Saturday, April 22, 2006

ACSH Commentary Suggests Anti-Smoking Movement has Gone Off the Deep End

A commentary published yesterday by Dr. Elizabeth Whelan, founder and president of the American Council on Science and Health, suggests that the anti-smoking movement has gone over the deep end in overstating the acute health effects of secondhand smoke in order to promote smoking bans, and in silencing any suggestion that use of smokeless tobacco may be less hazardous than smoking.

In the commentary, entitled "The Intolerance and Arrogance of the Modern-Day Anti-Smoking Movement," Dr. Whelan suggests that the anti-smoking movement has become "increasingly unscientific, arrogant, absolutist, and intolerant of dissenting views."

According to the commentary: "Cigarette smoking is the leading preventable cause of premature death, accounting for approximately 400,000 deaths annually in the U.S. -- nearly one in every four deaths, and one in every two premature deaths each year. But we at ACSH hold to the belief that the best way to lose an argument is to overstate it. And overstatement is exactly what a growing number of members of the anti-smoking community are doing. Indeed, anti-smokers are becoming increasingly unscientific, arrogant, absolutist, and intolerant of dissenting views."

Two examples are cited to support this contention. First is the way that the movement has treated dissent to the dogma that we cannot suggest that smokeless tobacco is less hazardous than cigarette smoking. Apparently, ACSH hosted a conference on harm reduction strategies and "Despite ACSH's attempt at balance, veteran members of the anti-smoking community were irate that ACSH was hosting such a meeting, and one anti-smoking leader called ACSH to announce that I would be 'excommunicated' from the anti-smoking movement if I moved forward with this event. (ACSH did move forward, so I guess I am out.)"

The second example is the exaggerated claims being made about the acute cardiovascular effects of secondhand smoke:

A few egregious examples: a leading tobacco researcher made the improbable claim that the smoking ban in Helena, Montana resulted in a 40% decline in heart attack admissions in a six-month period after the ban. 'We used to think that heart disease came after years of exposure' said Dr. Richard Sargent, an anti-smoking Montana physician, who then went on to argue that even short-term exposure to exhaled smoke can damage the heart: 'if you go into a restaurant for a sandwich, if you go into a bar for a beer, and you get exposed to a heavy amount of secondhand smoke, you're just as at risk for a heart attack as a smoker.'"

Finally, Dr. Whelan points out how the anti-smoking movement treats any dissent to its established dogma, even when that dogma flies in the face of common sense and scientific fact: "Funny thing about communication in science and medicine. When a politically correct theory or claim takes hold and is loudly trumpeted (as in 'secondhand smoke, even in trace amounts, kills'), dissenters are terrified to step forward and challenge that theory lest (a) they be called apologists for, in this case, the cigarette industry or (b) they be accused of not getting on the bandwagon of what is an inherently good public health cause.

The Rest of the Story

I think that Dr. Whelan and ACSH are to be congratulated for coming forward and having the courage to tell it like it is, even though the anti-smoking movement will likely respond to this dissent by attacking the organization and accusing it of being cigarette industry apologists.

The last laugh will be ACSH's however, as the organization is, and has been, one of the strongest and most consistent voices speaking out against the tobacco industry.

At a time when many of the national tobacco control organizations - including the Campaign for Tobacco-Free Kids, American Cancer Society, and American Heart Association - attempted to bail out Big Tobacco from its legal woes by providing it with immunity for its wrongdoing, in exchange for billion of dollars, ACSH refused to be enticed by this buy-out offer and remained steadfast in its principles, publicly opposing the global tobacco settlement (or "global tobacco bailout" as some have called it).

In this battle between public health versus politics and money, our Campaign for Tobacco-Free Kids chose politics and money, while it was ACSH that stood up for the rights of American citizens and chose the side of public health.

At a time when nearly the rest of the anti-smoking movement was silent in the face of the American Legacy Foundation's stupid and harmful decision to honor the nation's leading publisher of cigarette advertisements seen by children, ACSH had the courage to criticize this action, even though the organization itself had a grant from Legacy. In contrast, nearly every other anti-smoking group was silent, most likely because of the fear that they might jeopardize their own funding if they criticized Legacy.

At a time when the Campaign for Tobacco-Free Kids supported the Master Settlement Agreement, which I view as the worst public health blunder of my lifetime, ACSH was again one of the few anti-smoking organizations to oppose this purely politically- and financially-motivated deal.

And now, when the Campaign for Tobacco-Free Kids and a host of other public health organizations are supporting FDA tobacco legislation that would provide Big Tobacco with virtual immunity in return for regulation of tobacco products in name-only (but not in a way that would produce any real public health benefit), ACSH stands nearly alone in the tobacco control movement in opposing this proposed policy.

So while ACSH might predictably take some hits from within the tobacco control community for suggesting that the movement is increasingly unscientific and intolerant (in other words, for calling a spade a spade), the ultimate irony is that ACSH has been a far more principled supporter of effective tobacco control policy than the Campaign for Tobacco-Free Kids, American Cancer Society, American Heart Association, American Lung Association, and American Legacy Foundation.

It is also interesting to note that the response I have received from the anti-smoking movement to expressing an opinion that differs from the established dogma is not unique. I am not the only one who has apparently been "ex-communicated" from the movement for expressing dissent. Perhaps we are on our way to establishing an "ex-communicated tobacco control movement."

The example that Dr. Whelan provides of the overstating the acute cardiovascular effects of secondhand smoke is particularly compelling. How could someone without severe existing heart disease be at the same risk of a heart attack as a smoker from having a sandwich in a smoky restaurant? How could the person be at any risk of a heart attack if they don't have pre-existing coronary artery disease? It's medically impossible for an acute exposure to secondhand smoke to cause a heart attack in a healthy person unless it causes coronary spasm, and there's no evidence for that.

The rest of the story is that ACSH is one of the only national tobacco control organizations I am aware of in the United States which is willing to publicly stand up for basic principles of public health practice in tobacco control. And here, ACSH has told it like it is: the anti-smoking movement is becoming increasingly unscientific, absolutist, and intolerant of dissenting views.

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