Monday, August 27, 2007

The Science Doesn't Matter: All Three Anti-Smoking Groups Fail to Defend or Correct their False Claims About Acute Cardiovascular Effects of ETS

One week ago, I discussed a new research article showing that eating a single high-fat meal causes the same degree of endothelial dysfunction as 30 minutes of exposure to secondhand smoke. In light of these findings, I questioned the widespread assertions by a large number of anti-smoking groups that 30 minutes of exposure to secondhand smoke causes hardening of the arteries, atherosclerosis, heart disease, decreased coronary artery blood flow, strokes, heart attacks, and death. After all, based on this new research, there is no reason to view 30 minutes of secondhand smoke any differently than we would view eating a high-fat meal.

While the research shows that a high-fat meal can cause endothelial dysfunction and therefore trigger the initial stages of atherosclerosis, it clearly takes many high-fat meals, eaten for years and years, before atherosclerosis, heart disease, decreased coronary blood flow, strokes, heart attacks, and death ensue.

But for some reason, the anti-smoking groups are taking the identical evidence with respect to secondhand smoke and concluding, instead, that a single 30-minute exposure to secondhand smoke can and does cause these consequences.

Last Monday, I challenged three of the anti-smoking groups which are most responsible for spread of these fallacious claims to either defend these claims, explaining how they could possibly be correct, or to issue retractions or corrections of their public claims, thus instructing other groups nationwide to do the same.

In response to my questioning of the scientific validity of these claims, I was personally attacked. However, none of the three groups either defended their claims or retracted, corrected, or clarified them.

The groups and their claims are as follows:

1. American Cancer Society - "Immediate effects of secondhand smoke include cardiovascular problems such as ... arteriosclerosis (hardening of the arteries) or heart disease..." (link is here).

2. TobaccoScam - "30 minutes exposure = stiffened, clogged arteries" (link is here).

3. Americans for Nonsmokers' Rights - "Just thirty minutes of exposure to secondhand smoke can cause heart damage similar to that of habitual smokers" (link is here).

The Rest of the Story

Before commenting on the lack of a substantive response from any of the anti-smoking groups, let me first try to show why each of the three claims is absurdly false on its face (without even needing to be an expert in vascular biology).

1. The American Cancer Society claims that atherosclerosis is an "immediate effect" of exposure to secondhand smoke. Fortunately, it is medically impossible for a brief exposure to secondhand smoke (or even primary smoke) to immediately cause heart disease. Can you imagine how many people would be walking around with hardened arteries if all it took was a single brief exposure? Clearly, the American Cancer Society's statement is false. Atherosclerosis takes many years to develop. Even in active smokers, it takes no less than about 20 years of exposure before heart disease develops. So how could heart disease be an immediate effect of secondhand smoke exposure?

2. TobaccoScam claims that 30 minutes of secondhand smoke exposure results in clogged arteries. Again, the process of artery clogging is not one that occurs in minutes. It takes many years of exposure in order for the process of atherosclerosis to occur to the extent that an artery becomes clogged. Even in active smokers, it takes no less than about 20 years of exposure before their arteries even begin to become clogged. So how could this occur after just 30 minutes of secondhand smoke exposure?

3. Americans for Nonsmokers' Rights claims that 30 minutes of secondhand smoke exposure causes heart damage similar to that seen in active smokers. First of all, if 30 minutes of secondhand smoke causes heart damage, then certainly it would have been unethical for Otsuka and colleagues to have exposed their research subjects to secondhand smoke. You cannot knowingly expose research subjects to something that is likely to cause heart damage. If ANR is correct, then I sure hope that Otsuka and his colleagues have very good lawyers to protect them from malpractice lawsuits. Second of all, the heart damage that is seen in active smokers is due to heart attacks from smoke-induced atherosclerosis. So ANR is implying that this same process of atherosclerosis, heart attacks, and heart damage can occur from 30 minutes of secondhand smoke. That is an absurd claim because it takes years for the atherosclerotic process to take place to such a degree that a person suffers a heart attack and heart damage.

Despite my attempts, for over a year now, to generate some discussion within the tobacco control movement about the scientific validity of the statements we are making to the public, it is now apparent to me that none of these organizations care.

You see - after this experience, it has become clear to me: the science doesn't matter.

Our cause is a good one; therefore, it doesn't really matter whether or not the science supports the specific claims that we are making. We are trying to save people's lives. We are doing this, ultimately, for the children. Thus, we don't need to defend our claims against legitimate scientific challenges.

It's clear to me now that to the anti-smoking groups, it doesn't matter whether I am right or wrong. There is no need to defend the claims if they are right. There is no need to retract the claims if they are wrong. There is no need to clarify the claims if they are technically accurate, but misleading. It just doesn't matter. The overall goal is a noble one, so it doesn't matter if we forget to dot a few "i's" and cross a few "t's" along the way. Any of our inaccuracies pale in comparison to those of the tobacco industry anyway. In the end, this is good versus evil and if good needs a little help from some stretching of the science, so be it.

My mistake all along has been thinking that the tobacco control movement and its organizations actually care about their scientific integrity. Because I thought that they truly cared, but for some reason were just not able to see the truth about these particular statements, I was able to convince myself for nearly two years that if only I kept bringing this to these groups' attention, they would eventually attend to either invalidate my arguments or to clarify, correct, or retract their claims. I thought they would do this because they really cared about their scientific integrity...because they really had scientific integrity.

Now I realize my flaw all along was that I made a false assumption. I assumed that these groups had scientific integrity and truly cared about it.

I was wrong.

The only thing that matters is the ends to which these groups are working. How they get there is of no particular consequence. If it means stretching the science, so be it. No group would have the integrity to admit making a mistake and to correct it. It simply is not in the playbook.

It is the playbook of a crusade, not of a science-based public health movement.

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