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I am going through some of my old files of unpublished (or, more often, only obscurely published) material, and though I would post some of it.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:
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.
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.
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.