Monthly Archives: March 2016

Smoking is normal, and acknowledging that is part of proper tobacco harm reduction

by Carl V Phillips

Audrey Silk, via her CLASH organization in New York, recently launched a “Smoking is Normal” campaign (CLASH Facebook page, campaign Facebook page, press release). All the talk we hear about e-cigarettes “renormalizing” smoking is premised on a claim that something that about a fifth of the U.S. population does (and a larger portion in most rich countries) is not normal. In terms of prevalence, it is much more normal than being gay or being an American muslim. But think of the outcry — from very people who tend to be anti-smoker — that results when someone so much as points out those statistics, let alone suggests anything is abnormal about being in one of these minorities. Smoking is more normal than marrying outside one’s race or even marrying someone whose height percentile differs markedly from one’s own.

Of course, “denormalization” rhetoric is not an empirical claim about prevalence. It is a political tactic, an attempt to denigrate some people as being abnormal, in a sense that means abhorrent or deviant. In that sense, it is every bit as anti-THR as the most visited topic of this blog, attempts to convince people that a low-risk alternative to smoking is more harmful than it really is. No one who supports “denormalization” of smokers can be said to genuinely support tobacco harm reduction. Continue reading

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An excellent indictment of public health paternalism

by Carl V Phillips

This is mostly an outsource: Go read this truly excellent case against paternalism by a professor of public health at Boston University with the unfortunate name, Leonard Glantz. I do not recall reading any analysis of this caliber by a public health professor since…, well since I was a public health professor (and I cannot claim I wrote anything quite so good on this particular topic back then). It deserves the highest praise: I wish I had written that.  Continue reading

An old letter to the editor about Glantz’s ad hominems

by Carl V Phillips

I am going through some of my old files of unpublished (or, more often, only obscurely published) material, and though I would post some of it. While I suspect you will find this a poor substitute for my usual posts, I hope there is some interest (and implicit lessons for those who think any of this is new), and posting a few of these will keep this blog going for a few weeks.

This one, from 2009, was written as a letter to the editor (rejected by the journal — surprise!) by my team at the University of Alberta School of Public Health. It was about this rant, “Tobacco Industry Efforts to Undermine Policy-Relevant Research” by Stanton Glantz and one of his deluded minions, Anne Landman, published in the American Journal of Public Health (non-paywalled version if for some unfathomable reason you actually want to read it). The authorship of our letter was Catherine M Nissen, Karyn K Heavner, me, and Lisa Cockburn. 

The letter read:

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Landman and Glantz’s paper in the January 2009 issue of AJPH is a litany of ad hominem attacks on those who have been critical of Glantz’s work, with no actual defense of that work. This paper seems to be based on the assumption that a researcher’s criticism should be dismissed if it is possible to identify funding that might have motivated the criticism. However, for this to be true it must be that: (1) there is such funding, (2) there is reason to believe the funding motivated the criticism, and (3) the criticism does not stand on its own merit. The authors devote a full 10 pages to (1), but largely ignore the key logical connection, (2). This is critical because if we step back and look at the motives of funders (rather than just using funding as an excuse for ignoring our opponents), we see that researchers tend to get funding from parties that are interested in their research, even if the researcher did not seek funding from that party (Marlow, 2008).

Most important, the authors completely ignore (3). Biased motives (whether related to funding or not) can certainly make us nervous that authors have cited references selectively, or in an epidemiology study have chopped away years of data to exaggerate an estimated association, or have otherwise hidden something. [Note: In case it is not obvious, these are subtle references to Glantz’s own methods.] But a transparent valid critique is obviously not impeached by claims of bias. The article’s only defense against the allegation that Glantz’s reporting “was uncritical, unsupportable and unbalanced” is to point to supposed “conflicts of interest” of the critics. If Glantz had an argument for why his estimates are superior to the many competing estimates or why the critiques were wrong, this would seem a convenient forum for this defense, but no such argument appears. Rather, throughout this paper it seems the reader is expected to assume that Glantz’s research is infallible, and that any critiques are unfounded. This is never the case with any research conducted, and surely the authors must be aware that any published work is open to criticism.

Indeed, presumably there are those who disagree with Glantz’s estimates who conform to his personal opinions about who a researcher should be taking funding from, and yet we see no response to them. For example, even official statistics that accept the orthodoxy about second hand smoke include a wide range of estimates (e.g., the California Environmental Protection Agency (2005) estimated it causes 22,700-69,600 cardiac deaths per year), and much of the range implies Glantz’s estimates are wrong. But in a classic example of “a-cell epidemiology” [Note: This is a metaphoric reference to the 2×2 table of exposure status vs. disease status; the cell counting individuals with the exposure and the disease is usually labeled “a”.], Glantz has collected exposed cases to report, but tells us nothing of his critics who are not conveniently vulnerable to ad hominem attacks.

It is quite remarkable that given world history, and not least the recent years in the U.S., people seem willing to accept government as unbiased and its claims as infallible. Governments are often guilty of manipulating research (Kempner, 2008). A search of the Computer Retrieval of Information on Scientific Projects database (http://report.nih.gov/crisp/CRISPQuery.aspx) on the National Institute of Health’s website found that one of the aims of the NCI grant that funded Landman and Glantz’s research (specified in their acknowledgement statement) is to “Continue to describe and assess the tobacco industry’s evolving strategies to influence the conduct, interpretation, and dissemination of science and how the industry has used these strategies to oppose tobacco control policies.” Cleary this grant governs not only the topic but also the conclusions of the research, a priori concluding that the tobacco industry continues to manipulate research, and motivating the researcher to write papers that support this. Surely it is difficult to imagine a clearer conflict of interest than, “I took funding that required me to try to reach a particular conclusion.”

The comment “[t]hese efforts can influence the policymaking process by silencing voices critical of tobacco industry interests and discouraging other scientists from doing research that may expose them to industry attacks” is clearly ironic. It seems to describe exactly what the authors are attempting to do to Glantz’s critics, discredit and silence them, to say nothing of Glantz’s concerted campaign to destroy the career of one researcher whose major study produced a result Glantz did not like (Enstrom, 2007; Phillips, 2008). If Glantz were really interested in improving science and public health, rather than defending what he considers to be his personal turf, he would spend his time explaining why his numbers are better. Instead, he spends his time outlining (and then not even responding to) the history of critiques of his work, offering only his personal opinions about the affiliations of his critics in his defense.

References

1. Landman, A., and Glantz, Stanton A. Tobacco Industry Efforts to Undermine Policy-Relevant Research. American Journal of Public Health. January 2009; 99(1):1-14.

2. Marlow, ML. Honestly, Who Else Would Fund Such Research? Reflections of a Non-Smoking Scholar. Econ Journal Watch. 2008 May; 5(2):240-268.

3. California Environmental Protection Agency. Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Executive Summary. June 2005.

4. Kempner, J. The Chilling Effect: How Do Researchers React to Controversy? PLoS Medicine 2008; 5(11):e222.

5. Enstrom, JE. Defending legitimate epidemiologic research: combating Lysenko pseudoscience. Epidemiologic Perspectives & Innovations 2007, 4:11.

6. Phillips, CV. Commentary: Lack of scientific influences on epidemiology. International Journal of Epidemiology. 2008 Feb;37(1):59-64; discussion 65-8.

7. Libin, K. Whither the campus radical? Academic Freedom. National Post. October 1, 2007.

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Our conflict of interest statement submitted with this was — as has long been my practice — an actual recounting of our COIs, unlike anything Glantz or anyone in tobacco control would ever write. It read:

The authors have experienced a history of attacks by those, like Glantz, who wish to silence heterodox voices in the area of tobacco research; our attackers have included people inside the academy (particularly the administration of the University of Alberta School of Public Health (National Post, 2007)), though not Glantz or his immediate colleagues as far as we know. The authors are advocates of enlightened policies toward tobacco and nicotine use, and of improving the conduct of epidemiology, which place us in political opposition to Glantz and his colleagues. The authors conduct research on tobacco harm reduction and receive support in the form of a grant to the University of Alberta from U.S. Smokeless Tobacco Company; our research would not be possible if Glantz et al. succeeded in their efforts to intimidate researchers and universities into enforcing their monopoly on funding. Unlike the grant that supported Glantz’s research, our grant places no restrictions on the use of the funds, and certainly does not pre-ordain our conclusions. The grantor is unaware of this letter, and thus had no input or influence on it. Dr. Phillips has consulted for U.S. Smokeless Tobacco Company in the context of product liability litigation and is a member of British American Tobacco’s External Scientific Panel.

Harm reduction, State, and Utopia

by Carl V Phillips

There is an interesting debate-free debate going on among vaping advocates, about how to respond to pro-ecig tobacco controllers and similar authorities. There is concern about whether it is wise to embrace and exalt tobacco control crusaders — people and organizations who have been a part of the junk science, vile tactics, and authoritarian approaches used in that crusade — because they have taken some kind of pro-ecig stance. Most of the concerns expressed about that embrace are along the lines of: Continue reading

Admin notes

In a bit of good news for readers, I realized that I have several posts that I have conceived or that are even mostly drafted that I had been suppressing when CASAA published this blog (either due to the legal problems that might arise from CASAA’s nonprofit status for discussing partisan politics, or because of CASAA’s aversion to disagreeing with anyone who is pro-ecig).  I will be trickling those out, though not at the pace I kept up in the CASAA days.

Also, I have revived my THR science discussion page at Facebook. For the moment anyway, it is my new home for discussing these issues. (Never trust a pundit who lives in an echo chamber and does not engage in such discussions!) I apologize for those who do not do Facebook — I hate it too, but it is convenient. Anyone is welcome to join in; if you read this blog, you are the target audience.

Phillips and Burstyn departure from CASAA

by Carl V Phillips

CASAA (The Consumer Advocates for Smoke-free Alternatives Association), the publisher of this blog up until today, has decided to focus its resources on mobilizing responses to state and local regulation proposals and it thus cannot devote substantial resources to science and education efforts. The position of chief scientist (held by me since its creation) has been eliminated and thus my role with CASAA has ended. Citing a lack of interest in an organization with this change of focus, Igor Burstyn resigned his membership on the CASAA Board of Directors and is also no longer associated with the organization.

I will be keeping possession of this blog, though obviously nothing from this point forward will be written on behalf of CASAA as the previous posts were. I am not entirely sure what I am going to do with it. For the moment I will keep posting, resources permitting, though I expect I will focus on big-picture and deeper issues rather on critiques of individual bits of bad science (as I have been tending toward for the last several months anyway). While the former is not such great click-bait as the latter, it is important that someone keeps on it. Even though it is not as widely read for entertainment, I notice that the deeper analysis does trickle into the wider conversation. I think my scientific education efforts regarding THR over the last decade, along with Rodu’s, Bates’s and others’, have empowered enough people to be able to do the hot takes on the individual bits of junk science, so my efforts there are not so important as they once were.

Of course, it is possible that whatever I do next (I am still trying to sort that out) will preclude me from continuing the blog and related research and analysis. I might I go off in a completely different direction, such that I cannot keep up with this. Or I might take a position that is not compatible with speaking freely. We shall see. Continue reading

Newsflash: Tobacco companies are incredibly timid

by Carl V Phillips

In the previous post, I commented upon the most recent in the endless series of analysis-free and truth-free McCarthyist demands from “public health” to censor industry-funded research (as well as upon what I felt was an inadequate retort to it). I quipped on Twitter that every time I read one of those pieces, I feel like I am reading @DPRK_News. If you are not familiar, that is a great parody feed that satirizes what official communications from North Korea might say about domestic and foreign events. The parody is grounded in filtering events through over-the-top premises about the depravity of the West and the success of the North Korean government. It is not exactly a mystery why the political statements of core “public health” people resemble what we might expect to hear from a cult of personality that keeps its subjects completely cut off from reality, bragging about its performance (which is, of course, mind-boggling disastrous), while making up crazy stories about the rest of the world. Continue reading