Tuesday, 9 July 2013

'The real reason for public smoking bans'

Ronald Bayer, professor at sociomedical sciences at Columbia University's Mailman School of Public Health, has been talking to PBS about an article he's written entitled Banning Smoking In Parks And On Beaches: Science, Policy, And The Politics Of Denormalization.

I last came across Bayer in 2008 when he wrote a thoughtful article about denormalisation and the regressive nature of sin taxes (Stigma and the ethics of public health: Not can we but should we). He is in the dwindling minority of 'public health professionals' who actually studies aspects of public health (specifically AIDS), rather than lifestyle factors connected with non-communicable diseases. Even more unusually, he has some understanding of ethics.

In his PBS interview, he discusses the kind of junk science that I often mention on this blog. He will no doubt find himself being crossed off a lot of Christmas card lists when the anti-smoking lobby reads it.     

I noticed when my students of public health talked about illicit drugs like heroin or cocaine or marijuana, they adopted a libertarian point of view -- emphasizing how the government has no business intruding on people's choices and all those negative consequences. But when I raised the issue of tobacco, they all became in a way, authoritarian. "We have to limit smoking, we have to limit where people smoke, we have to protect people from themselves, we have to protect their children." I was struck by the difference.

It is strange, isn't it? I have a few theories for why this inconsistency/hypocrisy exists. It may be because these students have seen the damage wrought by the war on drugs but have not yet seen the damage that tobacco prohibition will bring. It may be that students like the idea of radical change and therefore find the idea of switching the legal status of these products on their head appealing. It may be that they have been so bombarded by anti-smoking messages from the day they were born that they think tobacco smoke is more dangerous that mustard gas. Or perhaps the Mickey Mouse field of public health attracts zealots and moral imbeciles. At least Peter Hitchens is consistent in wanting the whole lot banned, just as I am consistent in wanting the whole lot sold on the free market.

Bayer then discusses the current wave of draconian smoking bans that are sweeping into American from the Bay Area, including those in private homes, in parks and on beaches.

I discovered the evidence was really weak. The evidence of harm to non-smokers on the beach or in a park from someone smoking is virtually non-existent. The evidence that fish and birds are dying because of cigarette butts is virtually non-existent. And even the evidence that seeing someone in a park or beach will encourage kids to smoke is extremely weak.

So I said to myself, what's going on here? What's the public health impulse that's involved that leads to these bans if the evidence is so weak? Because everyone in public health believes that what we do should be evidence-based.

It's quite simple, Ronald. They're charlatans who will stop at nothing. Their 'evidence' is manufactured to order.

As I thought about it, it became very clear that what was involved wasn't that we were trying to protect non-smokers from sidestream smoke on parks and beaches. We weren't really concerned about birds and fish. There wasn't really evidence that we were going to protect kids by disallowing smoking in parks and beaches.

What was involved was that we really wanted to make it less and less possible for people to smoke...

Well, yeah. You don't need to be Miss Marple to work that out.

The question now is, how come public health officials can't come out straight and say the reason we're banning smoking on parks and beaches is we want to protect smokers? We want to get them to give it up, we want them to smoke less and we want to make it more difficult for people to begin smoking.

The answer, of course, is that civilised societies do not allow one group to inflict their preferences on another group merely because they think it would be 'for their own good'.

I think it's because public health officials don't want to be tarred with the brush of the "nanny state," of "Big Brother."

That's a large part of it, of course. More precisely, they don't want to be exposed as the authoritarian busybodies that they are. They could be honest about it and say "we don't like what you're doing so we're going to make your life as difficult as we can until you stop", but that would give the game away. They would have to admit to the world—and, more painfully, to themselves—that they are not 'liberals'. Their only alternative is to concoct the kind of ridiculous 'evidence' which people such as Michael Siegel have spent years debunking.

My concern is that when public health officials make claims that can't be backed by the evidence, they run the risk of people saying, "We can't trust you." I understand it is probably more effective to say the reason we're banning smoking in parks and beaches is that we're protecting you from sidestream smoke, or your kids from looking at something very bad for them or that we're protecting wildlife. That might be more effective way in the short run of getting these statutes or regulations passed and put into place.

But in the long run, I think, that if people begin to feel that they're being toyed with, that the evidence is not being presented in a straightforward way, it's going to backfire.

I wholeheartedly agree. This is why the rest of the scientific community should stop turning a blind eye to the junk science that is done in the name of tobacco control (and, increasingly, in the name of alcohol and obesity control) before the public health racket drags the reputation of all science into the gutter. You can't fool all the people all the time. What good has ever come from people deciding that it's acceptable to lie to achieve their aims?


JohnB said...

Bayer is a strange one. He rightly highlights that the reasons given by PH advocates for particularly outdoor bans – e.g., protecting nonsmokers from “harm” – are nonsensical. He suggests that advocates come clean about what is a purely social-engineering intent. Further, he’s all for denormalization and social engineering: He thinks they are good enough reasons to further restrict smoking, e.g., outdoors, through legislation for smokers’ “own good”:

There is however a case for such bans --it rests on the duty of government acting in the name of public health to restrict smoking in order to protect smokers themselves. By banning smoking in public settings the crucial task of denormalizing which contributes to lowering smoking rates is fostered in important ways.

"Banning smoking in public settings may have seemed beyond the pale 25 years ago, but with changes in the political context and in social norms, the public has increasingly come to consider them as interventions designed to serve the common good. However, local coalitions pressing for smoking bans need to be strong enough to overcome the opposition of the tobacco and hospitality industries and of people who invoke threats of Big Brother," writes Dr. Bayer.
While the rules for bans on smoking in public are gaining in popularity and the evidence may help to reduce tobacco-related illness and death in the short term, Dr. Bayer and co-author Kathleen E. Bachynski suggest that healthcare policymakers will need to make a stronger case with more conclusive evidence to gain the public trust. Likewise, advocates for smoking bans should be more candid about the limits of the arguments when interventions depend on weak evidence.

"Instead of relying on weak or contestable evidence of third party harms, public health officials should assert boldly that the challenge of tobacco related morbidity and mortality necessitates measures that will help smokers to limit their smoking and ultimately quit. Beach and park bans represent measures that contribute to those goals," said Dr. Bayer.

He sounds like a eugenics, prohibitionist thinker to me. And he believes he doesn’t need to be masquerading his intent - this is how far down the twisted track we are.

JohnB said...

This is why the information in the Godber Blueprint is critical. It highlights that the current antismoking crusade – like most before – is a moralizing, social engineering, eradication/prohibition crusade, and has been so from the outset. But the antismoking fanatics/zealots/extremists recognized in the 1970s that there were few takers for social engineering. Particularly in relatively free societies, including America and the peculiar state of California, coercive measures to conformity were viewed as repugnant by the majority.

The zealots had all sorts of coercive measures in mind – extortionate taxes, smoking bans, indoor and outdoor. But they recognized that the social engineering crusade had all but stalled. They were already talking in the late-70s that the only way forward was to convince nonsmokers that secondhand smoke exposure was a threat to their health.

So, since the 80s we’ve had self-installed social engineers telling the public that they weren’t doing social engineering. They concocted storylines to masquerade their social engineering intent. Extortionate, punitive taxes – well, so their storyline goes, is because smokers are a “cost burden” to society. Smoking bans – they’re necessary to protect nonsmokers from secondhand smoke “danger”. “There’s no slippery slope; we’re not doing social engineering”, squealed the zealots. They’re lies that have been told many times over during the last three decades. And, to their great shame, governments around the world, led by the West, got suckered in by the inflammatory rhetoric.

JohnB said...

Consider this information in an article linked to Bayer’s research:
This belief is held in many other states. California leads the nation in imposing these smoking bans, as 155 parks and 46 beaches in the state no longer allow smoking, followed by Minnesota and New Jersey.
Public response to these bans has also favored the denormalization of smoking. In approval polls across the nation, the response started out mostly negative. In 2000, only 25 percent of survey respondents agreed that smoking should be banned in parks and other public areas. In 2002, a California-specific survey revealed that 52 percent of survey participants supported the smoking restrictions. A national survey in 2008 indicated that 40 percent of Americans agreed with smoking bans. And, another 2011 survey indicated that 60 percent of respondents supported smoking bans. This increase in those who support smoking bans appears to be a result of the denormalization of smoking.


If these surveys are to be believed, they demonstrate one thing – what can be achieved with a few decades of obscenely funded inflammatory propaganda. A considerable proportion of people have been manipulated/brainwashed into an extreme position (which antismoking is) that only a few decades ago they would have found repugnant. These people should be distressed that they have been manipulated and that they are so easily manipulated. The brainwashing has been so successful that folk like Bayer believe the time is ripe to come clean about the social engineering intent and there’s no problem with such an intent. Well, there was a huge problem with such an intent, and not all that long ago. And there still is a major problem, because the current deluded embracing of social engineering – that it’s “wonderful” activity - has been produced by years of brainwashing, a litany of fraudulent claims.

westcoast2 said...

But in the long run, I think, that if people begin to feel that they're being toyed with, that the evidence is not being presented in a straightforward way, it's going to backfire.

Dr Siegel has been making statements like this for over 5 years. He wrote similar comments on the first bans on smoking in homes, the first bans on employing smokers in hospitals and so forth.

At first it was about the science. There was much discussion and most of the evidence was debunked. Now it has become a moral crusade, the 'evidence' has been established as absolute and the words now reflect 'denormalization' which, it is assumed, all agree on. The words now say whatever can be done needs to be done whether it works or not. The justification is the process itself.

Why has the questioning of the science failed? Why can something like all the heart 'miracles' still be quoted and be believed? What shift occurred between the need for scientific evidence and the position now where the scientific evidence is almost background noise? When will this all backfire?

You can't fool all the people all the time. What good has ever come from people deciding that it's acceptable to lie to achieve their aims?

A good question. Yet the bans continue, the taxation continues, the discrimination (legal it seems) continues. All this on shaky foundations that seem to have solidified.

Many see all these things as 'acceptable' and seem to believe that 'good' has come. Why and how have they become 'acceptable' and when will they be seen for what they are, lacking basic evidence and unacceptable?

When will the consequences of the actions to 'denormalize' finally hit home?

Many are not fooled, yet are not in a position to affect what is happening or care not that it is, when will this change?

JD said...

Alcohol 'research' is much the same lying bullshit, but the reason it 'works' in the sense that it isn't called out for the rubbish it is, is that good money drives out bad. That is, if you are knowledgeable and (suitably) scientifically sceptical, you will become hated by the rest in the field who are in general ignorant, gullible and only interested in their next press release and government grant.
I always found it interesting that most of my academic colleagues outside medicine and what passes for 'public health' - half-arsed sociology - didn't believe the prohibitionist propaganda such as the 14 unit/wk limit for women. However the pols love it - invincible ignorance I think it's called in theological circles.

JD said...

Sorry - I did of course mean 'bad money drives out good'

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