Tag Archives: ethics

Real implications of the RSPH “sting” of ecig vendors

by Carl V Phillips

So apparently there is a UK organization known as the Royal Society of Public Health which presumably had some importance back when the East India Company was not just a retail brand. And apparently they did some secret shopper research of vape stores for purposes of generating publicity for themselves (like a retail brand would). The main payload was the breathless observation that half the shops did not interrogate the customer about their smoking status before selling e-cigarette products to them, and that most of the rest did not refuse to sell upon learning the faux-customer was playing the role of a nonsmoker. The RSPH then portrayed this as a violation of a largely-nonexistent “code of conduct” and managed to get this non-story all over the press in the UK.

I write that so dismissively — about the organization and the research — for a reason. This was much ado about nothing (as Paul Barnes entitled his post about it, which you can read for more of the basic details; see also Clive Bates’s post in which he dismisses it as a “cheap publicity stunt”). But despite this just being a blast of silly throwaway junk — what we observers of the public health industry simply call “Friday” — blogs and Twitter just lit up about it.

Part of the heightened reaction, as compared to all the other bullshit press releases, can be explained by the strange British obsession with anything containing the word “Royal”. Partially it is because the core failure — the notion that legal retailers of a consumer good should be policing their adult customers to see if they were “the right kind of people” — is something everyone can spot the flaws in; it is not some arcane matter of sample selection bias or confounding. So, for example, we can observe that no retailer ever checks to make sure an adult customer is a smoker before selling her cigarettes. This also makes it particularly easy and fun to satirize. (Incidentally, if a retailer in the USA discriminated in the way RSPH demands, refusing to sell to a potential customer because of his nonsmoker status, there is a good chance it could be successfully sued.)

But I also think the widespread reaction to this silliness, even among those who recognized it was just a publicity stunt, reflects a gut-level feeling that there is something more nefarious here than the surface level reaction implies. Since I try to point out the forest that is hidden among the trees (or should I use the royal “amongst” today), I will point out three deeper issues here. As I often do, I am trying to make a case that just responding to attacks like this at the level of their specific merits, even when the response is that they have no merits at all, is a fail. It is a terrible strategy to treat research like this as if it were fundamentally legitimate but merely flawed, as if it exists in isolation, and as if it were the work of decent ethical people who merely erred. That remains true no matter how effectively you eviscerate it on the surface. Continue reading

Anti-muslim fanatic and tobacco control fanatic, a dialogue

by Carl V Phillips

Somewhere in an imaginable land, a dialogue.

ANTI-MUSLIM FANATIC: Hey, I wanted to thank you. We have adopted your blueprint.

TOBACCO CONTROL FANATIC: You’re welcome. … Wait, what?

AMF: Yeah, we now have a plan for the endgame for driving Muslims from this country.

TCF: That is terrible. What does it have to do with us?

AMF: I told you, we are following your blueprint: Punitive taxes. Limiting where people can practice Islam. Vilification campaigns. All your favorites.

No more immigrants. That last one is a bit different, but we adapted your plan to forbid the development of new products.

Also, a ban on little rugs.

TCF: But that is a gross violation of people’s rights and the norms of our society. Religion is an intimate private decision. Even if you think your goal is a good idea, are you saying you want to trample on people’s happiness and the fundamental glue that holds our society together in pursuit of some personal pique?!

AMF: Are you sure you want to go down that path?

TCF: Um, fair enough. But how are you ever going to get support for that? We always had a plan to expand beyond those with the burning pique to enlist a lot of useful idiots.

AMF: It’s all in your blueprint. We can do it. Get this: “Think someone being Muslim does not hurt you? Well 9-11 cost America over $5 trillion. That’s $17,000 from every man, woman, and child.”

TCF: But that’s absurd. Most of that cost was the result of people like you making the country lash out in the wrong directions, impose security theater, and such. The attack itself caused only a small fraction of that loss.

AMF: Um, “quit smoking because it is expensive, makes you leave your friends in the pub while you go outside, and could cost you your insurance or your job.” Again, are you sure you want to go down this path?

TCF: ….

AMF: ….

TCF: Ok, props for that.

But that attack was a few foreign militants and their international support network. It had nothing to do with the practice of Islam among people living here. If you are worried about terrorism, wouldn’t it be more effective to withdraw our active support for Wahhabism, to whom much of it traces; not arm “moderate” warlords, because there is no such thing as a moderate warlord; back off on policies that inspire such attacks; and avoid destroying the social structures in the mideast that provide a bulwark against the rise of such factions?

AMF: Um, look, I realize that the necessary conceit of this dialogue is that both of us are far more thoughtful, honest, self-aware, articulate, and willing to engage in open dialogue than anyone who actually espouses either of these positions. Still, that statement seems to strain the conceit beyond any semblance of reasonableness. And I don’t just mean that “to whom much of it traces” grammar.

TCF: Yeah, fair enough. Ok, try this: If your goal is to prevent terrorist attacks, a goal very few people would question, why not focus on policies that are targeted at discouraging militants rather than discouraging the practice of Islam more generally? Doesn’t attacking law-abiding members of society actually hurt the goal?

AMF: Oh, I didn’t say that the goal was stopping attacks. In fact, a few more attacks would really do us a lot of good. Playing on fear and costs is just how we build support for the campaign. We hate it that anyone around us practices Islam and want to put a stop to it. We don’t care if their personal faith is perfectly peaceful and harmonious. We don’t care how much it might mean to them. It is still Islam, and it has to go.

TCF: With all due respect, you are monsters.

AMF: Um, actually we got all that from you too.

TCF: From us?! How…? Oh, I see.

AMF: Thanks again, by the way.

TCF: You are still monsters. We are fighting against a scourge that people get habituated to it at an early age, before they are capable of understanding the ramifications of their choice. They are innocent victims of what they see around them being considered normal, and of the machinations of huge corporations who can only keep going by recruiting at an early age.

AMF: [raises one eyebrow]

TCF: Yeah, ok. But the same is true for being a Christian or any other religion. What right do you have to decide the indoctrination of being brought up in one religion needs to be stamped out but another is fine?

AMF: We both know the youthful brainwashing claim is meaningless for either one of us. It describes countless behaviors and beliefs, like patriotism, studying hard, playing sports, eating meat, reading fiction, masturbation, cooking with curry, drinking soda, respecting one’s elders…

[seven pages of transcript omitted]

Anyway, to answer your question, we decide. We can decide because we are ascending in influence here. Might is right.

We got that one from you too.

TCF: Yes, I suppose you did. But it is still different. Tobacco is addictive.

AMF: “Addictive” refers to compulsive drug use that seriously impairs someone’s functioning. Tobacco use does not do that.

TCF: We just mean that using it makes you more inclined to use it. You get cravings to do more of it.

AMF: That describes about half the things on the list I just recited.

TCF: Well addictive also means it makes you very unhappy to give it up once you start. And people who choose to quit are really glad they did.

AMF: You might be over-generalizing a bit there. But anyway, that still probably describes about quarter of the things on my list. Notably including being a Muslim.

TCF: Hmm. So you are going to portray the people you are abusing as dupes who thus are really being made better off by the abuse. And do that after you anchor everyone’s thinking on the worst-case product …er, people… to condemn the entire practice. I guess we really are on the same page. Your ideas are starting to grow on me.

But, wait! No! No no no! You are trying to trick me. The difference is that your goal is just the zealous preference of a group of fanatics who have no right to judge how others choose to live their lives, while our goal is….

AMF: [other eyebrow]

TCF: Our goal is good! It just is. We know we are right. And we know that is right because we know we are right. Turtles all the way down. We will have to agree to disagree.

AMF: Why is there any need for agreement in order to disagree? I’ve never understood that.

TCF: Moving on, I think you have a serious implementation problem. I really don’t see how our blueprint will let you pull off an endgame.

AMF: One might say you also have a serious…. Nah, I’ll go a different direction here: There are a lot fewer Muslims in our country than there are tobacco users. And more people who hate them and want them to go away. So I would say we are better positioned than you.

TCF: But the tactics won’t translate. I see how immigration controls can work. But how are you going to tax people for being Muslim?

AMF: First you strip the tax-exempt status from mosques and Islamic organizations. Someone will have to pay that, and it can only be the individual Muslims because all taxes are ultimately paid by consumers.

Ha! you probably assumed that because I am espousing alt-right ideas that I don’t understand basic economics.

TCF: Well, yeah, that seemed like a good bet. But I do remember the conceit of this conversation, so ok. I’ll have to take your word for it, though, because the conceit cannot possibly go as far as to give me credit for understanding economics. Anyway, go on.

AMF: We also impose a head tax on them. We will make it low to start with so people just get used to paying it. Then we will crank it up until it impoverishes them. The first bit has a long history. The second bit we got from you.

TCF: Ah, so then they eventually succumb and abandon their faith. Yup, that should work. But, wait, can’t they just declare they renounce Islam it without really doing so? It is not like they have to buy anything, or that you have a test for it like we do.

AMF: Actually, we don’t expect many of them to either give it up or pretend to. We just like the idea of impoverishing them. We got that from you too. People don’t just give up true belief. The cost of pretending can also be rather steep, especially if you still want to do a Hajj. It is not a cheap and simple evasion like buying black-market cigarettes to avoid the tax.

TCF: But then what is the point of doing it?

AMF: Same reason you do it: To give governments a financial stake in the War on Muslims. If they want the money, then they have to support our policies. That’s when we get them to unleash the rest of your tactics:

We start ridiculing Muslims, using their own tax payments to broadcast the message that they are vile. God, I love that part!

We teach every child in school that any practice of Islam is vile. Kids are great, aren’t they? You can claim everything is being done to protect the little naive innocents, and then sell them simplistic generalizations because they are so naive and innocent.

Also, we are going to ban proselytizing immediately and then expand than to ban anyone associated with Islam from making any positive statements about Islam, whether true or not. And if anyone else says anything, we will accuse them of being secretly in the pay of Big Muhammad and try to get them sent to Gitmo.

TCF: But that tramples over so many of the fundamental freedoms that our society cherishes. It is a slippery slope to all kinds of other actions. It is difficult to imagine where that could end.

AMF: Yes. So?

TCF: Nothing. Just making sure we were still on the same page.

AMF: At some point, we will make it illegal to bow toward Mecca except in designated areas. We got that from you, but it turns out ghettoizing works for religions too.

TCF: Um, actually we may not deserve credit for originating that idea.

AMF: Oh, and then we will slowly move those designated areas to even more remote locations. Also we will embed broken glass in the pavement.

TCF: I think maybe we could learn something from you. We will have to stay in touch. Secretly, of course — you are still a monster.

AMF: Back atcha.

TCF: So what else of ours have you figured out how to use?

AMF: Here is one I have been working on: “Treating law-abiding and peaceful Muslims differently from terrorists is like getting hit by a jetliner in a 7 story building rather than a 110 story building.”

TCF: That’s…. horrific.

AMF: So you don’t like it?

TCF: No, I love it! You really have studied the script.

AMF: How about these: “I get it dude [sneer], yours is a noble and peace-loving faith.” …and… “Allowing muslims to integrate into our pluralistic society will give you oral cancer.”

TCF: Um, what?

AMF: Yeah, that last one needs a little work. Still, it is no further from the truth than how you use it. Oh, and we have a great one about “third-hand salat”, but I am keeping that under wraps until we need a media boost.

TCF: Clever. So what is your timeline for endgaming the Muslims? We always attach a year to our slogans, like “a tobacco-free world by 2020”.

AMF: We are not setting a deadline. We only wanted to borrow your tactics. We did not see any reason to borrow your hubris and embarrassing legacy of failed promises.

“E-cigarettes are a gateway” is a genuine scientific claim

by Carl V Phillips

The latest entrant into the Dunning-Kruger gateway follies is ASH Wales, with this report that is headlined, “New research shows e-cigarettes are not a gateway for young people to take up smoking”. What evidence do they present that supports this remarkable claim that a universal negative is true? None.

The gateway claim, that using e-cigarettes causes some would-be never-smokers to smoke, is a legitimate scientific hypothesis. As such, it should not be asserted to be true (to a nontrivial extent) without useful evidence, especially since it is such an unlikely causal sequence, as I have explained elsewhere. The assertions that gateway effects are occurring have been based on evidence that does not actually show that. This is certainly the major problem in this area. But similarly, the claim should not be dismissed with word games or junk science. In this particular case, ASH Wales — like many others before them — seem to not understand a 101-level point from epidemiology, the difference between “not many people are at risk” and “it never happens among those who are at risk.” They claim that because a large majority of e-cigarette users among teens have already smoked, there is therefore no gateway effect. Um, yeah.  Continue reading

The weakness of ethical thinking in public health: a case study

by Carl V Phillips

I continue to be appalled by what passes for ethical analysis in the realm of THR. This is clearly a symptom of the ethical failings of public health in general. Of course it is somewhat better to see someone actually trying to analyze ethics as compared to the normal “public health” approach of simply making a declarations about what should be done without any mention of what ethical goal they are basing that upon, let alone defending the legitimacy of that goal. The latter is a level of political discourse comparable to the average social media or comments section “debate”. But the attempts at analysis seem only to rise to the level of a freshman term paper. Continue reading

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

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

Serious ethical concerns about public health research conduct; the case of vape convention air quality measurement

by Carl V Phillips

A recent paper in Tobacco Control (official version; unpaywalled version), “Electronic cigarette use and indoor air quality in a natural setting”, in which Eric K Soule, Sarah F Maloney, Tory R Spindle, Alyssa K Rudy, Marzena M Hiler, and Caroline O Cobb, of Thomas Eissenberg’s FDA-funded shop at Virginia Commonwealth University, reports on the researchers’ surreptitious observations at a vape convention. The research methods employed are extremely troubling to me and many others. Continue reading

New “public health” panic: Ecig users practice freedom of association without proper supervision!

by Carl V Phillips

This is completely trivial compared to the vast amount of genuinely threatening anti-THR that is out there. But it is funny — too funny to pass up. This paper was recently published. It seems that The Journal of Public Health Policy is a bit hard to access (good news in itself, really) and I am certainly not going to pay for a download. But we have the abstract, and for papers like this the abstract is really all you can stand to read anyway. It begins: Continue reading