Thursday, June 29, 2006

Misrepresentation of Science in Surgeon General's Communications Suggests that Tobacco Control Movement Needs More Room for Discussion of Issues

The misrepresentation by the Surgeon General's office of the science of the acute cardiovascular and carcinogenic effects of a brief exposure to secondhand smoke suggests to me that there is a dire need for more open discussion of scientific issues within the tobacco control community.

This misrepresentation of the heart disease risk attributable to a brief secondhand smoke exposure comes many months after I began to gradually reveal more than 80 anti-smoking groups making similar claims, explained why I view these claims as misleading, and attempted to initiate, within the movement, a discussion about the scientific validity of these assertions.

Unfortunately, rather than engaging in a discussion of the scientific issues, the tobacco control list-serves on which I had begun to communicate my concerns to thousands of scientists and advocates decided to throw me out and to stifle any further discussion. Actually, that's misleading. There was no discussion to begin with. The response I engendered was not arguments about the validity of my reasoning; it was personal attacks about my honesty, character, and funding. But my expulsion from the movement's communication infrastructure did stifle any possible future discussion of these issues; I'm confident that with time, advocates' defensive reactions would eventually have given way to a serious consideration of the scientific issues at hand.

By taking this issue off the table for discussion, it made it impossible for the Surgeon General's office to become aware of the importance of carefully considering the differences between the physiologic phenomena of transient changes in endothelial function, platelet activation, lipid metabolism, artery elasticity, and cardiac autonomic tone that follow a brief secondhand smoke exposure and the actual risk of developing heart disease or suffering a heart attack due to that brief exposure.

The lesson here, for me, is that the tobacco control movement needs to find ways of opening up scientific and policy discussion, rather than closing it off. The movement needs to find ways of making individuals more comfortable to share their opinions about our agenda, our tactics, our actions, and our public statements, not to create an atmosphere where people are afraid to speak out lest their careers be threatened or destroyed.

Only a major change in the way in which the movement operates will allow this problem to be corrected so that it does not recur in the future. But that change is not so radical - what it simply requires is a willingness to consider alternative viewpoints and to address arguments on their merits. It's time to drop the defensive posturing that treats any criticism of the anti-smoking movement as a heretical violation of some sacred code and elicits an offensive attack on the perpetrator of this heinous crime of dissent. Tolerating dissent and taking the time to consider the opinions of others, even if those opinions challenge the prevailing dogma, can only help the movement in the long run. And it could probably prevent the massive misleading of the public that occurred yesterday.

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