Tag Archives: UMN

Hatsukami completes her descent into Hecht-dom?

by Carl V Phillips

Dorothy Hatsukami has long been mostly honest, not bad by tobacco control standards anyway, and one of the few ANTZ careerists who acts more like a genuine research professor and less like a busybody sociopath who happens to have landed a job in a school of “public health”. Of course, she was second author with Mitch Zeller in the attempt to co-opt the term “tobacco harm reduction” to mean “moving toward abstinence, by means our cabal approves of”, and has earned no forgiveness for that. And she has often signed on to some of the anti-smokeless-tobacco lies penned by her University of Minnesota colleague, Stephen Hecht. But now she seems to be taking the lead. Continue reading

Anti-THR liars of the year #6, #5, and #4: Minnesota, NYC, and the EU

The countdown continues with:

  • Anti-THR liar #6: Minnesota: politicians, the University of Minnesota, and Kelvin Choi
  • Anti-THR liar #5: New York City politicians and activists
  • Anti-THR liar #4: European Union politicians and civil servants masters

No, we are not calling particular land areas liars. Instead, today’s “winners” in the liar derby represent the rhetoric surrounding these places’ THR policies. These three cases share the characteristic that the lying has been more the outgrowth of a particular policy goal than the cause of it.  That is, the anti-THR policies were not motivated by factual claims, whether true or false.  The lying followed the policy process rather than leading it, and served merely to try to win over a few more votes and rationalize the policy to the masses.  Unfortunately, it also spills over into influencing policy decisions in other jurisdictions where the facts (and thus the lies) are considered by the decision-makers.

As with most entries in this list, they are standing in for other similar examples (or at least Minnesota and New York are — there is nothing in the world quite like the EU).  So if you think Oklahoma should be there along with Minnesota, or any number of cities alongside New York, please consider them included by reference.  And for the majority of humanity that does not share CASAA’s geographic focus, I invite you to expand that to other places in the world (though we do mention both Europe and Canada today — and the rest of the world is represented tomorrow — because our analysis is not so USA-centric as our political activity necessarily is).

But though there are other candidate examples, there is something quite interesting about these that make for an interesting tale of three place.  The lies coming out of these places run the usual full spectrum of what is covered in this blog, and each represents a classic case of throwing every possible claim against the wall to see what sticks.  When the lying is an ex post rationalization rather than actual reasoning, those uttering the lies tend to be quite promiscuous.  Thus, today’s entry does not delve into the specific lies, but on the stories of how they happened.  The tales start out quite differently.

Minnesota is a small state that in many ways is pro-freedom.  But it is also the most Canadian part of America, meaning that it shares Canada’s unfortunate problem of having a relatively efficient bureaucracy and a communitarian-tending population that puts up with that.  It is also insular in a million little ways, thus not liking things that “ain’t from ’round here”.  When most people think of aggressive “public health” measures by US states, they tend to think of Massachusetts and California, but this stereotype overlooks the fact that Minnesota is similar in attitude, but often is much “better” at implementation.  So, like Canada, Minnesota moved to hurt the market for e-cigarettes long before any pro-THR opposition organized.  Specifically, Minnesota imposed a huge tax on e-cigarette products coming into the state (which due to its specifics creates some interesting distortions in the market that tend to favor mods over disposables, but that is beyond the present scope).  More recently, one Minnesota city after another has pursued usage restrictions on e-cigarettes.  This resulted in a deluge of lies by the anti-THR activists to try to trick lawmakers who had not (unlike the activists) already made up their minds before seeking information.

Kelvin Choi is just a bit player, but happens to be the only Minnesotan noted in the blog by name this year (though some other Minnesotans contributed to the upcoming first and second place awards).  Choi seems to be actively trying to set himself up as an Ellen Hahn or Stanton Glantz-like figure — doing pretend science with preordained conclusions for purposes of becoming an activist spokesman — though it seems unlikely he will succeed at this because he lacks the Barnum-like showmanship the other two have.  But though he will probably remain just a minor annoyance, his institution, the University of Minnesota, is among the most anti-THR organizations historically, playing a substantial role in anti-THR in the pre-ecig era.  His activism suggests it might regain some of that role.  That this university includes anti-THR activists seems to be coincidental with the state’s tendencies, but it does make this inward-looking state much more likely to be anti-THR.

New York City politicians and activists (is there even a difference there?) deployed the full armada of anti-THR lies in their move to treat e-cigarettes as if they were cigarettes in terms of onerous place restrictions.  Once again, the policy seemed to have little to do with the facts.  Indeed, given how lopsided and inevitable the vote was, there was not really even a reason to lie to win votes.  Instead, it is more a case of the local extremist activists (Bloomberg, et al.) creating policy as an effort to promote the lies.  In almost diametric contrast with Minnesota, New York is the meeting place of the world and thus has a lot of influence.  It was not local insularity as with Minnesota or Canada; it was local politicians trying to affect the policies of the entire world.  Still, the lies that came out of each (some of which were recognized here yesterday) looked pretty much the same.

The European Union is responsible for the worst anti-THR regulation in the world, the ban on snus (outside of Sweden) which has kept Sweden’s great THR success from spreading to most of its nearest cultural and geographic neighbors (in contrast with its impressive spread into non-EU Norway).  But they largely do not even bother to lie about it anymore — they just keep the policy without trying to justify it.  This says a lot about their motives as they deliberate how to regulate e-cigarettes (if what they are doing could be called deliberation).

Whatever the European Union ends up doing with e-cigarette regulation is, of course, huge.  It could still be anything between a de facto ban and minimal intervention and it forcibly affects hundreds of millions of people; thus what is in play is as momentous as anything happening in THR today (the only competing candidate being what the US FDA decides to do with e-cigarettes and its MRTP process).  But the EU does not top the list of liars because there has been remarkably little effort to aggressively lie.  The proposed bad policies are largely not influenced by the anti-THR lies.  Instead, the roots largely trace to simple officiousness.  Unlike the American system where “allowed unless specifically prohibited” is the legal and moral norm, nations that still put the pictures of hereditary monarchs on their money have found it all too easy to create an institution that defaults to “banned unless specifically permitted by the royal court”.

Interestingly, one corner of America that does use a banned-by-default rule is the FDA.  And what the EU started with (though it now appears to be off the table) is very similar to what FDA tried to do in 2009, which is to effectively ban the products as unapproved drug delivery devices.  In both cases, this seemed to have little to do with intentional policy making (and thus had nothing to do with the lies) and everything to do with just blindly following onerous rules according to the worst stereotypes of government bureaucrats.  In fairness, it is not entirely clear that the rule-makers should be included with the liars in this case, since it is usually the UK government sock-puppets that dominate the anglophone anti-THR lying related to the EU process.  But the lies are, again, following the policy.

In some sense, these top liars of the year blur the lines between speech and action.  In this case, the policy making — by communicating the message that these bad policies have some legitimate justification — is in itself the lie.

Kelvin Choi is remarkably clueless (and a liar) – part 2/2

Yesterday I started dissecting the simplistic and false anti-e-cigarette claims being made by University of Minnesota researcher, and Ellen Hahn wannabe, Kelvin Choi.  This post picks up where that one left off.  To recount, Choi recently released a paper that contains some possibly useful historical data from a survey of knowledge and attitude about e-cigarettes.  But not content to do real science, he proceeded to tack on anti-e-cigarette lies and a conclusion that does not in any way follow from the research.  He then published an interview in which he bungles even the description of e-cigarettes and presents his reasons for worrying about the health effects, none of which actually involve any claim about any health effects.

I will note that the interview I am dissecting did not appear in some free weekly local paper or a radio news report.  It was published by the American Public Health Association (which runs the “journal” where Choi’s paper appeared), and was clearly crafted as a written document by that organization and Choi.  So we cannot attribute the gaffes to trying to dumb things down for a grade-school audience or misspeaking.

Continuing with examples of the lies that Choi and APHA chose to publish:

To date, e-cigarette marketing is not regulated.

Presumably he means in the United States (his apparent failure to recognize that regulations vary across jurisdictions is so minor among his errors that I only mention it because I need to clarify before continuing), in which case he is badly wrong.  Not only is e-cigarette marketing regulated by all basic federal and state rules about truth-in-advertising and such, but it is also severely restricted in terms of health claims.  Merchants cannot offer their customers any comparative risk or smoking cessation information, such as the obvious truths that switching to e-cigarettes is a good way to quit smoking for many people, or the health risk from e-cigarettes is trivial compared to that from smoking.  If this is Choi’s view of anarchy, I would hate to see what he considers to be regulation.

Advertisements for e-cigarettes appear on TV, magazines, the Internet and even in social media. Cigarette advertising has been known to have a strong influence on the perceptions and the use of cigarettes.

Ah, that explains it.  I believe he is mixing up the words “regulated” and “banned”, a common mistake when a native ANTZ speaker tries to communicate in English.

Therefore, it is similarly possible that e-cigarette advertising is one of the sources of influence on young adults’ views about e-cigarettes.

It is worth recalling that this interview was to tout a paper that reports results from a 2010-11 survey.  There was not exactly a lot of advertising of e-cigarettes back then.  This is the standard “public health” bait-and-switch:  do one simple and minor bit of research on a topic, with no policy analysis and no apparent understanding of the big picture, and then claim to be an authority on what policies should be implemented.

It appears that his complaint is that advertising — you know, that “unregulated” advertising which is prohibited from truthfully informing people about the smoking-cessation benefits or comparatively low risk of e-cigarettes — is contributing to people’s knowledge that e-cigarettes have low risk and are good for quitting smoking.  (Note that “knowledge” is the English word; to trANTZlate that into Choi’s ANTZ-speak, I believe their word for “knowledge” is “misinformation” when used in a context that means “knowledge that the ANTZ want to prevent people from learning”.)

I am sure the marketers will be glad to know that they are successfully communicating information that they are not allowed to communicate.  I suspect that during his continuing research on this topic, Choi will eventually learn about the restrictions on the advertising and then realize, like Stanton Glantz, that he needs to crusade for broader censorship of accurate information.

He concludes this thought with:

The challenge is whether we should swiftly regulate e-cigarette advertising before the issue gets out of hand.

Even trANTZlating “regulate” into “ban”, it is difficult to make any sense of this.  What issue?  What constitutes “out of hand”?  I am not even sure this qualifies as lying hype because although it tries to be hype, it is not at all clear what is being claimed.  So, moving on…

The second challenge lies in developing a better understanding of the effective communication channels to reach specific populations and how to best use these channels. For example, we know that a lot of young adults use Facebook, but we do not know how to effectively use Facebook to communicate the correct information about e-cigarettes to young adults. I think we still have a lot to learn in that regard.

Nice discovery about that Facebook thing.  Maybe he will write a paper about it before Facebook ceases being used by a lot of young adults — though I would not recommend holding your breath for that given that his claim to fame is his new paper about survey data from two years ago (ancient history in this fast-moving area, something he apparently does not understand).  But, of course, we again need the trANTZlator here to point out that when he suggests exploring ways to “communicate the correct information”, he really means to “get people to believe his lies”.

Because, after all, if he really wanted to use Facebook to communicate correct information, all he would need to do is point people to pages like CASAA, the We Are CASAA members page, ECCA UK, Vapers Network, the Tobacco Harm Reduction page created by my research group (which I believe is about as old as Facebook, though most of the traffic has shifted to those others over the last few years), or any of several other very active pages with a plethora of truth and where incorrect information is seldom posted without being corrected by someone.  His “we” may well be as clueless as he claims, but fortunately we are way ahead of them.

I wonder if this self-appointed e-cigarette “expert” has ever even seen those Facebook pages and our websites.  Probably not, or he would not have bungled so many simple points.  Still, maybe he is one of the rare ANTZ who actually reads outside of their echo chamber, and he will read this post and follow those links.  I look forward to seeing his comments there trying to provide us with “correct information”.  If you are reading this, Dr. Choi, please consider yourself encouraged to jump into the conversation — unlike your fellow ANTZ, we do not censor contributions from people who disagree with us.  Oh, but be warned, also unlike life inside your ANTZ echo chamber, when someone is lying, we call them on it.

Kelvin Choi is a liar

by Carl V Phillips

A new ANTZ on the scene seems to be aspiring to be the new Ellen Hahn.  I supposed it is possible, given that he is at University of Minnesota that he aspires to the be the new Stephen Hecht, but that might be a stretch since Hecht seems to do somewhat useful bench science, and then just lies about the health and political implications.  Choi, by contrast, seems to be fully ensconced in the “public health” junk science paradigm.  Consider this recent abstract:

Objectives. We assessed the characteristics associated with the awareness, perceptions, and use of electronic nicotine delivery systems (e-cigarettes) among young adults. Methods. We collected data in 2010-2011 from a cohort of 2624 US Midwestern adults aged 20 to 28 years. We assessed awareness and use of e-cigarettes, perceptions of them as a smoking cessation aid, and beliefs about their harmfulness and addictiveness relative to cigarettes and estimated their associations with demographic characteristics, smoking status, and peer smoking. Results. Overall, 69.9% of respondents were aware of e-cigarettes, 7.0% had ever used e-cigarettes, and 1.2% had used e-cigarettes in the past 30 days. Men, current and former smokers, and participants who had at least 1 close friend who smoked were more likely to be aware of and to have used e-cigarettes. Among those who were aware of e-cigarettes, 44.5% agreed e-cigarettes can help people quit smoking, 52.8% agreed e-cigarettes are less harmful than cigarettes, and 26.3% agreed e-cigarettes are less addictive than cigarettes. Conclusions. Health communication interventions to provide correct information about e-cigarettes and regulation of e-cigarette marketing may be effective in reducing young adults’ experimentation with e-cigarettes. (Am J Public Health. Published online ahead of print January 17, 2013: e1-e6. doi:10.2105/AJPH.2012.300947).

Let’s set aside obvious problems, like the limited value for anything other than historical tracking of an awareness survey about e-cigarettes from 2010, or describing 20-something-year-olds as “experimenting”, as if they are children.  (Many of those crazy kids are also experimenting with buying houses, military service, and parenthood.)  Consider the core conclusion.  How can a simple cross-sectional survey of awareness and belief tell us anything about the effects of communication and regulatory interventions?  If you said, “I have no idea”, you nailed it.  It is a complete lie that the conclusion follows from the research.

And, of course, there is the little matter of which bits of information he wants to correct.  Does he want to help the 55.5% who do not realize that e-cigarettes help smokers quit?  Or is it the 47.2% who do not realize they are lower risk than smoking?  As you might guess, it is the ones who actually know the truth that he wants to “correct”.

(Note:  I trust my regular readers will recognize as subtle ridicule my use of three significant figures in reporting those numbers.  As anyone who understands sampling — and anyone familiar with my writing — knows that reporting that level of unwarranted precision is a bit of junk science in itself.)

There is some potential usefulness in the actual survey in terms of helping us learn about the rate of at which accurate knowledge of e-cigarettes and THR has spread.  However, what has no apparent usefulness are Choi’s thoughts and opinions, as evidenced by this interview.

I will skip past his first answer, a remarkably amateurish description of what e-cigarettes are, something that could be corrected by basically anyone who is familiar with the topic.  (But go ahead and read the whole interview if you are inclined to find unintentional comedy in ANTZ rantings — it is a good one for that.)  I skip that because it gets far worse:

There are a variety of reasons why e-cigarettes are unhealthy. First, they contain nicotine, which is a known addictive chemical. A recent study conducted by Vansickel and Eissenberg found that experienced e-cigarette users can obtain a significant amount of nicotine through e-cigarettes, which may be comparable to smoking cigarettes.

E-cigarettes deliver nicotine?  Who knew?  Glad we had that study (by the guy who originally claimed just the opposite and never admitted his error — but that is another story).  And the reason that they are unhealthy is that this chemical is addictive (whatever the heck that means), not because it is harmful.  Choi might want to ask for a tuition refund from whoever claims to have taught him about health.

Second, previous chemical analyses of the e-cigarette nicotine liquid found that some samples contain tobacco-specific cancer-causing agents and anti-freeze.

Yawn.  Yes, this PhD “researcher” cannot do any better than some random county public health nurse, citing the propaganda (rather than the actual scientific results) from the FDA.  Another tuition refund, please.  Oh, but wait.  Maybe that nurse could do better.  She probably would not claim that e-cigarettes actually “contain…anti-freeze” [sic], but merely “an ingredient found in antifreeze”.  The latter form of this is an example of lying with literal truths, of course, as previously discussed in this blog (did you know that breast milk contains an ingredient found in antifreeze?!! we should stop nursing babies immediately!).  Apparently Hahn Junior does not even realize that he is reciting propaganda meant to confuse people — he is among the genuinely confused.

Third, with the product being promoted as a cigarette alternative at places where smoking is not allowed, smokers may use these products to sustain their nicotine addiction, and may therefore be less likely to quit smoking

And another “problem” that is not an actual health risk from e-cigarettes.  That “where smoking is not allowed” pseudo-argument deserves a post or two of its own, which I will do that soon.  So today I will politely refrain from pointing out how utterly moronic it is.

And that is all he offers.  Not even a single claim of health risk.  Apparently he wants to keep people from “experimenting” with e-cigarettes because they… …um… cause no health risk at all.

Oh, but it gets dumber.  So much dumber.

I think the perception of e-cigarettes as cessation aids is of the greatest concern. First, this perception may drive young adults to use e-cigarettes when trying to quit smoking instead of proven-effective cessation treatments. To date, no studies have shown that e-cigarettes are more effective than proven-effective cessation treatments such as nicotine replacement therapy and counseling. Therefore, e-cigarettes may hinder young adult smokers from quitting smoking.

E-cigarettes are (correctly) perceived as being useful for quitting smoking?  Well, that is a dire concern indeed.  As for the claim they are not shown to be more effective than other methods that are “proven” to help a mid-single-digit percentage of smokers quit (to charitably take a best-case figure from the biased research on the topic), so what?  Even setting aside the fact that he is baldly lying about that — the evidence strongly supports the claim that e-cigarettes are more effective — how exactly do they prevent someone who wants to quit smoking from trying those other methods if the e-cigarettes do not work?

Anyone with a basic understanding about smokers and quitting — even at the casual layperson level of knowing actual humans who smoke or smoked — understands that most people who are interested in quitting try multiple methods.  How exactly can one method, even if he genuinely believes it is of no value at all, interfere with the others?  Does he really think that smokers are so dumb as to say “well, I wanted to quit and tried an e-cigarette, but it did not work for me, so I will just keep smoking because I have never heard of any other method I might try.”  Gee, if only there were some way to inform smokers that the powers-that-be think they should try NRT and counseling.  Someone should really get on that.

And if Choi really believes that introducing a new method of quitting will actually prevent the use of other options, does he rail against the introduction of new NRT products or counseling methods because they will keep people from trying the existing methods he thinks are actually “proven”?  I didn’t think so.

In short, either he has not even given enough thought to this topic to be considered even a generally aware layperson, and so is grossly lying about his expertise, or he is just making up lies because he wants a ride on the ANTZ gravy train.

Is there more?  Oh, yes, there is more.  It will have to wait until the next post.

Policy recommendations as lies

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.

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

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.

Stephen Hecht’s latest lies

posted by Carl V Phillips

Continuing with a debunking of the claims in this recent press release by University of Minnesota toxicologist Stephen Hecht, which was picked up by various non-expert health sites and news outlets.  Yesterday we pointed out how toxicology claims, in the context of anti-THR, turn out to be almost entirely lies, in part because they are used to make claims that contradict the epidemiology; epidemiology trumps toxicology in the same way that looking out the window to see if it is raining trumps looking at yesterday’s weather forecast for today.

Today we will address some of the background lies about epidemiology that Hecht included in this press release — claims that have nothing to do with this particular bit of research, but that he needs in order to fool people into believing the research matters.  [Note: some of the posts in this blog will be pretty self-contained, while others will appeal to extensive bodies of knowledge that cannot fit into one post.  This is an example of the latter.  More detail on the particular points will probably eventually be covered in this series, but in the meantime you can find more in more in-depth writing about THR by me, Brad Rodu, casaaa.org, and tobaccoharmreduction.org.]


smokeless tobacco is a known cause of oral cancer

The subtle little problem with that claim is that it is just not true, at least not in the current US context that is noted as the focus of concern in the press release.  The tiny subset of the epidemiology that Hecht and his co-conspirators like to cite to support this claim consists of one old study of archaic US products and various studies of Asian products, most of which are not even tobacco.  They then try to trick the reader into ignoring the many studies of the products that people actually use in the US and Scandinavia, which have shown that if there is any risk, it is too small to measure.

This is not to say that we know there is absolutely no risk, of course, but it is clear that the risk is very small and not even clearly established to be nonzero, whereas Hecht is communicating that it is large and clearly exists.

Evidence has been accumulating for years that people who use smokeless tobacco have an increased risk of cancer of the mouth, esophagus and pancreas.

This claim of an accumulation over time is more patently false than the claim that there is a risk.  The belief that smokeless tobacco causes oral cancer traces mostly to the one major study of a niche US product (almost never used and impossible to even find anymore) done in the 1970s, and to a lesser extent some low-quality, smaller studies from that era or earlier.  By the 1990s, those results had not been replicated and several major studies had instead found no risk from modern products; further research continued to support this new conclusion of no measurable risk after all.  That is apparently what passes for “has been accumulating for years” at the University of Minnesota.

As for pancreatic cancer, “accumulating for years” refers to two studies from the 2000s which claimed to find a risk, but which actually flatly contradict each other (i.e., if you choose to believe one of them is the right way to measure the effect, then the other agrees with the rest of the evidence, which suggests there is no measurable risk).  The accumulating evidence on esophageal cancer showed an amazingly consistent pattern of no risk, until recently when just a few studies suggested an association; the weight of the evidence clearly remains on the no measurable risk side.  (Also, most of the “evidence” that there is risk from smokeless tobacco from the 2000s came from a single research group that was clearly cooking their results; I suspect this blog will get to them eventually.)

That said, notice the subtle phrasing here:  “people who use…have an increased risk…”  Now this might just be accidental — Hecht seems to have no qualms about stating out-and-out falsehoods — but it might be another case of lying with a technically true statement.  It turns out that, in the US population, many smokeless tobacco users are former smokers and many are current smokers (who, thanks to people like Hecht, do not realize they would be much better off using the smokeless exclusively).  Smokers definitely have much higher risks of cancer of the mouth and esophagus (pancreas is a bit trickier).  Moreover, people who choose to use nicotine products have somewhat poorer health on average, apart from any effects of the behavior.

So, the statement as phrased is not actually claiming that smokeless tobacco causes these diseases, but rather it says that if you do not control for confounding then you will find an association.

Hecht had to present these lies, which have nothing to do with his research, in order to be able to sell his message that he had found a cause of cancer.  He would look really stupid if he said “Lookee everyone! I have found the reason why these products [which do not seem to cause a measurable risk of cancer] cause cancer!”  Better to be a liar than to look stupid, eh?

So how about both?

Toxicology, almost always a lie in the THR context

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.