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?
