More movie madness

Last night I watched Bridesmaids (it's pretty good). I didn't notice any smoking in it, but then I'm not a wide-eyed obsessive living in terror of a waft of on-screen smoke. Apparently, however, at least one person does smoke at some point because the film is named and shamed in Stanton Glantz's latest work of pseudo-academia. According to the great mechanical engineer, the movie has delivered 60,020,706 "tobacco impressions" and so has led to hundreds, if not thousands, of youngsters to suddenly taking up the habit.

Welcome to the world of SmokeFree Movies, Glantz's quixotic campaign to banish tobacco from our screens (for the children, natch). Despite years of being ridiculed and ignored on this issue, Stan is continuing his crusade and has written yet another paper on the subject (he has written a lot).

Today, he claims that 100,000 Californian 12-17 year olds are smokers as a direct result of seeing smoking in the movies. This is a figure that he alone invented and which even hardcore anti-smoking head-bangers like Simon Chapman find laughable.

He also claims that these 100,000 people will cost the taxpayer $1.6 billion. This figure is based on a total misrepresentation of the academic literature and a fundamental misunderstanding of externalities and social costs. As I hope you know by now, it is doubtful that smokers incur any net costs on other taxpayers, but even if they do, they are vastly outweighed by revenue from tobacco taxes (see here for a refresher).

This is all bog-standard junk from the godfather of junk science. The real bees in Stanton's bonnet are the taxpayer subsidies of Hollywood films which show a practice of which he disapproves. They must stop, he says. There will be no more smoking in the movies on his watch and he has a plan to do something about it:

The policy solution is to amend the California tax credit program statute, adding the following to the existing list of productions disqualified from eligibility for subsidy: “…any production that depicts or refers to any tobacco product or non-pharmaceutical nicotine delivery device or its use, associated paraphernalia or related trademarks or promotional material.”

You will note that this only applies to smoking. Movies showing homicide, rape, drug abuse, drinking, speeding, violence and wife-beating will continue to receive their subsidies.

Or at least they will for now. If the government takes heed of the mechanic, we can be sure that drinking will be in the firing line, with minor vices such as mass murder and incest following in due course. This is sheer, unbridled, censorious puritanism. Note that smoking and tobacco paraphernalia cannot even be referred to under Stan's regime! Film scripts will not be allowed to include words like 'cigarette' or 'pipe'.

Even the word 'e-cigarette' will be verboten because the proposed ban includes all "non-pharmaceutical nicotine delivery device". Why not include all nicotine products? Cynics would say it's because SmokeFree Movies was founded with money from Johnson & Johnson, the makers of various 'nicotine replacement therapies', and continues to receive grants from the company's philanthropic wing the Robert Wood Johnson Foundation.

The good news is that this proposal is too nuts even for California. Glantz can stamp his feet all he likes, but the movie industry rightly perceives him as a crank and we can assume he will continue to be shown the door. We must certainly hope so, for if monomaniacs like him ever gain a stranglehold on the creative arts, it will be another nail in the coffin of the free society.

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BBC in cahoots with Big Tobacco, suspects raving lunatic

I have always feared for Stanton Glantz's mental health, but it's only since he started blogging that I've realised that the guy is genuinely certifiable. His latest post is an absolute belter. It seems that the Welsh government is consulting on whether to allow television and film actors to smoke in the studio. This is because the BBC has opened a production centre in Cardiff—there is already an exemption for actors in England—and the corporation has kept some productions in England as a result of the über-draconian favoured by the sheep-worriers.

The exemption is ridiculously narrow. No children can be present (as ever, I urge you to think of the children) and no members of the public are allowed to watch the scene being filmed. The exemption will only apply if "the artistic integrity of the performance makes it appropriate for the performer to smoke."

The swivel-eyed professor of nowt has, of course, gone ballistic.

BBC lobbying to weaken Welsh smokefree regulations: Yes, this is real.

From Glantz's vantage point way down the rabbit hole, the BBC is a pro-smoking organisation.

...one wonders what else is going on in the shadows. After all, there is a long history of collaboration between Big Tobacco and the movie industry.

Nurse!

There is absolutely no evidence that any movie production moved from one place to another because they couldn't smoke.

But the BBC is saying exactly that, Stanton, and that definitely counts as evidence. As the consultation document states...

The exemption for performers ... would make Wales a more attractive place for programme making and would remove current costs involved with taking smoking scenes on productions being filmed in Wales to England. The smoking ban has been a major issue for a number of productions that have been filmed in Wales, especially period dramas set in a time when smoking was commonplace.

This means that you can believe one of two things. Either the Welsh Assembly and the BBC are lying because they're engaged in some kind of pro-tobacco industry plot to undermine the smoking ban, or they are telling the truth and the smoking ban is deterring the Beeb from filming more shows in Wales. If you look at the output of both the BBC and the Welsh Assembly in recent years, I think it's pretty clear that if they are are engaged in a pro-smoking conspiracy, it has been phenomenally well-camouflaged.

Glantz continues to rant on about his theories in his usual illiterate style...

Are we really to believe that the BBC has ignore [sic] the fact that it just opened a major new production center in Cardiff, Wales to take advantage of lower labor costs that exist in London just so they can favor actors [sic] generate secondhand smoke? I think not.

A prize to anyone who can explain what the hell he's babbling about.

It gets better...

Moreover, there would be nothing to stop BBC [sic] from having an actor wave around an unlit cigarette, cigar or pipe, then put the smoke in with CGI.

Yes, that's a much simpler solution, Stan, you old fruitcake.

The only beneficiary of this change would be the tobacco industry.

That's not quite true, is it now? If the BBC is lobbying for this unutterably trivial amendment, it would strongly suggest that they stand to benefit from it—by, for example, not having to spend hours pissing around with CGI. Companies don't generally lobby for policies that won't benefit them, y'see. The tobacco industry, on the other hand, is not lobbying for it and stands to gain—at best—the sale of a couple of packs of cigarettes to be smoked in some god awful period drama.

If the BBC wants to lobby to get smoking laws changed, they should be lobbying the government in London to remove the exemption that allows actors and other film makers to be poisoned by secondhand smoke at BBC studios in London.

Yes, yes. But as I've just explained, they're not going to do that because (a) they would not benefit from it; au contraire, they would be damaged by it, and (b) if they wanted to stop actors being, ahem, "poisoned by secondhand smoke at BBC studios", they would do so voluntarily. I know, Stan, that you struggle to comprehend the difference between public and private action, but not everything in life needs to be dealt with through repressive legislation.

I do hope someone at the BBC comes across Stan's blog. It might give them an idea of the type of crack-pots they've been giving such credulous coverage to all these years.

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Stanton Glantz: How to deceive without actually lying

Last year, the Netherlands relaxed its smoking ban after a campaign by small bar owners and their customers. It came after a battle between the Dutch and EU governments' lavishly-funded NGOs and fake charities who masqueraded as nonsmokers' rights groups against Wiel Maessan and others gave their time for free to undo the worst of the ban's damage to small bars. 

This is how things work these days. State funded astro-turf groups create the illusion of support for draconian laws. Ordinary people fight against them. Usually the astro-turf groups win. Sometimes, as in the Netherlands, ordinary people claim a scalp.

Anti-smoking dinosaurs like Simon Chapman and Stanton Glantz (pictured) try to maintain the facade of it being a battle between the whole of humanity—made up of people who don't smoke and people who do smoke but want tobacco control to save them—versus the big, bad, evil, all-controlling tobacco industry.

Stanton Glantz knows that the tobacco industry weren't involved in the campaign to relax the smoking ban in the Netherlands. He knows because he interviewed Wiel Maessan personally several months ago and got it from the horse's mouth. If that weren't enough, he's failed to uncover a scintilla of evidence of industry involvement with the campaign despite looking under every stone. It was a grass-roots campaign by people who believed in property rights, individual freedom and—in the case of bar-owners—self-interest. End of story.

This is mind-blowing information to someone like Glantz who is so far down the rabbit hole of delusional self-righteousness that he probably believes his own studies. So when he writes up his account of what happened in the Netherlands, he can't bring himself to tell the truth, but he can't lie either. Instead, he uses innuendo and suggestion to give the reader the impression that Big Tobacco was at work, while never risking libel by stating it up front.

The introduction of his latest article (from the European Journal of Public Health) gives the flavour of what is to come...

Introduction

The tobacco industry has made maintaining smoking in hospitality venues a priority worldwide by organizing and sometimes financing hospitality and ‘smokers’ rights’ groups to oppose smoking restrictions. Bars are particularly important to the tobacco industry because they are adult only venues where young adults can be targeted [what on earth does this mean? - CJS]. As claims of adverse economic effects on restaurants have lost credibility, the tobacco industry has focused on bars as a wedge to undermine 100% smoke-free laws, including in the Netherlands.

Get the picture? It's the tobacco industry who want people to smoke in bars, not smokers or the people who own the bars.

It carries on in much the same vein, with Stan always talking about the kind of things the tobacco industry might do, while being careful to never say that they actually did them.

Echoing tobacco industry messaging, opponents accused the government of violating individual freedom, and called Minister Klink a ‘nanny’.

Perhaps, because of the dominance of the pro-industry messaging in the media, the health groups did not gain much traction.

And then finally, on page 5 of this 7 page article, we get a glimpse of the truth.

While the tobacco companies did not play an open public role in these events...

They didn't play any role in these events—open or covert, public or private—and Glantz knows it. If he had any evidence to the contrary he would present it. Instead, he continues with the same innuendo.

...the strategies and rhetoric deployed to oppose the smoking restrictions parallels tobacco industry global strategies, including arguing that smoke-free laws represent a form of intolerance and extremism [they do—CJS], and that, despite consistent evidence to the contrary, smoke-free laws harm bars [they do; it's basic economics—CJS]. Other industry tactics are to encourage and publicize venues flouting the law to create the perception of widespread noncompliance [I went to Amsterdam when the ban was in force and there was widespread noncompliance—CJS], to encourage (and fund) hospitality venues to challenge the law in court, and to promote ventilation.

And just in case you haven't taken the nudge and the wink, he finishes with this...

Conclusion

Owner-run bars in the Netherlands have been used by tobacco industry allies as a wedge to undermine public perception of and encourage noncompliance with smoke-free regulations. (Compliance remained high in other hospitality venues). The reversal in the Netherlands was the result of a failure to present and defend the law as a way to protect non-smokers, together with continuing to allow smoking rooms. There is a danger that the Netherlands may be cited by the tobacco industry and its allies as evidence that 100% smoke-free bar laws are unpopular and unenforceable and that tobacco control best practices embodied in the FCTC do not work.

"Allies", "parallels", "tactics", "pro-tobacco messaging". What weasel words these are. Misleading but never quite libellous; untrue but never quite lies. Using the same techniques, I will say this about the great mechanical engineer...

There is no direct evidence that Stanton Glantz is a criminally insane fraudster. That said, his refusal to acknowledge facts which clash with his delusions is a common phenomenon often observed in psychiatric patients. Although never officially certified with a mental illness, Glantz's constant references to dark conspiracies for which there is no evidence is a classic symptom of paranoid schizophrenia, as is the belief that ordinary people are working for sinister organisations. Asylums are filled with people with delusions of grandeur who obsessively repeat the same words over and over as if they had a profound meaning.

Glantz has recently written an article that was published in The Lancet, the same journal that published the notorious study on autism and MMR which has been described as "deliberate fraud" involving "clear evidence of falsification of data." Glantz has also worked with Prof. Anna Gilmore.

Glantz has written a book in which he explains his beliefs, thereby mirroring the strategies and rhetoric deployed by the suspected murderer O. J. Simpson, the disgraced politician Jeffrey Archer and the genocidal dictator Adolf Hitler whose book, Mein Kampf, was written whilst in prison in Germany. Like many of the most evil men in history, Glantz uses the Latin alphabet and owns a pen.

On the eleventh of September 2001, two passenger aircraft were flown into the twin towers of the World Trade Centre. Glantz did not play an open public role in these events, although he has never publicly denied involvement. Nor has he denied involvement in the disappearance of Madeleine McCann, the schoolgirl who went missing in Portugal six years later. Some reports have suggested that the kidnapper was a white male.

Stanton Glantz, a white male, has never been formally charged with racially motivated violence. He lives in the United States of America, where lynchings of ethnic minorities were common until quite recently. His home state of California endorsed eugenics and carried out an extensive sterilisation programme which did not end until 1979, at which point Glantz was working at the University of California, San Francisco.

You see how easy it is? Glantz has long since scraped through the barrel and at this rate will reach the core of the Earth by 2019. It's garbage. The truth is—as his study tells you if you can cut through the guff—that the tobacco industry only appears twice in this story. On the first occasion, they were invited by the government to attend a meeting as a stakeholder. The industry's lobbying at this meeting was ignored and a total ban was introduced. On the second occasion, a law firm working on behalf of the hospitality industry allegedly approached the Dutch Cigarette Manufacturers Association to ask for funding so that bar-owners could sue the government. The Dutch Cigarette Manufacturers Association turned them down.

That's yer conspiracy, right there. Scary, huh? If you want to hear what really went on, I suggest you listen to the conversation between Wiel Maessan and Stanton Glantz (listen here).

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Heart miracles are impossible

King-size cigarette,
pint-size intellect

It's good to see Dr. Carl V. Philips back and blogging over at Ep-ology. In his last two posts he has been discussing the North Carolina heart miracle 'study', which is as bad a piece of advocacy-driven junk science as you will ever see.

In particular, he makes a point which I have tried to made before, which is absolutely fundamental to all the heart miracle studies. The results they report—of heart attacks falling by 17%, 21%, 40% or whatever—are simply impossible.

Let's go along with the "consensus" view that long-term secondhand smoke exposure increases the lifetime risk of heart disease by around 20-30%. Nevermind whether that is a realistic estimate. For good or ill, it is the figure used by the Surgeon General and other authorities, and it is accepted by those who conduct the heart miracle studies.

That being the case, is it plausible that the elimination of secondhand smoke from restaurants, offices and bars could reduce the heart attack rate by 21% (as reported in North Carolina) or 40% (as reported in Helena, Montana)?

It is not.

For one thing, most restaurants, some bars and nearly all offices were non-smoking before the ban. In addition, many non-smokers avoided the few remaining smoky venues before the ban. The vast majority of heart attack cases are elderly and not the kind of people to be out partying in bars, nor indeed working in pubs or waiting tables in restaurants. Furthermore, the amount of secondhand smoke inhaled by this subsection of non-smokers before the ban is minimal compared to the long-term exposure that the 20-30% figure is based on.

As Carl explains...

How many people go from being exposed to restaurant/bar smoke to unexposed as a result of the ban? It is a bit fuzzy to define this since there will be a lot of people whose exposure is reduced, and a spectrum of how much it is reduced. But we can start with the observation that roughly half of everyone had approximately zero such exposure before the ban, never or almost never going out to eat and drink, or avoiding smoking-allowed venues when they did...

Thus, even if you believed that exposure at the level of visiting restaurants and bars causes somewhat more than 20% increase in risk, which is an absurd belief in itself, there is no possible way the effect of the smoking ban could be more than about half of the claimed 21%.

Even if we assume that secondhand smoke does cause heart attacks, smoking bans have so little effect on so few non-smokers (and have no effect at all on the smokers, unless it compels them to quit), that the kind of reductions in the heart attack rate reported by these studies defy both science and common sense. If there is an effect, it is too small to measure and would never show up in population-level statistics. Once that is understood, it is obvious that any studies which claim a dramatic effect on the heart attack rate must be flawed, cherry-picked or distorted. Sure enough, when such studies are examined, they prove to be flawed, cherry-picked and distorted.

We can figure that half of the population was not exposed in the first place, that easily a third of those exposed were smokers, that many of those exposed had very minor and occasional exposure, and that many others that were exposed had only a minor reduction in exposure since most of their exposure was elsewhere. So it seems unlikely that even one-fifth of the population experienced a substantial reduction in exposure, getting the effect down below 1% of the total.

If, to take North Carolina as an example, the smoking ban caused the heart attack rate to drop by 21%—which it unequivocally did not—it follows that smoking in bars, restaurants and offices must have been responsible for a fifth of all heart attacks before the ban.

It is quite possible that thirty years of induced panic about passive smoking has persuaded many people that such diluted tobacco smoke is capable of wreaking such havoc, but the empirical evidence shows that it cannot be so. If it were, the relative risk from secondhand smoke exposure would be far higher than 20-30%. Indeed, secondhand smoke would be responsible for more heart attacks than smoking. It would mean that passive smoking (at work and at home) was the single biggest risk factor for heart attacks. Even the most tobaccophobic hypochondriac surely cannot believe such a thing.

In the case of Stanton Glantz's bar-lowering Helena study (2004), the smoking ban effect was even greater—an astonishing 40%. Again, this implies that smoking in a subsection of private venues was responsible for two-fifths of all heart attacks before the ban—a manifestly risible idea.

Interestingly, Glantz must have known that his findings were inherently implausible because he addressed them in the text of the study itself. His comments tell you much about the man's mathematical illiteracy and, sadly, tell us much about the decline of the peer-review process (the study was published in the prestigious British Medical Journal). He wrote:

The effect associated with the smoke-free law may seem large but is consistent with the observed effects of secondhand smoke on cardiac disease. Secondhand smoke increases the risk of a myocardial infarction by about 30%; if all this effect were to occur immediately, we would expect a fall of - 0.30 x 40.5 = - 12.2 in admissions during the six months the law was in effect, which is within the 95% confidence interval for the estimate of the effect (a drop of - 32.2 to - 0.8 admissions).

His argument here is that secondhand smoke exposure increases the risk of heart disease by 30% and so, "if all this effect were to occur immediately", a smoking ban should reduce the heart attack rate by around 30%. 40% is, he concedes, a little higher than might be expected but it is within the margin of error.

This piece of reasoning is so patently flawed that I still cannot believe it was allowed to be published. Let's leave aside the fanciful idea that the effect of a lifetime's exposure would suddenly be nullified by a smoking ban in non-domestic settings. The key point is that Glantz ignores the fact that secondhand smoke is one of dozens, if not hundreds, of risk factors for heart attacks (or heart disease—he treats them as if they were the same thing). He seems not to comprehend the difference between relative risk and absolute risk. He does not acknowledge that a relative risk which affects a subsample of the nonsmoking population is not going to have a commensurate effect on the entire population. And he implicitly treats secondhand smoke as if it were the sole cause of heart disease. These are staggering schoolboy errors for a man with pretensions of being an epidemiologist (which just goes to show that a degree in mechanical engineering is not always the best grounding for a career in cardiology).

Look at it this way. If using a mobile phone while driving increases your risk of having an accident by 90%, what will be the effect on the number of car crashes in a country that bans the practice?

The answer is that we do not know. There are countless other risk factors for car crashes and so, even if using a mobile phone has a substantial effect on individual risk, the effect at the population level will be too small to measure.

By Glantz's logic, however, the effect of a mobile phone ban will be to reduce the number of car crashes by 90%—because he doesn't understand the basic difference between individual relative risk and absolute risk to the population. How can he be so ignorant? There are, as Carl says, only two possibilities.

Interestingly, it is not entirely clear whether he spouts junk because he has not acquired a modicum of understanding about the science in the field where he has worked for decades, or because he is a sociopath-level liar; I am not entirely sure which is the more charitable interpretation.

Do go read both of Carl's pieces about the North Carolina nonsense:

Unhealthful News 189 - Absurd claims about the effects of smoking place restrictions, North Carolina edition (Part 1)


Unhealthful News 190 - Absurd claims about the effects of smoking place restrictions, North Carolina edition (Part 2)

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That didn't take long

On Thursday, I mentioned Stanton Glantz's latest contribution to the SmokeFree Movies campaign when he published a study which found that films that showed smoking make 13% less at the box office than 'smokefree movies'.

To give Glantz his due, he did not fall into the trap of mistaking correlation with causation in the study itself.

Fear not, dear reader. Even Stan is not prepared to mistake correlation and causation so grievously (although it surely won't be long before advocates use this study to tell Hollywood: "Get rid of smoking in your films and you'll boost sales by 13%"). He does not claim that smoking in films is the cause of lower revenues. He does not explore what the actual reasons may be, but it seems likely that smoking is more common in indie films, gritty dramas, European releases and other movies which tend to make less money than big budget cartoons and family blockbusters.

I did, however, ask how long it would be before some dumb-bell took the study as 'proof' that putting smoking in a film directly leads to fewer people going to see it and, therefore, making less money.

It didn't take long, and Scientific American is skating on thin ice with this headline:

Smoking Is a Drag at the Box Office

And they plunge straight through the ice with statements like this:

Movie-makers are burning potential earnings when they have onscreen characters light up, new research suggests.

Oh dear, oh dear. All we need now is some dumb-bell to step forward and spell out this fallacious thinking explicitly. Step forward, Stanton Glantz...

"Putting smoking in the film isn't leading to more popular films that make more money," Glantz says. "It's leading to less popular films that make less money."

Bingo.

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Stanton Glantz: Clueless clown

"..and then divide by the number you first thought of..."

It is a rare month when Stanton Glantz, doctor of mechanical engineering and professor of something-or-other at the University of San Francisco, does not publish some advocacy-based junk in a low-grade public health journal. The old fellow has many imitators these days, but efforts like this from the forthcoming issue of Tobacco Control show that he will not give up his crown without a fight.

Movies with smoking make less money

Stanton A Glantz, Jonathan R Polansky

Objective: To determine the relationship between presence of smoking in films and total box office receipts.

The conclusion of this study is rather given away by the title. By reviewing a whole load of films, Glantz found that movies which depicted smoking made l3% less money than those which didn't. The methodology was as follows:

...we compared the reported box office gross receipts (in 2010 dollars) of the 1316 films, with and without tobacco imagery, that ranked among the top 10 in ticket sales in any given week of their ‘domestic’ (USA and Canada) theatrical release between 2002 and 2010.

What a pitiful thought it is that someone in California has been paid to watch over a thousand movies to look out for a glimpse of tobacco smoke. And how tragic it is that Glantz keeps the resulting dossier in his office to be whipped out for studies like this. Nevertheless, the methodology is not unreasonable and we shall assume—possibly naively—that the basic conclusion is sound.

The question is: So what? No one has ever claimed that directors portray smoking to boost sales. It is an artistic decision which reflects a real world in which 1 in 5 people smoke. Surely Glantz is not going to insist—as he does with smoking bans—that cow-towing to tobacco controllers is going to be good for business?

Fear not, dear reader. Even Stan is not prepared to mistake correlation and causation so grievously (although it surely won't be long before advocates use this study to tell Hollywood: "Get rid of smoking in your films and you'll boost sales by 13%"). He does not claim that smoking in films is the cause of lower revenues. He does not explore what the actual reasons may be, but it seems likely that smoking is more common in indie films, gritty dramas, European releases and other movies which tend to make less money than big budget cartoons and family blockbusters.

Since there is no cause-and-effect here, what is the point of the study? For Stan, the point is that Hollywood has nothing to fear from his SmokeFree Movies ruse because a lack of smoking on the screen does not put off punters.

One hypothesis to explain the persistence of high levels of smoking in US films is that smoking pays off at the box office.

Er, no it isn't. As far as I'm aware, nobody has ever made such an argument and it is telling that Glantz does not provide a reference for this claim. Nobody seriously believes that people are specifically attracted to films which show smoking, nor is anyone deterred from seeing films which do show smoking. It's irrelevant at the business end. This is purely an issue of artistic freedom versus censorship.

Having constructed his straw man, Glantz demonstrates that it is false. Well done him. However, while he shows that tobacco imagery has no effect on box office takings, he inadvertently manages to show that his SmokeFree Movies scheme would financially damage the movie industry.

This study shows why movie studios tend to push for a PG-13 rating: such movies make 18% more at the box office compared ones with an R rating.

This is the real point of SmokeFree Movies. The purpose is not merely to restrict smoking in the movies to R rated films. The purpose is to coerce movie studios into getting rid of all smoking from their films for fear of losing their PG rating and, therefore, a significant proportion of their audience.

Under Glantz's regime, the makers of The Simpsons Movie or Avatar would have to think very carefully about whether they wished to maintain their artistic vision or maintain their PG rating. If they say "screw these cranks, the film stays as it is" then they will lose their PG rating and, therefore, will lose money—to the tune of 18%, according to Glantz, although this gap may not be entirely due the classification status.

What Glantz demonstrates in this study is that the presence or absence of smoking has no effect on box office takings (no one ever thought it did), but that the SmokeFree Movies plan will lead to a significant loss in box office takings if directors choose not to capitulate to the anti-tobacco fanatics.

Glantz, however, comes to exactly the opposite conclusion in his new study:

...implementing an R rating for smoking to remove it from youth-rated films will not conflict with the economic selfinterest of producer-distributors.

Garbage. R ratings have a negative effect on sales. The SmokeFree Movies plan will lead to more films being given an R rating. Therefore, the SmokeFree Movies plan will very much "conflict with the economic self-interest of producer-directors."

The only way to escape this financial damage will be for film-makers to remove every hint of smoking from their films. That is what Glantz wants, of course, but if they refuse—as they have every right to do—they will be penalised at the box office. This is blackmail, pure and simple. Comply or die. If directors refuse to cleanse their films to suit the zealots they risk losing millions of dollars. No wonder Hollywood has consistently told them to sod off.

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At the movies with the prohibitionists

It's been quite a month for wowser propaganda, what with Facebook folly, obesity babble and multiple drinking delusions. With so much junk coming from their temperance and fat-fighting rivals, the anti-smoking wingnuts must be feeling quite left out. But, like a champion limbo dancer, when the bar is lowered, you can rely on Tobacco Control to lower it once more...

Films that 'encourage smoking' claim £338m in UK tax credits

Imperial College team says government is 'seriously undermining' anti-tobacco campaign

This 'news story'—reported in the Observer—is a variation of a press release that was knocking around last week which gave us the SHOCKING news that some Hollywood films subsidised by the US government depict smoking—a deviant activity which only 1.4 billion people engage in. The message is that this is UNACCEPTABLE and that governments should not provide assistance to film-makers who wish to depict this foul and despicable practice (other foul and despicable practices are okay). Won't somebody please think of the children? etc.

Personally, I find it shocking that Hollywood films receive subsidies. I had assumed it was only the piss-poor, loss-making British efforts that demanded aid from the reluctant tax-payer.

The UK version of this non-story is even lamer than the original. Foreign film-makers working in Britain receive tax relief for whatever reason and some of the movies they make contain images of the most evil habit in the Universe and, therefore, makes kiddies start smoking.

The evidence that teenagers start smoking because they see people (usually villains and perverts) smoking on screen has been entirely created by Californian fruitcake Stanton Glantz, who hilariously insists that half of all smokers take up the habit because they see Gandalf smoking in The Lord of the Rings or something. Even Glantz's opposite number in Australia, the creepy sociologist Simon Chapman, has described this evidence as "epidemiological alchemy" and, as former editor of Tobacco Control, he knows all about that.

Needless to say, the Observer story stems from yet another smokefree movies study from Glantz:

"California's state film subsidy program is undermining its longstanding tobacco control efforts," said lead author Stanton Glantz, PhD, UCSF professor of medicine and director of the Smoke Free Movies Project based at UCSF. "These activities never made sense, but are even more remarkable at a time when health and education programs are being slashed."

"In addition to ending subsidies for films that promote smoking, modernizing the rating system to give smoking films an R rating will provide a market incentive for producers to keep smoking out of movies that they market to adolescents."

Glantz has moved on from his original goal of banning smoking in all but R-rated films, and now wants the government to withdraw financial support from films that depict smoking. Since film-makers want the lowest classification possible and also want subsidies, this is one way of stopping the movie industry from showing the world as it is, and instead make it look like the fantasy that people like Glantz have in their heads. Don't be fooled into thinking this is just about changing the classification system. The aim is to get rid of smoking from all movies. It is censorship, pure and simple.

Glantz's co-author for the latest of his rants on this subject is Christopher Millett—a sociologist who works in obesity prevention. He crunched the numbers with the great mechanical engineer and concluded...

"In the period we looked at, the government gave £48m a year in tax credits to American films that feature smoking, almost all of which were rated suitable for children and adolescents," said Christopher Millett, from the School of Public Health at Imperial College London. "By comparison, the government spent £23m a year on mass media anti-smoking campaigns."

Note the spurious comparison here, as if the government is spending twice as much promoting smoking as it is trying to prevent it—as if the brief appearance of some villain smoking a cigarette is an equal and opposite reaction to an anti-smoking commercial.

The good news is that Glantz's 'smokefree movies' ruse has so far fallen on stony ground. The WHO and the CDC have been happy to support his demands for censorship, but the film industry generally doesn't like being told what to do by single-issue fanatics and has ignored them (it would open the floodgates to obsessives of all kinds if it didn't). The government has also shown no interest in supporting the zealots and when Glantz got his knickers in a twist over Avatar last year, he made himself a laughing stock.

Excellent. Anything that reminds the public that they are dealing with censorship-loving screwballs who want to turn art into propaganda is to be encouraged so, please continue 'Dr' Glantz. It's delightful.

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The heart miracle scam revisited

One of the more blatant scientific scams of recent years has been the heart miracle phenomenon, in which tobacco control campaigners create studies showing a dramatic fall in heart attacks after smoking bans. It began when Stanton Glantz of Americans for Nonsmokers' Right announced the 'Helena miracle' in 2003, claiming a 60% drop in heart attacks after the smoking ban in this small town in Montana (later revised to 40%). It continued through places like Bowling Green, Ohio (47%) and Pueblo, Colorado (41%).

These places are not exactly major conurbations, you may have noticed, and the numbers of heart attacks are so low—often single or double figures—that large fluctuations are common. When whole countries have been studied, advocates have been forced to resort to methodological jiggery-pokery (Scotland, 17%) and bald, unverifiable assertions (England, 2.4%).

Stanton Glantz has produced two meta-analyses in an attempt to shore up his hypothesis, claiming that heart attacks fall by 27%, and then 17%, after smoking bans are enacted.

But when the actual hospital admissions data are made available, they invariably fail to provide any evidence of an effect of smoking bans on the heart attack rate. The statistics from Denmark, Wales, Australia, England, Scotland, New Zealand and the United States have all failed to support the smoking ban/heart miracle hypothesis.

What should we trust? The evidence from places like Bowling Green, Ohio or the evidence from the entire USA? It has been obvious from the very beginning that anti-smoking campaigners have been mining the data to find big drops in heart attacks that roughly coincide with smoking bans. A study recently presented to an American Heart Association conference illustrates how easy this cherry-picking can be.

The study's finding are very interesting. The researchers looked at 74 US cities and found that the heart miracle effect has now fallen to just 3% (0.97 (0.95-99)). When the sample was limited to cities where the smokefree law was "meaningful"—ie. where there was a full smoking ban, rather than just restrictions—the effect disappeared entirely (0.99 (0.96-1.02). (Meaning that cities with lax smoking bans saw a bigger fall in heart attacks than those with "meaningful" smoking bans. Once again, the evidence fails to fit the theory.)

A drawback of the study is that there is no indication of how much the heart attack rate was falling before the ban, nor do the researchers compare rates to those in the cities which didn't have a smoking ban. When the study is published—if it is—hopefully the researchers will use a control group and look at the long-term trend.

What we do know is that rates of heart disease are falling in the USA, as they are in the UK and Europe. Even if one picks the more generous 3% figure, a modest decline of this order is likely to be in line with the secular trend. In other words: the smoking bans didn't make any difference.

If you look at the cities which brought in full smoking bans, you can see there is a great deal of variation in the heart attack rate with some going up, some going down and some going nowhere.

The variation is so great that no honest statistician would claim that there is any trend to be found amongst the data. But notice that four of the cities showed a statistically significant reduction in heart attacks and that the reduction was quite strong (at around 25%-30%). Now put yourself in the shoes of the tobacco control advocate who wants to show that smoking bans have a major effect on the heart attack rate. Which city would you choose to write your paper about? Evanston or Flagstaff?

The question, I think, answers itself. This is how they have been doing it. This is how we end up with 'news stories' like this from the BBC in 2003:

Town slashes heart attacks

Banning smoking in public places could prevent hundreds of deaths from heart disease, according to a study in a small US town.

Heart attacks in Helena, Montana, fell dramatically when smoking in public places was banned for six months last year.

The number of admissions dropped to fewer than four a month - a fall of nearly 60%.

From "nearly 60%" to nearly zero in just 8 years. What a ridiculous fraud this whole thing has been and how pathetic that so many have fallen for it.

Thanks to Michael J. McFadden for the tip.

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Laughing at you, not with you, Stan

One of the joys of America's SmokeFree Movies campaign is that it brings frothing-at-the-mouth anti-smoking mentalism under the noses of people who otherwise wouldn't pay attention. It's a pleasure to watch the jaws of people who are largely apathetic about smoking bans drop as they learn that there are people in the world who genuinely seem to believe that the depiction of smoking in films kills 100,000 Americans every year.

They also believe that no fewer than 390,000 American "kids" start smoking every year because of the smoking they see on screen, and they've got the studies to prove it. Admittedly, these studies are nearly all written by the guy who runs SmokeFree Movies, Stanton Glantz, who also founded Americans for Nonsmokers' Rights, but I'm sure he would never let his personal obsession lead his conclusions.

While the SmokeFree Movies claims are not inherently more ludicrous than anything else that comes out of Glantz's mouth, they are perhaps more obviously ludicrous to the casual observer. His latest pearl of wisdom is that: "A lot of kids are going to start smoking because of this movie". The movie in question is Johnny Depp's Rango. I haven't seen this film and probably never will, but according to a shocked spokeswoman for Breathe California, smoking is depicted many times:

Because there are so many scenes in which characters smoke, she said, her group might not be able to get a definitive count until Rango comes out on DVD.

It would, of course, be premature to say exactly how many "kids are going to start smoking because of this movie" until this crucial piece of scientific research has been carried out. Let's pray that the carnage is not as bad as first feared.

Jacob Sullum has written about this at Reason and the National Review has reported it with the suitably sarcastic headline 'Tobacco study suggests smoking on film may kill the audience':

The anti-smoking movement has undoubtedly been of great benefit to the health of Quebecers. The province, long derided as Canada’s ashtray, saw its smoking rate drop to 22.5% in 2009 from more than 30% in 1998. But when it has come to sitting in front of movies with a stopwatch, noting whether a smoking character conveys sexiness, rebellion or some other veiled message, you are well on your way to earning your reputation as a killjoy.

But best of all is Filmdrunk, who must have missed Glantz's chest-pounding about Avatar last year, because the great man has only just come onto his radar.

Let me be very clear about something: Stanton Glantz is not a real person. He can’t be. An anti-smoking advocate named Stanton Glantz who lives in San Francisco and makes conclusory doomsday statements like “A lot of kids are going to start smoking because of this movie” sounds like something even Michael Bay would dismiss as being too on-the -nose. No, I’ll not be fooled by this.

Additionally, and I don’t even know if this is possible, but I’m picturing him with two sole patches.

On Feb. 23, Smoke Free Movies, a project of Glantz’s, ran a full-page ad in Variety and the Hollywood Reporter that slammed the smoking in Rango. “How many studio execs did it take to OK smoking in a ‘PG’ movie?” the ad asked.

Said Glantz, “If we had known it’s as bad as it is, this ad would have been even tougher.”

I love that he thought the original ad was tough in the least. I just picture him sitting around saying, “Yes, this smugly worded question will surely cut through these executives like a samurai sword."

Nevertheless, Rango has renewed the call by Glantz and other anti-smoking advocates for the Motion Picture Association of America, or MPAA, to rate any film that shows smoking as “R.”

(*spins directly off planet*)

Look, I don’t want kids smoking any more than the next guy (provided the next guy isn’t Joe Camel). But these morons who take it upon themselves to try to eradicate tobacco use from the planet one city ordinance and petition at a time need to be stopped. I’m sorry if your enjoyment of the park is lessened because Johnny Motorcycle lit up a Marlboro Light and the smell of smoke just drives you batty. But tough sh*t. I don’t like country music, but I’m not going to go out and picket every Keith Urban concert. As I said up top, I can understand banning smoking in tight, confined spaces like bars or airplanes for the health of consumers and employees. But when your argument devolves into “ALL MOVIES WITH SMOKING SHOULD BE RATED-R REGARDLESS OF CONTEXT,” then you’re no longer doing a service to your cause.

And you’re an asshole.

And I hate you.

The comments don't suggest that Glantz is getting a lot of support from the movie-going public either.

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Stanton Glantz: Then and now

Stanton Glantz is arguably the most influential anti-smoking activist of the last thirty years. To his friends, he is a pioneering hero; to his enemies, a dangerous crank. Whether under the guise of activist or researcher, Glantz has been involved in most of the major developments in the tobacco control enterprise since 1975. He was the main proponent of 'denormalisation' in the 1970s - long before the approach even had a name. In the 1980s, he founded American for Nonsmokers Right and led the fight for the first smoking bans in his home town of San Francisco. In the 1990s, he was the source for the claim that 50,000 Americans died every year as a result of secondhand smoke (a figure that was not accepted by the EPA). He was instrumental in bringing secret tobacco industry documents before the public and has written prolifically about almost every aspect of Tobacco Control.

In recent years, Glantz has been a key player in the efforts to persuade the public that secondhand smoke is not merely dangerous but is extraordinarily lethal. His written output in this decade has included such papers as 'Even a little secondhand smoke is dangerous' [PDF] - in which it was claimed that just 30 minutes of exposure to smoke could cause a heart attack. He also co-authored the infamous Helena heart attack study, which purported to demonstrate that exposure to smoke caused 40% of heart attacks in one Montanan town. He is also perhaps the only person on earth who believes that passive smoking causes breast cancer despite a mountain of evidence to the contrary and despite the fact that active smoking does not cause the disease (1).

Glantz has been accused of twisting data and disregarding crucial facts to promote his extreme anti-smoking agenda (he is unashamedly prohibitionist). It comes as a surprise, then, to find that one of his earliest published papers was an appeal for greater scientific rigour in epidemiological studies.

Written in 1978, and published in the American Heart Associations' journal Circulation two years later, 'Biostatistics: How to detect, correct and prevent errors in the medical literature' is one of the least known works in Glantz's extensive canon. It does not get a mention on his lengthy online CV.

There is a reason for that.

"Simple mistakes"

The thrust of Stanton Glantz's 1980 Circulation paper was that too many researchers use statistical methods incorrectly and, therefore, many studies produce erroneous results. As a consequence, he wrote, "readers often conclude that statistical analyses are maneuverable to one's needs, meaningless, or too difficult to understand." One of the most striking sentences in the paper comes when he criticises researchers for making basic errors in study design and interpretation. He makes the rather obvious point that flaws in a study's design can result in an association being found between A and B when, in truth, none exists. Such errors in study design, he says, are often so basic as to be inexcusable:

"Ironically, these errors rarely involve sophisticated issues that provoke debate among professional statisticians, but are simple mistakes, such as neglecting to include a control group."

He stated that 44% of studies made the error of omitting a control group. It is interesting that Glantz specifically identified the failure to include a control group as a "simple mistake" since many of his own studies have been criticised for that very reason. Between 1994 and 2007, Glantz co-authored six papers which purported to show that smoking bans did not significantly damage the hospitality industry. Half of them did not include a control group. Nor was there any no control group in a study Glantz championed which claimed that the New York smoking ban resulted in 8% fewer heart attacks.

His own study of heart attack admissions (in Helena, Montana) did have the virtue of having a control group but, as I have written previously, he made a very "simple mistake" when he claimed that it was scientifically feasible for 60% of all heart attacks to be caused by secondhand smoke (to say nothing of the error of calculating a 60% drop, which later had to be corrected to 40%).

But the main complaint the Stanton Glantz of 1978 had to make about epidemiological studies involved statistical significance.

The significance of significance

Epidemiologists have wrestled for years with the question of whether the statistics they unearth represent a useful line of enquiry or are the result of chance. To deal with this problem, they have long-used a statistical test to distinguish the random from the real and it is one that many readers of this website will be familiar. It is statistical significance.

Statistical significance is not a difficult concept to define and the following quote, from Glantz's Circulation article, succinctly explains why a measure of statistical significance is necessary and how it works. First he explains why a standard of significance is necessary:

"In an experiment, an investigator rarely studies all possible members of the population, but only a small, representative sample. The mean value computed from such a sample is an estimate of the true mean that would be computed if it were possible to observe all members of the population. Because the sample used to compute the mean consists of individuals drawn at random from the population being studied, there is nothing special about this sample or its mean. In particular, had the luck of the draw been different, the investigator would have drawn a sample containing different individuals and computed a mean value."

He then explains how this can be done, using the example of drug testing:

"Traditionally, when the chances of observing the computed test statistic when the intervention has no effect are below 5%, one rejects the working assumption that the drug has no effect. There is, of course, about a 5% chance that this assertion is wrong. This 5% is the p value, or "significance level."

In other words, even if the drug being tested has no effect, there will inevitably be a small variation between the two randomly selected groups of people it is tested on. Because of chance, the difference between two random variables is almost never zero. The standard 95% significance test Glantz described is designed to distinguish small and meaningless associations from those that are significant. (In epidemiology, 'significant' does not mean 'substantial' or 'serious' as it does in normal parlance; it simply means that the association is probably not the result of chance*.)

When Glantz explained statistical significance in his Circulation paper, he did not pretend that there was anything groundbreaking or controversial about its usage, and any professional epidemiologist would have been well aware of the importance of testing for significance. Indeed, nothing in the article was in the least bit radical. Testing for significance, like avoiding "simple errors", was the bare minimum a researcher could do to avoid creating bogus results. (The young Glantz made no great claims for his paper saying: "This article presents a few basic ideas and rules of thumb.")

And, it seems, the reminder was needed. Glantz bemoaned the fact that "approximately half the articles published in medical journals that use statistical methods use them incorrectly" and recommended that "journal editors should insist that statistical methods be used correctly." In closing, he insisted that "students and research fellows should receive formal training in applied statistics, if only to increase the skepticism with which they approach the literature."

When this budding academic wrote his assault on faulty epidemiology, he was still a fairly obscure mechanical engineer-turned-junior faculty member at the University of California, San Francisco. Although he was, even then, a prominent anti-smoking activist, Glantz had no particular reason to question standard epidemiological practice. The first epidemiological study on passive smoking was still three years away from being published. Anti-smoking activists like Glantz expected it to be only a matter of time before science 'proved' that secondhand smoke was a cause of cancer and other diseases. The first step towards finding this proof would be showing statistically significant associations in epidemiological studies.

But epidemiology failed to do so. The first two studies encouraged them (Hirayama, 1981 & Trichopoulos, 1981) but Lawrence Garfinkel's large American study put a spanner in the works when he found a relative risk of 1.17 (0.85-1.61) for nonsmoking women married to smokers. The relative risk of 17% was statistically insignificant and neither Garfinkel nor the American Cancer Society (whose data he had used) pretended that the study lent any support to the passive smoking theory.

Over the next ten years a succession of studies showed no statistically significant elevation in risk (Gao (1987), Brownson (1990), Janerich (1990), Garfinkel (1985), Dalager (1986), Kabat (1984), Shimizu (1988), Nyberg (1989), Koo (1987) etc.) and one even showed a statistically significant fall in risk - ie. passive smokers were less likely to contract lung cancer (Wu-Williams (1987)).

It was at this point that the assault on epidemiological standards began. With the great majority of studies failing to show any tangible association between secondhand smoke and lung cancer, the anti-smoking movement began to belittle and disparage the very concept of statistical significance. At the forefront of this new assault was Stanton Glantz.

In 1993, the Environmental Protection Agency was caught playing hard and fast with epidemiological data in its effort to find a link between secondhand smoke and lung cancer. Even after cherry-picking the data, the EPA was only able to show the slimmest of risks by dropping the measure of statistical significance from 95% to 90%. This doubled the EPA's chances of finding a significant result and understandably raised eyebrows but Stanton Glantz was surprisingly relaxed about it. Fifteen years earlier, he had stressed how important the significance test was, but now he described it as "hairsplitting that only professors care about" and said:

"I know that scientifically it's widely used, but there is a strong body of thought that people are too slavishly tied to 95 percent."(2)

Soon afterwards, Philip Morris began to fund The Advancement of Sound Science Coalition. The organisation aimed to set basic standards for epidemiologists and, in the wake of the EPA report, Philip Morris had an obvious motive for supporting such a body. There was nothing in the Advancement of Sound Science Coalition's guidelines that would have been out of place in Austin Bradford Hill's famous criteria of causation or in Stanton Glantz article of 1980, including this remark about significance:

"Two-sided hypothesis tests are encouraged. If a one-sided test is employed, this should be noted and the rationale for using it provided. The presentation of confidence intervals for the estimate of risk gives more information than a single point value with an associated p value. Generally, 95% confidence intervals are preferred."

This was a statement of fact. 95% was indeed the preferred confidence interval in epidemiology. The EPA's use of a lowered 90% interval was almost unheard of and, in his 1980 paper, Stanton Glantz had firmly promoted the 95% confidence interval. But when The Advancement of Sound Science Coalition did the same, Glantz sang to a very different tune. Glantz accused it of "attempting to change the scientific standards of proof" and complained that its recommendations "would make it impossible to conclude that secondhand smoke - and thus other environmental toxins - caused diseases." (3) That may have been true but it was hardly the fault of epidemiology if it was unable to back up Glantz's beliefs.

Faced with a slew of studies that did not meet the test of significance, the anti-smokers preferred to dismiss the significance test itself rather than dismiss the studies. In truth, it was Glantz who was "attempting to change the scientific standards of proof" by abandoning his faith in a crucial criterion; one which could not be met by the null results that continued to appear in studies on secondhand smoke.

Things got worse for the anti-smokers in 2000, when the World Health Organisation's IARC found no statistically significant association between passive smoking and lung cancer. Glantz was incensed and he launched an all-out attack on the 95% confidence interval and, as ever, sought to blame the tobacco industry:

"The [tobacco] industry imposes a one-sided interpretation of confidence intervals, focusing the entire discussion on whether the lower bound of the 95% CI [confidence interval] for a relative risk includes 1. By definition, if the lower bound exceeds 1, then the risk is statistically significantly raised (with p=0.05).

Whether or not there is anything magic about 95%, the true risk is equally likely to be anywhere inside the 95% CI, including values above the point estimate. In environmental and health and safety regulation, it is common to take the health-protective approach of basing public policy on the upper 95% confidence limit...The industry has represented the fact that the increase in risk observed did not reach statistical significance as indicating that the study did not find any increased risk." (4)

This was an extraordinary turn-around. It was the very opposite of what he had written in 1978. Glantz gives an accurate definition of what constitutes a statistically significant risk ("if the lower bound exceeds 1") but then immediately claims that this is a "one-sided interpretation" dreamed up by the tobacco industry. He then suggests that since the true risk falls somewhere within the two confidence intervals, it is reasonable to pick any figure between the two. Furthermore, it is apparently acceptable for anti-smoking advocates to select the highest figure within the confidence interval as being the true risk. What is this if not a "one-sided interpretation" of confidence intervals?!

The troubling implications of such thinking can scarcely be overstated. Glantz is explicitly stating that environmental and health legislation should be based on the top end of the confidence interval ie. the highest level of risk, even when there is no statistical significant association to begin with and, therefore, no risk. Such an assumption makes it possible to 'prove' anything. Even if an epidemiological study finds a nonsignificant reduction in risk (eg. 0.9 (0.7-1.2)), policy makers will only see the 1.2 upper limit and assume a 20% increase in risk. Nothing studied can ever have a neutral effect; everything is harmful; nothing is safe.

Such a practice is not so much bad science as anti-science since it requires no evidence before a theory becomes a 'fact'. It gives the upper hand to pessimists, fanatics and hypochondriacs at the expense of science and reason. The power lies with anybody who can finance and successfully promote the research. Zero-evidence epidemiology can effectively manufacture health hazards at will and the precautionary principle requires politicians to legislate, regulate and abolish as if the risk was real and proven.

Glantz's transition from being a defender of scientific standards to becoming an assailant is an extraordinary one. That it came about due to his need to 'prove' that secondhand smoke kills offers an explanation but is scarce justification. It would a laughable exaggeration to claim that Glantz is some sort of fallen angel. His Circulation article would be unexceptional were it not for its author's subsequent U-turn and Glantz has done as much as anyone to discredit epidemiology as a serious science ever since. Since his training was in mechanical engineering rather than epidemiology, a charitable defence of the man's work might be that he simply does not know any better. I would suggest that his Circulation article, written at the dawn of his career, removes that defence. At one time, Glantz clearly did understand the principles of epidemiology and was prepared to defend them. The fact that he has since become a ringleader of junk science and debased epidemiology is all the more striking in the context of this forgotten article.




(1) 'Alcohol, tobacco and breast cancer', British Journal of Cancer, 2002, 87, pp. 1234-1245; doi: 10.1038/sj.bjc.6600596; see also 'Cigarette smoking and breast cancer', Field et al. International Journal of Epidemiology 1992; 21: 842-848.

(2) Quoted in Michael Fumento, 'Is EPA Blowing Its Own Smoke?' Investor's Business Daily, January 28, 1993. Republished by the American Smokers Alliance at www.smokers.org/research/ articles/08-epa_ blowing _ smoke html.

(3) http:// academicsenate.ucdavis.edu/forums/SoundScienceAJPH.pdf
Incidentally, in his Circulation article, Glantz cites the work of the great epidemiologist Alvas Feinstein. Glantz would later dismiss Feinstein as a "industry consultant" when he cast doubt on the passive smoking theory. http://circ.ahajournals.org/cgi/reprint/116/16/1845.pdf

(4) www.tobaccoscam.ucsf.edu/pdf/5.1.2b-Ong&GlantzIARC.pdf

* In reality, the idea that significant results are correct 95% of the time is a fallacy that can easily be confirmed by reading about the health scares and miracle cures that are reported in every daily newspaper. To quote John Brignell in The Epidemiologists:

"In the comparison of two random variables the correlation coefficient is never zero. The first question to be determined is whether it is far enough from zero to be significant, which in the case of epidemiology means resorting to the one-in-twenty lottery. Even if the correlation is deemed significant, however, that is not sufficient evidence to warrant a claim of causation." (p. 199)



[Originally published at velvetgloveironfist.com]

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Quote of the day...

...comes from Jeff Stier of the American Council on Science and Health, discussing the sacking of James Enstrom:

“They fired him because he allegedly went beyond the science of his paper, and inserted his own opinion,” says ACSH’s Jeff Stier. “If that were the standard that the University of California system used for firing people, they’d be left with no professors.”

Indeed. And, for no particular reason at all, here's a photo of UCSF's Prof. Stanton Glantz with the newly promoted Prof. Anna Gilmore:

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The root of all evil

When I wrote the last post about the public health cash torrent shifting from tobacco to obesity, I hadn't spotted that Carl V. Phillips had already written a much better piece about it at the Ep-ology blog.

It is pretty clear that this “controversy” has been engineered by those worried about losing their unending supply of anti-tobacco funding, taking advantage of their current power and influence, including with the press, to defend their empire against anyone with another priority. 

In the same article, Stanton Glantz is quoted, “Given that tobacco kills four times as many people as obesity does, why is the government putting more money into obesity?” Since he seems to be believe that passing exposure to second hand smoke causes 1/3 of all heart attacks, I can only assume that he actually thinks that is a valid argument. But sadly, most others seem to miss the point also: What matters is the marginal effect of additional spending.

Meanwhile, as Smokles reports, the aforementioned mechanical engineer, cardiologist and all-round Renaissance man Stanton Glantz has popped up in Tobacco Control claiming that shifting smokers towards tobacco products which are 99%-100% less harmful will not result in less harm.

Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.

A slight improvement on the conclusion given when Glantz presented the same study to a conference last year:

Promoting smokeless tobacco as a safer alternative to cigarettes will not result in a reduction of harm and may lead to an increase in harm at the population level.

I don't have the full study to hand so I can't say whether it was paid for by organisations which have a stake in promoting pharmaceutical nicotine.

Whoever it was, I'm sure their motives were pure...

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Is the bank closing?

Apologies for the light blogging, dear reader. I'm very busy with other things, including a heated debate involving my latest book (see here, here, here and here for the tip of that iceberg).

I'll be back with more news and views from the dark side of prohibition at the weekend. Until then, I see that The New York Times is reporting that the Robert Wood Johnson Foundation (RWJF) is diverting its vast wealth away from tobacco control and towards obesity. (And yes, RWJF's primary funders Johnson & Johnson sell a number of weight-loss drugs, as well as making nicotine replacement drugs.)

Tobacco Funds Shrink as Obesity Fight Intensifies

When the Robert Wood Johnson Foundation decided in 1991 to take on Joe Camel, it became the nation’s largest private funding source for fighting smoking. The foundation spent $700 million to help knock the cartoon character out of advertisements, finance research and advocacy for higher cigarette taxes and smoke-free air laws and, ultimately, to aid in reducing the nation’s smoking rate almost by half.

But a few years ago, the Johnson foundation, based in Princeton, N.J., added another target to its mission, pledging to spend $500 million in five years to battle childhood obesity. As the antiobesity financing rose to $58 million last year, a new compilation from the foundation shows, the organization’s antismoking grants fell to $4 million.

And RWJF are not the only ones to be shifting focus.

The steep drop-off in private funds illustrates the competition under way for money as public health priorities shift. In the race for preventive health care dollars, from charities and from federal and state government sources, the tobacco warriors have become a big loser...

The 1998 Tobacco Master Settlement Agreement between 46 states and cigarette companies provided more than $200 billion through 2025. For a while it financed preventive programs like the “Truth” media campaign from the antismoking group American Legacy Foundation. But as states used money elsewhere, “Truth” spending declined, to a low of $35 million last year from $104 million in 2000.

Naturally, uber-zealot Stanton Glantz is not happy about being moved further down the trough.

Stanton A. Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, asked, “Given that tobacco kills four times as many people as obesity does, why is the government putting more money into obesity?”

From a European perspective, the funds allocated to tobacco control remain eye-wateringly huge. Whilst I would never condone the government giving money to lobby groups, the amounts received by ASH (England) and its wealthier little sister ASH (Scotland) are peanuts compared to the billions enjoyed by American groups. And yet the smoking rate in America is virtually identical to that of Britain. Does this mean that British anti-smoking groups are exceptionally effective or are American anti-smoking groups exceptionally useless? Or are they both simply irrelevant?

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*Splutter*

[Warning: if you're drinking a cup of coffee, finish it before you read this. You may splurt it all over your keyboard]

From the New York Times:

“At one level, it’s true the pharmaceutical companies are competing with the tobacco companies. But this is not Coke versus Pepsi,” Professor Glantz said. “The tobacco companies are promoting products that kill half a million people a year. The pharmaceutical companies are trying to promote health.”

Professor Glantz added: “Those are two of the world’s experts, and we need to have people in there who are not going to get snookered by the industry, falling for a bunch of phony pseudoscience."

Stanton Glantz said that. 

Yes, that Stanton Glantz.

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Stanton Glantz: A one man junk science machine

Readers may have heard about the anti-smoking backlash against the movie Avatar last month. It was led, as usual, by the notorious tobacco control-freak Stanton Glantz, who took umbrage at one of the characters - heaven forfend! - smoking cigarettes. 

In the debate below, Glantz manages to be rude and obnoxious to both the presenter and the other guest, as well as making the laughable claim that "hundreds of thousands" of children start smoking each year because of brief scenes of smoking in a handful of movies (most films that depict smoking have adult ratings for other reasons, so it really is a handful). 

As Glantz argues with characteristic grace and courtesy in part two, this only applies to smoking. Magically, scenes of eating don't make people fat and scenes of violence don't make people violent.

The first words out of his mouth are: "There is overwhelming scientific evidence..." a phrase which, at some point in the last few years, has come to mean the exact opposite of what it should. He goes on to say:

"There is a huge scientific literature in this area of research that's been done all over the world that clearly shows that the more kids see smoking on screen, the more likely there are to smoke."

Overwhelming evidence there is not. A vast literature there certainly is. Never mind the quality, feel the quantity. See if you can see a pattern...

Mekemson C, Glantz SA. How the tobacco industry built its relationship with Hollywood. Tob Control.2002;11 (suppl 1):i81–i91

Glantz SA, Kacirk K, McCulloch C. Back to the future: smoking in movies in 2002 compared with 1950 levels. Am J Public Health. 2004;94 :261 –26

Polansky JR, Glantz SA. First-run smoking presentations in US movies 1999–2003. 2004.

Hazan AR, Lipton HL, Glantz SA. Popular films do not reflect current tobacco use. Am J Public Health. 1994;84 :998 –999

Stockwell TF, Glantz SA. Tobacco use is increasing in popular films. Tob Control. 1997;6 :282 –284

Kacirk K, Glantz SA. Smoking in movies in 2000 exceeded rates in the 1960s. Tob Control.2001;10 :397 –398

Glantz SA. Smoking in the movies: a major problem and a real solution. Lancet. 2003;362 :258 –259

Glantz SA. Rate movies with smoking "R." Eff Clin Pract. 2002;5 :31 –34

Charlesworth A, Glantz SA, Smoking in the Movies Increases Adolescent Smoking: A Review, Pediatrics, Vol. 116 No. 6 December 2005, pp. 1516-1528

Polansky J, Glantz S (2009) Taxpayer subsidies for US films with tobacco imagery. UCSF Center for Tobacco Control Research & Education.

Polansky J, Titus K, Glantz S (2009) Two years later: Are MPAA's tobacco labels protecting movie audiences?

Titus K, Polansky J, Glantz S (2009) Smoking Presentation Trends in U.S. Movies 1991-2008

Lum KL, Polansky JR, Jackler RK, Glantz SA (2008) Signed, sealed and delivered: Big Tobacco in Hollywood, 1927-1951

Polansky J, Titus K, Glantz S (2007) Six months later: Are MPAA's tobacco ratings protecting movie audiences? University of California, San Francisco Center for Tobacco Control Research and Education

Song AV, Ling PM, Neilands TB, Glantz SA (2007) Smoking in movies and increased smoking among young adults. Am. J. Prev. Med. 33(5):396-403.

Polansky J, Glantz S (2007) First-Run Smoking Presentations in U.S. Movies 1999-2006. University of California Center for Tobacco Control Research and Education

Alamar B, Glantz S (2006) Tobacco industry profits from smoking in the movies. Pediatrics 117:1642.

Charlesworth A, Glantz S (2006) Tobacco and the movie industry. Clin Occup Environ Med. 5:73-84.

Polansky JR, Glantz S (2005) Clearing tobacco from films would avert deaths worldwide at virtually no cost. Global Health & Environment Monitor 13(2):3-5.

What a busy fellow he is.

(PS. Since Glantz started bitching about it, Avatar has become the highest grossing movie in history. The curse strikes again.)

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Cooking the books on Alzheimer's

Study shows cigarette smoking a risk for Alzheimer’s disease

No it doesn't...

When all studies were considered together, the risk factor for developing AD from smoking was essentially neutral at a statistically insignificant 1.05.

So where did the dramatic headline come from? Step forward Dr. Stanton A. Glantz (for it is he), who has found an association after "controlling for study design, quality of the journals, time of publication, and tobacco industry affiliation of the authors." 

Blimey, that's a lot of controlling and sounds very subjective. Is the self-styled "anti-smoking lunatic" Glantz really the best man to be judging bias? When it comes to identifying 'tobacco industry affiliation' he generally seems to use the six degrees of separation theory.

If anyone has the study, I'd love to see it. Please e-mail me: author@velvetgloveironfist.com.

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Inevitable consequences

If I linked to Frank Davis every time he wrote an eloquent and thought-provoking post it would become a daily task, but this short article is well worth reading. Frank's point is that - as an enthusiastic smoker - his tolerance towards others has declined as tolerance towards his own pleasures has diminished. 

Of course, many people would argue that smoking is an irrational habit, but that is hardly the point, for the same can be said of many other lifestyle choices:

[A]part from the fact that they both voted for the smoking ban, one of the reasons I don't like Kerry McCarthy and Paul Flynn is because he's a druid and she's a vegan. And that means that they're both profoundly irrational people, who also happen to be MPs, unfortunately. 

Smokers are not always in the minority. A non-vegan smoker is in the majority if the debate turns to veganism. A non-druid smoker is in the majority if the debate turns to paganism. The protection offered by numbers swiftly disappears when the tables are turned. If we cannot find any higher reason to be tolerant, simple self-protection should suffice.

Philosophically speaking, tolerance should probably not be contingent on others being tolerant back. Turn the other cheek and all that. But in terms of human behaviour, it is inevitable that the creation of divisions is going to generate resentment on both sides.

This is the aspect that most worries me about the "denormalisation" crusade. The creation of divisions - or, let's put it more bluntly, hatred - is not a side-effect of denormalisation, it is the pre-meditated intention of the whole endeavour. It deliberately creates divisions where there was once tolerance. There is a fine line between denormalisation and stigmatisation. There is an even finer line between stigmatisation and hate-mongering. 

Stanton Glantz, one of the architects of "denormalisation" once described it as “implicitly defining smoking as an anti-social act.” It is, quite explicitly, a top-down approach designed to get people to pressure their peers into not smoking, but it does not account for the more thuggish and tribal part of the human psyche. The result has been that we now have high-profile millionaires calling for children to report their own parents to the police.

But, as Frank's post shows, the antipathy works both ways:

Before the ban I was a left-leaning liberal, and a Lib Dem voter. And I vaguely looked upon Greenpeace and Friends of the Earth and the green movement and environmentalism in a friendly, approving sort of way. And although I didn't do it myself, I really wasn't bothered if friends of mine stopped smoking, and started eating organic vegetarian food and going to yoga classes and Buddhist retreats. I was tolerant to the point of super-tolerance. Lesbians, are you? Pleased to meet you.

That's all over now. It all ended around about 1 July 2007.

It was an inevitable and intended consequence of denormalisation that nonsmokers would become less tolerant of smokers. Less anticipated, perhaps, was the fact that this would also work in reverse. The result has been the creation of another little pocket of hate in the world. Try as I might, it's difficult to think of any social problem that's ever been solved by the creation of more hate.

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Heart miracle article in Spiked

In today's issue of Spiked, I have returned to the topic of smoking ban/heart attack miracles. 

The myth of the smoking ban ‘miracle’

Restrictions on smoking around the world are claimed to have had a dramatic effect on heart attack rates. It's not true.

Please read the rest...

It is also worth mentioning that the new 'study' which inspired the latest wave of media hysteria (the funniest headline being The Scotsman's 'Smoking ban slashes heart attacks by up to a third across world') was not a new study, but a meta-analysis (a study of studies). It was co-authored by Stanton Glantz, founder of Americans for Nonsmokers' Rights, director of TobaccoScam, director of SmokeFree Movies etc.

It is remarkable how few key people are responsible for so many theories, studies, facts and figures in the world of anti-smoking research (and how many of them started out as anti-smoking activists). Glantz has built up the heart miracle hypothesis almost single-handedly. His input so far has included:

Writing the meta-analysis which 'proved' that secondhand smoke causes heart disease (1991).

Coming up with the estimate that 50,000 Americans die from secondhand smoke each year (never independently verified and rejected by the EPA) (1991).

Writing 'Even a little secondhand smoke is dangerous', which claimed that brief exposure to smoke causes heart attacks, thereby paving the way for the heart miracle studies (2001).

Writing the Helena heart attack study (with 2 other anti-smoking activists) (2004).

Writing 'Cardiovascular effects of secondhand smoke; nearly as large as smoking' (2005).

Writing the first meta-analysis of heart miracles (2007).

Writing the second meta-analysis of heart miracles (2008).

Writing the third meta-analysis of heart miracles (2009).

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