‘Meerokenwetenschap is nep-wetenschap’
In de Washington Post werd vandaag een analyse gepubliceerd van de hand van wetenschapper Gio Batta Gori. Hij beschrijft daarin de onmogelijkheid om preciese schattingen te maken van doden door meeroken.
De schattingen die in dat soort onderzoek worden gedaan over de levenslange blootstelling aan rook zijn hoogst onnauwkeurig volgens Gori. Hoe kan bijvoorbeeld iemand van 60-70 jaar nog vertellen aan hoeveel rook hij in zijn jeugd heeft blootgestaan en of er bijvoorbeeld altijd ramen open stonden? Ook zullen zieke niet-rokers eerder de blootstelling aan rook overdrijven. De antwoorden op dat soort telefonisch gestelde vragen worden in dit soort onderzoeken echter altijd genoteerd als exacte metingen.
Ook genereren meerokenonderzoeken zelden statistisch relevante resultaten en dus is de reproductie van de uitkomsten moeilijk volgens Gori.
Het is opvallend hoeveel relativerende artikelen er de laatste tijd in de grote Amerikaanse dagbladen verschijnen als het over roken gaat. Nog vorige week werd in de New York Times een artikel gepubliceerd van de hand van Michael Siegel, een kritische anti-roken wetenschapper.
In reality, it is impossible to summarize accurately from momentary and vague recalls, and with an absurd expectation of precision, the total exposure to secondhand smoke over more than a half-century of a person’s lifetime. No measure of cumulative lifetime secondhand smoke exposure was ever possible, so the epidemiologic studies estimated risk based not only on an improper marker of exposure, but also on exposure data that are illusory.
Adding confusion, people with lung cancer or cardiovascular disease are prone to amplify their recall of secondhand smoke exposure. Others will fib about being nonsmokers and will contaminate the results. More than two dozen causes of lung cancer are reported in the professional literature, and over 200 for cardiovascular diseases; their likely intrusions have never been credibly measured and controlled in secondhand smoke studies. Thus, the claimed risks are doubly deceptive because of interferences that could not be calculated and corrected.
In addition, results are not consistently reproducible. The majority of studies do not report a statistically significant change in risk from secondhand smoke exposure, some studies show an increase in risk, and ¿ astoundingly ¿ some show a reduction of risk.
Some prominent anti-smokers have been quietly forthcoming on what “the science” does and does not show. Asked to quantify secondhand smoke risks at a 2006 hearing at the UK House of Lords, Oxford epidemiologist Sir Richard Peto ¿ a leader of the secondhand smoke crusade ¿ replied, “I am sorry not to be more helpful; you want numbers and I could give you numbers…, but what does one make of them? …These hazards cannot be directly measured.”
It has been fashionable to ignore the weakness of “the science” on secondhand smoke, perhaps in the belief that claiming “the science is settled” will lead to policies and public attitudes that will reduce the prevalence of smoking. But such a Faustian bargain is an ominous precedent in public health and political ethics. Consider how minimally such policies as smoking bans in bars and restaurants really reduce the prevalence of smoking, and yet how odious and socially unfair such prohibitions are.
By any sensible account, the anachronism of tobacco use should eventually vanish in an advancing civilization. Why must we promote this process under the tyranny of deception?
Presumably, we are grown-up people, with a civilized sense of fair play, and dedicated to disciplined and rational discourse. We are fortunate enough to live in a free country that is respectful of individual choices and rights, including the right to honest public policies. Still, while much is voiced about the merits of forceful advocacy, not enough is said about the fundamental requisite of advancing public health with sustainable evidence, rather than by dangerous, wanton conjectures.
A frank discussion is needed to restore straight thinking in the legitimate uses of “the science” of epidemiology ¿ uses that go well beyond secondhand smoke issues. Today, health rights command high priority on many agendas, as they should. It is not admissible to presume that people expect those rights to be served less than truthfully.
Gio Batta Gori, an epidemiologist and toxicologists, is a fellow of the Health Policy Center in Bethesda. He is a former deputy director of the National Cancer Institute’s Division of Cancer Cause and Prevention, and he received the U.S. Public Health Service Superior Service Award in 1976 for his efforts to define less hazardous cigarettes. Gori’s article “The Surgeon General’s Doctored Opinion” will appear in the spring issue of the Cato Institute’s Regulation Magazine.
Bron: Washington Post