Tuesday, May 30, 2006

Rest of the Story Author Thrown Off of List-Serve; Censorship Alive in Anti-Smoking Movement, But Little Room for the Truth

In a startling turn of events, a 21-year veteran of the tobacco wars, who has published more than 50 peer-reviewed articles in leading scientific journals on tobacco science and policy issues, testified more than 10 times in tobacco cases, serves as a statistical editor for one of the leading tobacco control journals, and who has testified in more than 100 hearings for smoke-free workplace laws, was thrown off the largest and most prominent international tobacco control list-serve for calling on anti-smoking organizations to be truthful in their communications to the public of scientific issues regarding secondhand smoke.

After posting a note to the list-serve in which I suggested that anti-smoking organizations were making junk science claims by widely disseminating to the public the claim that 30 minutes of secondhand smoke exposure causes atherosclerosis in nonsmokers and that we need to rectify the problem to protect our credibility, I was thrown off of the list-serve.

Interestingly, I was not told I was being kicked off the list-serve. I found out because I was no longer able to access the list-serve, post messages, or receive or view messages. After confirming with many other list-serve members that they were having no technical problems with access and after waiting a week with no resolution to the problem of my access to the list-serve, it became clear that I was indeed off the list-serve. I also received definitive internal confirmation that the list-serve management team did in fact meet (via email) to take actions to censor the expression of my opinions on the list-serve.

My final post on the list-serve, which apparently was just too much for the anti-smoking groups to take, stated the following:

"For many years, tobacco companies and many other opponents of tobacco control policies have accused the tobacco control movement of engaging in junk science, especially regarding the health effects of secondhand smoke.

For example, we have been accused of cherry-picking the science on secondhand smoke, making up the science, and spreading scientific claims that are implausible, and therefore junk.

But recently, I believe that junk science has actually entered the anti-smoking movement.

The greatest example is the claim we are making that 30 minutes of secondhand smoke exposure can cause hardening of the arteries. Apparently, this claim stems from a study published in the Journal of the American Medical Association which showed that a 30-minute tobacco smoke exposure causes endothelial dysfunction (damage to the function of the cells lining the coronary arteries) in nonsmokers. Endothelial dysfunction is a marker of the earliest stage of atherosclerosis.

The significance of this study is that it demonstrates a plausible biologic mechanism by which chronic exposure to secondhand smoke can cause heart disease: repeated damage to the endothelial lining of the coronary arteries could result in a process of atherosclerosis, over a period of many years.

But instead of representing the study for what the science actually showed, we are distorting the scientific findings and using them to claim that a single 30-minute exposure to secondhand smoke is enough to cause atherosclerosis, forgetting to tell the public about the chronic (repeated) exposure part.

Moreover, a group of major anti-smoking organizations prepared a strategy document urging all of us in the movement to make this claim publicly in order to promote smoking bans. By making the damage from secondhand smoke seem immediate and severe, it was suggested, we could help break down barriers to the adoption of these smoking bans because our statements would have more of an emotional effect.

But by forgetting this key component of the scientific evidence - that it documented only a transient effect that represented the very earliest stage of atherosclerosis and did not imply that a single exposure could cause irreversible effects that would go on to result in heart disease - we turned what was otherwise good science into junk science claims.

And in doing so, we are doing everything that we had been accused of doing:

First, we are cherry-picking the evidence. For example, we are reporting the part of the study that showed that coronary blood flow under the artificial and strictly experimental conditions of hyperemia was impaired, but ignoring the part of the study which documented that there was no change in coronary blood flow in subjects exposed to secondhand smoke for 30 minutes. This is resulting in widespread claims by our organizations that 30 minutes of tobacco smoke exposure causes decreased coronary blood flow, which is a highly misleading, if not fallacious claim.

Second, we are making up the science. One of our major groups is claiming that a 30-minute exposure to secondhand smoke increased the risk of a fatal heart attack among nonsmokers to the same level as that of smokers. This is a "made up" claim, because there isn't a shred of evidence that this is the case. In fact, the claim is so preposterous that it fails, on its face, without even a need to conduct any scientific study. It simply can't be the case that a person exposed to just 30 minutes is at the same risk of a fatal heart attack as someone exposed for a lifetime to actively smoking 2-3 packs of cigarettes per day.

Third, we are making scientific claims that are completely implausible. You can't develop hardening of the arteries in just 30 minutes. It takes years.

The bottom line is that by turning otherwise good science into junk science, I believe that we as a movement are legitimizing the claims of groups (including the tobacco companies) that have wrongly (in the past) accused us of disseminating junk science claims. Now, I would have to agree with them. There is junk science in the anti-smoking movement.

The real problem is that the public cannot necessarily discriminate between good science and junk science. If some of the claims we are making are based on junk science, then what's to tell the public that all of our claims are not junk science claims. We are risking having the media, the public, and policy makers reject everything we are saying, because some of what we are saying is based on shoddy science or is completely untrue.

As I've stated before, the science is good enough. We don't need to distort it. We don't need to make it up. We don't need to cherry-pick. We don't need to make implausible claims. The truth is good enough.

By not being satisfied with letting the science speak for itself, by transforming good science into junk science in order to scare people into thinking that secondhand smoke is more severe of an acute hazard than it really is in order to support our agenda, I believe that we are in danger of losing our most prized possession - our reputation and credibility."

After this post, there were calls for my expulsion from the list-serve by a number of advocates, with personal insults and attacks hurled publicly at me, and the demand for banning me from expressing my opinions on the list-serve was apparently heeded.

The Rest of the Story

Censorship is alive and well in the anti-smoking movement. It is quite clear that there is simply no room for dissenting opinions, and if you express such an opinion, you will likely be censored.

You have to conform to the established dogma and prevailing wisdom of the movement, no matter how outrageous are the actions being taken by, and claims being made by anti-smoking groups. You absolutely cannot criticize; if you do, you risk being expelled from the movement, at least in terms of your ability to express your opinion in any tobacco control discussion forum. This is now the second list-serve from which I have been expelled for expressing my opinions and interfering with the "quality" of the list-serve discussions.

It has become apparent to me that these list-serve "discussions" are not really "discussions" at all. Instead, they amount to little more than a system of forced indoctrination of prevailing views onto anti-smoking advocates. You either have to conform to the dictates of the movement, or you're out of there, at least if you let it be known that you do not conform. I'm sure there are many others who, like myself, find a lot of the health claims being spewed out by anti-smoking groups to be exaggerated, if not inaccurate, but who are afraid to express their opinions because the lack of conformity to the doctrines of the movement will result in negative repercussions for their own careers. And seeing what has happened to me, I understand why they feel that way. They are correct - if they do express their opinions, they will be placing their careers in jeopardy.

Now I see how it is that the anti-smoking movement has been able to get away with making such completely implausible and absurd claims as they have been (like the 40% decline in heart attacks due to a smoking ban in Helena or the 30 minutes of secondhand smoke exposure causing hardening of the arteries). It isn't necessarily that everyone in the movement believes this crap. It's that those who don't believe it are afraid to speak out publicly because they would be risking serious repercussions, including potentially being censored, expelled from discussion groups, or most importantly, having their funding and reputations threatened.

The rest of the story is that there simply is not room for the truth in the anti-smoking movement. The perceived success of the movement is falsely believed to rely on the ability to say, do, and claim anything, as long as it advances the anti-smoking cause. And anything or anyone who attempts to hold the movement to scientific accuracy and truth is therefore perceived as a serious threat to the movement - a threat which must be removed. The call for the whole truth, and nothing but the truth, cannot be tolerated. There just isn't room for that in the movement's current group-think mentality.

I of course find this mildly ironic - a little too ironic, don't you think: that a movement that is essentially founded upon the idea that the tobacco industry has been lying to the public for decades and that we are the ones who will tell the public the truth cannot actually tolerate the truth in our own movement.

But forgetting my own careful and thorough documentation of exactly why many of the claims being made by anti-smoking groups are inaccurate (it should be clear to regular readers of this blog that I'm not simply throwing my opinions out there - I've attempted to provide clear, well-documented, and compelling explanations for them), it has become clear to me that there is no room in the anti-smoking movement for even expressing one's opinion of what the truth is.

In other words, it wouldn't matter if I was right or wrong in my interpretation of the scientific data and in my opinion of whether the claims being made by anti-smoking groups are fallacious or not. Clearly, that is not the relevant issue. In fact, on the list-serve there has been absolutely zero discussion of the scientific issues and no arguments provided to refute or even challenge my opinion.

Instead, it is the opinion itself, and the expression of the opinion itself, that is the problem. It doesn't matter how well-documented your arguments are; what matters is what side you are arguing. If it is construed as being against what anti-smoking groups are doing or saying, then you are a threat and your opinions can therefore not be tolerated.

It's sad to me that a movement which features the "truth" campaign as its sentinel public health intervention is unable to tolerate the "truth" in its own discourse. You would think that the movement would pride itself on the truth, not avoid the truth at all costs.

And if what I'm arguing is not the truth - if I'm wrong in suggesting that atherosclerosis takes years to develop - then there should be a sound and rigorous refutation of my opinion and a presentation of the scientific evidence that supports this claim. I'm not asking anyone to blindly accept my opinions, but I do expect that those who are making the claims I'm challenging should be able to provide scientific evidence to support these claims.

So far, there hasn't been a single study advanced to support the contention, widely being disseminated by anti-smoking groups, that a single, acute exposure to secondhand smoke can cause hardening of the arteries in exposed nonsmokers or that it poses any risk of a catastrophic or fatal coronary event in anyone other than individuals with severe existing coronary artery disease.

Obviously, I don't think that I'm wrong in challenging the claims that are being made which I think are fallacious. But what I'm trying to say is that if for some reason I am wrong, then I need to be told why. Simply throwing me off list-serves so that I don't interfere with the "discussion" (more accurately - "indoctrination") does not make the problem go away.

Sure - it does get rid of me; it stops me from expressing my opinions and taking part in the internal discussions in the tobacco control movement. But it doesn't solve the real problem, which is the serious threat to the credibility of the anti-smoking movement that is posed by the ridiculous claims that we are making.

And now we have an even bigger problem. Because now the public is aware of the rest of the story - they are aware of how we treat colleagues within our movement who demand that we speak the truth and stick to it in our public communications. Now they are aware of the tremendous double standard that characterizes us. The tobacco companies must tell the truth. But it's OK for us to distort the truth. After all, they're killing people and we're trying to save lives. What does it matter if we are untruthful in our communications if we are helping to save the children?

The problem of maintaining our scientific credibility in the face of increasingly absurd claims being made by anti-smoking organizations is a huge one. But it's nothing compared to the damage that we are doing to our own reputation by revealing that there is no room for the truth in our movement and that we will censor the expression of the opinions of those who try to speak it.

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