A doctor writes: erroneous data "unforgivable" but message "sound"
Wednesday, November 23, 2011 at 15:05 Further to Brian Monteith's article in the Scotsman on Monday, Brian received this response from a former GP:
I fully appreciate the content of your article: the use of unchecked and erroneous data by those apparently representing all doctors is unforgivable; indeed a public retraction for the use of this would not be out of order. However, the principle behind the thinking is reasonable to many people. Tobacco smoke in a confined space will be more hazardous to all exposed to it than in the open air, where the concentration is much diluted. Just use your common sense. YOU may choose to expose yourself to your own cigar smoke, but would others have the same choice?
As a former GP, I find the generalization that one cannot trust doctors is particularly worrying. It may sell papers, but it does terrible damage to the doctor-patient relationship which HAS to be based on real trust. I have no idea whether you have had personal experience of significant ill-health or not, but I do know from the feedback which my patients gave me, that trust was very important to supporting them through difficult times.
I don't expect to see any apology for your damaging piece in the Scotsman as I'm sure you stand by every word. Whilst the BMA's pronouncement is based on erroneous data, the sentiment behind the health prevention message is sound. Perhaps you should think longer and harder about the effect YOUR message has on real people's health care.
There are two conclusions to be drawn from this. One, the end justifies the means. The erroneous data may be "unforgivable" but the underlying health message is "sound" so let's not worry about a few facts and figures.
Two, let's shoot the messenger. If anyone is to blame for damaging the doctor-patient relationship, I suggest it's the British Medical Association and no-one else.
If the media is to be criticised it's for accepting at face value the word of the BMA and fellow travellers like ASH. In future, perhaps, reporters, especially health correspondents, will think twice before they publish garbage statistics and other junk science.
If that were to happen some good will come out of all this. I'm not holding my breath, though.
Reader Comments (17)
Here is a message for the worried GP
I don't trust you, you are a liar, you are a muppet, I don't trust you.
I don't trust you, I am a an ordinary person, with no influential friends, I don't trust you. You happily repeat lies and propaganda. I don't trust you.
I don't trust you, you hate me. I paid for your education, I pay for your elevated position in our society. You keep trying to take control of my life, I don't trust you.
Which bit of take your personal opinion and shove it up your ar*e don't you understand?
What is most damaging is that people are now wary of admitting drinking and smoking to their GP in case medical treatment is refused. I registered with a GP recently and refused to comment when the nurse asked me if I smoked. She fully understood where I was coming from and didn't mind. She's probably getting used to it. Does the doctor not realise this? Even more serious is that people with mental health problems might steer clear of hospitalisation because of the smoking ban.
The doctor doesn't address the fact that the proposal is to ban smoking in all cars - not just those carrying children, so his concerns about health are not as relevant as he thinks..
I am sorry Mr. GP but in science and doctors we expect objectivity. One of the points that Nobel Prize winning Austrian School economist the late Freidrich Von Hayek outlined in his 1944 book 'The Road To Surfdom' was the debasement of science for political ends. The Road To Surfdom was written when state control both fascist and communist was all pervasive and documents the descent into tyranny, slice by slice. I think we all know the quote from the late Dir George Godber peaking at the United Nations the the UK Chief Medical Oficer said in 1975 ("..foster an atmosphere where it was perceived that active smokers would injure those around them, especially their family and infants or young children who would be exposed involuntarily to the smoke in the air." It was not until 1982 that the first study was published and ever since there has been a concerted effort to twist the facts to meet the political ends.
http://iarnuocon.newsvine.com/_news/2007/10/17/1028570-secondhand-smoke-mirrors
"Godber recollected that he had said in 1962 to Keith Joseph, another of his Conservative ministers, that "we really have to do something about abolishing smoking" (having won the approval of the Health Minister Enoch Powell).
Joseph looked quite shocked and said: "You really can't expect to abolish smoking."
Godber replied: "No, but I want to see it reduced to an activity of consenting adults in private."
http://www.independent.co.uk/news/obituaries/sir-george-godber-governments-chief-medical-officer-who-helped-to-establish-the-fledgling-national-health-service-1607201.html
"Tobacco smoke in a confined space will be more hazardous to all exposed to it than in the open air, where the concentration is much diluted.
Just use your common sense. "
Bullcrap!!!
Common sense is NOT informed reasoning.
The BMA's statement was about Pm2.5 and the levels they found were only a small part of what the US govt says are permmissible exposure levels.
US govt says that urban air contains as much airborne arsenic per cubic meter as is found in all the smoke from the average cigarette.
Common sense would tell you NOT to breathe urban air?
Studies-about 3rd hand smoke- have found that never-smoker's homes have about 40% of the airborne nicotine that is found in the homes of smokers that do not go outside to smoke.
Common sense would tell you that the only reason people breathe that air is because they are addicted to the nicotine that is in it?
23 x 0, = 0.
11 x 0, still = 0.
What's to understand?
If the soundness of the message is based on evidence that turns out to be erroneous then the soundnesss of the message is compromised and I woudln't trust any doctor who still thought that it wasn't.
"the use of unchecked and erroneous data by those apparently representing all doctors is unforgivable"
followed almost immediately by
"Tobacco smoke in a confined space will be more hazardous to all exposed to it than in the open air, where the concentration is much diluted. Just use your common sense."
This is what we are fighting against. Someone who acknowledges that the claims are nonsense and then supports them anyway. No, I won't use common sense - I'll rely on objective double-blind trials to inform evidence-based policy (if really necessary and not counter to basic civil liberties), thank you.
As you should. You quack.
Hat tip Michael McFadden.
Professor Simon Chapman is Professor of Public Health at Sydney University and is largely credited with wit smoking bans in Australasia and the Far East. It appears a report into SHS and lung cancer and had the 'wrong' results. Here he is in a panic organising the spin, smoke and mirrors.
"Note: “‘I am DEEPLY concerned about the implications for the credibility of our whole report arising from the calculations.… If we look at Table 7 in the way any journalist would … a reasonable conclusion will be that the idea that there is ANY lung cancer caused by ETS (environmental tobacco smoke) in Australia will be seen as a huge joke. Journalists … will be hard pressed to write anything other than ‘Official: passive smoking cleared—no lung cancer’ … I think we had better get out a thesaurus and find a lot of words to express the words ‘conservative estimate’ in hundreds of different ways…. We are looking down the barrel of a MAJOR public relations problem …”
http://members.iinet.net.au/~ray/ETS1.jpg
@Dave
This is the kind of double-digit compost that needs boiling down in fish oil and force feeding to every brain-free politician who voted for the smoking ban in the first place.
I can only assume that this GP has been "former" for a very long time and still assumes that we're living in a pre-anti-smoking age when people trusted and respected their doctors as people who could help them if they were ill or unhappy rather than, as now, as interfering, high-handed busybodies who are more interested in telling you how to live your life rather than attending to whatever it was that brought you into the surgery ...
Dear GP,
Common sense you say? Let's try some.
Why did the baby boom generation and their children didn't fall like flies when smoke was present everywhere?
Why does it take at least 20 years (if ever) for a heavy smoker to develop disease suspected to be caused by smoking yet you expect us to trust you when you tell us that occasional or even regular exposure to hundreds of times diluted second hand smoke will do a non-smoker in or at least significantly harm him? And let's not forget that not only does the smoker breathe his mainstream smoke but also his own second hand smoke and everyone else's since he doesn't find it necessary to avoid smoke filled cars or other places.
No doctor, I don't trust you.
Perhaps it is you who should be ashamed of the harm rabid anti-smoking is causing: http://cagecanada.blogspot.com/2010/12/beliefs-manipulation-and-lies-in.html
Good point Misty. I can't imagine Dr Finlay saying in a radio interview that smokers should be refused medical treatment.
The Gori and Mantel's 1991 paper commented on the fact that cigarette consumption of 4-5 day poses no higher risk of lung cancer and heart disease from papers published (1).
The general rule of thumb for inhalation by non smokers as a fraction of active smoking is:
Smoky bar: 1/100th
Ventilated room: 1/1,000th
Outside: 1/10,000th
ASH Trustee Dr. Martin Jarvis produced the highest estimate of the equivalent of the number of cigarettes inhaled by non smokers (2).
“..studies based on cotinine measurements in non-smoking children exposed in the home continue to show nicotine intake equivalent to smoking 100-150 cigarettes per year where both parents smoke*. Although exposure levels in adults are lower than this in general, studies in particular groups, (eg. non-smoking adults working in smoky bars) show nicotine intakes as high as half a cigarette per day.”
I don't know whether you are aware but Jarvis is the author of the Scientific Committee on Tobacco and Health (SCOTH) last published on November 2004, just as the smoking ban momentum was under way in Parliament, Jarvis states on page 8:
"...increased risk associated with exposure to SHS is about 25%,
a substantial fraction of the risk from active smoking, although
uptake of smoke by non-smokers is typically only about 1% of that
by active smokers.."
So there we have it even Jarvis admits on his own figures non smokers are not at risk, assuming if 4-5 fags a day are safe.
You can read more on my blog. (3)
1. http://www.forcesitaly.org/italy/download/gori-mantel.pdf
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1747624/pdf/v010p00368.pdf
3. http://daveatherton.wordpress.com/2011/04/25/a-critical-review-of-the-evidence-on-passive-smoking/
Re; Dave's post about "Oh no! The actual research contradicts our agenda!" post... In the light of the recent Climate Gate emails, how do these people sleep at night? They can't actually believe their rubbish when their own studies contradict them. Can they?
And more importantly, why aren't they hauled before an ethics committee and banned from research for life, if this sort of stuff is in the public domain?
I can't wait until someone releases the "TobaccoGate" emails. My God, that would make for some entertaining reading!
"Although exposure levels in adults are lower than this in general, studies in particular groups, (eg. non-smoking adults working in smoky bars) show nicotine intakes as high as half a cigarette per day.”
"As HIGH as..." Isn't that a very good example of NEWSPEAK? An example of the abuse of logic by the quacks and propagandists? Even if the (probably perverted) calculations were correct, the right interpretation can only be 'as LOW as...'
But there is no need for either 'as high as' or 'as low as'. A proper, un-propagandised statement would simply say 'in the vicinity of'.
That is part of the serious problem in dealing with these people. Their statements are 'slanted' by such phrases as "as high as". Remember Duggan?
For example, when Christopher Ogden, chief executive of the Tobacco Manufacturers Association, said in 2010 that the smoking ban had severely threatened the pub and bingo industry because of lost jobs and livelihoods, the reality was a little different. Data from the Office for National Statistics shows a net increase in the number of people visiting pubs since the smoking ban. When England went smoke-free in 2007, the number of premises licensed for alcohol increased by 5 per cent, and it has continued to grow every year since.
Cleverly phrased statements which give unreliable impressions to the unwary. England did not go 'smoke-free' in 2007.
Damn! Forgot to say that the ONS stats showed A DECREASE in the number of people visiting pubs.