Tag Archives: toxicology

New Glover-Phillips paper: “Potential effects of using non-combustible tobacco and nicotine products during pregnancy: a systematic review”

Posted on 3 March 2020 by | 1 comment

by Carl V Phillips

This new paper, by Marewa Glover and me, is just out in Harm Reduction Journal. In it, we review the available epidemiology evidence about the effects of nicotine-sans-smoke (NRT, snus, vape) on pregnancy outcomes. It was a bit of a challenge to get it published because we wrote the paper we needed to, rather than a “typical review”. As you might know, the journal publication process is rather …well, let’s just say conservative.

(I should note that we finalized the review before this new contribution to the literature by Igor Burstyn et. co., “Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample” (note that this link bypasses the paywall, but does not seem to work in all browser configurations). Igor’s paper is higher quality than anything we reviewed.)

A typical review of epidemiology looks at the results that are reported in journal articles and then just naively believes them, suggesting that What We Know consists of a vague summary of whatever results the previous authors chose to publish. Or even worse — so much much worse — suggesting that a calculated average of those results is the best estimate. That is never a legitimate assessment of existing knowledge, and less so in our case. Continue reading →

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Peer review in “public health” — Tobacco Control journal own-goal edition

Posted on 21 December 2015 by | 7 comments

by Carl V Phillips

Clive Bates prods me to write something about this editorial in the journal/political magazine/comic book, Tobacco Control, by Editor-in-Chief Ruth Malone, honoring their “top reviewers”. (Oh, wait, it is a British publishing house, so that should be: “honouring their toup reviewers”.) You can view it yourself, because it is open access, unlike their regular articles which they hide behind a paywall to inhibit real peer review (very few libraries subscribe to Tobacco Control, to their great credit). They really should have hidden this one from scrutiny too. Continue reading →

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Chi-Ming Hai is a liar – nicotine does not cause measurable risk of CVD

Posted on 17 December 2013 by | 10 comments

by Carl V Phillips

You have never heard of Chi Min Hai.  He is not an ANTZ (though he became an instant ANTZ mascot), but either he or his institution (Brown University) is aggressively trying to spread anti-e-cigarette lies about his research.  I do not know if Hai is culpable or just a naive dupe in this — that will be determined based on whether he steps up and points out his results are being over-interpreted.

Hai has done some toxicological research on why smoking causes atherosclerosis.  This, unlike most research on smoking from “public health” people, was not useless.  It is actually not well understood why smoking causes some particular cardiovascular diseases (CVD), and it might explain how to make smoking less harmful.  What Hai discovered is that in his particular experiment (the details of which are not important), cigarette smoke, smoke without nicotine, and nicotine alone all caused vascular tissue damage.

Ok, fine.  It might be generally true for this situation, might be lab error, might be idiosyncratic.  It might be interesting for informing further science.  What it most certainly is not, however, is any reason to believe that nicotine use, ex smoking, causes heart disease to any consequential degree.  Yet this is exactly the message that Hai and Brown University are aggressively communicating to the press, trying to get into the news by claiming that his conference paper about a completely artificial experiment has real-world implications.  And of course, the innumerate health press corp is buying the whole lie (example, Jen Christensen, CNN), and reporting that this is evidence that e-cigarettes cause heart disease.

I know that it has been aggressively touted because a week ago one reporter sent me a copy of the research to ask me about it, and told me it was being aggressively touted.  Because he was sensible enough to not just copy-and-paste the press release, he was able to include my comment that this is nonsense.  (He also asked me why the university would aggressively tout something that was nonsense.  I pointed out that it happens all the time, and they just want to get their names in the paper, and do not care how.)  Unfortunately, the reporter just quoted a soundbite assertion from me and did not explain to the reader (as I explained to him) why it was nonsense, which made what could have been a penetrating article into a fail, just a he-said-she-said.

That reporter did, however, provide evidence suggesting Chi-Ming Hai is indeed a liar and not a dupe, quoting him as saying,

In my opinion, if taking nicotine for a short time can lead to complete cessation of smoking, e-cigarette included, then it will be beneficial to take nicotine for a short time as a bridge to smoking cessation,” he added. “However, our data suggest that long-term consumption of nicotine by e-cigarette smoking is likely to increase the risk of developing atherosclerosis by stimulating invasion of vascular smooth muscle cells.

The reason that the claim is nonsense and thus this quote qualifies Hai as a liar is that we know that nicotine use does not cause a measurable risk for heart disease.  We have extensive epidemiology about smokeless tobacco use that has failed to show measurable risk.  Epidemiology (the evidence about what is happening with real people in the real world) trumps toxicology (the search, under artificial lab conditions, for phenomena that might — but usually do not — translate into the real world).  Sometimes it is tempting to just say that all toxicologists are liars any time they make conclusions about real health outcomes, though this would be a bit too strong.  But there is no question about this case, which is one of the classic toxicologist lies that goes something like this:  “We have discovered why exposure E causes disease D, though we already know E apparently does not actually cause D.  Therefore, this E causes this D.”

Granted, a small risk of CVD from nicotine would be completely buried in the confounding, so we cannot rule it out.  Indeed that is the reason that the conventional wisdom is that smokeless tobacco and e-cigarettes are 99% less harmful than smoking.  The reason for that remaining 1% is not because of any affirmative evidence of risk, but to be conservative about CVD risk from nicotine that may exist but is too low to measure.  Thus, it would not be terrible to offer an interpretation of this toxicology data in terms like “while we know that nicotine without smoke causes very little risk of heart disease, this evidence suggests that it might not be zero.”  Even that would be an over-interpretation of the toxicology; you can basically damage tissue in a lab with any chemical that is not completely inert if you want to.  But at least it would not have been the full-on toxicology lie.

But Hai seals his liar status by not just making false epidemiologic claims based on what he could concoct in a lab, but by going so far as to make behavior/policy recommendations based on his incredibly tenuous results.  (Until I reread that quote, I had a more equivocal title for this post, but that sealed it.)  He further suggests his ANTZ-wannabe status by referring specifically to e-cigarettes.  He clearly has little understanding of the real world he just threw his baseless opinions into — he apparently does not even know the epidemiology, let alone the politics.  I will give him a few weeks to speak up against the (inevitable) misuse of his results in anti-THR propaganda to establish himself as an honest scientists and not an ANTZ or dishonest self-promoter.  But I am not holding my breath, because I suspect the ANTZ are already writing him big checks from their copious warchests to pay him to go full-liar on this.

As for us, here is the soundbite we need to use in response to the inevitable deluge of lies from this:  “That claim is based on only one very abstract lab work that probably does not relate to the real world.  We have extensive evidence, from smokeless tobacco use, that nicotine without smoke causes no measurable risk for heart disease.”

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What is conflict of interest?

Posted on 16 September 2012 by | 7 comments

posted by Carl V Phillips

A background post today, on the topic of conflict of interest (COI; aka “competing interests”).  This is a critical topic to understanding when identifying and critiquing lies.  It is a favorite topic of some commentators.  But it is also woefully misunderstood, and almost never discussed accurately.

About 90% of the time that someone mentions COI in the context of THR, they really do not care about  COI at all.  It is just one of the anti-THR liars looking for an ad hominem attack on a political opponent because they have no honest arguments and factual lies can only take them so far.  But that is actually just one example of the misuse of the concept that occurs about 99.9% of the time that the term is used in related contexts (and, as far as I can tell, many other contexts).

To understand what COI really means, we need to start with the term itself:  What is conflicting or competing with what?  I suspect that most people who write about COI have never even thought that through.  The interest that most authors, particularly a scientists/researchers, are supposed to be motivated by is communicating the truth.  Any desire to support a particular worldly political goal is another interest that may compete with that.  Researchers who are anti-THR liars are clearly more motivated by their desire to discourage THR than they are by the ethics of doing honest research (and there is no enforcement or system of rewards in this area that compels them to do honest research).

Notice one immediate implication of this:  If it is unambiguous that someone is communicating from an advocacy perspective, then their interest in advocating does not represent a conflict.  When CASAA advocates that people should get honest information and that smoke-free alternative should be available, there cannot be a COI because promoting those are our stated interests.  By contrast, when Christina Gratziou or Stephen Hecht conducts and reports research that is primarily motivated by political (anti-THR) goals, but pretends they are just motivated by scientific truth-seeking, there is a clear COI.  When people like Gratziou or Ellen Hahn produce anti-THR broadsides and statements to the press, they could avoid the COI problem by identifying themselves as being political activists rather than scientists (they would still be liars because their claims are false, but at least they would not be liars with unreported COI).  However, when they pretend to be acting merely as scientific purveyors of information — implying that their primary interest is that of honest researchers or academics — then they create a COI with that lie.

By now you have probably noticed the lack of any mention of funding in all of this.  That is because — contrary to the common naive view — funding is not COI. This is perhaps the most important thing to understand about COI:  It is about preference or belief — and willingness to act on those preferences when it is unethical to do so — not about what motivates someone to those actions.

Receiving funding from an entity with an interest in THR is neither a necessary nor sufficient condition for having a COI.  The relationship of funding to COI is very similar to the relationship between toxicology and real world outcomes that I discussed before:  Funding is one possible explanation for why someone might have a COI, but it is not the COI.  The COI is the motivation to get a particular result from research or to communicate particular claims apart from their truth, no matter what the motive.

Indeed, it is actually quite naive to think that research grants create much COI.  There has been a lot written recently about how Gratziou and Hahn have both been paid by pharmaceutical companies who stand to lose revenue when THR succeeds.  But I really doubt that this funding had much effect on those people’s anti-THR positions.  I have little doubt that their primary motives, like those of most anti-THR liars, are the non-funder-related motives we identified when this blog was started.  It might be that funding has some influence at the margin, but I lived in that world long enough to know that funding generally chases true believers, rather than creating them.

The exception to the “funding is not sufficient to cause COI” observation is when someone is employed by an organization with a position on the matter at hand (THR or whatever) or the rarer case when someone owns intellectual property or other substantial assets that will dramatically change in value based on research results.  Someone who invented a product obviously should not be the one we trust to do the research on whether it works.  Employees of anti-THR organizations like, say, the American Cancer Society or most units of the US government, would probably suffer serious consequences if they told the truth about THR.  Such individuals have such extreme COI that if they wanted to try to be honest scientists, they would need to go to great lengths — making sure their work was extremely transparent, thoroughly reviewed by anyone who wants to review it, etc.

For an example of that, consider the scientific research that comes out of BAT.  The researchers there know that they have a clear COI because of their employment status, but are intent on doing honest research that contributes to our understanding of the health impacts of tobacco products (THR and otherwise), and having it taken seriously.  (I can testify to these motives based on extensive communication with many of them; this contrasts with those who casually make declarations about people’s motives with neither material evidence nor any familiarity with the people in question.)  Knowing that they have to deal with that COI, the researchers openly share their research to the extent possible and are very conservative in their conclusions.  Contrast that with most research from anti-THR organizations and individuals that is secretive, never seriously reviewed, and overstated.

Notice also that I mentioned the US government.  As noted in yesterday’s post, and as will become further apparent from future posts, the US government is and has been the most aggressive anti-THR liar in the world.  The EU government and the UN are similarly anti-THR and similarly dishonest.  So if funding were tantamount to COI, then anyone receiving funds from the US government or most other large governments or quasi-governments would have a COI.  Indeed, it is rather more likely that a government would cut off someone’s funding for taking the “wrong” position than would a pharmaceutical or tobacco company.  Governments and their puppets and puppet masters are all about politics, after all, while manufacturers have a real stake in good science, and are generally capable of distinguishing between someone’s scientific contribution and their political views.

You might notice that the only people who could be seen as being without sin — those who never take any money to work on THR (pro or con) and do not anticipate that their work on the subject will affect their income in any way — do not seem to make a big deal about COI.  The only people who come to mind are Bill Godshall and most of the CASAA board of directors.  Pretty much every complaint about funding in this arena comes from people who are lavishly funded by someone with an interest in the outcome, and who are trying to keep it that way.

Still not convinced?  How about a personal example.  A plurality of my recent income has come from the pharmaceutical industry, as has a solid majority of my family’s income.  Over the course of my life, weighted by how much value the marginal income had to me, I have gotten more from pharma than any other industry (not counting universities themselves as an industry).  So that explains why I am so biased in favor of pharma when I write about THR, huh?  Um, yeah, right.  Also solidly in the top few industries for providing my lifetime income is the energy industry, and those who are familiar with some of my other work will notice that I am oh so positive about them.  [These last few sentences were all sarcasm, in case it was not obvious.]  The key is that, in contrast with government grants and hiring which are almost always heavily motivated by politics, it is my experience (and the reported experience of everyone I know who has worked in all of these realms) that most corporations — pharma, tobacco, or otherwise — are interested in the learned input of anyone who is honest and productive, even if they are often on the wrong “side”.

To summarize:  COI is not about funding, it is about interests, and it is much more common than generally perceived.  Lying by an ostensible scientist or expert is definitive evidence that she has a COI, whereas having a COI certainly does not mean that someone is lying.  Moreover, if you do decided to look at funding sources for clues about who might have a COI and thus be lying, you should be somewhat less concerned about corporate funding than the usual rhetoric implies, and way more concerned about government and advocacy group funding and employment.

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The passive vaping fable

Posted on 5 September 2012 by | 9 comments

posted by Elaine Keller (with input from Carl V Phillips)

Mr. Smith was delivering a speech across town in front of 800 people when the murder occurred. He had no blood on his clothing. Police could find no trace evidence at the scene that leads to Mr. Smith, and were unable to come up with a motive for the crime. Mr. Smith is a prime suspect.

The last sentence is a confounding conclusion. Not confounding in the epidemiologic sense – I will leave that topic to Carl – but in the sense of being baffling. It causes surprise or confusion because it acts against the reader’s expectations. When such conclusions appear in a murder mystery or puzzler, they can be entertaining. When they appear in scientific journal articles, they are perplexing. Or, in the spirit of this blog, they are lies.

Take the case of the paper published by German researchers on the subject of chemicals in electronic cigarette (e-cigarette) vapor.

Schripp T, Markewitz D, Uhde E, Salthammer T. Does e-cigarette consumption cause passive vaping? Indoor Air. 2012 Jun 2.

The final paragraph of the Conclusions section states,

“Overall, the e-cigarette is a new source of VOCs and ultra-fine/fine particles in the indoor environment. Therefore, the question of “passive vaping” can be answered in the affirmative. However, with regard to a health related evaluation of e-cigarette consumption, the impact of vapor inhalation into the human lung should be of primary concern.”

The reader is left with the impression that Schripp et al. found chemicals in e-cigarette vapor that would definitely endanger the health of users. The most likely way readers will interpret the phrase “passive vaping” is that the researchers found chemicals in the exhaled vapor that would be hazardous to the health of bystanders as well, given the fact that the CDC attributes 49,000 deaths each year to “passive smoking.”

The first rule of toxicology is “the dose makes the poison.” This means that it is important to know not only what chemicals are involved, but also the quantity of chemicals that are present. Almost any substance (even water) is toxic in large enough quantities and many “toxic” chemicals are harmless, or even helpful in some cases, in smaller quantities.

Fluoride is a good example of the first rule of toxicology. In concentrations of less than 0.5 percent in toothpaste, stannous fluoride and sodium fluoride helps strengthen teeth and prevent cavities. However, toothpaste overdose may cause stomach pain and possible intestinal blockage.

So what experiments did Schripp and his colleagues perform? There were two parts. The “large scale vaping/smoking experiment” was performed in an 8 cubic meter stainless-steel emission test chamber (about the size of the interior of American family SUV or minivan – with the windows up and the vents closed). A volunteer sat in the chamber and air quality was sampled after 20 minutes to establish a baseline. Then the volunteer was given an e-cigarette with one of three liquids: apple-flavored with no nicotine; apple-flavored with a nicotine concentration of 1.8%; and tobacco flavored with 1.8% nicotine. This was followed by a last trial, in which the volunteer smoked a cigarette.

For the large scale stainless steel chamber experiment, the researchers reported on the 20 compounds with the highest concentrations, comparing them to the concentrations at baseline. Fourteen of the 20 compounds that increased for the cigarette smoke showed no increase over baseline for the vapor of any of the three e-cigarette samples. The six compounds that did increase for vapor samples were 2-butanone (MEK), acetic acid, acetone, isoprene, formaldehyde, and acetaldehyde.

In their conclusions, the researchers failed to point out that many more compounds were found in smoke than in vapor, and they did not compare the quantities of compounds measured in vapor to those measured in smoke. The quantities measured in vapor ranged from 1/10th to 1/40th those generated by cigarette smoke.

Just how hazardous are the compounds in vapor? The Occupational Safety and Health Administration publishes permissible exposure limits (PELs) for hundreds of chemicals that might be present in the air at workplaces. Five of the six compounds were present in quantities that are less than 1% of the PEL. The sixth compound, formaldehyde, is produced naturally by the human body, and it was present at 2.4% of the PEL. If the researchers had provided this comparison in their data, it would have been obvious that their conclusions did not fit the facts.

Apparently the researchers were surprised at what they did not find. “Although 1,2-propanediol [propylene glycol] was detected in traces only within the 8 m³ chamber during the consumption of e-cigarettes, this compound must be released due to the visible fume in the exhaled breath. To determine the VOC composition in the breath gas directly, an e-cigarette smoker exhaled into a 10 L glass chamber.”  (Interestingly, this could be interpreted as them saying, “we changed our methodology on the fly because we did not like the results we were getting.”)

Perhaps they also were surprised that nicotine did not show up in their list of the 20 compounds with the highest concentration in smoke. Analysis of the immediately captured breath in the glass chamber resulted in a different list of chemicals than the stainless steel chamber experiment. The abstract states, “Prominent components in the gas phase are 1,2-propanediol, 1,2,3-propanetriol, diacetine, flavourings and traces of nicotine. As a consequence, ‘passive vaping’ must be expected from the consumption of e-cigarettes.”

The sequence of these sentences would lead the reader to believe that the chemicals specified in the first sentence lead to a condition they call “passive vaping” implying that it is similar in risk to “passive smoking.”

The extremely low quantities in the stainless-steel chamber experiment indicate that most of the chemicals found in concentrated captured exhalation disappear in the ambient air. For example, although nicotine was present (at 1.4% of the exposure limit) in the glass chamber experiment, no nicotine at all was detected in the stainless-steel chamber experiment. A bystander would need to lock lips with an exhaling e-cigarette user to be exposed to all the “prominent components of the gas phase” measured in the glass container experiment.

Even with the lip-lock, the highest level of chemical exposure in the second experiment (glycerin) is only 9.5% of the PEL. Two of the chemicals are not considered harmful at all. Not surprisingly, the highest concentration was for 1,2-propanediol, aka the non-toxic carrier, propylene glycol. If passive vaping is supposed to mean that bystanders are exposed to harmful levels of chemicals, then neither experiment in the study proved the existence of passive vaping.

Nothing in the perplexing conclusion to this article informs the reader about the extremely low level of danger represented by the quantities of chemicals detected. An accurate conclusion might have stated, “The consumption of e-cigarettes causes emissions of aerosols and VOCs, such as 1,2-propanediol, flavoring substances and nicotine, into indoor air; however the quantities of these substances are so low that they do not present a health hazard to bystanders or to the users themselves.”

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Policy recommendations as lies

Posted on 3 September 2012 by | Leave a comment

posted by Carl V Phillips

Finishing up the series on Stephen Hecht’s latest alleged research, we focus on his policy recommendations.  How can someone’s recommendation be a lie, you might well ask.  When it is presented as if it follows from particular research, but it does not actually follow.

The juxtaposition of a scientific analysis and a policy recommendation clearly is meant to imply that the analysis is sufficient to justify the recommendation, and indeed that is often stated explicitly.  This is false even for honest recommendations in epidemiology research reports, and even more so for toxicology reports that are pretended to be epidemiology because a policy recommendation needs to be based on the full body of evidence about the effects of the exposure, as well as an analysis of the other costs and benefits of the policy.  Such information is not present in a report about one study’s results, and is seldom even asserted or referred to.

This means that most, indeed almost all, policy recommendations that appear in health science are lies, so there is nothing unusual about the THR context.  But such lies are less harmful in contexts where only scientists are reading the papers and decision-making filters through a reasonably expert process.  No one is going to react to some off-the-wall tacked-on recommendation about workplace safety or how best to deploy a screening test, and indeed, scientific readers typically just scan past those sentences like they would an ad.  But in contexts where people alter their behavior based on bad recommendations, and the science is really about politics, then such lies matter.

A recommendation might follow from the research if it is very modest and general (e.g., “this suggests we should reduce the exposure to the extent that it is easy” rather than “should be avoided completely [at all costs]” or “should be reduced to 10 ppb”) and appropriately contingent (“if the entire body of research on this topic comes to the same conclusion as this study”).  Those of you who ever look at these research reports will know that such modest phrasing is almost never used.  Instead, there is the bald lie, “these results show that we should….”

Hecht’s version of the bald lie in this case is:

“Obviously, we need to decrease the levels of this material in all smokeless tobacco products — or eliminate it altogether.”

Yeah, obviously.  The only thing that is obvious is that this conclusion does not follow from the observation that this chemical is bad for rats in large doses.  Sugar, therapeutic drugs, and cars also cause serious health problems in rats in large doses, so obviously we need to decrease them or eliminate them all together.  Since the relevant smokeless tobacco products do not actually cause measurable rates of cancer, the need to change them to reduce some apparently non-cancer-causing carcinogen seems rather less than obvious.

Hecht adds that removing (S)-NNN from these products is feasible. In fact, some products on store shelves today have reduced levels of the carcinogen.

Credit is due for these two sentences at least, a huge improvement over most “public health” activist science which does not even acknowledge that the feasibility of a recommendation matters.  Still, this is presented as an aside rather than a core part of the policy recommendation, and it is obviously not enough information (e.g., we do not know whether further reductions might be highly costly).

Still, if he were “these products are already very low risk, but all else equal, there might be some health benefit from reducing this chemical”, there is nothing wrong with that.  But rather than telling the truth about the low risk, he is instead communicating the lie “these products might be acceptable if changes were made, but they are horribly dangerous now.”  As for “all else equal”:

Hecht explained that the U.S. Food and Drug Administration has the authority to regulate tobacco products, but no regulations on the levels of specific carcinogens exist yet. “My suggestion is that levels of (S)-NNN in smokeless tobacco be decreased to below 10 parts per billion. That would make it more consistent with the levels of nitrosamines in food products,” he said. (S)-NNN also is in cigarettes and other smoked tobacco items, and he suggested that the substance be regulated in these products, as well.

Ah, there it is.  Someone not familiar with Hecht and his co-conspirators would have no idea of the subtext here, which just trying impose any rule they can rationalize on THR products (and on cigarettes).  There is absolutely nothing in his research that justifies this 10 ppb threshold, or any other specific threshold.  How could giving a megadose to rats possibly inform us about what the exact right level is?  But the goal here is just to require something that is difficult because it is difficult not because it is useful.  Then they can complain when it does not happen (“we think harm reduction is a fine idea in principle, but the products have not met the necessary conditions that we arbitrarily imposed”).  Better still (in their minds), complying might punish the consumers of the product by increasing its price or lowering its quality.

Hecht, of course, did not acknowledge his activist views in the press release — a lie of omission in itself.  A non-expert in the politics of the area would not recognize the mention of the FDA as being a statement about a particular anti-THR activist strategy, though its inclusion was obviously irrelevant to the reporting of the science.  It is a classic example of dog whistle politics, designed to signal his goal to his co-conspirators while hiding it from the vast majority of readers who would not approve of it.

A final aside on this thread:  Many people consider it acceptable to inflict pain and death on non-human animals in pursuit of knowledge that can improve the health and medical treatment of people.  There is a spectrum of a beliefs about the necessary balance of suffering to justify potential knowledge gain.  But only an extreme tail of that distribution — basically those who feel no compassion toward animals at all — would support Hecht inflicting suffering on animals in pursuit of a political hobby project which offers no conceivable benefit.  He is basically hurting animals to look for carcinogens which are not causing cancer.  A little education can save people from succumbing to his lies, but it cannot help the animals he tortures to produce his propaganda.

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So, what is the point of Hecht’s latest press release?

Posted on 2 September 2012 by | 1 comment

posted by Carl V Phillips

I have been asked two very good questions about this topic:  (1) Is it really fair to treat Hecht as if his new claims reflect the same type of serial anti-THR lying found in Ellen Hahn?  (2) What exactly was the research that Hecht was touting in this press release?  The two questions are closely related, and one of them can be answered.

“This is the first example of a strong oral cavity carcinogen that’s in smokeless tobacco,” said Stephen Hecht, Ph.D., who led the study. “Our results are very important in regard to the growing use of smokeless tobacco in the world, especially among younger people who think it is a safer form of tobacco than cigarettes. We now have the identity of the only known strong oral carcinogen in these products.”

The answer to (1) is right there, in “…who think it is a safer form of tobacco than cigarettes.”  Out-of-control activists like Hahn might actually know very little about the relevant science they claim to be expert about, but Hecht has been at the center of anti-tobacco politics and research for many years.  There is no possibility he has failed to learn that smokeless tobacco is indisputably a safer form of tobacco than cigarettes.  Even in the unlikely event that he believes everything else he claims, the much lower risk of smokeless would still be obvious to him.  Perhaps his lies about the epidemiology, analyzed yesterday, could be seen as merely trying to puff up the perceived importance of his unimportant research rather than primarily being an active anti-THR effort.  But that “…who think…” lie is clear and obvious evidence of anti-THR activism disguised as science, which perfectly represents Hecht’s behavior over the years.

Notice also the “first” wording.  This is clearly meant to imply something like, “up until now, we were not really worried about smokeless tobacco causing oral cancer, but now we should look into it.”  The thing is, Hecht has been claiming that smokeless tobacco causes oral cancer for over a decade, claiming that the nitrosamines he has repeatedly reported on (particularly the chemicals known as NNN and NNK) were sufficient proof of that.  He has reported lab studies of basically the same thing, over and over and over again, and whatever the study result, his conclusions remained based on his politics.  His studies never changed the fact that the actual health science shows no measurable risk of cancer.  But that evidence never stopped Hecht from claiming that each of his non-new results provided new evidence that smokeless tobacco causes a high risk of cancer.

So what did he do this time?  It is very difficult to figure out because all we have is the press release.  Issuing a press release without making a working paper available is anti-scientific behavior in itself; even if everything presented were true, we are being asked to accept someone’s asserted conclusions without knowing their basis for those conclusions.  Some commentators focus on the lack of “peer review” in press releases, but this is really a red herring (peer review in health science is almost worthless — a topic for another day).  The real problem is the lack of information that would allow a reader to assess what was done and whether the methods and the conclusions seem reasonable.  All we actually know from the press release is that Hecht subjected rats to a mega-dose of a nitrosamine called (S)-NNN, presumably in a way that does not closely resemble smokeless tobacco use, though we do not know.  Some of the rats got cancer.

That is all we know.  We do not know what Hecht meant when he called this the first identification of a strong oral carcinogen in smokeless tobacco.  Is he admitting that his claims over the last decade about the other chemicals were lies?  Or are we supposed to conclude that “strong” has some subtle meaning, such that his previous claims were based on “non-strong” carcinogens and so he was not lying then about all of his claims then, but this is somehow different so he is not lying now about “first”?

Also we do not know how many trials Hecht ran, with how many different animals, with how many different chemicals administered in different doses and different ways, before he found a single result that made for good propaganda.  Actually, chances are we will never know that, even when this ends up in a journal.  When I said that toxicology was not inherently junk science, I glossed over the fact that this “hunt the carcinogen” branch of toxicology seems to have as its primary methodology, “keep doing ever-so-slightly different things until random error produces an outlier result for one trial, and then report on that result as if it were the only experiment that was done.”  That approach definitely qualifies as junk science.

The reader is not even told what (S)-NNN is, or how it differs from the NNN Hecht has been over-concluding about for years.  I could not easily find anything about it (e.g., it is not even clear whether this research represents Hecht discovering the chemical), though I am not a chemist so I might be missing something that the experts in that field could figure out.  But you know who are not experts in this entire area of chemistry?  Approximately everyone who reads the press release and the pseudo-news stories that resulted from it, who can thus be easily tricked by Hecht’s assertions.  All they came away “learning” were that Hecht and his ilk were not too worried about smokeless tobacco causing oral cancer last month, but based on this exciting new breakthrough, we should immediately take action.  More on that last aspect of the lies in the next post.

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Toxicology, almost always a lie in the THR context

Posted on 31 August 2012 by | 6 comments

posted by Carl V Phillips

We now close the case on Ellen Hahn for a while, having pretty clearly debunked basically everything she says about e-cigarettes.  While she is probably the most prolific and dangerous anti-THR liar of the year, she will probably end up being a flash in the pan.  When I first started working on THR, the “Ellen Hahn” role was played by the University of Florida dentist, Scott Tomar.  Remember him?  I didn’t think so.

But there are others who have been using disinformation to dissuade people from THR for a decade and are still doing so.  One of them is University of Minnesota toxicologist, Stephen Hecht.  Unlike Hahn, he is a real researcher, but like Hahn, he is mostly just on a crusade against THR.  (Hahn is a researcher only if the sense that the Japanese commercial whaling fleet is really doing research, as they claim.  Both are cases of someone doing what they want, in violation of regulations, trying to excuse their behavior as “research” by keeping a record of what happens.)

Hecht’s latest lies about the risks from smokeless tobacco are found in this report, which I will directly address starting with my next post.  Today I will focus on a more general point about toxicology.

Toxicology can basically be thought of as trying to figure out whether particular chemical exposures will cause cancer, acute poisoning, or other bad effects, but without actually observing whether the exposure does cause cancer etc.  Instead of observing what we really want to know, it tries to predict it by looking at the effects of chemicals on cells, tissue, and non-human animals.   (Toxicology also helps us figure out why something is causing its effects and how to perhaps do something about that.)  If we have the information we really want — about what the exposure actually does to real people who are really exposed — then that is called epidemiology.

It should be obvious from this that if we have decent epidemiology about whether an exposure actually does cause a disease, then the toxicology that predicts whether the exposure causes the disease is no longer informative.  It is kind of like looking at last week’s weather forecast to determine whether it is raining right now, rather than looking out the window.

Obviously there is a lot of value in weather forecasting, and there is a lot of value in trying to figure out whether something will kill people without actually killing people to find out.  Both are imprecise, but neither one is inherently junk science so long as its limitations are duly acknowledged.  But almost any time toxicology is invoked in the THR context, it turns out to be junk science lies.

There are the Hahn-type lies (see the previous posts that are tagged with “chemicals“) in which she claims that any tiny trace of a sometimes-toxic chemical causes disease.  Presumably Hecht, as a toxicologist, would be among the first to label this junk science.  But then there are the Hecht lies, wherein he has spent a good part of his career claiming that we should believe speculative toxicological conclusions about smokeless tobacco causing cancer, despite having epidemiologic evidence that shows that such speculation is incorrect.

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