Respectful Insolence

I’m not sure what to think of Michael Siegel. I’m really not. Even now, I remain of two minds on him.

Dr. Siegel first came to my attention back in July, around the time I was getting into online tussles with a certain opponent of indoor smoking bans, before which I had never heard of him. He’s a Professor in the Social and Behavioral Sciences Department at Boston University School of Public Health who’s made quite a reputation for himself casting a skeptical eye on what he considers to be extreme exaggerations, bad science, and even lies about the risks of tobacco and secondhand smoke. My first encounter with his blog occurred in the context of a discussion of a study of changes in admissions for myocardial infarction before and after the imposition of an indoor smoking ban in Helena, MT.

I had meant to look into his blog a bit further to see if perhaps I had been a bit unfair (or even too soft) on him when questioning his advocacy of a dubious-sounding study, but other topics intervened. I soon forgot about the incident and moved on to other topics; that is, until yesterday, when fellow ScienceBloggers Revere and Jake mentioned Dr. Siegel in the context of a challenge that he had issued to certain groups publicizing what he viewed as scientifically unsupported risks of SHS to provide scientific evidence to back up its statement. The reason these posts caught my attention was because I actually pretty much agreed with Dr. Siegel’s assessment in this case, thus making me wonder if I should take this opportunity to reevaluate my previous assessment of him. Here is the statement to which he objected so strongly, from Action on Smoking and Health (ASH):

Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker’s risk of suffering a fatal heart attack to that of a smoker.

As much as I detest cigarette smoking as the single largest cause of preventable death, which I’ve seen over the years as medical student, resident, and now surgeon and would love to see smoking brought as close to zero as possible, you’ll note that even I didn’t mention this claim, mainly because it’s hugely overblown and misrepresents what the CDC really did warn. This was Dr. Siegel’s challenge:

  1. Please document that the CDC has warned that 30 minutes of secondhand smoke exposure increases a nonsmoker’s risk of suffering a fatal heart attack to the same level as that of active smokers.
  2. Please provide the scientific evidence to back up the assertion that 30 minutes of secondhand smoke exposure increases a nonsmoker’s risk of suffering a fatal heart attack to the same level as that of active smokers.

And, indeed, his challenge is justified because there really is no good evidence to support either point, as he pointed out so well in a recent article he published:

It also appears to be untrue that the CDC claimed that a 30-minute exposure to secondhand smoke “can raise a nonsmoker’s risk of suffering a fatal heart attack to that of a smoker.” What CDC did claim was that “even 30 minutes of exposure to a typical dose of secondhand smoke induces changes in arterial endothelial function in exposed non-smokers of a magnitude similar to those measured in active smokers” [3, p. 981]. This statement was based on findings from a study conducted by Otsuka et al., published in 2001 in the Journal of the American Medical Association (JAMA) [6].

The relevant study [6] experimentally exposed nonsmokers to secondhand smoke for 30 minutes and analyzed changes in endothelial function, as measured by coronary flow velocity reserve (CFVR). The authors reported that acute secondhand smoke exposure resulted in reductions in endothelial function that were approximately equivalent to those observed in active smokers [6].

It is important to note that endothelial dysfunction, especially if transient, is not a direct predictor of myocardial infarction risk. What endothelial dysfunction indicates is the early process of atherosclerosis. As the authors concluded: “The present findings suggest that reduction of CFVR after passive smoking may be caused by endothelial dysfunction of the coronary circulation, an early process of atherosclerosis, and that this change may be one reason why passive smoking is a risk factor for cardiac disease morbidity and mortality in nonsmokers” [6, p. 440].

What this means is that acute exposure to secondhand smoke can result in endothelial dysfunction in nonsmokers that if prolonged and repeated over a long time, could eventually result in atherosclerosis and heart disease. This study provides a potential mechanism for the observed increase in heart disease risk among involuntary smokers. It provides biologic plausibility for a causal relationship between chronic exposure to secondhand smoke and heart disease. But it does not suggest that an otherwise healthy nonsmoker could suffer a heart attack as a result of a 30 minute exposure to secondhand smoke, and it certainly does not mean that a nonsmoker’s risk of a heart attack approaches that of a smoker after 30 minutes of exposure to secondhand smoke.

So what’s the problem? An overzealous antismoking group made an obviously overblown and scientifically unsupportable claim, and Dr. Siegel shot it down appropriately. As Revere says, you don’t fight liars like the tobacco industry by becoming a liar yourself, nor should a scientists check their standards at the door. End of story, right?

And yet…

Perusing Dr. Siegel’s blog, The Other Side of the Story: Tobacco News Analysis and Commentary, again yesterday gave me a most uncomfortable feeling in the pit of my stomach. Peruse it for yourself, and I hope you’ll see what I mean. For one thing, Dr. Siegel seems to revel a bit too much in his self-chosen role of gadfly. However, perhaps what most caught my attention was his frequent use of the term “junk science” to characterize various smoking studies of which he disapproves or that he considers substandard. Whether fairly or not, I had to wonder: Surely Dr. Siegel must be aware of the connotation behind that term and how it’s been appropriated by right wing denialists like Michael Fumento and in particular Steve Milloy. When coupled with his attacks on the claims of tobacco control activists and epidemiological studies on the effects of SHS that he views as dubious, Siegel’s frequent use of the same term, whether he realizes it or not, echoes Fumento and Milloy in a most disturbing fashion―at least to me. Couple this with my recent reading of Chris Mooney‘s The Republican War on Science, in which Mooney traces the history of the use of the term “junk science” by the right wing as a favored label to apply to scientific studies that have findings that either business interests or right-wingers don’t like, and that’s one reason why reading Siegel’s blog, even if he’s absolutely correct and on the side of angels, still leaves me with a distinctly crank-like impression. (His penchant for using multi-colored text doesn’t help, either.) As Mooney described (p. 74, paperback edition):

In a 2004 lecture, University of Texas law professor Thomas McGarity, president of the Center for Progressive Reform, amusingly summed up the conservative worldview with the following slogan: “Our science is sound science and their science is junk science.” Conservatives are wrong on both charges, but they have been vastly successful in getting the rest of the political world to adopt their loaded terminology.

Even Dr. Siegel, who has even gone so far as to say:

To be honest, I’ve seen a lot more deception out of the Campaign for Tobacco-Free Kids these days than I have from the tobacco companies. Perhaps we should be considering legislation to require pre-approval of claims made by the Campaign so that it can be determined that these claims are accurate and not misleading.

I’m sorry, but I find that statement very hard to believe, given the long and sordid history of tobacco companies lying about science for profit and to forestall regulation and being held responsible for the deaths and illness their products cause.

Looking through Dr. Siegel’s blog, in fact, I had a hard time finding any articles in which he had anything good to say about any studies of the effects of indoor smoking bans. Recent posts have savaged a studies from Scotland, Indiana, and Ireland. I looked for a single example of Dr. Siegel praising an SHS study, and I was unable to find one. Surely they can’t all be bad, can they? And if they’re all bad, then I have to wonder: Why does Dr. Siegel still believe that SHS is harmful to health if in his opinion the science of recent studies is so bad? A little balance every now and then would be helpful; it’s little wonder that tobacco cranks love to cite him, given that the overall gestalt of his blog, I’m sorry to have to say, is more than a little crank-like, at least to me. True, I could be mistaking passion for crankery, but even so that’s the impression that, try as I might, I can’t entirely shake.

Finally, what makes me uncomfortable about Dr. Siegel and his stance is that he’s inconsistent. For example, appropriately, he likes to rail against “science by press release.” Damn straight. I find such abuse of science as disturbing as he does. Unfortunately, when it serves his purposes, Dr. Siegel doesn’t appear to be above doing something rather similar, as I noted in July. That’s when he championed a “study” by David W. Kuneman and Michael J. McFadden (a study to which he claimed to have contributed by going over the authors’ data analysis) on his blog before it was ever published. McFadden is a die-hard anti-SHS regulation advocate who runs a website called Pennsylvania Smokers’ Action Network, which features a particularly stupid bit of propaganda called Dissecting Antismokers’ Brains, while Kuneman runs a website called The Smokers’ Club. The study, entitled Do Smoking Bans cause a 27 to 40% drop in admissions for myocardial infarction in hospitals? A preliminary study was published not in a peer-reviewed journal, but on Kuneman’s website.

I suppose I could chalk it up to intellectual honesty that Siegel would be willing to follow the data, no matter who’s analyzing it, but the way he championed the study on his blog (“science by blog release,” anyone?), coupled with his rhetoric, made me uncomfortable and raised significant questions in my mind about either his judgment, objectivity, or both. I also note that the study, as far as I can tell from searching PubMed, still remains unpublished in any peer-reviewed journal two years later. (The American Council on Science and Health (ACSH) and Dr. Siegel seem to be the only ones who still support this study.) When a discussion of Siegel and why his actions bothered me broke out in the comments of a post that I wrote about SHS, Kuneman and McFadden both showed up to defend their unpublished study (and will virtually certainly show up here; they both seem very vigilant at looking for references to their “work”). I asked them why, if Siegel had contributed so much analysis to it, he hadn’t signed on as an author or helped them to get it published. Four months later, I still consider it a legitimate question. Certainly, it’s a question I would have asked Dr. Siegel if I were Kuneman or McFadden.

Revere assures us that “Mike Siegel is no smokers’ rights partisan,” and I don’t think that he is. I believe him when he says that he wants to do everything possible to reduce fatalities from smoking and that he accepts the scientific consensus that SHS causes health problems. Certainly, his publication record and public interviews support these contentions. Moreover, he probably does serve a useful purpose in keeping activists honest. I do, however, think that Siegel has shown poor judgment, certainly in the case of the McFadden and Kuneman article, and in using rhetoric that is perhaps a little too easily appropriated by smokers’ rights partisans. I may be completely wrong about this, but I can’t help but speculate that perhaps he’s become a little more enamored than is good for him of his chosen role of watchdog over scientific claims made by the antismoking movement which he has come to view as hopelessly corrupt:

In essence, the role that I am now playing is one that the tobacco industry used to play, albeit for a different reason. The tobacco industry played a watchdog role because they wanted to discredit tobacco control and undermine its public credibility. I am now playing this watchdog role because I want to restore the scientific integrity of the movement and save its public credibility. Nevertheless, the role that I am playing is very similar to what the tobacco industry used to do.

To some extent, it is surprising to me that the tobacco companies have not made more of a public display over the outright misrepresentation of science by anti-smoking groups. I suppose they feel that if they just lay back, the movement will destroy its own credibility. This may be a wise strategy, since it seems that every day, the claims get more and more absurd.

So, what am I to think of Mike Siegel? Four months after discovering his blog, I still don’t know. All I can do is to cheer him on when he’s right, as he was in criticizing ASH’s ludicrous statement and in destroying the ridiculous claim that 340 young people die every day from seeing smoking in the movies. And when he’s in the wrong, as in my opinion he was in touting the McFadden and Kuneman study on his blog before it was published in a peer-reviewed journal and, in my opinion, in generalizing cases of exaggeration or misrepresentation of the science behind SHS into blanket declarations that the “tobacco control movement has lost its scientific integrity,” there should be no hesitation to call him out on it.

Just like the tobacco control scientists that Dr. Siegel seems to love to castigate so much.

Comments

  1. #1 Mike
    November 20, 2007

    It seems that you really have an ax to grind. Look at one of the quotes from Siegel: “To be honest, I’ve seen a lot more deception out of the Campaign for Tobacco-Free Kids these days than I have from the tobacco companies.”

    The key words here are “these days.”

    How do you respond? By bringing up history from decades ago? Your response is irrational and shows that you uninterested in having a fair and reasonable discussion. If you had been interested in a fair and reasonable counter, you would have brought specific facts from the past year or two.

  2. #2 bob koepp
    November 20, 2007

    Fair is fair. For Orac to complain that Siegel “loves to castigate so much” is hilarious.

  3. #3 Ben
    November 20, 2007

    I unfortunately had a recent spat with these people in the comments of one of his recent posts. It was interesting to say the least, and I’d encourage you to think twice about participating in “discussion” over there lest you get attacked and misinterpreted immediately and repeatedly.

  4. #4 Dan
    November 20, 2007

    Orac I am glad to finally hear you comment on this. Did you ever look at the journal links I provided on the bottom of this discussion?

    http://scienceblogs.com/insolence/2007/07/blowing_smoke_over_second_hand_smoke_1.php

    One of them is authored by Dr. Michael Siegel. I agree that at times, he does not seem to know where he stands and is inconsistent. For example, he supports work place smoking bans because he believes SHS represents a significant health threat to workers. However, he is against car smoking bans when children are passengers, because he feels this is an unwarranted intrusion of parental autonomy given the minimum risk. Yet he does advocate taking away property rights of small business owners (think bars) to decide for themselves whether to allow smoking even if the owner only hired smokers. You can find the inconsistencies in the following rather lengthy discussion.

    http://www.haloscan.com/comments/mbsiegel/699854631722645115/

  5. #5 daedalus2u
    November 20, 2007

    Endothelial function is mostly mediated by nitric oxide. A significant source of NO in the body is in the nasal passages. Inhaled particulates does reduce exhaled NO, most likely by reducing the generation of NO in the nasal passages.

    http://www.ehponline.org/members/2003/5880/5880.html

    Inhaling SHS through the nose might be very different than smoking through the mouth. Also, some of the normal targets of NO are also activated by CO. The CO in smoking at the high concentrations obtained in first hand smoking might be “protective” against some of the NO loss. SHS may not provide sufficient CO to activate those same pathways.

  6. #6 James Austin
    November 20, 2007

    Orac wrote:
    “However, perhaps what most caught my attention was his frequent use of the term “junk science”…Whether fairly or not, I had to wonder: Surely Dr. Siegel must be aware of the connotation behind that term and how it’s been appropriated by right wing denialists…”

    “[E]ven if he’s absolutely correct and on the side of angels, still leaves me with a distinctly crank-like impression.”

    I would most certainly bet that Dr. Siegel is a liberal. You may now believe what he says without question.

    As to his latest euphemism, junk science, you can only write “shoddy” so many times before it becomes a criminal offense.

    Off topic, but I have a genuine question to you as a surgeon, if you don’t mind. Would you rather operate on a person who brought the need for surgery upon themselves (smoking, football, single car accident, obesity, etc) or on someone who’s “blameless” (child with heart abnormality or a tumor, that sort of thing)?

  7. #7 Dan
    November 20, 2007

    Orac wrote: “Finally, what makes me uncomfortable about Dr. Siegel and his stance is that he’s inconsistent. For example, appropriately, he likes to rail against “science by press release.” Damn straight. I find such abuse of science as disturbing as he does. Unfortunately, when it serves his purposes, Dr. Siegel doesn’t appear to be above doing something rather similar, as I noted in July.”

    In a comment on his blog today in the comments section he appears to address what you say here. I am not sure if it is response to your comments. Michael Siegel writes:

    “I think it is important to point out that the mere fact that a study has been peer reviewed does not mean that it is valid. There are certainly a lot of very poor studies that manage to find the way to publication.

    I think the important point is that one needs to evaluate every study, and judge it based on its scientific merits. Not merely on whether it has been peer-reviewed. Not merely based on the perceived character, affiliations, or friends of the authors. Not merely based on who may have quoted the author in the past. But based on the scientific merits of the article itself.

    This is why I find the science by press release approach to be so troublesome. Not because the study hasn’t been peer reviewed. But because the study is not made available for public review and scrutiny. If the authors were willing to put forward their article for public scrutiny, then I would have no problem with them issuing all the press releases that they want to. What’s inappropriate, in my view, is asking the media to carry your conclusions to the public but not being willing to share the data and reasoning upon which those conclusions are based. You are basically asking the public to blindly accept what you believe to be true. I don’t think we as scientists should be putting ourselves in that position.”

    This may be the justification for championing the study by David W. Kuneman and Michael J. McFadden.

  8. #8 Orac
    November 20, 2007

    I think it is important to point out that the mere fact that a study has been peer reviewed does not mean that it is valid. There are certainly a lot of very poor studies that manage to find the way to publication.

    I think the important point is that one needs to evaluate every study, and judge it based on its scientific merits. Not merely on whether it has been peer-reviewed. Not merely based on the perceived character, affiliations, or friends of the authors. Not merely based on who may have quoted the author in the past. But based on the scientific merits of the article itself.

    If Siegel is directing that response at my comment, it sounds like a straw man argument to me. I never claimed that peer review meant that a study is valid, nor did I say that we should pay more attention to institutional affiliations or whether or not a study has been peer reviewed over the content of the study. What I did say is that if a study fails to pass peer review, it’s a red flag. That’s it. It doesn’t mean that the study is bad (although it often is an indication, especially if there are repeated failures). As for Siegel’s comment about “science by press release,” that’s disingenuous at best. A lot of the studies he criticizes for that do ultimately show up in the peer reviewed literature.

    In any case, peer review is an important aspect of science; it serves as a quality check. It’s a messy, highly imperfect system whose imperfections I’ve blogged about before, but I’ve yet to see anyone propose a better one for vetting scientific reports. Consequently, from my point of view, it is quite reasonable to wonder why an article has failed to pass peer review. Kuneman and McFadden’s study may be the bee’s knees, epidemiologically speaking, but its failing peer review and their apparently not having resubmitted it to other journals do raise a red flag, and I don’t think it’s unreasonable to point that out. Nor do I think it’s unreasonable to ask Dr. Siegel, if he thinks the paper’s so great, why he didn’t offer to help Kuneman and McFadden get it published, either by helping them tune up the manuscript or by adding his name to it, given that he’s already stated that he helped verify their analysis.

    Here’s why it matters. One of the hallmarks of a crank is to cry “martyr!” or “persecution!” and then attack the peer review system for excluding his work. (Not for nothing is it said to beware the bashers of peer review.) Does that mean that anyone who complains about the peer review system is a crank? Of course not.As Dr. Siegel points out, even peer review doesn’t stop a lot of bad science from finding its way into publication in scientific journals. It’s not wrong to criticize known shortcomings of the system, although all too often such complaints are offered more because the system worked in excluding bad science. In any case, blithely dismissing the peer review system as in essence unimportant regarding “science by press release,” as Dr. Siegel has apparently done, is not a view I can agree with.

  9. #9 jre
    November 20, 2007

    As to his latest euphemism, junk science, you can only write “shoddy” so many times before it becomes a criminal offense.

    I imagine that’s meant to imply that Siegel’s choices of terms were limited, and thus his use of the phrase “junk science” was innocent in context. Not so. The language is rich, and there are many ways to criticize a study; ask anyone who has had a paper rejected in peer review.
    Siegel’s repeated use of the term “junk science” (I counted ten instances on that one page) puts him in the same rhetorical camp as Steven Milloy and Michael Fumento.
    Milloy and Fumento are, to put it simply and directly, liars. Siegel must be aware of this, yet he has chosen to use their stock phrase in an approving sense.
    He would be far better off to set his spell-checker to reject “junk science” anywhere it creeps in, forcing him to vary his language and be more specific about the details, and keeping him away from unsavory company.

  10. #10 Dan
    November 20, 2007

    Orac, the quote from Dr. Siegel was a response to a comment that a reader made on his blog and not to anything you said. I included his reply but without the context of the comment he was addressing. So he is not responding to you or complaiming you said anything. I posted it here because the last paragraph in the quote gives his justification for his own use of science by press release. The quote was taken from this thread:

    http://www.haloscan.com/comments/mbsiegel/1669195609291938494/

    In response to someone going be the name Michelle. In order words, Dr. Siegel is not even talking about anything you said or did not say. The comment are regarding his posting:

    http://tobaccoanalysis.blogspot.com/2007/11/new-study-concluding-that-heart-attacks.html

  11. #11 James Austin
    November 20, 2007

    jre wrote:
    “He would be far better off to set his spell-checker to reject “junk science” anywhere it creeps in, forcing him to vary his language”

    Maybe you have an approved list you can send him, subject to peer approval, of course.

    “and be more specific about the details”

    You make it sound like he writes, “This study is junk science. The End.” If anything, he doesn’t know when to shut up. LOL

  12. #12 jre
    November 20, 2007

    The meanings of words and phrases do not exist apart from the way they are used. The phrase “junk science” has been brought into disrepute by clowns like Milloy, and Dr. Siegel — unless he has been living in a cave — must know this. If Dr. Siegel uses the same rhetorical devices as cranks and shills, a large number of reasonable, but busy, people will assume he is a crank or a shill, and look no further. If he doesn’t mind that, it’s fine with me.

  13. #13 Christine
    November 20, 2007

    I’m admittedly a latecomer to this discussion, but I can tell you I’m heartened and hopeful that the discussion is taking place.

    I’m neither a doctor nor a scientist. I’m a member of the public who tries to decipher the bombardment of information regarding my health (and risks to it) on a daily basis. I can’t speak as to whether a study is junk or valid, I can only speak to the message. The overwhelming message coming from so many different factions in the health community is that our lifestyles, or at least, the lifestyles we ‘enjoy’ are killing us.

    I’m not saying that we shouldn’t attempt to lead healthier lives either, but getting back to ‘the message’, a healthier lifestyle doesn’t seem to be acceptable any more. We must lead ‘perfectly’ healthy lives.

    Common sense seems to have been removed from every aspect of the message regarding our health to be replaced with alarmist headlines and indicting rare and worst case scenarios. Statistics are spewed out like candy and the term, higher risk, has come to mean absolute certainty, at least in the minds of legislators.

    This is where it is most frightening and WHY it is so important for scientists and their studies to carry real weight reporting real risks. What is happening right now verges on irresponsible social engineering by some who believe we should lead our lives their way, and if we don’t or won’t take the advice well then, bans must be put in place.

    I actually fear for my son and his future and whether he will be able to choose to BBQ a steak, (I mention BBQ because of a study released citing all the toxins released or created during the process) or fry a steak; or even if he will be able to buy a steak in the future. (another study citing more than 500g of red meat per week increases the risk of heart disease).

    Please be responsible. Is the risk of contracting something the same as contracting it? Can we live totally risk free? Can we enjoy our lives without risk?

    It is to be hoped that forums such as this and others like it will have scientist waking up to the very detrimental affects their studies can have on our way of life when they are used by activists and policy makers.

    Thank you.

  14. #14 Deech56
    November 20, 2007

    RE Christine: You raise an interesting point in regards to studies on food and food preparation, and in fact many foods do contain compounds that can be toxic in large amounts (as part of a plant’s defense mechanism, for example). We have to eat, and our bodies seem to take care of a fair amount of “insult”, but the key is moderation. Few would argue that a 100% fast-food diet would not be risky, but maybe an occasional burger and fries will not lead to instant death.

    But it’s the context of the comment I wonder about. The subject is SHS, and unlike food there is no benefit for those of us who may be exposed to it. As far as the use of scientific studies, the important topics get the attention for a reason. I would rather have decisions based on a set of scientific studies than a hunch. It is the job of the scientific community to make sure the research is …um… sound, but I think it is also important to use results of the studies to form some kind of narrative to help guide people who are not in that field.

    I am a scientist, but outside of my fields of expertise I may not have much more knowledge than someone from the general public. The advantage I may have as a scientist is the ability to judge the messages put out by people who talk about science – who has credibility and who does not – based on how they use science.

  15. #15 ks
    November 20, 2007

    Christine,

    I agree with Deech in that the analogy of eating unhealthy food to SHS is not really valid… but for different reasons. When your son chooses to eat a BBQ’d steak, he is not forcing his decision on others around him. When someone smokes indoors, they do force that decision upon others around them in the form of SHS.

  16. #16 Christine
    November 20, 2007

    Deech56,
    Thanks for responding.

    I deliberately used food because that is the next battleground for health activists. It doesn’t matter whether I believe the studies regarding the dangers of SHS, the war was so well played that true or not, it has been, or will be in the future, pretty much banned everywhere.

    Most thought banning workplace smoking was a reasonable step, except, now reason and common sense seem to have been thrown out the window. Around the world varying proposals are in place, to remove children, have a national smokers registry, and even to have smokers put signs on the doors of their homes (to warn council/hospice workers of the potential risk of entering). How did something so simple get so out of control worldwide?

    Apart from a few skirmishes that war is over, and where does that leave a community determined to eradicate (insert your favourite disease here). There have already been rumblings backed up by studies. Obesity, is out of control, and by association, the food we eat. I expect the exact same tactics to be employed . Start with something simple, something most can agree on, like, ‘let’s ban trans fats’. No one can argue that one right?

    Then backed up by scientific studies, spouting ever escalating risk factors the line will be moved again and again and sweeping bans will be put in place. Will it come to the point that mother’s baking cookies for their children will be under threat of having their children removed because they are feeding them ‘junk’?

    You may scoff at something so radical, but who would have thought 5 years ago that a no smoking ban in the workplace would result in parents being threatened with the loss of their children?

    Scientists need to get back in touch with acceptable risk instead of gleefully releasing studies that show ( I could use SHS but let’s stick with food) people who eat red meat are at XX% greater risk of heart disease. I don’t even know what that really means, and most lay people don’t, but it sounds bad doesn’t it?

    So to me it’s all junk science when the risks presented don’t match what I can observe in the people around me.

    Thank you though, it’s really refreshing to have the opportunity to discuss my concerns in a forum that is attended by the very community I’m concerned about.

  17. #17 HCN
    November 21, 2007

    I’ve been ignoring most of the messages here. I don’t care whether second hand smoke causes illnesses like cancer. I do care that it makes me sick to my stomach (oh, and that I have the allergy skin test to show that I am allergic to nicotine as evidence!).

    Back in the “good ol’ days” when smoking was allowed everywhere I had to work in a bullpen where one woman would smoke her cigarette down to the filter. If the smoke from tobacco wasn’t bad enough, the burning plastic would make your stomach turn. There was one guy who hated the stuff and would occasionally wear a gas mask to shield himself foul stuff.

    Then the company decided it would go smoke free. Hurray!!!

    Though some did not quite understand that one of the main reasons was because of the stink. I remember one time while walking down the hallway that a guy entered in front of me. There was a stream of smoke trailing behind him, along with a noticeable stench. He was trying to hide his lit cigarette in his hand. I asked him “Are you so daft as to not think anyone could smell that?”.

    Then I got pregnant. It turns out the slightest hint of a foul odor could make me retch. I am so glad that I did not have to smell the stench of cigarette (or the that fool woman’s filter) smoke!

    Who cares about heart disease?! Do you really want my lunch in your lap?

  18. #18 Michael Siegel
    November 21, 2007

    Orac,
    Thanks for highlighting this important issue. And thanks also for keeping an open mind about me, and being willing to re-think your position based on changing information, inclding Revere’s post. To me, that is the hallmark of a great scientist – being willing to re-think past positions as new information is uncovered. At any rate, I am grateful to you for your willingness to do this.

    I thought it might help if I address what I see as your 2 main reservations regarding me (my use of color is something that readers will just have to live with – I simply cannot resist that urge).

    The first thing that seems to trouble you is my “championing” of a study by McFadden and Kuneman. The trouble seems to be that the study has not been published and that it is authored by two smokers’ rights activists. I guess my reaction to this is that it should really be the scientific merit of research that serves the primary basis for our judgment, not the affiliations of the authors. Just because the authors happen to be smokers’ rights activists does not seem to be a sufficient reason to reject the research outright. I would also argue that the mere fact that a paper has not been published does not mean that the science is not valid. I have a number of (what I think are) excellent papers which have not been published. There are factors that affect publication that go beyond just scientific merit. In fact, as you know, many of the most important principles and standards in medical practice come not from published science, but from pearls of wisdom that are passed on from one generation of doctors to the next.

    The point is – I have conducted my own analysis of the McFadden and Kuneman study on my own, and I have made my own assessment of its scientific merits. Regardless of the fact that the authors are smokers’ rights activists, I cannot hide the fact that this data set provides important and useful information. If it is true, as claimed in the Helena and other studies, that smoking bans result in an immediate drop in heart attacks on the order of 40%, then one should be able to see this decline in population-based data, such as the HCUP data at the state level. The fact that the HCUP data do not show such a reduction in heart attacks really does cast the conclusions of Helena into doubt. I don’t see why we should reject the value of these data simply because they were compiled by smokers’ rights advocates. I actually hand-checked all the numbers myself and found the same result. I stand by the importance of that work not because I am trying to champion smokers’ rights, but because I truly believe that the results have scientific merit. If I am championing anything, it is what I see as scientifically meritorious information – data that adds substantively and meaningfully to the discussion about this interesting analytic question.

    The second thing that seems to trouble you is that I seem to be exaggerating or overstating the lack of scientific integrity in the tobacco control movement. I can certainly understand why one would get that impression. But I cannot stress to you enough the kind of inside knowledge I have of the movement. After 21 years, I know all the key players and how the movement operates. I have insights that are not available to most people outside of the movement. I have seen exactly how the misrepresentation of the science has occurred, and I can tell you that I am in fact under-stating the case.

    You seem to agree with me that the statement made by ASH is inaccurate (and absurd). Yet the same type of inaccurate statements are being made by over 100 anti-smoking groups (as I have documented on my blog). In the light of the widespread misrepresentation of the science by these anti-smoking groups, I’m not sure that it is an over-statement to suggest that the scientific integrity of the movement is in doubt. In fact, I believe that I have been quite careful to under-state the case.

    If it were just one organization, then I would accept your contention that I’m exaggerating. How can you take one exaggeration by one organization and claim that the movement has lost its scientific integrity? You can’t – I would agree with you.

    But when it’s over 100 organizations doing this, I find it hard to argue that it’s just 100 isolated and excusable examples of scientific misrepresentation and that we can just overlook it and conclude that the movement is full of scientific integrity, except for 100 of its organizations.

    If you accept that ASH has not demonstrated scientific integrity in misrepresenting what the CDC has stated about the acute cardiovascular effects of secondhand smoke (which you appear to do), then I would ask you to multiply that by 100 similar organizations. What does that leave you with? To me, a movement that is losing its scientific integrity. I don’t see any way to avoid that conclusion. At any rate, I don’t see it as an exaggeration to suggest that when over 100 organizations are making claims that are outright absurd (on their face), one can question the scientific integrity of those groups as a whole.

    As far as my use of the term “junk science,” you are right in that I chose the term intentionally. I chose that term specifically BECAUSE everyone in the tobacco control movement complains about junk science by the opposition all the time. By showing the movement that we are in fact doing the exact same thing (albeit for a good purpose), it demonstrates that we must stand far from scientific reproach. In other words, it is specifically BECAUSE we are criticizing OTHERS for junk science that it makes it all the worse that we are now using shoddy science. I think it brings us to a higher standard, because we have accused others of misrepresenting the science and have criticized them for doing so.

    Two final points. One is that I have not downplayed the importance of the peer review system. In fact, by criticizing the science by press release approach, I am in fact upholding the importance of the peer review process. I’m not sure where that impression came from, but it is not correct.

    Second is that while I can understand your surprise not to see any posts specifically on “good science” and the health effects of secondhand smoke, you have to understand that is not the purpose of the blog. I have spent 21 years of my career doing nothing other than that. I have published more than 60 scientific papers, testified at over 100 public hearings, given scores of media interviews, and testified in 7 tobacco trials, ALL in ways that have played a substantial role in educating the public about the hazards of secondhand smoke exposure and active smoking and the need to pass smoking bans as well as strong tobacco control policies and to hold the tobacco companies accountable. After 21 years of doing that, my blog is simply an attempt to provide the “rest” of the story.

    Admittedly, when you read just the “rest” of the story, you get a skewed impression of my overall contributions to the field of tobacco control. And I don’t blame anyone for coming to that impression. But it’s not really an accurate one.

    As any tobacco company lawyer will tell you, I’m the absolute last person in the world the companies would want showing up in the courtroom to testify against them. Even more so now that I have written in a way to show some balance and some objectivity.

  19. #19 Michael Siegel
    November 21, 2007

    Orac,
    Thanks for highlighting this important issue. And thanks also for keeping an open mind about me, and being willing to re-think your position based on changing information, inclding Revere’s post. To me, that is the hallmark of a great scientist – being willing to re-think past positions as new information is uncovered. At any rate, I am grateful to you for your willingness to do this.

    I thought it might help if I address what I see as your 2 main reservations regarding me (my use of color is something that readers will just have to live with – I simply cannot resist that urge).

    The first thing that seems to trouble you is my “championing” of a study by McFadden and Kuneman. The trouble seems to be that the study has not been published and that it is authored by two smokers’ rights activists. I guess my reaction to this is that it should really be the scientific merit of research that serves the primary basis for our judgment, not the affiliations of the authors. Just because the authors happen to be smokers’ rights activists does not seem to be a sufficient reason to reject the research outright. I would also argue that the mere fact that a paper has not been published does not mean that the science is not valid. I have a number of (what I think are) excellent papers which have not been published. There are factors that affect publication that go beyond just scientific merit. In fact, as you know, many of the most important principles and standards in medical practice come not from published science, but from pearls of wisdom that are passed on from one generation of doctors to the next.

    The point is – I have conducted my own analysis of the McFadden and Kuneman study on my own, and I have made my own assessment of its scientific merits. Regardless of the fact that the authors are smokers’ rights activists, I cannot hide the fact that this data set provides important and useful information. If it is true, as claimed in the Helena and other studies, that smoking bans result in an immediate drop in heart attacks on the order of 40%, then one should be able to see this decline in population-based data, such as the HCUP data at the state level. The fact that the HCUP data do not show such a reduction in heart attacks really does cast the conclusions of Helena into doubt. I don’t see why we should reject the value of these data simply because they were compiled by smokers’ rights advocates. I actually hand-checked all the numbers myself and found the same result. I stand by the importance of that work not because I am trying to champion smokers’ rights, but because I truly believe that the results have scientific merit. If I am championing anything, it is what I see as scientifically meritorious information – data that adds substantively and meaningfully to the discussion about this interesting analytic question.

    The second thing that seems to trouble you is that I seem to be exaggerating or overstating the lack of scientific integrity in the tobacco control movement. I can certainly understand why one would get that impression. But I cannot stress to you enough the kind of inside knowledge I have of the movement. After 21 years, I know all the key players and how the movement operates. I have insights that are not available to most people outside of the movement. I have seen exactly how the misrepresentation of the science has occurred, and I can tell you that I am in fact under-stating the case.

    You seem to agree with me that the statement made by ASH is inaccurate (and absurd). Yet the same type of inaccurate statements are being made by over 100 anti-smoking groups (as I have documented on my blog). In the light of the widespread misrepresentation of the science by these anti-smoking groups, I’m not sure that it is an over-statement to suggest that the scientific integrity of the movement is in doubt. In fact, I believe that I have been quite careful to under-state the case.

    If it were just one organization, then I would accept your contention that I’m exaggerating. How can you take one exaggeration by one organization and claim that the movement has lost its scientific integrity? You can’t – I would agree with you.

    But when it’s over 100 organizations doing this, I find it hard to argue that it’s just 100 isolated and excusable examples of scientific misrepresentation and that we can just overlook it and conclude that the movement is full of scientific integrity, except for 100 of its organizations.

    If you accept that ASH has not demonstrated scientific integrity in misrepresenting what the CDC has stated about the acute cardiovascular effects of secondhand smoke (which you appear to do), then I would ask you to multiply that by 100 similar organizations. What does that leave you with? To me, a movement that is losing its scientific integrity. I don’t see any way to avoid that conclusion. At any rate, I don’t see it as an exaggeration to suggest that when over 100 organizations are making claims that are outright absurd (on their face), one can question the scientific integrity of those groups as a whole.

    As far as my use of the term “junk science,” you are right in that I chose the term intentionally. I chose that term specifically BECAUSE everyone in the tobacco control movement complains about junk science by the opposition all the time. By showing the movement that we are in fact doing the exact same thing (albeit for a good purpose), it demonstrates that we must stand far from scientific reproach. In other words, it is specifically BECAUSE we are criticizing OTHERS for junk science that it makes it all the worse that we are now using shoddy science. I think it brings us to a higher standard, because we have accused others of misrepresenting the science and have criticized them for doing so.

    Two final points. One is that I have not downplayed the importance of the peer review system. In fact, by criticizing the science by press release approach, I am in fact upholding the importance of the peer review process. I’m not sure where that impression came from, but it is not correct.

    Second is that while I can understand your surprise not to see any posts specifically on “good science” and the health effects of secondhand smoke, you have to understand that is not the purpose of the blog. I have spent 21 years of my career doing nothing other than that. I have published more than 60 scientific papers, testified at over 100 public hearings, given scores of media interviews, and testified in 7 tobacco trials, ALL in ways that have played a substantial role in educating the public about the hazards of secondhand smoke exposure and active smoking and the need to pass smoking bans as well as strong tobacco control policies and to hold the tobacco companies accountable. After 21 years of doing that, my blog is simply an attempt to provide the “rest” of the story.

    Admittedly, when you read just the “rest” of the story, you get a skewed impression of my overall contributions to the field of tobacco control. And I don’t blame anyone for coming to that impression. But it’s not really an accurate one.

    As any tobacco company lawyer will tell you, I’m the absolute last person in the world the companies would want showing up in the courtroom to testify against them. Even more so now that I have written in a way to show some balance and some objectivity.

    Finally, I thank you again – both for highlighting this important issue and for having an open mind, and for your willingness to re-assess your position.

  20. #20 MattXIV
    November 21, 2007

    Orac,

    I’m pretty disappointed with the quickness with which you’re willing to break out the “crank” label not over actual bad science, but over rhetorical similarities to people who frequently misrepresent science. You seem to be sliding into the intellectually lazy practice of painting people who disagree with you as “denialists” who should be dimissed out of hand.

    For example, while Siegel doesn’t fall into the “smoker’s rights” camp, would it diminish the validity of his critiques of misrepresentations of the data on the effects of second hand smoke? And as Siegel has documented, there has defintely been a great deal of misrepresentation regarding the cardivovascular risks of SHS – should we be reflexively dimissive of anybody who mentions these effects?

    The “Denialism” approach seems to be infecting “skeptic” blogs and it isn’t having a saluatory impact. Not only is it intellectually lazy, it’s an ad hominen approach in the truest meaning of the expression, in that it shifts the focus from the validity of an argument to who is making it. Even to the extent that it is a useful heuristic for determining who to trust, it sheds no light on the underlying issue, which is almost always more important than the rhetorical manipulations surrounding it. The actual extent of CV risk due to second hand smoke is a lot more important of an issue than whether one can say “junk science” in polite company.

  21. #21 Orac
    November 21, 2007

    I’m pretty disappointed with the quickness with which you’re willing to break out the “crank” label not over actual bad science, but over rhetorical similarities to people who frequently misrepresent science.

    So you’re disappointed. Big deal. You’ll get over it.

    While I’m grateful that Dr. Siegel was nice enough to comment and most of his points are well-taken, you’re batting about a rather obvious straw man. No, I did not call Siegel a crank. I said his rhetoric often lapses into sounding “crank-like,” an impression fed in particular by his frequent use of the term “junk science.” There’s a difference. And then I explained why his use of the term bothered me. Another straw man is your characterization of my position that we should be “reflexively dismissive of anybody who mentions these effects.” Where did I say that?

    Nowhere, that’s where.

    When someone like Dr. Siegel frequently uses a term beloved of pseudoskeptics and defenders of corporate misrepresentations of science like Steve Milloy and Michael Fumento, a term that is favored by propagandists rather than scientists, it is jarring to me. It is a big deal, and, not unreasonably, it makes me wonder about the person using the term. It’s not as if Siegel used it only once or twice. If that were the case, it wouldn’t have stood out so much, and I wouldn’t have mentioned it. As jre put it earlier in the comments:

    The meanings of words and phrases do not exist apart from the way they are used. The phrase “junk science” has been brought into disrepute by clowns like Milloy, and Dr. Siegel — unless he has been living in a cave — must know this. If Dr. Siegel uses the same rhetorical devices as cranks and shills, a large number of reasonable, but busy, people will assume he is a crank or a shill, and look no further.

    To anyone who knows anything about how the term “junk science” has been appropriated for use as a cudgel by propagandists like Milloy and Fumento, hearing it used over and over again brings up unpleasant associations, associations that do not reflect well on the person using the term. This is especially true in the case of Milloy, where the tobacco industry itself helped to create the “Junkman,” as he likes to call himself. Once again, Dr. Siegel’s arguments could be pristine, but he gives the impression that they are not by utilizing such sloppy and lazy terms. Why shouldn’t I take him to task for that?

    Also in the same link is a good explanation why the term “junk science” is so loaded and reflects so poorly on those who like to use it:

    In 1999, University of Pennsylvania professor Edward S. Herman surveyed 258 articles in mainstream newspapers that used the term “junk science” during the years 1996 through 1998. Only 8 percent of the articles used the term in reference to corporate-manipulated science. By contrast, 62 percent used the term “junk science” in reference to scientific arguments used by environmentalists, other corporate critics, or personal-injury lawyers engaged in suing corporations.

    “What’s starting to happen is that this term, ‘junk science,’ is being thrown around all the time,” says Lucinda Finley, a law professor from the State University of New York at Buffalo who specializes in product liability and women’s health. “People are calling scientists who disagree with them purveyors of ‘junk.’ But what we’re really talking about is a very normal process of scientific disagreement and give-and-take. Calling someone a ‘junk scientist’ is just a way of shutting them up.”

    Exactly, which is why Siegel’s frequent use of the term dating back a year and a half disturbs me so much.

    The use of the term “junk science” as a propaganda weapon on the part of forces arrayed against environmentalists and health advocates, including the tobacco industry itself, is not a new story, either. Dr. Siegel must know this, given his area of academic interest. Perhaps he’s ironically appropriating the term from the tobacco industry, but if that’s the case it makes him look even worse. So, while I realize that in general he’s on the side of the angels and even accept that he may have had what he views as legitimate reasons for championing the Kuneman and McFadden study, on his blog, through his ill-advised use of Milloy- and Fumento-like rhetoric, he sure does give the impression otherwise.

    As for your complaint that “actual extent of CV risk due to second hand smoke is a lot more important of an issue than whether one can say ‘junk science’ in polite company.” I agree, which is why I really wish Dr. Siegel didn’t use a loaded term that makes him appear to be like Fumento or Milloy when he clearly is not. Language matters, and Siegel greatly weakens his argument by using terms that leave that impression of him.

  22. #22 Dan
    November 21, 2007

    Orac, I was going to respond in a detailed manner to your post, but decided not to because I still can not figure out how to do your fancy quotes (tabbed) or embedded links on this blog. I am still fairly new to the blog world and if you could point to instructions on how to post that would be great including indented quotes, embedded links, etc. But to make things short, I too do not understand your objection with the term “junk science” as I see it appropriate for much a read in the press and I believe it applies to much of the information tobacco control puts out. I guess I to was living in a cave because I have no idea who Milloy and Fumento are. If you can point to instruction on how to do a decent looking post like yours, I would be happy to try and make a better argument without having to embarrass myself at my lack of blogging skills. Then you are more then welcome to shout it down. As Dr. Siegel, pointed out, he was a member of the cabal and a student of Dr. Stanton Glantz (a mechanical engineer who holds the title professor of medicine, cardiology). I keep warning that the tactics used by tobacco control are undermining the entire medical scientific community. The links I provided in a previous post and reposted on revere’s blog should give a good start as to what is going on.

  23. #23 Orac
    November 21, 2007

    You don’t know who Michael Fumento and Steve Milloy are? Well, that’s not my fault, is it? I’ll do what I can to educate you.

    They’re only two of the most famous defenders of corporate science out there. They’re ideologues who twist science to fit their political viewpoint, which generally involves disparaging anything that smacks of a liberal cause and defending anything that casts big business in a good light. I say this as probably the most politically conservative (or at least one of the two or three), too. They’ve been written about extensively on ScienceBlogs:

    1. Steve Milloy
    2. Michael Fumento
  24. #24 Dan
    November 21, 2007

    Ok, I accept that they are cranks. Now if you could point out how to do the quotes or embedded links, that would be great. Then we could butt heads without me looking completely silly. You will probably win as I am a notoriously bad writer, but I am bilingual. Still the term ‘junk science’ does not invoke a crank label from me.

  25. #25 MattXIV
    November 21, 2007

    Orac,

    Given that you belabor the “crank-like” rhetoric point in order to cast doubt on Siegel’s positions irrespective of their content, I don’t think it’s unfair to characterise your position as being reflexively dismissive in response to the rhetoric and to say that you’re using the label “crank” as an indicator of rheorical style rather than factual inaccuracy.

    As for

    Another straw man is your characterization of my position that we should be “reflexively dismissive of anybody who mentions these effects.” Where did I say that? Nowhere, that’s where.

    That quote is from a counter example where I’m obviously not attributing a position to you since I’m citing it as a position that you don’t hold that would be consistent with the line of reasoning you’re using. I think you’re simply misreading me, but if deliberate this would be more of a strawman than anything you’ve attributed to me.

    And your last point sounds like a concern troll – you say Siegel shouldn’t use the term because it is associated with Milloy and Fumento, but you’re the one making a big deal out of the association and using it to question Siegel’s credibility. As the study you cite shows, it is frequently but NOT exclusively used by people like Milloy and Fumento – 38% of the usage was not characterised as being a defense of industry. “Junk science” is a loaded term, but its quite a jump to its usage as a reliable indicator that someone is shilling for industry.

    Which is all a distraction from my main point, which is that using patterns of rhetoric as a heuristic is not a sound way to establish who is credible on an issue; I think Siegel’s case is a good example of precisely why it isn’t.

  26. #26 Michael Siegel
    November 21, 2007

    I actually started using the term “junk science” in my own discourse far more than 2 years ago. I started using the term specifically IN ORDER to fight the tobacco industry with their own medicine. I used the term repeatedly in the courtroom to refer to tobacco industry-funded studies which were designed to undermine the public’s appreciation of the hazards of smoking and secondhand smoke.

    While I understand Orac’s concern about the use of the term, and I in no way fault him for coming to the conclusion he did about me (and I admit – I opened myself up for that by using the term – yes, mea culpa), I do have to say that in my opinion, the best way to destroy the use of that term as an instrument of corporate front groups is to use it against those groups. In fact, I think the more WE in public health use the term, the more we diffuse its associated meaning.

    We can either sit idly by and let the corporate front groups have ownership of the term, or we can fight them with their own medicine, use the term ourself, and destroy the use of that term as a technique to undermine public health science.

    I have consciously chosen to use the term (originally as a tactic in my testimony against the tobacco industry, and more recently as a way of reminding anti-smoking groups that we are now doing exactly the same thing that we have repeatedly criticized tobacco front groups of doing).

    While I think Orac is precisely correct and my use of that term will automatically lead many people to reject me, I am looking more broadly and trying to destroy the connotations of that term. If I can succeed, eventually, in being able to use the term and still make my points, then I will have accomplished far more than merely point out that particular pieces of science are shoddy.

    But despite all of this, I understand where Orac is coming from, I accept the criticism, and I take it to heart.

  27. #27 Michael Siegel
    November 21, 2007

    One example of how I have used corporate front group terminology successfully to undermine the use of those very terms is by repeatedly using the term “cherrypicking” in my tobacco testimony. This is a term specifically coined by tobacco front groups to refer to what they claim is singling out particular studies which demonstrate health effects of secondhand smoke while ignoring other studies which don’t. Of course, our conclusions were based on the totality of the evidence, not on one particular study.

    But I started using the term in my testimony to refer to tobacco industry propaganda in which the companies would hone in on one particular study which may have failed to find a statistically significant increase in disease risk associated with secondhand smoke exposure.

    By using the term repeatedly, I was not only able to attack the industry effectively in front of the jury, but I was also able to essentially destroy the industry’s ability to use that term to effect with the jury.

    I guess I see the public now as the “jury,” and I feel that if we can take the term “junk science” out of the sole ownership of the corporate fronts, then we can undermine their use of that tactic.

  28. #28 Orac
    November 21, 2007

    We can either sit idly by and let the corporate front groups have ownership of the term, or we can fight them with their own medicine, use the term ourself, and destroy the use of that term as a technique to undermine public health science.

    And using the term “junk science” against the very same sorts of groups that the tobacco industry used to use the term against (i.e., tobacco control advocates) helps us take back ownership of term exactly…how?

    You see where I’m going, don’t you? By using the term against the same sorts of groups that industry used to use it against, you’re not taking back ownership of the term. Indeed, at the worst you may even be helping to cement the connotation that it already has. After all, if someone like you throws the term “junk science” at tobacco control groups, then by comparison you make Milloy and Fumento seem more reasonable when they do it. Think about it. Your use of the term, I would argue, is harmful to your cause.

  29. #29 Dan
    November 21, 2007

    And using the term “junk science” against the very same sorts of groups that the tobacco industry used to use the term against (i.e., tobacco control advocates) helps us take back ownership of term exactly…how?

    It does not. Ok, I figured the blockquote now. But tobacco control has stooped to the same level that the tobacco companies are accused of using. It fact the tobacco now has the high ground. The best example I can give is Dr. Stanton Glantz and his TobaccoScam web site. As you know he is the author of the Helena study which Dr. Siegel critiqued. He also runs a web site that advocates R ratings for movies depicting smoking. He may also be affiliated with the web site that makes the claim that smoking kills about 340 young people a day (scroll to bottom and look left) for which Dr. Siegel has taken them to task. He also run a Listserve that can be found here and by examining that site you can see the misinformation here spreads. This post is practice to see if I can get the HTML right and then provide a better post on how tobacco control is undermining the medical sciences. However, before I was not aware of your context for the term “junk science” but for me the shoe fits. Apologies for the crappy post as all the formatting got in the way of good English.

  30. #30 Dan
    November 21, 2007

    One further comment. Since you are hung up on the “junk science” term, but like the term “crank”. Would the term “crank science” be more acceptable?

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