Monthly Archives: September 2012

There are no “neutral” views on THR (but there are clues about who is honest)

posted by Carl V Phillips

I run into quite a few people who want there to be some authoritative honest broker who can provide a “neutral” opinion about THR.  (Actually, we see this all the time regarding most controversial subjects, and it fails for basically the same reasons.  But I will stick to talking about THR and you can extrapolate to other topics.)  Everyone defers to authority or conventional wisdom for the overwhelming majority of what they do and think — that is the only practical way to exist.  But when there is political controversy and the issue is important to your own health (or public health, for those making public health pronouncements), it is time to stop deferring and recognize that there often (perhaps usually) are no neutrals.

This is clearly the case when it comes to THR.  While these observations are probably obvious to anyone who is invested in this topic, it might provide some useful information for those trying to begin to understand it.

A favorite target to defer to on matters of health (even by many non-Americans) is the US government.  Deferring to them in this cases consists of thinking: “They say e-cigarettes and smokeless tobacco are very very bad for you, so it must be true.  After all and they would not mislead me.”

Really?  Does anyone really believe that the government would not be biased or try to sell you on a particular belief system?  Almost no one would ever make such a claim, and yet many people act as if they believe it.

I hope it is obvious that our government is not an unbiased neutral broker of information when it comes to, say, the Department of Defense opining on the usefulness and ethics of assassination-by-drone-aircraft, or the Drug Enforcement Agency offering its assessment of the Drug War.  The retort I might expect to that is that, FDA and CDC are supposed to be looking out for our best interests, not pushing an agenda.  But I would expect that the people at DoD and DEA also think that they are looking out for our best interests.

The government, of course, is not a unitary actor, but consists of a lot of operations that each have their own mission.  When officials create a particular unit or a particular assignment, they have a goal in mind, and it is seldom to create a neutral arbiter.  But even when that is the goal, the well-known phenomenon of “agency capture” means that the people who join the agency or exert the most effort to influence it will be those who are highly focused on the issue, which is basically synonymous with “interested in a particular outcome”.

Most of the time, the capture is by an industry that stands to make or lose profit based on agency actions.  Sometimes not.  Theoretically, the government units that deal with tobacco could have been captured by the tobacco industry, but instead they were captured by the tobacco control industry.  Why that happened is no mystery, but it is sufficient to just observe that it happened.  So, there are revolving doors (people moving between the tobacco control industry and government agencies that support them) and iron triangles (a generalization of Eisenhower’s “military industrial complex” concept, which is basically the epitome of capture) everywhere you look.  No agency employee would dare contradict the government anti-THR lies, let alone say that perhaps people can rationally choose to use tobacco rather than not.

Trusting government agencies to be neutral — on most anything — is simply absurd.  It is generally safer to assume the opposite.  In this case, it is easy to see who controls the agencies.  But it should be equally clear that for an issue like this, these observations about government generalize to any supposedly neutral committee (made of people with an interest in the issue, chosen by someone who has an opinion) or organization (which generally exist to advocate a particular position).

Moreover, for the case of THR, being neutral makes about as much sense as being neutral about the shape of the Earth.  Someone who claims the Earth it is flat is an outlier who apparently is unfamiliar with evidence, or is just lying for some purpose.  But someone who “sees that both sides have merit” is also a nutcase (or worse, an irresponsible journalist trying to provide “balance”).  It would certainly be possible for someone to present the arguments from the flat-earther alongside the rest of the evidence.  But anyone who did not then arrive solidly at “spherical” should not be considered a trusted source of information.

People who learn and understand the truth about THR — and tell the truth about it — invariably come down on the pro-THR side, or at least admit that it offers clear benefits for public health, overall welfare, and individual rights.  The honest brokers might recognize nuances and caveats that are absent from extreme pro-THR positions, but frankly there are not very many people who exhibit extreme pro-THR positions.

It is theoretically possible for someone to take an honest neutral position on THR or even an honest anti-THR position, but I am aware of nobody who does.  It is possible to argue “there is overwhelming evidence that the risk from smoke-free tobacco/nicotine products is very low, and there is no reason to believe that encouraging their substitution for cigarettes will have negative effects on health, but I oppose [or, am on the fence about] providing accurate information and legal access to these products because….”  The “….” would have to be a statement like “I do not really care about health outcomes, but only care about hurting the tobacco industry” or “I am more worried about whether other people sully their bodies by using a drug then their happiness or health”.

You never hear such honestly, but it is theoretically possible.  The one version of the “….” that you almost see sometimes is “I care more about whether people are ‘addicted’ than the effects of that behavior”, but even this it is never stated so honestly, and is never coupled with the honest presentation of the health benefits.

The truth has an overwhelming pro-THR bias, and those who would attack THR implicitly acknowledge that fact by avoiding the truth.  Everyone who is anti-THR, or even claims to be neutral, whatever their real motivations might be, lies about the health science and bases their stated oppositions on those lies.  So they clearly fail the “honest broker” test.

But there is still a useful guide to finding the truth in this, but (like any other useful guide) it is not as simple as “just trust the government”:  When you observe:

  • everyone of any visibility on the anti side repeatedly makes claims that those on the pro side point out are lies, often based on easily verifiable information
  • those on the pro side consistently acknowledge and respond to the claims made by the antis
  • while those on the anti side never engage in dialog, not even so much as to dispute the substantive statements made on the pro side, but instead just keep repeating the zombie lies
  • some of those on the pro side try to police their side’s information, while those on the anti side virtually never criticize anyone on “their team”,
  • and those on the pro side can explain and document the motives of the antis to lie, while the antis can only resort to (unsubstantiated, and indeed easily refuted) sputtering protests about the other side consisting entirely of some secret industry cabal (for a non-existent THR industry, no less!),

well, then, I really think that it is not too difficult to figure out where to find the honesty.

 

 

Aside: Something is always worst

posted by Carl V Phillips

I recently found myself making a brief comment in a conversation about anti-tobacco activism, asking (not for the first time, as you might guess), by what right do those people presume to tell others how to live their lives?  These people have convinced themselves not just that such nannying is a legitimate and even worthy cause, but that it is so worthy that it trumps every rule of ethical behavior, such as honesty (thus the need for this blog).  By what right?

Based on the content of their monologues, I am fairly certain that if faced with that question (if those people ever entered into conversations outside of their echo chamber), the answer would often be based on the claim, “it is the leading preventable cause of death”.

I would be really interested in hearing the answer to the follow-up question, “by what right do you presume to tell others that they must avoid the leading preventable cause of death.”  But setting that aside, as well as the fact that the this “leading preventable” claim is inherently nonsense, let us just accept their logic:  If something is the leading preventable cause of death, then it warrants all manner of expensive, utility reducing, and civil liberty destroying interventions.

Now imagine that they succeed (or, if you prefer a realistic scenario, that THR succeeds) and smoking is dramatically reduced, and so use of tobacco and nicotine is no longer leading.  The activists will be loath to admit this has occurred, ending their gravy train, but posit that at some point they will have to.  After all, they keep claiming that day is just around the corner.  Once that happens, something else is the leading preventable cause of death and, by their logic, warrants the full-blown attack on welfare and freedom.  That is the way superlatives work: even if nothing is all that bad, something is still worst.

In all the arguments about the “slippery slope”, in which the anti-tobacco activists claim there is no such slope while others observe it is playing out just that way, the activists protest that there is no such risk because there is something unique about their current cause.

It is the worst.

They do not seem to realize that by making that very quasi-argument, they are undermining their own claim of uniqueness, and thus the logic (such as it is) of their own answer to the “by what right?” question.

CDC on cigars – a great example of liar’s citations

posted by Carl V Phillips

I will come back to FDA in a few days, but we want to cover a few other things first.  One is to point out that the behavior of the FDA — in terms of both being anti-THR and junk science about tobacco/nicotine — does not represent either new or exceptional action by the US government.  The CASAA leadership just happened to be discussing this document from the US Centers for Disease Control and Prevention (CDC).  It is about cigars, which is related to THR, though not a core part of THR efforts.

There is good evidence that cigar smoking in traditional cigar style — puffing into the mouth with minimal inhalation into the lungs — is much less harmful than cigarette smoking.  Of course, the same method can be used with cigarettes too.  However, the interest in such substitution is limited and switching to smoke-free alternatives is far healthier, so there has been little interest in pursuing this.  (In addition, a lot of cigar consumption lately has been for products that are basically cigarettes and are smoked like cigarettes, as a way to avoid the punishing cigarette taxes.  That is understandable motivation, but it is not meaningful harm reduction.)

Still, that document says a lot about CDC’s approach to tobacco.  About half of the content is cited to three sources (links appear in the original if you really want to see them):

1. Campaign for Tobacco-Free Kids. The Rise of Cigars and Cigar-Smoking Harms . Washington: Campaign for Tobacco-Free Kids, 2009.

2. National Cancer Institute. Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9 . Smoking and Tobacco Control Monograph No. 9. Bethesda (MD): National Institutes of Health, National Cancer Institute, 1998.

3. American Cancer Society. Cigar Smoking . Atlanta: American Cancer Society, 2010.

This is a great example of lying with citations — putting in little footnotes that imply that the information presented is based on the best possible evidence, when actually the sources are rather useless.

You probably noticed that the first is to an anti-tobacco extremist organization, which, among other things, opposes harm reduction.  Moreover, it is not research by that organization, or even a review paper, but is just a two-page broadside.  The third reference is similar:  While ACS is thought of as a scientific organization, when it comes to this topic, they are also an extremist activist organization with little regard for honest science.  The cited webpages have a bit more content than the CTFK broadside, but not much, and do not even cite evidence for their claims.

So basically, we have an agency of the US government sourcing its scientific claims and consumer advice about a tobacco product to activist organizations whose mission is to say anything they can think of that is negative about tobacco products.  Their job description is to be biased, and that often means dishonest.  There is no possibility that CDC does not know this.  Could you imagine the State Department citing information in its travel advisories to the Middle East to anti-Islamic activists or the Department of Agriculture citing nutrition advice to anti-GMO activists?  This is similar in terms of credibility.

[You probably could, however, imagine agencies of the government deferring to other, more powerful, players for information in their areas of interest.  That observation — and its relation to the present topic — will be the subject of this week’s Background post in a couple of days.]

At least source #2 is a real scientific review.  The problem is that it is from 1998 — very old history in a field like this.  But, funny thing: the CTFK document cites that 1998 report extensively.  So what CDC is really doing, by citing CTFK, is trying to hide the fact that all their information traces to 1998 by citing a more recent document that cites the original.  A common sneaky trick used in undergraduate term papers, brought to you by an authoritative voice of our government.

It gets worse.  The first statements that are cited to those three sources are:

A cigar is defined as a roll of tobacco wrapped in leaf tobacco or in a substance that contains tobacco….[1][2]

The three major types of cigars sold in the United States are large cigars, cigarillos, and little cigars.[1][2][3]

There is nothing wrong with the information, of course.  What is baffling is why CDC felt a need to provide a citation for it.  What is even more baffling is that citation #1 does not even provide a definition for cigar; citation #2 probably does, but I am not going to hunt for it.  Interesting, #3 does provide a clear definition — based on tax law — but is not even cited for the first sentence.  There is also clearly no need to cite that second sentence, but if you are going to, it should be to something relevant (like the official tax or regulatory definitions).  Here is a hint for those of you who want to cite a definition:  try a dictionary.

That is mostly just amusing, but it shows a general lack of seriousness.  More serious, and equally lacking in seriousness, are the series of health and other claims that are also cited to these three sources.  And lest you think I am cherry-picking, there are no other cited sources that provide any health information.  I am not going to go into detail about the claims because, for the reasons noted above, their role in THR is limited.  Suffice it to say that there is a lot of doubt now about the conventional wisdom about the risks that existed in 1998 (that probably sounds a bit familiar for those who know the science about smokeless tobacco).

So, basically, the official word of our government is: “(a) as far as we know, nothing has been learned since 1998; (b) just go read these activists’ position statements because we just defer to them anyway.”

FDA does not understand how science and knowing work

posted by Carl V Phillips

Epistemology (roughly, how we know what we know) is at the core of scientific inquiry.  Some of the most profoundly anti-scientific claims that you will ever see — certainly among the most frustrating — are attempts to replace the complicated epistemic processes in science with simplistic rules of evidence.  Typically these are so oversimplified as to be suitable only for a stylized game like high school debate contests.  The rules are too simplified even for a courtroom, the context for which they are often designed.

As I noted in the first of this series of posts on the US FDA, FDA’s epistemic toolbox pretty much contains only one tool: their standard recipe for doing clinical trials of new pharmaceuticals.  That works pretty well for what it does, but it obviously represents only one little tiny corner of scientific methodology, let alone scientific knowledge.  The FDA document that I started discussing yesterday makes clear how unsuitable FDA’s limited understanding of science is when it comes to studying THR.  It includes:

Because clinical studies about the safety and efficacy of these products [e-cigarettes] have not been submitted to FDA, consumers currently have no way of knowing

This is followed by some bullet points, which I will address shortly.  But for now, just consider that sentence fragment.  No way of knowing?  Are they kidding? There is no way to complete that sentence truthfully, other than with something circular like “…no way of knowing what clinical studies submitted to FDA do say.”

The mind boggles at the arrogance.  The typical epistemic error is to claim that there is no evidence in the absence of studies that follow a particular clinical study recipe.  That is also completely wrong.  But there is something extra special about a unit of the government claiming that knowledge does not exist until it is formally submitted to them.  That is downright Soviet, or maybe even more l’état, c’est moi.

Since I cannot think of much to say about that other than shaking my head in disbelief, I am just going to pretend they said, “Because clinical studies have not been done….” and explain why this — the all-too common misconception that clinical trials are the best way to answer every single scientific question — is a lie.

The bullet points that complete the sentence are:

  • whether e-cigarettes are safe for their intended use,
  • what types or concentrations of potentially harmful chemicals are found in these products, or
  • how much nicotine they are inhaling when they use these products.

For some questions it takes a bit of work to explain why clinical studies are not the most useful method for finding an answer.  For example, clinical trials are not very good at answering the most important questions about whether smokers will switch to a THR alternative.  But that takes a bit of explaining (which I am sure I will eventually cover in this series).  But for now, FDA has provided examples that are so obviously wrong that there is no such challenge.

How do we know how much of what chemicals (nicotine and others) are in the vapor?  A clinical study is not well suited to answering this at all.  Instead, we need a method for drawing out and analyzing vapor that avoids the complication of the user absorbing some unknown portion of the chemicals (i.e., which does not include a clinical component).  And that has, of course, been done.  FDA even did it themselves (though they lied about the results).

We could replace the last point with something that actually does involve the user, like how much nicotine users are taking up?  That is possible to answer using clinical research methods.  Possible, but not necessary.  One way to measure nicotine uptake is blood chemistry.  But another is to just be the person taking up the nicotine and feeling the effects.  That will not answer some questions very well, but it is clearly a way of knowing.

How about whether e-cigarettes are safe (I am not sure what the “for their intended use” clause even means)?  Well, in that case some clinical studies would have been useful and would still be useful.  Indeed, we would have those if those in government “public health” thought of themselves as public servants (who would observe that the public wants this information and then try to provide it in order to possibly improve health) rather than public masters.  Nevertheless, clinical studies are obviously not the only way of knowing.

We have learned an enormous amount — in spite of governments’ uselessness in this matter — about the health effects of e-cigarettes.  We have ample data to rule out important negative acute effects, to be confident there are no non-rare major short-term health risks, to be optimistic about the lack of long-run effects, and to be quite sure that they are better than smoking by a lot.  This evidence comes from the experience of users as well as extensive data about other smoke-free nicotine sources and our knowledge from various sources about exposure to the other chemicals.

The general lesson here is that when someone claims “we know nothing” or “we have no evidence” about some scientific question, they either have no idea how scientific inquiry really works or they are lying.  Or both.

FDA is trying to manipulate people while avoiding an honest policy process

posted by Carl V Phillips

Continuing the series started yesterday, we are responding to disinformation from the FDA at the behest of one of our members whose employer (an agency of the US government) is trying to keep her from vaping based on FDA claims.  In particular, her boss justified his action based on this FDA document.

The first thing to observe is that this note from the FDA, identified as “news & events”, should be seen more as a blog post than a policy statement.  This may sound like a one-off observation, relevant for the one person to whom this note was presented as if it were government policy.  But it actually introduces an important point about the pattern of FDA’s (and some others’) lies:  FDA and some other actors often put out throw-away junk claims in forums where they are not subject to review or oversight, but can still give the impression that they are making official statements.  This is possibly against the law (I will leave it to others to judge that) but is certainly sleazy and bad behavior by a government agency.

I am not talking about things like the @FDAtobacco twitter feed which, as I have noted before, is embarrassingly amateurish and a serious embarrassment to the US government.  That is a different problem, but at least no one with any clue would take it seriously.  I refer to documents which look like official statements but are not — and thus lead to (presumably intentional) confusion like that of our member’s boss.

As noted yesterday, FDA is a police agency that often gets mistaken for a science agency.  It is perfectly legitimate for scientists to float their half-baked ideas in public to see what feedback they might get — indeed, public health science would be so much better if this were done like it is in “real” sciences.  But actors with police powers are obligated to avoid such behavior.  Imagine the legitimate objections if a police agency published a newsletter in which they wrote things like, “the district attorney refused to try to take action against Acme Novelties for selling faulty road runner traps despite the evidence we collected, but we still think they are guilty and intend to make arrests as soon as we find some evidence.”  Needless to say, this would provoke justified outrage; they are free to continue their efforts, of course, but effectively pre-declaring what police actions they are going to take is unacceptable and probably illegal.

Yet consider from the FDA document:

FDA [lost] the decision by the U.S. Court of Appeals … holding that e-cigarettes and other nicotine-containing products are not drugs or devices unless they are marketed for therapeutic purposes, but that other nicotine-containing products can be regulated as “tobacco products” under the Federal Food, Drug, and Cosmetic Act.  Therefore, FDA intends to develop regulations for electronic cigarettes.

This would be fine as a technical statement of agency plans, in an appropriate forum.  But consider what else appears in the document:

…contain ingredients that are known to be toxic …. may be attractive to young people and may lead kids to try other tobacco products …. no way of knowing whether e-cigarettes are safe …. Please report adverse events with e-cigarettes …. warning letters to electronic cigarette distributors for various violations of the Federal Food, Drug, and Cosmetic Act …. Public Health Experts Announce Potential Health Risk Posed by e-Cigarettes …. More Information on Safely Quitting Tobacco

You see the pattern.  I will address the various specific lies in subsequent posts.  My current point is that when “intend to develop regulations” is presented in that context, it is pretty clearly an accusation and threat that avoids proper procedure — procedure that exists for very good reasons.  A police agency can make a flat statement that they are investigating the public claims made by Mr. W.E. Coyote against the company.  But they cannot also publish every speculative claim and bit of unexamined evidence they can come up with.

FDA can propose or take action that they believe is within their policing authority.  When they do, they can then be subject to lawsuits, legislative action, and popular uprising.  Having done that once regarding e-cigarettes, and having lost, they have resorted instead to playing games of making unofficial statements that sound like official policy, but are not subject to any oversight or review.  This is a violation of the public trust and the authority granted to them as police (the spirit of it, if not their legal authority per se), just as much as their scientific lies, but it has largely been overlooked.  They are playing the role of cop in the worst way — making intimidating statements and exercising power via implicit threat (“you are not under arrest — we just want you to come in voluntarily and answer a few questions”) while avoiding the official action that would subject them to scrutiny.

In some ways, that is more disturbing than the lies themselves.

US FDA lies about THR. And lies. And lies. And lies.

posted by Carl V Phillips

As I mentioned to some of you, I am going to write about the leaked EU document that shows their plans to ban e-cigarettes, but I will come back to that (perhaps it will be disavowed as a horrible bit of anti-public-health anti-democracy by then, and I will not have to — we can dream, can’t we).  But today, at the request of one of our members who needs to respond to an employer’s claims about the US Food and Drug Administration’s position on e-cigarettes, I thought I would start a series about the FDA claims.  FDA is probably the single biggest anti-THR liar of the last couple of years, so this is probably overdue.

I am going to partially outsource the content of this post to Brad Rodu, who posted on FDA lying about THR a few months ago (it is a quick read, so pop on over to it).  The post is about a page on the FDA website that claims, in boldface, no less:

To date, no tobacco products have been scientifically proven to reduce risk of tobacco-related disease, improve safety or cause less harm than other tobacco products.

So the FDA, continuing the tradition of the US government for more than a decade, is telling people, “if you are considering using any tobacco product at all, then you might as well smoke.”

FDA’s only possible partial defense for the claims on this page (and I stress “possible”, “partial”, and “this page”) is that the primary purpose of the page is not to communicate to consumers or to provide scientific information, but to inform merchants and busybodies who might want to report on them that any comparative risk claim is “fraudulent”:

Claiming less harm or reduced risk of disease from using tobacco products misleads consumers to think that these products are safe to use.  FDA considers these kinds of claims to be health fraud.

The reason I start the discussion of FDA with this material is that it provides some useful insight about the organization that might not be generally understood.  FDA is a basically a law enforcement agency that does a little science, but many people mistake it for a scientific agency.  As with any branch of government that makes rules and focuses on enforcement, the mindset is not that of a scientist — seeking truth — but of a cop or legislator.  They declare how things are rather than seeking to learn about the world.

Consider the second quote, above.  Obviously not every claim of reduced risk would mislead consumers into thinking the products were safe.  For example, someone could say about a smokeless tobacco or e-cigarette product, “this product poses a health hazard to the user, however, that hazard is less than that from smoking.”  Frankly such a claim is such an understatement of the science that it could be used as an anti-THR lie, but it obviously would not be overstating the risk difference, and even more obviously would not lead to the conclusion the product is safe to use.  But the FDA “considers” even that fraud.

Considers.

Most people who think that FDA is a scientific agency would assume that “considers” implies a scientific conclusion based on scientific study.  The natural assumption would be that FDA has done that study and, taking the normal meaning of the word “fraud”, someone would assume that scientific study leads to the conclusion that it is false to say that smoke-free tobacco products are lower risk than cigarettes.  But once you recognize that FDA are cops and not scientists, it becomes clear:  FDA declares that any such claim is fraud — whether the claim is true or not.  They can define “fraud” to be anything they want, and in this case they have defined it to include true statements.

To further understand FDA, it is useful to explore why it is easy to mistake them for a scientific organization.  Much of what they do is to run and oversee a lot of studies, and those are a kind of science.  But despite the huge volume of work, there is not much scientific thinking going on.  The studies consist of carrying out the same couple of recipes, over and over again.  They are scientists in the sense that McDonalds employees are chefs.  More directly, it is like cops doing investigations, which generally follow the same routine — not unskilled and not thoughtless, for sure, but also not Sherlock Holmes.

Police follow fairly systematized procedures that mostly get the job done and mostly avoid the various obvious things that can go wrong if people are allowed to exercise more discretion.  The same observation applies to things like FDA’s pharmaceutical approval process.  But once we move beyond flipping burgers and interviewing the usual suspects, to trying to answer complicated questions based on complicated bodies of information, FDA is out of their expertise and — the evidence shows — out of their depth.

Just as it would not be wise to assign an average city police detective — however good he might be at his job — to, say, figure out who might be planning to attack an airliner somewhere in the world, it is not a good idea to trust FDA to do science that does not follow one of their recipes.  Unfortunately, the US government does not have an equivalent of the NSA for health science, so we are stuck with the FDA and their recipes.

Evidence for why this is such a problem can be found in the first quote, above.  Any scientist knows that there is no such thing as “scientifically proven”.  Proof naturally exists in math and logic and it is defined and created in law, but is absent in empirical science (it is often used as shorthand for “there is very very strong evidence supporting the claim” but that is not technically accurate).  Since FDA as a legal agency, it is used to dealing with “proof” in the legal sense.  What this means is when FDA declares that “if you follow our recipe for drug trials and particular results come out the other end, then particular things are proven“.  Again, it is them declaring something to be true, rather than discovering it; it is “proving” in a legalistic sense because the law declares that what matters is following the recipe, not true scientific inquiry.

Do not mistake any of this as excusing their lies.  They write in the language of science.  They portray themselves as having scientific expertise.  They explicitly offer scientific advice.  So they are subject to scientific standards and scientific criticism.  They could have chosen to just be honest cops, but they have chosen to be liars.

Even their legal declarations read as if they are making scientific claims.  In the second quote, they make the obviously false statement that consumers would over-interpret any possible comparative risk claim.  But it is they who are engaging in marketing tricks to mislead consumers.  If they said “we currently declare this to be fraud, regardless of what the science shows”, that would be honest.  If they said “no tobacco products have been subject to one of the two or three scientific recipes that we do, and we refuse to accept the scientific evidence”, that would be honest.

But when they suggest that the science supports their absurd claim that all tobacco and nicotine products pose exactly the same risk as smoking, they are lying.  It is not quite true to say that all of their statements about THR are lies, but remarkably close to all of their substantive claims are.  I will start addressing some of them.  I will quit when I run out of energy to do so — I suspect long before I run out of their lies.

Political philosophy is not a matter of personal opinion

posted by Carl V Phillips (with help from Julie Woessner)

I was not going to follow up on yesterday’s post about how normative statements can be lies, but Elaine Keller called my attention to this comment on the lies by Glantz that helped anchor that analysis.  It brought up a particular additional point on the subject that is worth making.

We see a lot of false statements about natural science because people do not understand the material.  [Note: natural science is basically the study of anything that would exist even if human society did not, and social science is the rest.]  But we see false statements about social science because of that but also, somewhat ironically, because people think they understand it better than they do because it does not use so many words they have never heard.  Moreover, discourse on both social science and political philosophy further suffers from sounding similar to topics where everyone is entitled to his or her own opinion (personal preferences and morality), which causes some people to make the mistake of thinking that their opinions are worth something even when the statement cannot be based on personal opinion.  Today’s example is a good illustration.

As I pointed out yesterday, Glantz wandered close to the neighborhood of avoiding his lie about what should be done (based on some accepted norm), replacing the lie with a true statement that he just has an extreme idiosyncratic view and his normative claim is based on that.  He did not get anywhere near close enough, but there was actually a hint there that he understood that he was basing his claim on a particular extremist viewpoint and not on anyone else’s measure of what constitutes the good.

Not so the anonymous commenter who, by comparison, managed to make Glantz’s grasp on reality look quite good.

We have every right to ban the unregulated use of any delivery method for a toxic recreational drug that has any potential to harm others whatsoever.

Yes, some idiot[*] really wrote that.  “We have every right to ban”.

[*Note: If you think I am being too hard on this guy, you can read the rest of the comment and see that I am not; I am just focused on one of several very stupid statements.  In fairness, this commentator, unlike Glantz, is not claiming to be an expert of any sort.  Still, anyone with grade-school level civics behind them should not have made the error in question.]

I will leave more in-depth analysis of such idiocy to those who write about liberty in the context of substance use.  (If you are interested in that topic but not sure who to read, start with Snowdon and branch out from there).  Suffice to say that a core part of post-Enlightenment Western political philosophy is about the rights of the individual to be free from tyranny and the very limited ways in which society should intervene in spite of those rights.  Notice that the word “rights” only shows up on one side of this equation, and it is not the nannying side championed by that writer.

Moreover, we can look at the specifics of the issue at hand.  Recall the context:  Glantz asserts that e-cigarettes should be banned anywhere that smoking is banned.  But there is no question that smoking bans are an extreme exception in the context of rights.  Smoking is one of the very few things that is not banned outright (like, say, punching someone in the face) but that private businesses (in many jurisdictions) cannot freely allow on their premises if they so choose, even if they make sure that everyone present is aware of that fact and even if all are required to explicitly declare they accept the situation before entering.  Indeed, most things that are banned outright are allowed under carefully constructed private agreements (you can enter into a contract to allow someone to punch you in the face, or hire someone whose job description includes allowing that to happen).  It is difficult to think of another example — outside of the rest of the Drug War and bans on sex work — where core freedoms are so thoroughly abrogated as with smoking bans.

But, of course, the likes of Glantz have been telling us for years that there is something unique about smoking.  There is a bit of merit to this.  For the many people who object to the smell of cigarette smoke, smoking is among the worst aesthetic insults someone nearby is likely to inflict, up there with talking loudly on the phone, blasting music, never bathing, or making racist/homophobic/anti-Islamic/etc. comments.  Private employers, hosts, etc. very often disallow all of these in the venues they control — as is their right as private actors — but are also free to allow them.  Indeed, some entities would have a hard time prohibiting the last on the list if they wanted to.  So smoking bans already defy normal notions of rights.

Then there is the health argument.  But there, the claims go, smoking is absolutely unique.  If you believe the common claims, it is several orders of magnitude worse than the next-worst thing that people inflict on their neighbors.  And even setting aside the exaggerations, it is still plausible to claim that it is an order of magnitude or two worse than any other common neighbor’s-health-affecting activity other than driving.

But even with all of that, the ethical case for taking away the rights of individual actors to decide whether to allow the exposure is very dicey.  It is quite controversial among the populace and even more so among people who seriously study such matters as rights.  Thus, it is obviously absurd to claim “every right” to ban something else that has a comparatively trivial impact.  There is no such right.  In fact, every notion of rights in our society cuts in the other direction.

This example illustrates that someone can be unambiguously lying when making claims in a non-scientific field.  It is possible to make a statement in political philosophy or some other area of ethics that is clearly false as a false scientific claim.  Someone saying “I personally think it is ok to….” is not a lie.  But misrepresenting the entire basis on which our society is built?  I would have to say that this is a rather worse lie (and a rather worse commentary on our educational system) than merely falsely claiming that something causes cancer.

Should

background analysis, posted by Carl V Phillips

A couple of recent posts here have identified as a lie an author’s statement about what should be done.  This might seem a bit odd.  After all, it would seem that someone’s opinion about what ought to be done in the world cannot be wrong.  That is indeed true, so long as they make clear that they are basing their normative statement on their own opinion per se.  (Normative = philosophy or economics jargon for a “should” claim.)  A statement like, “I would prefer a world in which smokers do not have low-risk options, and therefore X should be done to interfere with adoption of THR,” cannot be a lie.

But when a normative statement is made based on some stated goal other than the whim of the author, then it can be false.  And if the author knows the claim is false — or claims to be sufficiently expert that he should know — then it is a lie.

If someone claims that an anti-THR action (product bans, message to smokers, etc.) is justified by public health concerns, they are lying.  (Alternatively, they are utterly clueless and are just some other liar’s useful idiots — but I will set them aside for this analysis and just focus on those who claim expertise.)  It is theoretically possible to concoct a scenario in which promoting THR could be bad for public health, and if someone actually does that, then they are not lying about the “should” (though they might be lying when they describe the scenario).  But lacking such a tortured scenario as part of the analysis, THR is so clearly pro-public-health that the “should” is a lie.

Similarly, if someone states “e-cigarettes contain chemical X and therefore should be avoided” or “…should be prohibited from public use”, it is a lie if the quantity of chemical X creates no known risk, or a risk down in the range of the thousands of exposures that are normally accepted.

Of course, most of the time someone makes a normative statement, they offer no explicit explanation for the normative standards (ethical rules) that they are using.  Typically, however, this can be inferred from context.  If the discussion surrounding the normative statement is about public health, we can infer that the normative claim is about what would be best for public health.  If it is about individual users’ health, that is the implied basis for judging what is best and thus the “should”.

Someone is free to explicitly state their normative standard is something other than what the reader would naturally infer.  But if that is what they are doing, they are obliged to be specific and argue that their normative claim is supported in spite of the lack of a normal public health argument.  In general, if someone is arguing based on a motive or ethic that is hidden, they need to make that explicit.

If that last sentence sounds familiar, it should.  It is really just another way of bringing up the issue of conflict of interest that was the subject of last week’s background post.  So, for example, when the American Lung Association advocates against THR (see previous post), they are lying to most readers, who reasonably assume they are taking a position that would tend to improve lung health, when in reality their position is bad for lung health.  It turns out that buried in their mission statement is an incongruous anti-t0bacco extremist (and thus anti-THR) position.  But unless they make clear they are acting based on that extremist mission, rather than a goal of promoting public health (let alone lung health) then they are lying.  Moreover, they should make clear that they are acting based on a clear conflict of interest: anti-tobacco extremism conflicts with the missions of lung health and public health in general.

An honest author is obliged to make clear their motive and its downsides and COIs.  The ALA cannot be honest unless they explicitly say “we oppose low-risk alternatives to smoking in spite of the fact that promoting such alternatives is good for lung health.”  Obviously they cannot fit this into everything they write on the subject, but because they do not make that clear in any of their writings — but instead pretend that being anti-THR is part of their lung health mission — then everything they write on the subject is a lie.

Compare:  No one who honestly writes about THR fails to acknowledge that even low-risk nicotine products probably pose some small risk of premature mortality compared to complete abstinence.  Sophisticated writers on the subject further acknowledge that more people will (quite rationally) use tobacco/nicotine when low-risk products are an option, rather than just cigarettes.  We then argue that THR is good for public health (among other things) in spite of those facts.

In addition, when someone presents a basis for making a normative claim that is likely to be controversial, they are obliged to make that clear rather than trying to hide it.  Consider the example from the previous post, where Standon Glantz called for vaping to be banned wherever smoking is banned.  He was clearly misrepresenting the science of the study he cited, and that was an indefensible lie.  But setting that aside, he also hinted at an ethic that could make his normative claim defensible: “No one should have to breathe these chemicals, whether they come out of a conventional or e-cigarette.”  Not “no one should have to breath these chemicals when produced by someone else”, but specifically if they come out of one of those products (which, I noted, are what he really cares about: products, not people).

So, he could have written:  “There is no reason to believe that environmental e-cigarette vapor causes any health problems.  But I believe that unlike a thousand other minor sources of air pollution that people inflict upon each other, which should not be banned when they are trivial and have no apparent health effect, any bit of air pollution from an e-cigarette should not be allowed.”  That would have been honest.  But it then would have been his obligation to convince people that this position is acceptable to take in a free society where most people do not share his personal pique.

Moreover, he would also be obliged to explain why this value of accomplishing this one goal — eliminating any bit of emission from this one particular source — outweighs the costs.  In particular, why is the supposed value of this goal sufficient to outweigh the public health costs of encouraging smokers to continue smoking.  In addition, he would need to argue that his personal goal justifies depriving people of private property rights and a host of other considerations.

Indeed, that last point brings up a further important consideration:  Not only is “getting rid of products that a few people find objectionable” not an accepted basis for normative judgment, but “improving public health” alone (absent a consideration of the myriad other preferences that people have) is not either.  More on that another day (or just read the tens of thousands of words that I and others write on that subject every year).  But even starting from the absurd normative position that public health trumps all other human preferences, anti-THR “should” statements are almost always lies.