On the dangers of trusting in peer review

by Carl V Phillips

A recent CASAA effort asked our members to write a letter to Wyoming legislators opposing an amendment to their anti-tobacco laws (note the link is FYI — please do not fill out the form unless you are in Wyoming and reading this within a few days after it is posted). Someone looking at the details of what we objected to might find themselves saying, huh? (Note: this is not to be confused with the Call to Action from a few days before opposing an anti-consumer and anti-health massive increase on the smokeless tobacco tax.) The amendment was to add the following language about communication by the health department:

These programs shall include peer reviewed science based educational materials on tobacco harm reduction and the comparative risks of alternative nicotine products, vapor products, smokeless tobacco products, cigarettes and other combustible tobacco products.

What’s not to like, you might ask, about science-based educational materials about THR? It is that old devil-details thing. If RJR (who wrote the amendment) had been a little more careful and required it to say something like “scientifically accurate educational materials”, it might have been as good as it sounds on a naive quick read. But we all know what appears in the “peer-reviewed literature”, don’t we?

Basically most every statement ever made about tobacco products, no matter how contrary to the scientific evidence, no matter much of a blatant anti-THR lie, no matter how easy it is to debunk, appears somewhere in the fetishized peer-reviewed literature. Those who use the literature like a grade-schooler doing a toy research report assignment (as is sadly the case for most people writing in this area) will just say whatever they want and then find some journal article where the author asserts something similar. Since we already have evidence (example) of the anti-THR message the Wyoming Department of Health wants to communicate, it is easy to see where this goes. If the legislature actually provided the resources, it could go full-on California Lyin’ (warning: link is a PDF that takes forever to load — I think CA DPH runs their server via dial-up; other warning, in case you have not heard about California’s anti-ecig lies already: it is truly horrible).

[Aside: In fairness to the tobacco people who use references like a grade-schooler, this is the common practice in public health publishing and many other areas as well. I refuse — though often pushed to do otherwise by a coauthor or editor — to include a journal citation for a statement like “vaping is estimated to be two orders of magnitude lower risk than smoking.” How do I know that? Because I am familiar with most of the available science, in and out of journals, and have the expertise to evaluate it. I am not going to throw in a random citation to someone else saying the same thing, which adds nothing just because that opinion happened to have already appeared in a journal. The typical practice would be to just throw in a random citation, giving the false impression to naive readers that it substantiates the claim.]

But it is actually one step worse than that. Notice the reference is specifically to peer-reviewed educational materials. That could be interpreted as anything that provides information, thus being just a generic statement about what they post on their website, since that ought to be educational in the broad sense. But it could also be interpreted as meaning material that is specifically designed to be used in pedagogy. Who designs explicitly pedagogic material about tobacco products? We don’t. Industry doesn’t dare. Basically, it is just the ANTZ — and they can get anything they want into one of their own anti-tobacco “peer-reviewed journals”, of course. I do not actually know if there is official schoolish material out there, but I assume there is. If there is not, someone could just throw something together and get it successfully “peer-reviewed” no matter how bad it was.

The whole thing is kind of sad, actually, that CASAA had to oppose this (along with e-cigarette industry groups, AVA and SFATA). It is clear that RJR was trying to make sure that some government somewhere told some truth about THR, which seems like a good idea. It is just too bad that they did not try to get some real peer-review of the details, to avoid writing their amendment in a way that would basically just serve to put more force behind the lies, at least among those who are so naive as to believe in the usefulness of journal peer-review in this field.