. But it is transient and your coronary artery lining returns to normal.
The threat comes if you are chronically exposed to risk factors that cause endothelial dysfunction. Then, the changes may not reverse and the atherosclerotic process will be able to continue.
So if you are exposed to secondhand smoke for 30 minutes, it is true that there might be some endothelial dysfunction, much as you would get if you ate a high-fat meal. But that dysfunction is reversible and it will go away after the exposure ends. If you were to be repeatedly exposed over a long period of time, then the atherosclerotic process could continue. But a single 30 minute exposure is not going to cause a problem, because the endothelial dysfunction it causes is reversible.
Whereas smokers are continuing to cause endothelial dysfunction by smoking repeatedly, a person exposed to secondhand smoke for just 30 minutes has transient endothelial dysfunction and then they are back to normal, assuming that the exposure is not repeated, prolonged, and chronic.
So tater tots are not going to cause a fatal heart attack in a person without severe pre-existing coronary artery disease, and neither is being exposed to secondhand smoke for 30 minutes, despite what a prominent anti-smoking organization might say.
Based on information provided by Action on Smoking and Health (ASH), I have inferred that since a 30-minute exposure that causes endothelial dysfunction (passive smoking) can cause fatal heart attacks in otherwise healthy individuals, eating a high-fat meal can therefore trigger fatal heart attacks in healthy adults.
In addition, I have inferred from ASH's information that since a 30-minute exposure that causes endothelial dysfunction increases the risk of a fatal heart attack to the level observed in smokers, the risk of dropping dead from a heart attack after eating tater tots for 30 minutes is equal to the risk among smokers.
Therefore, as much as it pains me to do so, I am today calling for a nationwide ban on tater tots.
This is a serious problem, not only because of the fatal heart attack risk posed by this food product, but also because of the threat of student riots over a lack of tater tots. According to the Center for Emergency Health and Safety for Schools (CEHSS), this represents a serious threat of an emergency school situation:
"A coalition of respondents is prepared to handle the threat of terrorism in the Pewaukee School District. The group can control the chaos which could result if the Pewaukee High School cafeteria should become a target of an enraged faction of militant students urging for more tater tots."
The Rest of the Story
The serious aspect of this post is that the most important detail that ASH fails to provide its readers is that endothelial dysfunction is reversible.
This is the precise reason why eating a high-fat meal does not cause heart attacks in otherwise healthy people. Sure, after the meal you experience endothelial dysfunction. But it is transient and your coronary artery lining returns to normal.
The threat comes if you are chronically exposed to risk factors that cause endothelial dysfunction. Then, the changes may not reverse and the atherosclerotic process will be able to continue.
So if you are exposed to secondhand smoke for 30 minutes, it is true that there might be some endothelial dysfunction, much as you would get if you ate a high-fat meal. But that dysfunction is reversible and it will go away after the exposure ends. If you were to be repeatedly exposed over a long period of time, then the atherosclerotic process could continue. But a single 30 minute exposure is not going to cause a problem, because the endothelial dysfunction it causes is reversible.
Whereas smokers are continuing to cause endothelial dysfunction by smoking repeatedly, a person exposed to secondhand smoke for just 30 minutes has transient endothelial dysfunction and then they are back to normal, assuming that the exposure is not repeated, prolonged, and chronic.
So tater tots are not going to cause a fatal heart attack in a person without severe pre-existing coronary artery disease, and neither is being exposed to secondhand smoke for 30 minutes, despite what a prominent anti-smoking organization might say.
University of Wyoming Decides to Reject UST Funding for Planned "Living in Smoke-Free Laramie" Seminar
The University of Wyoming Center for Rural Health Research and Education has decided to reject UST sponsorship of a planned seminar entitled "Living in Smoke-Free Laramie" and to cancel the seminar.
I earlier reported that the University was planning this seminar, sponsored by UST (which owns the U.S. Smokeless Tobacco Company, maker of Copenhagen and Skoal), which was intended to "discuss tobacco and the various health related issues of both cigarettes and smokeless tobacco products." In my view, this was really a sham seminar whose purpose was ostensibly to help UST market smokeless tobacco products by taking advantage of an opportunity to market its products in the face of a smoking ban, where smokers might be encouraged to switch to smokeless products as a way to avoid the inconvenience of the Laramie smoking ban (or to avoid having to quit smoking entirely).
The University of Wyoming has decided to cancel the event and to reject the funds offered by UST.
The Rest of the Story
I have nothing but praise for the University of Wyoming, including the Center for Rural Health Research and Education, and their decision to reject the UST funding and cancel the seminar. It is quite clear that they have nothing but the highest and most sincere and noblest intentions, and that they quickly realized that this was a mistake.
No damage was done, and in fact, the University of Wyoming has now helped set a standard and an outstanding example for all academic institutions in the country by making it clear that academic institutions are not appropriate venues to collaborate in the marketing of tobacco products.
In the end, the University of Wyoming has not only avoided a potentially inappropriate collaboration with a tobacco company, but has set itself apart as having the highest standards for academic and scientific integrity.
I hope that this story will help educate people throughout the country about one tactic that tobacco companies are using in their marketing efforts - collaborations with academic institutions to market their products in a way that gives respectability and credibility to these efforts. Universities should not let themselves be used as pawns in the marketing efforts of a deadly product.
Congratulations to the University of Wyoming and to the University's Center for Rural Health Research and Education for distinguishing themselves by setting the highest standards for academic integrity!
I earlier reported that the University was planning this seminar, sponsored by UST (which owns the U.S. Smokeless Tobacco Company, maker of Copenhagen and Skoal), which was intended to "discuss tobacco and the various health related issues of both cigarettes and smokeless tobacco products." In my view, this was really a sham seminar whose purpose was ostensibly to help UST market smokeless tobacco products by taking advantage of an opportunity to market its products in the face of a smoking ban, where smokers might be encouraged to switch to smokeless products as a way to avoid the inconvenience of the Laramie smoking ban (or to avoid having to quit smoking entirely).
The University of Wyoming has decided to cancel the event and to reject the funds offered by UST.
The Rest of the Story
I have nothing but praise for the University of Wyoming, including the Center for Rural Health Research and Education, and their decision to reject the UST funding and cancel the seminar. It is quite clear that they have nothing but the highest and most sincere and noblest intentions, and that they quickly realized that this was a mistake.
No damage was done, and in fact, the University of Wyoming has now helped set a standard and an outstanding example for all academic institutions in the country by making it clear that academic institutions are not appropriate venues to collaborate in the marketing of tobacco products.
In the end, the University of Wyoming has not only avoided a potentially inappropriate collaboration with a tobacco company, but has set itself apart as having the highest standards for academic and scientific integrity.
I hope that this story will help educate people throughout the country about one tactic that tobacco companies are using in their marketing efforts - collaborations with academic institutions to market their products in a way that gives respectability and credibility to these efforts. Universities should not let themselves be used as pawns in the marketing efforts of a deadly product.
Congratulations to the University of Wyoming and to the University's Center for Rural Health Research and Education for distinguishing themselves by setting the highest standards for academic integrity!
Tobacco Company Claims Smokers' Heart Attack Risk is No Higher than Nonsmokers who Spend 30 Minutes in a Mildly Smoky Chinese Restaurant
In a statement released today, upstart tobacco company Global Tobacco claimed that the risk of a heart attack among smokers has been greatly exaggerated. According to the company, the actual risk of a heart attack among smokers is quite small - equivalent to that of a nonsmoker who breathes in low levels of secondhand smoke for just 30 minutes.
According to a Global Tobacco spokesperson: "A smoker who smokes two and a half packs per day for 45 years is at no more risk of a fatal heart attack than someone who never lit up a cigarette in their life but waited for 30 minutes to pick up take-out Chinese food in a restaurant that allows smoking. In fact, their risk of a fatal myocardial infarction is exactly the same."
In response to Global Tobacco's statement, anti-smoking groups were outraged. They called the claim completely fallacious and challenged Global Tobacco to provide documentation for its claim. One anti-smoking organization threatened to file a lawsuit charging Global Tobacco with consumer fraud for making such an obvious and blatantly fraudulent health claim.
According to a spokesperson for the upstart anti-smoking group Citizens for Truth: "This claim by Global Tobacco is simply an attempt to undermine years of public education about the dangers of smoking. Anyone with common sense knows that someone who has smoked for 40 years cannot possibly have the same risk of a fatal heart attack as someone who walks into a mildly smoky Chinese restaurant for 30 minutes. If Global Tobacco does not retract this statement, we are prepared to file a lawsuit tomorrow charging the company with making a fraudulent health claim under state consumer protection law."
When pressed for documentation of its claim, Global Tobacco defended itself by stating that it was simply taking the claim from material put out by an anti-smoking organization, which stated that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Control [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
Global Tobacco pointed out that in its opinion, it was actually being conservative, since the anti-smoking organization's claim related to drifting tobacco smoke such as sitting on a park bench, while its claim related to much higher exposure - waiting for an order of Moo Goo Gai Pan and Kung Bo Chicken in a mildly smoky restaurant. "We're not talking merely about drifting tobacco smoke; we're talking about a bona fide moderate exposure, with continuous moderate levels of smoke, not just drifting, but being immersed in the plume for 30 minutes."
Global Tobacco added that its health claim was further justified, because a published study had concluded that the effects of smoking on endothelial function in smokers were about equal to the effects among nonsmokers after 30 minutes of exposure to secondhand smoke. "The evidence clearly demonstrated that endothelial dysfunction among heavy smokers is no worse than among nonsmokers who are exposed transiently to secondhand smoke. And besides," added the Global Tobacco spokesperson, "there were two newspaper articles that said this."
Citizens for Truth countered by pointing out that the study cited by Global Tobacco only measured endothelial dysfunction in coronary arteries, not fatal heart attack risk: "Endothelial dysfunction is simply a measure of the very early stages of atherosclerosis. You're not going to tell us that you can go from clean coronary arteries to occluded coronary arteries in 30 minutes in a nonsmoker, when even in heavy smokers, it takes many years to develop coronary stenosis. If what Global Tobacco is saying were true, we would be seeing fatal heart attacks among lots of 18 year-olds. After all, they have smoked for a whole lot more than 30 minutes if they started at age 16."
A prominent cardiologist supported the Citizens for Truth position: "Atherosclerosis is a gradual process. It doesn't happen in 30 minutes."
A Citizens for Truth press release called it "particularly despicable" that Global Tobacco would undermine public health education efforts about the serious cardiovascular health effects of smoking: "This is the 21st century. We thought that tobacco company deception about the health effects of smoking was a thing of the past. But Global Tobacco's health claim completely undermines more than 40 years of public health efforts to ensure that the public understands the serious heart attack risk associated with smoking. To suggest that this risk is no more than being exposed to 30 minutes of secondhand smoke -- it's hard to believe that could happen in 2006."
Citizens for Truth said it is considering filing a post-trial amicus brief in the Department of Justice tobacco lawsuit, since this recent action by Global Tobacco "substantially strengthens the government's contention that RICO violations are continuing, not just a thing of the past."
Nevertheless, Global Tobacco did not seem overly concerned: "We're not worried. If this goes to court, we feel quite confident that any reasonable judge will agree that we are merely repeating the message sent by an anti-smoking organization, which, by definition, must be true. And even if it's not, why should we be held to a different standard than anyone else? Shouldn't there be a level playing field for scientific accuracy?"
(Thanks to Walt Hanley for the news tip).
According to a Global Tobacco spokesperson: "A smoker who smokes two and a half packs per day for 45 years is at no more risk of a fatal heart attack than someone who never lit up a cigarette in their life but waited for 30 minutes to pick up take-out Chinese food in a restaurant that allows smoking. In fact, their risk of a fatal myocardial infarction is exactly the same."
In response to Global Tobacco's statement, anti-smoking groups were outraged. They called the claim completely fallacious and challenged Global Tobacco to provide documentation for its claim. One anti-smoking organization threatened to file a lawsuit charging Global Tobacco with consumer fraud for making such an obvious and blatantly fraudulent health claim.
According to a spokesperson for the upstart anti-smoking group Citizens for Truth: "This claim by Global Tobacco is simply an attempt to undermine years of public education about the dangers of smoking. Anyone with common sense knows that someone who has smoked for 40 years cannot possibly have the same risk of a fatal heart attack as someone who walks into a mildly smoky Chinese restaurant for 30 minutes. If Global Tobacco does not retract this statement, we are prepared to file a lawsuit tomorrow charging the company with making a fraudulent health claim under state consumer protection law."
When pressed for documentation of its claim, Global Tobacco defended itself by stating that it was simply taking the claim from material put out by an anti-smoking organization, which stated that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Control [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
Global Tobacco pointed out that in its opinion, it was actually being conservative, since the anti-smoking organization's claim related to drifting tobacco smoke such as sitting on a park bench, while its claim related to much higher exposure - waiting for an order of Moo Goo Gai Pan and Kung Bo Chicken in a mildly smoky restaurant. "We're not talking merely about drifting tobacco smoke; we're talking about a bona fide moderate exposure, with continuous moderate levels of smoke, not just drifting, but being immersed in the plume for 30 minutes."
Global Tobacco added that its health claim was further justified, because a published study had concluded that the effects of smoking on endothelial function in smokers were about equal to the effects among nonsmokers after 30 minutes of exposure to secondhand smoke. "The evidence clearly demonstrated that endothelial dysfunction among heavy smokers is no worse than among nonsmokers who are exposed transiently to secondhand smoke. And besides," added the Global Tobacco spokesperson, "there were two newspaper articles that said this."
Citizens for Truth countered by pointing out that the study cited by Global Tobacco only measured endothelial dysfunction in coronary arteries, not fatal heart attack risk: "Endothelial dysfunction is simply a measure of the very early stages of atherosclerosis. You're not going to tell us that you can go from clean coronary arteries to occluded coronary arteries in 30 minutes in a nonsmoker, when even in heavy smokers, it takes many years to develop coronary stenosis. If what Global Tobacco is saying were true, we would be seeing fatal heart attacks among lots of 18 year-olds. After all, they have smoked for a whole lot more than 30 minutes if they started at age 16."
A prominent cardiologist supported the Citizens for Truth position: "Atherosclerosis is a gradual process. It doesn't happen in 30 minutes."
A Citizens for Truth press release called it "particularly despicable" that Global Tobacco would undermine public health education efforts about the serious cardiovascular health effects of smoking: "This is the 21st century. We thought that tobacco company deception about the health effects of smoking was a thing of the past. But Global Tobacco's health claim completely undermines more than 40 years of public health efforts to ensure that the public understands the serious heart attack risk associated with smoking. To suggest that this risk is no more than being exposed to 30 minutes of secondhand smoke -- it's hard to believe that could happen in 2006."
Citizens for Truth said it is considering filing a post-trial amicus brief in the Department of Justice tobacco lawsuit, since this recent action by Global Tobacco "substantially strengthens the government's contention that RICO violations are continuing, not just a thing of the past."
Nevertheless, Global Tobacco did not seem overly concerned: "We're not worried. If this goes to court, we feel quite confident that any reasonable judge will agree that we are merely repeating the message sent by an anti-smoking organization, which, by definition, must be true. And even if it's not, why should we be held to a different standard than anyone else? Shouldn't there be a level playing field for scientific accuracy?"
(Thanks to Walt Hanley for the news tip).
American Legacy Foundation Admits Partnering with Company that is Knowingly Recruiting Multitudes of New Young Smokers
In an advertisement that is first appearing in the Daily Variety today, the American Legacy Foundation has essentially admitted that it is partnering with a corporation that is knowingly recruiting multitudes of young smokers by exposing them to portrayals of smoking in the movies.
The advertisement, signed by the American Legacy Foundation, whose lead corporate partner is Time Warner (which owns Warner Brothers, one of the chief sources of youth exposure to smoking in the movies), cites a recent study published in the journal Pediatrics, which estimated that movie companies could reduce adolescent smoking by 60% by putting an R-rating on all films that contain smoking. Such a measure, according to the ad, would prevent 200,000 youths from starting to smoke each year, and would avert 62,000 premature deaths.
According to the advertisement: "The undersigned [meaning the American Legacy Foundation] expect the media corporations engaged in motion picture production and distribution [meaning Time Warner] to embrace their social responsibility and immediately adopt science-based policies, including the R-rating of tobacco imagery, to reduce youth exposure and risks to human health."
"Given the compelling evidence, any further delay can only mean the knowing recruitment of multitudes of new young smokers by this powerful promotional channel."
The Rest of the Story
Unless I am missing something, in this advertisement, the American Legacy Foundation is claiming that Time Warner is knowingly recruiting multitudes of new young smokers by the powerful promotional channel of their smoking-portraying movies.
That brings up some interesting questions:
What the heck is the American Legacy Foundation doing partnering with Time Warner and calling the company a "leader in this important movement" [the anti-smoking movement]?
Why would the American Legacy Foundation choose to partner with an organization that is knowingly recruiting multitudes of new young smokers?
Aren't there a couple of companies out there which don't recruit multitudes of new young smokers that Legacy could partner with instead?
And how in the world does knowingly recruiting multitudes of new young smokers constitute being a "leader" in the tobacco control movement?
Moreover, it seems particularly hypocritical for the American Legacy Foundation to partner with a company that is knowingly recruiting multitudes of new young smokers when it prohibits its grantees from even accepting research money from tobacco companies which recruit new young smokers. What in the world is the difference? And why is it OK for Legacy to have a bona fide partnership with companies that are recruiting smokers when its grantees are not allowed to even accept research dollars from such companies?
Don't get me wrong. I'm not arguing that it is appropriate for universities to accept tobacco industry funding for academic research. I'm just pointing out the extreme hypocrisy in what Legacy is doing.
The rest of the story is that the American Legacy Foundation appears to have acknowledged that they are partnering with a company that is knowingly recruiting multitudes of new young smokers and contributing substantially to 62,000 deaths annually. By virtue of this partnership, I feel that Legacy itself becomes something of an accomplice, or at least an enabler, in allowing this knowing recruitment of new young smokers to occur.
I don't see any way that Legacy can credibly maintain its mission of trying to create a world where young people can reject tobacco and effectively advocate for policies necessary to make that goal possible when Legacy itself is partnering with one of the chief culprits, a company that Legacy itself admits is recruiting our young people to smoke and contributing to thousands of premature deaths each year.
The advertisement, signed by the American Legacy Foundation, whose lead corporate partner is Time Warner (which owns Warner Brothers, one of the chief sources of youth exposure to smoking in the movies), cites a recent study published in the journal Pediatrics, which estimated that movie companies could reduce adolescent smoking by 60% by putting an R-rating on all films that contain smoking. Such a measure, according to the ad, would prevent 200,000 youths from starting to smoke each year, and would avert 62,000 premature deaths.
According to the advertisement: "The undersigned [meaning the American Legacy Foundation] expect the media corporations engaged in motion picture production and distribution [meaning Time Warner] to embrace their social responsibility and immediately adopt science-based policies, including the R-rating of tobacco imagery, to reduce youth exposure and risks to human health."
"Given the compelling evidence, any further delay can only mean the knowing recruitment of multitudes of new young smokers by this powerful promotional channel."
The Rest of the Story
Unless I am missing something, in this advertisement, the American Legacy Foundation is claiming that Time Warner is knowingly recruiting multitudes of new young smokers by the powerful promotional channel of their smoking-portraying movies.
That brings up some interesting questions:
What the heck is the American Legacy Foundation doing partnering with Time Warner and calling the company a "leader in this important movement" [the anti-smoking movement]?
Why would the American Legacy Foundation choose to partner with an organization that is knowingly recruiting multitudes of new young smokers?
Aren't there a couple of companies out there which don't recruit multitudes of new young smokers that Legacy could partner with instead?
And how in the world does knowingly recruiting multitudes of new young smokers constitute being a "leader" in the tobacco control movement?
Moreover, it seems particularly hypocritical for the American Legacy Foundation to partner with a company that is knowingly recruiting multitudes of new young smokers when it prohibits its grantees from even accepting research money from tobacco companies which recruit new young smokers. What in the world is the difference? And why is it OK for Legacy to have a bona fide partnership with companies that are recruiting smokers when its grantees are not allowed to even accept research dollars from such companies?
Don't get me wrong. I'm not arguing that it is appropriate for universities to accept tobacco industry funding for academic research. I'm just pointing out the extreme hypocrisy in what Legacy is doing.
The rest of the story is that the American Legacy Foundation appears to have acknowledged that they are partnering with a company that is knowingly recruiting multitudes of new young smokers and contributing substantially to 62,000 deaths annually. By virtue of this partnership, I feel that Legacy itself becomes something of an accomplice, or at least an enabler, in allowing this knowing recruitment of new young smokers to occur.
I don't see any way that Legacy can credibly maintain its mission of trying to create a world where young people can reject tobacco and effectively advocate for policies necessary to make that goal possible when Legacy itself is partnering with one of the chief culprits, a company that Legacy itself admits is recruiting our young people to smoke and contributing to thousands of premature deaths each year.
University of Wyoming Planning to Help U.S. Tobacco Market Smokeless Tobacco Products
As of the writing of this post, the University of Wyoming is planning to hold a seminar on March 27, sponsored by U.S. Tobacco, whose purpose seems ostensibly to be to promote the use of smokeless tobacco among smokers who can no longer smoke in public places because of the smoke-free workplace, restaurant, and bar ordinance that went into effect last April in Laramie.
According to a communication from the University of Wyoming: "The University of Wyoming's Center for Rural Health Research and Education and our local hospital have received a grant from UST to provide programming on the UW campus about tobacco use, prevention, cessation, etc. We are planning to have a seminar on Monday, March 27, 2006. ... We hope to have a couple nationally-recognized key notes, and then provide an opportunity for UW faculty from Nursing, Pharmacy, Psychology, and other departments to present their research on the issue."
Apparently, the University of Wyoming's Center for Rural Health Research and Education (CRHRE) and Ivinson Memorial Hospital are sponsoring a public forum entitled "Living in Smoke-Free Laramie," on Monday, March 27, from 7:00 - 9:00 p.m. at the Union on the University of Wyoming campus. The purpose of the forum is "to discuss tobacco and the various health related issues of both cigarettes and smokeless tobacco products." The intent is to have at least several nationally-known speakers on these issues. The forum is being paid for by U.S. Tobacco (as of the writing of this post).
The Rest of the Story
Something struck me as rather odd when I saw that the health related issues of both cigarettes "and smokeless tobacco products" were to be discussed at a forum entitled "Living in Smoke-Free Laramie." After all, what do smokeless tobacco products have to do with living in Smoke-Free Laramie?
Wouldn't a conference on living in smoke-free Laramie focus on the effects of secondhand smoke, the benefits of reduced exposure to secondhand smoke, and perhaps on the benefits of smoking cessation (since the smoke-free law could be an incentive for many residents to quit smoking)?
But when I saw that the conference was being sponsored by UST (which owns the U.S. Smokeless Tobacco Company, maker of Copenhagen and Skoal, each of which account for over $1 billion at retail), I figured it out.
One of the major new marketing strategies for UST to promote smokeless tobacco products is to try to attract smokers in cities that have adopted smoke-free laws, who can no longer smoke in many workplaces, bars, restaurants, and other public places.
For example, an advertisement from the May 16, 2005 issue of TIME Magazine (interestingly, very shortly after the Laramie smoking ban went into effect) shows what are apparently two "smokers" who are enjoying smokeless tobacco at a "smoke-free" sports bar. Rather than being nicotine-deprived because of the smoking ban, they are now able to enjoy the pleasure and benefits of nicotine in spite of the ban, thanks to the makers of Skoal and Copenhagen.
The ad shows two young men playing pool in a smoke-free sports bar and reads: "Enjoy tobacco in a smoke-free sports bar? Believe it."
A second ad in the series, which appeared in the May 30, 2005 issue of TIME, shows a man sitting as his office desk in a presumably smoke-free workplace and reads: "Enjoy tobacco in your office without stepping outside? Consider it done."
Clearly, this is a marketing campaign designed to take advantage of the spread of smoking bans by recruiting smokers to switch from cigarettes to smokeless tobacco products, and thus not to have to be bothered by the inability to obtain nicotine easily because of the spread of smoking bans. Now, instead of having to go outside to smoke, or instead of deciding that the hassle just isn't worth it and they will quit, smokers can simply switch over to smokeless tobacco (or add smokeless tobacco to their regimen while in smoke-free places) and continue obtaining nicotine with the utmost of convenience.
This marketing campaign continues in full swing, as the most recent issue of Popular Mechanics features a full-page Copenhagen ad ("Copenhagen pouches. Made for the great indoors"). This ad shows a man at a bar, and suggests that smokeless tobacco is a great alternative for smokers who cannot smoke because of bar smoking bans.
This new smokeless tobacco marketing campaign is particularly disturbing because it promises to undermine one of the main public health benefits of smoke-free workplaces and public places: decreased tobacco consumption. The campaign aims to take advantage of the spread of smoke-free policies to promote the use of smokeless tobacco among smokers who would otherwise either not smoke at all or have to take the trouble to go outside to light up.
In my opinion, it turns out that the "Living in Smoke-Free Laramie" seminar is nothing but a sham. It is little other than a marketing ploy by the U.S. Smokeless Tobacco Company to take advantage of the Laramie smoking ban to try to promote smokeless tobacco products in a region of the country where the potential market for smokeless products may be extremely high to begin with, but now with the smoking ban in place, may be even higher than ever before.
And the University of Wyoming, unless it changes its decision to accept this money to sponsor this sham seminar, is nothing other than a pawn in UST's marketing game.
How could an academic institution possibly sponsor a smokeless tobacco industry-sponsored seminar whose purpose is ostensibly to take advantage of a marketing opportunity to recruit new users of a carcinogenic and deadly product?
The involvement of the Ivinson Memorial Hospital is even more troubling, unless the rationale is that the hospital is trying to drum up some more business for its oral cancer ward, in which case this is an excellent business opportunity.
By bringing in nationally-recognized speakers, U.S. Smokeless Tobacco apparently is aiming to gain legitimacy for the discussion of smokeless tobacco products and to hide its promotion of these products under the guise of a "scientific" discussion of smoking, smokeless tobacco, and health issues.
But the forum is nothing of the sort. It is little other than a PR-op: a marketing and public relations opportunity.
Ironically, it seems to me that UST no longer has to do its own marketing. In the University of Wyoming, it appears to have a ready and willing partner to aid in its efforts to take advantage of the Laramie smoking ban to try to promote smokeless tobacco products.
And at the same time, another organization which is supposed to be on the "other side" of this issue - the American Legacy Foundation - has partnered with the very corporations that are delivering UST's new marketing campaign all over the country.
All of the ads mentioned above are carried by corporations that are American Legacy Foundation corporate partners. And Legacy has gone further and awarded the company that is carrying many of the advertisements, including two of the ads mentioned above, for its "progress in tobacco-free publications."
By virtue of its partnership with the producers of the above magazines, Legacy has become associated with the widespread promotion of smokeless tobacco use and with the promulgation of this new smokeless tobacco marketing campaign, which is clearly contrary to its overall mission.
With enemies like this, the U.S. Smokeless Tobacco Company doesn't appear to need friends. When it can rely on academic institutions and supposedly anti-smoking organizations to help enable and support its marketing efforts, it's a sad state of affairs for tobacco control.
UPDATE: Monday, February 27; 2:30 pm - The University of Wyoming and its Center for Rural Health Research and Education has decided to reject UST sponsorship of this event and to cancel the seminar. The updated story has just been posted on this blog, including my praise of the University of Wyoming and the Center for making this decision.
According to a communication from the University of Wyoming: "The University of Wyoming's Center for Rural Health Research and Education and our local hospital have received a grant from UST to provide programming on the UW campus about tobacco use, prevention, cessation, etc. We are planning to have a seminar on Monday, March 27, 2006. ... We hope to have a couple nationally-recognized key notes, and then provide an opportunity for UW faculty from Nursing, Pharmacy, Psychology, and other departments to present their research on the issue."
Apparently, the University of Wyoming's Center for Rural Health Research and Education (CRHRE) and Ivinson Memorial Hospital are sponsoring a public forum entitled "Living in Smoke-Free Laramie," on Monday, March 27, from 7:00 - 9:00 p.m. at the Union on the University of Wyoming campus. The purpose of the forum is "to discuss tobacco and the various health related issues of both cigarettes and smokeless tobacco products." The intent is to have at least several nationally-known speakers on these issues. The forum is being paid for by U.S. Tobacco (as of the writing of this post).
The Rest of the Story
Something struck me as rather odd when I saw that the health related issues of both cigarettes "and smokeless tobacco products" were to be discussed at a forum entitled "Living in Smoke-Free Laramie." After all, what do smokeless tobacco products have to do with living in Smoke-Free Laramie?
Wouldn't a conference on living in smoke-free Laramie focus on the effects of secondhand smoke, the benefits of reduced exposure to secondhand smoke, and perhaps on the benefits of smoking cessation (since the smoke-free law could be an incentive for many residents to quit smoking)?
But when I saw that the conference was being sponsored by UST (which owns the U.S. Smokeless Tobacco Company, maker of Copenhagen and Skoal, each of which account for over $1 billion at retail), I figured it out.
One of the major new marketing strategies for UST to promote smokeless tobacco products is to try to attract smokers in cities that have adopted smoke-free laws, who can no longer smoke in many workplaces, bars, restaurants, and other public places.
For example, an advertisement from the May 16, 2005 issue of TIME Magazine (interestingly, very shortly after the Laramie smoking ban went into effect) shows what are apparently two "smokers" who are enjoying smokeless tobacco at a "smoke-free" sports bar. Rather than being nicotine-deprived because of the smoking ban, they are now able to enjoy the pleasure and benefits of nicotine in spite of the ban, thanks to the makers of Skoal and Copenhagen.
The ad shows two young men playing pool in a smoke-free sports bar and reads: "Enjoy tobacco in a smoke-free sports bar? Believe it."
A second ad in the series, which appeared in the May 30, 2005 issue of TIME, shows a man sitting as his office desk in a presumably smoke-free workplace and reads: "Enjoy tobacco in your office without stepping outside? Consider it done."
Clearly, this is a marketing campaign designed to take advantage of the spread of smoking bans by recruiting smokers to switch from cigarettes to smokeless tobacco products, and thus not to have to be bothered by the inability to obtain nicotine easily because of the spread of smoking bans. Now, instead of having to go outside to smoke, or instead of deciding that the hassle just isn't worth it and they will quit, smokers can simply switch over to smokeless tobacco (or add smokeless tobacco to their regimen while in smoke-free places) and continue obtaining nicotine with the utmost of convenience.
This marketing campaign continues in full swing, as the most recent issue of Popular Mechanics features a full-page Copenhagen ad ("Copenhagen pouches. Made for the great indoors"). This ad shows a man at a bar, and suggests that smokeless tobacco is a great alternative for smokers who cannot smoke because of bar smoking bans.
This new smokeless tobacco marketing campaign is particularly disturbing because it promises to undermine one of the main public health benefits of smoke-free workplaces and public places: decreased tobacco consumption. The campaign aims to take advantage of the spread of smoke-free policies to promote the use of smokeless tobacco among smokers who would otherwise either not smoke at all or have to take the trouble to go outside to light up.
In my opinion, it turns out that the "Living in Smoke-Free Laramie" seminar is nothing but a sham. It is little other than a marketing ploy by the U.S. Smokeless Tobacco Company to take advantage of the Laramie smoking ban to try to promote smokeless tobacco products in a region of the country where the potential market for smokeless products may be extremely high to begin with, but now with the smoking ban in place, may be even higher than ever before.
And the University of Wyoming, unless it changes its decision to accept this money to sponsor this sham seminar, is nothing other than a pawn in UST's marketing game.
How could an academic institution possibly sponsor a smokeless tobacco industry-sponsored seminar whose purpose is ostensibly to take advantage of a marketing opportunity to recruit new users of a carcinogenic and deadly product?
The involvement of the Ivinson Memorial Hospital is even more troubling, unless the rationale is that the hospital is trying to drum up some more business for its oral cancer ward, in which case this is an excellent business opportunity.
By bringing in nationally-recognized speakers, U.S. Smokeless Tobacco apparently is aiming to gain legitimacy for the discussion of smokeless tobacco products and to hide its promotion of these products under the guise of a "scientific" discussion of smoking, smokeless tobacco, and health issues.
But the forum is nothing of the sort. It is little other than a PR-op: a marketing and public relations opportunity.
Ironically, it seems to me that UST no longer has to do its own marketing. In the University of Wyoming, it appears to have a ready and willing partner to aid in its efforts to take advantage of the Laramie smoking ban to try to promote smokeless tobacco products.
And at the same time, another organization which is supposed to be on the "other side" of this issue - the American Legacy Foundation - has partnered with the very corporations that are delivering UST's new marketing campaign all over the country.
All of the ads mentioned above are carried by corporations that are American Legacy Foundation corporate partners. And Legacy has gone further and awarded the company that is carrying many of the advertisements, including two of the ads mentioned above, for its "progress in tobacco-free publications."
By virtue of its partnership with the producers of the above magazines, Legacy has become associated with the widespread promotion of smokeless tobacco use and with the promulgation of this new smokeless tobacco marketing campaign, which is clearly contrary to its overall mission.
With enemies like this, the U.S. Smokeless Tobacco Company doesn't appear to need friends. When it can rely on academic institutions and supposedly anti-smoking organizations to help enable and support its marketing efforts, it's a sad state of affairs for tobacco control.
UPDATE: Monday, February 27; 2:30 pm - The University of Wyoming and its Center for Rural Health Research and Education has decided to reject UST sponsorship of this event and to cancel the seminar. The updated story has just been posted on this blog, including my praise of the University of Wyoming and the Center for making this decision.
Friday, February 24, 2006
A Double Standard for Scientific Integrity In Tobacco Control?
I have to honestly say, that as I try to wind down from a difficult week for me (in terms of the attacks and negative comments I have received from colleagues because of my questioning of the validity of scientific claims made by an anti-smoking organization), the thing that is disturbing me most is not the fact that I feel an anti-smoking organization is using misleading public claims to support its agenda.
Instead, what's most disturbing to me is the response I have received (through emails sent directly to me) from other anti-smoking organizations and advocates (colleagues), who have, uniformly, condemned me for having the gall (?chutzpah) to suggest that something an anti-smoking organization is stating may be scientifically inaccurate.
In fact, so far I'm not aware of any anti-smoking organization which has publicly suggested that perhaps ASH is not being scientifically accurate when it claims that a 30 minute exposure to secondhand smoke increases a nonsmoker's risk of a fatal heart attack to that of a smoker's.
The impression I am left with, sadly, is that there appears to be a double standard here. When the tobacco companies, or their front groups or allies (you know who you are!), misrepresent the science, it is wrong and despicable. But when an anti-smoking group misrepresents the science, it is acceptable. The assumption is that there is a valid explanation for it, that there is some data upon which the claim is made and that I am being overly critical and not basing my own commentary on science, and that I am actually the one who is a fanatic. Or that the scientific inaccuracy is acceptable because, after all, the intentions of the anti-smoking organization are good and the ends to which it is working are noble.
The Rest of the Story
Here is an excerpt from an email from an anti-smoking colleague, sent directly to me, condemning me for questioning the scientific validity of ASH's contention that 30 minutes of exposure to secondhand smoke increases the risk of a fatal heart attack among nonsmokers to that of smokers. Following the condemnation, I have inserted my commentary:
"What is going on here? What has happened to you...? Has someone done you a bad turn? You say that all of this is in the interests and greater good of tobacco control, yet I find it hard to get away from the impression that the underlying assumption behind much of your commentary is one of ill will. ... I have begged before for mercy - please! listen!"
Well, there are a number of theories that have surfaced as to what has happened to me. One is that I am being paid off by the tobacco companies. That accusation has been made several times on my blog itself. Another is that I am being paid off by the Republican party (an accusation that was made on a tobacco list-serve). Another is that I am a civil libertarian manque (an accusation also made on a list-serve).
Actually, the truth is that nothing has happened to me. It is the tobacco control movement that I see changing. There was a day, not long ago, when it would have been unfathomable to me that an anti-smoking organization would have made a public claim so ridiculous as the one that breathing in secondhand smoke for 30 minutes increases a nonsmoker's risk of a fatal heart attack to that of a smoker's. I am not the one who made that claim. I haven't changed. The anti-smoking movement is what seems to have changed. I simply don't remember such preposterous claims being used to support our effort to promote smoke-free workplaces during the past 20 years I have been in this field.
I am sorry to hear that criticism of what anti-smoking groups are doing, even if the allegation is a complete distortion and misrepresentation of the science, means that the dissenting speaker has taken a "bad turn" and harbors "ill will." If that is your definition, then I guess - yes - I have taken a bad turn. I have taken a bad turn because I actually care about honesty and scientific integrity. I have taken a bad turn because I actually believe that the ends do not justify the means and that we must not use deception and mislead people or stretch, distort, and misrepresent the science in order to promote our policy goals. I have taken a bad turn because I am willing, and courageous enough, to step forward and speak up for the ethical principles in which I believe and which I think ought to be the pillars of the tobacco control movement. I have taken a bad turn because I don't have a two-dimensional view of the world, where everything we say is right and everything they say is wrong, and there is no need for us to provide adequate scientific documentation of our claims because our cause is a noble one. So yes, I guess in the eyes of many in the tobacco control movement, I have taken a bad turn.
As far as ill will, no. I'm trying to protect the credibility, integrity, reputation, and basic ethical and public health principles of the tobacco control movement. My aim is to improve the movement by calling attention to things that I feel need to be changed to make the movement stronger, more credible, more consistent, more compassionate, and more effective.
As far as mercy goes, I try to be a compassionate and merciful person, but if mercy is defined as squelching the expression of my opinions and asking me not to share any opinions other than those which agree with the dogma of the movement, then this is a no go.
Finally, it's interesting to me that this comment is not suggesting that I'm wrong. Nowhere does it suggest or even imply that 30 minutes of exposure to secondhand smoke does increase the risk of a fatal heart attack among someone without pre-existing coronary disease. So apparently, where I've taken a bad turn is not in the shoddiness of my science, but in my willingness to suggest that an anti-smoking organization may be making a claim that I feel is wrong.
Incidentally, the response is missing the point. After all, the only reasonable defense to my questioning would be to provide documentation that 30 minutes of secondhand smoke exposure can cause a fatal heart attack and that it in fact does increase the risk of a fatal heart attack to that of a smoker. Isn't that what the appropriate focus of discussion should be about?
The fact that a number of colleagues have shifted the discussion from the scientific issue of the risks of secondhand smoke to ad hominem attacks against me personally is unfortunate, but also very telling.
Instead, what's most disturbing to me is the response I have received (through emails sent directly to me) from other anti-smoking organizations and advocates (colleagues), who have, uniformly, condemned me for having the gall (?chutzpah) to suggest that something an anti-smoking organization is stating may be scientifically inaccurate.
In fact, so far I'm not aware of any anti-smoking organization which has publicly suggested that perhaps ASH is not being scientifically accurate when it claims that a 30 minute exposure to secondhand smoke increases a nonsmoker's risk of a fatal heart attack to that of a smoker's.
The impression I am left with, sadly, is that there appears to be a double standard here. When the tobacco companies, or their front groups or allies (you know who you are!), misrepresent the science, it is wrong and despicable. But when an anti-smoking group misrepresents the science, it is acceptable. The assumption is that there is a valid explanation for it, that there is some data upon which the claim is made and that I am being overly critical and not basing my own commentary on science, and that I am actually the one who is a fanatic. Or that the scientific inaccuracy is acceptable because, after all, the intentions of the anti-smoking organization are good and the ends to which it is working are noble.
The Rest of the Story
Here is an excerpt from an email from an anti-smoking colleague, sent directly to me, condemning me for questioning the scientific validity of ASH's contention that 30 minutes of exposure to secondhand smoke increases the risk of a fatal heart attack among nonsmokers to that of smokers. Following the condemnation, I have inserted my commentary:
"What is going on here? What has happened to you...? Has someone done you a bad turn? You say that all of this is in the interests and greater good of tobacco control, yet I find it hard to get away from the impression that the underlying assumption behind much of your commentary is one of ill will. ... I have begged before for mercy - please! listen!"
Well, there are a number of theories that have surfaced as to what has happened to me. One is that I am being paid off by the tobacco companies. That accusation has been made several times on my blog itself. Another is that I am being paid off by the Republican party (an accusation that was made on a tobacco list-serve). Another is that I am a civil libertarian manque (an accusation also made on a list-serve).
Actually, the truth is that nothing has happened to me. It is the tobacco control movement that I see changing. There was a day, not long ago, when it would have been unfathomable to me that an anti-smoking organization would have made a public claim so ridiculous as the one that breathing in secondhand smoke for 30 minutes increases a nonsmoker's risk of a fatal heart attack to that of a smoker's. I am not the one who made that claim. I haven't changed. The anti-smoking movement is what seems to have changed. I simply don't remember such preposterous claims being used to support our effort to promote smoke-free workplaces during the past 20 years I have been in this field.
I am sorry to hear that criticism of what anti-smoking groups are doing, even if the allegation is a complete distortion and misrepresentation of the science, means that the dissenting speaker has taken a "bad turn" and harbors "ill will." If that is your definition, then I guess - yes - I have taken a bad turn. I have taken a bad turn because I actually care about honesty and scientific integrity. I have taken a bad turn because I actually believe that the ends do not justify the means and that we must not use deception and mislead people or stretch, distort, and misrepresent the science in order to promote our policy goals. I have taken a bad turn because I am willing, and courageous enough, to step forward and speak up for the ethical principles in which I believe and which I think ought to be the pillars of the tobacco control movement. I have taken a bad turn because I don't have a two-dimensional view of the world, where everything we say is right and everything they say is wrong, and there is no need for us to provide adequate scientific documentation of our claims because our cause is a noble one. So yes, I guess in the eyes of many in the tobacco control movement, I have taken a bad turn.
As far as ill will, no. I'm trying to protect the credibility, integrity, reputation, and basic ethical and public health principles of the tobacco control movement. My aim is to improve the movement by calling attention to things that I feel need to be changed to make the movement stronger, more credible, more consistent, more compassionate, and more effective.
As far as mercy goes, I try to be a compassionate and merciful person, but if mercy is defined as squelching the expression of my opinions and asking me not to share any opinions other than those which agree with the dogma of the movement, then this is a no go.
Finally, it's interesting to me that this comment is not suggesting that I'm wrong. Nowhere does it suggest or even imply that 30 minutes of exposure to secondhand smoke does increase the risk of a fatal heart attack among someone without pre-existing coronary disease. So apparently, where I've taken a bad turn is not in the shoddiness of my science, but in my willingness to suggest that an anti-smoking organization may be making a claim that I feel is wrong.
Incidentally, the response is missing the point. After all, the only reasonable defense to my questioning would be to provide documentation that 30 minutes of secondhand smoke exposure can cause a fatal heart attack and that it in fact does increase the risk of a fatal heart attack to that of a smoker. Isn't that what the appropriate focus of discussion should be about?
The fact that a number of colleagues have shifted the discussion from the scientific issue of the risks of secondhand smoke to ad hominem attacks against me personally is unfortunate, but also very telling.
IN MY VIEW: Why ASH's Fallacious Claim May Be Damaging to Smoking Education Efforts
In addition to ASH's claim (that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack among nonsmokers to that of smokers) being problematic because it is scientifically invalid, I think it is also problematic because it may do damage to smoking education efforts. Here's why:
If smokers actually believe ASH and think that their own risk of a heart attack is as low as that of a nonsmoker exposed to secondhand smoke for 30 minutes, then they may very well completely dismiss the idea that they are at any substantially increased risk of a heart attack. Their perception of their own risk of fatal heart disease due to smoking will likely become grossly underestimated.
After all, it is not irrational for a smoker to believe, as I do, that the risk of a nonsmoker having a fatal heart attack after 30 minutes of secondhand smoke exposure to be miniscule. Therefore, by inference, ASH could easily be perceived as implying that the risk of a fatal heart attack among smokers is miniscule.
This could be quite damaging to anti-smoking education efforts, because it may well undermine efforts to try to convince smokers of the serious health hazards associated with tobacco use.
Heart disease is, in fact, probably the most important health concern associated with smoking (it is by far the most prevalent chronic disease and the leading cause of death) and therefore, in many ways, smokers' perceptions of their own risk for heart attacks may drive their overall perception of risk from smoking.
So not only is the message that is being sent to the public wrong, but it is actually one that could well undermine efforts to impress upon smokers the serious consequences of tobacco use in terms of their own risk for dying from a heart attack.
If smokers actually believe ASH and think that their own risk of a heart attack is as low as that of a nonsmoker exposed to secondhand smoke for 30 minutes, then they may very well completely dismiss the idea that they are at any substantially increased risk of a heart attack. Their perception of their own risk of fatal heart disease due to smoking will likely become grossly underestimated.
After all, it is not irrational for a smoker to believe, as I do, that the risk of a nonsmoker having a fatal heart attack after 30 minutes of secondhand smoke exposure to be miniscule. Therefore, by inference, ASH could easily be perceived as implying that the risk of a fatal heart attack among smokers is miniscule.
This could be quite damaging to anti-smoking education efforts, because it may well undermine efforts to try to convince smokers of the serious health hazards associated with tobacco use.
Heart disease is, in fact, probably the most important health concern associated with smoking (it is by far the most prevalent chronic disease and the leading cause of death) and therefore, in many ways, smokers' perceptions of their own risk for heart attacks may drive their overall perception of risk from smoking.
So not only is the message that is being sent to the public wrong, but it is actually one that could well undermine efforts to impress upon smokers the serious consequences of tobacco use in terms of their own risk for dying from a heart attack.
ASH Responds by Reiterating and Reemphasizing its Claim that 30 Minutes of Secondhand Smoke Causes Fatal Heart Attacks in Otherwise Healthy Nonsmokers
In what is apparently a response to my questioning of Action on Smoking and Health's (ASH) claim that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack among an otherwise healthy nonsmoker to that of a smoker, ASH has defended its claim, reiterated it, and emphasized it to the public.
To remind readers of the claim, here it is:
ASH is publicly claiming, in an effort to promote its agenda, that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
They actually go further than this and warn cities that there is a good chance that nonsmokers may keel over from a heart attack if they are exposed to secondhand smoke in wide-open outdoors places like beaches or parks and that these cities can then be held liable for the heart attack deaths of these nonsmokers:
"In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, ... the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the 'reasonable' step of banning smoking as taken by many other outdoor areas."
In today's response, entitled "Summarizing the Deadly Effects of Secondhand Smoke," ASH lists four major points about the deadly effects of secondhand smoke. The first 3 of these points I have no problem with.
But the fourth point states that "even for some people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker." [emphasis is mine].
ASH goes on to defend its claim by:
The Rest of the Story
In many ways, this action by ASH is even more troubling to me than its initial promulgation of the fallacious claim.
After all, I am the first to admit that one can make mistakes, that one can unintentionally misstate scientific information, that one may not always be careful enough in reviewing scientific claims, and that when one is writing a long document, one may not take the time to verify and confirm every claim that is made.
Had ASH simply apologized for the misleading claim and corrected it, I would have had no problem, the point would have been clarified and fixed, and the story would be over. We could all simply move on.
Unfortunately, ASH instead chose, apparently, to defend and then restate, reiterate, reinforce and re-emphasize its fallacious claim.
Let's look now at ASH's justification for making this obviously false claim:
1. A CDC article suggested that it is possible that 30 minutes of exposure may cause a heart attack in a nonsmoker.
First of all, stating that it is "possible" is a far cry from stating that 30 minutes of exposure increases the risk of a heart attack. It is possible that eating a Big Mac could precipitate a heart attack in someone, but I wouldn't publicly make a claim that eating Big Macs raise one's risk of a heart attack unless I had a little better documentation than that.
Second of all, CDC never stated that the possibility of a heart attack holds for an otherwise healthy nonsmoker.
Third of all, let's completely give ASH the benefit of the doubt here and let's stipulate, for the sake of argument, that CDC has actually stated: "There is solid scientific evidence to support the conclusion that 30 minutes of secondhand smoke exposure significantly raises the risk of a fatal heart attack in an otherwise healthy nonsmoker."
Let me reiterate that CDC did not draw this conclusion, but let's stipulate that they had.
How do you get from that to the public claim that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack in a nonsmoker to that of a smoker? That's a fallacious extrapolation that CDC clearly did not make.
The "evidence" upon which that extrapolation was apparently made was a scientific study showing that 30 minutes of secondhand smoke exposure causes endothelial dysfunction equivalent to that observed in smokers. OK - fine. But you cannot simply replace "endothelial dysfunction" with "fatal heart attack."
As I have attempted to explain (attempt #1; attempt #2), endothelial dysfunction is simply a measure of the early stages of atherosclerosis. What the study means is that 30 minutes of secondhand smoke exposure is enough to initiate some of the early changes seen in the atherosclerotic process. If that exposure were repeated over and over again for many years, it could cause atherosclerosis. Thus, this study provides biologic plausibility for the finding that chronic secondhand smoke exposure causes heart disease. But it in no way implies that 30 minutes of exposure can cause your coronary arteries to go from normal to almost completely clogged. That just can't happen.
As I have also noted, eating a Big Mac or too many tater tots (that is, a high-fat meal) has been shown to cause endothelial dysfunction. But this doesn't mean that an otherwise healthy person could drop dead of a heart attack from eating a Big Mac!
2. A published scientific article which stated that: "The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.
This is accurate. But the rest of the story is that the "effects" that this article is talking about is not a "fatal heart attack," but instead, endothelial dysfunction, platelet aggregation, and other cellular and biochemical changes. You can't take this finding and turn it into a claim that brief passive smoking causes fatal heart attacks.
3. Some newspaper articles.
I would hope that we would be relying on something more definitive and reliable than newspaper articles to support our scientific claims as public health organizations.
While ASH is apparently trying to defend itself by claiming that it is merely reiterating what CDC reported, I find that defense to fail. Mainly because CDC never made a claim that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack among otherwise healthy nonsmokers to that of a smoker.
Now before I close, let me make one thing perfectly clear. I am not suggesting that in any way, ASH is lying or being dishonest. I'm not saying that they don't believe that what they are saying is true. I'm not saying that they are intentionally trying to distort the scientific data. I understand that they seem to have made an errant interpretation of some scientific data. That's fine. It's not dishonest. It's just errant. Perhaps they are simply reporting what they read in the newspaper. That's not dishonest in any way, it's just irresponsible when it comes to reporting scientific conclusions that one could independently confirm and evaluate without relying on the newspaper to interpret the data for you - especially when the scientific claim in question is so obviously ridiculous.
I'm not suggesting that every single piece of information in a newspaper needs to be fact-checked. I readily admit that I don't do that. But I think you need to have some minimum standards by which you at least fact-check, verify, and critically evaluate and analyze information that is so obviously ridiculous, implausible, and unbelievable.
Regardless of the reason, the end result is that ASH is making a fallacious scientific claim. And I'm simply stating my opinion that this is not an advisable practice for public health and tobacco control groups. At very least, it is misleading to the public, who might actually go away thinking that even if they don't have existing heart disease, if they walk down a street and breathe in secondhand smoke for 30 minutes, they are at substantial risk of dropping dead from a heart attack. I think it's irresponsible of a public health organization to be spreading such misinformation. And I think that ultimately, it might harm the scientific credibility and reputation of anti-smoking organizations.
Finally, I could let the whole thing go as just a simple mistake that could be quickly and easily forgotten if ASH had simply clarified, qualified, or corrected its statement. We all make mistakes. Readers of my blog will know that I myself have made some mistakes in reporting - some serious ones - and in that situation I attempted to immediately correct the error, clarify the facts, and apologize.
But instead, ASH has compounded the problem by defending its fallacious claim and in fact, reiterating it and re-emphasizing it to the public.
To remind readers of the claim, here it is:
ASH is publicly claiming, in an effort to promote its agenda, that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
They actually go further than this and warn cities that there is a good chance that nonsmokers may keel over from a heart attack if they are exposed to secondhand smoke in wide-open outdoors places like beaches or parks and that these cities can then be held liable for the heart attack deaths of these nonsmokers:
"In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, ... the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the 'reasonable' step of banning smoking as taken by many other outdoor areas."
In today's response, entitled "Summarizing the Deadly Effects of Secondhand Smoke," ASH lists four major points about the deadly effects of secondhand smoke. The first 3 of these points I have no problem with.
But the fourth point states that "even for some people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker." [emphasis is mine].
ASH goes on to defend its claim by:
- citing the published CDC article, which does itself seem to make a claim that it is possible that a brief exposure to secondhand smoke could cause a heart attack in a nonsmoker;
- citing a published scientific article which stated that: "The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking;” and
- citing 2 newspaper articles.
The Rest of the Story
In many ways, this action by ASH is even more troubling to me than its initial promulgation of the fallacious claim.
After all, I am the first to admit that one can make mistakes, that one can unintentionally misstate scientific information, that one may not always be careful enough in reviewing scientific claims, and that when one is writing a long document, one may not take the time to verify and confirm every claim that is made.
Had ASH simply apologized for the misleading claim and corrected it, I would have had no problem, the point would have been clarified and fixed, and the story would be over. We could all simply move on.
Unfortunately, ASH instead chose, apparently, to defend and then restate, reiterate, reinforce and re-emphasize its fallacious claim.
Let's look now at ASH's justification for making this obviously false claim:
1. A CDC article suggested that it is possible that 30 minutes of exposure may cause a heart attack in a nonsmoker.
First of all, stating that it is "possible" is a far cry from stating that 30 minutes of exposure increases the risk of a heart attack. It is possible that eating a Big Mac could precipitate a heart attack in someone, but I wouldn't publicly make a claim that eating Big Macs raise one's risk of a heart attack unless I had a little better documentation than that.
Second of all, CDC never stated that the possibility of a heart attack holds for an otherwise healthy nonsmoker.
Third of all, let's completely give ASH the benefit of the doubt here and let's stipulate, for the sake of argument, that CDC has actually stated: "There is solid scientific evidence to support the conclusion that 30 minutes of secondhand smoke exposure significantly raises the risk of a fatal heart attack in an otherwise healthy nonsmoker."
Let me reiterate that CDC did not draw this conclusion, but let's stipulate that they had.
How do you get from that to the public claim that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack in a nonsmoker to that of a smoker? That's a fallacious extrapolation that CDC clearly did not make.
The "evidence" upon which that extrapolation was apparently made was a scientific study showing that 30 minutes of secondhand smoke exposure causes endothelial dysfunction equivalent to that observed in smokers. OK - fine. But you cannot simply replace "endothelial dysfunction" with "fatal heart attack."
As I have attempted to explain (attempt #1; attempt #2), endothelial dysfunction is simply a measure of the early stages of atherosclerosis. What the study means is that 30 minutes of secondhand smoke exposure is enough to initiate some of the early changes seen in the atherosclerotic process. If that exposure were repeated over and over again for many years, it could cause atherosclerosis. Thus, this study provides biologic plausibility for the finding that chronic secondhand smoke exposure causes heart disease. But it in no way implies that 30 minutes of exposure can cause your coronary arteries to go from normal to almost completely clogged. That just can't happen.
As I have also noted, eating a Big Mac or too many tater tots (that is, a high-fat meal) has been shown to cause endothelial dysfunction. But this doesn't mean that an otherwise healthy person could drop dead of a heart attack from eating a Big Mac!
2. A published scientific article which stated that: "The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.
This is accurate. But the rest of the story is that the "effects" that this article is talking about is not a "fatal heart attack," but instead, endothelial dysfunction, platelet aggregation, and other cellular and biochemical changes. You can't take this finding and turn it into a claim that brief passive smoking causes fatal heart attacks.
3. Some newspaper articles.
I would hope that we would be relying on something more definitive and reliable than newspaper articles to support our scientific claims as public health organizations.
While ASH is apparently trying to defend itself by claiming that it is merely reiterating what CDC reported, I find that defense to fail. Mainly because CDC never made a claim that 30 minutes of secondhand smoke exposure increases the risk of a fatal heart attack among otherwise healthy nonsmokers to that of a smoker.
Now before I close, let me make one thing perfectly clear. I am not suggesting that in any way, ASH is lying or being dishonest. I'm not saying that they don't believe that what they are saying is true. I'm not saying that they are intentionally trying to distort the scientific data. I understand that they seem to have made an errant interpretation of some scientific data. That's fine. It's not dishonest. It's just errant. Perhaps they are simply reporting what they read in the newspaper. That's not dishonest in any way, it's just irresponsible when it comes to reporting scientific conclusions that one could independently confirm and evaluate without relying on the newspaper to interpret the data for you - especially when the scientific claim in question is so obviously ridiculous.
I'm not suggesting that every single piece of information in a newspaper needs to be fact-checked. I readily admit that I don't do that. But I think you need to have some minimum standards by which you at least fact-check, verify, and critically evaluate and analyze information that is so obviously ridiculous, implausible, and unbelievable.
Regardless of the reason, the end result is that ASH is making a fallacious scientific claim. And I'm simply stating my opinion that this is not an advisable practice for public health and tobacco control groups. At very least, it is misleading to the public, who might actually go away thinking that even if they don't have existing heart disease, if they walk down a street and breathe in secondhand smoke for 30 minutes, they are at substantial risk of dropping dead from a heart attack. I think it's irresponsible of a public health organization to be spreading such misinformation. And I think that ultimately, it might harm the scientific credibility and reputation of anti-smoking organizations.
Finally, I could let the whole thing go as just a simple mistake that could be quickly and easily forgotten if ASH had simply clarified, qualified, or corrected its statement. We all make mistakes. Readers of my blog will know that I myself have made some mistakes in reporting - some serious ones - and in that situation I attempted to immediately correct the error, clarify the facts, and apologize.
But instead, ASH has compounded the problem by defending its fallacious claim and in fact, reiterating it and re-emphasizing it to the public.
Thursday, February 23, 2006
IN MY VIEW: Why ASH's Recent Actions Are an Example of Fanaticism, Rather than Science-Based Advocacy
I have been appropriately challenged by a number of readers to defend my use of the term "fanaticism" to describe the recent actions of Action on Smoking and Health (ASH), which is now pushing for broad bans on smoking in virtually all outdoors places, including in sidewalks, streets, and parking lots, has now publicly boasted that they are going to break down the barriers to banning smoking in the final frontier - the private home, and is promoting policies to fire all smokers from their jobs and to refuse to hire any smoker.
I want to make it clear, up front, that it is not simply the draconian nature of what ASH is promoting - firing all smokers, making it impossible for smokers to get jobs, and banning smoking just about everywhere - that leads me to term what they are doing as being an example of fanaticism, rather than science-based policy advocacy.
Rather, it is the complete lack of critical judgment and the fact that ASH appears to have lost the ability to exercise critical thinking and judgment, and therefore to responsibly act as a public health advocacy group, that leads me to this conclusion.
The Rest of the Story
Fanaticism is not defined as "extreme enthusiasm or zeal." I do not think, and I'm not arguing that ASH is fanatical because they are so zealous that they are supporting policies that would ban smoking just about everywhere and would make it nearly impossible for any smoker to get a job.
Instead, fanaticism is defined as "extreme, uncritical enthusiasm or zeal." So the hallmark of fanaticism is not just excessive zeal, but the lack of careful evaluation and judgment in acting on that enthusiasm.
So let's look at how careful ASH is in its evaluation and judgment in its public campaigns to promote its agenda, which I think it is fair to say is quite zealous.
ASH is publicly claiming, in an effort to promote its agenda, that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
They actually go further than this and warn cities that there is a good chance that nonsmokers may keel over from a heart attack if they are exposed to secondhand smoke in wide-open outdoors places like beaches or parks and that these cities can then be held liable for the heart attack deaths of these nonsmokers:
"In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, ... the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the 'reasonable' step of banning smoking as taken by many other outdoor areas."
So let's get this straight. ASH is supporting its agenda - which is apparently to try to ban smoking almost everywhere - by claiming to the public and policy makers that an otherwise healthy nonsmoker who is exposed to secondhand smoke for just 30 minutes is at risk of a fatal heart attack, and moreover, that their risk is equivalent to that of a smoker.
In science and medicine, we have a technical term that can be used to describe such a contention: a bunch of crap.
This contention is completely fallacious. How often do you walk down a street and see a healthy nonsmoker keel over from a heart attack because they were exposed to smoke for a half hour? Does ASH really believe that a nonsmoker can develop coronary artery disease severe enough to cause a heart attack in 30 minutes?
It actually takes years to develop coronary artery disease, and the risk of an otherwise healthy nonsmoker developing atherosclerosis, stenosis of the coronary arteries, and complete compromise of the coronary circulation such that it precipitates a myocardial infarction in 30 minutes is ZERO.
And it's completely irresponsible to scare nonsmokers, the public, and policy makers into thinking that otherwise healthy people walking down a street and being exposed to secondhand smoke for 30 minutes are going to drop dead of a heart attack.
Even if one were to accept the contention that 30 minutes of exposure to secondhand smoke in an otherwise healthy nonsmoker could, theoretically, have a greater than zero (perhaps a 0.0000000001) chance of causing a heart attack, it is obviously completely fallacious to claim that the risk of that person having a heart attack is the same as that of a smoker, who may have smoked 2 packs a day for 40 years.
Actually, if you think about it, what ASH is really saying could be devastating to anti-smoking efforts and destructively misleading to smokers.
If I were a smoker, and I was told that my risk of a heart attack was equivalent to that of an otherwise healthy nonsmoker exposed to secondhand smoke for 30 minutes, you know what I would do? I'd keep smoking and forget about any significant risk of a heart attack, because I know that the risk of a healthy nonsmoker keeling over after 30 minutes in a bar is basically nil.
So ASH's public claim is not only fallacious, but it is devastatingly misleading to smokers and could well cause them to conclude that they are at essentially minimal risk of a heart attack.
I can't emphasize enough how irresponsible and potentially damaging this public propaganda is that ASH is disseminating to the public and policy makers.
Moreover, ASH has failed to correct its public statement, even though it has been out there for several weeks and they've had plenty of time to more carefully scrutinize their work and make any necessary corrections or clarifications. I'll be the first to admit that sometimes we are just careless and we don't catch our mistakes. But ASH has now had at least 3 1/2 weeks to critically review and check its claims and the fallacious claims are still out there as we speak (as of the writing of this post).
By the way, what the CDC did say, and what the relevant research does say, is that 30 minutes of exposure to secondhand smoke can cause endothelial dysfunction, as measured by coronary flow velocity reserve (CFVR), in nonsmokers to the same degree as seen in smokers (see Otsuka R, Watanabe H, Hirata K, et al. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA 2001; 286:436-441 and Pechacek TF, Babb S. How acute and reversible are the cardiovascular risks of secondhand smoke. BMJ 2004; 328:980-983).
But endothelial dysfunction is a far cry from a heart attack!!!
In fact, what endothelial dysfunction measures is the early process of atherosclerosis. As the authors (Otsuka et al.) concluded: "The present findings suggest that reduction of CFVR after passive smoking may be caused by endothelial dysfunction of the coronary circulation, an early process of atherosclerosis, and that this change may be one reason why passive smoking is a risk factor for cardiac disease morbidity and mortality in nonsmokers."
What this means is that acute exposure to secondhand smoke can result in endothelial dysfunction in nonsmokers that if prolonged and repeated over a long time, could eventually result in atherosclerosis and heart disease.
In other words, this study provides a potential mechanism for the observed increase in heart disease risk among passive smokers. It provides biologic plausibility for a causal relationship between exposure to secondhand smoke and heart disease. But it does not suggest that an otherwise healthy nonsmoker could suffer a heart attack as a result of a 30 minute exposure to secondhand smoke, and it certainly does not mean that a nonsmoker's risk of a heart attack approaches that of a smoker's after 30 minutes of exposure to secondhand smoke.
The only possible acute risk of secondhand smoke exposure in terms of heart attack risk is the slight possibility that in people with existing severe coronary artery disease, the endothelial dysfunction triggered by acute exposure to secondhand smoke might be enough to trigger a coronary event (i.e., a heart attack). There is very little evidence that this is the case, but it is possible, and I would agree with recommending that nonsmokers with coronary artery disease should try to minimize or eliminate their exposure to secondhand smoke.
By the way, eating a single high-fat meal can cause significant endothelial dysfunction. Plotnick et al., writing in the Journal of the American Medical Association, reported that: "A single high-fat meal transiently reduces endothelial function for up to 4 hours in healthy, normocholesterolemic subjects, probably through the accumulation of triglyceride-rich lipoproteins." (see Plotnick GD, Corretti MC, Vogel RA. Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal. JAMA 1997; 278:1682-86).
Is ASH also going to claim that eating a single high-fat meal raises the risk of a heart attack in an otherwise healthy individual? The reasoning is identical. This example shows how meaningless the relevant study is in terms of documenting any acute heart attack risk in healthy individuals. It is simply measuring endothelial dysfunction, which can be caused by eating too many tater tots. It is not measuring acute heart attack risk.
So I think what we have here, apparently, is a group that is so overly zealous and enthusiastic that they have lost any semblance of scientific credibility or critical judgment. They are making a completely fallacious public claim, coupled with a severe litigation threat to cities throughout the country (warning them that nonsmokers may drop dead from heart attacks on a beach because of small amounts of exposure to secondhand smoke and that the city will be held liable because it knew about the risk of this heart attack [I guess thanks to ASH] and failed to act.
This, friends, is uncritical, irrational zeal.
Look - even if ASH had just claimed that nonsmokers could walk down a street, be exposed to secondhand smoke for 30 minutes, and drop dead from a heart attack, you might persuade me that it is an example of being naive or unquestioning. But if you're going to go to the extent of making a public threat to cities throughout the country, trying to scare them into action by making them think that by allowing smoking in a park, they are putting nonsmokers at significant risk of keeling over from heart attacks, I think that has to go beyond just simple lack of questioning.
ASH is intentionally promoting these policies, and they are apparently intentionally using these unfounded, fallacious, and irrational public claims and warnings (i.e., scare tactics) to try to promote their agenda. And they are in what should be the responsible position of a science-based public health advocacy organization.
I won't even begin to go into the extreme hypocrisy of ASH's actions, and the fact that despite yet another overzealous justification for its support of banning smoking everywhere outdoors (to prevent kids from having to see smokers), ASH actually supported and promoted legislation that specifically allows and promotes smoking at outdoors areas of crowded shopping malls!
The rest of the story is that ASH's recent actions are an example not of rational, critical, science-based advocacy, but of extreme uncritical zeal - in other words, of fanaticism.
I want to make it clear, up front, that it is not simply the draconian nature of what ASH is promoting - firing all smokers, making it impossible for smokers to get jobs, and banning smoking just about everywhere - that leads me to term what they are doing as being an example of fanaticism, rather than science-based policy advocacy.
Rather, it is the complete lack of critical judgment and the fact that ASH appears to have lost the ability to exercise critical thinking and judgment, and therefore to responsibly act as a public health advocacy group, that leads me to this conclusion.
The Rest of the Story
Fanaticism is not defined as "extreme enthusiasm or zeal." I do not think, and I'm not arguing that ASH is fanatical because they are so zealous that they are supporting policies that would ban smoking just about everywhere and would make it nearly impossible for any smoker to get a job.
Instead, fanaticism is defined as "extreme, uncritical enthusiasm or zeal." So the hallmark of fanaticism is not just excessive zeal, but the lack of careful evaluation and judgment in acting on that enthusiasm.
So let's look at how careful ASH is in its evaluation and judgment in its public campaigns to promote its agenda, which I think it is fair to say is quite zealous.
ASH is publicly claiming, in an effort to promote its agenda, that: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
They actually go further than this and warn cities that there is a good chance that nonsmokers may keel over from a heart attack if they are exposed to secondhand smoke in wide-open outdoors places like beaches or parks and that these cities can then be held liable for the heart attack deaths of these nonsmokers:
"In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, ... the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the 'reasonable' step of banning smoking as taken by many other outdoor areas."
So let's get this straight. ASH is supporting its agenda - which is apparently to try to ban smoking almost everywhere - by claiming to the public and policy makers that an otherwise healthy nonsmoker who is exposed to secondhand smoke for just 30 minutes is at risk of a fatal heart attack, and moreover, that their risk is equivalent to that of a smoker.
In science and medicine, we have a technical term that can be used to describe such a contention: a bunch of crap.
This contention is completely fallacious. How often do you walk down a street and see a healthy nonsmoker keel over from a heart attack because they were exposed to smoke for a half hour? Does ASH really believe that a nonsmoker can develop coronary artery disease severe enough to cause a heart attack in 30 minutes?
It actually takes years to develop coronary artery disease, and the risk of an otherwise healthy nonsmoker developing atherosclerosis, stenosis of the coronary arteries, and complete compromise of the coronary circulation such that it precipitates a myocardial infarction in 30 minutes is ZERO.
And it's completely irresponsible to scare nonsmokers, the public, and policy makers into thinking that otherwise healthy people walking down a street and being exposed to secondhand smoke for 30 minutes are going to drop dead of a heart attack.
Even if one were to accept the contention that 30 minutes of exposure to secondhand smoke in an otherwise healthy nonsmoker could, theoretically, have a greater than zero (perhaps a 0.0000000001) chance of causing a heart attack, it is obviously completely fallacious to claim that the risk of that person having a heart attack is the same as that of a smoker, who may have smoked 2 packs a day for 40 years.
Actually, if you think about it, what ASH is really saying could be devastating to anti-smoking efforts and destructively misleading to smokers.
If I were a smoker, and I was told that my risk of a heart attack was equivalent to that of an otherwise healthy nonsmoker exposed to secondhand smoke for 30 minutes, you know what I would do? I'd keep smoking and forget about any significant risk of a heart attack, because I know that the risk of a healthy nonsmoker keeling over after 30 minutes in a bar is basically nil.
So ASH's public claim is not only fallacious, but it is devastatingly misleading to smokers and could well cause them to conclude that they are at essentially minimal risk of a heart attack.
I can't emphasize enough how irresponsible and potentially damaging this public propaganda is that ASH is disseminating to the public and policy makers.
Moreover, ASH has failed to correct its public statement, even though it has been out there for several weeks and they've had plenty of time to more carefully scrutinize their work and make any necessary corrections or clarifications. I'll be the first to admit that sometimes we are just careless and we don't catch our mistakes. But ASH has now had at least 3 1/2 weeks to critically review and check its claims and the fallacious claims are still out there as we speak (as of the writing of this post).
By the way, what the CDC did say, and what the relevant research does say, is that 30 minutes of exposure to secondhand smoke can cause endothelial dysfunction, as measured by coronary flow velocity reserve (CFVR), in nonsmokers to the same degree as seen in smokers (see Otsuka R, Watanabe H, Hirata K, et al. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA 2001; 286:436-441 and Pechacek TF, Babb S. How acute and reversible are the cardiovascular risks of secondhand smoke. BMJ 2004; 328:980-983).
But endothelial dysfunction is a far cry from a heart attack!!!
In fact, what endothelial dysfunction measures is the early process of atherosclerosis. As the authors (Otsuka et al.) concluded: "The present findings suggest that reduction of CFVR after passive smoking may be caused by endothelial dysfunction of the coronary circulation, an early process of atherosclerosis, and that this change may be one reason why passive smoking is a risk factor for cardiac disease morbidity and mortality in nonsmokers."
What this means is that acute exposure to secondhand smoke can result in endothelial dysfunction in nonsmokers that if prolonged and repeated over a long time, could eventually result in atherosclerosis and heart disease.
In other words, this study provides a potential mechanism for the observed increase in heart disease risk among passive smokers. It provides biologic plausibility for a causal relationship between exposure to secondhand smoke and heart disease. But it does not suggest that an otherwise healthy nonsmoker could suffer a heart attack as a result of a 30 minute exposure to secondhand smoke, and it certainly does not mean that a nonsmoker's risk of a heart attack approaches that of a smoker's after 30 minutes of exposure to secondhand smoke.
The only possible acute risk of secondhand smoke exposure in terms of heart attack risk is the slight possibility that in people with existing severe coronary artery disease, the endothelial dysfunction triggered by acute exposure to secondhand smoke might be enough to trigger a coronary event (i.e., a heart attack). There is very little evidence that this is the case, but it is possible, and I would agree with recommending that nonsmokers with coronary artery disease should try to minimize or eliminate their exposure to secondhand smoke.
By the way, eating a single high-fat meal can cause significant endothelial dysfunction. Plotnick et al., writing in the Journal of the American Medical Association, reported that: "A single high-fat meal transiently reduces endothelial function for up to 4 hours in healthy, normocholesterolemic subjects, probably through the accumulation of triglyceride-rich lipoproteins." (see Plotnick GD, Corretti MC, Vogel RA. Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal. JAMA 1997; 278:1682-86).
Is ASH also going to claim that eating a single high-fat meal raises the risk of a heart attack in an otherwise healthy individual? The reasoning is identical. This example shows how meaningless the relevant study is in terms of documenting any acute heart attack risk in healthy individuals. It is simply measuring endothelial dysfunction, which can be caused by eating too many tater tots. It is not measuring acute heart attack risk.
So I think what we have here, apparently, is a group that is so overly zealous and enthusiastic that they have lost any semblance of scientific credibility or critical judgment. They are making a completely fallacious public claim, coupled with a severe litigation threat to cities throughout the country (warning them that nonsmokers may drop dead from heart attacks on a beach because of small amounts of exposure to secondhand smoke and that the city will be held liable because it knew about the risk of this heart attack [I guess thanks to ASH] and failed to act.
This, friends, is uncritical, irrational zeal.
Look - even if ASH had just claimed that nonsmokers could walk down a street, be exposed to secondhand smoke for 30 minutes, and drop dead from a heart attack, you might persuade me that it is an example of being naive or unquestioning. But if you're going to go to the extent of making a public threat to cities throughout the country, trying to scare them into action by making them think that by allowing smoking in a park, they are putting nonsmokers at significant risk of keeling over from heart attacks, I think that has to go beyond just simple lack of questioning.
ASH is intentionally promoting these policies, and they are apparently intentionally using these unfounded, fallacious, and irrational public claims and warnings (i.e., scare tactics) to try to promote their agenda. And they are in what should be the responsible position of a science-based public health advocacy organization.
I won't even begin to go into the extreme hypocrisy of ASH's actions, and the fact that despite yet another overzealous justification for its support of banning smoking everywhere outdoors (to prevent kids from having to see smokers), ASH actually supported and promoted legislation that specifically allows and promotes smoking at outdoors areas of crowded shopping malls!
The rest of the story is that ASH's recent actions are an example not of rational, critical, science-based advocacy, but of extreme uncritical zeal - in other words, of fanaticism.
Wednesday, February 22, 2006
Many Anti-Smoking Advocates Don't Want to Hear Any Dissent
I have received quite a negative response from fellow smoke-free air advocates regarding my suggestion that perhaps regulating smoking everywhere outdoors as well as in the private home may be going too far. A number of colleagues have asked me to stop sharing my opinions, even though I am doing it on a list-serve whose purpose is to allow members to share their opinions about various issues.
Here are two recent pleas to me to stop voicing my opinions which were sent directly to me:
"It does neither of us any good for you to send notes like the following [a note questioning whether regulating smoking in the home is going too far] to me. Please stop it."
"Do you really need to have the whole text of this personal opinion delivered into my mailbox, when I have the option of reading it on your blog... . Wouldn't posting it on your blog, or posting a link to the blog, suffice? Mercy! Please!"
These, by the way, are the "nice," "kind," and "respectful" notes I have received. You don't want to see the "mean" ones.
The Rest of the Story
First, allow me to paraphrase these notes so that we can really see what these advocates are saying:
"It does neither of us any good for you to disagree with me. Please stop it."
"Do you really need to post an opinion on this list-serve which disagrees with the dogma of the movement? Can't you just post it on your blog and spare the rest of us from having to deal with any dissenting opinions? Mercy! Please!"
I have to be honest and say that I have never seen people who were so intolerant of dissenting opinions that they expected an individual not to post any opinions on the list-serve that disagreed with their own views.
Essentially, what these individuals are saying is that I should not post any opinions that differ from theirs. Perhaps what I should do is send them my notes before I post them to make sure they agree first. If not, then the note is destroyed.
I would never even think of writing a note to someone on a list-serve asking them to stop stating their opinions, simply because I disagree with them. I can't even fathom that.
But what really strikes me here is the degree to which these colleagues feel that I'm intruding upon them. They are pleading for mercy. My opinions are not just ones they may disagree with, but my expressing them is apparently causing them great pain.
There is a button on a computer called the "Delete" button. A magical thing happens when you press it. The post you are reading disappears and is gone forever. You don't have to read it. No one is holding you down and forcing you to read it.
The fact that these colleagues feel compelled not to simply delete my posts but instead to plead for mercy, asking me to stop expressing my opinions, is mind-boggling to me. But it suggests to me that there is something very bothersome to some in the tobacco control movement about any dissent. It just isn't acceptable, and cannot be tolerated.
There may be a ray of light, however. It is possible that the defensive reaction I am observing is an indication that my commentary is hitting a nerve. In other words, that it is bothering people because deep inside, they realize that there is some truth to it, and it creates dissonance that is difficult to tolerate. If it were truly not resonating at all, it would be easy for these colleagues to simply dismiss my opinions (that's where the "Delete" button would be eminently useful).
I have to acknowledge that given the mentality that I have observed (and been a part of) in the tobacco control movement, it takes a lot to be able to see that perhaps there is some degree of validity in arguments that run counter to the prevailing dogma of the movement. For many years, I simply assumed that everything we were doing was right and that anyone who criticized any aspect of our agenda must be somehow connected to tobacco interests. That is what I had been taught. It took many years, and a fair amount of willingness to actually read and get to know what FORCES was about, for example, for me to understand that FORCES was not a Big Tobacco front group but an organization of individuals representing their own interests.
I also had been led to believe that no dissent was allowed, that it was wrong to criticize anything a tobacco control organization was doing. And it took me a long time to break out of this indoctrination and be able to (and courageous enough) to publicly express my viewpoints. So it is perhaps to be expected that people would be very resistant to hearing the dissent that I am expressing about some aspects of the anti-smoking agenda.
Nevertheless, the rest of the story is quite alarming to me. Even some of my most vehement "enemies" have never suggested that I stop expressing my opinions because my views were causing them undue suffering and they needed mercy. These "enemies" actually looked forward to the opportunity to refute my opinions and show me how and why I was wrong. That seems to be an appropriate response to dissent, and the resulting discussion would I think advance the quality of the movement.
But no. Instead, I'm being asked to simply stop expressing my opinions. Mercy! Please!
Here are two recent pleas to me to stop voicing my opinions which were sent directly to me:
"It does neither of us any good for you to send notes like the following [a note questioning whether regulating smoking in the home is going too far] to me. Please stop it."
"Do you really need to have the whole text of this personal opinion delivered into my mailbox, when I have the option of reading it on your blog... . Wouldn't posting it on your blog, or posting a link to the blog, suffice? Mercy! Please!"
These, by the way, are the "nice," "kind," and "respectful" notes I have received. You don't want to see the "mean" ones.
The Rest of the Story
First, allow me to paraphrase these notes so that we can really see what these advocates are saying:
"It does neither of us any good for you to disagree with me. Please stop it."
"Do you really need to post an opinion on this list-serve which disagrees with the dogma of the movement? Can't you just post it on your blog and spare the rest of us from having to deal with any dissenting opinions? Mercy! Please!"
I have to be honest and say that I have never seen people who were so intolerant of dissenting opinions that they expected an individual not to post any opinions on the list-serve that disagreed with their own views.
Essentially, what these individuals are saying is that I should not post any opinions that differ from theirs. Perhaps what I should do is send them my notes before I post them to make sure they agree first. If not, then the note is destroyed.
I would never even think of writing a note to someone on a list-serve asking them to stop stating their opinions, simply because I disagree with them. I can't even fathom that.
But what really strikes me here is the degree to which these colleagues feel that I'm intruding upon them. They are pleading for mercy. My opinions are not just ones they may disagree with, but my expressing them is apparently causing them great pain.
There is a button on a computer called the "Delete" button. A magical thing happens when you press it. The post you are reading disappears and is gone forever. You don't have to read it. No one is holding you down and forcing you to read it.
The fact that these colleagues feel compelled not to simply delete my posts but instead to plead for mercy, asking me to stop expressing my opinions, is mind-boggling to me. But it suggests to me that there is something very bothersome to some in the tobacco control movement about any dissent. It just isn't acceptable, and cannot be tolerated.
There may be a ray of light, however. It is possible that the defensive reaction I am observing is an indication that my commentary is hitting a nerve. In other words, that it is bothering people because deep inside, they realize that there is some truth to it, and it creates dissonance that is difficult to tolerate. If it were truly not resonating at all, it would be easy for these colleagues to simply dismiss my opinions (that's where the "Delete" button would be eminently useful).
I have to acknowledge that given the mentality that I have observed (and been a part of) in the tobacco control movement, it takes a lot to be able to see that perhaps there is some degree of validity in arguments that run counter to the prevailing dogma of the movement. For many years, I simply assumed that everything we were doing was right and that anyone who criticized any aspect of our agenda must be somehow connected to tobacco interests. That is what I had been taught. It took many years, and a fair amount of willingness to actually read and get to know what FORCES was about, for example, for me to understand that FORCES was not a Big Tobacco front group but an organization of individuals representing their own interests.
I also had been led to believe that no dissent was allowed, that it was wrong to criticize anything a tobacco control organization was doing. And it took me a long time to break out of this indoctrination and be able to (and courageous enough) to publicly express my viewpoints. So it is perhaps to be expected that people would be very resistant to hearing the dissent that I am expressing about some aspects of the anti-smoking agenda.
Nevertheless, the rest of the story is quite alarming to me. Even some of my most vehement "enemies" have never suggested that I stop expressing my opinions because my views were causing them undue suffering and they needed mercy. These "enemies" actually looked forward to the opportunity to refute my opinions and show me how and why I was wrong. That seems to be an appropriate response to dissent, and the resulting discussion would I think advance the quality of the movement.
But no. Instead, I'm being asked to simply stop expressing my opinions. Mercy! Please!
No Holes Barred: Anti-Smoking Group Admits Intent to Promote Regulation of Smoking in the Home
Action on Smoking and Health (ASH) - a D.C.-based anti-smoking group - admitted yesterday that it has every intention of pursuing smoking bans not only in indoor workplaces and everywhere outdoors, but in private homes as well.
In boasting how the organization helped Newsweek re-write a story about smoking bans to emphasize that the trend is not only with respect to workplaces, but also with respect to the outdoors and private homes, ASH stated:
"the Virginia bill was only part of a developing trend -- one to restrict or even ban smoking more broadly, including both outdoors and in private homes. As the article now reports: "Some cities are even addressing outdoor smoking. Lawmakers in Calabasas, Calif., last week banned it on streets and sidewalks and in parking lots and restaurant patios. Instead, smokers will use small 'smokers' outposts.' In 18 states, smoking can be raised in child-custody disputes. 'Here we are literally reaching into the last frontier - —right into the home,' says [the] executive director of the antismoking group Action on Smoking and Health. No longer can you argue, 'My home is my castle. I've got the right to smoke'."
The Rest of the Story
I don't think ASH has done any favors to the effort to protect people from secondhand smoke by helping Newsweek re-write its story to emphasize that smokefree efforts are aimed not only at evidence-based efforts to protect workers from the hazards of secondhand smoke, but also at completely non-evidence-based fanaticism.
I don't think that gives smokefree advocates a good name; it hurts our reputation and seriously threatens our credibility. It also makes it clear (incorrectly I hope) that smokefree advocates have absolutely no regard for individual privacy. It casts us as back-door prohibitionists who are too timid to actually propose eliminating the production and sale of tobacco products, but who are trying to prohibit its use anyway by basically banning its use anywhere.
The sanctity and privacy of the home and of the great outdoors was previously what allowed advocates like me to make it clear to people that I knew where to draw the line and that this smokefree movement was not simply a fanatical effort to achieve a de facto prohibition of tobacco use. By emphasizing that we had no intention of regulating smoking in private homes or in all outdoor places, we retained credibility as being advocates who were promoting science-based policy and who had some respect for privacy and individual autonomy.
But ASH has now publicly destroyed that by giving the public the impression that the ultimate aim of the smokefree movement is to try to ban smoking everywhere, even in private homes.
By boasting that smokefree advocates are trying to reach "right into the home," ASH has, I believe, taken an action that is going to contribute towards destroying the credibility of even legitimate efforts to provide workers with a safe, smoke-free workplace.
ASH needs to be checked, and quickly, before it succeeds in completely destroying the credibility of smokefree efforts. And the only way to do that is for smokefree organizations to speak out and make it clear that ASH does not speak for them. They must make it clear that this is a science-based movement and that it is a movement that does respect the privacy of the home.
Unfortunately, my experience makes it clear that tobacco control organizations are unwilling to criticize any anti-smoking group, regardless of how improper is the action they are taking. I doubt any group will say anything. That's unfortunate, because it is going to hurt the smokefree movement, including the work of those organizations that have not crossed the line into outright fanaticism.
In boasting how the organization helped Newsweek re-write a story about smoking bans to emphasize that the trend is not only with respect to workplaces, but also with respect to the outdoors and private homes, ASH stated:
"the Virginia bill was only part of a developing trend -- one to restrict or even ban smoking more broadly, including both outdoors and in private homes. As the article now reports: "Some cities are even addressing outdoor smoking. Lawmakers in Calabasas, Calif., last week banned it on streets and sidewalks and in parking lots and restaurant patios. Instead, smokers will use small 'smokers' outposts.' In 18 states, smoking can be raised in child-custody disputes. 'Here we are literally reaching into the last frontier - —right into the home,' says [the] executive director of the antismoking group Action on Smoking and Health. No longer can you argue, 'My home is my castle. I've got the right to smoke'."
The Rest of the Story
I don't think ASH has done any favors to the effort to protect people from secondhand smoke by helping Newsweek re-write its story to emphasize that smokefree efforts are aimed not only at evidence-based efforts to protect workers from the hazards of secondhand smoke, but also at completely non-evidence-based fanaticism.
I don't think that gives smokefree advocates a good name; it hurts our reputation and seriously threatens our credibility. It also makes it clear (incorrectly I hope) that smokefree advocates have absolutely no regard for individual privacy. It casts us as back-door prohibitionists who are too timid to actually propose eliminating the production and sale of tobacco products, but who are trying to prohibit its use anyway by basically banning its use anywhere.
The sanctity and privacy of the home and of the great outdoors was previously what allowed advocates like me to make it clear to people that I knew where to draw the line and that this smokefree movement was not simply a fanatical effort to achieve a de facto prohibition of tobacco use. By emphasizing that we had no intention of regulating smoking in private homes or in all outdoor places, we retained credibility as being advocates who were promoting science-based policy and who had some respect for privacy and individual autonomy.
But ASH has now publicly destroyed that by giving the public the impression that the ultimate aim of the smokefree movement is to try to ban smoking everywhere, even in private homes.
By boasting that smokefree advocates are trying to reach "right into the home," ASH has, I believe, taken an action that is going to contribute towards destroying the credibility of even legitimate efforts to provide workers with a safe, smoke-free workplace.
ASH needs to be checked, and quickly, before it succeeds in completely destroying the credibility of smokefree efforts. And the only way to do that is for smokefree organizations to speak out and make it clear that ASH does not speak for them. They must make it clear that this is a science-based movement and that it is a movement that does respect the privacy of the home.
Unfortunately, my experience makes it clear that tobacco control organizations are unwilling to criticize any anti-smoking group, regardless of how improper is the action they are taking. I doubt any group will say anything. That's unfortunate, because it is going to hurt the smokefree movement, including the work of those organizations that have not crossed the line into outright fanaticism.
Tuesday, February 21, 2006
Anti-Smoking Hypocrisy Awards - February 2006
A new monthly feature of The Rest of the Story will be awards that will be given out for the best examples of hypocrisy in the anti-smoking movement. This month's winners are:
#5 - Ignite (Tobacco-Free Kids, Jr.)
Making a respectable fifth-placed finish in the first edition of the anti-smoking hypocrisy awards is a new anti-smoking organization run by youths and young people that I have nicknamed "Tobacco-Free Kids, Jr.," since the group is obviously heavily influenced by the Campaign for Tobacco-Free Kids and has received funding to start the group from this organization, as well as training and hands-on lobbying experience.
Ignite views the tobacco companies as terrorists and specifically defends its characterization of these companies in that way. According to Ignite: "Terrorists killed approximately 3,000 people in the U.S. on September 11, 2001. Those attacks were horrific. Tobacco is responsible for more than 3,000 people dying every three days. This is also horrific. Because Big Tobacco targets youth to use tobacco products through marketing campaigns, and because tobacco products are chemically addictive, people who die due to tobacco-related deaths do not die by choice, just as those who died in the September 11 attacks did not die by choice. ... To those who may be offended by the comparison: we're offended too. How dare our public officials allow an industry to cause over 400,000 U.S. deaths each year!"
Ignite also feels that there is no excuse for tobacco companies to have any influence on the policy-making process, and that public policies should be made solely on the basis of public health needs, not politics influenced by tobacco industry campaign donations: "The tobacco industry is just not accountable to the public. Citizens cannot force tobacco companies to change ... But our public officials do hold this power. They have the responsibility of protecting public health and regulating businesses, specifically, to ensure they do not harm consumers. ... Why does Big Tobacco get special treatment from our government? It shouldn't. ... It's time for members of Congress to stop giving tobacco companies special protection. We call on our public officials to step up to the plate."
However, despite its view of tobacco companies as being terrorists and despite its contention that Big Tobacco should get no special treatment from our government, Ignite is supporting FDA legislation that was prepared in order to appease Philip Morris' concerns, that contains most of the major provisions that Philip Morris deemed essential to include in the bill, that was negotiated with Philip Morris, and which contains numerous loopholes designed to protect the financial interests of Philip Morris.
These loopholes in the bill ensure that any major regulatory decisions made by the FDA will be subject to political influence, rather than made based on public health considerations.
If Ignite truly believes that Big Tobacco should not get "special treatment from our government," then they most certainly would agree that there is no reason why Big Tobacco should enjoy a huge number of special protections that manufacturers of drugs currently regulated by FDA do not enjoy, including ensuring that politics, and not science and public health, is the ultimate arbiter of the regulation of this deadly product.
#4 - Campaign for Tobacco-Free Kids (Sr.)
The Campaign for Tobacco-Free Kids comes in just slightly ahead of Ignite, its "daughter" organization, for the same reasons. According to the Campaign for Tobacco-Free Kids' web site, it believes that "special protection" for the tobacco companies should be ended. If the Campaign were really serious about ending special protections for Big Tobacco and providing for the regulation of tobacco products in the same way that other drugs are regulated by FDA, as it claims, then it would certainly have demanded that the special protections for Big Tobacco contained in the proposed legislation be eliminated. Despite numerous opportunities, the Campaign has refused to demand the elimination of the special protections for Big Tobacco contained in the bill solely for political reasons. The Campaign places slightly ahead of The Campaign, Jr., because it is an experienced adult-run organization and has less of an excuse for this hypocrisy.
#3 - Americans for Nonsmokers' Rights (ANR)
In action alerts released just one month apart, ANR first emphasized the need to include protection for all casino workers from secondhand smoke in the New Jersey smoking legislation and then conveniently forgot to mention that casino workers existed after the legislature sent forward a bill that exempted casinos from regulation.
In its December 7 action alert, ANR emphasized to its constituents how important it was to protect all workers from secondhand smoke, and therefore urged them to write New Jersey elected officials in support of a 100% smoke-free workplace law that would cover all casinos in the state. ANR emphasized the need to include casinos in this legislation, apparently anticipating political efforts to exempt the casinos:
"Senate Bill 1926 would protect all New Jersey workers from secondhand smoke by making all indoor public places and workplaces smokefree, including restaurants, bars, and casinos. ...Contact Acting Governor and Senate President Richard Codey, who has expressed support for a smokefree law, but prefers to exclude casinos. Let him know that you support a strong 100% smokefree law that includes casinos and will protect all workers, patrons, and visitors in New Jersey. ... If bars or casinos are exempted from the law, employees and guests in these workplaces will still have to breathe the toxic, smoke-filled air. Smokefree air is good for health and good for business, including casinos."
On January 5, ANR issued an action alert which claimed that Senate Bill 1926, which had been amended to exempt casinos, would protect all workers from secondhand smoke, but it left off the word "casinos" that had been included in the December action alert. It also omitted any reference to the need to protect casino workers and the fact that employees and guests in these workplaces would still have to breathe the "toxic," smoke-filled air:
"Today, New Jersey took one step closer to becoming a smokefree state! The New Jersey Assembly Health Committee voted 10-1 to pass Senate Bill 1926, which would make all workplaces, including restaurants and bars, 100% smokefree throughout the state."
ANR's massive deception in ignoring the 48,000 casino workers and suggesting to its constituents, incorrectly, that the bill protected all workers, and for expressing and then conveniently dropping its emphasis on the fact that "If bars or casinos are exempted from the law, employees and guests in these workplaces will still have to breathe the toxic, smoke-filled air. Smokefree air is good for health and good for business, including casinos," ANR is awarded a solid 3rd place finish in the inaugural anti-smoking hypocrisy awards.
#2 - American Legacy Foundation
According to the American Legacy Foundation, which reports to be trying to "build a world where young people reject tobacco and anyone can quit," the Foundation is concerned about tobacco industry methods "of attracting new smokers" because this "will undermine the significant achievements the public health community has made in reducing smoking rates among young people."
Legacy also specifically bemoans the fact that "teens are still exposed to tobacco ads nearly as often as young adults are, and awareness levels among all groups are still considerable" and concludes that "Given the strong, accumulated evidence documenting the effect of cigarette advertising on youth smoking behavior, these data are cause for concern. ... Our results highlight the inadequacy of current advertising restrictions to protect youth from persuasive messages that may cause them to experiment with cigarette smoking. ... these findings warrant a heightened level of vigilance over the channels through which the tobacco industry targets teens and young adults."
One of the major methods by which "the tobacco industry targets teens and young adults" is through advertising in magazines with high numbers of youth and young adult readers. And some of the most important magazines which carry those ads to youths and young adults are Sports Illustrated, Popular Mechanics, Esquire, and Cosmopolitan.
These magazines are published by Time Inc. and by the Hearst Corporation.
The American Legacy Foundation takes 2nd place in the anti-smoking hypocrisy awards because it has established a series of corporate partnerships with Time Inc. and the Hearst Corporation, which it claims are "standing as leaders in this important movement."
As I asked earlier: How can Legacy on the one hand, partner with an organization that is teaching girls how to be bold and resist tobacco advertising and on the other hand, partner with an organization that is carrying messages to teach girls that smoking Kool cigarettes is the way to "Be Bold and Be True" that smoking Kools is the way to "Be Authentic and Be True" and that smoking Camels is jazzy, sexy, glamorous, and fashionable?
I don't know how it can, but because it did, it takes 2nd place.
1. Action on Smoking and Health (ASH)
I think that any organization bold enough to publicly claim that 30 minutes of exposure to even small levels of secondhand smoke can cause a heart attack in an otherwise healthy nonsmoker and not only can cause a heart attack but raises the risk of a heart attack to that of a smoker, and which then goes on to support a law that allows smoking at crowded shopping malls, deserves a first place finish - hands down.
Congratulations to ASH on its first-place finish in the inaugural anti-smoking hypocrisy awards for February 2006!
#5 - Ignite (Tobacco-Free Kids, Jr.)
Making a respectable fifth-placed finish in the first edition of the anti-smoking hypocrisy awards is a new anti-smoking organization run by youths and young people that I have nicknamed "Tobacco-Free Kids, Jr.," since the group is obviously heavily influenced by the Campaign for Tobacco-Free Kids and has received funding to start the group from this organization, as well as training and hands-on lobbying experience.
Ignite views the tobacco companies as terrorists and specifically defends its characterization of these companies in that way. According to Ignite: "Terrorists killed approximately 3,000 people in the U.S. on September 11, 2001. Those attacks were horrific. Tobacco is responsible for more than 3,000 people dying every three days. This is also horrific. Because Big Tobacco targets youth to use tobacco products through marketing campaigns, and because tobacco products are chemically addictive, people who die due to tobacco-related deaths do not die by choice, just as those who died in the September 11 attacks did not die by choice. ... To those who may be offended by the comparison: we're offended too. How dare our public officials allow an industry to cause over 400,000 U.S. deaths each year!"
Ignite also feels that there is no excuse for tobacco companies to have any influence on the policy-making process, and that public policies should be made solely on the basis of public health needs, not politics influenced by tobacco industry campaign donations: "The tobacco industry is just not accountable to the public. Citizens cannot force tobacco companies to change ... But our public officials do hold this power. They have the responsibility of protecting public health and regulating businesses, specifically, to ensure they do not harm consumers. ... Why does Big Tobacco get special treatment from our government? It shouldn't. ... It's time for members of Congress to stop giving tobacco companies special protection. We call on our public officials to step up to the plate."
However, despite its view of tobacco companies as being terrorists and despite its contention that Big Tobacco should get no special treatment from our government, Ignite is supporting FDA legislation that was prepared in order to appease Philip Morris' concerns, that contains most of the major provisions that Philip Morris deemed essential to include in the bill, that was negotiated with Philip Morris, and which contains numerous loopholes designed to protect the financial interests of Philip Morris.
These loopholes in the bill ensure that any major regulatory decisions made by the FDA will be subject to political influence, rather than made based on public health considerations.
If Ignite truly believes that Big Tobacco should not get "special treatment from our government," then they most certainly would agree that there is no reason why Big Tobacco should enjoy a huge number of special protections that manufacturers of drugs currently regulated by FDA do not enjoy, including ensuring that politics, and not science and public health, is the ultimate arbiter of the regulation of this deadly product.
#4 - Campaign for Tobacco-Free Kids (Sr.)
The Campaign for Tobacco-Free Kids comes in just slightly ahead of Ignite, its "daughter" organization, for the same reasons. According to the Campaign for Tobacco-Free Kids' web site, it believes that "special protection" for the tobacco companies should be ended. If the Campaign were really serious about ending special protections for Big Tobacco and providing for the regulation of tobacco products in the same way that other drugs are regulated by FDA, as it claims, then it would certainly have demanded that the special protections for Big Tobacco contained in the proposed legislation be eliminated. Despite numerous opportunities, the Campaign has refused to demand the elimination of the special protections for Big Tobacco contained in the bill solely for political reasons. The Campaign places slightly ahead of The Campaign, Jr., because it is an experienced adult-run organization and has less of an excuse for this hypocrisy.
#3 - Americans for Nonsmokers' Rights (ANR)
In action alerts released just one month apart, ANR first emphasized the need to include protection for all casino workers from secondhand smoke in the New Jersey smoking legislation and then conveniently forgot to mention that casino workers existed after the legislature sent forward a bill that exempted casinos from regulation.
In its December 7 action alert, ANR emphasized to its constituents how important it was to protect all workers from secondhand smoke, and therefore urged them to write New Jersey elected officials in support of a 100% smoke-free workplace law that would cover all casinos in the state. ANR emphasized the need to include casinos in this legislation, apparently anticipating political efforts to exempt the casinos:
"Senate Bill 1926 would protect all New Jersey workers from secondhand smoke by making all indoor public places and workplaces smokefree, including restaurants, bars, and casinos. ...Contact Acting Governor and Senate President Richard Codey, who has expressed support for a smokefree law, but prefers to exclude casinos. Let him know that you support a strong 100% smokefree law that includes casinos and will protect all workers, patrons, and visitors in New Jersey. ... If bars or casinos are exempted from the law, employees and guests in these workplaces will still have to breathe the toxic, smoke-filled air. Smokefree air is good for health and good for business, including casinos."
On January 5, ANR issued an action alert which claimed that Senate Bill 1926, which had been amended to exempt casinos, would protect all workers from secondhand smoke, but it left off the word "casinos" that had been included in the December action alert. It also omitted any reference to the need to protect casino workers and the fact that employees and guests in these workplaces would still have to breathe the "toxic," smoke-filled air:
"Today, New Jersey took one step closer to becoming a smokefree state! The New Jersey Assembly Health Committee voted 10-1 to pass Senate Bill 1926, which would make all workplaces, including restaurants and bars, 100% smokefree throughout the state."
ANR's massive deception in ignoring the 48,000 casino workers and suggesting to its constituents, incorrectly, that the bill protected all workers, and for expressing and then conveniently dropping its emphasis on the fact that "If bars or casinos are exempted from the law, employees and guests in these workplaces will still have to breathe the toxic, smoke-filled air. Smokefree air is good for health and good for business, including casinos," ANR is awarded a solid 3rd place finish in the inaugural anti-smoking hypocrisy awards.
#2 - American Legacy Foundation
According to the American Legacy Foundation, which reports to be trying to "build a world where young people reject tobacco and anyone can quit," the Foundation is concerned about tobacco industry methods "of attracting new smokers" because this "will undermine the significant achievements the public health community has made in reducing smoking rates among young people."
Legacy also specifically bemoans the fact that "teens are still exposed to tobacco ads nearly as often as young adults are, and awareness levels among all groups are still considerable" and concludes that "Given the strong, accumulated evidence documenting the effect of cigarette advertising on youth smoking behavior, these data are cause for concern. ... Our results highlight the inadequacy of current advertising restrictions to protect youth from persuasive messages that may cause them to experiment with cigarette smoking. ... these findings warrant a heightened level of vigilance over the channels through which the tobacco industry targets teens and young adults."
One of the major methods by which "the tobacco industry targets teens and young adults" is through advertising in magazines with high numbers of youth and young adult readers. And some of the most important magazines which carry those ads to youths and young adults are Sports Illustrated, Popular Mechanics, Esquire, and Cosmopolitan.
These magazines are published by Time Inc. and by the Hearst Corporation.
The American Legacy Foundation takes 2nd place in the anti-smoking hypocrisy awards because it has established a series of corporate partnerships with Time Inc. and the Hearst Corporation, which it claims are "standing as leaders in this important movement."
As I asked earlier: How can Legacy on the one hand, partner with an organization that is teaching girls how to be bold and resist tobacco advertising and on the other hand, partner with an organization that is carrying messages to teach girls that smoking Kool cigarettes is the way to "Be Bold and Be True" that smoking Kools is the way to "Be Authentic and Be True" and that smoking Camels is jazzy, sexy, glamorous, and fashionable?
I don't know how it can, but because it did, it takes 2nd place.
1. Action on Smoking and Health (ASH)
I think that any organization bold enough to publicly claim that 30 minutes of exposure to even small levels of secondhand smoke can cause a heart attack in an otherwise healthy nonsmoker and not only can cause a heart attack but raises the risk of a heart attack to that of a smoker, and which then goes on to support a law that allows smoking at crowded shopping malls, deserves a first place finish - hands down.
Congratulations to ASH on its first-place finish in the inaugural anti-smoking hypocrisy awards for February 2006!
Hypocrisy in the Anti-Smoking Movement
In response published last Thursday to a Los Angeles Times editorial which questioned whether the Calabasas outdoors smoking ban was going too far, Action on Smoking and Health, a D.C.-based anti-smoking group, stated: "You ... ignore evidence showing that an asthmatic attack can be triggered by even a tiny amount of smoke, and the long-standing policy of protecting citizens from any unnecessary involuntary exposure to cancer-causing substances."
According to ASH: "even the small amounts of tobacco smoke hovering over a sidewalk CAN be enough to trigger an asthmatic attack in those who are particularly susceptible -– and almost 100 million Americans have chronic medical conditions which make them particularly susceptible to tobacco smoke."
Also according to ASH: "no person should be involuntarily and unnecessarily exposed to any level, however low, of known cancer-causing substances which is why the public is shielded from inhaling even minute amounts of asbestos dust as they walk by a building being renovated."
And, according to - again - ASH: "breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
In addition, ASH has warned cities that: "In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, asthmatic attack, or other similar problems, the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the '“reasonable'” step of banning smoking as taken by many other outdoor areas."
And, to make sure there is no misunderstanding about this, ASH also emphasizes that "people have a right not to be involuntarily exposed to known carcinogenic substances, even if only to small amounts and for brief periods."
Moreover, if the health effects of even minute amounts of secondhand smoke were not enough: "Discarded cigarette butts may also be harmful to birds and other wildlife which nibble on or even swallow them, especially on a beach or park, but also even on a public sidewalk."
And, for those who aren't particularly concerned about the health damages suffered by pigeons: "prohibiting smoking in outdoor places frequented by the public -– like parks, playgrounds, beaches, etc. -– shields young children from seeing smoking as a common adult behavior to be emulated, even if some may observe smoking by the parents and other adults in private homes."
The Rest of the Story
Despite all of these admonitions about the extreme dangers to humans - adults and especially children - and pigeons of even tiny levels of exposure to secondhand smoke and despite ASH's contention that no person should be unnecessarily exposed to ANY amount of secondhand smoke for ANY amount of time, ASH supported and has boasted about the great sense of a smoking law that....
.... allows smoking in outdoors designated smoking areas at crowded shopping malls, with tons of youths running around.
Not only did ASH support the Calabasas ordinance, which did just that, but it also ignored or dismissed the existence of this "loophole" in the law, which is most certainly going to result in more than minute levels of exposure to secondhand smoke among visitors to the Calabasas Commons - which is itself an open-air shopping complex - and other Calabasas shopping malls.
According to ASH's own arguments, we can now expect people to be dropping dead of heart attacks at the Calabasas Commons, since the smoke emanating from the smoking outposts at this mall, heavily frequented by young people, is apparently going to increase the risk of heart attacks among its visitors to that of smokers.
In fact, it would probably be wise for the city to build an emergency medical facility right next to the smoking outpost, since according to ASH, we can expect there to be numerous asthma attacks and heart attacks triggered by exposure to the secondhand smoke in this crowded place, with swarms of nonsmokers all over the place.
If we believe ASH's rhetoric, people are going to be dropping like flies at the Calabasas Commons. If I were a opportunistic mortician, I might see if there is any available space for lease right at the Commons. Wouldn't it be nice for the families of the affected heart attack victims to be able to do "one-stop shopping?"
This level of hypocrisy is just too much to take. So I decided that I'm not going to take it any more. Instead, I'm going to reward it!
Each month, I will offer my anti-smoking hypocrisy awards of the month. You can check out the first series of awards here. Unfortunately, there is heavy competition out there, and I'm going to have to make some very difficult choices. But I'll save you some suspense: ASH is right at the top of the list.
According to ASH: "even the small amounts of tobacco smoke hovering over a sidewalk CAN be enough to trigger an asthmatic attack in those who are particularly susceptible -– and almost 100 million Americans have chronic medical conditions which make them particularly susceptible to tobacco smoke."
Also according to ASH: "no person should be involuntarily and unnecessarily exposed to any level, however low, of known cancer-causing substances which is why the public is shielded from inhaling even minute amounts of asbestos dust as they walk by a building being renovated."
And, according to - again - ASH: "breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker'’s risk of suffering a fatal heart attack to that of a smoker."
In addition, ASH has warned cities that: "In cases where drifting tobacco smoke was present and a nonsmoker suffered a heart attack, asthmatic attack, or other similar problems, the municipality which owns and operates the beach, park, playground, etc. could be liable since it was on notice of the known health dangers but failed to take the '“reasonable'” step of banning smoking as taken by many other outdoor areas."
And, to make sure there is no misunderstanding about this, ASH also emphasizes that "people have a right not to be involuntarily exposed to known carcinogenic substances, even if only to small amounts and for brief periods."
Moreover, if the health effects of even minute amounts of secondhand smoke were not enough: "Discarded cigarette butts may also be harmful to birds and other wildlife which nibble on or even swallow them, especially on a beach or park, but also even on a public sidewalk."
And, for those who aren't particularly concerned about the health damages suffered by pigeons: "prohibiting smoking in outdoor places frequented by the public -– like parks, playgrounds, beaches, etc. -– shields young children from seeing smoking as a common adult behavior to be emulated, even if some may observe smoking by the parents and other adults in private homes."
The Rest of the Story
Despite all of these admonitions about the extreme dangers to humans - adults and especially children - and pigeons of even tiny levels of exposure to secondhand smoke and despite ASH's contention that no person should be unnecessarily exposed to ANY amount of secondhand smoke for ANY amount of time, ASH supported and has boasted about the great sense of a smoking law that....
.... allows smoking in outdoors designated smoking areas at crowded shopping malls, with tons of youths running around.
Not only did ASH support the Calabasas ordinance, which did just that, but it also ignored or dismissed the existence of this "loophole" in the law, which is most certainly going to result in more than minute levels of exposure to secondhand smoke among visitors to the Calabasas Commons - which is itself an open-air shopping complex - and other Calabasas shopping malls.
According to ASH's own arguments, we can now expect people to be dropping dead of heart attacks at the Calabasas Commons, since the smoke emanating from the smoking outposts at this mall, heavily frequented by young people, is apparently going to increase the risk of heart attacks among its visitors to that of smokers.
In fact, it would probably be wise for the city to build an emergency medical facility right next to the smoking outpost, since according to ASH, we can expect there to be numerous asthma attacks and heart attacks triggered by exposure to the secondhand smoke in this crowded place, with swarms of nonsmokers all over the place.
If we believe ASH's rhetoric, people are going to be dropping like flies at the Calabasas Commons. If I were a opportunistic mortician, I might see if there is any available space for lease right at the Commons. Wouldn't it be nice for the families of the affected heart attack victims to be able to do "one-stop shopping?"
This level of hypocrisy is just too much to take. So I decided that I'm not going to take it any more. Instead, I'm going to reward it!
Each month, I will offer my anti-smoking hypocrisy awards of the month. You can check out the first series of awards here. Unfortunately, there is heavy competition out there, and I'm going to have to make some very difficult choices. But I'll save you some suspense: ASH is right at the top of the list.