Tag Archives: UCSF

What is peer review really? (part 4a – case study followup)

by Carl V Phillips

I thought it would be worth taking this series non-linear to follow up on Part 4, which used the recent Popova-Ling “peer-reviewed journal article” as a case-study to illustrate much of what is wrong with journal peer review and the fetishizing thereof in “public health”. Popova and Glantz relied on that paper in the comment to the FDA that I discussed in yesterday’s post about Swedish Match’s MRTP application, which asks permission to remove the false and misleading “warning” labels from their products. This is a great illustration of why the fetishization, “it is in a peer-reviewed journal, so it must be right”, is such a dangerous travesty. (H/t to Brian Carter inspiring some of the observations that appear here.) Continue reading

More on the FDA and MRTP

by Carl V Phillips

In the previous post, I linked to CASAA’s comment to the FDA re Swedish Match’s MRTP application, wherein they ask to be able to change the “warning” labels on their smokeless tobacco products to not “warn” about risks that do not exist and to move a bit(!) closer to communicating the low risk of these products as compared to smoking. Clive Bates also weighed in on this, via this post and his own comment to FDA on the application. It is worth following up on some of his points and some others. Continue reading

New public health research: lying to people can affect them (as if they didn’t already know)

by Carl V Phillips

A new paper in the normally more-respectable BMC Public Health, by never-respectable ANTZ at the University of California (San Francisco) reports research that mostly showed that, if people were given disinformation claiming (nonexistent) health effects from smokeless tobacco and e-cigarettes, accompanied by gory pictures, then they will be tricked into to thinking the risk was higher. Surprise!

Well, of course, it is no surprise that people can be tricked and no surprise that UCSF “researchers” would conduct such unethical research. It is rather more of a surprise that the non-ANTZ BMC Public Health would publish it and that an ethics committee would allow it to be done. Ok, maybe not the latter — the ethics committees are pretty much in the pocket of public health. That committee at UCSF probably would never allow, say, Farsalinos’s survey of e-cigarette users, and would trump up some claim that it was a threat to the study subjects, whereas they allowed serial liars Lucy Popova and Pamela M Ling a free hand to tell people they might as well smoke.

Anyway, Clive Bates was first off the block in responding to this travesty, and he covered the breadth of it well, so I am not going to reinvent the wheel here.  Go read what he wrote first. Then come back to this, wherein I go deeper into a few specific points. Continue reading

More anti-THR junk science from UCSF, the new Karolinska

by Carl V Phillips

As I alluded to yesterday, there is another bit of anti-ecig junk science out today.  Once again, it is from the Glantz shop at UCSF.  Glantz did not put his name on this paper (presumably to create the illusion among the naive that this is not all part of a single organized disinformation campaign), but that hardly matters.

The little study (published as a “research letter”) followed a small group of smokers for one year, and compared quit rates for those who had recently tried an e-cigarette at the baseline survey and those who had not.  They found that those in the former group had a slightly lower abstinence from smoking at followup.  Clive Bates does a good job of pointing out how this thin result led to overblown conclusions, and then UCSF created a misleading press release, and this tricked the press into reporting out-and-out falsehoods.  Do read Clive’s post for more — there is no reason for me to repeat it here.  (If the NYT picks up the story, I might respond to that, but I am not inclined to spend any effort responding to random stories from unsophisticated news sources.) Continue reading

Anti-THR liars of the year (and #8: Stanton Glantz and UCSF)

2014 might be the year that determines whether tobacco harm reduction (THR) will sweep the world (at least the wealthy parts of it) by 2025, or whether its delay, and the resulting suffering and death, will drag out for another decade after that.  That made 2013 an interesting year for those of us who monitor the extremists who are actively working in support of the suffering.

After we decided we should do a year-end countdown for 2013, it quickly became apparent that this does not lend itself to just listing particular individuals.  The lying is really not about particular personalities, though we do mention a few who stand out (not in a good way).  Thus, the list is a hybrid of people, types of liars, and types of lies, with the named entities mostly serving as symbolic representations.  It also became apparent that it was not all that useful to just base this on some rough counting of the lies, how blatant they were, and how loud they were shouted.  Rather, this is a gut-level hybrid that considers that, but also how much the lies and the liar matter and other considerations.  So you will see that the entity whose actions matter the most on this list is at #3, while the most blatant and aggressive liar is #8.  Also, rather than forcing the count to match the number of fingers humans happened to evolve, we identified those worth mentioning and went with that count.  Thus, we start with #8: Stanton Glantz (from the archives) and the University of California, San Francisco, whose once good reputation among real scientists has been heavily damaged by Glantz and his anti-tobacco extremist colleagues.

Now some might be surprised to see Glantz so low on the list because, as noted, he does earn the special award for Most Aggressive Liar.  For the course of a decade of all the anti-smokeless-tobacco lies, he was relatively silent about THR, despite being one of the most toxic anti-smoker activists, in terms of both his lies and general innumeracy and cluelessness about science.  But this year he turned his superpowers — an apparent inability to distinguish lies from truth (or the sociopathology to not care about the distinction) and ability to trick people into thinking he understands science at better than a middle-school level — to anti-e-cigarette activism.  He ranks low, however, because he is just an accident of history, the person who happened to stumble into the crazy jester niche that someone always fills.

For any contentious and important topic, there is room for someone to gain fame and fortune by being the extremist liar, and so someone always fills that niche.  For most lie-based activist positions, the Loudest Liar niche tends to be filled by some entertainer or gadfly of letters, or an organization that can attract a few wealthy backers.  But when there is government grant money backing the lies, it is often an unscrupulous mediocre professor who fills the niche.

Still, Glantz is worth mentioning as more than a generic type because of a few particular propensities.  Most notably he excels at relentlessly repeating lies about what research shows, even after being explicitly publicly corrected by the researchers (and anyone else with basic literacy skills who weighs in), who point out that he is completely misrepresenting their results.  Those are some serious crazy-liar chops.  Few people, even among the other major anti-THR liars, will so baldly misrepresent what the science shows (except when it is the junk science from their tobacco control industry fellows, and thus the authors misrepresent it in the first place).  Fewer still are so unconcerned with their reputation that they will keep repeating the lies after being pointedly reprimanded for them (or perhaps they actually have a sense of decency).  For that, Glantz rises above (which is to say, sinks below) just being a font of generic lies.

He further secures a position on the list, in spite of having descended to jester status — even within the tobacco control community — because he and UCSF won one of FDA’s huge Tobacco Centers of Regulatory Science (TCORS) grants.  Frankly, this award says more about the process used to decide these awards.  (Aside:  it is not just those of us who prefer real science over tobacco control who feel that process was an embarrassing failure.  In addition to turning down some excellent applications from politically neutral centers and industry-academic cooperations, they turned down quality applications from established tobacco controllers who are good scientists — and were also livid about this — in favor of the UCSF hacks who apparently do not even know 101-level concepts like the difference between correlation and causation.)  Unfortunately, that center grant is going to lend some credibility to the hacks among the ignorant masses even though, among the knowledgeable, it instead serves to damage the credibility of the granting process.

The one bright spot about funding in this story is that UCSF sought grassroots crowdsourced donations to support one of their anti-e-cigarette “research” efforts but were offered only a pittance from a few donors in spite of offering incentives.   (If you click that link, notice that they already declared what conclusion they would reach in the request for funding, much as they did with the TCORS application — they do not do research, they write political propaganda and do not even try to hide that plan.)  Contrast this with CASAA’s research fundraising, in which we secured that sum for the Igor Burstyn research in four days.  There simply is no grassroots support for the likes of Glantz and UCSF, and tobacco control in general.  There might be millions of people who will express pro-TC and anti-THR opinions in opinion surveys, but their feelings are only a millimeter deep — they would not spend a dollar or a minute of their time supporting that cause.  As some of the rest of this countdown will further illustrate, anti-THR exists only because extremists have seized control of some government and other institutions, but that control is eroding as their lies become more widely understood.

Stanton Glantz – liar or innumerate? New evidence says: both!

by Carl V. Phillips

I am working on a couple of things that will lead to some original research appearing here.  In the meantime, I will contribute to some ongoing discussions.

As my readers will know, I have had a long-time hobby project of trying to figure out to what extent that anti-tobacco extremist Stanton Glantz, a professor at UCSF (I assume he teaches innumeracy), is just utterly clueless about what he claims expertise in, or whether he is intentionally lying.  You can search the archives and see that I have come to lean toward “intentionally dishonest” quite often, but he still offers enough detail about some of his claims that suggest he just does not understand simple scientific points.

Readers of this blog will know there are many of each kind of liar.  My casual empiricism suggests that most institutions identified as anti-THR liars intentionally lie while most single individuals who are identified simply do not know what they are talking about (in which case their intentional lie is to claim expertise that they do not have and to try to inappropriately influence others’ beliefs).  On the other hand, when individual anti-THR liars are at respectable universities, the trend shifts to them apparently knowing that they are lying.  Of course, the anti-smoking operation at UCSF resembles a respectable university only in the sense that it takes place indoors.  Bottom line:  No clues about Glantz from general principles.

To find further evidence, consider a story that has been covered in two posts by Michael Siegel, about Glantz’s interpretation of a recent research paper.  The paper reported on a study of smokers who called “quit lines”, and was a basic overview of who they were, with a bit of semi-useful follow-up data.  Like any such study, it is not very informative about anything, but not useless, and the authors seemed to understand this.  The paper emphasized e-cigarettes, and the study asked why those who tried them did so (mostly to try to quit, of course).  One of the observations in it was that those callers who had tried e-cigarettes in the past were a bit less likely to quit during a period after calling the quit line than those who had not.  (Surprise! People who tried a very effective method for quitting but still kept smoking were the type of people who would not then quit a short time later.)

To be clear, the authors did not suggest any causal claims about this.  Several commentators criticized the study authors for doing biased anti-e-cigarette research and drawing inappropriate conclusions.  But if you read the paper, they really did not (the introduction about e-cigarettes was rather naive, but that is just a throw-away).  Moreover, when they blogged about it, they actively disputed the inappropriate interpretation (subtext: they smacked Glantz down rather thoroughly), rather than employing the “public health” tactic of embellishing headline-generating claims that were not even in the paper.  All in all, very respectable and honest work by the original authors.

Glantz, in what appeared to be a demonstration of his lack of knowledge of even elementary-level epidemiology, interpreted the study as evidence that e-cigarettes do not help smokers quit.  He seemed genuinely unaware of what the study actually showed, even though any second-semester student should have been able to figure it out.  There are some very basic epidemiologic concepts (selection bias, immortal person-time, unhealthy survivor effect) that anyone with a basic understanding of the science would see make it impossible to draw the conclusions that he did.

Basically, any smoker who “survived” the use of e-cigarettes and remained a smoker (i.e., trying e-cigarettes did not take them out of the study population) is necessarily someone for whom e-cigarettes are not an easy path to quitting.  The mere fact that they were able to be studied meant that they are not among those who e-cigarettes were a good way to quit.  Obviously this shows that e-cigarettes do not work for everyone (no shock there) but tells us nothing about how often they do work.  Moreover, the fact that they tried e-cigarettes and also called a quit line suggests that they are looking for a personally acceptable way out of smoking and not finding it.  Studying such a population can be interesting for some purposes, but obviously not for purposes of drawing conclusions about smokers in general.

The study authors understood this and presented it (though, I would argue, not as clearly as they could have).  Expert readers noticed it without needing that clarification.   Glantz, however, seemed genuinely oblivious, so score a point for the “innumerate” theory.

However, the plot thickens.  Because this is a rare case where someone spouting a very specific anti-THR lie is actively shot down by the very people he claims to be citing, any further repetition of the lie is a clear indication of intentional dishonesty.  As Siegel noted, it had been clearly pointed out to Glantz by himself and the study authors (and this was such a one-person issue that there is no possible way he did not receive multiple copies of each of these), and yet he persisted in making the exact claims, in particular in a radio interview.  Score a decisive point for the “intentional liar” theory.

So the answer seems to be both.  That is, Glantz seemed to have genuinely made the elementary error in his initial analysis, and seemed to believe what he was saying.  And yet after he was definitively corrected, he kept saying it.  So:  Innumerate about the field he works in and actively dishonest in his public statements.  He certainly chose his career path wisely, finding one of the few jobs for which those are considered beneficial traits.

Credit where due: FDA

by Carl V Phillips

I’m back.  Sorry for the long absence — for obvious reasons, the blog loses out to paid work, family vacation, and (the only bit that is actually of interest to you) preparing a presentation for and attending the Tobacco Merchants Association meeting last week.  A bit more about TMA in a later post.  Today I want to focus on what was said about and by FDA at that meeting.

First, the good news:  In a presentation at the meeting, the head of TMA, Farrell Delman, pointed out that FDA had changed their website in a few places to make clear that the CDC estimated deaths from smoking are from smoking and not tobacco.  (I did not note which specific pages Farrell showed in his talk, but here (pdf) is one example I just found.)  As regular readers know, blaming “tobacco” or “tobacco products” for the risks from smoking is probably the most pervasive anti-THR lie.  It perpetuates the misperception that smoke-free tobacco/nicotine products create a substantial health risk.

Unfortunately, the change is not universal, but I will choose to embrace Farrell’s optimism for the moment.  We can hope that the remaining instances of the misleading “tobacco” bundling language are either dated info releases that would not be appropriate to change (the government is really not allowed to memory hole past statements) or places where they have just not yet noticed they need to make the change (like here or the sidebar here — hint, hint!).

And, of course, no doubt if you followed those links you noticed various other bits of anti-THR misinformation that still remain.  But any steps in the right direction are good news.  Pervasive myths are not fixed in a day.

Also on the frustrating side was the continued emphasis, as seen in the presentation of David Ashley, the CTP science chief, of the supposed possibility that low-risk products could lead to an increase in total population health risk by attracting new users who avoid smoking because of the risks (my liberal paraphrase of a couple of much less detailed bullet points).  Simple arithmetic shows that is impossible, but FDA has to emphasize it because it is so clearly enshrined in their enabling legislation.  This relates closely to my presentation at TMA, so I will comment more in a post about that (probably at EP-ology, but I will cross-post something here).

Back to the good news:  Mitch Zeller, the new head of the FDA’s tobacco unit (CTP) presented at the meeting and took questions.  So did Ashley.  Kathy Crosby, the new head of communications, had a prominent role in a panel.  The significance of this should not be underestimated.

During the Q&A for Zeller’s presentation, CASAA questioned CTP about the lack of consumer (i.e., the primary stakeholders in all of this) representation in their proceedings.  He invited us to submit a formal request, which we will send today or tomorrow.  It appears certain that this will give us a chance to present the consumer views to CTP in a special meeting.  It is less certain whether we will have a spot on the agenda for future hearings where other stakeholder presentations (industry, etc.) are included, but we are making every effort to ensure that consumers are given a place at the table.  We will keep you posted (and might recruit you to support our request should it seem useful).

In his presentation, Zeller made clear that the top priorities for the CTP currently include the “deeming regulation” that would bring e-cigarettes and some other products under FDA jurisdiction.  (Contrary to what you sometimes read, they are not currently regulated by FDA as a tobacco product, but probably will be.)  Whether this is done in a way that makes e-cigarettes better (i.e., serves the consumers’ interest, as FDA regulation is supposed to do) or in a way that threatens innovation or their very existence (serving the interests of the anti-tobacco extremists, who want to prevent harm reduction) remains to be seen.

Another stated priority is to get through some of the backlog of applications.  Unfortunately this does not matter much for real consumer interests, since as far as we can tell the overwhelming majority of these are just “substantial equivalence” applications by cigarette makers who just want approval for some insignificant change of their products.  It does not appear that there are any “MRTP” applications pending.  (That is the misnamed category that would allow harm reduction claims about a product — it is “modified risk tobacco products”, though the products that really matter are not modifications of existing products, but entire categories that have always been very low risk compared to smoking.  The misnomer itself is an anti-THR lie because it is designed to hide the fact that different categories of products have hugely different risks, though that is not the fault of FDA, but rather of the ANTZ that wrote the legislation that created CTP and their mission.  At least lawmakers changed the ANTZ’s proposed wording that would have completely forbidden any claims comparing low risk products to smoking, an obvious attempt to prevent THR.)  We believe there is at least one MRTP application in the pipeline, though unfortunately it is not for a low-risk product.

And on a less recent note, many of you may recall that FDA rebuffed attempts by the ANTZ at University of California San Francisco to make CTP their own private activist organization by threatening to boycott if stakeholders (in that case, industry) were allowed to even present their views.  (Though, of course, they showed up at the hearing to announce they were not showing up at the hearing.  We cannot expect them to be honest even in their protests, after all.)  CTP did not make any public response to this attempt to subvert the American political system, but they clearly did not give in.

I guess the bottom line is that we are in far from a perfect world, with regard to THR-related regulation, but it looks like a much better world than existed a year ago.

ANTZ and the mirror-image delusion

by Carl V Phillips

Last week there was a flurry of discussion about a call by UCSF’s ANTZ queen, Ruth Malone (and endorsed by that institutions chief ANTZ liar, Stanton Glantz), for a boycott of FDA proceedings that involved a dialog with tobacco companies.  The demand that actual stakeholders be excluded from policy, in favor of just leaving it to the self-appointed busybodies, is so utterly insane that I am not even going to bother to respond to it.  Others have done so.  And I certainly do not want to try to talk them out of the boycott like others have — if they want to let their megalomania and obsessions lead them to stay out of the discussion, but all means let them.

But the discussion surrounding this has starkly illustrated one particular delusion that seems endemic among the ANTZ, something that is common among non-thinking fanatics, and can be observed in various areas where people let their ideology determine their “facts”:  the belief that the one’s opponents are just like oneself, only in support of an opposing ideology, the mirror image delusion.  As a genuine delusion, this is not actually a lie, though it is the cause of numerous lies.  (Recall the position of this blog that actively affirming a false claim out of ignorance is still a lie if there is an explicit or implicit claim of expertise; even if you view inexcusable ignorance as different from a lie, there is still the lie about the expertise.  But this does not represent a claim of expertise.)

The clearest example of the mirror image delusion is that the ANTZ do not hesitate to corrupt scientific inquiry, lie about scientific results, and otherwise produce stinking pools of junk- and pseudo-science, and so they assume that their opponents have the same lack of concern about good science and ethics.  The calls by Malone and company to forbid stakeholder involvement are obviously transparent attempts to keep everyone but their fanatical minority out of the policy process.  But they attempt to justify the claim with something they seem to actually believe:  that the tobacco companies, and even the consumers (see, e.g., the previous posts about Glantz trying to censor consumers’ own testimonials about their success with THR), are liars.

The reality, of course, is that both the tobacco industry and THR consumer advocates conduct high-quality scientific research which is basically never challenged by the ANTZ.  Despite how glaringly clear this is, and despite the fact that the ANTZ surly must be aware that they never, in fact, find any evidence of lying or even aggressive spinning by the tobacco industry and other serious researchers and commentators, for many ANTZ these claims seem to be more than a mere tactic.  They seem to really believe them.  The only apparent explanation is that the ANTZ’s delusion leads them to assume that the people they are attacking must be as dishonest as they are, despite no evidence to support that claim.

One of the reasons the ANTZ never challenge the accuracy and honesty of their opponent’s research and analysis is that they would lose.  They have no ground to stand on.  As far as I am aware, no ANTZ has ever even tried to refute the arguments presented in this blog, and that is perfectly typical of their behavior.  However, I believe that another explanation is that they really do not think there is any point in disputing a claim because they do not pay any attention when someone disproves one of their claims, and they (falsely) assume their opponents act the same way.  I, and most of us in THR, would withdraw a claim (whether it be a scientific claim, an analysis that shows someone is a liar, or anything else) if it were shown to be wrong or even merely seriously disputable.

But the ANTZ basically never withdraw anything they have ever said, no matter how obviously false, and their mirror image delusion means that they are incapable of understanding that others act differently.  That is, they do not fail to debate merely because they would lose the debate (they would, but they often clearly are so clueless that they do not realize that), but because they live in an echo chamber and ignore everyone else, and so think that is true of everyone else also.

Another example relates specifically to their attempts to censor the stories of ex-smokers who have successfully used THR.  They claim that somehow all of the consumers reporting this evidence are corrupt and are only doing it on behalf of “industry”.  This seems to reflect several different bits of mirror image delusion.  Most of the ANTZ would never take the time to do anything they were not being paid for, and are themselves often doing the bidding of their paymasters.  For many, their delusions make them incapable of understanding that consumers and the rest of us who are genuinely concerned with public health do not behave that way.  Even more important, they know that most of the “public health” people who repeat the ANTZ lies are unthinking useful idiots who are acting entirely due to the manipulation by others (i.e., by the ANTZ leaders), and so they assume it must be true of the consumers too.

Perhaps most important, returning to the topic of junk science, the ANTZ do not actually care what information their “research” provides, and so they assume the same is true for their opponents.  They do not care whether or not a study shows some genuine reason to be concerned about a health effect; they just want to cook up results that seem to show a bad effect in order to support their ideology.  Their mirror image delusion prevents them from understanding that actual stakeholders — the people who have some real stake in THR, as opposed to the busybodies who have no stake and so are happy to sit on the outside and lob bombs at it — care quite a lot about the science.  Their failure to grasp this obvious non-similarity means that they assume that our scientific analysis must be like theirs — an attempt to support an ideology, rather than an attempt to understand and perhaps improve people’s health.

I suspect there are other good examples.  If any come to mind, I welcome them in the comments.