Anti-THR Lies: Ecig proponents need to learn lessons from other activists

[caramel]

The third is rarely brought up directly by anyone here, but not sure what ex-smoker still sees smoking as legitimate choice rather than regrettable mistake.

Me. I enjoyed smoking. Why would I come up now and say that I didn't, and the whole thing was nothing but a mistake?

 

[Jman8]

I'm convinced that the taxes that were extorted from me for having a problem of addiction to smoking have caused me more health damage than the smoking.

The good news is those taxes are now being used to fund those who are anti-vaping and all their studies.

 

[nicnik]

The good news is those taxes are now being used to fund those who are anti-vaping and all their studies.

Except they aren't real studies. Put quotes around that word and stop trying to get me depressed.

 

[AndriaD]

Me. I enjoyed smoking. Why would I come up now and say that I didn't, and the whole thing was nothing but a mistake?

I liked it pretty well most of the 39 yrs I did it, but my utter dependence on it grew tiresome some time ago, and the ever-increasing cost of it offended my penny-pinching soul, especially when the whole economy imploded but I still had to have my cigarettes. I'm still that way (dependent) to some extent with vaping, but I eagerly anticipate that beginning to change when I'm done with the WTA.

Andria

 

[nicnik]

I'm still waiting for Carl to provide some evidence to substantiate his claims about the economics of cigarette smoking, as the articles he posted (following my request) just referenced the two decade old study by Viscussi (that failed to consider many economic benefits of living longer), and several articles regarding European countries (which have vastly different cigarette taxation and healthcare systems than the US).

There's a Dutch study from 2008 was discussed in some mainstream media articles that concludes that smokers save society money. I think that's the only other one I've come across:

Full text:
PLOS Medicine: Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

I think this Huffington Post article is from Associated Press and appeared in USA Today and other newspapers:
How Much Does Smoking Cost Society?

That same "ghoulish" strawman appears at the end, and looking around the web, it seems to be ANTZ' main defense against criticism of leaving out cost savings:

"The natural train of logic that follows from that is that then anybody that's admitted around age 65 or older that's showing any signs of sickness should be denied treatment," Pechacek said. "That's the cheapest thing to do."

Here's a sililar NYT article:
http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html?_r=0

The other defense I sometimes see is claiming that smokers cost even more, because some of the costs have been left out. But aside from the savings from early death, similar savings and some cancelling out some of the costs because the money is still a part of, and stimulation for the economy, are also left out.

FULL accounting is the only option for HONEST, ACCURATE accounting. ANTZ seem to have no wish to be honest or accurate.

Here's a real good article focusing on Australia, from a factchecking organization that adds other complexities to consider:
Does smoking cost as much as it makes for the Treasury? - Full Fact

 

[Kent C]

in some mainstream media articles that concludes that smokers save society money. I think that's the only other one I've come across:

You're probably right about 'mainstream media' but....
Godshall interview exposes how FDA deeming reg bans nearly all e-cig, how vapers can fight back

 

[nicnik]

You're probably right about 'mainstream media' but....
Godshall interview exposes how FDA deeming reg bans nearly all e-cig, how vapers can fight back

Oooh, thanks! That post kinda flew by me before, and I'd forgotten about it. I wasn't in the mood yet to click on the links and read them at that time, and I'm all for Social Security, Medicare and Medicaid, so I got distracted by the beginning of your post. I've now started reading the links...

 

[Kent C]

Oooh, thanks! That post kinda flew by me before, and I'd forgotten about it. I wasn't in the mood yet to click on the links and read them at that time, and I'm all for Social Security, Medicare and Medicaid, so I got distracted by the beginning of your post. I've now started reading the links...

With all the anti-tobacco PR, and the demonization of smokers, one assumes 'they're costing us billions' - but that's at 'level one thinking' (actually a reaction) which doesn't even take into account anything else. There are similar political driven "studies" that show it cost more to carry out the death penalty, vs. spending money to house and feed murders for life imprisonment for decades. When you can't argue rationally, then you argue pragmatically/scientifically - it's easier to cook the data than to argue sympathetically for, say, a serial killer.

 

[caramel]

When you can't argue rationally, you try to express everything in dollars and cents and argue "economically".

Failing to mention that the right thing to do is seldom the cheapest one.

 

[CarolT]

The drug companies have never been the driving force behind anti-THR extremism and policy activism.

But the drug companies have given several hundred million dollars to CTFK, ACS, AHA, ALA, AMA, AAP, AMA, etc since 1995 that has funded virtually all of the following activism by those entities:
- promote and mandate governmental and healthcare policy subsidization of ineffective smoking cessation drugs and counseling services,
- lobby governments to fund anti THR propaganda programs (they called it tobacco "prevention"),
- lobby governments to fund programs to promote and give away FDA approved cessation drugs,
- enact the 1997 so-called Global Tobacco Settlement (that I helped convince the US Senate to defeat in 1998) that would have protected cigarette companies from lawsuits (as Big Pharma and Big Tobacco were leaders of the American Tort Reform Association ATRA that protected big business from lawsuits),
- tax smokeless tobacco at the same rate as far more harmful cigarettes (to oppose THR),
- deceive and lobby Congress (from 2004-2009) to enact the anti THR Tobacco Control Act,
- advocate and defend (in US Court) FDA's unlawful e-cig ban from 2009-11,
- ban the sale of e-cigs in a half dozen states from 2009-13 (which we defeated),
- enact hundreds of vaping bans since 2009 (by falsely redefining smoking as including vaping), and
- aggressively advocate the FDA's proposed Deeming Regulation (that would ban >99.9% of all nicotine vapor products).

Without drug industry money, NONE of those anti-THR policies and pro drug industry policies would have been enacted.

It is simply wrong to claim that drug industry funding hasn't played a key role in anti THR activism.

My presentation at the 2005 National Conference on Tobacco or Health criticized and denounced the Tobacco Control Act legislation in Congress (as well as Philip Morris, CTFK, ACS, AHA, ALA, GlaxoSmithKline, for negotiating and agreeing to lobby to enact it into law) by pointing out that the TCA protected cigarette markets and smoking cessation drug markets by banning new THR products and truthful THR claims for smokeless tobacco, and by requiring even larger deceitful warnings on smokeless (while at the same time prohibiting the FDA from banning cigarette sales, even to 18 year old high school students).

It was my exposing and opposing of those drug industry funded campaigns by those groups (in DC and at the state level)
that got me banned from speaking at Tobacco Control and Public Health conferences, banned from coalitions, list-serves, etc. (which were controlled by the drug industry and DHHS funded groups that had coalesced to lobby for the TCA and many other anti-THR policies).

The world did not begin in 1995, and neither did the anti-smoking persecution. By 1995, the ACS/AHA/ALA had already had their puppets installed at the Office on Smoking Health (or its prior incarnations) for 30 YEARS. The Cancer Society had openly declared war on smoking in 1957. The tobacco lawsuits were the crowning glory of nearly 50 years of plotting and scheming toward this goal. They not only only controlled the federal health establishment at the National Institutes of Health, but had been instrumental in their very creation. They've been the ones steering the ship all along, using our tax dollars to commit scientific fraud, with no sign of any "Big Pharma" because it hardly existed back then. Then, johnny-come-latelys like you come along and blame the pharmaceutical companies for everything, and pretend like if only Big Pharma would go away, then everything would be hunky-dory. This is a crock. This is the false narrative peddled by the Harvard School of Public Health, because they are the veritable mothership of charlatanism and they want their little PC goon squads to bash Big Pharma to help Harvard keep them in line, as well as misdirect smokers into wasting their time.

 

[CarolT]

Source? Link?

Personal communication that I do not have permission to share.

 

[CarolT]

Glad to take that piece up and debate if you think that equals thorough refutation. I would say it is not and challenge you to defend it.

How about if you try to defend Levy & Marimont against Lukachko & Whelan.

1. Levy and Marimont discount over one-third of the estimated 400,000
annual deaths caused by smoking with the erroneous claim that “small”
increases in the risk of disease or death—marked by relative risks less
than 2.0— are “statistically insignificant,” and “insufficiently
reliable to conclude that a particular agent (e.g., tobacco) caused a
particular disease.”​

Any problems so far?

Contrary to the authors’ misstatement, relative risks less than 2.0,
while small, can indeed be statistically significant and reflect a
causal relationship. A relative risk is a measure of the strength of an
association between exposure (e.g. smoking) and a disease. Given the
pervasiveness of a risk factor, such as smoking, and the prevalence of
some of the diseases it causes, small relative risks can, and do,
represent serious threats to public health.​

I would have said that small 'risks' "may" represent a health risk, but only if they're not specious results caused by confounding. And I would have given specific proven examples, not just a broad-brush dismissal.

Levy and Marimont’s assumptions regarding small relative risks violate
basic principles of epidemiology. The authors confuse two distinct
concepts, that of relative risk and that of statistical significance.
The size of a relative risk, alone, does not signify its statistical
significance. Rather, research findings must undergo statistical tests
to assess their “significance.” Small relative risks suggest a weak
association (or risk factor), not necessarily an insignificant finding.​

This is a valid criticism.

2. Levy and Marimont argue that the American Cancer Society’s Cancer
Prevention Survey (CPS)—a widely used data set for the calculation of
public health statistics—is unrepresentative of the general population
and is therefore “the wrong sample [to use] as a standard of comparison”
when estimating smoking-related deaths in the US.​

Lukachko & Whelan point out that other data sets show the same thing.

3. The authors state that the Centers for Disease Control and Prevention
(CDC) fails “to control for obvious confounding variables” in its
cal-culation of smoking-related deaths. They argue that after accounting
for other factors that may contribute to deaths among smokers, the CDC’s
estimate should be greatly reduced.​

Lukachko & Whelan said that "the impact of potential confounders on the CDC’s
age-adjusted risk of death due to smoking would be minimal." And subsequently, the Cancer Society did its own reanalysis and showed the same. http://jama.jamanetwork.com/article.aspx?articleid=192965

So, defend Levy & Marimont for us.

 

[Jman8]

How about if you try to defend Levy & Marimont against Lukachko & Whelan.

1. Levy and Marimont discount over one-third of the estimated 400,000
annual deaths caused by smoking with the erroneous claim that “small”
increases in the risk of disease or death—marked by relative risks less
than 2.0— are “statistically insignificant,” and “insufficiently
reliable to conclude that a particular agent (e.g., tobacco) caused a
particular disease.”

Any problems so far?

Just the wording of "caused a particular disease." Little things like that.

Contrary to the authors’ misstatement, relative risks less than 2.0,
while small, can indeed be statistically significant and reflect a
causal relationship. A relative risk is a measure of the strength of an
association between exposure (e.g. smoking) and a disease. Given the
pervasiveness of a risk factor, such as smoking, and the prevalence of
some of the diseases it causes, small relative risks can, and do,
represent serious threats to public health.

Relative risks do not reflect a causal relationship. Heck, the statement right after those words backs this up. The rest of this paragraph is hyperbole, based on the flawed rationale for causation.

Levy and Marimont’s assumptions regarding small relative risks violate
basic principles of epidemiology.

Great! It ought to be violated. It is close to junk science and insidious as a philosophical paradigm.

The authors confuse two distinct concepts, that of relative risk and that of statistical significance.
The size of a relative risk, alone, does not signify its statistical
significance. Rather, research findings must undergo statistical tests
to assess their “significance.” Small relative risks suggest a weak
association (or risk factor), not necessarily an insignificant finding.

IOW, allow us to self justify our own findings as significant, even if you rationally disagree.

2. Levy and Marimont argue that the American Cancer Society’s Cancer
Prevention Survey (CPS)—a widely used data set for the calculation of
public health statistics—is unrepresentative of the general population
and is therefore “the wrong sample [to use] as a standard of comparison”
when estimating smoking-related deaths in the US.
Lukachko & Whelan point out that other data sets show the same thing.

Their words that deal with this issue are:

The American Cancer Society bases its CPS study on a million men and women volunteers, drawn from the ranks of the Society’s members, friends, and acquaintances. The persons who participate are more affluent than average, overwhelmingly white, married, college graduates, who generally do not have hazardous jobs. Each of those characteristics tends to reduce the death rate of the CPS sample which, as a result, enjoys an average life expectancy that is substantially longer than the typical American enjoys.

Because OTA starts with an atypically low death rate for never-smokers in the CPS sample, then applies that rate to the whole population, its baseline for determining excess deaths is grossly underestimated. By comparing actual deaths with a baseline that is far too low, OTA creates the illusion that a large number of deaths are due to smoking.

That same illusion pervades the statistics released by the U.S. Surgeon General, who in his 1989 report estimated that 335,600 deaths were caused by smoking. When Sterling, Rosenbaum, and Weinkam recalculated the Surgeon General’s numbers, replacing the distorted CPS sample with a more representative baseline from large surveys conducted by the National Center for Health Statistics, they found that the number of smoking-related deaths declined to 203,200. Thus, the Surgeon General’s report overstated the number of deaths by more than 65 percent simply by choosing the wrong standard of comparison.

Sterling and his coauthors report that not only is the death rate considerably lower for the CPS sample than for the entire U.S. but, astonishingly, even smokers in the CPS sample have a lower death rate than the national average for both smokers and nonsmokers. As a result, if OTA were to have used the CPS death rate for smokers, applied that rate to the total population, then subtracted the actual number of deaths for all Americans, it would have found that smoking saves 277,621 lives each year. The authors caution, of course, that their calculation is sheer nonsense, not a medical miracle. Those “lives would be saved only if the U.S. population would die with the death rate of smokers in the affluent CPS sample.”

*Red text emphasis mine.

3. The authors state that the Centers for Disease Control and Prevention
(CDC) fails “to control for obvious confounding variables” in its
calculation of smoking-related deaths. They argue that after accounting
for other factors that may contribute to deaths among smokers, the CDC’s
estimate should be greatly reduced.

Lukachko & Whelan said that "the impact of potential confounders on the CDC’s
age-adjusted risk of death due to smoking would be minimal." And subsequently, the Cancer Society did its own reanalysis and showed the same. http://jama.jamanetwork.com/article.aspx?articleid=192965

Well if epidemiologists say it would be minimal, then who could possibly disagree with this? Or let's see what Levy & Marimont said:

Even if actual deaths were compared against an appropriate baseline for nonsmokers, the excess deaths could not properly be attributed to smoking alone. It cannot be assumed that the only difference between smokers and nonsmokers is that the former smoke. The two groups are dissimilar in many other respects, some of which affect their propensity to contract dis- eases that have been identified as smoking-related. For instance, smokers have higher rates of alcoholism, exercise less on average, eat fewer green vegetables, are more likely to be exposed to workplace carcinogens, and are poorer than nonsmokers. Each of those factors can be a “cause” of death from a so-called smoking-related disease; and each must be statistically controlled for if the impact of a single factor, like smoking, is to be reliably determined.

Sterling, Rosenbaum, and Weinkam found that adjusting their calculations for just two lifestyle differences—in income and alcohol consumption—between smokers and nonsmokers had the effect of reducing the Surgeon General’s smoking- related death count still further, from 203,200 to 150,000. That means the combined effect of using a proper standard of com- parison coupled with controls for income and alcohol was to lower the Surgeon General’s estimate 55 percent—from 335,600 to 150,000. Thus, the original estimate was a disquiet- ing 124 percent too high, even without adjustments for impor- tant variables like occupation, exercise, and nutritional habits.

What if smokers got plenty of exercise and had healthy diets while nonsmokers were couch potatoes who consumed buckets of fast food? Naturally, there are some smokers and nonsmokers who satisfy those criteria. Dr. William E. Wecker, a consulting statistician who has testified for the tobacco industry, scanned the CPS database and found thousands of smokers with relatively low risk factors and thousands of never-smokers with high risk factors. Comparing the mortality rates of the two groups, Dr. Wecker discovered that the smok- ers were “healthier and die less often by a factor of three than the never-smokers.” Obviously, other risk factors matter, and any study that ignores them is utterly worthless.

 

[Kent C]

@Jman8 This might help:

http://object.cato.org/sites/cato.org/files/serials/files/regulation/2000/4/fortherecord.pdf

"Our regulation article “lies,
Damned Lies, & 400,000 Smoking-
Related Deaths” exposes the pseudoscientific,
antismoking emissions of the
Centers for Disease Control and Prevention
(cdc). For that service, we stand
accused by Ms. Lukachko and Dr. Whelan
of “straying from basic epidemiological
principles” and “touting opinions
that masquerade as facts.” In
response, we examine Lukachko and
Whelan’s four specific charges, then
offer some concluding comments.

RELATIVE RISK
Lukachko and Whelan claim that
we erroneously omit certain diseases on
the ground that relative risks of less
than 2 (a 100 percent increase) are
“insufficiently reliable to conclude that
a particular agent (e.g., tobacco) caused
a particular disease.” Well, consider
this cautionary statement: “Relative
risks less than 2 are considered
small.… Such increases may be due to
chance, statistical bias, or effects of
confounding factors that are sometimes
not evident.” That statement
comes not from us, but from a 1994
release by the National Cancer Institute
(nci), referring to a study of abortion
and breast cancer...

...nci goes to great lengths to
dispute the potentially harmful effects
of abortions while it trumpets the
harmful effects of cigarettes, applying
equally dubious evidence.

But do not take our word. A special
report from Science magazine illuminates
the real world of epidemiology
in practice. From Gary Taubses’s article,
“Epidemiology Faces Its Limits” (Science
269, July 14, 1995: 164), here is what
respected scientists from both the public
and private sector, within the United
States and without, have said about
low relative risks.

•Sir Richard Doll of Oxford University:
“No single epidemiological study is
persuasive unless one can be statistically
confident of at least a threefold
increase in risk.”

• Harvard researcher Dimitrio Trichopolous:
“A fourfold risk increase is
the lower limit.”

•Marcia Angell, editor of the New England
Journal of Medicine: “As a general
rule of thumb, we are looking for a relative
risk of three or more before
accepting a paper for publication.”

• Robert Temple, director of drug
evaluation at the U.S. Food and Drug
Administration: “If the relative risk
isn’t at least three or four, forget it.”

• And from interviews conducted by
Science magazine: “Most epidemiologists…
said they would not take seriously
a single study reporting a new potential
cause of cancer unless… exposure
to the agent in question increased a person’s
risk by at least a factor of three.”
Even then, interviewees warn, “skepticism
is in order.”

Yet Lukachko and Whelan assure
us that “a relative risk less than 2,
although small, can indeed be statistically
significant.” Well, yes, that is certainly
true—and completely irrelevant,
as even they concede. Statistical significance
measures chance error,
which depends in part on risk levels
for smokers and nonsmokers, and in
part on sample size.

All else equal, given a specified background
risk among nonsmokers, the
smaller the relative risk, the less likely
that the difference in risk between
smokers and nonsmokers is statistically
significant. Still, large samples can
produce statistically significant results
even when the relative risk is low. But
that is not the point at all.

A relative risk less than 2 means that
it is less probable, though not impossible,
that a relationship is statistically
significant.

Low relative risk may indicate that a
study did not adequately control for
confounding variables [see Carl's piece]
.... or that it was
affected by bias on the part of
researchers or participants. Thus, statistical
significance is necessary to
demonstrate that a study is valid—it
denotes low probability of sampling
error—but it is not sufficient. The
potential problems associated with confounders
and bias do not disappear
merely because of a large sample size.

Lukachko and Whelan understand
that concept quite well. As they correctly
state, “Even if a result is statistically
significant, bias and potential
confounders must be addressed to
demonstrate a valid association.”
Astonishingly, having acknowledged
that principle, they wholly disregard
its implications. Relative risk is an
indicator not only of statistical significance
but also of possible confounders
and bias. That is why epidemiologists
uniformly hold that a
low relative risk goes hand in hand
with suspect validity.

Inexplicably, Lukachko and Whelan
persist in arguing that a small relative
risk can represent a serious threat to
public health. In support, they point to
the relationship between smoking and
heart disease. The relative risk of smoking
for many types of heart disease is
less than 2. But heart disease kills many
more people than lung cancer. Therefore,
according to Lukachko and Whelan,
“the number of smoking-related
deaths from heart disease rivals those
from lung cancer.” Verbal gymnastics,
but manifestly untrue. The missing link
is obvious: low relative risks mean that
deaths from various types of heart disease
have not been shown to be smoking-
related. To characterize those
deaths as “smoking-related” simply begs
the question."

There's more than that of course....

 

[Kent C]

Personal communication that I do not have permission to share.

I can respect that, but what you say about that is then rendered irrelevant as hearsay. Carl has been cited by Cato on a few occasions but not specifically regarding that subject.

 

[Kent C]

There's more than that of course....

Conclusion:
http://object.cato.org/sites/cato.org/files/serials/files/regulation/2000/4/fortherecord.pdf

"We started that article with this declaration:
“Truth was an early victim in the battle against tobacco.” We ended the article with this admonition: “When that goal [i.e., truth] yields to politics, tainting science in order to advance predetermined ends, we are all at risk. Sadly, that is exactly what has transpired as our public officials fabricate evidence to promote their crusade against big tobacco.” Our essential points are that government has lied to us, junk science has replaced honest science, and we have been propagandized by an avalanche of misinformation—much of it from those who should know better, some of it from those who do know better. Those problems are every bit as troublesome as the harmful health effects of a legal product that 45 million Americans consume with full knowledge of its risks, that 45 million other Americans have elected no longer to consume, and that, unhappily, will kill members of both groups—but far fewer than 400,000 per year—at an average age of 72, until we find cures for their diseases."

"Robert A. Levy
Senior Fellow in Constitutional Studies
Cato Institute

Rosalind B. Marimont
Formerly of the National Institutes
of Health and the National Bureau
of Standards"

Italics/underline - my emphasis - that was in 2000 - sound familiar??

 

[DC2]

The real enemy of THR is much more likely the Tobacco Control industry, funded by MSA payments and tobacco tax money. That is a very big pie and plenty enough to go around. The drug industry may have some small role in this, but it is minor compared to what is coming into the Tobacco Control industry as a whole. The drug industry and the Tobacco Control industry are not one and the same.

The Tobacco Control industry are mainly just the foot soldiers doing the dirty work.
But they are doing their dirty work on behalf of both Big Pharma and Big Government.

And of course, their own deep-seated hatred of the Big Tobacco industry.
And of course, their own jobs.

 

[Kent C]

That turns my stomach.

Pretty sure it turned Dr. Siegel's stomach as well.

"Siegel clashed with ANR leadership when he insisted that one of his earlier claims, which he now believed was mistaken, be removed. ANR claimed that maintaining their political position was more important than Siegel's personal and scientific integrity. Siegel disagreed strongly and has become highly critical of many mainstream antismoking efforts in the following years."

Scroll down to "Siegel, Michael" - reading the whole piece - it's why some of us have that 'love/hate' view of some THRers.

Advocates - TobaccoControl Tactics

Interesting 'bios' of some of the TC/THR advocates.

 

[philoshop]

The best way to keep vaping available is to vote out of office those who would like to take the option away.

 

[CarolT]

Just the wording of "caused a particular disease." Little things like that.


Relative risks do not reflect a causal relationship. Heck, the statement right after those words backs this up. The rest of this paragraph is hyperbole, based on the flawed rationale for causation.


Great! It ought to be violated. It is close to junk science and insidious as a philosophical paradigm.


IOW, allow us to self justify our own findings as significant, even if you rationally disagree.


Their words that deal with this issue are:


*Red text emphasis mine.


Well if epidemiologists say it would be minimal, then who could possibly disagree with this? Or let's see what Levy & Marimont said:

Whose wording of "caused a particular disease"? Levi and Marimont's? That's who L&W are quoting. And what do you propose instead?

Your reply that "Relative risks do not reflect a causal relationship" does not refute L&W's point that it is possible that they can be statistically significant, and that they can reflect a causal relationship. Or do you deny this as well? And what, precisely, is the "hyperbole" in the rest of the rest of the paragraph?

Smearing epidemiology in general as "close to junk science," while endorsing Levy & Marimont's arbitrary tossing out small risks, amounts to supporting full-blown junk science.

Statistical tests of significance are not 'self-justifying findings as significant'. And your disagreement, rational or otherwise, does not negate those statistical tests, either.

The pertinent issue is not whether the CPS studies have lower death rates than the general US population. The issues are whether and to what extent smokers' death rates differ from those of non-smokers, and whether and to what extent this is due to smoking.

There is no red text emphasis.

Levi & Marimont presented only speculation about what might lead to confounding. But when the CPS data were actually analyzed, this was shown not to be the case.

I'm afraid your case is a perfect fail.