Monday, December 03, 2007

The Rest of the Story: An Act of Conscience

I realize that I have never told the full story about the reasons why I started The Rest of the Story in the first place. Today, I discuss one of the major factors in my decision to start this blog: my troubled conscience.

For the past several years, I have felt quite uncomfortable about the tactics being used by a number of major anti-smoking groups. While I wasn't losing sleep at night, I was waking up each morning feeling very uncomfortable about being part of a movement in which these kind of tactics were being used.

How could I just go off to work to do my normal, every-day routine - studying the effects of tobacco policies, studying the effects of secondhand smoke, preparing to testify in tobacco litigation, preparing to testify in support of smoking bans, etc. - when I knew that many of the groups I was working with were disseminating inaccurate scientific information about secondhand smoke, supporting increasingly intrusive policies that were no longer justified by scientific data, making false and/or undocumented accusations about individuals, misusing youths to support policies designed to protect the financial interests of tobacco companies, demonstrating blatant hypocrisy, and deceiving the public in ways similar to those used by the tobacco companies?

For some reason, I felt at least partially responsible for the actions of these tobacco control groups. Even if I wasn't a member of the particular group, I viewed myself as one of the leaders of the overall movement, and I felt some degree of responsibility for the actions of the major groups in the movement. Mostly, my conscience was shaken up.

In many ways, writing this blog was (and still is) a mechanism by which I can somewhat clear my conscience by publicly exposing the tactics being used by these groups and holding the movement accountable for its actions. I knew I was not going to be able to stop this behavior (I had already tried unsuccessfully for two straight years prior to the blog), but did I not have a responsibility to speak out, even if it was just to 20 or 30 readers of my blog?

Fortunately, my readership has gradually grown and I am now able to speak out to thousands of readers, including some of the most important players in the tobacco science and policy arena. But I still do so, each day, with at least part of my goal being to clear my conscience.

I just can't and don't feel comfortable anymore just going about my normal business. How can I, for example, spend so much of my time slaving over data in order to accurately assess the health effects of secondhand smoke when I know that there are nearly 100 anti-smoking group websites that tell the public that 30 minutes of secondhand smoke exposure is enough to clog their coronary arteries? What is the point of my continuing to publish papers about the real effects of secondhand smoke if the public is going to be told that a few minutes of exposure can kill you immediately? It seems that the groups don't need my information anymore. What's the point of my working so hard to produce and supply that information?

The response I was receiving from many groups was troubling to me. They had no problem disseminating the results of my many papers which documented the serious health effects of secondhand smoke, especially the hazards to restaurant and bar workers. But when I questioned the conclusion that brief exposure to secondhand smoke causes fatal arrhythmias (a claim for which there is absolutely no scientific support), all of the sudden I was no longer credible. As I learned, what credibility seems to mean is the direction of your conclusions. If they are favorable, you are a credible source. If unfavorable, you are not credible. So the same source (me) could at once be a credible and non-credible source of information.

My conclusions about the health effects of secondhand smoke on bar and restaurant workers are widely cited by anti-smoking groups throughout the country. But you will be hard pressed to find a single anti-smoking group that would also share with the public my conclusions about the Helena or Indiana heart attack studies.

But how can I be a credible source with respect to some conclusions and a non-credible source with respect to others? It just doesn't follow. If my conclusions about Helena are flawed because I am biased towards a pro-smoking position, then how in hell did I come up with the conclusions I drew in my JAMA article in which I concluded that the observed increase in lung cancer among nonsmoking restaurant workers must be attributable to secondhand smoke exposure? And why would I agree to testify in the Engle case, which almost ended up costing the tobacco companies $145 billion?

Writing this blog actually allows me to continue working in the tobacco control field (though not as part of the mainstream tobacco control movement). Without this release for my conscience, I simply could not continue going along with the flow.

While I clearly have a positive view of tobacco control, I don't shy away from pointing out the blemishes in the interest of accuracy. Maybe it's my lifetime in scientific research, but I do have a passion for accurate reporting, and I expect the same from others. What I also learned was that others are more likely to believe me when I point out the blemishes, because it doesn't look like I'm just spewing propaganda.

When someone takes the same side of an issue every time, you ought to have some suspicion about the potential bias that may be operating. The fact that I was willing to criticize my own side when it was called for should have been - to these groups - a sign that they had someone in the movement who was not blinded by anti-smoking zeal but who was truly a scientist who was passionate about scientific accuracy and the degree of scientific justification for the anti-smoking agenda. Instead, my willingness to criticize was viewed as heresy and traitorousness.

Actually, it was just an act of conscience.

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