Who's Telling the Truth
[7.0] If some of the information that is out there is so wrong, why do so many organizations/websites/people say it?
Winston Churchill once observed that a lie gets halfway around the world before the truth has a chance to get its pants on. The idea behind this is that it is very easy for someone to just make up a claim, and for others to repeat it, while to compile the evidence and careful argument to show it is wrong is very difficult. If anyone has ever started a false rumor about you, you probably know this very well.
This problem is made much worse if there are people who are intent on convincing everyone of something (even though it is not true), and so are sending their lies around the world. Since it takes only a minute to make up (or repeat) a false claim, but it takes hours or days to carefully refute it, as long as there are people who want to mislead you, there will likely always be more misinformation than honest information. Our goal is to help you distinguish between them.
[7.1] Why should we believe you?
That is an excellent question. When people claiming to be experts argue about something that you have limited expertise about, sometimes flatly contradicting each other, it is usually quite difficult to figure out who to believe. We have made a study of that point, and have a few suggestions. We have developed these, in part, by reading about highly controversial issues we are not experts in, and trying to sort out who seems to be right and who pretty clearly is wrong. We hope that the value of the suggestions will be apparent (so you do not have to take our word for them, which would complicate things!).
[7.1.1] First, and foremost, try to notice who is responding to arguments by their opponents, and who is not.
Even if you cannot understand every point of an argument or verify the factual claims being made, you can usually recognize when someone is directly challenging their opponents' key points. Similarly, you can recognize when someone seems to be completely ignoring challenges to their position. Almost always, the side that is responding to challenges is telling the truth and knows what they are talking about, while the side that just repeats themselves and talks around the argument is wrong.
For example, we have presented details about how the scientific research shows that the risks of cancer and other deadly diseases from smokeless tobacco are extremely small or possibly zero. We explain why most of the claims made by anti-smokeless-tobacco advocates are simply not supported by the science. We suspect that you will not find anyone trying to provide real scientific evidence that contradicts us (there isn't any!), but you will find people repeating the claims that we have refuted and appealing to very old analyses which we have shown are not supported by the science. Notice the pattern: we explain why their claims are wrong, while they just repeat the same claims again. If they had any real argument against what we have written, you can be sure they would make it.
[7.1.2] Second, ask tough questions.
We have written an FAQ, provided a reference list and created discussion forums because we want to demonstrate that we can explain and defend any of our claims. If we are presented with an important question that we have not answered, we will add it to the FAQ. Anyone who does not let you ask questions may realize that they do not have any legitimate answers to offer. Anyone who is really interested in getting to the truth will not only accept questions, but will even present the best arguments against their position and try to respond to them (as we try to do).
If you get a chance, try putting some tough questions to someone presenting arguments against tobacco harm reduction:
If they claim that smokeless tobacco is just as bad for you as smoking, ask them which disease smokeless tobacco creates more risk of than smoking does (since switching to smokeless tobacco clearly reduces your lung disease risk, something else would have to be higher to make up for it). If they respond "oral cancer", ask them how a rare disease that is mostly caused by smoking could have such a large effect. Even better, just ask them if they even know what the risk of oral cancer from smoking is.
If they admit that smokeless tobacco is not as bad for you as smoking, but claim that it is still quite bad, ask them what fraction of the risk from smoking it causes. If the answer is 5% or more, ask what rates of what diseases cause that risk (and then ask them how they justify those numbers).
If someone claims that harm reduction might be acceptable, but only by using pharmaceutical nicotine products (which, as we noted, is an increasingly popular ploy), ask them for the evidence that pharmaceutical products are less risky than smokeless tobacco, and by how much.
Perhaps the best question to ask is "how much safer than smoking does an alternative source of nicotine have to be before it is an acceptable alternative?", rather than putting a smoker through the pain of withdrawal, the frustration of failed quit attempts, and the loss of the benefits of nicotine. (If the answer is "100% safer" or "no use of nicotine is acceptable, no matter how low the risk", then you are talking to someone who cares more about some purification crusade than they do about people's well being.)
If you actually get an answer to any of your questions, and if it seems convincing, please send it to us. We will try to explain how it fits into what we are saying.
[7.1.3] Third, look for the most obviously invalid arguments.
The most common statement by anti-harm-reduction advocates seems to be "smokeless tobacco (or any source of nicotine) is not safe" or "is not a safe alternative to smoking". As we point out above, no one is claiming that any source of nicotine is safe, and the idea of harm reduction certainly does not require that the alternative be perfectly safe. The whole argument is not that the alternative is perfectly safe, but simply that it is a lot less harmful, and thus could provide huge benefits. It is clear that "not safe" or "not harmless" is not in any way an argument against harm reduction. Anyone who seems to be basing their "argument" on the fact that the alternative is "not safe" must not have anything valid to say.
An even weaker "argument" is to talk about funding instead of about the substance of the argument. This is what is known as an ad hominem argument, attacking the people instead of addressing the substance of what they have to say. If someone suggests that the argument for harm reduction is invalid because some proponents of harm reduction receive research grants from industry, it is about the same as suggestion the argument is wrong because some of us are Canadian, or some of us wear our hair funny. If someone has a valid argument against what we are saying, that argument is valid no matter where our funding comes from. If they have no valid argument, talking about our funding is no more a valid argument than criticizing the color scheme of our website. When someone complains about our funding, we simply translate that into "they realize our arguments are valid, but they just don't like the conclusions". (As for why people who can offer no real criticisms of our points do not join us, instead of continuing to tell smokers to quit or die, we can only speculate. It is kind of sad.)
[7.1.4] Do not be swayed by the sheer volume of misleading information. Repetition does not create truth.
Bad information is much easier to produce than good information. Bad information can just be made up, off the top of your head. Good information takes research, and careful reasoning and presentation. There will always be more bad information than good. So you have to learn to identify what is good, and not let the sheer volume of bad information confuse your judgment. Governments and other powerful and reputable organizations sometimes provide bad information. (If you read the news, you probably know that). Ultimately you have to sort out the truth; you should not believe us merely because we are university researchers with professional reputations to protect, and you should not believe the American Cancer Society just because they are rich and powerful.
Importantly, do not expect anyone to try to respond to every point their opponents make. That is simply impossible. We will try to respond to most of the core arguments of anti-harm-reduction advocates. We will do our best to be comprehensive, and will take your suggestions about what else we need to respond to. We ask you to compare this to how little they actually say about the real substance of our argument.
[7.2] Why do anti-smoking advocates mostly seem to oppose harm reduction?
It is unfortunate that the term anti-tobacco is seen by many to be synonymous with anti-smoking. As we've mentioned elsewhere, almost all the harm in tobacco comes from burning it and then inhaling the smoke.
For many in the movement, the passion for reducing tobacco use overrides all other concerns including any evidence that some forms of tobacco use might be preferable to others (such as smokeless tobacco helping people quit smoking), or that smoking itself might be of benefit under some conditions (as it is for some schizophrenics, Parkinson's sufferers, and Tourette's syndrome[1]), as well as the overstating of the dangers of anything associated with tobacco (such as second hand smoke[2]).
This approach offers little relief to the inveterate smoker who, if they had all the information, might consider switching to a low harm alternative like smokeless tobacco. However pushing the "all tobacco is harmful" message restricts the users' options to "quit or die".
The indiscriminatory condemnation of all tobacco use undermines the anti-smoking movement [3]. To oppose smoking is scientifically a near unassailable position but to be against all instances of tobacco use introduces unsubstantiated elements which call into question the integrity of the movement as a whole.
The anti-smoking forces have also embarked on vilifying all tobacco funding no matter what the end purpose is, and putting forth the argument that any development that adds to the coffers of the tobacco companies is a bad thing. Therefore, according to their reasoning, even if increased sales of smokeless tobacco led to an improvement in public health, it would still intrinsically be a bad thing.
Our position is that the death toll from smoking is a bad thing. Anything that reduces worldwide mortality or morbidity from smoking, even if it makes somebody richer than before, is a good thing. Ironically, it may be tobacco companies that end up effecting the greatest change in regards to the 25 million inveterate smokers in the United States.
"Aggressive nationwide promotion by major companies of spitless, smokeless tobacco products (also referred to as snus) which have been scientifically demonstrated to be 98% safer than cigarettes, may accomplish in a short time what decades of trivial "tips for smokers" and millions of dollars of ineffective consumer education have failed to do, namely, get smokers to stop smoking." (Dr. Brad Rodu commenting in response to the news that Reynolds was test marketing Camel Snus (2006)).
[7.3] Why should we believe you; we hear that you get money from the tobacco industry?
The researchers who produced this website receive or have received research support from the smokeless tobacco industry, from the pharmaceutical industry, from other industries, from government, and from non-profit organizations. Something that most people do not realize about university research, particularly health science research, is that most of it is supported by some outside funding. Universities simply do not have enough of their own money, so researchers have to get research grants from someone. As you might expect, when an industry has an interest in a particular line of research, they are often willing to provide funding. (It is also worth noting that when an industry has such interest, such as the smokeless tobacco industry with tobacco harm reduction, it is often difficult to get government or anyone else to fund the work. They tend to say "let the industry fund this so we can reserve our money for things that no industry will fund.")
Those who provide research funding sometimes exert some control over the research, and many university researchers are forced to yield to those constraints. Government grants usually limit funding to a particular research project that is pre-approved by the funding agency, and often decide what researchers should be doing by directing their funds to particular projects chosen by the government. Advocacy organizations (including anti-tobacco groups) typically limit their funding to projects that will support their positions. The pharmaceutical industry has even been known to suppress or try to change results they do not like. Fortunately, none of the funding supporting our harm reduction projects have any of these limitations. We are free to do what we think is best, and report whatever we find.
Something you may not realize, but should be obvious once you read it, is that most industry funding goes to people who are already working on something of interest to the industry. Industry funders do not tend to go in search of someone to win over or "buy off". Rather, researchers who are already doing particular work and need funding figure out which industry sources might support their work and ask them for money. In particular, we were already working on tobacco harm reduction before we asked the industry for the funding that partially supports our current work.
ASTER is especially fortunate because much of our funding comes from a completely unrestricted, completely hands-off grant to the University of Alberta, which Dr. Phillips requested and received from U.S. Smokeless Tobacco Company. We make no secret of this; we mention this funding on almost everything we write. Unlike most research grants, this one lets us do whatever work we think is best, with absolutely no involvement by the funder. Whether they like what we do or not, they have promised to keep funding it.
Our funding is quite small compared to the enormous operations that anti-tobacco organizations and anti-tobacco government agencies have. Unlike our work, which focuses on the scientific evidence, wherever it might lead us, anti-tobacco organizations have a very one-sided agenda. While we are independent university researchers, much of what those organizations produce is written by people whose job description is being an anti-tobacco advocate. Yet part of their strategy is to try to make it sound like we are the ones who are biased and that we have huge amounts of money from rich industries. But they can afford to buy television ads, while we can only afford to have a website and write research papers.
Fortunately, having the truth and overwhelming evidence on our side is a great equalizer.
Because we have to depend on the truth, while they can use millions of dollars worth of slick advertising, we have tried to provide advice for sorting out the truth from the misinformation. We also try to provide as much detailed evidence as we can, and even provide a place for anyone to try to show us that we are wrong in our forum. If we are wrong, we want to know so we can change what we are saying! (Can you say the same about those who get their money from anti-tobacco organizations?)
[7.4] Isn't it a bit odd that some of you get grants from organizations that will benefit from the harm reduction message?
Not only is getting funds from interested parties not unusual, but in matters relating to tobacco such things are almost universal. Pretty much everyone involved in tobacco research and advocacy takes money from organizations that will benefit from particular messages. That may not be an ideal world, but it is the world we are in, and you should know that when you are trying to sort out the truth. If anything, anti-harm-reduction advocates seem more likely to be biased by their funding than anyone could possibly be influenced by unrestricted university grants.
Before continuing, we want to make clear we are not lowering ourselves to the level of people who talk about funding to distract people from the truth. We do not claim that people should not take research funding where they can get it or that anyone's claims are wrong just because they take money from an interested organization (whether that organization is an anti-smokeless-tobacco advocate or a company that will lose money because of tobacco harm reduction, such as certain pharmaceutical and cigarette companies). If someone thinks our science is wrong, tell us (and the world) where the flaws are. When we observe that someone else's claims are wrong, we will make that clear based on the science, not their funding. Beware those whose "arguments" are based on innuendo about funding and not facts.
Most of the vocal opponents of smokeless tobacco and harm reduction are paid by the pharmaceutical industry or organizations that are officially opposed to harm reduction. In contrast with university research grants (which do not increase the researcher's personal income), such funding is typically money into people's pockets, in the form of salaries, consulting fees, or honoraria. Some anti-harm-reduction advocates draw their paycheck from an advocacy group or government agency that wants to abolish all nicotine use. Others receive funding from pharmaceutical companies, companies that compete for profits with smokeless tobacco in the market for people who want to quit smoking. Even research grants from these organizations usually come with many limitations on what the researcher can do and say, as opposed to all of the funding from the smokeless tobacco industry (that we are aware of), which is totally unrestricted and hands-off.
Moreover, unlike those of us who collaborate on this website, who are university researchers and have scientific reputations to protect, many of those who attack tobacco harm reduction are judged only by their fellow activists. They receive rewards and career advancement based on how vocal and influential they are, and are unlikely to be penalized for misleading the public about the science. We are judged based on doing good science and being accurate in what we say, and could not get away with making invalid claims.
(A few of us involved in tobacco harm reduction get money as consultants from smokeless tobacco companies. Ironically, most of this comes from helping the companies defend against the lawsuits that occur when someone claims that smokeless tobacco caused a disease. If we are successful in getting people to understand the very low risks from smokeless tobacco, those consulting fees could disappear. Fortunately, we feel that public health is a lot more important than making money. It is too bad that not everyone feels that way.)
If you think that government and other major health organizations are immune from issues of funding and apparent conflicts-of-interest, think again. Those organizations are not god-like sources of objective information. Many of them have accomodated the dominant political ideologies and established interests at the expense of helping people. Obviously, we can expect no more objectivity from such sources than we can from cigarette advertisements.
For example, we launched this website on the World Health Organizations's (WHO) "No Tobacco Day", because WHO was focusing as much on smokeless tobacco as on the real problem, cigarettes. Why? Well, Jack Henningfield, the person who describes himself as the "invited lead author" of the WHO report that was the basis for the anti-smokeless-tobacco message (rife with many inaccuracies which we will document and post) is the Vice President of a consulting firm that gets a huge amount of money from GlaxoSmithKline, the leading manufacturer of pharmaceutical nicotine products. He has also helped develop pharmaceutical nicotine products, and has a personal financial stake in the market for reduced-harm pharmaceutical products.
On a more local scale, the most vocal critic of those of us at University of Alberta, Charl Els, is a professor who gets research funding from pharmaceutical companies, as well as "honoraria" (which in the medical profession often means paying doctors who help promote a certain drug, often more money for giving one speech than most people make in month). His own work focuses on the possibility of long-term pharmaceutical nicotine use. Again, we are not saying that anyone's funding makes them wrong, but only that everyone looks pretty similar from that perspective (which is why we offer strategies for trying to sort out the truth).
Just as a reminder, we strongly support the possibility of using pharmaceutical nicotine products in harm reduction, if pharmaceutical companies would start selling the right products at the right price. Only people who are more interested in profit than in helping people that would insist that only one strategy should be tried. Those of us most interested in people's health welcome any effective alternative to smoking.
References
1. Benowitz 1996; Pharmacology of nicotine: addiction and therapeutics. Annual Reviews in Pharmocology and Toxicology 36:597-613. Abstract.
2. Siegel 2006; False claims about secondhand smoke being used to promote smoking bans and misleading policy makers. The rest of the story: Tobacco news and commentary.
3. Whelan 2006; The intolerance and arrogance of the modern-day anti-smoking movement. American Council on Science and Health.
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