Friday, July 26, 2013

Disappointed that Many Anti-Smoking Researchers Seem Not to Care About the Truth

To me, scientific research is all about the search for the truth. You may have hypotheses to start, but you let the results take you where they may. Some of the most important discoveries have come from findings that were surprising, or even shocking, and which shattered the a priori hypotheses. For example, our understanding that the universe is expanding at an ever-increasing rate (the concept of inflation) came as a shock to astrophysicists. No one, even Einstein, had imagined that.

It is no different in public health. The truth is what you are after because you cannot find ways to reduce morbidity and mortality unless you accurately identify the underlying causes. And you cannot take the actions that are most likely to reduce morbidity and mortality unless you have an accurate understanding of what works and what does not.

Thus, it came as both a surprise and a disappointment to me when I came to realize that for many anti-smoking researchers, uncovering the truth no longer appears to be the ultimate aim. The latest episode, with Dr. Glantz comparing exposure of one day's worth of electronic cigarette use with 1/16th of a day's worth of nicotine inhaler use, is just the latest demonstration of this sad realization.

If one were after the truth, then it seems to me that one would want to compare daily carcinogen exposure from electronic cigarettes and nicotine inhaler use. But what appears to have happened is that Dr. Glantz was so intent on demonstrating his pre-determined conclusion that electronic cigarettes are toxic and inappropriate that he failed to try to determine what an appropriate comparison would be. He appears to have taken the data as they were reported because the findings were "favorable" to his pre-determined cause.

But it takes only a quick internet search to discover that no one uses just one nicotine inhaler cartridge per day. The absolute minimum recommended number of cartridges for the Nicorette inhaler is 6 per day. Not everyone has to use the same assumptions I did in my analysis, but if you are sincerely interested in the truth, rather than just making a point, then you need to make some attempt to compare apples and apples.

Why is this realization so difficult for me? Because sadly, it reduces much of the idealism that I brought into the field of scientific research in public health.

But the saddest part of the story for me is the way that this is affecting people's lives. Because of the biased conclusions that many anti-smoking groups have drawn about electronic cigarettes, thousands of vapers who had quit smoking successfully using e-cigarettes have been discouraged from continuing to use these products and a number of them have returned to cigarette smoking as a result. Many more have decided not to quit smoking because of unfounded fears regarding the alleged dangers of vaping. And on a grand scale, electronic cigarette companies have been forced to uniformly lie to their customers about the real purpose of their products.

This in no way serves the public's health. It harms the public's health. And that's the saddest part of the story.

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