COVID has accelerated the speed of fake news around the world much to the delight of the dangerous and delusional. In such times, the lay person could be forgiven for thinking that when the media cite ‘peer-reviewed’ papers, the publishing journals in which they appear would be an oasis of unbiased evidence and probity. The expectation is that the editors would have sufficient gravitas to weed out those papers which should never see the light of day. If only.
Richard Smith is the former editor of the British Medical Journal. On leaving his post, he wrote a refreshingly honest book entitled, The trouble with medical journals. Commenting on the quality of much research that manages to get into print, often after multiple rejections. he quoted Drummond Rennie, deputy editor of the Journal of the American Medical Association who observed,
“There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, no analysis too self-serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print”.
There are numerous examples of the bogus science Rennie refers to littered through the literature of tobacco control as it struggles to find as much bad news as possible about tobacco harm reduction.
However, the situation is getting worse. As the anti-tobacco harm reductionists are increasingly finding themselves on the wrong side of history, they fall back on the tired tropes about industry influence. Bad enough this nonsense appears in their own press releases, tweets, blogs and reports. Now, in a stroke of supreme irony, a Bloomberg-funded ‘study’ has wormed its way into the self-same British Medical Journal subsidiary publication Tobacco Control. The authors claim that consumer groups campaigning for the right to health are (yawn) the running dogs of Big Tobacco (BT). What evidence did the authors provide? This statement hints at an answer; ““We found no evidence that the individuals affiliated with INNCO or its member organizations were themselves funded by FSFW [Foundation for a Smoke Free World] or by the TI [Tobacco Industry] directly”. So why publish this ‘original research’ in the first place?
They base their spurious arguments on the number of tweets sent out by consumer activists around the time of the FCTC COP 8 meeting in 2018. Pro-tobacco harm reduction consumers – in fact anybody who advocates for this valid public health option – are denied access to the COP meeting and are often excluded from other international fora. No wonder then that consumers turn to (free) social media so their voice can be heard even if only among their own constituents.
The idea being touted in this article is that such activity is somehow being orchestrated by BT to ‘disrupt’ a high-level international tobacco control meeting attended by the health ministers and officials of dozens of nations. Tweets? Really? To quote John MacInroe, ‘you cannot be serious’. In her reply, the lead author trumpets openness and transparency (in contrast to those devious consumers) by citing Bloomberg Philanthropies as the funder. All this reveals is that the ‘study’ was funded by an organisation openly and transparently hostile to tobacco harm reduction. Nothing to celebrate here.
Here are responses to such ludicrous assertions:
Sadly, Cancer Research UK, with a track record of supporting tobacco harm reduction has supported this work and been rightly attacked:
NNA's letter to CRUK, complaining about their part funding and tweeting of the COP8 Twitter activity paper:
Putting the record straight: consumers are not tobacco industry minions
On its website, the BMJ proudly declares among its values that “Improving healthcare requires independent and unbiased information” and that, “the best decisions depend on the best evidence”. Precious little evidence these values being adhered to in this case.
But there is a more serious issue at stake here. Already cigarette sales are up in the USA (ground zero and funder of most anti-tobacco harm reduction rhetoric) and South Korea as the noose around the availability of vaping products tightens. Do the authors of articles such as this really want to see surge in cigarette use? If not, they should twice about this gratuitous scramble for conspiracies, although granted it does seem to be accompanied by fat cheques.
And while we are wallowing on the ocean floor of science, it’s that man Glantz again, although indirectly this time. In 2019, Glantz and a co-author published a paper which claimed that vaping caused heart attacks. It transpired the study cohort of ex-smokers suffered heart problems before they started vaping. The journal was forced unwillingly to retract the paper prompting SG to claim this had happened due to industry ‘influence’, as usual through inference rather than anything resembling evidence.
The authors of this recent article on the potential heart risk to vapers from metals cited the reference in their paper.
Bhatta DN, Glantz SA. Electronic cigarette use and myocardial infarction among adults in the US population assessment of tobacco and health. J Am Heart Assoc. 2019;8:e012317. This population-based study used data from the Population Assessment of Tobacco and Health Wave 1 survey to show that e-cigarette use is associated with a higher risk of myocardial infarction. A limitation of the study is that there are few participants who solely used e-cigarettes in the absence of past or current traditional smoking. It should be noted that this manuscript has been retracted with pressure from the vaping industry, but the findings and understanding the limitations of the study remain relevant.
Two issues emerge from this. There are differing views as to whether it is legitimate to cite a retracted paper. Some would argue whatever the reason for the retraction, it should be stricken from the scientific record. Period. Others take a more nuanced approach by saying that you need to examine the reason for the retraction. There may be copyright rather than methodological issues or it could be not all the retracted paper is in dispute. An aspect of the paper might remain valid in relation to the paper in which it is subsequently cited.
In this case however, it is quite clear that the whole premise of the Glantz paper was flawed and should not have been neither published nor cited. But even if the authors of the new paper thought that there was some merit in the Glantz paper, to cite the reason for the retraction as simply a response to industry pressure when neither Glantz nor anybody else has provided a scintilla of evidence, is unacceptable in a scientific paper. The editors should never have allowed it to happen.