Studies: New Study From Scotland

17 February 2009
Smoking out ‘deniers’ and ‘dissidents’
Anti-smoking activists are now comparing their critics to Holocaust deniers. It is a vile attempt to shut down debate.
Christopher Snowdon
In a five-page journal article published online this month, Martin Dockrell, the policy and campaigns manager for the UK’s main anti-smoking campaign, Action on Smoking and Health (ASH), has launched an extraordinary attack on the journalist and broadcaster Michael Blastland (1). Calling him a ‘conspiracy theorist’ and a ‘dissident’, Dockrell explicitly compares Blastland to the ‘AIDS dissidents’ who disputed the link between HIV and AIDS.
Blastland’s crime was to criticise a study that claimed that the incidence of acute coronary syndrome (ACS) fell by 17 per cent after Scotland’s public smoking ban came into force in 2006. The study then applied a logical fallacy: since the reduction followed the ban, it must have been caused by the ban. Blastland covered the story for the BBC in November 2007, two months after the findings were reported by the international media following a presentation at a tobacco control conference.
Since the paper was, at the time, unpublished, Dockrell accuses Blastland of ‘reject[ing] the research before they had had the opportunity to look at it’. Strangely, Dockrell does not criticise those journalists who unquestioningly reported this unseen study with headlines such as ‘Scottish smoking ban brings big cut in heart attacks’ (2). Nor does he criticise the Scottish government for producing a press release to promote the findings. And he has nothing to say about the report author Jill Pell’s decision to announce the results of a study that had been neither peer-reviewed nor published.
Nor, for that matter, does he criticise his own boss at ASH – Deborah Arnott – for greeting the study with the words: ‘We knew from epidemiological statistics there was a risk from secondhand smoke to cardiovascular health, but not how much of a risk until now.’ (3) For Dockrell, blind faith is the only acceptable response to an unpublished study. Scepticism is not.
Blastland had good reason to debunk the study. Using official data from the Scottish National Health Service (NHS), he could see that the fall in heart attack admissions had been nowhere near 17 per cent: ‘These [data] show a fall in heart attacks for the year from March 2006 – not of 17 per cent, but less than half as much at about eight per cent. What’s more, taking out the recent trend, this is halved again. Heart attacks have been falling steadily for some years now.’
This was the essence of Blastland’s critique. Using official data, rather than the case group selected by Pell, it was plainly obvious that the fall in 2006-07 was an unexceptional extension of an existing downward trend. (For more on Blastland’s article, see Health fears go up in smoke, by Christopher Snowdon).
One of the most puzzling things about the Pell’s ‘StopIt’ study was that she chose to use a sample group when hospital admission data was freely available. Dockrell leaps to her defence, saying: ‘Pell makes no secret of the difference between the data from the StopIt study and the routine discharge data… Although Pell and colleagues had access to the AMI [acute myocardial infarction] discharge data, the StopIt study refers to ACS, a broader measure for heart attacks, verified by assay.’
This is true, but Dockrell fails to mention that Pell had access to the ACS discharge data, too. Everybody does – it is freely available on the Scottish NHS website – and it shows that admissions fell by 7.2 per cent in the first year after the smoking ban and rose by 7.8 per cent in the second year.
Brazenly ignoring the elephant in the room, Dockrell does not mention the rise in admissions in year two, instead pointing out that ‘raw discharge data’ from hospitals is ‘not peer-reviewed’ and suggests that it is not, therefore, reliable. This is not only a ridiculous assertion, it is also a slur on those who compile them. The NHS employs professional statisticians to compile and publish this data. There is no requirement at all for these figures to be peer-reviewed by a medical journal. They are official statistics, reviewed meticulously before being published.
It is hard to believe that Dockrell is seriously suggesting that Pell’s 20-month study of patients in a selection of hospitals trumps a decade of comprehensive data from the Scottish NHS, but that does seem to be the implication.
The news that rates of acute coronary syndrome are now higher in Scotland than they were before the smoking ban was enforced would have been enough to kill off the hypothesis in a less politicised area of research. The Scottish ‘miracle’ has ceased to be. It is no more. It has gone up to join the choir invisible. If Pell hadn’t nailed it to its perch, it would be pushing up the daisies. But instead of quietly backing away from this minor embarrassment, ASH has resolved to defend it at any cost. Left high and dry by the facts, they have resorted to name-calling.
Ad hominem attacks are often used against those who question any aspect of passive-smoking epidemiology. Activists frequently accuse critics of being employees or ‘allies’ of the tobacco industry. Such claims are usually untrue, and certainly are in the case of Michael Blastland. But he writes and broadcasts for the BBC – hardly a pro-tobacco organisation – and is the author of The Tiger That Isn’t, a book which looks at the misuse of statistics. He rarely discusses smoking at all except when, as here, it involves statistical sleight of hand.
Deprived of an opportunity to accuse critics such as Blastland of being in the pay of industry, Dockrell resorts to the slur of saying that: ‘Their position echoes the so-called “AIDS dissidents” who continued to contest that HIV was a causal agent in AIDS long after the scientific debate was over.’
This is a poor argument, particularly coming from a member of ASH. Anti-smoking activists like Dockrell are the first to complain when smokers’ rights groups accuse them of being ‘Nazis’ on the basis that the modern anti-smoking campaign has ‘echoes’ of Hitler’s own efforts to stamp out tobacco.
Comparing critics of these heart studies to AIDS deniers could hardly be more spurious. AIDS deniers, as Dockrell states, protested ‘long after the scientific debate was over’. Debate about studies that purport to show that smoking bans reduce heart attack admissions has barely begun. The first of them only appeared in 2003 and the majority of the other studies have been published in the past two years. Pell’s paper appeared barely six months ago. To compare this slender and recent body of epidemiological evidence to the vast body of scientific evidence about HIV is absurd.
By mentioning the AIDS ‘dissidents’, Dockrell is clearly attempting to persuade the reader that both bodies of evidence are of equal merit, and both sets of detractors are equally deranged. Worryingly, this fallacious argument comes hot on the heels of an article published in the European Journal of Public Health, titled ‘Denialism: what it is and how should scientists respond?’. The article, by the journal’s editor Martin McKee, groups together creationists, AIDS deniers and critics of the Pell study as being peas in the same pod (4).
McKee writes: ‘It took many decades for the conclusions of authoritative reports by the US surgeon general and the British Royal College of Physicians on the harmful effects of smoking to be accepted, while even now, despite clear evidence of rapid reductions in myocardial infarctions where bans have been implemented, there are some who deny that secondhand smoke is dangerous.’
The implication is clear: those who dispute studies such as Pell’s also deny that primary smoking is dangerous. Somewhat inevitably, McKee then introduces the most infamous and most repellent form of ‘denial’: Holocaust denial. ‘This phenomenon has led some to draw a historical parallel with the Holocaust, another area where the evidence is overwhelming, but where a few commentators have continued to sow doubt.’
This goes beyond the pale, but it serves as a reminder of why the word ‘denier’ is becoming so popular amongst those who would prefer to close down debate. It is quite deliberately chosen to bring to mind images of cranks, fraudsters and neo-Nazis. It is, perhaps, the ultimate insult and it is, of course, utterly fallacious.
The evidence for the Holocaust is documented in hours of film footage and is remembered by hundreds of thousands of eyewitnesses. Similarly, the link between HIV and AIDS has been proven by solid biological evidence. What McKee laughably calls the ‘clear evidence of rapid reductions in myocardial infarctions where bans have been implemented’ consists of nothing more than a handful of epidemiological studies of dubious value, created and funded by highly partisan bodies and individuals. Comparing this feeble selection of flawed studies to the thousands of studies conducted into primary smoking, let alone 60 years of evidence for the Holocaust, is obscene.
This kind of abuse ‘echoes’ (as Dockrell might say) the accusation – common in Stalinist Russia – that those who failed to accept the state’s ‘scientific Marxism’ (or the junk science of Lysenko) were either mentally ill or were ‘dissidents’ (Dockrell uses the word dissidents or dissidence seven times in his article). This prevailing view effectively ended scientific and political debate in the Soviet U nion in the 1930s just as Dockrell and McKee would like to end the debate over the ‘heart miracles’ today. Both their articles push for a revival of the notion of scientific heresy, rebranded as denialism, something so devilish that it must not be allowed to be heard. It is hard to think of a concept that could be further removed from the scientific method.
Dockrell refers to the famous criteria of causation set out by the noted epidemiologist Austin Bradford Hill – who produced the first, definitive research on smoking and lung cancer in the UK – and claims that the Pell study would pass Hill’s test of strength and consistency. Aside from the fact that the rise in heart attacks in year two of the smoking ban shows this to be sheer nonsense, both he and McKee would do well to remember that neither Hill nor his colleague Richard Doll ever resorted to character assassination when their early studies were contested by other scientists. They might also learn from the example of Albert Einstein, who invited Arthur Eddington to put his ideas to the most rigorous of tests. Or do they believe the findings of Dr Pell to be more robust than the theory of relativity?
Scientific debate should not be reduced to ad hominem attacks. Good scientists are happy to have their theories scrutinised, even when they believe their opponents to be utterly misguided. Good scientists do not announce their findings to the press and then refuse to answer questions. Good scientists do not refuse to release their raw data. Good scientists do not claim that a scientific debate is over before it has been allowed to begin. Above all, good scientists do not slander their critics with barely concealed accusations of madness, corruption or worse.
It is time for the scientific community to speak out about the erosion of scientific discourse and reject the ugly concept of ‘denialism’, censorship and all the twisted reasoning inherent in the rottweiler-style attacks of Dockrell and McKee.
Christopher J Snowdon is the author of the forthcoming Velvet Glove, Iron Fist: A History of Anti-Smoking, available from his website here.

---

Large Rise In ACS In Scotland Since Ban

Colin Grainger
28th November 2008

That’s right folks!

Acute Coronary Syndrome sees a huge rise in Scotland SINCE the smoker ban was enacted. And as one observer notes, the Scottish smoker ban is responsible for many, many deaths. The ban can be said to have CAUSED hundreds of heart attacks.

We doubt you are going to see this anywhere else.

In yet another F2C exclusive, author Chris Snowdon gives us the news. The mainstream media are nowhere near as savvy, or as determined, as Chris is. He waited patiently, (like the freaks should have done), and sure enough, the NHS went and published their stats for the year.

Professor Jill Pell, (remember her?), around this time last year she was trotting around, basking in the limelight, having announced, not just to Scotland, but to the WORLD, that we had witnessed a miracle. She brayed that heart attacks were down by 17%. And it was all thanks to the smoker ban.

Useful idiots the world over based their bans on her figures. Like her, they didn’t stop to think. They didn’t bother to suspect that the miracle was a fake.

Well guess what?

Her figures were wrong, wrong, WRONG!

There was NO miracle.

There was NO 17% reduction.

We said so at the time. We knew the truth would out.

And so it has come to pass.

Let’s go over to Christophers place and see what he has to say:

Go To Story…
Velvet Glove Iron Fist
A History of Anti-Smoking
by Christopher Snowdon

---

Challenge to Anti-Smoking Groups to Publicize Two-Year Data from Scotland on Trends in Heart Attacks
December 2, 2008
By? Michael Siegel
Today I am challenging anti-smoking groups to publicize the two-year follow-up results of trends in heart attacks or acute coronary syndrome in Scotland since the smoking ban went into effect.
The first group to do this will receive a $200 donation to their organization.

---

Data Released by Scottish National Health Service Show that Conclusions of Earlier Study about Effect of Smoking Ban on Heart Attacks Was Wrong
Now that a full two years worth of data are available on heart attack and unstable angina admissions to all Scotland hospitals, it is clear that the conclusions of the article earlier this year is wrong: the observed decline in heart attack admissions was not due to the smoking ban, but instead was simply a statistical blip in the data.
By Michael Siegel

---

The facts in the way of a good story

November 14, 2007

It looked like a vindication of the smoking ban in Scotland – in little more than a year, the heart attack rate had been cut by almost a fifth. But look at official figures, says Michael Blastland, and it just doesn’t stack up.

It was dramatic research that made headlines everywhere. A 17% fall in the number of heart attacks in the year since Scotland stubbed out smoking in public places.

Startling – if true.

Few questioned the research when it was revealed two months ago. Politicians trumpeted the numbers as vindication of a policy introduced a year earlier than in England. Journalists obediently followed suit.

The most arresting finding was that heart attacks among non-smokers had apparently fallen even faster than smokers, suggesting that passive smoking was often to blame.

Then a week ago, with rather less fanfare, routine statistics on hospital activity were published by the official source for health data in Scotland, as they are every year, this time including the time since the ban.

These show a fall in heart attacks for the year from March 2006 – not of 17%, but less than half as much at about 8%.

What’s more, taking out the recent trend, this is halved again. Heart attacks have been falling steadily for some years now. The percentage falls in the three years before the ban were 5.1%, 4.7% and 5.7%. So the fall since is still bigger than the trend would lead us to expect, but bigger only by about three or four percentage points – an improvement, but retreating fast from the magnitude of 17.

The latest release also makes clear that even an 8% fall in heart attacks is not unprecedented. There was another, larger drop between 1999 and 2000 of about 11% (see chart).

This seems to demonstrate significant variability around the trend, suggesting that last year’s 8% drop might even be the result of chance. It is conceivable, although perhaps unlikely, that the smoking ban had no effect at all. The figures could be a result of no more than the ordinary ups and downs of statistical variation from one year to the next.

There have been several other initiatives designed to reduce heart attacks in Scotland recently, and any or all might also have played a part.

If we look at all heart attacks, rather than just emergency admissions, the fall last year according to the official data was slightly smaller again – about 7% – against falls in the past three years on this measure typically of about 4%.

Rise and fall

Scotland’s deputy chief medical officer, Peter Donnelly, said at the time of the study in September: “One of the most important findings is the reduction in heart attacks. We believe that the smoking ban was a large contributory factor to this drop.”

It is not clear on what evidence he could now make such a claim. Any claims of causation now look premature. Even the latest figures are provisional and subject to revision.

Such claims are, in fact, positively damaging. What is unquestionably a good news story – the consistent and impressive decline in heart attacks in Scotland over many years – has become overshadowed by squabbles about the smoking ban.

Worse, the true reasons for this success may be overlooked if too much credit is attributed to the ban on unreliable evidence.

So why such a discrepancy between the two numbers?

The first study was presented at a conference in Edinburgh two months ago by a research group called StopIt (Study Of Public Place Intervention on Tobacco Exposure).

The latest statistics come from ISD Scotland, part of the NHS responsible for health data. Dr Colin Fishbacker, an ISD official, says the two studies used data from different sources. “We wouldn’t expect the sources to agree exactly. The routine data we publish is based on the discharge summary sent to the GP and medical records for coding. The StopIt study was a specific research exercise.”

Numbers game

There are other factors that may might help explain the discrepancy. The first study, unlike the routine data, was a sample, not a total for all Scotland. And although the sample included nine Scottish hospitals with about two-thirds of heart attack admissions, patients did not have to take part.

There is also a suggestion that the StopIt study compared 10 months before the ban in March 2006, with 10 months after. So the two periods might have spanned different parts of the year. It paid particular attention to distinguishing between smokers and non-smokers, and this may have affected the way the study was carried out.

But because the data on which the StopIt study was based has never been published, and nor has the study itself, it is impossible to say exactly how it was done. Attempts to obtain it or to talk to the lead researcher have gone unanswered.

Once the number was out, politicians were certainly not about to exercise any scientifically-minded reservations about its reliability. The story became political as much as medical.

None of this rules out the possibility that the ban is having an effect. Such a conclusion would be as reckless as declaring that the ban explains everything. But how much effect it’s having – if any – no-one knows.

As for the flurry of excitable headlines, what appeared to be hard medical evidence now looks more like over-hasty and over-confident research, coupled with wishful political thinking and uncritical journalism. Whether the same will happen now attention has shifted to the effect of the bans in England and Wales remains to be seen.

Michael Blastland is the author, with Andrew Dilnot, of The Tiger that Isn’t – Seeing Through a World of Numbers.

---

Radio Station Link:
http://www.talk107.co.uk/
September 13, 2007
Audio Link for Colin Grainger’s Interview
http://www.toe-the-oche.co.uk/players/ColinRadioBroadcast.mp3

---

Scottish heart attacks drop sharply after smoking ban goes into effect

Sept. 12, 2007
Brian White

Scotland’s recent smoking ban has had an apparent positive effect on heart attack percentages in that country. Reports this week out of Scotland have the heart attack rate dropping 17 percent in the last 18 months since the smoking ban was enacted.

Now, what is to say how many of these attacks were actually prevented by a lack of smoke inhalation, but with such a drastic decline happening at the same time as a reduction in nationwide public smoking, one has to wonder.

With smoking bans increasing in countries around the globe, it would be interesting to see heart attack rates subside in substantial fashion in countries all over the world.

When examining something like the Scottish “Magical Study By Press Release” tactic it’s important to examine the history of previous scams.
?
The best documented of these is of course the original “Great Helena Heart Miracle” study done several years ago in the U.S.?? The thing that makes Helena so notable and unique is that it was published in the British Medical Journal which has an admirable editorial policy of extending peer review to a much larger group and in a much more public venue than most medical journals.?
?
Rather than have an article merely examined by a few journal editors and commented on by one or two external “experts” who are sometimes merely co-workers or friends of the original study authors, the BMJ opens a reviewed, controlled, yet very fair public forum for informed individuals to comment on and criticize published studies.
?
Helena served as the model for all future copycat “Instant Heart Attack Reduction” efforts: Pueblo, Bowling Green, Piedmont, Ireland, and now Scotland.? The extent and depth of the fraud that has been perpetrated upon the public can be seen merely by reading the Rapid Responses to Helena that the BMJ accepted for publication and noting the almost nonexistent defense of their work mounted by the study authors (who nonetheless have continued, in the best tradition of traveling snake oil peddlers to market their wares in public forums worldwide).
?
See:
http://bmj.bmjjournals.com/cgi/eletters/bmj.38055.715683.55v1
and then, after seeing the depth of problems associated with this archetypal study, see the treatment accorded to a *much* larger follow-up study that had the additional strength of being based upon completely open and publicly verifiable data. See:
http://kuneman.smokersclub.com/
and the analysis published through the American Council for Science and Health and reproduced at:
http://www.illinoissmokersrights.com/helena_acsh.html

The important lesson here is that the grandfather of all such studies, when carefully analyzed in the years after publication, has been shown to have virtually no substance at all.? Copycat studies, such as the recent Scottish and Irish efforts, will almost certainly be also shown to be just as devoid of meaning.
?
BUT…? the antismoking lobby will still have scored a victory, and a very deliberately and fraudulently intended victory, by grabbing the headlines in initial press releases that will leave a substantial and lasting impression in the minds of tens of millions that wisps of secondary tobacco smoke are horrifically deadly assaults upon the innocent and “the children”… and thereby lend to an atmosphere where smoking and smokers can be defiled, persecuted, and assaulted beyond all reason.
?
This is wrong.? Just as wrong as all the bases upon which these smoking ban laws are predicated.
?
Don’t be fooled by the shiny lights and the flashing mirrors: these people are lying to you, no matter how cleverly they hide it and confuse it, they are lying when they present as fact that science justifies these extremists incursions into our private lives, choices, and personal freedoms.? Letting them get away with it opens the door to far worse down the road.
?
Stop them now.
?
Michael J. McFadden
Author of “Dissecting Antismokers’ Brains”
Mid-Atlantic Director, Citizens Freedom Alliance, Inc.
Director, Pennsylvania Smokers’ Action Network (PASAN)
web page: http://pasan.thetruthisalie.com/
mailto: Cantiloper@aol.com