I mentioned in
a recent post the extraordinary influence of San Francisco-based tobacco control advocate Dr Stanton Glantz in all areas of tobacco control, and particularly with regards to the smoking ban/heart attack hypothesis.
Glantz is the founder of Americans for Nonsmokers' Rights, the director of SmokeFree Movies, the director of TobaccoScam and director of the Center for Tobacco Control Research and Education. I doubt that even he would describe himself as wholly impartial on the smoking issue.
He co-authored the
original "heart miracle" study and has co-authored no fewer than three meta-analyses at a rate of one a year, all of which concluded that smoking bans immediately brought about a dramatic - if implausible - reduction in heart attack rates.
Aside from a
discredited study from Iceland, there has been no fresh evidence to support the smoking ban/heart attack hypothesis for some time and yet it is rarely out of the news. It has been kept there purely on the basis of press releases which promote new reviews and meta-analyses which, in turn, rely on old data, none of which stands up to scrutiny on its own merits.
The "smoking bans slash heart attacks" story was in the newspapers
last month as a result of another of Stanton Glantz's meta-analyses. It was in the newspapers again
this month as a result of a review from the Institute of Medicine. This latest paper, somewhat unusually, does not credit Glantz as a co-author but, as
Michael Siegel has revealed today, he once again played a key part in the process.
The Committee held a public meeting in which it heard presentations by experts in the field covering various topics. According to the report, the topic of smoking bans was only presented by one expert: Dr. Stan Glantz.
And, as Dr Siegel, points out:
Dr. Glantz has a very particular view of the smoking ban studies
This is putting it mildly. In fact it would be true to say that the whole hypothesis is Glantz's baby. He, more than anyone, has a great deal invested in seeing the idea lodge in the public consciousness. Not only does it help in the campaign for more smoking bans in public places, but it implicitly suggests that passive smoking is even more dangerous than advocates like Glantz have previously claimed. It supports the notion that, as one of Glantz's research papers once stated, "
even a little secondhand smoke is dangerous".
If, on the other hand, the public saw that the heart attack rate has not fallen dramatically as a result of smoking bans in
England, Scotland or Wales, and that there has been considerable cherry-picking in the studies that suggest otherwise, it would damage Glantz's reputation considerably. It may even put the whole tobacco control movement under the spotlight.
Sure enough, the Institute of Medicine's study did not include the hospital data from the UK, nor did it include a
study of the entire US which showed no association between the introduction of smoking bans and declines in heart attack rates.
The report claims to have reviewed unpublished data and to have attempted to identify unpublished studies that might have found no effect of smoking bans on heart attacks. The report states that "no such studies were identified."
I find this difficult to believe, especially since I was a reviewer of the report and I made the committee aware of several unpublished analyses which documented no significant effect of smoking bans on heart attacks.
The fact that this data was omitted, and that Stanton Glantz was given another starring role in the creation of the IoM's report, should be of concern to anyone who expects impartial research from such organisations.
What I think we are seeing now is a frenzy of activity to establish the smoking ban/heart attack hypothesis in the public's mind before more national hospital data exposes it as a myth.
In my view, the anti-smoking movement has bitten off more than it can chew by creating a hypothesis that can so easily be disproved. Junk science thrives in the darkness. So long as the raw data cannot be viewed, it is difficult to comprehensively debunk it. But that is not the case here.
Perhaps they did not realise that hospital admissions data was publicly available when they set out with this hypothesis. Perhaps they thought that nobody would check it. Whatever the case, it is crucial that they make the public believe that the evidence for their hypothesis is "overwhelming". Once it takes hold in the public's mind, any evidence to the contrary can be dismissed as the work of the tobacco industry, "flat-earthers" or "tobacco harm deniers".
And it's working. Thanks to a well-drilled PR machine and an unquestioning media, the latest report - based on no new data at all - has been picked up worldwide (
517 articles, according to Google). Last month's report - also based on no new data at all - generated around
300 articles.
And yet, new data keeps coming along - complete data from whole nations, rather than selected data from small communities. In the last few days, the Danish Health Department has released a
comprehensive report [PDF] using data from the National Hospital Register showing that there was no decline in the heart attack rate after the smoking ban was introduced in August 2007. It concludes:
In none of the four studies was there an effect from the law for men and women in the two age groups. We could not detect any difference in hospitalization rates after the Act came into force. The expected greater effect among younger than among older people could not be found.
The graph below shows the heart attack rate amongst the two age groups (35-49 and 50-64). As usual there is a gradual decline over time which is not accelerated at all by the smoking ban (marked by the black line):
Number of news articles on Google about these findings (at the time of writing):
zero.
(Thanks to
Klaus K for the tip and for the English translation)
