I've come across a very well-written and incisive PDF—sadly anonymous—which I recommend to anyone interested in the use and misuse of statistics. It's a good complement to the work of John Brignell, who wrote two excellent books about the vanity of ultra-low risk epidemiologists about ten years ago. It focuses on lung cancer risk and it has the most comprehensive annotated list of passive smoking studies yet compiled (more so than the one I produced in 2008, which was limited to female exposure).
Don't be put off by the title ('The Plain Truth About Tobacco'). It's not about plain packaging and it doesn't argue that smoking is not the main cause of lung cancer (in fact, any remaining deniers should be forced to read it), but it does give a well-deserved kicking to those who cite statistics without bothering to understand what they mean.
You would not believe the things that epidemiologists have tried to "link" lung cancer to. If you've ever heard that you can get lung cancer (or protect yourself from lung cancer) by owning a pet canary, see pages 92 to 106 of this book. I learnt a lot and I think you will too.
Download it here. Stick it on your iPad or Kindle or whatever and away you go...
37 comments:
It's good. I read it all. I wish I knew who wrote it so I could read more of their stuff, if any exists.
It is clear he is American whoever he is.
In the eugenics tradition:
Ukraine: Mums-to-be could face fines for
smoking or drinking
Only more disturbing is the vote at the bottom of the article.
http://www.euronews.com/2012/03/19/ukraine-mums-to-be-could-face-fines-for-smoking-or-drinking/
JOINT STATEMENT ON THE RE-ASSESSMENT OF THE TOXICOLOGICAL TESTING OF TOBACCO PRODUCTS"
7 October, the COT meeting on 26 October and the COC meeting on 18
November 2004.
http://cot.food.gov.
uk/pdfs/cotstatement
tobacco0409
"5. The Committees commented that tobacco smoke was a highly complex chemical mixture and that the causative agents for smoke induced diseases (such as cardiovascular disease, cancer, effects on reproduction and on offspring) was unknown. The mechanisms by which tobacco induced adverse effects were not established. The best information related to tobacco smoke - induced lung cancer, but even in this instance a detailed mechanism was not available. The Committees therefore agreed that on the basis of current knowledge it would be very difficult to identify a toxicological testing strategy or a biomonitoring approach for use in volunteer studies with smokers where the end-points determined or biomarkers measured were predictive of the overall burden of tobacco-induced adverse disease."
It ends with a very strange rant about eugenics which the author uses to attack epidemiology. The guy would seem to be a fruitcake. (And I write as someone who is sceptical of much epidemiolgy myself, and suspicious of the honesty and competence of writing about passive smoking. But for heaven's sake, eugenics!)
Hi Chris, OT, but just pointing out to readers new to your blog that Michael Blastland wrote an excellent article in yesterday's Times covering the findings of the General Lifestyle survey on alcohol consumption. You addressed exactly the same points on March 8th
http://velvetgloveironfist.blogspot.co.uk/2012/03/boozy-britain-what-bbc-wont-tell-you.html
It's very interesting, and great information regarding statistics. But i really don't think it is going to persuade any "remaining deniers" about smoking not causing lung cancer. It hasn't persuaded me about it, and the author says that a smokers cough is caused by irritation, and this is what causes the cancer. The couch is actually caused by the smoke stimulating mucous production (unless someone is smoking a drier tobacco that irritates them), and that won't be causing any cancer. There's also a fair amount not touched upon - let's face it, it isn't there to delve into the vast history of primary smoking research and so doesn't do it.
Chris, I saw someone's blog (that I just randomly read because it trackbacked to one of my recent posts -- I can say nothing about its accuracy) that attributed authorship to Steve Kelly. I am not sure who that is, and a quick search find a few random relevant writings but nothing identifying.
Also, you should mention Nook alongside Kindle and iPad. You are a book guy, so you should at least shill a bit for the company that is the best hope for treating books as something other than a side business.
I think dearieme misconstrued about eugenics. The author wrote of the derivation of biostatistical techniques common to eugenics and lifestyle epidemiology and certainly didn't suggest that lifestyle epidemiology was racist.
The main developers of modern biostatistical techniques or what's now called "lifestyle epidemiology" were Francis Galton (who coined the word "eugenics") and his proteges Karl Pearson and Ronald Fisher (first two men to hold the Galton Chair of Eugenics at University College London).
This is well known and you will often see references particularly to Pearson's and Fisher's specific techniques in today's ETS and other lifestyle epidemiology studies.
Statistics can be used wisely or unwisely. Eugenics used mad statistics and most of today's lifestyle epidemiology likewise uses the same techniques to a mad end.
The new junk science is the "son of" the old junk science. The author isn't saying the modern junk science is racist. In fact, he points out that racism and the name of eugenics died out of public disgust, but that mad statistical practice, following directly from the techniques of the original eugenicists, lives on.
Statistics can show, albeit with great imprecision in individual studies, that considerable long term smoking has risks.
But that has been over-interpreted by the health professions and such false perspective has led, by piling fallacy upon fallacy over decades, to today's level of frothing madness about ETS and some of the other crazy "lung cancer causes" like pet birds and rice pudding.
Junk science is junk science and madness is madness. Lifestyle epidemiology isn't racism. It is junk, at this point, and also mad, just as were its old-time eugenicist progenitors. That's the point that was being made.
1
Dearieme,
Eugenics is most notorious for its racial/heredity/breeding dimension. However, the full scope of eugenics also includes a behavioral dimension – anti-tobacco, anti-alcohol, dietary prescriptions/proscriptions, and physical exercise.
There were many eugenicists floating about post-WWII, mostly in America. They didn’t just disappear or change their minds: The issue of eugenics was never resolved in America. They were not held to account for anything and simply “reinvented” themselves. They de-emphasized (temporarily) the racial/breeding dimension (their thoroughly-flawed heredity trees were replaced by the discipline of genetics), they stopped using the “E”[ugenics] word, and they targeted the behavioral dimension, starting with tobacco (this now also includes alcohol, diet, and physical exercise). The obsession with physical health (at the expense of all other dimensions of health), i.e., biological reductionism, that emerged in the 1970s has been called “healthism”. Yet healthism is the behavioral dimension of eugenics by another name. We are now even seeing denial of employment to smokers - which was also seen earlier last century, and denial of medical treatment for [non-conforming] smokers – another eugenics favorite.
“Eugenics” refers to “good breeding”. Including the behavioral dimension, “eugenics” is better understood as “good breeding and good [behavioral] lifestyle for good breeding”. If we remove the racial/breeding dimension from eugenics, what do we have left? Exactly what we’ve seen the last four decades – an emphasis on the behavioral dimension. Health has again been dangerously reduced to just a physical (absence-of-disease) phenomenon – physicalism is the foundational layer of eugenics and “prevention” is the cornerstone.
2
Along this behavioral dimension we have seen an aggressive attempt at social engineering. It involves the typical eugenics personnel, e.g., physicians, biologists, behaviorists. It uses flimsy population-level statistics that were created by eugenicists for population control – all is reduced to quantification, to arithmetic. It uses the same repugnant methodology of denormalization/propaganda to achieve its ideological goals. And it involves the eugenics aspiration to societal rule (social engineering) by a self-installed physicalist elite.
How much more evidence is needed to understand that we are witnessing a eugenics assault along the behavioral dimension? Eugenics constantly compares groups, declaring one group “better” than another. It doesn’t have to be racial, just that one group is superior to another, e.g., nonsmokers are superior to smokers, that one group is beneficial to society and another, a “burden”. Considering smoking, smokers have been defined as “defective” and “undesirable”, that society should not tolerate one more smoker. They have been depicted as a “burden” to society and “bad” role models for The Children™. A smoker’s only hope is to conform – quit smoking – to be reinstated in [eugenics-defined] “normal” society. And typical of the superficiality of eugenics is the madness it breeds – contempt, fear, bigotry, cruelty, discord, social division. Contemporary antismoking has been driven by a physicalist elite that has produced a bigotry bandwagon. If it was directed at a racial group, it would be racism. Either is destructive.
One critical problem is that there has been such little scholarly scrutiny of eugenics in America. There is little online (see Ruth Engs). Fortunately there are still books on eugenics in university libraries. Seek these out.
A series of posts by Magnetic on the following blog provides some context for eugenics earlier last century to contemporary “lifestyle” epidemiology:
http://cfrankdavis.wordpress.com/2011/06/23/the-nazi-antismoking-legacy-1/
Professor Idle was asked by ITL's solicitors to give an opinion based upon his own area of scientific expertise in answer to the following five questions:
(1) In your opinion was it 'almost universally accepted by scientists' in 1964 [as averred on behalf of Mrs McTear] that cigarette smoking can cause lung cancer?
(2) In your opinion had cigarette smoking been established as a cause of lung cancer as at 1964?
(3) In your opinion had cigarette smoking been established as a cause of lung cancer as at 1971?
(4) In your opinion had cigarette smoking been established as a cause of lung cancer as at September 2003?
(...)
He said that his report was structured into a number of time periods: the period up to 1964, the period from 1965 to 1971 and the period from 1972 until the completion of the report in September 2003. In constructing the report he had reviewed the scientific evidence involving the various theories of the causation of cancer in general, and of lung cancer in particular; the toxicological experiments that comprised the administration to experimental animals of cigarette smoke or its derived condensates; and the chemistry of cigarette smoke and its derived condensates. He took a chronological and historical perspective of the published laboratory data that he judged to be of relevance to answering the above questions. He reviewed approximately 1,600 original scientific articles, books, reports and scientific communications. On and off, this took about six years. He concluded by answering the first four questions in the negative...
1
The problem lies in what is understood by health.
Consider the World Health Organization’s definition of health instituted in 1948:
The World Health Organization (WHO) defines health in its preamble as "a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being."
Notwithstanding a few questionable concepts such as “complete”, we can be sure that this definition was a direct result of the Nuremberg trials addressing the horrors of Nazi eugenics. Whatever was directed at Nazi eugenics was also directed at American eugenics. Eugenics is biologically reductionist or, as noted by the Nazis, “applied biology”. The WHO definition attempts to account for the fact that health is more that just absence of disease, more than just a biological phenomenon. It involves other dimensions such as psychological and social.
Given that this WHO definition was put into circulation by Brock Chisholm, the first director of the WHO and a eugenicist, there is always a suspicion as to how the WHO, a medical organization, could potentially warp this definition in the long-term. It could have been an “appeasing” definition, given the anti-eugenics sentiment of the time.
However, what should be noted is the limited scope of the WHO. It does not have a monopoly on health. Being a medical organization, it is intimately bound to the biological level. It is not really a world health organization but a world medical organization – a global medical headquarters. It would have to accept that there are aspects of health that are not its domain or jurisdiction. Just this idea, properly applied, should discourage potentially destructive ventures into social engineering as was seen in eugenics early last century.
2
Yet with all this history, as we have seen over the last half century, particularly pertaining to antismoking, the WHO and the medical establishment generally, and contrary to the WHO’s very own definition of health, have deteriorated back into a biological reductionist view of health and ventures into social engineering.
Over the last half century, health has been reduced to the behavioral dimension of eugenics – anti-tobacco, anti-alcohol, prescribed diet, and physical exercise. The WHO adopted antismoking as a societal ideal many decades ago (Godber Blueprint) and now most nations are signed-up to the WHO Framework Convention on Tobacco Control. With this ideological stance comes social engineering, i.e., coercion to conformity.
We have seen smoking bans on hospital grounds where patients have to venture considerable distances in night-attire and in all manner of weather to have a cigarette. This becomes a psychological and social health issue. Indoor smoking bans with no prospect of accommodation have alienated particularly the elderly. This is a psychological and social health issue. Denormalization, a repugnant, vulgar concept very much identified with eugenics, has again come to the fore. Smokers have been incessantly slandered, ridiculed, and terrorized by official, government programs of denormalization. This is a psychological and social health issue. Many nonsmokers have been manipulated into irrational fear and bigotry to advance the ideological cause. This is an issue of psychological and social health. Smokers are being bullied out of normal social life on a purely ideological basis. This is an issue of psychological and social health. With this propaganda barrage, medical care professionals are demonstrating a cruel, bigoted streak – again - that can compromise the medical treatment of those who smoke. This is an issue of psychological, social, and physical health. Not only are psychological and social health issues important in their own right, but these can also have detrimental ramifications for physical health. Health has again been reduced to quantification, dollar cost-benefit analyses, another eugenics trait.
Everywhere we turn health has again been reduced to only a biological phenomenon (e.g., behavioral) and with the [eugenics] intent of social engineering. “Get healthy”, “he’s looking after himself”, “I work out” all pertain to physicalism. In the obsession with physicalism, psychological, social, moral, and ideo-political aspects of health have been brutalized and discarded - again.
1
A post from Siegel’s blog:
Miki: “Patient X is admitted and treated for a kidney stone……”
Michael, what is wrong with you people? Patient X is admitted and treated for a kidney stone. Why does it not stop there? Why is there the need for a rant about getting the patient to quit smoking? Why can there not just be a smoking-cessation pamphlet on the bedside table that patients can pursue if they are interested? It is you medical twits that have created the “disease” of smoking that requires “treatment”. It is you guys that have created this perverse situation of ideological and financial vested interests in the “treatment” of smoking.
Fortunately, even in Fiore’s corrupted fantasy world, someone who smokes still has a quasi “opportunity”, however down the list of possibilities, to refuse “treatment”. But how much of an opportunity is this when the facility they find themselves in is rabidly antismoking? How does this ideological bent distort medical care for patients refusing “treatment”? Contrary to the belief of at least some physicians that they are “god”, physicians are human. They are prone to human foibles; medical practitioners are probably most prone to a “god complex”. They are prone to bigotry and racism as was clearly demonstrated in only recent history. Why is this fundamental, critical issue NEVER discussed?
And the medicos rave about “doctor/patient relationship” and “what’s in the best interests of their patients”. But the facts do not bear this out. The stance of the medical establishment is near-dictatorial with the intent of coercing people – even visitors to the facility and employees – into nonsmoking conformity, one way or the other.
Consider the circumstance of removing smoking shelters on hospital grounds and banning smoking for the entire grounds. Does this seem to respect the wishes of their smoking patients? Or visitors and employees? It demonstrates an utter contempt for anything other than their monomaniacal, ideological view and the financial interests that support the twisted view.
2
One of the rare criticisms of such smoking bans, where even elderly patients are forced to travel considerable distances - and in all weather - to have a cigarette, came from a just-retired physician.
http://www.irishtimes.com/newspaper/letters/2012/0114/1224310242616.html
Contrast the above with this sanctimonious, bigoted piece from Australia:
http://www.couriermail.com.au/news/queensland/sick-but-theyd-die-for-a-smoke/story-e6freoof-1226288323788?from=public_rss
There is no outrage from practicing physicians; have they lost their sensibilities altogether? Outdoor smoking shelters are now being removed with glee and even fanfare. The circumstance is appalling. It only gets worse.
http://www.bbc.co.uk/news/uk-wales-17357406
http://www.thisisplymouth.co.uk/Shelter-removed-hospital-site-goes-smoke-free/story-15514927-detail/story.html
Consider also:
"Hospitals should not judge patients. They should treat patients," Tapper said….
http://www.winnipegfreepress.com/local/hospital-smoking-bans-endanger-patients-study-132980933.html
Dick Puddlecoat has the latest on Bloomberg and the NYC council in attempting to control the diet of…… the homeless.
Bloomberg’s NYC is rivaling California in eugenics behavioral control – and that’s saying something. Consider another recent propaganda-piece targeting “light” smokers. Even those who smoke less than 10 cigarettes per day must quit. There is no tolerance; all smokers must quit.
There are quite a number of serious misrepresentations in the blathering concerning risks associated with light smoking and it extols the “virtues” of NRT. But the point that should really get people’s attention is this:
“Join an exercise group to substitute smoking with a healthy activity. Search
BeFitNYC on NYC.gov for a list of physical activity opportunities throughout the
city and ways you can Make NYC Your Gym.”
http://www.nyc.gov/html/doh/html/pr2011/pr033-11.shtml
There you go. Make NYC your gym. The only thing missing is that the public be required, through force of penalty or peer pressure, to come out onto the streets at lunchtime for an hour of calisthenics……. as their duty to the state. This could be the “next step”.
Bloomberg is also the pompous, little, supremacist twerp that openly advocated sneering at people who smoke for peer-pressure effect.
In Bloomberg’s NYC, apart from the serious targeting of alcohol, we are seeing the typical eugenics repertoire along the behavioral dimension – anti-tobacco, dietary prescriptions/proscriptions, and physical exercise.
Good points, Mag. Eugenics changed its name but not its nature. The Bloombergs & Koops & the rest are like Hugh Cumming or Harry Laughlin or Paul Popenoe & the rest of the eugenics gang in its USA heyday. Eugenics was about more than race. It was about nothing so much as about social division and (dictated) hate. That lives on. It's gotta be stopped once & for all.
That PDF looks very good although I haven't read it all yet.
Just to nitpick a little though, I think that on page 20 the author confuses 'relative risk (RR)' and 'odds ratio (OR)'. In his example on that page, I calculate the OR = 6 and the RR = 2.
See http://www.medcalc.org/calc/odds_ratio.php
Tony
The author explains in text that he computes odds ratios and uses the term "relative risk" as it has been commonly used as catch-all term for computations including odds ratio, hazard ratio, risk ratio, while also explaining that in literal or technical sense "relative risk" is exact synonym for "risk ratio."
This is a really interesting link to an article that is very informative, even the part about eugenics. You would have to be very unaware not to have observed similarities between public health extremists and eugenicists but the link to epidemiology is enlightening for me. The tone is a bit strident at times but the information content is great. It is good to be reminded of the nastiness that is Jane DeVille-Almond. I note that she has moved with the times and now chairs the British Obesity Society. No doubt she believes that fatties as well as smokers should reform or die.
Technically, the true relative risk or rate ratio computation would not be appropriate for the page 20 example since it refers to a (fictional) case/control study while specific or literal RR is only appropriate for cohort studies.
People have compared sweet nurse Jane to Cruella DeVille in '101 Dalmations'. That's apt, but as I recall Cruella smoked, which probably counts somewhat in her favor, as I suppose does her desire to kill canines rather than humans!
For those not aware, the 15th World [Eugenics] Conference on Tobacco Or Health is currently underway in Singapore.
http://wctoh2012.org/
Since the 1970s, these World Conferences have developed the anti-smoking/tobacco themes that would be inflicted on societies around the world in the three or four years to the next Conference. These World Conferences are where the extreme foam-at-the mothers congregate and where their foam-saturated chins are quite the norm. The fanatics can indulge in fine dining, fine sight-seeing, have a good ol’ time, and plot how to get the neurosis/bigotry bandwagon further out of control. Wonderful!
Here’s the bmj’s "coverage" of the insanity.
http://blogs.bmj.com/tc/2012/03/20/weve-come-a-long-way-bullies/
Apologies :)
Foam-at-the mothers (what!) should read foam-at-the-mouthers.
Mag: the foam-at-the-mouthers are "mothers" of one sort. I won't say exactly what.
I have read the whole thing through today. It is hard to discover what precisely 'is going on'. Perhaps one should not speak until one has read it again!!! But....
Ignoring the eugenicist part, what is the author telling us? It must be, surely, that the epidemiological evidence for all smoking related harm is not all it is cracked up to be. The simple illustration of this was the McTear v Imperial Tobacco Limited case (2005), where ASH ET AL were unable to produce evidence of 'general causation' [that smoking 'causes' lung cancer]. My impression from reading the Judge's extremely long and complex Opinion is that ASH ET AL knew very well that, if they produced the statistical evidence for smoking harm, it would not stand up to objective scrutiny, and so they decided not to produce it.
Be that as it may.
However, there is something odd about the way in which the anti-smoking statistics are constructed.
Let us say that a 'smoking study' starts with 2000 participants. Those participants break down into various age groups - say, 20 -34,35 -49, 50 - 64, 65 +. That means that there are 500 per age group. But then each subgroup has to be broken down into non-smokers, ex-smokers and current smokers, which breaks the number down to about 133 per group. But then you have to break those figures down into 'numbers of cigarettes per day, which may be <10, 10 - 20, >20, which means that each group is now numbered in the region of 45 persons. You could break the groups down even further, by whether or not smokers inhale....etc. In the end, you finish up with single figure groups, from which it is not possible to derive generalities. In other words, no two people react in precisely the same way.
What we learned from the McTear case was that, DEFINITELY, there is no physical evidence at all which could definitely, categorically, show that smoking 'causes' lung cancer, even with the lower standard of proof which is 'balance of probabilities'.
If that is the actual truth of the matter, what chance has SHS?
But my important point relates to the dilution of evidence by sub-division. In other words, the vast majority of studies, if they are small, are too small, and the ones which are large are too complex.
According to the paper, ASH ET AL have a clear field. No one can oppose, especially if politicians bury their heads in the sand and chant, "NHS COSTS - TAX INCOME".
What is historically clear is that these ploys always fail. Always.
There are prices to be paid. that is the difference between the internet and the MSM. Bloggers will not allow the persecutors to get away scot-free. They have hurt us too much. That is important.
"An alternate explanation which has been suggested by American researchers for the rise
and fall of adenocarcinoma is that it may be a reaction to air pollution. This is implausible
in that air pollution levels have been reduced, between about the ‘seventies to the present,
in slow gradation. Air pollution did not suddenly fall off, at any point, as the
adenocarcinoma rates are now doing."
I will take issue with the author on this.
There is this form of air pollution here
Not only was there a clear reduction from about the seventies, (the American researchers) but in addition this reduction was followed by a sudden drop (the Author).
It satisfies both.
Chris, tell me please, do you also refer to climate sceptics as "deniers"?
Cross-examination of Professor Jeffrey Idle:
Counsel then referred to the passage headed "The effects of smoking: principal findings" and the subheading "Lung cancer" on p.31, under which it was stated:
"Cigarette smoking is causally related to lung cancer in men; the magnitude of the effect of cigarette smoking far outweighs all other factors."
The following exchange then took place:
"Q So that is the conclusion they reach. Do you see that?
A I do.
QAnd have they not gone about it in an entirely appropriate way; getting a body of eminent men, reviewing all the scientific literature up to that time and reaching a conclusion on it?
A There are two statements which we have read in the last fifteen minutes which contradict each other. One says that epidemiology can never lead to cause, and then they go on to say that reaching a cause relied on epidemiology. That is where my problem lies. The statement above says 'In conjunction with other experimental data' or 'with other data' and that is what I agree with. So they have gone about it the right way - to answer your question - but the interpretation of their findings I cannot agree with."
Just to follow up my earlier comment. I have now read the whole document albeit rather quickly and agree that it is very good and worthy of a much slower and more intensive read.
Whilst I stand by my earlier nitpicking remark about ORs and RRs (21 March 2012 19:54 ), I'd like to clarify that it doesn't affect any of the discussion and so doesn't matter.
As to the 'denier' bit, I think that in the current climate, I'll take that as a compliment. And I don't see anything in this book that alters my views.
Tony
Tony: The technical RR is not applicable to pg 20 (which is described on that page specifically as odds ratio with "relative risk" in quotations since it's explained -- a few pages previously -- that "relative risk" is being used in common catch-all sense -- this is common -- to avoid complexity of explaining for hundreds of such results shown in paper that there are several specific types of computations generally suggesting concept of "relative risk" and that for general readership it would be punctilious to parse over and over about odds ratio, risk, ratio, hazard ratio, etc., for each individual result). Specifically the page 20 computation is an odds ratio -- as is stated on that page -- and furthermore, risk ratio or technical relative risk is not a valid computation in the circumstance. Technical relative risk or risk ratio computation is not valid for case/control studies. It is only appropriate for cohort studies. The example is case/control.
Tony: in case you want to continue being a pain in the a** or ar** (depending on where you come from) please note from page 15 (which you should have come to before you reached page 20): 'In common usage, both within and without the health professions, “relative risk” is used as
a catch-all term, referring to results derived by risk, odds, hazard, or rate ratio
computation. It is in this common sense that we have and will use the “relative risk” term
in this essay. Where relative risks are herein computed we shall use the most common and
versatile calculation, which is, specifically, the odds ratio.'
The essay suggests that smoking is an influence on lung cancer but makes a point that this is not properly considered as 'cause'. This is a main point of essay as a whole but in particular see pages from about 45 to 48.
It seems if anything that, far from swaying 'deniers' that they should immediately jump to the popular opinion, the author of the paper goes to quite some length to explain that smoking is NOT a cause of lung cancer, but is rather quite strongly linked to the disease statistically.
Given the main purpose of the paper is to seriously look at the manipulation of statistics in science, i've come away from reading it feeling rather more validated in my position as a 'denier', and judging from comments here and over at Frank's blog, it appears i'm not the only one.
When I wrote my 23 March 2012 19:30 comment, I should have stated only that I stand by my RR/OR calculation. What I should also have said, and will say now, is that I completely retract my suggestion that the author was confusing the two. It is clear (p15 and p20), as anon has pointed out, that author did not confuse the two. My apologies.
Tony
I also accept that the RR (as opposed to the OR) may not be appropriate in the example on page 20.
Tony
Richard White: I feel as you do. Paper is suggesting cancer is inherent vulnerability for anybody. Some things we do can influence risk but risk exists for everybody. So potential influences are best called what they are rather than what they aren't (i.e. they are not really 'cause', but madly, most 'authorities' take them as 'cause' in a very literal sense, leading to utterly false conclusions.) Tony: you're gracious, I think introductory explanation about various computations & use of 'RR' in common catch-all sense rather than strict technical sense was meant to avoid endless technical parsing for general readership, & I also apologize for barking at you about it.
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