Stan Glantz defames Brad Rodu, criticizes harm reduction articles on smokeless tobacco and e-cigarettes

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Ande

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The thing is- they aren't even considering the question as being "is using snus safer than continuing to smoke."

Glantz's hypothesis that he's set out to "test," as I understand it, is: "Snus, bad. Not use tobacco, good." Or something similarly simpleminded.

Using lower risk tobacco is undoubtedly not risk free, but all of this anti propaganda seems to be based on the falacy that, without reduced harm alternatives, all users of such alternatives would simply have quit.


And I wouldn't have.

Also sick of hearing about "dual use = harm escalation." If I used to smoke 20 cigarettes a day, and switch to using 5 portions of snus and 10 cigs a day, then it's still harm reduction. The only way you could argue "harm-escalation" would be if A) Snus is more dangerous than cigarettes (which would be a stupid statement to make), or B) smokers actually increased their overall consumption when switching.

There's a LOT of data that neither A nor B hold up. Dual users seem to always reduce their cigarette consumption. We can argue about the overall dangers of snus, but the relative risk picture is clear- it is MUCH less dangerous than cigs.

Forces me to a conclusion: Either Stanton Glantz is simpleminded (and therefore unable to understand the studies) or he's an amoral fanatic who doesn't care about the truth and only wants to argue his corner at any cost.

Is there another possibility I'm missing?

Ande
 
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sqirl1

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Yes. The ULSAM cohort was much, much smaller. Furthermore it consisted of elderly men, which tells us that much of their snus use took place before the TSNA levels were reduced.



There were 14 cases of heart failure among the 78 snus users, and 81 cases among the 998 non-users.

The thing I find most annoying is that Glantz is trying to use this study to prove that snus increases risk rather than reduces it. This is impossible to prove unless you are comparing the cases among former smokers who switched to snus to the cases among continuing smokers. In the larger cohort, all former or current tobacco smokers were excluded to avoid con-
founding from smoking. I guess this would make sense if what you are trying to prove is that if you are a non-user, you should not start using snus.

Nobody is advocating that never-uses become snus users to improve their health. Tobacco Harm Reduction (THR) involves switching from smoked to non-smoked tobacco. Since this study did not look at that question, it proves absolutely ZERO about the role of snus in THR.

I even disagree with that in some cases! I was a nonsmoker when I started all this and nicotine works for me a HELL of a lot better than adderall did when I took it, I say if snus is doubling my chances for having heart failure, that addeall must increase it eightfold! of course the mainstream doesn't accept the idea that nicotine is a natural medication quite yet, so for the purposes of campaigning I'd still stick with what you're saying.
 
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DC2

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Using lower risk tobacco is undoubtedly not risk free, but all of this anti propaganda seems to be based on the falacy that, without reduced harm alternatives, all users of such alternatives would simply have quit.
Yeah, that's pretty much the theory that drives them.

Forces me to a conclusion: Either Stanton Glantz is simpleminded (and therefore unable to understand the studies) or he's an amoral fanatic who doesn't care about the truth and only wants to argue his corner at any cost.
If you read up on Stanton Glantz, you'll find he is an amoral fanatic of the worst kind.
If a person were targeting our worst enemies to engage in battle, he'd be in the crosshairs rather quickly.
 

Ande

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The thing that *****s me off, of course- Glantz is what he is. Intellectually dishonest, manipulative, economically interested, self aggrandizing semi-crazy.

BUT...my extended family aren't. They're just "ordinary" people, not much into reading, church-going non-smoking folks.

And when guys like Glantz get headlines, the "normal" folk have no real reason, or inclination, to doubt him.

And that is a pain.

Ande
 

Tom09

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... And when guys like Glantz get headlines, the "normal" folk have no real reason, or inclination, to doubt him.

In my mind, there is even a bigger issue. While the general population is just an object to be worked on, Glantz’ direct audience is the tobacco control / public health community. For a large part, members of this community are professionals, so that interest in the topic and basic reading skills should be taken for granted. This thread on his recent community message, has shown that virtually none of his sentences comes without deception and/or manipulation, distorting the actual facts presented in the referenced sources. The problem is that this integrity standard seems to be accepted in the tobacco control / public health community at large. Thus, the character of Glantz' work is just a prominent symptom of the larger problem (leaving aside very few fringe figures who repeatedly ventured to critique such blunder): i.e. a broken community without correctives that is actually dictating public health policies.
 

DC2

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This thread on his recent community message, has shown that virtually none of his sentences comes without deception and/or manipulation, distorting the actual facts presented in the referenced sources. The problem is that this integrity standard seems to be accepted in the tobacco control / public health community at large. Thus, the character of Glantz' work is just a prominent symptom of the larger problem (leaving aside very few fringe figures who repeatedly ventured to critique such blunder): i.e. a broken community without correctives that is actually dictating public health policies.
Emphasis mine...

It's not just accepted, but embraced.
In fact, it's probably a race to see who can put out the best "sounds bites" that can become mantra.

Stan Glantz is certainly a looked up to and respected leader in these efforts.
Truth is merely a matter of inconvenience for these people.
 

rolygate

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Glantz has probably cherry-picked a Snus survey that shows the 'best' results for his purposes.

There seem to be over a hundred surveys, trials and reports on Snus in Sweden; and the opinion of the experts seems to be that surveys that produce results not supported by other surveys are best considered outliers, and dropped. Some trials have very large numbers of subjects, over periods of decades, so an accumulation of the results would seem to have the potential for accuracy.

Peter Lee has carried out a series of meta-analyses of Snus surveys and trials. He excludes those whose methodology or some other aspect indicates reduced reliability. Since he is an expert medical statistician, using large numbers of trials as the basis for his work, and excludes those that seem less reliable, such reports would appear to have the right foundations.

His analysis of 89 studies showed no identifiable connection with cancer:
Systematic review of the relation between smokeless ... [BMC Med. 2009] - PubMed - NCBI

His latest survey is said to use 150 reports as a basis for its conclusions, which is that Snus has no statistically measurable connection with any form of cancer, heart disease or stroke. If there is any risk, which is not reliably calculated with the data available, it is 1% that of smoking:
Summary of the epidemiological evide... [Regul Toxicol Pharmacol. 2011] - PubMed - NCBI

A Peter Lee powerpoint presentation:
http://www.ihra.net/files/2010/09/22/139.pdf
 

Tom09

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In his defamatory message, Stan Glantz (see OP) alleged that a large longitudinal study of snus users in Sweden would have found that snus more than doubled the risk of heart failure. This refers to the ULSAM cohort in a recent paper of Arefalk et al. 2011 (journal abstract, AHA-medpage review). As previously pointed out in this thread, the database of this study involving 1,076 older men boils down to 78 snus users, of whom about 80% also smoked cigarettes, and researchers even acknowledged a limitation by the small number of nonsmoking snus users (16 individuals).

In a recent blog post, Brad Rodu pointed out more problems regarding the ULSAM data treatment by Arefalk et al. 2011.
In short, the „analysis was tailor-made to produce the desired result“.
In more depth, see Brad Rodu at tobaccotruth, Thursday, December 15, 2011.
 
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As long as we're in big collective gripe session about Glantz (and there's nothing wrong with that ;) ... let's not forget the drivel that Grana, Benowitz and Glantz just spewed out in Circulation.

The specific form of injury there is that they try to combine the results of five dreadful cessation "studies" (if we can disgrace that term by applying it to stuff like the Grana, Popov & Ling letter in JAMA Internal Med., published in March). I believe I've used the phrase "garbage in, garbage out" to describe the current excreble excuse for pubic health science. Take five pieces of junk, shove 'em into the statistical equivalent of a food processor and - presto! - out comes a whole new piece of ... trash.

The insult that the media is now adding to this injury is being perpetrated by a number of outlets like the Chrisian Science Monitor who are falsely implying - by the use of the sorts of cleverly misleading phrases that would make the writer of a credit card contract jealous - that the Curculation journal article references "83" studies showing that vaping allegedly has minimal (or negative) cessation value.

Did ya ever stop to wonder whether Glantz is engaged in a temper tantrum, because he's more than merely a little upset that West rained on his pathetic parade with some solid (if not apples-to-apples) evidence that UCSF cessation research is probably junk science?

(Hmm, I wonder what the CDC is going to do. I bet they're not overjoyed either. Maybe it's time for something else to start "skyrocketing." Remember that survey of 20,000 schoolkids? I was thinking they were going to wait until after labor day for maximum "back to school" impact. But maybe they can't afford to let this West thing hang around too long without finding some way to blow it out of the water.)
 
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AgentAnia

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....Did ya ever stop to wonder whether Glantz is engaged in a temper tantrum, because he's more than merely a little upset that West rained on his pathetic parade with some solid (if not apples-to-apples) evidence that UCSF cessation research is probably junk science?....

I prefer "temper tantrum cum hissy fit," as this incorporates both adult and juvenile inappropriate behavior, both of which apply in this case, IMO... :D
 
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