Challenge to Anti-Smoking Groups to Publicize Two-Year Data from Scotland on Trends in Heart Attacks

Today I am challenging anti-smoking groups to publicize the two-year follow-up results of trends in heart attacks or acute coronary syndrome in Scotland since the smoking ban went into effect.

The first group to do this will receive a $200 donation to their organization.

The rules are quite simple:

1. To be eligible, an anti-smoking organization must have previously issued a public communication (including a web site posting), press release, or media statement in which it publicized the results of the Scottish smoking ban study (either the original press release before the study was published or the results of the published paper in the New England Journal of Medicine) and communicated to the public the conclusion that the smoking ban in Scotland led to an immediate, dramatic (17%) decrease in heart attacks (or acute coronary syndrome) in Scotland.

2. The organization must issue a public correction of the conclusion of the study, either through a press release, web site posting, or other major public communication, based on the complete two-year follow-up data, which demonstrate no significant effect of the smoking ban on admissions for acute coronary syndrome in Scotland.

The Rest of the Story

The rest of the story is that I cannot afford the $200 prize I am offering, especially given the stock market crash, which was seriously exacerbated yesterday. However, I am so convinced that no anti-smoking organization will take up this challenge that I am willing to put the money on the line.

Why am I so sure that no anti-smoking organization will take up the challenge?

Because as I have learned, these anti-smoking groups aren't truly interested in getting out the facts. They are interested in putting out information which is favorable to their cause. The goal is not scientific accuracy or integrity. It is putting out information to support the agenda. If that information turns out to be premature or wrong, so what? It's all for a good cause anyway, so there's no real harm in a little bit of premature or false information. After all, the movement is saving lives.

Now some might argue that there is nothing wrong with anti-smoking groups being biased and even inaccurate in their reporting of the science because this is what partisan advocacy groups do. I disagree, however, because I view anti-smoking groups as part of the public health movement and because they have put themselves forward as being a credible source of scientific information. In other words, these groups have taken on a responsibility to the public by virtue of their putting themselves in the position of advocating for policies to improve the public's health. Moreover, they have put themselves forward as accurate communicators of scientific information to the public. In fact, much of these groups' work is dedicated to criticizing the tobacco companies for their misleading scientific statements to the public.

You can't have it both ways. If you are going to criticize the tobacco companies for being biased and inaccurate in their communication of the scientific facts about smoking and secondhand smoke to the public, then you cannot justify being inaccurate in your own communications.

I am not going to lose sleep worrying about my $200 because I am sure that no anti-smoking groups will respond appropriately. This is not about the scientific truth. It is about putting out information that supports these groups' agenda (and agenda that I largely support, by the way). However, where I differ is that I believe that these groups should be promoting these policies based on sound science, not inaccurate science that results from biased and premature conclusions that turn out to be wrong.


Examples of Groups Which Communicated the Original Study Conclusions to the Public

Campaign for Tobacco-Free Kids: "Since the implementation of its smoking ban, Scotland has seen a 17 percent reduction in heart attack admissions in 9 major hospitals."

Americans for Nonsmokers' Rights: "A study of nine Scottish hospitals has found a 17 per cent fall in admissions for heart attacks in the first year after the smoking ban came into force."

American Heart Association: "A public smoking ban in Scotland reduced hospital admissions for heart attacks by 17 percent in one year, according to researchers at the University of Glasgow, Scotland. The ban was most beneficial for people who had never smoked (21 percent reduction in hospitalizations) and former smokers (19 percent reduction). Hospitalizations decreased by 14 percent among smokers. In the decade before the ban, hospital admissions for heart attacks had dropped by about 3 percent per year."

Action on Smoking and Health (ASH - U.S.): "Now a number of major studies – in Helena [MO], Pueblo [CO], New York State, Piedmont [Italy], Ireland, and Scotland – have consistently shown a major decrease in hospital admissions for heart attacks after smokefree laws went into effect."

ClearWay Minnesota: "Smoking ban brings big cut in heart attacks in Scotland, study finds."

Henry Ford Health System: "If Michigan were to implement a comprehensive smoking ban tomorrow, we would see a 12 percent drop in heart attack admissions after the first year," says Mouaz Al-Mallah, M.D., Henry Ford's director of Cardiac Imaging Research and lead author of the study."

ASH UK: "A study of nine Scottish hospitals has found a 17 per cent fall in admissions for heart attacks in the first year after the smoking ban came into force."

ASH Scotland: "A study of nine Scottish hospitals has found a 17 per cent fall in admissions for heart attacks in the first year after the smoking ban came into force. The research is part of a national evaluation of the impact of Scotland's smoke-free legislation which shows that the smoking ban has had an overwhelmingly positive effect. The evaluation found that after the legislation came into force there was: a 17 per cent reduction in heart attack admissions to nine Scottish hospitals. This compares with an annual reduction in Scottish admissions for heart attack of 3 per cent per year in the decade before the ban."

Healthier Scotland: "Evaluation of the smoke-free legislation has so far found: ... reduced cases of myocardial infarction and reduced hospital admissions for acute heart attack."

ASH Scotland: "A 17% fall in admissions for heart attacks in the first year after the smoking ban came into force compared with 3% in preceding years."

ASH Australia: "A study in the prestigious New England Journal of Medicine provides strong new evidence that laws requiring smokefree workplaces have a rapid and significant impact on health. The study found that after smokefree legal changes in Scotland there was a 17% fall in hospital admissions for acute heart attacks - and two-thirds of the improvement was among non-smokers. ... Several other studies have demonstrated reductions in coronary events in the wake of smoke-free laws. However, the Scottish study is particularly strong because it used larger samples, examined the effect among non-smokers and smokers, included measures of exposure to secondhand smoke, and included a strong geographic control."

Medical Research Council (UK): "The effect of the Scotland ban has been quantified in the first year after the smoking ban has come into force. There has been a 17 per cent fall in admissions for heart attacks, which compares with an annual reduction in Scottish admissions for heart attack of 3 per cent per year in the decade before the ban."

Health Scotland: "17% reduction in heart attack admitted to 9 major Scottish hospitals. Average reduction of 3% per year in Scottish heart attack admissions in the 10 years leading up to the ban."

Office of the Chief Medical Examiner (Scotland): "Heart attack admission rates fell at an average rate of 3.8% per year in the ten years before the smoke-free legislation. For the six months following the implementation of the legislation the annual rate of decline increased by more than six-fold to 25% 11. A separate study of people admitted to coronary care units in 9 major Scottish hospitals found a 17% fall in admissions in the 10 months after the legislation compared with the corresponding 10 months in the preceding year, with a larger reduction among non-smokers."

Chartered Institute of Environmental Health (Wales): "Early research findings from Scotland, where smoke-free legislation came into force in March 2006, have been extremely positive. These include a 17 per cent reduction in heart attack admissions...".

Smoke Free Action (UK): "Recently released research from Scotland shows that admissions to hospital for heart attacks have declined by 17 per cent since the introduction of the smoking ban in public places."

British Heart Foundation: "A study of nine Scottish hospitals has found a 17% fall in admissions for heart attacks during the first year of the smoking ban. This compares with an annual reduction in Scottish admissions for heart attacks of 3% per year in the decade before legislation to ban smoking in public places."

Smokefree Philly: "A new study from Scotland provides what public-health experts in the U.S. say is the strongest evidence yet that public bans on smoking improve health."