Category Archives: Lies

Regular entries for this blog – bits of the catalog of lies.

Do vapers have an obligation?

by Carl V Phillips

I read an interesting brief thread just before taking my current yet-another break from Twitter (it is depressing, the world today; note that this means I will tweet that I have posted this, but may not look at my mentions). I am not linking or identifying the thread because the poster expressed a hint of doubt that s/he should really be quite so combative and emphatic about the point. But the emphatic nature of the tweets definitely had value because it got me thinking.

The upshot was, basically, “hey, you paid grandee types, please stop telling us, ordinary people who made a choice in our lives to quit smoking via vaping, that we have some obligation to get out there and spread the word, tell our stories, and push back against those other paid grandees who are attacking vaping.” It is a valid thought that is worth exploring.

Where might such an obligation come from?

There is the argument that we should all do something to try to make the world a better place, apart from our paid labor, and we should play to our comparative advantages there. That is, the admonishments can be read with the same tone as advice to vote or pick up litter: “Everyone do your part.” Then add the fact that vapers have an advantage in one particular area, offering help to smokers who might benefit from switching: “Anyone can pick up litter, but you are in a unique position to credibly tell the world ‘this works! try it!’.”

For some views of the social contract, this is enough to justify urging vapers to speak up. According to other views, of course, it is not. And for some vapers, it may not be their major comparative advantage (which might be creating public art or taking care of children), so this is relevant to some vapers, but not all. Universally-phrased admonitions imply that there are no such exceptions.

If that alone is not enough to create obligation (for either some or all success-story vapers), is there something more? Perhaps.

There is an argument that pay-it-forward situations create additional social obligation, beyond a generic “just do something to make the world better.” I could say that I and a few others worked hard for many years, at great personal sacrifice, to make your success story possible, and the least you could do is speak up to keep it going forward. But a legitimate retort to that is (a) “thank you, however I did not agree to repay, pay forward, or pay at all, so please do not suggest your largesse an obligation” and (b) “thank you, but today most people today who are telling me I should be out there doing stuff are profiting quite nicely from their work in this area, so it is not like I owe them anything.” (Yeah, I just suggested that the only legitimate responses include thanking the pioneers, even if it ends there — doing ethical philosophy does not remove all human desires :-).)

On the other hand, and I think this is in the spirit of the tweets that triggered this, there are a lot of things we could all be paying forward. We benefit from the efforts to defeat the Nazis, create the internet, eradicate smallpox, and ensure access to elementary education. But please do not tell me I should spend concerted time every day doing something for the next generation as a specific response to the advantage I got from each of those. (Note that I chose examples that someone profited from, quite a lot, but the people who really made sure it happened were doing it because it was social good.) What business does anyone have telling people which (supposed!) social obligation they should be proactively paying forward?

In some sense, telling someone that their vaping success is a defining element of their niche in society is just a variation on the tobacco control obsession mentality. It is a Most Important Thing In The World for a few people, but not for most people. For someone who fought or fights this war, just like someone who carried a rifle in a Good War (setting aside the question of whether anyone under the age of 90 qualifies as having done so), it is personally defining. So it is easy to think it is more socially defining — or personally defining for those affected — than it really is.

That’s all. No conclusions or policy recommendations. Just some thoughts about something that deserves some thoughts.

An overlooked lesson from Glantz harassment and fraud cases: tobacco is way out of FDA’s skill-set

by Carl V Phillips

I have written repeatedly about how FDA is totally outside their comfort zone and skill-set in dealing with tobacco products. The most obvious example might be them trying to deal with data from e-cigarette manufacturers, which caused their computer systems to melt down multiple times. I would guess it is a bigger database than every other database they have, combined, and is still growing. Similarly, their comically quaint attitude toward illicit markets, apparently genuinely thinking that the huge illicit market they would create by banning e-cigarettes or most e-liquid flavors, or removing the nicotine from cigarettes, will be as easy to handle as the tiny markets they deal with (not really very effectively) in counterfeit drugs and raw cheese. But the Glantz affair (see this post and what it links back to) brings up a more subtle problem.

FDA is used to dealing with criminals in the iron triangle they share with pharma and other big businesses. But it is the genteel world of halls-of-power crime.  People in that world clean up their own messes, cover up, and pay hush money and fines when necessary, and always create plausible deniability. But the tobacco portfolio puts FDA in bed with tobacco control, who are more like the Sopranos: They also get away with what they are doing, but not because create an image of respectability that deflects allegations. Their behavior is obvious for all to see, but they use intimidation, omerta, and corruption of those who should be policing to let them to get away with it.

This is not FDA’s preferred kind of crime. It puts them in a position for which they are not prepared.

A new BuzzFeed article by Stephanie M. Lee claims that FDA has no policy in place for dealing with sexual harassment charges against extramural researchers. Since this is a direct quote from an FDA spox, I suspect it is probably accurate, even though so much of the rest of Lee’s article is naive or out-and-out wrong.

(My personal favorite is when she credits Retraction Watch with breaking the story of the Glantz settlement in an article that came out… a mere week after I published my much deeper and more accurate analysis of the settlement. And I read at least three other stories about it in between those. My seven-year-old also sometimes does that too — thinking that whoever he first heard about something from is the one who discovered it — so I guess he is ready to write for BuzzFeed. I am still ok giving her a link, though, because she gets legacy credit for originally publicizing the story last year.)

More interesting is Lee’s naivety that probably generalizes to other observers, that FDA’s lack of a policy should be seen as nothing deeper than an outgrowth of NIH’s less-than-muscular response to situations like this. A key bit of background here (which Lee and most others may not realize) is that because doing grants is outside of FDA’s comfort zone, they were officially outsourced to NIH and thus are subject to NIH rules. NIH recently put a stronger policy in place and put out an article that at least says all the right stuff about #MeToo. It is not difficult to connect the dots here: It would not be surprising if UCSF raced to get this case against Glantz settled without an admission of guilt because of NIH’s new positions. (As I noted in my analysis of the settlement, the plaintiff got rolled into agreeing to get almost nothing, perhaps because her lawyer decided she would not be convincing on the stand.) The alleged acts of sexual harassment are actually a minor part of what Glantz is accused of in that and another suit, but they are what pop press readers understand.

But today’s point is how FDA itself has no institutional capacity for dealing with such matters. NIH is not exactly good at dealing with these issues, but at least they have experience creating subsidiary shops at universities and thus with all the potential complications this creates. It seems safe to assume that there is plenty of harassment in the companies FDA works for …er, regulates, to say nothing of scientific fraud, but they cover their own messes and FDA can pretend it does not exist. They cannot ignore what happens in their subsidiary shops, and have no idea how to deal with it.

Lacking institutional capacity, and given that the Commissioner is a stuffed shirt, FDA’s response to this matter will probably default to the Center for Tobacco Products leadership. That is, it will default to career tobacco controllers. Chances are they will do what they usually do about fraud and other misdeeds: pretend they do not exist. Oh, but oops, tobacco controllers are also out of their element here too: Normally nobody looks closely at their misdeeds and they can bedazzle the press with faux-science. But a government-funded sexual harasser (to look at this case with the inaccurate simplicity of the pop press) gets traction.

It could be hard for both FDA and tobacco controllers to ignore if it is a recurring tangent in everything anyone writes about FDA for a while. They will have no clue how to deal with it. It will be amusing to watch.

Peer review of: Michal Stoklosa (American Cancer Society), No surge in illicit cigarettes after implementation of menthol ban in Nova Scotia, Tobacco Control 2018

For an explanation of what this post is, please see this brief footnote post.

The paper reviewed here is available, open access, here.


 

It is vaguely embarrassing to write a review of this piece, which is effectively a bad local newspaper story, dressed up as if it were scientific research (though not nearly as embarrassing as being the the journal that published it). However, it is worth a few minutes because it will inevitably be used in the absurd-but-persistent propaganda efforts to claim that bans — in particular, flavor bans — do not create alternative supply chains. The open access status of the article, unlike most articles at the journal, is a bit of a giveaway about its purpose.

On the upside, it is a good quick teaching example about the standard public health research practice of ignoring competing hypotheses and explanations. There are three layers of that in this case. Continue reading

Peer review of: Dunbar et al. (Rand Corp), Disentangling Within- and Between-Person Effects of Shared Risk Factors on E-cigarette and Cigarette Use Trajectories From Late Adolescence to Young Adulthood, Nicotine & Tobacco Research, 2018

by Carl V Phillips

For an explanation of what this post is, please see this brief footnote post.

The paper reviewed here is available at Sci-Hub. The paywalled link is here.

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The typical “gateway” paper consists of observing the exposure of whether subjects (typically teenagers) have, at baseline, engaged in a particular behavior (vaping, in this case), and then observing the association with an outcome behavior (in this case, smoking). There is also an even worse collection of papers that do not even assess the order of events and simply look at whether prevalent ever-exposed status is associated with prevalent smoking. All of these suffer from the obvious fatal problem that a positive association is inevitable because inclination to ever vape is associated with inclination to ever smoke. In a counterfactual world in which vapor products did not exist, someone who vaped in the real world would be more likely to smoke than average, and this would obviously not be caused by (nonexistent) vaping. In short, since a positive association is inevitable, regardless of whether the hypothesis “vaping causes smoking” is true, observing a positive association obviously tells us nothing about about the hypothesis.

The present paper attempts to improve upon the standard worthless analysis. This is a commendable goal, and there is information value in what was done (unlike most gateway papers). However, the contributed information is very modest and does not actually support the authors’ conclusions. In particular, they claim that their results support the gateway hypothesis, and that they do so in ways that the usual longitudinal studies do not. This is simply false. Continue reading

A subtle tobacco control self-contradiction lie, re FDA pumping cigarette stock prices

by Carl V Phillips

Tobacco controllers contradict themselves all the time. That is the inevitable result of them saying whatever seems expedient at the time, without any concern for whether the evidence supports it, or even even flatly contradicts it. When someone is sociopathic enough to do this (*cough* Trump *cough*), they will not only contradict the evidence, but (unless they have incredible discipline and intelligence, which they do not) also inevitably contradict themselves. Many of tobacco control’s self-contradictions are quite simple, with patently contradictory statements appearing in the same document, or even the same paragraph. It hardly seems worth searching out the contradictions that require analysis and observations across multiple threads. But this one is kind of interesting.

A classic tobacco control trope, which you still see a fair bit, is that tobacco companies have to recruit new generations of smokers to replace their current customers. Most of those reciting this probably actually believe it, which reflects public health people’s fundamental lack of awareness about how the world works. Anyone familiar with business (and I mean at just the level of reading the newspaper) will know that markets these days hardly look beyond the next quarter’s earnings. There is not the slightest interest in future generations, and barely any interest in two years from now. C-suite executives respond mainly to these very-short-term incentives. Even stakeholders in the company – medium- to high-level employees who are planning on working there for another couple of decades — do not care about selling products to future generations.

Similarly, an economic theory or long-term shareholder perspective says companies should not care about future generations. Even the most modest discounting of future profits makes sales to upcoming generations approximately worthless in present value terms. Shareholders would rather the companies buy back shares rather than investing in “recruiting” future smokers. If you believe in an anthropomorphic view that cigarette companies “want” to stay in business – rather than making the economically rational choice of maximizing profits as far as they go and sunsetting – then they would be better off expanding horizontally into other logistics businesses (including other tobacco products) rather than worrying about whether anyone is smoking in 2060.

But let’s assume that tobacco controllers are sufficiently innumerate about business that they actually believe that companies “need” to recruit new generations. Then it cannot possibly be that they also believe this:

FDA’s attacks on the vapor product industry drove up cigarette company stock prices because they portend less competition for cigarettes over the time horizon that actually matters to the markets, a couple of years. The market cap increase reflects the expectation that the companies will be able to sell cigarettes for a higher per-unit profit and sell more cigarettes (the former is more important in terms of profits — another simple market fact that tobacco controllers do not understand — but the latter is what matters most in terms of social impacts).

Here’s the thing: If someone believes that the companies (i.e., their shareholders) actually care about selling to future generations, as they have claimed for decades, and believes that vaping will cause future generations to smoke, as they claim in this tweet and frequently, they they would have to predict that threatening to shut down the vapor product industry would depress share prices, or at least not send them through the roof.

As I said, tobacco control lies of self-contradiction are typically so blatant that there is no reason we have to dig this deeply. I certainly do not want to give tobacco controllers too much credit, by implying that they ever actually assess their hypotheses against the evidence. Still, it does not hurt to run through the scientific implications of what they say to illustrate the layers of their dishonesty.

Dual use and the arithmetic of combining relative risks

by Carl V Phillips

It was called to my attention that UCSF anti-scientist, Stanton Glantz, recently misinterpreted the implications of one of his junk science conclusions. Just running with the result from the original junk science (which I already debunked) for purposes of this post, Glantz make the amusing claim that because vaping increases heart attack risk by a RR=2 and smoking by a RR=3 (set aside that both these numbers are bullshit) then dual use must have a RR=5. WTAF?

First off, there is no apparent way to get to 5 except by pulling it out of the air. It is apparent that Glantz thinks he was adding the risks: 2+3=5. Except you cannot add risks that way. Every first-semester student knows the formula for adding risks, which is based on the excess risk. Personally I have always thought that having students memorize that as a formula, rather than making sure they inuit it, is a major pedagogic failure. But that aside, they do memorize the formula, which subtracts out the baseline portion of the RR then adds it back, as should be obvious: (RR1 – 1) + (RR2 – 1) + 1. So, the additive RR = 2-1 + 3-1 + 1 = 4. Think about it: If you “added” Glantz’s way then two risks that had RR=1.01 (a 1% increase in risk) would add to 2.02 (more than double). Or two exposures that reduced the risk by 10% (RR=0.9) would add to an increased risk, RR=1.8. Not exactly difficult to understand why this is wrong.

Additivity of risks is a reasonable assumption if the risk pathways from the exposures are very independent. The excess risk of death caused by both doing BASE jumping and smoking is basically just the excess risk of each added together. (A bit less because if one kills you, you are then not at risk of being killed by the other.) If the risks from the two exposures travel down the same causal pathways (or interact in various other ways), however, adding is clearly wrong. If vaping causes a risk (for heart attack in this example, though that does not matter), then smoking almost certainly causes the same risk via the same pathway. There is basically no aspect of the vaping exposure that is not also present with smoking (usually more so, of course). When this is the case, there are various possible interaction effects. One thing that is clear, however, is that simply adding the risks as if they did not interact is wrong.

The typical assumption built into epidemiology statistical models is that the risk multiply. This is not based on evidence this is true, but merely on the fact that it makes the math easier. The default models that most researchers tell their software to run, having little or no idea what is actually happening in the black box, build in this assumption. It is kind of roughly reasonable for some exposures, based on what we know. In the Glantz case, this would result in a claim of RR = 2 x 3 = 6, which is also not the same as 5.

So, for example, if a certain level of smoking causes lung cancer risk with RR=20, and a certain level of radon exposure causes RR=1.5, then if someone has them both, it is not unreasonable to guess that the combined effect causes RR=30. The impact on the body in terms of triggering a cancer and then preventing its growth from being stopped seems like it would work about like that. On the other hand, there are far more examples where the multiplicative assumption is obviously ridiculous. If BASE jumping once a week creates a weekly RR for death of 20, and rock climbing once a week has RR=2, doing each once a week obviously adds, as above, for RR=21, rather than multiplying to 40. (Aside: most causes of heart attack are probably subadditive, less than even this adding of the excess risks, as evidenced by dose-response curves that flatten out, as with smoking.)

But importantly, notice the “each once a week” caveat. That addresses the key error with the stupid “dual use” myths by specifying that the quantity of each activity was unaffected by doing the other. If, on the other hand, someone is an avid BASE jumper, doing it whenever he can get away, and he takes up rock climbing, the net effect is to reduce his risk. The less hazardous activity crowds out some of the more hazardous activity. This, of course, is what dual use of cigarettes and vapor products (or any other low-risk tobacco product) does. This is not complicated. Every commentator who responds to these dual use tropes — and I am not talking epidemiology methodologists, but every last average vaper with any numeracy whatsoever — points this out. Vaping also does not add to the risk of smoking because it almost always replaces some smoking rather than supplementing it. In this case, using Glantz’s fictitious numbers, it would mean the RR from dual use would fall somewhere between 2 and 3. Not added. Not multiplied. Not whatever the hell bungled arithmetic that Glantz did. Between.

As I said, everyone with a clue basically gets this, though it is worth going through the arithmetic to clarify that intuition. It is not clear whether Glantz really does not understand or is pretending he does not — as with Trump, either one is plausible for most of of his lies. Undoubtedly many of his minions and useful idiots actually believe it is right. The “dual use” trope gets traction from the fact that interaction effects from some drug combinations are worse than the risk of either drug alone. Many “overdose” deaths are not actually overdoses (the term that should be used for all drug deaths is “poisonings” to avoid that usually incorrect assumption), but rather accidental mixing of drugs that have synergistic depressant effects, often because a street drug was secretly adulterated with the other drug.

But as already noted, that is obviously not the case with different tobacco products, whose risks (if any) are via the same pathways. Even if total volume of consumption was unaffected by doing the other (as with “each once a week”) the risks would not multiply and would probably not even add. Since that is obviously not true — since in reality, consuming more of one tobacco product means consuming less of others — the suggestion is even more clearly wrong. In fact, using the term “dual use” to describe multiple tobacco products makes no more sense than saying that about someone who smokes sticks that came out of two different packs of Marlboros on the same day.

In the context of tobacco products, the phrase “dual use” is inherently a lie. It intentionally invokes the specter of different drugs (or other exposure combinations) that have synergistic negative effects. That is not remotely plausible in this case. It also intentionally implies additivity of the quantity of exposure (“doing all this, and adding in this other”) when it is actually almost all substitution, as with which pack you pull your cigarette from. To the extent that it increases total consumption of all products, this is a minor effect (a smoker who vapes not only as a partial substitute, but also occasionally when he would not have smoked even if he did not vape). This only matters to someone who does not care about risk, let alone people, and only cares about counting puffs.

There is a long list of words and phrases that when used by “public health” people should make you assume they whatever they are saying is a lie: “tobacco” (when used as if it were a meaningful exposure category), “addictive” (meaningless for drugs with little or know functionality impacts), “chemical” (a meaningful word, but invariably used because it sounds scary), and “carcinogen” (when used as a dichotomous characterization, without reference to the relevant dosage and risk). “Dual use” should be added to this list, in the same general space as “chemical”, another word that is inherently just a simple boring technical descriptor, but that is almost exclusively used to falsely imply negative effects.

My new paper: Understanding the basic economics of tobacco harm reduction

by Carl V Phillips

In case you missed it, my new IEA paper, Understanding the basic economics of tobacco harm reduction, is available here. You should go read it. The summaries do not do it justice. (Not really joking there — the summaries have picked up on one particular conclusion, but the value of the paper is laying out how to think about the whole issue.) I am posting this here primarily to create an opportunity for comments, since that is not available at the original.

Speaking of summaries, you can find this one at CityAM, which was kind enough to also run my op-ed that was based on the paper. (Needless to say, I did not choose the headline nor the link in the first paragraph — can you imagine me citing the RCP report as if they were the source of that information???)

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.