Wednesday, October 25, 2006

Anti-Smoking Groups Fail to Correct Misleading Statements about Effects of Secondhand Smoke

Despite being informed that they were making misleading statements about the health effects of secondhand smoke, not a single one of the anti-smoking groups which received my letter has corrected its misleading claims.

One group - SmokeFreeOhio - did apparently delete from its "fact sheet" one of its misleading statements, but it retained two other ones.

SmokeFreeOhio did eliminate the following statement: "After twenty minutes of exposure to secondhand smoke, a nonsmoker'’s blood platelets become as sticky as a smoker’s, reducing the ability of the heart to pump and putting a nonsmoker at an elevated risk of heart attack."

However, it retained the statement: "Secondhand smoke can cause the debilitating disease pulmonary emphysema, causing severe damage to the walls of the air sacs, with the lungs eventually losing their capacity to expand and contract."

And it also retained the statement: "Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system and interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of a heart attack."

None of the other groups challenged to correct or clarify their misleading claims made any changes in them.

The statement that SmokeFreeOhio chose to retain is even less well-supported than the one it apparently chose to delete. Neither the Surgeon General nor the California EPA concluded that secondhand smoke is a cause of emphysema, and the Surgeon General in fact concluded that there is not adequate evidence to make such a statement.

So SmokeFreeOhio has decided to retain a health claim that conflicts with the conclusions of the Surgeon General and the California EPA.

How does the group defend this decision? According to the individual with whom I corresponded, the conclusion that secondhand smoke causes emphysema was made in one study, and if I have a problem with that, I should contact the authors of that study.

By that criterion, smokers' rights groups are perfectly justified in telling the public that secondhand smoke does not cause heart disease and lung cancer. Because one could simply pick a study that didn't find such a result and base one's overall conclusion on that one study.

In other words, what SmokeFreeOhio is doing is cherrypicking, plain and simple. They found one study they liked, which happened to report an association between secondhand smoke and emphysema. Never mind the studies which failed to find an association. Never mind the conclusion of the Surgeon General that there is not adequate evidence to conclude that secondhand smoke causes emphysema.

Conveniently, when it came to the other retained statement - that even brief secondhand smoke exposure causes heart attacks - the representative of SmokeFreeOhio with whom I corresponded defended the statement solely based on the fact that the Surgeon General made this claim.

This is cherrypicking: when it comes to a statement you want to make, you simply pick out something that is in the Surgeon General's summary of his report. When it comes to a statement that you don't want to admit to (i.e., that secondhand smoke has not been found to cause emphysema), you simply ignore what is in the same Surgeon General's report.

This doesn't say a lot for the quality of the science in the tobacco control movement today, but it does show how things work in the movement nowadays.

The Rest of the Story

I can now say that the misleading statements being made by a large number of anti-smoking groups do not appear to be simple mistakes. Instead, they appear to be reflect intentional decisions to try to hype up the health effects of secondhand smoke to create more dramatic sound bites for the public.

Each of these organizations had the opportunity to correct or even just clarify their statements. They also had the opportunity to defend their statements, but failed to do so. The bottom line is that they have now chosen to retain these misleading statements on their web sites. These misleading and/or fallacious claims can no longer be attributed to innocent mistakes. This is an intentional effort to hype up the health effects of secondhand smoke, regardless of what the science actually supports.

At a minimum, each of these groups could simply have chosen to put a qualifying clause in their statements, noting that the alleged increased risk of a heart attack from a brief secondhand smoke exposure pertains only to people with severe existing coronary artery disease. Instead, they chose to keep their statements general, so that people might reasonably infer that anyone exposed to secondhand smoke even briefly might keel over from a heart attack.

Surely, it wouldn't have hurt anything to qualify these claims. What damage could possibly be done by trying to prevent the public from being misled?

Of course when you make a blanket statement that brief exposure to secondhand smoke causes heart attacks, the public is going to reasonably infer that this could happen to anyone. There is no way that any lay person (or even many scientists) would figure out that the claim only refers to people with severe existing coronary artery disease.

Thus, it is my opinion that each of these anti-smoking groups has intentionally chosen to retain what could easily be viewed as a claim that is very misleading to the public. There was no necessity to do this. These statements could have been clarified (at very least, qualified).

It is now clear to me that anti-smoking groups are quite comfortable with the notion that their communications might mislead the public into thinking that secondhand smoke is more hazardous than it actually is.

It is also clear to me that anti-smoking groups are severely biased in their appraisal of the scientific evidence. They are cherrypicking the studies which support the conclusions they would like to make, and ignoring the evidence that runs counter to their favored statements. This is not objective science. It is partisan science, and we are now no different from many of the groups and individuals who we criticize.

It is, honestly, very sad to me that the once-clear distinction between the scientific integrity of the tobacco control movement and that of the tobacco industry has been blurred. We have now adopted the tactic - once belonging to the tobacco companies - of cherrypicking evidence to support our position. We have adopted the tactic of misleading the public in order to support our agenda.

I guess it makes sense that it is the acute cardiovascular effects of secondhand smoke that seems to be the focal point for our misrepresentation of the science. After all, it is very alarming to the public to be told that even a brief secondhand smoke exposure may cause them to drop dead from a heart attack. Sudden death is a scary thing, and apparently, if we can tell people that secondhand smoke can cause it, we will. All we need is a shred of remote, indirect evidence and apparently that is enough to back up our claim. The days of substantiated claims in tobacco control are gone.

It is particularly disappointing for me because I no longer see a need for my own research on secondhand smoke. If anti-smoking groups are going to claim that brief secondhand smoke exposure increases the risk of a heart attack in a nonsmoker to the same level as a smoker, then what point is there for me to produce data that could be used to make accurate statements about secondhand smoke?

Perhaps the most troubling aspect of the lack of response to my letter is that not even the preposterous claim that 30 seconds of secondhand smoke exposure impairs coronary function to the same degree as chronic active smoking was corrected.

Let's face it: even if my arguments why it is not sound to conclude that 30 minutes of secondhand smoke exposure causes heart attacks are faulty, no one actually believes that 30 seconds of exposure has the same effect on coronary function as a lifetime of active smoking. The Association of Nonsmokers - Minnesota, has to (it seems to me) recognize that their statement was wrong.

If it were me, I would correct it the moment I realized the mistake. But it does not appear that the group has done that. I don't understand this failure to respond. To me, the impression I get is that this is an intentional decision to let the misleading (and absurd) statement stand. Why would you do this? It makes it appear that you couldn't care less about the public's perception of your scientific integrity.

The rest of the story is that it is now clear to me that the widespread dissemination of misleading and in many cases fallacious health claims by anti-smoking groups is not just a simple mistake. It appears to be an intentional decision to try to hype up the perceived effects of secondhand smoke.

By making the public think that even a brief exposure to secondhand smoke can make anyone keel over from a heart attack, I believe anti-smoking groups think they can create stronger public support for their agenda: promoting smoking bans.

While I support the agenda, I condemn the means being used to achieve this end.

Not only do I think it is unethical and does a severe disservice to the public, but I also think that our loss of scientific integrity will end up harming our credibility and reputation with the public, the media, and policy makers. Ultimately, this will set back efforts to protect the public from the hazards of secondhand smoke, negating any fleeting gains from making people think that 30 minutes in a restaurant with smoking present is enough to make a healthy young person drop dead of a heart attack.

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