Carl V Phillips is a scientific researcher who works in tobacco harm reduction — THR — which encourages smokers to move to other avenues of nicotine intake, e.g. smokeless tobacco and e-cigarettes.

Whilst he believes that smoking is harmful, he also takes issue with government bodies and some Tobacco Control individuals in this regard.

Phillips and fellow researcher Elaine Keller run a blog called Anti-THR Lie of the Day, which does what it says on the tin. It exposes untruths and sloppy science in Tobacco Control.

On September 16, 2012, Phillips addressed what lurks behind a commonly-used term thrown around with abandon in Lifestyle Control. This is ‘conflict of interest’, or COI.

In ‘What is conflict of interest?’ Phillips introduces the topic then goes on to say (emphases mine):

By now you have probably noticed the lack of any mention of funding in all of this.  That is because — contrary to the common naive view — funding is not COI. This is perhaps the most important thing to understand about COI:  It is about preference or belief — and willingness to act on those preferences when it is unethical to do so — not about what motivates someone to those actions.

Receiving funding from an entity with an interest in THR is neither a necessary nor sufficient condition for having a COI.  The relationship of funding to COI is very similar to the relationship between toxicology and real world outcomes that I discussed before:  Funding is one possible explanation for why someone might have a COI, but it is not the COI.  The COI is the motivation to get a particular result from research or to communicate particular claims apart from their truth, no matter what the motive.

… It might be that funding has some influence at the margin, but I lived in that world long enough to know that funding generally chases true believers, rather than creating them.

… Someone who invented a product obviously should not be the one we trust to do the research on whether it works.  Employees of anti-THR organizations like, say, the American Cancer Society or most units of the US government, would probably suffer serious consequences if they told the truth about THR.  Such individuals have such extreme COI that if they wanted to try to be honest scientists, they would need to go to great lengths — making sure their work was extremely transparent, thoroughly reviewed by anyone who wants to review it, etc.

For an example of that, consider the scientific research that comes out of BAT.  The researchers there know that they have a clear COI because of their employment status, but are intent on doing honest research that contributes to our understanding of the health impacts of tobacco products (THR and otherwise), and having it taken seriously.  (I can testify to these motives based on extensive communication with many of them; this contrasts with those who casually make declarations about people’s motives with neither material evidence nor any familiarity with the people in question.)  Knowing that they have to deal with that COI, the researchers openly share their research to the extent possible and are very conservative in their conclusions.  Contrast that with most research from anti-THR organizations and individuals that is secretive, never seriously reviewed, and overstated.

Notice also that I mentioned the US government.  As noted in yesterday’s post, and as will become further apparent from future posts, the US government is and has been the most aggressive anti-THR liar in the world.  The EU government and the UN are similarly anti-THR and similarly dishonest.  So if funding were tantamount to COI, then anyone receiving funds from the US government or most other large governments or quasi-governments would have a COI.  Indeed, it is rather more likely that a government would cut off someone’s funding for taking the “wrong” position than would a pharmaceutical or tobacco company.  Governments and their puppets and puppet masters are all about politics, after all, while manufacturers have a real stake in good science, and are generally capable of distinguishing between someone’s scientific contribution and their political views.

In another post, he explores this at length:

As a first foray into that, I will address the testimony of US Surgeon General Richard Carmona before the a House of Representatives subcommittee hearing on smokeless tobacco in 2003.  That is the one that came up in a recent post because it was used as an especially stupid source citation.

The US government was the dominant anti-THR liar when I first started documenting anti-THR lies a decade ago, and they currently hold that position.  The United Nations might or might not have edged them out for a while during the years in between, but the FDA has put them solidly in the lead again.  Long before the lies about e-cigarette chemistry research from FDA, Samet, at al. became the most-cited anti-THR lie, it was Carmona lying about smokeless tobacco

Not that Carmona’s opinion was expert.  Far from it.  The core claim was:

No matter what you may hear today or read in press reports later, I cannot conclude that the use of any tobacco product is a safer alternative to smoking.

Someone really has to be clueless to make a claim like this.  Even the preamble clause is an embarrassment, saying, “no matter what evidence I hear, my conclusion will not change”.  But deadly lie is the rest.

It is rather difficult to believe that Carmona was actually so stupid as to believe that smokeless tobacco was not less harmful than cigarettes.  Realizing the truth did not take an expert, a genius, or even education about health science (and you might expect a Surgeon General testifying about a topic to have one or two of those characteristics).  Someone just had to know enough to reason, “let’s see: about half of the deaths from smoking are from lung diseases, and no one claims that smokeless tobacco causes any measurable risk for those; the only claim anyone ever makes about smokeless tobacco causing more risk than smoking is for oral cancer, and that would be in the order of 1% of the total risk worst case”.  A bit of grade school arithmetic will then get you to “I can conclude the use of smokeless tobacco is safer than smoking.”

As it turns out, there was already ample evidence and expert assessment that the risk was in the low-single-digit percent range compared to smoking.  There was already clear evidence that the hypothetical oral cancer risk did not exist to a measurable degree.  Indeed, there was (and is) no disease for which any measurable risk had been demonstrated for popular Western forms of smokeless tobacco.  Someone who knew the science would not have to resort to the rough-cut reasoning I proposed.  Still, even someone with only rudimentary knowledge of maths and the subject matter could use that reasoning to figure out that the risk was lower than for smoking.

There is more at the link. The issue is that many of us blindly believe what the government says — whether in the US or elsewhere — about health. Health has always been a hot-button issue, just as it was in Jesus’s time with the tens of thousands of people who flocked to Him for healing and not much else. And throughout history when people relied on barbers to bleed them up through to the present day.

And nothing, sadly, is a greater health bugbear than smoking.

Phillips makes an excellent point about Carmona’s testimony in his conclusion. It should make us sceptical about government health policies. Remember the year is 2003:

This is another great example of the conjunction lie I noted previously — he could have said “…by smoking or other forms of tobacco use or gazing upon my face and turning to stone”, and it would still be accurate.  He was using word games to imply that some nontrivial part of that figure cited was the toll from smokeless tobacco.  Indeed, that figure was the official estimated toll from smoking alone, so he was actually saying that neither smokeless tobacco nor his gorgon-like powers were killing anyone.  That is a bit of accidental truth that is conveniently overlooked by the anti-THR liars who still quote this national embarrassment to this day.

It is difficult to not be reminded of another bit of testimony from the same year from another cabinet-level official, Colin Powell insisting that Iraq had weapons of mass destruction.  In later years, Powell has expressed serious regret and apology for making that claim, and it basically cost him his legacy as a respected statesman, though he deserves a lot of credit for the apology.  But whatever one thinks of Powell and the war, the key observation is this:  Who would be stupid enough, years later, to quote Powell’s testimony and say, “this testimony is evidence that there were WMDs in Iraq”?  And yet that is equivalent to what the anti-THR liars are doing when they quote Carmona’s embarrassing and false testimony a decade later.

It seems curious that we accuse politicians and other officials of obfuscation in every aspect except health.

Let’s take time to research and get the facts first.

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