Anti-Smoking Group Cherry-Picking Studies to Mislead Pubic About the Science: Americans for Nonsmokers' Rights is Hiding Information from the Public

As a former Board member of Americans for Nonsmokers' Rights (ANR), I can attest to the fact that as an organization, we used to attack the tobacco companies for cherry-picking studies that supported their claims, hiding key information from the public to make it appear that there was no evidence to show that secondhand smoke is harmful.

For example, the tobacco companies would point to one study which failed to find a connection between secondhand smoke and heart disease, while ignoring all the rest of the studies. Of course, we criticized the industry, arguing that all studies need to be considered and that failure to do so is misleading the public by hiding key scientific information.

Today, I report that Americans for Nonsmokers' Rights is itself engaging in cherry-picking by only sharing one side of the scientific evidence on the relationship between smoking bans and immediate reductions in heart disease.

In this document, ANR purports to share with the public a list of the U.S. studies examining the short-term effects of smoking bans on heart attack rates. Under the category of "United States," ANR lists just one study - a study which concluded that smoking bans do lead to immediate reductions in heart attacks.

The Rest of the Story

Curiously, ANR omitted from its list, the two largest studies conducted in the U.S., both of which failed to find a short-term effect of smoking bans on heart attacks.

What ANR could have, and should have added to the list are these studies:

1. Shetty KD, DeLeire T, White C, Bhattacharya J. Changes in U.S. hospitalization and mortality rates following smoking bans. Journal of Policy Analysis and Management 2011; 30(1):6-28.

This study by researchers from the RAND Corporation, Center for Studying Health System Change, University of Wisconsin, and Stanford University is the first to examine the relationship between smoking bans and heart attack admissions and mortality trends in the entire nation, using national data. All previous U.S. studies only examined one particular city. In contrast, this study examined data from the Nationwide Inpatient Survey (NIS), which is nationally representative and includes 20% of all non-federal hospital discharges in the United States.

The study found no significant effect of any smoking restrictions (including bar and restaurant smoking bans) on either heart attack admissions or mortality. The paper concludes: "We find no evidence that legislated U.S. smoking bans were associated with shortterm reductions in hospital admissions for acute myocardial infarction or other diseases in the elderly, children, or working-age adults."

2. Rodu B, Peiper N, Cole P. Acute myocardial infarction mortality before and after state-wide smoking bans. J Community Health 2011.

This study systematically examined changes in heart attack mortality trends within the first year of implementation of smoking bans in the six states which adopted such bans during the period 1995-2003. The results were that in four of the six states (California, Utah, Delaware, and South Dakota), the smoking bans were not associated with any significant short-term decline in heart attack mortality. In one of these states - South Dakota - there was an 8.9% increase in heart attack mortality during the first year of the smoking ban which was significantly different from the expected decline of 7.2%. The paper concludes: "The major finding of this study is that state-wide smoke-free laws resulted in little or no measurable immediate effect on AMI [acute myocardial infarction] death rates."

What's Going On Here?

Unfortunately, I no longer believe that the omission of these studies is just a curious, inadvertent omission of these key studies. Instead, I now believe that this is an intentional action on the part of ANR to deceive the public about the scientific evidence by hiding negative studies and only sharing studies that support the organization's pre-determined conclusions.

This is not science, it is politics. ANR has ceased being a science- or policy-based organization and has entered the political realm. This, of course, is the reason why I stepped down from the ANR Board when I first saw the organization start eschewing scientific integrity in favor of using these political tactics (a fact that incidentally - ANR acknowledged).

It's sad for me to see the deterioration of the scientific integrity of the tobacco control movement, and it is particularly disheartening to see our organizations adopting many of the same tactics that we attacked the tobacco companies for using in years past.